点阵模式激光在瘢痕治疗中的临床应用

Application of fractional laser resurfacing in the treatment of superficial scar

目的 评价两种剥脱性点阵模式激光治疗浅表瘢痕的安全性及有效性.方法 共88例患者,其中痤疮瘢痕66例,烧伤瘢痕12例,其他瘢痕10例.所有患者均经以下任何一种治疗：像柬激光≥3次;或点阵激光≥2次;或像束激光＋点阵激光综合治疗≥3次.治疗过程中视病情需要配合应用脉冲染料激光抑制瘢痕增生,减轻红斑.结果 本组共88例,瘢痕改善程度评价标准：改善程度〉25%视为有效,〉50%视为显效,本组患者显效率50%（44/88）,有效治疗达80%（70/88）.像束激光治疗共244人次,点阵激光治疗共86人次,色素沉着共7例,均在半年内消退,无其他严重并发症.结论 点阵模式的激光治疗创伤小,风险低,是治疗浅表瘢痕,尤其是痤疮瘢痕的有效手段,其作用的机制包括组织气化、磨削作用及热损伤带来的促进组织修复的强大动力.

Objective To study the therapeutic effect,safety and risk of fractional resurfacing with ablative laser in the treatment of superficial scar.Methods 88 cases of superficial scar,including 66 cases of acne scar,12 cases of burn scar and 10 cases of other scar,were treated.All the patients were treated with Pixel（Er：YAG 2940 nm,≥3 times）,or Encore（Ultrapulse CO2 10600 nm,≥2 times）,or a combination of Pixel and Encore（≥3 times）.Results The therapeutic effect of treatment was graded as medium when the scar was improved 〉25%,as good when the scar wag improved 〉50%.The effective result Was achieved in 80% of the patients.Good effect was achieved in 50% of the patients.There were 244 treatments of Pixel and 86 treatments of Encore.Persistent hyperpigmentation was happened in one case with Encore treatment.which relieved four months later.No other complication was happened.Conclusions The fractional resurfacing with ablative laser is an effective method for surperficial scar,especially acne scar.It is mini-invasive with low risk.The key mechanism is the ability of enhancing the tissue remodeling induced by heat effect of laser.