不同温度的MEBO对超脉冲CO_2点阵激光术后创面修复的影响
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摘要
目的对比观察不同温度的湿润烧伤膏(moist exposed burn ointment,MEBO)对超脉冲CO_2点阵激光术后创面的修复效果。方法将2016年11月—2017年1月中山市中医院皮肤科、南方医科大学皮肤病医院皮肤外科与皮肤肿瘤科及中山市黄圃人民医院皮肤科收治的62例面部光老化患者随机分为常温组(30例)与低温组(32例),其中常温组患者于超脉冲CO_2点阵激光术后采用28℃的MEBO治疗术后创面;低温组患者于超脉冲CO_2点阵激光术后采用4℃的MEBO治疗术后创面,对比观察两组患者创面开始脱痂时间、创面愈合时间及肤质改善情况。结果常温组患者创面开始脱痂时间为(3.80±0.71)d,创面愈合时间为(9.17±0.83)d,低温组患者创面开始脱痂时间为(4.41±1.07)d,创面愈合时间为(9.84±1.61)d,两组对比。t'值分别为2.660及2.078,P均<0.05,差异具有统计学意义;VISIA皮肤检测仪检测数据分析结果显示,治疗1个月后,常温组患者皮肤斑点(t=5.199)、紫外线色斑(t'=8.725)、纹理(t=3.701)、毛孔(t'=4.080)及皱纹(t=3.873)等肤质改善程度明显优于低温组,P均<0.01,差异具有统计学意义。结论不同温度的MEBO对超脉冲CO_2点阵激光术后创面的修复效果存在差异,28℃的MEBO更适宜激光术后创面的修复。
Objective To observe the repair effect of MEBO on postoperative wound of super pulsed CO_2 fractional laser surgery at different temperatures. Methods 62 patient with photoaging, admitted to Dermatology Department of the Hospital of Traditional Chinese Medicine of Zhongshan, Dermatology Department and Skin Oncology Department of the Dermatology Hospital of Southern Medical University and Dermatology Department of the People's Hospital of Huangpu, Zhongshan city, between November 2016 and January 2017, were randomly divided into normal temperature group(30 cases)and low temperature group(32 cases). Patients of normal temperature group were treated with MEBO at 28℃ after super pulsed CO_2 fractional laser surgery and patients of low temperature group were treated with MEBO at 4℃ after super pulsed CO_2 fractional laser surgery. Wound decrustation time, wound healing time and skin quality improvement of the two groups were compared. Results In normal temperature group, decrustation began on day(3. 80 ± 0. 71),healing time was(9. 17 ±0.83) d. much shorter than the low temperature group, for which decrustation began on day(4.41 ± 1.07),healing time was(9. 84 ± 1.61) d. The comparison showed statistically significant difference(t'=2. 660 and 2. 078,both P <0. 05); VISIA data showed that after 1 month of treatment, bigger improvement was observed in normal temperature group in terms of UV spots(t'=8. 725), stains(t =5. 199), texture(t =3. 701), pores(t'=4. 080) and wrinkles(t =3. 873) and the comparison showed statistically significant difference(all P < 0. 01). Conclusion MEBO has different effect on the repair of postoperative wound of super pulsed CO_2 fractional laser surgery at different temperatures and it is most suitable to repair postoperative laser wound by MEBO at 28℃.
Objective To observe the repair effect of MEBO on postoperative wound of super pulsed CO_2 fractional laser surgery at different temperatures. Methods 62 patient with photoaging, admitted to Dermatology Department of the Hospital of Traditional Chinese Medicine of Zhongshan, Dermatology Department and Skin Oncology Department of the Dermatology Hospital of Southern Medical University and Dermatology Department of the People's Hospital of Huangpu, Zhongshan city, between November 2016 and January 2017, were randomly divided into normal temperature group(30 cases)and low temperature group(32 cases). Patients of normal temperature group were treated with MEBO at 28℃ after super pulsed CO_2 fractional laser surgery and patients of low temperature group were treated with MEBO at 4℃ after super pulsed CO_2 fractional laser surgery. Wound decrustation time, wound healing time and skin quality improvement of the two groups were compared. Results In normal temperature group, decrustation began on day(3. 80 ± 0. 71),healing time was(9. 17 ±0.83) d. much shorter than the low temperature group, for which decrustation began on day(4.41 ± 1.07),healing time was(9. 84 ± 1.61) d. The comparison showed statistically significant difference(t'=2. 660 and 2. 078,both P <0. 05); VISIA data showed that after 1 month of treatment, bigger improvement was observed in normal temperature group in terms of UV spots(t'=8. 725), stains(t =5. 199), texture(t =3. 701), pores(t'=4. 080) and wrinkles(t =3. 873) and the comparison showed statistically significant difference(all P < 0. 01). Conclusion MEBO has different effect on the repair of postoperative wound of super pulsed CO_2 fractional laser surgery at different temperatures and it is most suitable to repair postoperative laser wound by MEBO at 28℃.
引文
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[10]唐乾利,李利青,何晓微,等.MEBT/MEBO对糖尿病足溃疡创面愈合中Smad3、β-catenin mRNA表达的影响[J].中国烧伤创疡杂志,2014,26(5):331-341.
[11]李凤春,何仁亮,杨志波,等.超脉冲二氧化碳点阵激光联合湿润烧伤膏治疗痤疮瘢痕的临床观察[J].中国临床新医学,2015,8(8):731-734.
[12]赵俊祥.MEBT/MEBO在烧伤创面应用中的几点体会[J].中国烧伤创疡杂志,1999,11(1):16-17.
[13]Graham JE,Song S,Engeland CG.Acute pain speeds skin barrier recovery in healthy men and women[J].J Psychosom Res,2012,73(6):452-458.
[14]Engehretsen KA,Johansen JI),Kezic S,et al.The effect of environmental humidity and temperature on skin barrier function and dermatitis[J].J Eur Acad Dermatol Venereol,2016,30(2):223-249.
[15]Park GH,Rhee do Y,Moon HR,et al.Effect of an epidermal growth factor-containing cream on postinflammatory hyperpigmentation after Q-switched 532-nm neodymium-doped yttrium aluminum garnet laser treatment[J].Dermatol Surg,2015,41(1):131-135.
[16]谭军.点阵CO_2激光联合MEBO瘢痕再生皮肤疗法的组织学研究报告[J].中国烧伤创疡杂志,2012,24(4):271-283.
[17]何仁亮,黄桃源.湿润烧伤膏在皮肤科的临床应用[J].中国烧伤创疡杂志,2015,27(4):294-299.
[2]谭军,丁卫,李高峰,等.点阵CO_2激光作用皮肤光老化模型后表皮干细胞的分布特征[J].中国组织工程研究,2013,17(6):1075-1080.
[3]de Sica RC,Rodrigues CJ,Maria DA,et al.Study of 1550-nm Erbium glass laser fractional non-ablative treatment of photoaging:comparative clinical effects,histopathology,electron microscopy,and immunohistochemistry[J].J Cosmet Laser Ther,2016,18(4):193-203.
[4]佘文莉,黄海玲,刘晖,等.Q开关Nd:YAG激光治疗皮肤色素性病变术前术中局部冰敷效果评估[J].广东医学,2013,34(4):648-649.
[5]齐慧颉,胡晓根,任冲,等.水胶体敷料及术后冰敷在2940 nm铒像素激光治疗痤疮瘢痕中的应用价值[J].中华医学美学美容杂志,2015,21(4):223-225.
[6]柴家科.实用烧伤外科学[M].北京:人民军医出版社,2014:18-45.
[7]赵辨.中国临床皮肤病学[M].南京:江苏科学技术出版社,2010:680-682.
[8]俞美萍,李建胜,钟金瑞.烧伤湿性医疗技术治疗大面积深度烧伤35例临床总结[J].中国烧伤创疡杂志,2010,22(3):177-179.
[9]何仁亮,余志和,李红毅,等.毛囊单位移植联合原位再生技术修复创面的初步研究[J].中国烧伤创疡杂志,2014,26(4):287-294.
[10]唐乾利,李利青,何晓微,等.MEBT/MEBO对糖尿病足溃疡创面愈合中Smad3、β-catenin mRNA表达的影响[J].中国烧伤创疡杂志,2014,26(5):331-341.
[11]李凤春,何仁亮,杨志波,等.超脉冲二氧化碳点阵激光联合湿润烧伤膏治疗痤疮瘢痕的临床观察[J].中国临床新医学,2015,8(8):731-734.
[12]赵俊祥.MEBT/MEBO在烧伤创面应用中的几点体会[J].中国烧伤创疡杂志,1999,11(1):16-17.
[13]Graham JE,Song S,Engeland CG.Acute pain speeds skin barrier recovery in healthy men and women[J].J Psychosom Res,2012,73(6):452-458.
[14]Engehretsen KA,Johansen JI),Kezic S,et al.The effect of environmental humidity and temperature on skin barrier function and dermatitis[J].J Eur Acad Dermatol Venereol,2016,30(2):223-249.
[15]Park GH,Rhee do Y,Moon HR,et al.Effect of an epidermal growth factor-containing cream on postinflammatory hyperpigmentation after Q-switched 532-nm neodymium-doped yttrium aluminum garnet laser treatment[J].Dermatol Surg,2015,41(1):131-135.
[16]谭军.点阵CO_2激光联合MEBO瘢痕再生皮肤疗法的组织学研究报告[J].中国烧伤创疡杂志,2012,24(4):271-283.
[17]何仁亮,黄桃源.湿润烧伤膏在皮肤科的临床应用[J].中国烧伤创疡杂志,2015,27(4):294-299.