黄金微针射频与超脉冲CO2点阵激光治疗面部痤疮所致的不同类型凹陷性瘢痕的疗效比较

 目的 比较黄金微针射频与超脉冲CO₂点阵激光治疗不同类型面部凹陷性痤疮瘢痕的临床疗效及安全性。方法 选取我院门诊2019年8月—2021年8月诊治的80例凹陷性痤疮瘢痕患者为研究对象，采用随机数字表法分为治疗组和对照组，每组各40例。治疗组采用黄金微针射频治疗；对照组采用超脉冲CO₂ 点阵激光治疗。比较两组疗效，并按临床亚型（V型、U型和M型）对患者进行分类和评价。结果 两组患者治疗后痤疮瘢痕临床评分量表（ECCA）权重评分均降低，但差异无统计学意义（t=0.46， P=0.644）。 两组患者总体有效率比较差异无统计学意义（X²=1.89，P=0.176）。两组瘢痕亚型比较，治疗组M型瘢痕疗效较好（t=2.34, P＜0.05），对照组V型瘢痕疗效较好（t=-2.36, P＜0.05），而两组U型瘢痕疗效无明显差异（t=0.24, P＞0.05）。治疗组患者术中疼痛程度、术后红肿期程度评分均低于对照组，痂皮脱落愈合时间短于对照组，差异均有统计学意义(均P＜0.05)。结论 黄金微针射频与CO₂点阵激光均能有效地改善面部凹陷性痤疮瘢痕，其中前者对M型瘢痕疗效显著，后者对V型瘢痕疗效显著。提示临床工作中可对痤疮瘢痕进行亚型分析，进而选择性治疗，必要时可联合治疗，起到协同作用。

Comparison of therapeutic effects of fractional microneedle radiofrequency and ultra pulsed CO2 fractional laser on different types of facial depressed scars caused by acne

Objective Comparison of the clinical efficacy and safety of fractional microneedle radiofrequency and ultra pulsed CO₂ fractional laser on different types of facial acne depressed scars. Methods A total of 80 patients with acne depressed scars diagnosed and treated in our outpatient clinic from August 2019 to August 2021 were selected as the subjects.They were divided into the treatment group and the control group by random number table method.Treatment group: fractional microneedle radiofrequency.Control group: Ultra-pulsed CO₂ fractional laser. Results Compared with those before treatment, the ECCA weight scores of two groups were decreased after treatment, and the difference was no statistically significant (t=0.46, P=0.644).There was no significant difference of IGA between two groups (X²=1.89,P=0.176). However, fractional microneedle radiofrequency has a significant effect on M-type scars (t=2.34, P＜0.05), while CO₂ fractional laser has a significant effect on V-type scars (t=-2.36, P＜0.05),However,both of groups have no significant effect on U-type scars(t=0.24,P=0.809). There were significant differences of intraoperative pain, postoperative erythema and edema period and healing times of crust peeling between two groups (all P<0.05).Conclusions Both treatment methods can effectively improve facial acne depressed scars.However, fractional microneedle radiofrequency has better effect on on M-type scarsCO₂ fractional laser has better effect on on V-shaped scar.CO₂ fractional laser has more adverse reactions than fractional microneedling radiofrequency, and the recovery and healing time is longer.In clinical work, the patients′ facial acne depressed scars are classified and evaluated. Combined therapy maybe used to play a synergistic effect.