Objective To explore the effect and safety of fractional 1565 nm laser on white striae gravidarum (SG) in abdomen and observe the influencing factors of treatment effect.Methods Thirty-six patients,aged 24-39 years old,were randomly divided into two groups(group A,n =16,group B,n =20):patients in group A underwent two passes of laser treatment:striae were locally scanned at moderate level energy(35 mJ/μb) with high density(300 dot/cm2),and high level energy (45 mJ/μb)with low density(150 dot/cm2) was adopted for the whole area.Group B received one pass of treatment at moderate energy with high density 35 mJ/μb,300 dot/cm2).All patients received three laser treatments at a 6 weeks interval.Improvement of SG appearance was assessed by blinded reviewers,3 months after the last treatment,using a percentage category scale.Meanwhile,patients satisfaction was evaluated.The impact of skin aging on laser treatment was evaluated.Patient satisfaction scores and side effects were evaluated.Results All patients completed the overall trial.The average improvement of scores was 1.69±0.95,which contributed to a fairly good response rate of 88.89％.The patients satisfactory and very satisfactory rate was 58.3％ (21/36).There was no significant difference in improvement score between group A(1.88±0.89) and group B(1.55± 1.00) (P＜ 0.01).The operation duration of group B was shorter than group A,(29.6±4.9) min vs.(53.7±5.5)min,P＜0.05.There was a moderate negative correlation between aging and laser treatment effect (r=-0.553).The abnormal color of skin (erythema and post-inflammatory hyperpigmentation) in group A lasted longer than group B,(9.17 ± 4.03) d vs.(6.73 ± 2.29) d,P ＜ 0.05.The pain score during treatment was tolerable,with the score of 2.61±0.76.Conclusions The treatment with fractional 1565 nm laser can.improve the appearance of SG.It is more timesaving when the entire implicated area treated by one pass at moderate level energy with high density.Skin aging will discount the effect.%目的 探讨点阵1565 nm激光治疗白色妊娠纹的安全有效方案及其影响因素.方法 中国医学科学院北京协和医学院整形外科医院收治36例腹部白色妊娠纹患者,年龄24～39岁.采用随机数字表法分为2个治疗组:A组16例,行双遍治疗,即皮损内中能量、高密度治疗,能量35 mJ/μb、密度300 dot/cm2,皮损累及区高能量、低密度治疗,能量45 mJ/μb、密度150 dot/cm2;B组20例,行单遍治疗,即整个区域中能量、高密度治疗,能量35 mJ/μb、密度300 dot/cm2.6周治疗1次,3次1个疗程.每次治疗前及末次治疗后3个月进行拍照,评估妊娠纹改善情况及调查患者满意度.同时,评估皮肤老化程度,分析年龄、皮肤老化对疗效的影响.观察不良反应发生的情况.结果 总体妊娠纹改善情况(1.69±0.95)分;患者满意13例、非常满意8例、基本满意7例、不满意8例.A组治疗后妊娠纹改善情况(1.88±0.89)分,B组(1.55±:1.00)分,2组比较差异无统计学意义(P＞0.05).A组治疗过程(53.7±5.5) min,B组(29.6±4.9) min,B组操作时间更短,差异具有统计意义(P＜0.05).A组红斑期(9.17±4.03)d,较B组(6.73±2.29)d略长,差异具有统计意义(P＜0.05).治疗后疼痛指数,A组为2.35±0.74,B组为2.81±0.73,2组比较差异无统计学意义(P=0.072).皮肤老化程度、年龄等与治疗效果呈负相关(P＜0.05).结论 采用点阵1565 nm激光,整个病变区域采用中能量、高密度的单遍治疗方案,操作省时,能有效地改善妊娠纹,且结痂、红斑等不良反应均较轻.
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