强脉冲光联合点阵铒激光治疗痤疮后增生性瘢痕的效果观察

目的观察痤疮后增生性瘢痕患者应用强脉冲光联合点阵铒激光治疗后效果。方法随机将我院91例痤疮后增生性瘢痕患者分组,对照组45例给予强脉冲光治疗,观察组46例联合点阵铒激光治疗,对比治疗疗效。结果观察组VSS评分低于对照组,总有效率高于对照组(P <0.05)。结论强脉冲光联合点阵铒激光有效改善瘢痕色泽、血管分布、厚度及柔软度,治疗痤疮后增生性瘢痕效果显著。     

铒激光联合表皮生长因子溶液治疗痤疮浅表型凹陷性瘢痕疗效观察

目的探究铒激光联合表皮生长因子溶液在治疗痤疮浅表性凹陷性瘢痕中的临床疗效。方法选择2017年1月—2018年12月于我院接受治疗的82例痤疮浅表性凹陷性瘢痕患者,按照随机数字表法将其均分为研究组与对照组(每组各41例),对照组接受常规铒激光治疗,研究组接受铒激光联合表皮生长因子溶液治疗,对比2组治疗总有效率及痂皮脱落时间,对比治疗前、治疗后1个月、治疗后3个月2组痤疮瘢痕权重评分(ECCA)评分、凹陷性瘢痕基底深度,并随访记录2组治疗不良反应发生率。结果①研究组治疗3个月后总有效率显著高于对照组(95.12%vs. 77.78%,P0.05);②研究组痂皮脱落时间(5.26±2.11)d,显著短于对照组为(7.51±1.45)d(P0.05);③治疗前2组ECCA评分对比差异无统计学意义(P0.05),治疗1个月及3个月后2组的ECCA评分均较治疗前显著下降,且治疗1个月显著低于治疗3个月(P0.05),组间对比研究组ECCA评分均低于对照组(P0.05);④治疗前2组凹陷性瘢痕基底深度对比差异无统计学意义(P0.05),治疗1个月及3个月后2组凹陷性瘢痕基底深度均有减小(P0.05);2组组间治疗1个月与3个月对比差异无统计学意义(P0.05),组间对比研究组凹陷性瘢痕基底深度低于对照组(P0.05);⑤随访显示研究组不良反应发生率低于对照组,但对比差异无统计学意义(P0.05)。结论铒激光联合表皮生长因子溶液在治疗痤疮浅表性凹陷性瘢痕中有较好的效果,能够缩短痂皮脱落时间,增加上皮修复效果,且治疗安全性较高。     

两种点阵激光治疗萎缩性痤疮瘢痕的回顾性研究

目的:评价2 940 nm铒点阵激光与二氧化碳点阵激光治疗萎缩性痤疮瘢痕的疗效、安全性及副作用。方法:回顾分析2011-2017年在我所分别采用铒点阵激光及二氧化碳点阵激光治疗的萎缩性痤疮瘢痕患者各50例,评价其术后红肿时间、脱痂时间、治疗2次3个月后瘢痕改善情况、患者对治疗的主观评分等。结果:铒点阵激光组及二氧化碳点阵激光组治疗后红肿时间分别为(3.85±0.36)天和(3.75±0.42)天,二者无明显差异(P>0.05);脱痂时间分别为(7.76±2.21)天和(5.25±1.87)天,二者有明显差异(P<0.05)。两组瘢痕严重程度评分均下降,二氧化碳点阵激光组平均下降(25.34±5.06)分,改善度达(40.09±8.01)%;而铒点阵激光组平均下降(19.42±4.75)分,改善度达(29.39±7.93)%。结论:两者治疗萎缩性痤疮瘢痕均有效,安全性好。二氧化碳点阵激光治疗组改善瘢痕更加明显,且脱痂时间短,副作用较少。     

铒YAG激光辅以胶原蛋白贴治疗面部凹陷性痤疮瘢痕疗效观察

目的观察铒YAG激光辅以胶原蛋白贴敷料治疗面部凹陷性痤疮瘢痕的临床疗效。方法将78例患者随机分为铒YAG激光辅以胶原蛋白贴敷料治疗组和铒YAG激光辅以金霉素软膏对照组,治疗3个月后,分别比较疗效及色素沉着发生率。结果治疗组、对照组有效率均为100.00%,治疗组色素沉着发生率为4.2%,对照组为20.0%,两者差异有显著性意义(P<0.05)。结论铒YAG激光辅以胶原蛋白贴敷料治疗面部痤疮凹陷性瘢痕疗效明确,术后色素沉着少。     

黄金微针射频联合低能量超脉冲CO2点阵激光治疗面部痤疮凹陷性瘢痕的疗效观察

 目的 观察黄金微针射频联合低能量超脉冲CO2点阵激光治疗面部痤疮凹陷性瘢痕的疗效。方法选取2018年4月—2020年4月就诊于河南大学第一附属医院的74例凹陷性痤疮瘢痕患者为对象,随机分为2组,每组各37例。治疗组采用黄金微针射频联合低能量超脉冲CO2点阵激光治疗;对照组采用黄金微针射频治疗。比较2组治疗前后痤疮瘢痕权重评分（ECCA）、瘢痕改善程度IGA评估及术后不良反应。结果2组治疗后ECCA评分均明显降低,但治疗组评分降低更明显(Z=-2.65,P＜0.05);治疗组IGA评估有效率较对照组高。2组不良反应发生率无统计学差异。结论黄金微针射频联合低能量超脉冲CO2点阵激光能更好地改善痤疮后凹陷性瘢痕,两种方法联合能够起到协同作用且不增加治疗相关副作用。     

CO2点阵激光联合外用重组人碱性成纤维细胞生长因子治疗痤疮凹陷性瘢痕的临床疗效观察

目的探讨CO_2点阵激光联合外用重组人碱性成纤维细胞生长因子治疗痤疮凹陷性瘢痕的临床有效性和安全性。方法76例患者分为对照组和治疗组,对照组采用点阵激光治疗,治疗组联合外用重组人碱性成纤维细胞生长因子。结果治疗组治疗有效率为92.1%,对照组有效率为68.4%,两组比较差异有统计学意义(P 0.01)。结论 CO_2点阵激光联合外用重组人碱性成纤维细胞生长因子治疗痤疮凹陷性瘢痕疗效确切,安全性好,术后恢复快。     

2940nm与1550nm点阵激光治疗凹陷性痤疮瘢痕自身前后疗效及安全性对照观察

目的探讨比较2 940nm铒激光与1 550nm铒玻璃激光治疗痤疮凹陷性瘢痕的疗效与安全性。方法选取10例诊断为痤疮凹陷性瘢痕患者,左右半侧面部分别使用2 940nm铒激光与1 550nm铒玻璃激光治疗。每4周治疗1次,共3次。通过治疗前后拍照、VISIA皮肤图像分析仪、CK皮肤检测仪评估疗效与皮肤屏障功能。结果 3次治疗后与治疗前比较,毛孔显著缩小,且1 550nm治疗侧毛孔缩小量大于2 940nm治疗侧(P0.05);紫质、棕色斑减少(P0.05),但1 550nm与2 940nm两侧差异无统计学意义(P0.05);每次治疗前与治疗后1周相比,经皮水流失量增多(P0.05),且2 940nm治疗侧大于1 550nm治疗侧(P0.05)。结论使用推荐能量的中低档时,1 550nm铒玻璃激光治疗冰锥型痤疮凹陷性瘢痕疗效优于2 940nm铒激光,并且皮肤屏障的损伤小于2 940nm铒激光。     

Profile铒激光治疗痤疮瘢痕128例疗效评价

目的:评价Profile铒激光治疗痤疮瘢痕的疗效。方法:Profile铒激光治疗痤疮瘢痕128例,其中凹陷性瘢痕106例,增生性瘢痕22例。结果:Profile铒激光治疗痤疮瘢痕的总有效率为93%,凹陷性瘢痕总有效率93.3%,增生性瘢痕总有效率92.2%。术后出现暂时性色素沉着6例(4.7%),均于3个月内基本消退。结论:Profile铒激光治疗痤疮瘢痕疗效好(凹陷性瘢痕优于增生性瘢痕),副作用小。     

点阵CO2激光联合皮下分离术治疗痤疮凹陷性瘢痕的疗效观察

目的分析点阵CO_2激光联合皮下分离技术治疗痤疮凹陷性瘢痕的应用价值。方法选取2018年6月到2020年10月某医院收治的痤疮凹陷性瘢痕患者82例,随机分为研究组(n=41)和对照组(n=41),对照组予以点阵CO_2激光治疗,研究组予以点阵CO_2激光联合皮下分离治疗。对比两组术前、术后6个月临床痤疮瘢痕评估量表(ECCA)权重评分、瘢痕面积、色素沉着面积变化和凹陷边缘直径减少50%所用时间变化。结果术后6个月,研究组ECCA权重评分明显低于对照组;术后6个月,研究组瘢痕面积、色素沉着面积明显小于对照组;研究组凹陷边缘直径减少50%所用时间明显短于对照短,且上述差异均有统计学意义(P 0.05)。结论点阵CO_2激光联合皮下分离技术治疗痤疮凹陷性瘢痕可促进瘢痕恢复,减少瘢痕面积和色素沉着面积。     

点阵CO2激光治疗痤疮凹陷性瘢痕的临床疗效观察

目的:为点阵CO_2激光治疗痤疮凹陷性瘢痕寻找更佳的参数设置及治疗操作方法。方法:选取42例痤疮凹陷性瘢痕患者,面部两侧随机分为实验组、对照组,实验组采用点阵CO_2激光"局部加强模式+大面积平扫模式";对照组采用单纯"大面积平扫模式",治疗间隔时间为2个月,共治疗2次,治疗前及每次治疗后2个月予痤疮瘢痕权重评分(ECCA)值、凹陷度、光滑度、疗效、不良反应及患者满意度评分。结果:实验组的ECCA值、凹陷度、光滑度、皮损总积分的改善及满意度均优于对照组(P0.05);实验组VS对照组的疗效评估:显效3例(7.1%)vs 1例(2.3%),有效28例(66.7%)vs 18例(42.9%)(P0.05)。两组中均以货车厢型改善最显著,滚动型疗效最差,冰锥型介于二者之间,滚动型与冰锥型之间的差异无统计学意义(P0.05)。结论:点阵CO_2激光采用"局部加强模式+大面积平扫模式"治疗痤疮凹陷性瘢痕疗效显著,且对皮肤的质地、光泽、毛孔有更好的改善。     

超脉冲CO2点阵激光治疗面部萎缩性痤疮瘢痕40例分析

目的：评价超脉冲CO2点阵激光治疗面部萎缩性痤疮瘢痕的疗效.方法：面部萎缩性痤疮瘢痕40例,根据患者皮肤类型、痤疮瘢痕形状、深度、密度选用超脉冲CO2点阵激光的参数治疗,并进行治疗前后对比.结果：与治疗前相比,总有效率为92.5%,治疗中未观察到严重不良反应.结论：超脉冲CO2点阵激光治疗面部萎缩性痤疮瘢痕疗效显著,副作用小,安全性高.     

The efficacy of fractional ablative carbon dioxide laser combined with other therapies in acne scars

Fractional ablative carbon dioxide laser resurfacing is a frontline treatment for acne scars. It creates multiple microscopic treatment zones to accelerate the collagen formation and the healing process of reepithelialization, according the principle of fractional photothermolysis. At present, the fractional CO₂ laser with a wavelength of 10,600 nm is commonly used in the field of cosmetology and clinical therapies for various skin diseases, and it can effectively improve skin regeneration and scar formation. To obtain satisfactory results for patients with scars, repetitive fractional laser therapy is always required; however, this treatment could easily lead to complications such as erythema, edema, infection, and post‐inflammatory hyperpigmentation. In addition, different types of acne scars may have different responses to laser, further limiting its widespread use. In recent studies both home and abroad, a new pattern of fractional laser combined with other therapies to improve acne scar has been recommended to guarantee the safety and effective of treatment. This article reviews the recent pertinent literatures and summarized the progression of ablative fractional CO₂ laser combined with other therapies on acne scar.     

Clinical studies of the treatment of facial atrophic acne scars and acne with a bipolar fractional radiofrequency system

Few clinical studies have examined the utility of bipolar fractional radiofrequency (FRF) therapy as a treatment for atrophic acne scars and active acne in people with darker skin. This study was designed to compare the safety and efficacy of bipolar FRF therapy as a treatment for atrophic acne scars and acne vulgaris. Twenty‐three Japanese patients with atrophic acne scars and mild to severe acne on both cheeks were treated with a bipolar FRF system (eMatrix; Syneron, Yokneam Illit, Israel). Five treatment sessions were carried out at 1‐month intervals, and the patients were followed up for 3 months after the final treatment. Assessments of scar severity and the number of acne lesions and 3‐D in vivo imaging analysis were performed. Evaluations of the treatment outcomes and their effects on the patients’ quality of life (QOL) were also carried out. We demonstrated that the improvement in scar volume was marked in the patients with mild scars and was at least moderate in 23 (57.5%) of the treated areas. With regard to the number of acne lesions, the treated areas exhibited significantly fewer lesions compared with the baseline at each time point (P < 0.05). The patients’ assessments of the treatment outcomes and their QOL indicated that both had improved significantly by the end of the study. Furthermore, significant reductions in the patients’ sebum levels, skin roughness and scar depth were observed. Bipolar FRF treatment significantly improved the atrophic acne scars and acne of Japanese patients and had minimal side‐effects.     

富血小板血浆联合CO2点阵激光治疗萎缩性痤疮瘢痕疗效和安全性Meta分析

目的：系统评价富血小板血浆联合CO₂点阵激光治疗面部萎缩性痤疮瘢痕的有效性及安全性。方法：检索从建库到2019年7月Cochrane Library、Embase、Medline、中国知网、万方数据库及维普数据库中富血小板血浆联合CO₂点阵激光治疗面部萎缩性痤疮瘢痕的随机对照试验,筛选符合要求的文献并根据Cochrane偏倚风险评估方法评价纳入文献质量, 采用Revman5.3软件进行Meta分析。结果：最终纳入5个RCTs和Meta分析,结果显示：①联合疗法的总有效率和治愈率均高于单用激光组（P=0.008,0.0002）;②联合疗法和单用激光组的红斑、水肿持续时间及疼痛评分无统计学差异（P=0.21,0.35,0.50）。结论：富血小板血浆联合CO₂点阵激光治疗萎缩性痤疮瘢痕的疗效优于单独使用CO₂点阵激光,不良反应无明显差异。     

Efficacy and safety of 1550-nm fractional laser in the treatment of acne scars in Chinese patients: A split-face comparative study

Objective: To evaluate the efficacy and side effects of 1550-nm fractional Er:Glass laser in treating atrophic acne scar. Materials and methods: Thirty Chinese patients aged 18–65 with atrophic acne scars on both cheeks received a split-face treatment, one side with four sessions of treatment with fractional 1550-nm Er:Glass laser at 20-day interval and the other with topical asiaticoside cream application three times daily as control. Clinical response and side effects were evaluated by a dermatologist three weeks after each treatment and again 12 weeks after the last laser treatment. In addition, self-evaluation of satisfaction by the patients was done at the end of treatment. Results: The study found that mean scores decrease after treatment was 5.65 ± 4.34 for the treated side and 1.23 ± 3.41 for the control side. The improvement in acne scars after the fractional Er:Glass laser 1550-nm treatment was more significant than the control side (p = 0.0001). The side effects were mainly local skin irritation and erythema, which disappeared within one week. Conclusion: The research results show that the fractional 1550-nm Er:Glass laser is an effective and safe treatment device for atrophic acne scars.     

CO2点阵激光联合胶原贴敷料治疗面部痤疮凹陷性瘢痕的临床观察

目的 观察胶原贴敷料对CO2点阵激光治疗面部痤疮凹陷性瘢痕术后的修复作用及安全性。 方法 选择70例面部痤疮凹陷性瘢痕患者,随机分为试验组和对照组各35例。试验组CO2点阵激光治疗后外敷胶原贴敷料20 min,共10 d;对照组不用敷料,其余处理同试验组。治疗后随访6个月,观察治疗后急性炎症反应情况、痂皮脱落时间、患者舒适度评价、误工期、炎症后色素沉着率及其他不良反应发生情况。 结果 试验组急性炎症反应评分（W = 312,P < 0.01）、痂皮脱落时间（t = 2.08,P < 0.05）、激光术后自身舒适程度评价（W = 172,P < 0.01）均优于对照组,试验组炎症后色素沉着发生率（χ2 = 6.06,P < 0.05）、误工期（t = 3.14,P < 0.05）均低于对照组,两组均无新发生的瘢痕。 结论 CO2点阵激光术后应用胶原贴敷料可减少术后不良反应发生率,提高患者满意度。     

Clinical trial of a laser device called fractional photothermolysis system for acne scars

Ablative laser resurfacing is an effective treatment for acne scars. However, edema and prolonged erythema are common. Additionally, scarring and hyperpigmentation are often induced. A new concept of laser called fractional photothermolysis has been designed to create microscopic thermal wounds to achieve skin rejuvenation without significant side-effects. We treated 10 patients with acne scars using this laser system (Reliant Fraxel SR Laser). All the patients were successfully treated with minimal adverse effects. The fractional photothermolysis system represents an optional method for the treatment of acne scars.     

Clinical trial of a pinpoint irradiation technique with the CO2 laser for the treatment of atrophic acne scars

Ablative laser resurfacing is an effective treatment for atrophic acne scars. However, it often induces complications such as edema, prolonged erythema, scarring and hyperpigmentation. Therefore, a new concept of laser treatment called fractional photothermolysis has been designed to create microscopic thermal wounds to achieve skin rejuvenation treatment of atrophic acne scars. This study was designed to prospectively evaluate the use of a technique similar to fractional photothermolysis using only the standard CO₂ laser without the fractional laser device in the treatment of atrophic scars and demonstrates it as a safe, effective and economical treatment option. Clinical improvement was achieved in all 35 patients with minimal adverse effects.     

Laser resurfacing of the skin for the improvement of facial acne scarring: a systematic review of the evidence

This review presents and evaluates the evidence of the effectiveness of laser resurfacing for facial acne scars. Primary studies of all types of design in any language were identified from MEDLINE, EMBASE, the Cochrane database, Science Citation Index and various internet sites. Studies were accepted if they included patients treated by any laser for atrophic or ice-pick acne scars. The quality of the studies was assessed and data extracted by two independent researchers. There were no controlled trials but 14 case series were found which reported the effects of either the carbon dioxide or erbium:YAG laser. All of the studies were of poor quality. The types and severity of scarring were poorly described and there was no standard scale used to measure scar improvement. There was no reliable or validated measure of patient satisfaction; most improvement was based on visual clinical judgement, in many cases without blinded assessment. The inaccurate use of ordinal scales meant that any improvement was impossible to quantify with any validity, although the evidence suggested that laser treatment had some efficacy (a range in individual patients of 25-90% for both the carbon dioxide laser and the erbium:YAG laser). Changes in pigmentation as a side-effect were common (in up to 44% of patients), although lasting only a few weeks. Laser resurfacing technology is increasingly used in clinical practice to treat acne scars. Despite the poor quality evidence, it is plausible that there is some improvement of acne scarring; there is insufficient information, however, for patients to make informed decisions on whether to opt for treatment and there is not enough evidence to compare the two types of laser. There is a particular lack of information about the psychological effects of acne scar improvement. Good quality randomized controlled trials are needed with standardized scarring scales and validated patient outcome measures in order to assess the effectiveness of laser resurfacing in this group of patients.