点阵激光对膨胀纹防治作用的研究

发布时间：2018-06-29 13:49

  本文选题：膨胀纹 + 点阵激光　； 参考：《复旦大学》2011年硕士论文

【摘要】：【背景】膨胀纹是主要发生于全身的张力部位的萎缩性条索,寻找安全又有效的治疗方法是现在目前研究的主要方向。 【目的】了解点阵激光对中国人膨胀纹的治疗作用并寻找合适治疗参数,建立合理的治疗方案,提高疗效的同时减少副作用的发生。 【方法】共招募60例躯干四肢膨胀纹患者,其中43名女性,17名男性。使用点阵激光进行治疗。采用随机数码表随机分为3组。分为对照组、ActiveFX及DeepFX组。每位受试者接收1次至3次的治疗。基线时、每次治疗前以及每次随访时由三名不参与治的皮肤科临床医生单独对受试者进行膨胀纹的评分并以数码相机记录等,并记录疗效情况、不良反应发生情况及受试者对治疗效果进行自评。对病例的治疗前和治疗后皮损进行反射式共聚焦显微镜(Reflectance confocal microscopy, RCM)检测,并对两名患者进行治疗前及治疗后1个月的免疫组化。 【结果】60名病例完成治疗及随访。根据每位患者在基线时及末次治疗后3个月随访时作出的评价发现,对治疗组和对照组分析结果表明,治疗组在总体改善、皮肤粗糙度方面均与对照组有显著性差异(P0.01)。而DeepFX与对照组相比较,在皮肤深度上有显著性差异(P0.01)。将ActiveFX与DeepFX两组比较疗效,发现他们之间存在显著性差异,而在粗糙度、皮肤深度两项有统计学意义(P0.05)。患者的满意度自评结果提示治疗组与对照组均有显著性差异(P0.01)。将ActiveFX与DeepFX两组比较后存在显著性差异。SD分型分析后发现各组间差异存在统计学意义(P0.05),激光治疗对Ⅰ型及Ⅵ型SD均有良好的临床疗效。治疗次数为3次的病人其预后最佳,组间存在差异。治疗组与对照组相比色素沉着上有显著性差异(P0.01)。两组治疗组比较下来DeepFX疼痛度较ActiveFX明显。RCM检测示治疗后在1周可见毛细血管扩张、水肿等炎性反应,1个月后可见到胶原纤维呈网状排列。免疫组化结果示SD因治疗后组织真皮增厚、毛细血管扩张及水肿等炎性反应。胶原蛋白Ⅰ及胶原蛋白Ⅲ在治疗后染色呈阳性。DeepFX方法在总体改善、粗糙度及皮肤深度等评价均较ActiveFX为佳。患者的满意度自评结果提示治疗组的满意度均高于对照组,其中DeepFX治疗的患者满意度最高。激光治疗对Ⅰ型及Ⅵ型的SD有明显的临床疗效。治疗3次的病人其预后最佳,副作用评价显示,ActiveFX及DeepFX均可见轻度色素沉着的表现,DeepFX疼痛度较ActiveFX明显。点阵激光能安全又有效的治疗膨胀纹。
[Abstract]:[background] expansion lines are atrophic strips that mainly occur in the tension part of the body. To find a safe and effective treatment method is the main research direction at present. [objective] to understand the therapeutic effect of dot array laser on swelling stria in Chinese, to find out the appropriate treatment parameters, and to establish a reasonable treatment plan. [methods] A total of 60 patients with swelling marks of trunk and extremities were recruited, including 43 women and 17 men. A dot array laser was used to treat the patients. A random code list was used to divide the data into 3 groups. They were divided into two groups: active FX and DeepFX groups. Each subject received one to three treatments. At baseline, before each treatment and at each follow-up, three dermatologists who were not involved in the treatment separately scored the swelling lines on the subjects and recorded them with digital cameras, and recorded the curative effects. Adverse reactions and self-evaluation of the therapeutic effect were carried out. Reflectance confocal microscopy (RCM) was used to detect the skin lesions before and after treatment, and immunohistochemical staining was performed on two patients before and one month after treatment. [results] 60 cases were treated and followed up. According to the evaluation of each patient at baseline and 3 months after the last treatment, the results of analysis of treatment group and control group showed that there were significant differences in overall improvement and skin roughness between the treatment group and the control group (P0.01). Compared with the control group, DeepFX had a significant difference in skin depth (P0.01). Comparing the efficacy of active FX and DeepFX, we found that there were significant differences between them, but there were significant differences in roughness and skin depth (P0.05). The results of self-evaluation of patients' satisfaction indicated that there was significant difference between the treatment group and the control group (P0.01). There was significant difference between active FX group and DeepFX group. SD typing analysis showed that there was significant difference between the two groups (P0.05). Laser therapy had good clinical effect on type 鈪，

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