低能量半导体激光在促进颌面部骨折手术伤口愈合中的临床研究

doi:10.7518/hxkq.2025.2024237

华西口腔医学杂志 ›› 2025, Vol. 43 ›› Issue (1): 68-75.doi: 10.7518/hxkq.2025.2024237

低能量半导体激光在促进颌面部骨折手术伤口愈合中的临床研究

熊茂婧(), 杨露, 马丽源, 刘磊, 杨波()

口腔疾病防治全国重点实验室国家口腔医学中心国家口腔疾病临床医学研究中心口腔转化医学教育部工程研究中心口腔再生医学国家地方联合工程实验室四川大学华西口腔医院创伤整形外科，成都 610041

收稿日期:2024-06-21 修回日期:2024-10-23 出版日期:2025-02-01 发布日期:2025-01-22
通讯作者: 杨波 E-mail:254662842@qq.com;dr.yangbo@scu.edu.cn
作者简介:熊茂婧，主管护师，硕士，E-mail：254662842@qq.com
基金资助:
四川省卫生健康委员会科技项目(24YWYL02)

Clinical study on low-energy semiconductor laser treatment in the promotion of wound healing after maxillofacial fracture surgery

Xiong Maojing(), Yang Lu, Ma Liyuan, Liu Lei, Yang Bo()

State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Engineering Research Center of Oral Translational Medicine, Ministry of Education & National Engineering Laboratory for Oral Regenerative Medicine &Dept. of Trauma and Plastic Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China

Received:2024-06-21 Revised:2024-10-23 Online:2025-02-01 Published:2025-01-22
Contact: Yang Bo E-mail:254662842@qq.com;dr.yangbo@scu.edu.cn
Supported by:
Health Commission of Sichuan Province Medical Science and Technology Program(24YWYL02)

摘要/Abstract

摘要：

目的评价低能量半导体激光在促进颌面部骨折手术伤口愈合中的临床效果。方法采用前瞻性随机对照研究，选取2021年8月—2023年6月在四川大学华西口腔医院创伤整形外科住院治疗的颌面部骨折患者为研究对象，随机分为试验组和对照组。试验组于术后第1天开始在每日常规换药后使用低能量半导体激光治疗仪进行面部皮肤伤口治疗，每日1次，连续治疗6 d；对照组仅进行常规换药处理，不使用低能量半导体激光治疗。比较2组患者伤口愈合时间、伤口愈合情况、修正Stony Brook瘢痕评定量表（mSBSES）评分、疼痛指数和伤口感染率的差异。结果本研究共纳入患者211例，其中试验组104例，对照组107例；男128例，女83例。试验组在低能量半导体激光治疗后，面部皮肤伤口愈合时间较对照组明显缩短（P<0.05），且试验组在术后第7天的伤口甲级愈合率高于对照组（P<0.05）。术后伤口评价指标中，试验组在各观察点的mSBSES评分均高于对照组（P<0.05），且试验组较对照组在伤口宽度、高度、颜色和切口线等指标的评分更高，差异有统计学意义（P<0.05）。术后伤口疼痛评价方面，试验组在经过低能量半导体激光治疗后疼痛指数较对照组明显降低（P<0.05）。2组伤口感染率差异比较无统计学意义（P>0.05）。结论对于颌面部骨折手术面部皮肤伤口，低能量半导体激光治疗能够有效促进伤口愈合，提升伤口愈合质量，淡化瘢痕，缓解疼痛。

关键词: 半导体激光, 颌面部骨折, 疼痛, 伤口愈合, 瘢痕

Abstract:

Objective This study aims to evaluate the clinical effect of low-energy semiconductor laser treatment on the promotion of wound healing after maxillofacial fracture surgery. Methods A prospective randomized controlled study was conducted. Patients with maxillofacial fractures who were hospitalized in the Department of Trauma and Plastic Surgery, West China Hospital of Stomatology, Sichuan University, from August 2021 to June 2023 were selected as the study subjects and randomly divided into experimental and control groups. The experimental group was treated with a low-energy semiconductor laser once a day for six consecutive days after daily routine dressing change on the first day after surgery. The control group only underwent routine dressing change treatment and did not receive low-energy semiconductor laser treatment. Wound healing times, wound healing conditions, modified Stony Brook scar evaluation scale (mSBSES) scores, pain indices, and wound infection rates were compared between the two groups. Results A total of 211 patients were included in this study. A total of 104 and 107 cases comprised the experimental and control groups, respectively. A total of 128 males and 83 females were included. After low-energy semiconductor laser treatment, the facial skin wound healing time of the experimental group was found to be significantly shorter than that of the control group (P<0.05). Moreover, the wound grade A healing rate of the experimental group was higher than that of the control group on the seventh day after surgery (P<0.05). Among postoperative facial skin wound evaluation indices, the mSBSES scores of the experimental group at all observation points were higher than those of the control group (P<0.05), and the scores of the experimental group were higher than those of the control group in terms of wound width reduction, height reduction, color lightening, and incision line loss (P<0.05). In postoperative wound pain evaluation, the pain index of the experimental group after low-energy semiconductor laser treatment was significantly lower than that of the control group (P<0.05). No significant difference in wound infection rates was found between the two groups (P>0.05). Conclusion For facial skin wounds in maxillofacial fracture surgery, low-energy semiconductor laser treatment can effectively promote wound healing, improve wound healing quality, fade scars, and relieve wound pain.

Key words: semiconductor laser, maxillofacial fracture, pain, wound healing, scar

中图分类号:

R782.05⁺3

熊茂婧, 杨露, 马丽源, 刘磊, 杨波. 低能量半导体激光在促进颌面部骨折手术伤口愈合中的临床研究[J]. 华西口腔医学杂志, 2025, 43(1): 68-75.

Xiong Maojing, Yang Lu, Ma Liyuan, Liu Lei, Yang Bo. Clinical study on low-energy semiconductor laser treatment in the promotion of wound healing after maxillofacial fracture surgery[J]. West China Journal of Stomatology, 2025, 43(1): 68-75.

图/表 10

图 1

表 1

2组颌面部骨折患者资料比较

组别	例数	性别		年龄/岁	体重指数/（kg/m²）	致伤原因				骨折分型			镇痛泵		受伤至手术时间/d
组别	例数	男	女	年龄/岁	体重指数/（kg/m²）	跌伤	交通事故伤	高处坠落伤	重物击打伤	下颌骨骨折	颧上颌复合体骨折	多部位复合型骨折	有	无	受伤至手术时间/d
试验组	104	59	45	36.89±1.94	21.63±2.56	31	33	18	22	35	16	53	85	19	16.42±14.54
对照组	107	69	38	40.19±1.62	21.79±3.27	37	32	19	19	21	20	66	97	10	11.85±9.62
$X 2$ /t值	-	3.455		1.620	0.116	2.161				5.323			-1.878		-1.973
P值	-	0.074		0.118	0.937	0.672				0.070			0.060		0.071

表 1

表 2

2组颌面部骨折手术伤口愈合情况比较

组别	例数	伤口愈合时间/d	术后7 d			术后1月			术后6月			术后1年
组别	例数	伤口愈合时间/d	甲	乙	丙	甲	乙	丙	甲	乙	丙	甲	乙	丙
试验组	104	5.82±0.30	70	26	8	99	5	0	103	0	1	104	0	0
对照组	107	7.54±0.29	29	66	12	96	4	7	107	0	0	107	0	0
$X 2$ /t值	-	0.073	-3.000			-0.706			-1.571			-
P值	-	0.002	0.005			0.530			0.243				-

表 2

表 3

表 4

表 5

表 6

表 7

图 2

图 3

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组别	例数	mSBSES总分				F值	P值
组别	例数	术后7 d	术后1月	术后6月	术后1年	F值	P值
试验组	104	2.97±0.95	3.35±0.93^a	3.71±0.78^a	4.38±0.94^ab	72.369	<0.001
对照组	107	2.17±0.85	2.33±0.95^a	2.78±1.05^a	3.29±1.23^ab	66.362	<0.001
t值		-4.874	-5.746	-5.667	-5.849
P值		<0.001	<0.001	<0.001	<0.001

组别	例数	宽度/分				F值	P值
组别	例数	术后7 d	术后1月	术后6月	术后1年	F值	P值
试验组	104	0.85±0.42	0.82±0.38^a	0.90±0.28^a	1.19±0.39^ab	22.397	<0.001
对照组	107	0.52±0.49	0.56±0.50^a	0.64±0.47^a	0.98±0.55^ab	6.772	0.002
t值		-2.599	-3.250	-3.560	-3.412
P值		0.012	0.002	0.001	0.001

组别	例数	高度/分				F值	P值
组别	例数	术后7 d	术后1月	术后6月	术后1年	F值	P值
试验组	104	0.71±0.45	0.76±0.42^a	0.81±0.51^a	0.98±0.60^ab	3.697	0.043
对照组	107	0.51±0.50	0.55±0.50^a	0.60±0.48^a	0.68±0.47^ab	6.762	0.002
t值		-2.132	-2.383	-2.223	-2.078
P值		0.036	0.019	0.029	0.040

组别	例数	颜色/分				F值	P值
组别	例数	术后7 d	术后1月	术后6月	术后1年	F值	P值
试验组	104	0.73±0.43	0.77±0.42^a	0.81±0.51^a	1.12±0.53^ab	9.342	0.001
对照组	107	0.53±0.50	0.58±0.50^a	0.60±0.48^a	0.74±0.42^ab	5.358	0.012
t值		-2.182	-2.239	-2.259	-2.832
P值		0.031	0.027	0.027	0.005

组别	例数	切口线/分				F值	P值
组别	例数	术后7 d	术后1月	术后6月	术后1年	F值	P值
试验组	104	0.80±0.41	0.88±0.32^a	1.17±0.46^a	1.32±0.54^ab	27.417	<0.001
对照组	107	0.61±0.48	0.62±0.48^a	0.90±0.28^a	0.99±0.38^ab	26.351	<0.001
t值		-2.501	-3.434	-3.453	-3.726
P值		0.014	0.001	0.001	<0.001

低能量半导体激光在促进颌面部骨折手术伤口愈合中的临床研究

Clinical study on low-energy semiconductor laser treatment in the promotion of wound healing after maxillofacial fracture surgery

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