背景:关于在疤痕切除中使用分数CO2激光没有基于证据的指导。
目的:探讨点阵CO2激光治疗瘢痕疙瘩的有效性和安全性。
方法:在本荟萃分析中,我们搜索了PubMed,Embase,和Cochrane数据库从成立到2023年4月。我们仅纳入报告分数CO2激光治疗瘢痕疙瘩的研究。我们排除了重复发表的研究,不完整的研究,那些数据不完整的人,动物实验,文献综述,和系统的研究。
结果:汇总结果表明,温哥华疤痕量表(VSS)参数的身高加权平均差(WMD)=-1.10,95%置信区间(CI):-1.46至-0.74),色素沉着(WMD=-0.61,95%CI:-1.00至-0.21),和柔韧性(WMD=-0.90,95%CI:-1.17至-0.63)在分步CO2激光治疗瘢痕疙瘩后显着改善。然而,血管分布无明显变化.此外,治疗后总VSS显著改善(WMD=-4.01,95%CI:-6.22~-1.79).患者疤痕评估量表在治疗后显著改善(WMD=-15.31,95%CI:-18.31至-12.31)。关于安全,色素沉着过度的发生率,色素沉着减退,疼痛,毛细血管扩张症,萎缩5%,0%,11%,2%(95%CI:0%-6%),和0%(95%CI:0%-4%),分别。
结论:分数阶CO2激光治疗瘢痕疙瘩有效,可有效提高身高,色素沉着,和柔韧的疤痕,患者对这种治疗感到满意。进一步的研究应该探讨联合治疗的作用。
BACKGROUND: There is no evidence-based guidance on the use of fractional CO2 laser in the excision of scars.
OBJECTIVE: To explore the effectiveness and safety of fractional CO2 laser in the treatment of keloids.
METHODS: In this meta-analysis, we searched the PubMed, Embase, and Cochrane databases from inception to April 2023. We only included studies reporting fractional CO2 laser treatment of keloids. We excluded duplicate published studies, incomplete studies, those with incomplete data, animal experiments, literature reviews, and systematic studies.
RESULTS: The pooled results showed that the Vancouver Scar Scale (VSS) parameters of height weighted mean difference (WMD) = -1.10, 95% confidence interval (CI): -1.46 to -0.74), pigmentation (WMD = -0.61, 95% CI: -1.00 to -0.21), and pliability (WMD = -0.90, 95% CI: -1.17 to -0.63) were significantly improved after fractional CO2 laser treatment of keloids. However, vascularity did not significantly change. Additionally, the total VSS was significantly improved after treatment (WMD = -4.01, 95% CI: -6.22 to -1.79). The Patient Scars Assessment Scale was significantly improved after treatment (WMD = -15.31, 95% CI: -18.31 to -12.31). Regarding safety, the incidences of hyperpigmentation, hypopigmentation, pain, telangiectasia, and atrophy were 5%, 0%, 11%, 2% (95% CI: 0%-6%), and 0% (95% CI: 0%-4%), respectively.
CONCLUSIONS: Fractional CO2 laser is effective in the treatment of keloids and can effectively improve the height, pigmentation, and pliability of scars, and patients are satisfied with this treatment. Further studies should explore the role of combination therapy.