Profile铒激光治疗瘢痕114例临床研究.docVIP

Profile铒激光治疗瘢痕114例临床研究[摘要] 目的 评价铒激光治疗各类病理性瘢痕的疗效。方法 从2007年11月～2008年12月,应用铒激光微剥脱模式分别治疗病理性瘢痕114例,其中凹陷性瘢痕72例和增生性瘢痕42例,分析两组病例疗效差别。结果 铒激光治疗瘢痕的总有效率为93.9%,凹陷性瘢痕组痊愈率、显效率和有效率分别为27.8%、81.9%和98.6%;增生性瘢痕组分别为11.9%、64.3%和85.7%。结论 铒激光治疗瘢痕总体疗效较好,凹陷性瘢痕的疗效明显优于增生性瘢痕。 [关键词] 铒激光; 病理性瘢痕; 凹陷性瘢痕; 增生性瘢痕 [中图分类号] R62 [文献标识码] A [文章编号] 1673-9701(2009)23-01-02 Erbium Laser in the Treatment of Pathological Scar:A Clinical Analysis of 114 Cases HUANG Hai ZHANG Jianping WANG Weizhen CHEN Lin Wuhan Yimei Cosmetology Hospital ,Wuhan,Hubei 430022,China [Abstract] ObjectiveTo evaluation the effect of Erbium laser on pathological scars. MethodsFrom Nov. 2007 to Dec. 2008,114 patients with pathological scars were treated by Erbium laser. Among the total 114 cases,there were 72 patients with pitted scar and 42 patients with hyperplastic scar. The difference of curative effect between pitted scars and hyperplastic scars was analyzed. ResultsThe total effective rate of pathological scars was 93.9%. The cure rate,excellence rate and effective rate of pitted scars were 27.8%,81.9% and 98.6%,respectively. And those of hyperplastic scars were 11.9%,64.3% and 85.7%,respectively. ConclusionThe effect of the pathological scar by Erbium laser is very good and safe,and the treatment effect of pitted scars is much better than that of hyperplastic scars. [Key Words]Erbium laser; Pitted scar; Hyperplastic scar 瘢痕的诊治是整形美容科常见的问题。从2007年11月～2008年12月,我科应用铒激光器(Er:YAG)治疗病理性瘢痕总计114例,报道如下。 1 临床资料 病程至少大于3个月的稳定期瘢痕患者114例,全部来自我科日常门诊。其中男性38例,女性76例;年龄6～52岁;面部瘢痕102例,躯干及四肢12例;瘢痕面积0.5～200cm2;凹陷性瘢痕72例,增生性瘢痕42例。 2 治疗方法及操作要点 2.1 仪器 采用Profile超脉冲铒激光(美国Sciton公司生产),波长2940nm,最大功率45W,脉宽100ηs,频率1～20Hz。 2.2 参数选择 根据瘢痕的皮损面积选择光斑直径2mm或4mm手具,面积超过20cm2的片状皮损可选择LAPG扫描器。选择治疗深度10～100ηm(能量密度2.5～25j/cm2)。 2.3 操作步骤 每次治疗前用数码相机采集皮损图像,摄影条件相对固定。术前皮损处封包5%复方利多卡因乳膏1h后,清除麻药。术野常规消毒后,选择直径合适的光斑磨削瘢痕组织,选择治疗深度一般选择15～30ηm(能量密度3.75～7.5j/cm2),光斑重叠10%～20%,从瘢痕边缘开始,由外周向瘢痕中央治疗,治疗过程酌情重复磨削2～3次,凹陷性瘢痕着重磨削瘢痕边缘,向中心渐浅;增生性瘢痕着重治疗瘢痕中心,至创面接近平