摘要
目的 评估非剥脱1 565 nm铒玻璃点阵激光治疗妊娠纹的有效性和安全性。方法 简单随机化方法将30例妊娠纹受试者腹部左右侧妊娠纹分为治疗侧和对照侧，治疗侧接受3次1 565 nm非剥脱铒玻璃点阵激光治疗，治疗间隔4周；对照侧不予治疗。在基线、第4周、第8周和第12周随访并拍照，测定皮肤弹性和妊娠纹宽度；在末次治疗后第4周由被设盲医师根据临床照片和3D照片评估临床改善情况，对受试者行疗效满意度调查，并取3例受试者治疗侧和对照侧妊娠纹处皮肤行病理检查。末次治疗后4个月电话随访受试者复发及不良反应情况。结果 27例受试者完成整个试验。末次治疗后4周，医生判定25例（92.6%）治疗有效；21例（77.8%）受试者认为治疗有效。经过3次治疗，治疗侧妊娠纹最大宽度从4.852 mm降至3.296 mm（P 〈 0.001），皮肤弹性从0.803上升至0.878（P 〈 0.001）。组织学上，非治疗侧表皮明显萎缩，真皮胶原蛋白和弹性蛋白明显减少；治疗侧平均表皮厚度增加，表皮突延长，真皮变厚，胶原纤维和弹性纤维均有明显增加，并规则排列。治疗过程中的即刻不良反应包括红斑、水肿，其他不良反应包括微结痂、瘙痒感和炎症后色素沉着。炎症后色素沉着在末次治疗后4个月随访时较末次治疗后4周好转。结论 非剥脱1 565 nm铒玻璃点阵激光可以显著改善妊娠纹的宽度和外观，提高治疗区域的皮肤弹性。
Objective To assess the efficacy and safety of nonablative 1 565-nm Er：Glass fractional laser in the treatment of striae gravidarum. Methods The left and right sides of the abdomens of 30 subjects with striae gravidarum were divided into 2 groups by simple randomization： treatment group treated with nonablative 1 565-nm Er：Glass fractional laser every 4 weeks for 3 sessions, and control group receiving no treatment. These subjects were followed up at the baseline, 4th, 8th and 12th week. At the same time, photos were taken, the skin flexibility was evaluated, and the width of striae was measured. Four weeks after the final treatment, clinical improvement was evaluated by 2 doctors, who were blind to the therapeutic protocol, according to clinical photos and three-dimensional （3D） images, and satisfaction scores were also evaluated. Skin biopsies were taken from the left and right sides of the abdomens of 3 subjects, and subjected to histopathological examination. Four months after the final treatment, all the subjects were telephoned for evaluation of adverse reactions and recurrence. Results A total of 27 subjects completed the whole trial. Four weeks after the final treatment, 25（92.6%） of the 27 subjects were considered to achieve an improvement by doctors. However, 21（77.8%） of the 27 subjects considered themselves to achieve an improvement. After 3 sessions of treatment, the treatment group showed a significant decrease in the largest width of striae from 4.852 mm to 3.296 mm （P 〈 0.001） and a significant increase in skin flexibility from 0.803 to 0.878 （P 〈 0.001）. Histopathologically, the control group showed obviously atrophic epidermis and decreased collagen and elastin in the dermis, while the treatment group showed thickened epidermis and dermis, extended rete ridges, and increased collagen and elastic fibers which arranged more regularly. Immediate adverse reactions during the treatment included erythema and edema, and other adverse reactions included mild crust, itching
出处
《中华皮肤科杂志》
CAS
CSCD
北大核心
2018年第1期48-50,共3页
Chinese Journal of Dermatology
