split-face模式研究强脉冲光及595nm染料激光治疗痤疮后面部红斑的疗效

发布时间：2018-02-27 19:52

本文关键词： 寻常痤疮痤疮后红斑染料激光强脉冲光随机对照试验　出处：《昆明医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：[目的]:评价及对比强脉冲光和595 nm染料激光治疗痤疮后红斑的临床疗效及安全性。[方法]:采用随机自身左右面部对照临床试验研究的方法,选取20名患有痤疮后红斑的患者,每个患者的一侧面颊随机分配接受强脉冲光或595nm染料激光治疗3次,时间间隔为4周;分别在每次治疗前以及最后一次治疗1个月后使用VISIA拍照,通过VISIA评估治疗前后皱纹、纹理、毛孔分值,测量红斑值,观察红斑值变化;通过四分红斑严重程度表评价治疗前后双侧面部红斑严重程度,每次治疗后均填写疼痛评分表、不良反应记录表,最后一次治疗通过问卷形式对患者进行满意度调查。[结果]:强脉冲光侧红斑值平均数治疗前472.25±86.02,治疗后357.15±82.71;595nm染料激光侧红斑值平均数治疗前476.40±74.25,治疗后360.05±64.83,经重复测量资料方差分析,患者红斑值随治疗时间有一定变化(F=197.666, P0.001),可以认为随治疗时间延长,患者红斑值有所降低。两组治疗效果有差异(F=1173.909, P0.001),可以认为强脉冲光侧治疗效果优于595nm染料激光侧;强脉冲光侧皱纹、纹理、毛孔治疗前后差异均有统计学意义(P0.001 ),染料激光侧皱纹、纹理、毛孔治疗前后差异均有统计学意义(P0.001),其中,强脉冲光侧与595nm染料激光侧治疗对比除纹理差异无统计学意义外(P=0.444),其余指标差异均有统计学意义(P0.05);强脉冲光侧患者治疗前后四分红斑严重程度差异有统计学意义(Z=28.735, P0.001),即强脉冲光侧治疗有效,595nm染料激光侧患者治疗前后四分红斑严重程度差异有统计学意义(Z=31.450,P0.001),即595 nm染料激光侧治疗有效。通过对激光术后VAS视觉评分研究,发现595nm染料激光疼痛度低于强脉冲光,两者差异有统计学意义(P0.05);通过对满意度的调查发现,对595nm染料激光评价满意和非常满意的患者有17例,对强脉冲光评价满意和非常满意的有15例,但两者差异无统计学意义(P0.05)。强脉冲光不良反应包括红斑、灼烧感、紧绷感、水疱、色素沉着;595nm染料激光不良反应包括红斑、紫癜反应,所有不良反应均在数小时至数天消失。[结论]:应用强脉冲光及595nm染料激光治疗痤疮后红斑均安全有效,适合临床推广应用,强脉冲光相较于595nm染料激光治疗疗效更优,但疼痛度更高,强脉冲光治疗皱纹、毛孔的疗效优于595nm染料激光。
[Abstract]:Objective: to evaluate and compare the efficacy and safety of intense pulsed light and 595 nm dye laser in the treatment of postacne erythema. One cheek of each patient was randomly assigned to receive intense pulsed light or 595 nm dye laser for 3 times, with an interval of 4 weeks. VISIA was taken before each treatment and 1 month after the last treatment. Wrinkles before and after treatment were evaluated by VISIA. Texture, pore score, measure erythema value, observe the change of erythema value, evaluate the degree of erythema on both sides before and after treatment by quadrilateral erythema severity table, fill out pain score form after each treatment, and record the adverse reaction. The satisfaction of patients was investigated by questionnaire in the last treatment. [results]: the mean value of erythema was 472.25 卤86.02 before treatment, 357.15 卤82.71 nm after treatment, 476.40 卤74.25 before treatment and 360.05 卤64.83 after treatment. The erythema value of the patients varied with the time of treatment (P 0.001), and it could be considered that the value of erythema decreased with the prolongation of the treatment time. There were differences in the therapeutic effects between the two groups (F 1173.909, P 0.001), and it could be concluded that the therapeutic effect of intense pulsed light side was better than that of 595 nm dye laser side. There were significant differences in the side wrinkles, textures and pores of intense pulse light before and after treatment (P 0.001), while there were significant differences in the side wrinkles, textures and pores of dye laser before and after treatment (P 0.001). Compared with 595 nm dye laser side treatment, there was no significant difference in texture, but there was significant difference in other indexes (P 0.05), and there was significant difference in the severity of erythema in patients with intense pulse light side before and after treatment. There were significant differences in the severity of erythema in patients with severe pulsed light side treatment before and after treatment. There was a significant difference in the severity of erythema in patients with dyestuff side of 595 nm laser, that is, 595 nm dye laser side, which was effective in treating the side of erythema. The visual score of VAS after laser operation was studied. It was found that the pain degree of 595 nm dye laser was lower than that of intense pulse light, and the difference was statistically significant (P 0.05). There were 15 cases satisfied with and very satisfied with the evaluation of intense pulsed light, but the difference was not statistically significant (P 0.05). Adverse reactions of intense pulse light included erythema, burning sensation, tension, blister, pigmentation and 595 nm dyestuff adverse reactions, including erythema. All the adverse reactions disappeared in hours to days. [conclusion]: it is safe and effective to use intense pulsed light and 595 nm dye laser in the treatment of erythema after acne, which is suitable for clinical application. Compared with 595 nm dye laser, intense pulsed light is better than 595 nm dye laser, but the pain is higher. Strong pulse light is better than 595 nm dye laser in treating wrinkles and pores.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R758.733

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