氨基酮戊酸-光动力疗法联合CO_(2)点阵激光治疗痤疮增生性瘢痕的效果

Clinical effects of photodynamic therapy combined with CO_(2) fractional laser in treatment of hyperplastic acne scars

目的探讨5-氨基酮戊酸(ALA)光动力疗法(PDT)联合CO_(2)点阵激光对增生性瘢痕的治疗效果。方法2017年1月至2019年12月,空军特色医学中心皮肤科对下颌部痤疮增生性瘢痕患者20例[男17例,女3例,年龄19~36(24.40±4.24)岁)]进行ALA-PDT联合CO_(2)点阵激光治疗,每月1次共3次,随访观察6个月。用温哥华瘢痕量表(VSS)评估疗效、安全性、复发情况。结果3次治疗后20例均有效。首次治疗后VSS评分明显下降,随着治疗次数增加,VSS进一步下降。治疗后最先改善的是厚度和硬度。随访6个月无1例复发。不良反应主要为疼痛、红斑、色素沉着。结论PDT联合CO_(2)点阵激光可作为增生性瘢痕的治疗手段之一,值得临床应用。

Objective To investigate the clinical effect of 5-aminolevulinic acid(ALA)photodynamic therapy(PDT)combined with CO_(2) fractional laser on hypertrophic scars.Methods From 2017 to 2019,20 patients[17 males,3 females,aged(24.4±4.24)years]with mandibular acne keloid in the Department of Dermatology of Air Force Medical Center,were treated with ALA-PDT combined with CO_(2) fractional laser treatment,once a month,3 times in total,and were followed up for 6 months.The efficacy,safety,and recurrence were evaluated by the Vancouver scar scale(VSS)score.Results The effective rate was 100%after three treatments.The VSS score decreased significantly after the first treatment,and as the number of treatments increased,the VSS score further decreased.The first improvement after treatment was thickness and hardness.There was no recurrence during the 6-month follow-up.The main adverse reactions were pain,erythema and pigmentation.Conclusions ALA-PDT combined with CO_(2) fractional laser can be used as a new treatment for hypertrophic scars.