微型环钻切除术联合CO2点阵激光治疗萎缩性痤疮瘢痕的疗效与安全性评估OA
Evaluation of the efficacy and safety of micro-punch excision combined with CO2 fractional laser in the treatment of atrophic acne scars
目的 评价微型环钻切除术联合CO2点阵激光治疗萎缩性痤疮瘢痕的临床疗效和安全性.方法 选取2023年9月至2024年9月河南医药大学第三附属医院皮肤科70例面部萎缩性痤疮瘢痕患者,随机分为观察组(微型环钻切除术联合CO2点阵激光)和对照组(单纯CO2点阵激光),每组35例,分别于治疗前、第1次治疗后3个月及第2次治疗后3个月评估临床疗效(盲态评估)、痤疮瘢痕严重程度(ECCA权重评分)、疼痛(VAS评分)、焦虑(SAS评分)、患者满意度及不良反应发生情况.结果 第1次治疗后3个月,观察组总有效率为97.14％,明显高于对照组的82.86％(x2=8.57,P=0.003).第2次治疗后,观察组总有效率达100％,明显高于对照组的82.86％(x2=13.79,P=0.006);观察组 ECCA 评分下降较对照组更明显(18.91±9.05 比 25.46±8.04,t=4.53,P＜0.05),VAS评分高于对照组(6.02±1.03比4.96±1.92,t=4.07,P＜0.001),满意度评分显著高于对照组(8.89±1.35比6.98±1.76,t=7.20,P＜0.001).观察组第一次治疗后SAS评分高于对照组,差异有统计学意义(t=4.57,P＜0.001),而第二次治疗后评分无明显差异(t=1.09,P=0.279).两组患者均无严重不良事件发生,组间不良反应发生率无明显差异(P＞0.05).结论 微型环钻切除术联合CO2点阵激光治疗萎缩性痤疮瘢痕疗效优于单纯激光治疗,能显著改善瘢痕严重程度、缓解患者焦虑并提高满意度,且安全性良好.
Objective To evaluate the efficacy and safety of micro-punch excision combined with CO2 fractional laser treatment for facial atrophic acne scars,and to compare it with CO2 frac-tional laser therapy alone.Methods From September 2023 to September 2024,70 patients with facial atrophic acne scars admitted to the Department of Dermatology at the Third Affiliated Hospi-tal of Henan Medical University were randomly divided into an experimental group and a control group,with 35 cases in each group.The experimental group received micro-punch excision com-bined with CO2 fractional laser treatment,while the control group received CO2 fractional laser monotherapy.Prior to treatment and three months after the first and second treatments,clinical ef-ficacy,ECCA scores,pain VAS scores,adverse reactions,anxiety scores,and patient satisfaction were compared between the two groups.Results Three months after the first treatment,the total effective rate in the experimental group was significantly higher than that in the control group(97.14％vs.82.86％,x2=8.57,P=0.003).Three months after the second treatment,the total effective rate in the experimental group remained higher than that in the control group(100％vs.82.86％,x2=13.79,P=0.006).Additionally,combination therapy significantly reduced acne scars(ECCA score)compared to the control group(18.91±9.05 vs.25.46±8.04,t=4.53,P＜0.05).Moreover,the pain VAS score was higher in the experimental group than in the control group(6.02±1.03 vs.4.96±1.92,t=4.07,P＜0.001).After the second treatment,patient satisfaction scores were also higher in the experimental group compared to the controls(8.89±1.35 vs.6.98±1.76,t=7.20,P＜0.001).The SAS score of the observation group was significantly higher than that of the control group after the first treatment(t=4.57,P＜0.001),but there was no significant difference after the second treatment(t=1.09,P=0.279).However,the incidence of adverse reactions was comparable between the two groups(P＞0.05).Conclusions Micro-punch excision combined with CO2 fractional laser therapy ex-hibits superior benefits compared to CO2 fractional laser monotherapy for the treatment of atrophic acne scars.This combination therapy can markedly improve acne scars,mitigate patient anxiety,and enhance patient satisfaction scores.
朱明明;翟慧娟;梁静;焦园园;康志楠;何坤铭;李晋雪;张钰沅
河南医药大学第三附属医院,河南 新乡 453003河南医药大学第三附属医院,河南 新乡 453003河南医药大学第三附属医院,河南 新乡 453003河南医药大学第三附属医院,河南 新乡 453003河南医药大学第三附属医院,河南 新乡 453003河南医药大学第三附属医院,河南 新乡 453003河南医药大学第三附属医院,河南 新乡 453003河南医药大学第三附属医院,河南 新乡 453003
痤疮萎缩性瘢痕环钻切除术CO2点阵激光
acneatrophic scarmicro-punch resectionCO2 fractional laser
《皮肤性病诊疗学杂志》 2026 (3)
186-192,7
河南省医学科技攻关计划联合共建项目(LHGJ20230547)
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