Randomized Controlled Clinical Study Of Keloid Treatment By 532nm Q-switched Laser With Injection Of Diprospan For Lesions

Objective:Through randomized controlled clinical study verification 532 nm Q-switched laser with injection of diprospan for lesions in the treatment of keloids with efficiency and safety.Methods:According to 1:1 ratio randomly assigned to 532 nm Q-switched laser with injection of diprospan(combination group) and lesion injection of diprospan(hormone group) to recruited in line with the conditions of keloids subjects, and patients received up to in number of four treatments four weeks apart. Follow-up observation effective of two groups, and compared the two groups of efficiency,keloids of pigmentation, vascularity, pliability and height, and the improve situation of itching and pain intensity, and compared the two groups of adverse events' rate,satisfaction of treatment and recurrence rate of six month, respectively.Results:102 cases(111 subjects were recruited)were followed up for analysis, including46 cases in combination group and 56 cases in hormone group. There was no significant difference between two groups of baseline data. The effective rate of 16 weeks was 78.26% with combination group and 60.71% with hormone group, there was no significant difference[?2=3.611, P =0.057, RR=2.329, 95%CI(0.964,5.629)].The effective rate of 4,8,12 weeks were 9.43%,21.15%,44.00% with combination group and 7.01%,15.79%,35.71% with hormone group(P =0.736,0.633,0.384), the combination group was higher than the hormone group, but the difference was notsignificant. The two groups of itching and pain intensity scores were gradually decline after each treatment, but there was no significant difference(P>0.05). The keloids of pigmentation and vascularity scores of the combination group were significantly lower than hormone group after second treatments. The keloids of pigmentation and vascularity median scores of 16 weeks were 0,1 with combination group and 1,1 with hormone group, there was a significant difference(u=5.179,P=0.001,u=2.302,P =0.021). The keloids of pliability median scores of 16 weeks were0 with combination group and 1 with hormone group, there was a significant difference(u=2.206, P =0.027). The two groups all have pain, swelling, ulceration,congestion, atrophy, blood blisters, hypopigmentation and hyperpigmentation of adverse infection, and there was no significant difference(P>0.05), excepting ulceration. The ulceration adverse incidence of combination group were significantly higher than hormone group after each treatments. In addition, secondary bacterial infection occurred among combination group and hormone group has no occurred.The patient satisfaction was no significant difference between two groups[?2=0.042,P =0.837,RR=0.914,95%CI(0.389 ~ 2.149)]. The recurrence rate of six month was 12.1% with combination group and 34.4% with hormone group, there was a significant difference [P =0.042, RR=0.263,95%CI(0.074,0.942)].Conclusion:532nm Q-switched laser with injection of diprospan for lesions was an effective and safe treatment of keloids method, and there was a significant of patient satisfaction and low recurrence rate.