Efficacy Observation of 595 nm Dye Laser Combined with CO<sub>2</sub> Fractional Laser in the Treatment of Early Hypertrophic Scars after Thyroid Surgery

目的：初步探讨595 nm脉冲染料激光结合CO2点阵激光治疗甲状腺术后早期增生性瘢痕的临床应用效果及治疗安全性。方法：收集我院甲状腺外科2023年11月至2024年4月，行传统甲状腺开放手术后，颈部瘢痕符合入选标准的患者，根据随机数字表分成3组：对照组A，对照组B，实验组C。实验组C予以CO2点阵激光结合595 nm脉冲染料激光(复合激光)，对照组A予以CO2点阵激光治疗，对照组B予以595 nm脉冲染料激光治疗。三组治疗皆每间隔1个月一次，共治疗3次。入组时及治疗周期结束后2个月，拍摄标准化数码照片，实验者采用温哥华瘢痕评估量表(VSS)、观察者瘢痕评估量表(OSAS)对三组瘢痕分别进行评估并记录，患者本人采用患者瘢痕评估量表(PSAS)对自身瘢痕进行评估并记录，且治疗期及随访期记录不良反应情况，并进行统计学分析。结果：1) 经过每月1次，共3次的不同方案激光治疗后，对照组A总有效率为14例(87.5%)，对照组B对照组B总有效率为14例(87.5%)，实验组C总有效率为15例(93.8%)。2) 经方差分析可知，对照组A、对照组B和实验组C三组患者治疗后VSS评分(F = 8.374, P 2点阵激光治疗甲状腺术后早期增生性瘢痕，相较于单种激光治疗，总有效率更高，VSS评分及POSAS评分改善更多，在治疗血管分布、色泽、柔软度方面效果更佳。Objective: Preliminarily explore the clinical application effect and treatment safety of CO2 fractional laser combined with 595 nm pulsed dye laser in the treatment of early hypertrophic scars after thyroid surgery. Methods: Patients who underwent traditional open thyroid surgery in the Thyroid Surgery Department of our hospital from November 2023 to April 2024 and whose neck scars met the inclusion criteria were collected. According to the random number table, they were divided into three groups: control group A, control group B, and experimental group C. Experimental group C was treated with CO2 fractional laser combined with 595 nm pulsed dye laser (combined laser), control group A was treated with CO2 fractional laser, and control group B was treated with 595 nm pulsed dye laser. The treatment for all three groups was carried out once every one-month interval, with a total of three treatments. Standardized digital photos were taken at the time of enrollment and 2 months after the end of the treatment cycle. The experimenters used the Vancouver Scar Scale (VSS) and the Observer Scar Assessment Scale (OSAS) to evaluate and record the scars of the three groups respectively. The patients themselves used the Patient Scar Assessment Scale (PSAS) to evaluate and record their own scars. In addition, the adverse reactions were recorded during the treatment period and the follow-up period, and statistical analysis was performed. Results: 1) In this study, 54 patients were initially enrolled. However, 6 patients failed to complete the treatment due to their own reasons. Eventually, 48 patients completed the study, with 16 patients in each of the control group A, control group B and experimental group C. After laser treatments with different regimens once a month for a total of 3 times, the following results were obtained: The total effective rate was 14 cases (87.5%) in Control Group A, 14 cases (87.5%) in Control Group B, and 15 cases (93.8%) in Experimental Group C. 2) Analysis of variance showed that there were differences in VSS scores (F = 8.374, P 2 fractional laser and 595 nm pulsed dye laser for treating early hypertrophic scars after thyroid surgery shows a higher total effective rate compared with single-laser treatment. It also leads to greater improvements in VSS scores and POSAS scores, and is more effective in treating aspects such as vascular distribution, color, and softness of the scars.