微创结合光动力治疗中重度痤疮的临床观察和护理

Clinical observation and nursing of minimal invasive surgery combined with photodynamic therapy for moderate to severe acne

目的观察微创结合光动力治疗中重度痤疮的临床效果。方法收集来本院皮肤科门诊就诊的中重度痤疮患者60例，采用随机数字表法将其分为观察组与对照组，各30例。观察组采用微创结合光动力疗法进行治疗，对照组使用光动力疗法进行治疗，两组患者治疗前和治疗后痤疮皮损面积和严重程度指数评分、治疗后的临床疗效以及不良反应发生率进行比较。结果治疗后两组患者的粉刺、丘疹、脓疱和结节／囊肿个数以及GAGS评分均低于治疗前，且治疗后观察组的粉刺、丘疹、脓疱和结节／囊肿个数以及GAGS评分均低于对照组，差异有统计学意义（P〈0．05）；观察组总有效率为93．3％，对照组总有效率为63．3％，差异有统计学意义（P〈0．05）；两组患者在红斑、肿胀疼痛、反应性痤疮、色素沉着和面部瘙痒方面的不良反应发生率比较，差异无统计学意义（P〉0．05），而对照组的脱屑反应发生率高于观察组，差异有统计学意义（P〈0．05）。结论微创结合光动力治疗中重度痤疮的疗法简单、安全、有效，推荐在临床上应用。

Objective To observe the clinical effect of minimally invasive surgery combined with photodynamic therapy for moderate to severe ache. Methods 60 cases of moderate to severe acne were collected from the department of dermatology of our hospital, then randomly divided into observation group （30 cases） and control group （30 cases）. The observation group was treated with photodynamic therapy combined with minimal invasive surgery, while the control group was treated with photodynamic therapy. Then acne lesions area and clinical scores of severity index of two groups before and after treatment, and the clinical efficacy and the incidence of adverse reactions after treatment of the two groups were compared. Results After treatment, the numbers of acne, pimples, pustules, and nodules/cyst, and GAGS score of the two groups were lower than those before treatment; the numbers of acne, pimples, pustules, and nodules/cyst, and GAGS score after treatment of the observation group were significantly lower than those of the control group, with statistically significant differences （P〈0.05）. The total effective rate in the observation group was 93.3%, and the total effective rate in the control group was 63.3%, with statistically significant difference （P〈0.05）. There were no statistically significant differences in the incidences of adverse reactions such as erythema, swelling and pain, reactive acne, pigmentation, and facial itching between the two groups （P〉0.05）; the incidence of desquamation in the control group was higher than that in the observation group, with statistically significant difference （P〈0.05）. Conelnsion Minimal invasive surgery combined with photodynamic therapy for moderate to severe acne is simple, safe, and effective, recommended in clinical application.