摘要
目的 比较侵入性微针射频与等离子点阵射频治疗面部痤疮凹陷性瘢痕的疗效及安全性。方法 2017年1 - 3月，中南大学湘雅医院皮肤科收集30例痤疮凹陷性瘢痕患者，将每例患者两侧面部按随机数字表分为侵入性微针射频侧与等离子点阵射频侧，治疗间隔8 ~ 12周，共进行3次治疗。治疗前后由研究者采集患者面部照片对瘢痕评分，根据痤疮瘢痕临床分级标准权重评估整体改善度，由医生对皮损改善度进行主观评分；记录治疗后患者的不良反应；患者自评疼痛度及满意度，用德国皮肤生理检测仪记录治疗前后面部表皮含水量、经表皮失水率、皮脂含量等数据。结果 30例患者均完成3次治疗及3次随访。疗效：3次治疗后，侵入性微针射频侧评分为3.00 ± 0.91，22例获得 〉 50%改善，而等离子点阵射频侧评分为3.57 ± 0.57，29例获得 〉 50%改善，等离子点阵射频总体疗效优于侵入性微针射频（t = 2.894，P = 0.005）。对于Ⅴ型和U型瘢痕，侵入性微针射频侧与等离子点阵射频侧的整体改善率比较，差异无统计学意义（均P 〉 0.05），对于M型Rolling瘢痕，侵入性微针射频侧整体改善率为（36.5 ± 2.1）%，低于等离子点阵射频侧［（48.7 ± 3.4）%，P 〈 0.01］。侵入性微针射频侧疼痛评分为5.54 ± 0.57，明显低于等离子点阵射频侧（8.07 ± 0.79），差异有统计学意义（P 〈 0.01）。3次治疗后，侵入性微针射频侧与等离子点阵射频侧的患者满意度比较，差异无统计学意义（χ2 = 0.10，P 〉 0.05），表皮含水量、TEWL、皮脂含量等指标差异无统计学意义（均P 〉 0.05）。两治疗侧均出现红斑、渗出或出血等不良反应。结论 对于V型、U型瘢痕等较小的痤疮瘢痕，等离子点阵射频与侵入性微针射频治疗均可临床应用。而较大的M型Rolling瘢痕，优先选择等离子点阵射频治疗。
Objective To compare the clinical efficacy and safety of invasive microneedle radiofrequency versus plasma fractional radiofrequency in the treatment of atrophic facial acne scars. Methods A total of 30 patients with atrophic acne scars were enrolled from the Department of Dermatology of Xiangya Hospital affiliated to Central South University between January 2017 and March 2017. By a random number table, every patient randomly received the treatment with invasive microneedle radiofrequency on one half of the face and plasma fractional radiofrequency on the other facial side once every 8 - 12 weeks for 3 sessions. Before and after each treatment, facial photos were taken, acne scars were scored by the ECCA grading scale （échelle d′évaluation clinique des cicatrices d′acné）, and improvement rates of these lesions were evaluated subjectively by doctors. Adverse reactions were recorded after treatment, and the degree of pain and satisfaction was evaluated by the patients themselves. The Germany CK physiological index detector was used to detect the skin moisture content, transepidermal water loss （TEWL） and sebum content. Results All of the 30 patients completed 3 sessions of treatment and follow-up. After the 3 sessions of treatment, the average score on invasive microneedle radiofrequency-treated sides was 3.00 ± 0.91, and 22 patients achieved more than 50% improvement. However, the average score on plasma fractional radiofrequency-treated sides was 3.57 ± 0.57, and 29 patients achieved more than 50% improvement. The overall therapeutic effect of plasma fractional radiofrequency was significantly superior to that of invasive microneedle radiofrequency （t = 2.894, P = 0.005）. For V-shaped and U-shaped scars, there was no significant difference in the overall improvement rate between the invasive microneedle radiofrequency-treated side and plasma fractional radiofrequency-treated side （both P 〉 0.05）. For M-shaped rolling scars, the overall improvement rate was significantly lower on the in
出处
《中华皮肤科杂志》
CAS
CSCD
北大核心
2018年第2期126-130,共5页
Chinese Journal of Dermatology
基金
国家自然科学基金（81573074、81502709）
关键词
寻常痤疮
瘢痕
激光疗法
治疗结果
侵入性微针射频
等离子点阵射频
Acne vulgaris
Cicatrix
Laser therapy
Treatment outcome
Invasive microneedleradiofrequency
Plasma fractional radiofrequency
