Clinical Observation Of Ultrapulse Fractional CO2 Laser In The Treatment Of Superficial Scar With Hyperpigmentation

Objective:To observe the clinical effect and safety of Ultra Pulse Encore fractional laser in the treatment of superficial scar with hyperpigmentation;to explore the factors related to its clinical treatment effect.Methods:A total of 57 patients with superficial scar and hyperpigmentation admitted to the plastic and cosmetic laser department of the people's hospital of Hunan province from July2011 to July 2018 were selected.All patients were treated with Ultra Pulse Encore fractional laser,and the energy,mode,scanning shape and spot size of the treatment were determined by the appearance of the scar.Efficacy evaluation indexes: 1.Two clinicians not related to the experiment made an objective effectiveness evaluation by comparing the photos before and after treatment.According to the degree of improvement,it can be classified as significantly effective(76-100%),effective(51-75%),generally effective(26-50%)and ineffective(0-25%).Total effective rate =(significant effective +effective)cases/total cases;2.The color of scar before and after treatment was scored by the observer,and the scoring criteria was the color score in the Patient and Observer Scar Assessment Scale(POSAS).The score was 1-10,with 1 being closest to normal skin and 10 being worst.3.Evaluation of patients' satisfaction before and after treatment,including:very satisfied,satisfied,generally satisfied and dissatisfied,satisfaction rate =(very satisfied + satisfied)cases/total cases;4.Physicians recorded the duration of nursing and all adverse reactions during each treatment,so as to evaluate the efficacy and safety.5.All data were statistically processed using SPSS 24.0 software.The measurement data were expressed as mean standard deviation,and the count data were analyzed by T test.p<0.05 was considered statistically significant.Results:1.In this study,the observer evaluated the efficacy of57 patients with superficial scar and pigmentation: a total of26 patients received only one treatment,of which 6 were significantly effective,16 were effective,3 were generally effective,and 1 was ineffective,with a total effective rate of 84.6%;A total of 17 cases were treated twice,3 cases were significantly effective,7 cases were effective,and the total effective rate was 58.8%.A total of 10 cases were treated for 3 times,among which 2 cases were significantly effective and8 cases were effective,with a total effective rate of 100%.The total effective rate was 66.7%.Only 1 patient was treated5 times and the effective rate was 100%.2.Among the 51 patients who were followed up successfully,the satisfaction rate was 68.6%;Among them,12 cases(23.5%)were very satisfied,23 cases(45.1%)were satisfied,10 cases(19.6%)were generally satisfied,and 6 cases(11.8%)were not satisfied.The duration of nursing care during the treatment was(10.76�3.22),in which 1 case was allergic to burn cream,and 1 case was hyperpigmentation,which slowly subsided.None of the remaining 55 cases(96.5%)showed hypopigmentation,subcutaneous tissue atrophy or skin infection.3.There was no correlation between the efficacy and patients' age,gender,lesion site,causes and medical history.the average age was 21.32�10.84 years old,and there were 20 children in total,12 children were effective and the effective rate was 60%,37 adults were effective and 33 patients were effective and the effective rate was 89.2%,and there was no significant difference between adults and children(P>0.05).37 cases were female,and the effective rate was 81.1%.Among the 20 male patients,the effective rate was 75%,and there was no significant difference between men and women(P>0.05).In this study,53 cases of facial lesions,the effective rate was79.2%;In 4 cases of limbs,the effective rate was 75%,and there was no statistical difference between the lesion site and the effective rate(P>0.05).Among them,31 cases were burned and burned,25 cases were effective,the effective rate was 80.6%;17 cases were traumatic,16 cases were effective,the effective rate was 94.1%;5 cases were color-sink after hemangio-tumor freezing,the effective rate was 40%,and 4 cases were infected.The effective rate was 60%,and the etiology and effectiveness were not statistically different(P>0.05).In terms of medical history,8 of 10 patients with a history of <3 years were effective,the effective rate was 80%;47 cases with a history of >3 years,37 cases were effective,the effective rate was53.8%,and there was no statistical difference between the length of the disease and the validity.(P>0.05).4.The therapeutic effect is related to the number of treatments.The more times of treatment,the greater the degree of improvement of pigmentation,the better the curative effect.Among the 57 cases,26 cases received only one treatment,and the scores before and after treatment were(4.50�1.63)and(2.52�1.14),and the color improved after treatment,and the difference was statistically significant(p<0.05).A total of17 cases were treated with the second treatment,and the color rating before and after the treatment were(4.13 � 1.57),(3.59�1.00)and(2.65�1.11),respectively.The color of the scar was improved before and after the treatment,and the difference was statistically significant(p<0.05).Treatment for three times in 10 cases,color grading for(5.20�1.81)before and after the treatment,(4.30� 1.85),(3.20� 1.81)(2.80 � 1.69),color has improved after treatment,the difference was statistically significant(p<0.05),for a total of 4 cases,four treatment scores before and after the treatment(7.75 � 0.96),(6.75 � 0.50),(5.52 � 0.96),(4.25 � 1.50),(3.00�1.83),color has improved after treatment,there was no statistically significant difference(p>0.05),It was considered that the sample size was too small.Since only 1patient was treated for the fifth time,its correlation and T value could not be calculated.Conclusion:1.Ultra Pulse Encore fractional laser has definite curative effect on superficial scar with hyperpigmentation and high safety.2.The effectiveness of Ultra Pulse Encore fractional laser on superficial scar with hyperpigmentation is independent of the patient's age,gender,lesion site,causes and medical history.3.The effect of Ultra Pulse Encore fractional laser on superficial scar with hyperpigmentation is related to the number of treatments.