摘要
目的探讨剥脱性CO_(2)点阵激光联合Er∶YAG激光治疗面部凹陷性痤疮瘢痕的临床疗效和安全性。方法选择2018年1月至2020年1月,面部凹陷性痤疮瘢痕患者30例,采用自身半脸随机对照法,分为联合组和对照组。联合组患者一侧面部给予剥脱性CO_(2)点阵激光联合Er∶YAG激光治疗,剥脱性CO_(2)点阵激光治疗选择Deep模式,能量50~60 m J,覆盖率5%,频率0.25~1.0 Hz;Er∶YAG激光治疗,脉冲宽度400 ms,能量30~50 J/cm^(2),频率1.4 Hz。对照组,在患者另一侧面部单独给予Er∶YAG激光治疗,脉冲宽度400 ms,能量30~50 J/cm^(2),频率1.4 Hz。两组均每6周治疗1次,共4次。第4次治疗后6周采用痤疮瘢痕权重评分法(échelle d’évaluation clinique des cicatrices d’acné,ECCA)对两组患者的痤疮凹陷性瘢痕性状及数量进行权重评分;根据患者治疗前后大体照片进行评分;采用皮肤超声测量治疗前后瘢痕深度的变化;同时记录患者疼痛程度、红斑持续时间、掉痂时间等不良反应。结果两组患者治疗后ECCA评分、大体照片、痘坑深度较治疗前均有所改善,差异具有统计学意义(P<0.05);其中联合组改善程度优于单纯Er∶YAG激光组(P<0.05)。两组均无严重不良反应。结论单独应用Er∶YAG激光或剥脱性CO_(2)点阵激光联合Er∶YAG激光均可有效治疗痤疮凹陷性瘢痕,且安全性高,其中联合组疗效较好。
Objective To determine the efficacy and safety of Er∶YAG laser alone or the combination with ablative carbon dioxide(CO_(2)) fractional laser therapy(deep model)in the treatment of acne scars.Methods From Jan.2018 to Jan.2020,totally 30 cases of acne scars were randomized half-face control study.Deep-model fractional CO_(2) laser treatment(energy:50~60 m J,coverage fraction:5%and frequency:0.25~1.0 Hz)was unilaterally performed locally on the severe acne scars and then 2 940 nm Erbium laser(pulse length:400 ms,energy:30~50 J/cm^(2) and frequency:1.4 Hz)was used to the rest mildly atrophic scars.The other side of the patient’s face was treated with 2 940 nm Erbium laser alone(pulse length:400 ms,energy:30~50 J/cm^(2) and frequency:1.4 Hz).Totally 4 sessions were performed at an interval of 6 weeks during the study period.Results The ECCA scores,differences between pretreatment and post-treatment results in global photographs and the changes of scar depth measured with skin ultrasound were compared between the two groups.Despite of the achievement of improvement in both groups,the change was greater in the combination group.No serious adverse reaction was observed in either group.Conclusions Er∶YAG laser alone or combination with ablative fractional CO_(2) laser may play an important role in promoting atrophic facial acne scars,but the effect of the combination is much better.
作者
黄悦
张启国
赵小燕
袁瑾
李桂琼
屠秀顾
周昆丽
陈盛根
黄一锦
蔡良奇
HUANG Yue;ZHANG Qi-guo;ZHAO Xiao-yan;YUAN Jin;LI Gui-qiong;TU Xiu-gu;ZHOU Kun-li;CHEN Sheng-gen;HUANG Yi-jin;CAI Liang-qi(Department of Dermatology,the First Affiliated Hospital of Xiamen University,Xiamen 361002,China)
出处
《中国激光医学杂志》
CAS
2021年第3期140-144,180,共6页
Chinese Journal of Laser Medicine & Surgery
基金
厦门大学附属第一医院院内青年科研发展基金(XYY2017007)。
关键词
激光
痤疮瘢痕
治疗
Laser
Acne scars
Treatment
