本文關(guān)鍵詞： 尋常痤瘡 痤瘡后紅斑 染料激光 強(qiáng)脈沖光 隨機(jī)對(duì)照試驗(yàn)　出處：《昆明醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：[目的]:評(píng)價(jià)及對(duì)比強(qiáng)脈沖光和595 nm染料激光治療痤瘡后紅斑的臨床療效及安全性。[方法]:采用隨機(jī)自身左右面部對(duì)照臨床試驗(yàn)研究的方法,選取20名患有痤瘡后紅斑的患者,每個(gè)患者的一側(cè)面頰隨機(jī)分配接受強(qiáng)脈沖光或595nm染料激光治療3次,時(shí)間間隔為4周;分別在每次治療前以及最后一次治療1個(gè)月后使用VISIA拍照,通過VISIA評(píng)估治療前后皺紋、紋理、毛孔分值,測(cè)量紅斑值,觀察紅斑值變化;通過四分紅斑嚴(yán)重程度表評(píng)價(jià)治療前后雙側(cè)面部紅斑嚴(yán)重程度,每次治療后均填寫疼痛評(píng)分表、不良反應(yīng)記錄表,最后一次治療通過問卷形式對(duì)患者進(jìn)行滿意度調(diào)查。[結(jié)果]:強(qiáng)脈沖光側(cè)紅斑值平均數(shù)治療前472.25±86.02,治療后357.15±82.71;595nm染料激光側(cè)紅斑值平均數(shù)治療前476.40±74.25,治療后360.05±64.83,經(jīng)重復(fù)測(cè)量資料方差分析,患者紅斑值隨治療時(shí)間有一定變化(F=197.666, P0.001),可以認(rèn)為隨治療時(shí)間延長(zhǎng),患者紅斑值有所降低。兩組治療效果有差異(F=1173.909, P0.001),可以認(rèn)為強(qiáng)脈沖光側(cè)治療效果優(yōu)于595nm染料激光側(cè);強(qiáng)脈沖光側(cè)皺紋、紋理、毛孔治療前后差異均有統(tǒng)計(jì)學(xué)意義(P0.001 ),染料激光側(cè)皺紋、紋理、毛孔治療前后差異均有統(tǒng)計(jì)學(xué)意義(P0.001),其中,強(qiáng)脈沖光側(cè)與595nm染料激光側(cè)治療對(duì)比除紋理差異無統(tǒng)計(jì)學(xué)意義外(P=0.444),其余指標(biāo)差異均有統(tǒng)計(jì)學(xué)意義(P0.05);強(qiáng)脈沖光側(cè)患者治療前后四分紅斑嚴(yán)重程度差異有統(tǒng)計(jì)學(xué)意義(Z=28.735, P0.001),即強(qiáng)脈沖光側(cè)治療有效,595nm染料激光側(cè)患者治療前后四分紅斑嚴(yán)重程度差異有統(tǒng)計(jì)學(xué)意義(Z=31.450,P0.001),即595 nm染料激光側(cè)治療有效。通過對(duì)激光術(shù)后VAS視覺評(píng)分研究,發(fā)現(xiàn)595nm染料激光疼痛度低于強(qiáng)脈沖光,兩者差異有統(tǒng)計(jì)學(xué)意義(P0.05);通過對(duì)滿意度的調(diào)查發(fā)現(xiàn),對(duì)595nm染料激光評(píng)價(jià)滿意和非常滿意的患者有17例,對(duì)強(qiáng)脈沖光評(píng)價(jià)滿意和非常滿意的有15例,但兩者差異無統(tǒng)計(jì)學(xué)意義(P0.05)。強(qiáng)脈沖光不良反應(yīng)包括紅斑、灼燒感、緊繃感、水皰、色素沉著;595nm染料激光不良反應(yīng)包括紅斑、紫癜反應(yīng),所有不良反應(yīng)均在數(shù)小時(shí)至數(shù)天消失。[結(jié)論]:應(yīng)用強(qiáng)脈沖光及595nm染料激光治療痤瘡后紅斑均安全有效,適合臨床推廣應(yīng)用,強(qiáng)脈沖光相較于595nm染料激光治療療效更優(yōu),但疼痛度更高,強(qiáng)脈沖光治療皺紋、毛孔的療效優(yōu)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 鹵86.02 before treatment, 357.15 鹵82.71 nm after treatment, 476.40 鹵74.25 before treatment and 360.05 鹵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.
【學(xué)位授予單位】：昆明醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R758.733

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