局灶点阵激光治疗痤疮萎缩性瘢痕效果及不良反应分析

目的观察痤疮萎缩性瘢痕采用局灶点阵激光技术(FFLT)治疗的效果,并评价其不良反应。方法选取2017年12月~2018年12月我院收治的30例面部痤疮萎缩性瘢痕患者作为研究对象,以患者左侧面部为对照面,给予大面积平扫技术治疗,以患者右侧面部为观察面,给予局灶点阵激光技术治疗,观察比较两组的治疗结果和治疗过程中的不良反应等。结果治疗前,患者对照面和观察面的痤疮瘢痕权重评分和皮肤纹理值比较差异均无明显差异(P> 0.05)。治疗后3个月,评分均有降低,观察面低于对照面,组间比较差异显著(P <0.05)。治疗后均出现疼痛、水肿等不良反应,观察面的疼痛、水肿评分均低于对照面,有显著性差异(P <0.05),但红斑和结痂持续时间方面比较并无明显差异(P> 0.05)。结论痤疮萎缩性瘢痕实施FFLT技术治疗,创面小,恢复快,不良反应少,疗效显著,具有临床应用价值。     

点阵CO_2激光治疗萎缩性痤疮瘢痕

点阵CO2激光常应用于萎缩性痤疮瘢痕,安全有效,不良反应小。激光设备种类较多,一般较高能量较低密度设置能更有效治疗痤疮瘢痕,单次治疗有显著疗效,多次治疗可以有更好的改善,治疗间隔大多为1~2个月,也可延长至3~6个月。组织病理提示治疗后3周表皮完全再生,真皮胶原重建,热休克蛋白长期表达;激光在皮肤上穿透的深度是预估疗效的重要因素,穿透的深度因不同的设备及治疗参数等有差异。最常见的不良反应是红斑、水肿、脱屑和结痂,2周内恢复;疼痛指数高的患者常见于应用相对高的能量参数;炎症后色素沉着(postinflammatory hyperpigmentation,PIH)大部分在6周内消失,只有少数持续超过6个月,深肤色的患者PIH风险增加,高密度参数是PIH最重要的决定性因素。     

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。     

点阵激光治疗萎缩性瘢痕的技巧

1局灶性光热作用理论 皮肤年轻化治疗中很重要的机制被认为是真皮组织受到一定的刺激后出现新的胶原组织.对真皮的刺激可以是带有创伤性的气化型（ablative）治疗方法,也可以是没有明显创伤的所谓非气化型的（non—ablative）治疗。     

点阵激光治疗痤疮性瘢痕进展

痤疮后凹陷性瘢痕是痤疮愈合后常见的后遗症,给患者的生活和心理带来很多困扰。传统的治疗方法很多,如化学剥脱、外科切除、磨削、组织填充等,但这些方法疗效不甚理想,常常伴有术后感染、瘢痕加重及色素变化等严重的不良反应。点阵激光是以局灶性光热作用原理作为理论指导的一种新型激光治疗模式,可分为剥脱性点阵激光和非剥脱性点阵激光,在痤疮瘢痕的治疗中取得了显著的疗效。     

点阵激光治疗痤疮瘢痕的临床效果观察

目的观察点阵激光应用在治疗痤疮瘢痕中的效果。方法选取2018年1月~2019年5月在我院进行痤疮瘢痕治疗的82例患者作为观察对象,并遵循随机数字表法分为对照组(41例,进行点阵射频治疗)与实验组(41例,进行高能量CO2点阵激光治疗),比较两组疼痛情况、治疗安全性与临床治疗效果。结果实验组的疼痛评分(2.54±0.69)分明显低于对照组(3.97±0.78)分,P <0.05;实验组不良反应发生率低于对照组,P <0.05;实验组治疗总有效率(92.68%)明显高于对照组(73.17%),P <0.05。结论对痤疮瘢痕患者应用点阵激光治疗,可以改善患者症状,增强治疗效果,且不良反应轻微,值得推广。     

点阵二氧化碳激光治疗瘢痕不良反应的防治及护理

目的研究点阵二氧化碳激光治疗瘢痕的不良反应及其护理与防治措施。方法观察统计点阵二氧化碳激光治疗瘢痕所出现的常见不良反应,针对常见的不良反应,临床采取针对性的护理措施预防或减少不良反应。结果点阵二氧化碳激光术后不良反应的发生率为10%,最常见的不良反应是疼痛、红斑、水肿、水疱、色素沉着或减退、瘢痕等。通过术前严格治疗参数、应用表面麻醉剂、口服糖皮质激素、术后患处冷敷、防晒等针对性护理措施,绝大多数的不良反应可以预防或显著减轻。结论掌握好治疗参数、有针对性的护理措施可以很好的预防或减少点阵二氧化碳激光治疗瘢痕不良反应发生。     

MCL30铒点阵激光治疗面部痤疮瘢痕的疗效观察

我科2010年1月至2011年12月,采用德国阿司克莱激光公司的铒点阵激光MCL30治疗痤疮瘢痕65例,取得满意疗效,现对临床治疗经验总结如下……     

1550nm非剥脱点阵激光治疗痤疮瘢痕的疗效观察

目的:观察1550 nm非剥脱点阵激光治疗痤疮瘢痕的疗效。方法:选取痤疮瘢痕患者37例,应用1550 nm非剥脱点阵激光治疗,采用GoodmanBaron痤疮瘢痕分级系统和GoodmanBaron痤疮瘢痕评分系统对疗效进行评估。结果:治疗后,43%(16/37)的患者GoodmanBaron痤疮瘢痕分级有改善,2%(1/37)的患者分级改善2级,41%(15/37)的患者分级改善1级。治疗后,92%(34/37)的患者GoodmanBaron痤疮瘢痕评分有改善,改善分数最高为13分,最低为0分,平均改善分数为3.24分。治疗中均未发现任何严重不良反应。结论:1550 nm非剥脱点阵激光是治疗痤疮瘢痕安全、有效的方法。     

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CO2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CO2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...     

皮秒翠绿宝石激光与超脉冲CO2点阵激光治疗面部萎缩性痤疮瘢痕的疗效与安全性比较

【摘要】 目的 通过前瞻性、半脸对照研究,比较皮秒翠绿宝石激光与超脉冲CO2点阵激光治疗面部萎缩性痤疮瘢痕的疗效与安全性。方法 2015年10月至2017年10月在中国医学科学院皮肤病医院激光科收集面部对称性萎缩性痤疮瘢痕患者,左侧面部痤疮瘢痕采用超脉冲CO2点阵激光治疗,右侧采用皮秒翠绿宝石激光点阵模式治疗,治疗间隔为2个月,共治疗3次。治疗前后由皮肤科医生根据ECCA评价表对瘢痕进行评分,患者根据四分法自评临床疗效。记录治疗时疼痛程度和不良反应。两侧间、治疗前后ECCA评分及疼痛程度评分比较采用配对t检验,组间四分法评分比较采用 Wilcoxon 秩和检验。结果 治疗前皮秒激光侧和点阵激光侧间ECCA评分差异无统计学意义（t = 1.06,P = 0.300）,治疗3次后差异有统计学意义［（70.98 ± 21.48）分比（58.04 ± 17.63）分,t = 3.76,P = 0.001］。与治疗前相比,皮秒激光侧瘢痕改善评分（2.21 ± 1.09）分,CO2点阵激光侧（2.83 ± 1.11）分,两组差异有统计学意义（z = 2.70,P = 0.007）。与CO2点阵激光侧相比,皮秒激光侧不良反应更少,表现为一过性红斑、水肿,治疗疼痛评分亦明显降低［（3.71 ± 0.62）分比（6.23 ± 1.06）分,t = 11.93,P < 0.001］。结论 皮秒翠绿宝石激光与超脉冲CO2点阵激光均能有效改善萎缩性痤疮瘢痕,CO2点阵激光疗效更显著,而皮秒激光不良反应更少。     

CO_2点阵激光Deep与Superficial模式联合治疗萎缩性痤疮瘢痕的临床分析

目的:评价CO2点阵激光Deep与Superficial模式联合治疗萎缩性痤疮瘢痕的临床疗效和安全性。方法:对纳入的20例萎缩性痤疮瘢痕患者进行病例对照研究,每例患者治疗2个疗程,治疗后3个月进行疗效和安全性评价,对治疗前后萎缩性痤疮瘢痕严重程度评分,评估临床疗效和不良反应,同时统计患者主观评价。结果:所有患者瘢痕严重程度评分由治疗前(64.3±19.8)分下降至(39.8±14.3)分,改善百分比达(37.6±9.6)%,其中17例患者认为皮损明显或显著改善,无严重不良反应。结论:CO2点阵激光Deep与Superficial模式联合治疗萎缩性痤疮瘢痕,是一种安全有效的新型治疗方法。     

黄金微针射频联合自体富血小板血浆治疗面部痤疮凹陷性瘢痕的疗效评估

目的 探讨黄金微针射频联合自体富血小板血浆(PRP)治疗面部痤疮凹陷性瘢痕的疗效。方法 选择河南大学第一附属医院皮肤科门诊2019年4月—2021年4月接收且诊治的74例凹陷性痤疮瘢痕患者为对象,随机分为2组。观察组采用黄金微针射频联合PRP治疗,对照组采用滚轮微针联合PRP治疗,两组均治疗间隔4周,连续治疗3次,3次为1疗程。1个疗程结束后6个月随访,比较两组ECCA权重评分和临床疗效分析、记录治疗引起的皮肤损伤相关时间指标。结果 观察组治疗前ECCA权重评分为53.38±19.15,对照组为52.43±25.94,两组差异无统计学意义(Z=-0.64,P=0.524);治疗后观察组ECCA权重评分降低为24.46±14.38,对照组降低为36.08±20.38,观察组低于对照组(Z=-2.20,P<0.05)。观察组和对照组总体有效率分别为91.89%和72.97%,两组差异有统计学意义(χ²=4.57,P<0.05)。观察组患者的红肿持续时间、愈合时间和停工时间均短于对照组患者,差异均有统计学意义(均P<0.05)。结论 黄金微针射频联合P...     

微等离子体与超脉冲CO2点阵激光治疗痤疮凹陷性瘢痕的对比研究

目的 比较微等离子体与超脉冲CO2点阵激光治疗痤疮凹陷性瘢痕的疗效及不良反应。 方法 对21例痤疮凹陷性瘢痕患者进行自身对照试验,一侧面部进行微等离子体治疗,另一侧进行CO2点阵激光治疗,1次治疗后随访6个月,观察两种治疗方法的疗效和不良反应。对各组治疗前后及组间痤疮瘢痕权重评分（ECCA）、患者自身评估（四分值法）微等离子体治疗1次后6个月的瘢痕改善值及治疗后疼痛评分、水肿评分、结痂时间和炎症性红斑持续时间进行非参数秩和检验,比较治疗前后及不同方法间的临床疗效及不良反应。选用1只新西兰大耳兔,在双侧兔耳分别造瘢痕模型,分别用微等离子体和CO2点阵激光在两侧兔耳瘢痕模型上扫描1遍,即刻取下组织,观察组织学改变。结果 痤疮凹陷性瘢痕治疗1次后,微等离子体组ECCA从50.71降至34.76,评分下降率为31.5%,21例中有19例治疗后ECCA评分下降,有效率为90.5%;超脉冲CO2点阵激光组评分从53.57降至38.10,评分下降率为29.9%,其中18例治疗后ECCA评分下降,有效率为86.7%,两组间有效率差异无统计学意义（P > 0.05）。治疗后微等离子组水肿较轻,红斑持续时间为13.95 d,结痂持续时间为6.95 d,而超脉冲CO2点阵激光组分别为45.81 d和10.10 d。微等离子体侧无1例发生色素沉着,而CO2点阵激光治疗侧色素沉着发生率达19%。兔耳瘢痕组织HE染色显示,微等离子体的微剥脱区宽而浅,CO2点阵激光的微剥脱区窄而深。结论 微等离子体和超脉冲CO2点阵激光对痤疮凹陷性瘢痕均有较好疗效,但微等离子体相对不良反应较小,色素沉着发生率低。     

Efficacy and safety of a single treatment using a 10,600-nm carbon dioxide fractional laser for mild-to-moderate atrophic acne scars in Asian skin

BackgroundAblative laser therapy with carbon dioxide is effective for acne scars; however, the long downtime limits its use, especially in types III and IV skin. The fractional ablative 10,600-nm carbon dioxide laser system reportedly maximizes efficacy and minimizes side effects. The goal of this study was to evaluate the efficacy and safety of an ablative 10,600-nm carbon dioxide fractional laser system in a single treatment session on atrophic acne scars in Asian patients.MethodsTwenty-five patients with atrophic acne scars were enrolled. The laser fluences were delivered using the Deep FX mode. Comparative photographs were taken with VISIA complexion analysis. Physician evaluation and patient satisfaction were graded on a four-point scale.ResultsAt follow-up 1 month after treatment, four patients showed 51–75% improvement, 16 had 26–50% improvement, and five had minimal or no improvement. At 3 months, two patients had excellent results (76% and 100% improvement). Postinflammatory hyperpigmentation was present in six of the 25 (24%) patients; by 3 months' follow-up, this had faded in five of six cases.ConclusionA single treatment with the carbon dioxide fractional laser system is effective for acne scars in Asian patients, with minimal and acceptable side effects.     

Treatment of atrophic facial acne scars with fractional Er:Yag laser

Background: Acne scars are often a permanent disfiguring sequel of acne vulgaris. Although many treatment modalities are available, they are often non satisfactory for all patients. Objective: To determine the effectiveness and safety of fractional 1540 nm erbium_glass laser treatment of facial acne scars in Iraqi patients. Patients and methods: Twenty one patients were enrolled in this prospective clinical study. Three sessions of the 1540 nm erbium glass laser were applied at 2-week intervals. The patients were assessed at 1, 3, and 6 months after the last session. The effect of treatment was assessed by objective (Sharquie scoring system for grading acne scarring and visual analog scale) and subjective (patient satisfaction) methods. Results: Two patients were defaulted. Eleven patients (57.9%) showed improvement from moderate to mild grade, and no grade changes were detected in eight patients (42.1%). The mean score of the visual analog scale prior to treatment was 8.61 ± 0.86 and decreased to 6.15 ± 1.28 (P = 0.037). Ten patients were satisfied to varying degrees. No significant side effects were noted. Conclusion: Non-ablative fractional 1540 nm erbium glass laser is an effective and safe method to treat acne scars and represent good alternative for patients who cannot use the ablative methods because of its longer downtime.     

Evaluation of the efficacy and safety of fractional bipolar radiofrequency with high-energy strategy for treatment of acne scars in Chinese

Background: Fractional technology overcomes several problems of ablative lasers such as a high incidence rate of post- inflammatory hyperpigmentation (PIH). A new technology fractional radiofrequency, which induces deep dermal heating and leaves the epidermal less affected results in less adverse effect in Chinese. Objective: To evaluate the efficacy, safety and tolerance of fractional bipolar radiofrequency (RF) in the treatment of acne scars in Asian people with the strategy of high energy. Methods: Twenty-six healthy Asian patients with acne scars received four monthly high energy (85–95mj/pin) treatments with a fractional bipolar RF device. Improvement and tolerance were evaluated at each treatment and a 4-week and 12-week follow-up visit. Results: Twenty-three patients completed the study. Acne score showed a significantly decrease at 4-week and 12-week follow-up visits. Patients’ evaluation of global improvement and satisfaction increased at the 12-week visit compared with baseline. Side effects were limited to transient pain, erythema, dryness and low risk of PIH. Conclusion: Treatment with high energy of fractional bipolar RF is safe and effective for acne scars in Asian people. Common side effects such as PIH, eschars are less than fractional lasers.