摘要：

目的： 研究带蒂复合组织皮瓣移植术联合点阵激光（fractional laser，FL）在头面部中重度烧伤患者美容修复中的应用效果。方法： 选择2018年5月至2023年5月于本院就诊的82例头面部中重度烧伤患者，将其随机分为对照组和研究组，每组各41例，对照组采用带蒂复合组织皮瓣移植术，研究组采用带蒂复合组织皮瓣移植术联合FL疗法。对比2组干预效果、皮瓣存活率、皮肤愈合时间，干预前、后皮肤弹性、光泽度、瘢痕评分，以及血清肿瘤坏死因子α（tumor necrosis factor-α，TNF-α）、白细胞介素8（interleukin-8，IL-8）水平；统计2组不良反应（感染、血肿、皮瓣挛缩、伤口裂开）发生例数。结果： 干预后，研究组治疗总有效率、皮瓣存活率、皮肤弹性评分、光泽度评分、瘢痕评分均高于对照组（P<0.05），皮肤愈合时间比对照组短（P<0.05），血清TNF-α、IL-8水平低于对照组（P<0.05）；研究组不良反应的发生例数少于对照组（P<0.05）。结论： 带蒂复合组织皮瓣移植术联合FL疗法可提高头面部中重度烧伤患者的美容修复效果，联合应用可加快皮肤愈合，减轻炎症刺激，减少不良反应，具有一定的临床应用价值。

关键词: 带蒂复合组织皮瓣移植术, 点阵激光, 头面部, 烧伤, 美容修复

Abstract:

Objective: To study the effect of pedicle composite tissue flap transplantation combined with fractional laser (FL) therapy in the cosmetic restoration of patients with moderate to severe burns of the head and face.Methods: A total of 82 patients with moderate to severe burns on the head and face, who attended our hospital from May 2018 to May 2023, were selected and divided into the control group and the research group, 41 cases each, using a statistical randomization method. The control group underwent pedicle composite tissue flap transplantation, while the research group received pedicle composite tissue flap transplantation combined with FL therapy. The intervention effect, flap survival rate, skin healing time, skin elasticity score, luster score, scar score, and serum tumor necrosis factor-α (TNF-α) and interleukin-8 (IL-8) levels were compared between the two groups before and after the intervention. Additionally, the number of adverse reaction cases (infection, hematoma, flap contracture, wound dehiscence) was recorded.Results: After the intervention, the research group was higher than the control group in terms of total treatment efficiency, flap survival rate, skin elasticity score, luster score, and scar score (P<0.05); the research group was shorter than the control group in terms of skin healing time (P<0.05); the research group was lower than the control group in terms of serum TNF-α and IL-8 levels (P<0.05); and the research group was less than the control group in terms of the number of cases of adverse reactions (P<0.05).Conclusion: The combination of pedicle composite tissue flap transplantation and FL therapy improves cosmetic restoration in patients with moderate to severe burns of the head and face, accelerates skin healing, reduces inflammatory irritation, and decreases adverse reactions, demonstrating significant clinical application value.

Key words: pedicle composite tissue flap transplantation, fractional laser, head and face, burns, cosmetic repair

中图分类号: 

• R782