超脉冲CO2激光联合2940nm铒像素激光治疗重度痤疮凹陷性瘢痕疗效及影响因素分析

Analysis of the Effects of 2940 nm Erbium Pixel Laser Combined with Ultrapulse CO2 Laser in Treatment with Severe Depressed Acne Scar Patients and the Influencing Factors

目的:探讨2940nm铒像素激光联合超脉冲CO2激光治疗重度痤疮凹陷性瘢痕的疗效及影响因素。方法:选取2018年1月-2019年1月在笔者医院就诊的重度痤疮凹陷性瘢痕患者90例,根据随机数字法及患者和家属意愿将其分为采用2940nm铒像素激光治疗的对照组和采用2940nm铒像素激光联合超脉冲CO2激光治疗的观察组,每组45例。比较两组患者的疗效,并记录患者不良反应情况。采用单因素分析和多元Logistic回归模型分析重度痤疮凹陷性瘢痕患者治疗效果的影响因素。结果:治疗后,观察组治疗总有效率(91.11%)高于对照组的总有效率(82.22%)(P<0.05);观察组痤疮瘢痕权重评分(ECCA)低于对照组(P<0.05);观察组不良反应总发生率(26.67%)低于对照组(44.44%)(P<0.05)。单因素分析显示,年龄、性别、BMI、病程、伴发其他皮肤疾病及家族史均与重度痤疮凹陷性瘢痕患者的治疗效果有关(P<0.05)。多因素Logistic分析显示,性别、病程、伴发其他皮肤疾病、家族史均是影响重度痤疮凹陷性瘢痕患者治疗效果的危险因素(P<0.05)。结论:2940nm铒像素激光联合超脉冲CO2激光治疗重度痤疮凹陷性瘢痕可显著提高疗效,减少不良反应的发生。性别、病程、伴发其他皮肤疾病及家族史均可对重度痤疮凹陷性瘢痕患者的疗效造成影响。

Objective To investigate the effects of 2940 nm erbium pixel laser combined with ultrapulse CO2 laser in treatment with severe depressed acne scar patients and analyse the influencing factors.Methods 90 patients with severe depressed acne scar who were treated in our hospital were selected from January 2018 to January 2019.According to the random number method and the wishes of patients and their families,the patients were divided into two groups:the control group(n=45)treated with 2940 nm erbium pixel laser and the observation group(n=45)treated with 2940 nm erbium pixel laser combined with ultrapulse CO2 laser.The curative effects of the two groups were compared and the adverse reactions were recorded.The univariate analysis and multiple logistic regression model were used to analyze the influencing factors of treatment effect in patients with severe depressed acne scar.Results After treatment,the total effective rate of the observation group(91.11%)was higher than that of the control group(82.22%),and the difference was statistically significant(P<0.05).After treatment,the clinical evaluation scale of acne scar(ECCA)score in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).The total incidence of adverse reactions in the observation group(26.67%)was lower than that in the control group(44.44%),and the difference was statistically significant(P<0.05).Univariate analysis showed that age,gender,BMI,course of disease,combined with other skin diseases,family history were all related to the treatment effect of patients with severe depressed acne scar(P<0.05).Multivariate Logistic analysis showed that gender,course of disease,combined with other skin diseases,and family history were all risk factors affecting the treatment effect of patients with severe depressed acne scar(P<0.05).Conclusion 2940 nm erbium pixel laser combined with ultrapulse CO2 laser in patients with severe depressed acne scar can significantly improve the treatment effect and reduce the occurrence of adverse reactions.The gender,course of disease,combined with other skin diseases,and family history were all risk factors affecting the treatment effect of patients with severe depressed acne scar.