透明质酸联合氨甲环酸真皮内局部电子注射治疗黄褐斑的疗效分析

Efficacy analysis of local intradermal electronic injection of hyaluronic acid and tranexamic acid on melasma

目的观察透明质酸联合氨甲环酸真皮内局部电子注射治疗黄褐斑的临床疗效。方法回顾性分析31例黄褐斑患者经透明质酸联合氨甲环酸真皮内局部电子注射治疗前后的临床资料,通过黄褐斑面积和严重指数(MASI)评分以及医生整体评估(PGA)评分评估治疗效果,观察不良事件发生情况。结果治疗后,31例患者中27例得到不同程度的改善,3例改善不明显,1例皮疹范围扩大。患者治疗前的MASI评分为(15.45±1.07)分、治疗后为(10.83±0.76)分;治疗后的MASI评分低于治疗前,差异具有统计学意义(P<0.05)。患者治疗后平均PGA评分为4.16分,为轻度改善。不良事件包括注射过程中的疼痛、点状渗血、皮丘样轻度肿胀,几乎发生于所有患者,一般2~3 d自行消退;5例患者注射后出现多发瘀点,1周内完全吸收,考虑可能跟电子注射器负压过大有关;1例患者黄褐斑加重,皮损范围较治疗前扩大,推测可能该患者处于疾病活动期。结论透明质酸联合氨甲环酸真皮内局部电子注射治疗黄褐斑可得到轻度改善,不良反应少。

Objective To observe the clinical efficacy of local intradermal electronic injection of hyaluronic acid and tranexamic acid on melasma.Methods The clinical data of 31 patients with melasma before and after treatment with local intradermal electronic injection of hyaluronic acid and tranexamic acid on melasma were retrospectively analyzed.The therapeutic effects were assessed by melasma area and severity index(MASI)scores and physician global assessment(PGA)scores,and the occurrence of adverse events was observed.Results After treatment,27 of the 31 patients showed varying degrees of improvement,3 patients showed insignificant improvement,nd 1 patient had enlarged rash.The MASI score of patients was(15.45±1.07)points before treatment and(10.83±0.76)points after treatment.The MASI score after treatment were lower than those before treatment,and the difference was statistically significant(P<0.05).The average PGA score of patients after treatment was 4.16 points,which was a mild improvement.Adverse events include pain during injection,punctate bleeding,and mild swelling of skin mounds,which occurred in almost all patients,and generally resolved spontaneously within 2-3 d;5 patients developed multiple petechiae after injection,which was completely absorbed within 1 week,which may be related to the excessive negative pressure of the electronic injector.In 1 patient,the chloasma was aggravated,and the skin lesions expanded compared with that before treatment.It is speculated that the patient may be in the active disease stage.Conclusion Local intradermal electronic injection of hyaluronic acid and tranexamic acid on melasma can slightly improve the melasma with less adverse reactions.