双波长非剥脱点阵激光“水增强法”治疗面部凹陷性瘢痕疗效观察(1)
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[摘要]目的：探讨双波长(1320nm+1440nm)非剥脱性点阵激光“水增强法”治疗面部凹陷性痤疮瘢痕的临床疗效和安全性。方法:35例患者随机分成两组，治疗组(A组)：先在凹陷性瘢痕处注射利多卡因注射液，然后再使用双波长非剥脱性点阵激光治疗；对照组(B组)：仅使用双波长非剥脱性点阵激光治疗。每组间隔6周治疗1次，共5次。治疗前后均以ECCA权重评分表对瘢痕部位进行评分统计。结果：35 例患者均完成治疗观察，经过整个疗程治疗后，所有凹陷性瘢痕均有不同程度的改善，A、B组治疗前后ECCA权重评分明显下降，经方差分析检验(P<0.05)差异有统计学意义。A、B组治愈率分别达55.4%和25.0%，无1例出现严重副反应，超过80%的患者表示满意和非常满意。结论：双波长非剥脱性点阵激光“水增强法”治疗面部凹陷性痤疮瘢痕疗效确切，安全性高，无明显副作用，为治疗面部凹陷性痤疮瘢痕开辟了一条新的思路。
[关键词]点阵激光；凹陷性瘢痕；水
[中图分类号]R619+.6 [文献标识码]A [文章编号]1008-6455(2012)02-0272-04
Observation of the therapeutic effect for facial atrophic scars of acne by water augmentation Affirm double wave fractional photothermolysis laser
YANG Peng1, MAI Yue1 ，LI Juan1,SUN Lin-chao2
(1.Department of Dermatology, Sun Hospital Affiliated to Dalian Medical University, Shenzhen 518000,Guangdong, China; 2.Guangzhou Mylike Cosmetic Hospital, Guangzhou 510010,Guangdong, China)
Abstract：Objective To evaluate the efficacy and safety in the treatment for facial atrophic scars of acne by water augmentation Affirm double wave fractional photothermolysis(FP)laser. Methods 35 patients with facial atrophic acne scars were enrolled in the study. All patients were randomly divided into two groups，Group A were treated with Affirm double wave FP laser after the scars were filled with injection of Lidocaine Hydrochloride. Group B treated with Affirm double wave FP laser alone.All cases received a total of five sessions FP laser treatments at 6-week intervals. Comparative photographs were taken using B.Dreno's ECCA grading scale to identify and quantify facial atrophic scars.Results All of the cases obtained different degree of improvement were treated by 5 times. A group and B group cure rate achieved 55.4%, 25%.Over 80% patients considered their results satisfactory or very satisfactory.No severe side effect was observed. Conclusions Application of the water augmentation Affirm double wave FP laser is effective and safe in the treatment of facial atrophic acne scars,the side effects was rare, It providing a new therapeutic option for atrophic acne scars.
Key words： fractional photothermolysis;atrophic acne scars;water
痤疮后凹陷性瘢痕是一种常见的损容性皮肤病,严重影响患者的容貌及身心健康。过去20年，传统的超脉冲CO2激光仍是治疗痤疮瘢痕的金标准[1]，但创面大，恢复慢，易留色素沉着，限制了在亚洲人中的开展。随着点阵激光的诞生[2]，已成为治疗该病较为理想的选择[3]。剥脱性点阵激光可在最轻微的治疗损伤下提供最明显的临床效果，但术后持久性红斑、炎症后色素沉着仍是影响临床使用的一个重要因素，特别在亚洲人群中[4]。非剥脱性点阵激光避免了上述严重的副反应，但疗效显现迟缓也制约了该技术的推广。2009年8月～2011年6月，笔者科室采用双波长非剥脱性点阵激光“水增强法”对痤疮后瘢痕患者进行治疗，取得了满意疗效，现报道如下。
1 资料和方法
1.1临床资料： 选取2009年8月～2011年6月在我院皮肤激光美容科就诊的面部痤疮后凹陷性瘢痕患者进行观察，共35例，其中男20例，女15例，年龄19～36岁,平均25.4岁，Fitzpatrick皮肤分型Ⅲ～IV型，遗留中度到重度凹陷性瘢痕，病程6月～12年，平均3.5年，所有患者至少半年以上均无活动性痤疮。35例患者合计凹陷性瘢痕部位96处，其中额部16处，左右颊部52处，颧部28处。所有病例均随机分为治疗和对照两组，治疗组20例,男11例，女9例，年龄18～36岁,平均24.3岁，凹陷性瘢痕部位56处；对照组15例 ......
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