点阵式Er:YAG激光治疗面部混合型萎缩性痤疮瘢痕的疗效观察

The Clinical Observation of Ablative Fractionated Er: YAG Laser on the Mixed Facial Atrophic Acne Scars

目的评价点阵式Er：YAG激光治疗面部混合型萎缩性痤疮瘢痕的有效性和安全性。方法采用点阵式Er：YAG激光治疗56例面部萎缩性痤疮瘢痕患者，其中车厢型（B）与滚动型（R）混合型20例，B与冰锥型（I）混合型16例，R＋I混合型20例，能量选用800-1400mJ，治疗4次为1个疗程，每次治疗间隔1个月。在治疗前和治疗后1个月各组进行疗效评定以及治疗后6个月评价患者满意度，同时观察不良反应。结果疗程结束后所有患者均认为至少有中度改善；三组中B＋R组的评价最好（80．00％），R＋I组（70．00％）次之，B＋I组（62．50％）最差，而且在医师评价中，B＋R组与B＋I组对比，差异有统计学意义（P〈0．05）；术后6个月患者满意度较术后1个月有所提高。治疗后有疼痛、红斑、肿胀、色素沉着等不良反应，但均在7—10d内恢复。结论点阵式Er：YAG激光治疗各型面部萎缩性痤疮瘢痕是一种安全有效且较理想的治疗方法。

Objective To evaluate the efficacy and safety of fractional Er：YAG laser in the treatment of facial a- trophic acne scars （AAS） of mixed type. Methods Fifty-six cases of facial AAS were treated with fraction- al Er： YAG laser every one month for 4 times, including 20 cases of the Boxcar type （B） ＋ Rolling type （R） mixed type, 16 cases of B ＋ Ice-pick （I） mixed type, 20 cases of R ＋ I mixed type, using energy 800 ~ 1 400mJ. Before treatment and one month after treatment the efficacy were evaluated, and the satisfaction of patients were estimated after treatment for 6 months. Meanwhile, the adverse reaction also were involved. Results The lesions of all the patients were at least moderate improvement after treatment. To analyze the evaluation of patients, B ＋ R group（80. 00% ） was the best, and B ＋ I group（62. 50% ） was the worst, then the R ＋ I group（70. 00% ）was between the two groups. Compared B ＋ R group with B ＋ I group,there was a significant difference （ P 〈 O. 05 ） in the assessment of physician. The satisfaction of patients was more im- proved 6 months after treatment than that of 1 month. Some adverse reactions were occurred after treatment, incuding pain,swelhng,erythema,pigmentation and so on, but all recovered in 7 - 10 days. Conclusion The fractional Er： YAG laser treatment of various types of facial AAS is a safe and effective method.