Nd:YAG激光和CO2点阵激光治疗面部痤疮凹陷性瘢痕疗效比较分析(1)
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[摘要]目的:比较CooltouchIII 1 320nm Nd:YAG激光和KL型10 600nm CO2点阵激光治疗面部痤疮萎缩、凹陷性瘢痕的疗效及安全性。方法:痤疮萎缩、凹陷性瘢痕患者85例,采用CooltouchIII1320nmNd:YAG激光治疗35例,KL型10 600nm CO2点阵激光治疗50例。治疗前后使用ECCA权重评分表对治疗部位进行评分,比较两种治疗方案的疗效差异。定量测量患者疼痛度、停工期及并发症发生比例,对比两种激光治疗的安全性。结果:CO2点阵激光治疗组治疗后ECCA评分平均降低17.4,CooltouchIII治疗组降低为13.1,两者差异有统计学意义(P<0.05)。CO2点阵激光平均疼痛度、停工期及并发症发生率均大于CooltouchIII治疗组。结论:两种方法均可用于治疗痤疮后萎缩、凹陷性瘢痕,KL型10 600nm点阵激光比CooltouchIII 1 320nm激光疗效更为显著,尤其对于重度痤疮凹陷性瘢痕患者,但患者疼痛感明显,停工期长,有一定持续性红斑和色素沉着的风险。后者治疗时疼痛感较轻微,停工期较短,未见明显色素沉着发生,但需要疗程相对长,疗效相对稍差。故患者可以根据自身需求选择治疗。
[关键词]激光;痤疮瘢痕;治疗
[中图分类号]R454.2 [文献标识码]A[文章编号]1008-6455(2010)10-1506-03
Clinical observation between CO2 Fractional Laser and Nd:YAG Laser for the treatment of acne scars
WANG Qi-hai, LI Dong, ZHOU Xiang, MO Hai-yan, XIAO Xiang-yuan, WEI Jie
(The Center of Plastic and AesthetiSurgery,the Fiist Affiliate Hospital of Guangxi Medical University,Nanning 530007,Guangxi, China)
Abatract: ObjectiveTo compare the therapeutic effects and safety of KL type 10 600nm CO2 Fractional Laser and CooltouchIII 1 320nm Nd:YAG Laser with acne scars.Methods 35 cases with acne scars were treated by CooltouchIII 1320nm Nd:YAG and 50 by KL type 10 600 nm CO2 Fractional Laser. Before and after treatment., ECCA grading scale, pain level, downtime and complications wereassessed and compared.ResultsAfter treatment,ECCA grading scale was decreased by 17.4 for KL type 10 600nm CO2 Fractional Laser and 13.1 for CooltouchIII 1 320nm Nd:YAG.Conclusions Two kinds laser are effective ways of treatment for acne scars.The curative effectiveness of CO2 Fractional Laser treatment exceeded remarkably of cooltouch Nd:YAG Laser,especially for severe acne scars.However, the later had advantge in pain level ,downtime and complications.
Key words:laser;acne scar;therapy
痤疮是一种累及毛囊皮脂腺的慢性炎症性皮肤病,青春期多发,好发于皮脂溢出部位(如面颊、额部),若皮损在发展过程中出现脓疱、结节、囊肿等,愈后会留下增生性或萎缩性瘢痕[1-2]。严重的痤疮瘢痕令原本光洁平滑的皮肤变得凹凸不平并出现红褐色的色素沉着,对青少年的心理和容貌常产生严重影响。随着激光技术的发展,新的激光治疗方法不断涌现,逐渐取代了一些传统的治疗方法(如皮肤磨削术及化学剥脱术等),尤其点阵技术的应用,使痤疮瘢痕的治疗达到微创甚至无创化。目前,各种激光治疗痤疮萎缩、凹陷性瘢痕的疗效及安全性的差异报道尚少见。2008年7月～2010年6月,我中心采用CooltouchIII Nd:YAG激光和KL型CO2点阵激光治疗面部萎缩、凹陷性瘢痕患者85例,并比较观察其疗效及安全性差异,现将结果报道如下。
1临床资料
1.1一般资料:面部萎缩、凹陷性瘢痕患者85例,其中男22例,女63例,年龄18～46岁,平均年龄28.5岁。Fitzpatrick皮肤分型为III～IV。将患者随机分为两组:A组:35例,采用KL型10 600nm CO2点阵激光治疗;B组:50例,采用CooltouchIII 1 320nm Nd:YAG激光治疗 ......
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