富血小板血浆局部外用/皮内注射联合二氧化碳点阵激光或铒激光治疗痤疮后瘢痕。
Fractional Carbon Dioxide Laser or Erbium:Yttrium-Aluminum-Garnet Laser Assisted by Topical Application/Intradermal Injection of Platelet-Rich Plasma for Postacne Scars.
机构信息
From the Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College; and Xi Yuan Hospital, Chinese Academy of Medical Sciences.
出版信息
Plast Reconstr Surg. 2021 Dec 1;148(6):915e-927e. doi: 10.1097/PRS.0000000000008513.
BACKGROUND
Fractional carbon dioxide or erbium:yttrium-aluminum-garnet (YAG) laser combined with platelet-rich plasma has been used for postacne scars. Nevertheless, there is limited evidence on its use because of the small size of relevant studies. This study aims to evaluate the efficacy of platelet-rich plasma-assisted laser for postacne scars.
METHODS
Randomized controlled trials comparing carbon dioxide or erbium:YAG laser combined with platelet-rich plasma to laser alone were searched for using the PubMed, Embase, Web of Science, Cochrane Library, and Google Scholar databases.
RESULTS
In total, 13 studies involving 672 cases were included. The overall degree of clinical improvement favored platelet-rich plasma combined with carbon dioxide laser (mean difference, 0.55; 95 percent CI, 0.40 to 0.70) or erbium:YAG laser (mean difference, 0.63; 95 percent CI, 0.31 to 0.96). Notably, the use of carbon dioxide laser combined with platelet-rich plasma was more effective in both greater than 50 percent improvement of acne scars (OR, 1.63; 95 percent CI, 1.10 to 2.42) and greater than 75 percent improvement of acne scars (OR, 2.78; 95 percent CI, 1.75 to 4.42), compared with laser alone. Erbium:YAG laser combined with platelet-rich plasma was more effective in greater than 75 percent improvement of acne scars compared with laser alone (OR, 3.45; 95 percent CI, 1.31 to 9.05). Moreover, patient satisfaction was significantly higher with platelet-rich plasma combined with carbon dioxide laser (OR, 2.98; 95 percent CI, 1.72 to 5.16) or erbium:YAG laser (OR, 2.88; 95 percent CI, 1.33 to 6.21) compared to laser alone.
CONCLUSION
This meta-analysis provides reliable evidence that fractional carbon dioxide or erbium:YAG laser combined with platelet-rich plasma is an effective and safe combination therapy for postacne scars.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.
背景
分比二氧化碳或铒雅铬（YAG）激光联合富血小板血浆已被用于治疗痤疮后疤痕。然而，由于相关研究规模较小，其应用证据有限。本研究旨在评估富血小板血浆辅助激光治疗痤疮后疤痕的疗效。
方法
使用 PubMed、Embase、Web of Science、Cochrane 图书馆和 Google Scholar 数据库检索比较二氧化碳或铒 YAG 激光联合富血小板血浆与激光单独治疗的随机对照试验。
结果
共纳入 13 项研究，共 672 例患者。总体临床改善程度倾向于富血小板血浆联合二氧化碳激光（平均差值，0.55；95%置信区间，0.40 至 0.70）或铒 YAG 激光（平均差值，0.63；95%置信区间，0.31 至 0.96）。值得注意的是，与激光单独治疗相比，二氧化碳激光联合富血小板血浆在痤疮疤痕改善大于 50%（OR，1.63；95%置信区间，1.10 至 2.42）和大于 75%（OR，2.78；95%置信区间，1.75 至 4.42）方面更有效。与激光单独治疗相比，铒 YAG 激光联合富血小板血浆在痤疮疤痕改善大于 75%方面更有效（OR，3.45；95%置信区间，1.31 至 9.05）。此外，与激光单独治疗相比，富血小板血浆联合二氧化碳激光（OR，2.98；95%置信区间，1.72 至 5.16）或铒 YAG 激光（OR，2.88；95%置信区间，1.33 至 6.21）患者满意度显著更高。
结论
本荟萃分析提供了可靠的证据，表明分比二氧化碳或铒 YAG 激光联合富血小板血浆是治疗痤疮后疤痕的一种有效且安全的联合治疗方法。
临床问题/证据水平：治疗性，II 级。
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