点阵激光治疗面颈部浅表性瘢痕疗效观察.docVIP

点阵激光治疗面颈部浅表性瘢痕疗效观察[摘要]目的：总结点阵激光治疗面颈部浅表性瘢痕的临床经验并观察其临床疗效。方法：采用点阵激光治疗不同原因所致面颈部浅表性瘢痕，根据疗效评定标准对治疗效果进行评价。结果：共治疗50例，一次治疗后的总显效率为62%。点阵激光治疗后创面愈合时间为5～14天，平均9天，无感染、新生瘢痕、明显色素沉着、色素减退等较严重并发症。结论：点阵激光治疗面颈部浅表性瘢痕疗效良好。 [关键词]点阵激光；浅表性瘢痕；治疗 [中图分类号]R751 R622[文献标识码]A [文章编号]1008-6455（2008）10-1508-02 Clinical observation of treating superficial scars in the face and neck with fractional laser TAN Jun,LI Gao-feng,WU Dong-hui,LI Bo （Department of Plastic and Cosmetic Surgery, the People’s Hospital of Hunan Province, Changsha 410005,Hunan，China） Abstract： ObjectiveTo sum up the clinical experience of treating superficial scars in the face and neck with fractional laser and observe the curative effect.MethodsThe superficial scars caused by acne, incision, contusion and burn were treated with ActiveFXUltraPulse Encore fractional laser. The curative rate were evaluated.Results 50 patients were involved.The total curative rate after one time treatment was 62%.After laser treatment,the wound healing time was 5～14 days,mean 9 days.the complications including infection,hypertrophic scar, hyperpigmentation, depigmentation were seldom occurred. ConclusionTreating the superficial scar in the face and neck with fractional laser can achieve satisfactory effect. Key words:fractional laser;superficial scar;treatment 浅表性瘢痕是一种稳定成熟性瘢痕，形成原因多为浅度烧烫伤、皮肤挫伤、痤疮和手术切口瘢痕等。位于面颈部的浅表性瘢痕因凹凸不平或色素改变而明显影响外观。传统的治疗方法有手术切除、砂纸、钻头、普通CO2激光或微晶磨削[1-3]。我科自2007年9月～2008年4月采用科医人公司必威体育精装版引进的ActiveFXUltraPulse Encore点阵激光治疗浅表性瘢痕50例，取得了良好的临床效果，现报道如下。 1资料和方法 1.1一般资料：50例面颈部浅表性瘢痕均来自我科门诊，其中男8例，女42例，年龄18～38岁，病程6个月～20年。痤疮瘢痕28例，手术伤口缝合瘢痕10例，挫伤瘢痕8例，浅度烧烫伤瘢痕4例。瘢痕凹凸深度或高度在3mm以内。瘢痕面积最小者约1cm×2cm，面积最大者约10cm×15cm，凹凸不平，色泽不均。 1.2仪器：ActiveFXUltraPulse Encore点阵激光脉冲波能量100～225mJ，能量密度7.0～16.9J/cm2，功率1.0～60.0Ｗ，频率10～60Hz。配有特殊的电脑图形发生器(CPG)手具。可发射出正六边形、菱形、正方形、条形、长方形、三角形和空心圈等7种图形，图形大小有1～9等，密度亦有1～9级。 1.3治疗方法：采用复方利多卡因乳膏表面麻醉或者利多卡因液浸润麻醉。根据瘢痕凹凸不平高度选择激光能量大小，越不平，能量越大。根据瘢痕面积选择点阵图形大小及密度，面积越大，可相应选择大图形、高密度。瘢痕磨削时，通常需变换点阵激光参数。对于大面积凹凸不平、肤色不均瘢痕，可先以大图形、高密