二氧化碳点阵激光联合瘢痕内分离术治疗面部凹陷性瘢痕的回顾性分析  

A retrospective study of fractional carbon dioxide laser combined with subcision of scar for depressed scar of face

作　　者：姚婷[1] 李凯[1] 坚哲[1] YAO Ting;LI Kai;JIAN Zhe(Xijing Dermatology Hospital,Fourth Military Medical University,Xi'an 710032,China)

机构地区：[1]第四军医大学西京皮肤医院,陕西西安710032

出　　处：《临床皮肤科杂志》2022年第7期436-440,共5页Journal of Clinical Dermatology

基　　金：空军军医大学第一附属医院2018年度学科助推计划(基金编号:XJZT18ML05);陕西省重点研发计划(2019SF-111)资助项目。

摘　　要：目的:评价二氧化碳点阵激光联合瘢痕内分离术治疗面部凹陷性瘢痕的临床疗效及安全性。方法:对2018年10月至2020年5月在第四军医大学西京皮肤医院接受面部凹陷性瘢痕治疗的80例患者的临床资料进行回顾性分析,其中单纯采用二氧化碳点阵激光治疗者40例(对照组),采用二氧化碳点阵激光联合瘢痕内分离术治疗者40例(观察组),治疗间隔2个月,连续治疗5次。两名研究人员采用盲法对患者治疗前、治疗1次、3次及5次后的照片进行温哥华瘢痕量表(VSS)评分、医生视觉(IVA)评分,同时分别对患者治疗1次、3次、5次后的疗效进行电话随访及满意度评价,并记录治疗中、治疗后的不良反应。结果:两种方法治疗后VSS评分均有下降(P<0.05),IVA评分均有提高(P<0.05),差异均有统计学意义;相较于对照组,观察组治疗后VSS及IVA降低更明显(P<0.05),且观察组患者满意度在不同治疗次数后的评价均高于对照组(P<0.05),差异均有统计学意义。所有患者治疗后即刻均出现不同程度出血、水肿及红斑,5例患者皮损出现色素沉着,持续3~4周后自行消退。结论:相较于单纯二氧化碳点阵激光,二氧化碳点阵激光联合瘢痕内分离术治疗面部凹陷性瘢痕疗效更为明显,疼痛可耐受,且患者满意度高,是一种值得推广的治疗方式。Objective: To evaluate the clinical efficacy and safety of fractional carbondioxide laser combined with subcision of scar for depressed scar of face. Methods: A retrospective study of 80 cases treated with facial depressed scar in Xijing Dermatology Hospital, Fourth Military Medical University, between October 2018 and May 2020. Totally, 40 cases received fractional carbondioxide laser treatment(control group) and 40 cases underwent fractional carbondioxide laser combined with subcision of scar(observation group) for 5 times with 2-month intervals. Vancouver scar scale(VSS) scoring, physician visual(IVA) scoring, and satisfaction evaluations were performed based on the patients’ photos before the treatments, 2 months after the first, third and fifth time of treatment, and adverse reactions during and after treatment were recorded via telephone follow-up by two blinded researchers. Results: After treatment, VSS scores were significantly lower(P<0.05), IVA were significantly increased(P<0.05) in both groups. Compared with the control group, the VSS score and IVA of the observation group decreased more significantly after treatment(P<0.05), and the satisfaction of patients in the observation group after different treatment times was higher than that of the control group, with statistically significant difference(P<0.05). All the patients showed different degrees of bleeding, edema and erythema immediately after treatment. Pigmentation occurred in 5 cases, which subsided spontaneously after 3 to 4 weeks. Conclusion: Compared with the simple carbon dioxide lattice laser, carbon dioxide fractional laser combined with subcision of scar has more significant curative effects with tolerable pain and high patient satisfaction, which is worth promoting.

关 键 词：二氧化碳点阵激光 瘢痕内分离术 凹陷性瘢痕 温哥华瘢痕量表 

分 类 号：R751.05[医药卫生—皮肤病学与性病学]