强脉冲光联合点阵铒激光对痤疮后增生性瘢痕的有效性与安全性分析

Efficacy and safety of intense pulsed light and erbium fractional laser in treating acne scar

摘要:

目的研究分析强脉冲光联合点阵铒激光对痤疮后增生性瘢痕的有效性与安全性。方法选择上海交通大学附属医学院苏州九龙医院2013 年8 月-2016 年7 月收治的135 例痤疮后增生性瘢痕患者。采用随机数字表法将其分为强脉冲组、点阵组、联合治疗组，每组45 例，比较治疗前和2 次治疗后的疗效、温哥华瘢痕评价量表（VSS）评分以及不良反应情况和误工期。结果3 组治疗有效率比较，差异无统计学意义（P >0.05），但治疗后3 组患者色泽、血管分布、厚度、柔软度和VSS 评分比较，差异有统计学意义（P <0.05），并均有下降趋势。联合治疗组2 次治疗后色泽、血管分布、厚度、柔软度和VSS 评分与强脉冲组和点阵饵激光组比较，差异有统计学意义（P <0.05），联合治疗组各项指标低于其他两组。治疗后3 组患者的生活质量评分比较，差异有统计学意义（P <0.05）。治疗后联合治疗组的自我感知、情感功能、痤疮症状、社会功能等生活质量评分与同时期的强脉冲组和点阵铒激光组比较，差异有统计学意义（P <0.05），联合治疗组各指标均高于其他两组。联合治疗组的误工期与强脉冲组和点阵铒激光组比较，差异有统计学意义（P <0.05），联合治疗组均低于其余两组，但3 组不良反应发生率差异无统计学意义（P >0.05）。结论强脉冲光联合点阵铒激光治疗痤疮瘢痕具有非常好的疗效，治疗副作用较少，安全性高，同时能够降低误工期，具有广阔的临床应用前景。

Abstract:

Objective To study the efficacy and safety of intense pulsed light and erbium fractional laser in treating acne scar. Methods In this study, 135 cases of acne scar patients from August 2013 to July 2016 were randomly divided into strong pulse group (n = 45), lattice group (n = 45) and combined treatment group (n = 45).Treatment efficacy, VSS score, adverse reaction and duration for delayed work were compared before treatment and after twice of treatment. Results There were no significant differences in the efficiency of treatment among the three groups ( P> 0.05). There were significant differences in the color, vascularity, thickness, softness and VSS score among the three groups after treatment (P < 0.05), and there was a significant decrease in the color and vascularity.Color, vascular distribution, thickness, softness and VSS scores after twice of treatment in the combined treatment group were significant different from those in the strong pulse group and the lattice laser group (P < 0.05). There were significant differences in the quality of life scores among the three groups after treatment (P < 0.05). The scores of self-perception, affective function, acne symptoms, social function and other quality of life after treatment in the combination therapy group were significantly higher than those in the strong pulse group and the lattice erbium laser group at the same time (P < 0.05). The duration of missed work in the combined therapy group was significantly shorter than that in the strong pulse group and the lattice erbium laser group (P < 0.05). But there were no significant differences in the incidences of adverse reactions among the three groups (P > 0.05). Conclusions Intense pulsed light combined with erbium fractional laser in the treatment of acne scar can significantly improve the efficiency of treatment, the incidences of adverse reactions are low, with relatively high security and short duration for delayed work. It has high clinical application value.