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

Fractional CO2 laser combined with a collagen dressing for the treatment of atrophic facial acne scars： a clinical observational study

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10d;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（x2=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.

Objective To evaluate the efficacy and safety of a collagen dressing for healing of wounds induced by fractional CO2 laser in patients with atrophic facial acne scars.Methods Seventy patients with atrophic facial acne scars were recruited to this study,and randomly divided into a treatment group and a control group.Both the two groups were treated by two sessions of fractional CO2 laser with an interval of one month.After each session of laser therapy,the treatment group were topically treated with a collagen dressing for 20 minutes once a day for 10 consecutive days,while the control group did not apply any collagen dressing.All the patients were followed for 6 months.Efficacy was evaluated by the degree of acute inflammatory reaction,time needed for crust shedding and patient comfort level.The length of downtime as well as incidence of post-inflammatory hyperpigmentation and other adverse reactions were also assessed.Results Compared with the control group,the treatment group showed a decrease in the score for acute inflammatory response （W =312,P 〈 0.01）,time needed for crust shedding （t =2.08,P 〈 0.05）,incidence rate of post-inflammatory hyperpigmentation （x2 =6.06,P 〈 0.05）,length of downtime （t =3.14,P 〈 0.05）,but an increase in self-reported comfort level （W =172,P 〈 0.01）.No new scar formed in any of these patients.Conclusion The collagen dressing is effective in reducing incidence of adverse reactions and improving satisfaction degree of patients with atrophic facial acne scars after fractional CO2 laser therapy.