420nm强脉冲光联合剥脱性点阵激光治疗重度痤疮瘢痕的美学效果研究OACSTPCD
Study on Cosmetic Effect of 420 nm Intense Pulsed Light and Ablative Fractional Laser in the Treatment of Severe Acne Scars
目的:分析420 nm强脉冲光(Intense pulsed ligh,IPL)联合剥脱性点阵激光(Ablative fractional laser,AFL)治疗重度痤疮瘢痕的美学效果.方法:选笔者医院2023年2月-2023年8月收治107例重度痤疮瘢痕患者为研究对象,按随机数字表法分为IPL组(n=35)、AFL组(n=35)及联合组(n=37).IPL组采用420 nm IPL治疗,AFL组采用剥脱性点阵CO2激光治疗,联合组采用420 nm IPL联合点阵CO2激光治疗.均治疗3个疗程后,对比疗效、红斑、色素沉着、瘢痕、生活质量、皮肤屏障及不良反应发生情况.结果:联合组的有效率明显高于IPL组、AFL组,差异有统计学意义(P＜0.05),但IPL组、AFL组两组间有效率比较无统计学意义(P＞0.05).治疗后,联合组的痤疮瘢痕临床评分量表(ECCA)评分＜AFL组＜IPL组,且联合组治疗红斑、色素沉着的有效率明显高于AFL组、IPL组(P＜0.05),差异有统计学意义(P＜0.05);但AFL组、IPL组两组间比较无统计学意义(P＞0.05).治疗后,联合组的皮肤病生活质量量表(DLQI)评分低于IPL组、AFL组(P＜0.05),但IPL组、AFL组两组间的DLQI评分差异无统计学意义(P＞0.05).治疗后,三组皮肤含水量均较治疗前减少、经皮水分丢失量(TWEL)均增加,但三组间比较无统计学意义(P＞0.05).末次治疗结束后2个月时,三组皮肤含水量均较治疗前增加、TWEL均减少,且联合组的皮肤含水量高于IPL组、AFL组,TWEL少于IPL组、AFL组,差异均有统计学意义(P＜0.05);但IPL组、AFL组两组间比较无统计学意义(P＞0.05).治疗期间,三组刺痛、潮红等不良反应发生情况比较无统计学意义(P＞0.05).结论:420 nm IPL、点阵CO2激光用于重度痤疮瘢痕治疗中均有明显疗效,但两者联合治疗效果更佳,可明显改善患者红斑、色素沉着及瘢痕状况,改善皮肤病相关生活质量及皮肤屏障功能,且安全性值得肯定.
Objective To analyze the cosmetic effect of 420 nm intense pulsed light(IPL)and ablative fractional laser(AFL)in the treatment of severe acne scars.Methods A total of 107 patients with severe acne scars admitted to the hospital from February 2023 to August 2023 were selected as study subjects and divided into the IPL group(n=35),the AFL group(n=35),and the combined group(n=37)according to the random number table method.The IPL group was treated with 420 nm IPL,the AFL group received ablative fractional CO2 laser treatment,and the combined group received 420 nm IPL combined with fractional CO2 laser treatment.After three courses of treatment,the efficacy,erythema,pigmentation,scar quality of life,skin barrier,and occurrence of adverse reactions were compared.Results The effective rate in the combined group was significantly higher than that in the IPL group and the AFL group(P＜0.05),but there was no statistical significance between the IPL group and the AFL group(P＞0.05).After treatment,the Echelle d'Evaluation Clinique des Cicatrices d'acné(ECCA)score was as follows:combined group＜AFL group＜IPL group.The effective treatment rates for erythema and pigmentation in the combined group were significantly higher than those in the AFL group and the IPL group(P＜0.05),but there were no statistical differences between the AFL group and the IPL group(P＞0.05).After treatment,the Dermatology Life Quality Index(DLQI)score was lower in the combined group than in the IPL group and the AFL group(P＜0.05),but the difference in DLQI score between the IPL group and the AFL group was not statistically significant(P＞0.05).After treatment,the skin water content decreased while the transepidermal water loss(TEWL)increased in the three groups compared to before treatment,but there were no statistical differences among the three groups(P＞0.05).At 2 months after the last treatment,the skin water content in all three groups was enhanced while the TEWL was reduced compared to before treatment.The skin water content in the combined group was higher than that in the IPL group and the AFL group,while the TEWL was lower than that in the IPL group and the AFL group(P＜0.05),but there were no statistical differences between the IPL group and the AFL group(P＞0.05).During treatment,there were no statistical differences in adverse reactions such as tingling and flushing among the three groups(P＞0.05).Conclusion Both 420 nm IPL and fractional CO2 laser have significant efficacy in the treatment of severe acne scars,but the combined treatment has better efficacy.It can better improve erythema,pigmentation,and scar status,enhance dermatology-related quality of life,and improve skin barrier function.Its safety is worthy of affirmation.
贾鑫璇;张胡莲;高贵彬;周婷;潘悦
成都市新都区人民医院皮肤科 四川 成都 610500
临床医学
痤疮瘢痕420nm强脉冲光剥脱性点阵激光美学效果
acnescars420 nm intense pulsed lightablative fractional lasercosmetic effect
《中国美容医学》 2024 (009)
109-113 / 5
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