点阵二氧化碳激光联合微创瘢痕松解治疗痤疮后萎缩性瘢痕的临床效果  

Clinical effects of fractional carbon dioxide laser combined with minimally invasive scar release in the treatment of post-acne atrophic scars

作　　者：葛艳娜[1] 潘焕焕[1] 赵绛波[1] 陈娅 Ge Yanna;Pan Huanhuan;Zhao Jiangbo;Chen Ya(Department of Plastic Surgery and Cosmetology,the First Affiliated Hospital of Henan University of Traditional Chinese Medicine,Zhengzhou 450099,China)

机构地区：[1]河南中医药大学第一附属医院整形美容科,郑州450099

出　　处：《中华烧伤与创面修复杂志》2023年第1期53-58,共6页Chinese Journal of Burns And Wounds

摘　　要：目的探讨点阵二氧化碳激光联合微创瘢痕松解治疗痤疮后萎缩性瘢痕的临床效果。方法采用回顾性观察性研究方法。2021年1—6月,河南中医药大学第一附属医院接诊60例符合入选标准的3、4级痤疮后萎缩性瘢痕患者。根据采用的治疗方法,将点阵二氧化碳激光联合微创瘢痕松解治疗的30例患者纳入联合治疗组[男19例、女11例,年龄(26±4)岁],将单纯点阵二氧化碳激光治疗的30例患者纳入单纯激光组[男18例、女12例,年龄(25±6)岁],每2个月治疗1次,共3次。首次治疗前及末次治疗后2个月,对瘢痕进行痤疮瘢痕临床评分量表(ECCA)评分;末次治疗后2个月,根据ECCA评分行疗效评价并计算治疗总有效率。记录患者治疗过程中的不良反应发生情况。对数据行独立样本t检验、Wilcoxon秩和检验、Mann-Whitney U检验、χ^(2)检验、Fisher确切概率法检验。结果首次治疗前,2组患者ECCA评分相近(P>0.05);末次治疗后2个月,联合治疗组患者ECCA评分明显低于单纯激光组(Z=-2.89,P<0.05)。联合治疗组、单纯激光组患者末次治疗后2个月ECCA评分均较首次治疗前明显降低(Z值分别为-4.81、-4.79,P<0.05)。末次治疗后2个月,单纯激光组患者瘢痕达到痊愈者2例、显效者13例、有效者7例、无效者8例,联合治疗组患者瘢痕达到痊愈者4例、显效者22例、有效者3例、无效者1例;联合治疗组患者瘢痕治疗总有效率为96.67%(29/30),明显高于单纯激光组的73.33%(22/30),P<0.05。治疗过程中,联合治疗组中有3例患者出现疼痛、1例患者出现红肿、1例患者出现色素沉着,单纯激光组中有1例患者出现疼痛、2例患者出现色素沉着;2组患者创面均未发生感染。结论与单纯点阵二氧化碳激光治疗相比,点阵二氧化碳激光联合微创瘢痕松解治疗痤疮后萎缩性瘢痕,可获得更高的治疗总有效率,且操作简单,效果良好,值得临床推广。Objective To explore the clinical effects of fractional carbon dioxide laser combined with minimally invasive scar release in the treatment of post-acne atrophic scars.Methods A retrospectively observational study was conducted.From January to June 2021,60 patients with grade 3 and 4 post-acne atrophic scars who met the inclusion criteria were admitted to the First Affiliated Hospital of Henan University of Traditional Chinese Medicine.According to the adopted treatment methods,30 patients treated with fractional carbon dioxide laser combined with minimally invasive scar release were included in combined treatment group(19 males and 11 females,aged(26±4)years),and 30 patients treated with fractional carbon dioxide laser alone were included in laser alone group(18 males and 12 females,aged(25±6)years).All the patients received the treatment once every two months,totally 3 times.Before the first treatment and 2 months after the last treatment,the scars were assessed byéchelle d'évaluation clinique des cicatrices d'acné(ECCA).In 2 months after the last treatment,the curative effect was evaluated and the total effective rate was calculated according to the ECCA score.The adverse reactions of patients during the treatment were recorded.Data were statistically analyzed with independent sample t test,Wilcoxon rank-sum test,Mann-Whitney U test,chi-square test,and Fisher's exact probability test.Results Before the first treatment,the ECCA scores of patients in the two groups were similar(P>0.05).In 2 months after the last treatment,the ECCA scores of patients in combined treatment group were significantly lower than those of laser alone group(Z=-2.89,P<0.05).The ECCA scores of patients in combined treatment group and laser alone group in 2 months after the last treatment were both significantly lower than those before the first treatment(with Z values of-4.81 and-4.79,respectively,P<0.05).In 2 months after the last treatment,the treatment in laser alone group cured the scars in 2 patients,and were markedly effective

关 键 词：瘢痕 激光疗法 寻常痤疮 瘢痕松解 

分 类 号：R619+.6[医药卫生—外科学] R730.57[医药卫生—临床医学]