透明质酸敷料联合超脉冲点阵CO2激光对面部痤疮凹陷性瘢痕患者瘢痕修复情况及疼痛程度的影响

林琳 宋俊红 陈立荣

[摘要]目的：探討透明质酸敷料联合超脉冲点阵CO2激光对面部痤疮凹陷性瘢痕患者瘢痕修复情况及疼痛程度的影响。方法：选取2018年2月-2020年2月河北医科大学第一医院皮肤科收治的面部痤疮凹陷性瘢痕患者64例，通过随机数字表法将其分为研究组和对照组，每组32例。对照组给予超脉冲点阵CO2激光治疗，研究组给予透明质酸敷料联合超脉冲点阵CO2激光治疗，两组均治疗3个月。比较两组治疗期间的结痂、痂皮脱落、愈合时间及不良反应发生情况，观察治疗前和治疗1、3个月后的瘢痕修复情况及疼痛程度。结果：治疗期间，研究组结痂时间、痂皮脱落时间及愈合时间均短于对照组（P<0.05）。治疗1、3个月后，两组ECCA、VAS评分较治疗前呈逐渐降低趋势，研究组低于对照组（P<0.05）。治疗期间，两组不良反应发生率比较，研究组低于对照组（9.38%vs31.25%，P<0.05）。结论：透明质酸敷料联合超脉冲点阵CO2激光可明显改善面部痤疮凹陷性瘢痕患者瘢痕修复情况及疼痛程度，有助于促进患者病情恢复，且具有较高安全性。

[关键词]寻常痤疮;凹陷性瘢痕;面部;透明质酸敷料;超脉冲点阵CO2激光;瘢痕修复;疼痛

[中图分类号]R619+.6    [文献标志码]A    [文章编号]1008-6455（2021）11-0048-03

Effects of Hyaluronic Acid Dressing Combined with Ultra-pulse CO2 Fractional Laser on Scar Repair and Pain Degree in Patients with Depressed Facial Acne Scar

LIN Lin， SONG Jun-hong， CHEN Li-rong

（Department of Dermatology， the First Hospital of Hebei Medical University， Shijiazhuang 050000， Hebei， China）

Abstract： Objective  To investigate the effects of hyaluronic acid dressing combined with ultra-pulse CO2 fractional laser on scar repair and pain degree in patients with depressed facial acne scar. Methods  64 cases of patients with depressed facial acne scar were admitted to the department of dermatology， first hospital of hebei medical university between February 2018 and February 2020 as the research objects， and they were divided into the research group and the control group by random number table method， with 32 cases in each group. The control group was treated with ultra-pulse CO2 fractional laser， and the treatment group was treated with hyaluronic acid dressing combined with ultra-pulse CO2 fractional laser. Both groups were treated for 3 months. The scabs， exfoliation， healing time and the incidence of adverse reactions were compared during the treatment between the two groups; the scar repair and pain degree were compared before and after 1， 3 months of treatment between the two groups. Results  During the treatment， the time of scab formation， exfoliation and healing time in the research group were shorter than the control group （P<0.05）. After 1， 3 months of treatment， the ECCA and VAS scores were gradually lower than before treatment in the two groups， and the research group were lower than the control group （P<0.05）. During the treatment， comparison of the incidence of adverse reactions between the two groups， the research group was lower than the control group （9.38% vs 31.25%， P<0.05）. Conclusion  Hyaluronic acid dressing combined with ultra-pulse CO2 fractional laser could significantly improve the scar repair and pain degree of patients with depressed facial acne scar， thereby helping to promote the recovery of the patients condition， and with higher safety.

Key words： acne vulgaris; depressed scar; facial; hyaluronic acid dressing; ultra-pulse CO2 fractional laser; scar repair; pain

寻常痤疮是一种毛囊皮脂腺慢性炎症性皮肤病，愈合过程中腺体及皮肤胶原的损害可形成面部凹陷性瘢痕，严重影响患者外观形象及生活质量[1-2]。目前，临床治疗面部痤疮凹陷性瘢痕多以激光治疗为主，其中超脉冲点阵CO2激光可消融瘢痕组织，改善瘢痕外观，但部分患者经该方式治疗后易产生色素沉着、皮肤红斑等不良反应，影响预后[3]。透明质酸敷料主要含透明质酸成分，透明质酸作为高分子量非蛋白酸性黏多糖，具有调节蛋白质、水电解质扩散及运转的作用，可有效促进创伤愈合，修复创面[4]。本研究探讨两者联合应用对面部痤疮凹陷性瘢痕患者瘢痕修复情况及疼痛程度的影响，以期为临床治疗面部痤疮凹陷性瘢痕提供指导，现报道如下。……