PRP联合自体脂肪/HA治疗面部凹陷瘢痕疗效比较

Comparison of the Therapeutic Effects of PRP Combined with Autologous Fat/HA in the Treatment of Facial Depressed Scars

摘要: 目的：比较富血小板血浆(PRP)联合自体脂肪与联合透明质酸(HA)治疗面部凹陷瘢痕的疗效。方法：选取2023年1月~2024年12月我院门诊60例患者，随机分为实验组(PRP + 脂肪)和对照组(PRP + HA)各30例，均行联合填充治疗。术前及术后1、3、6个月用ECCA量表评估疗效，统计术后6个月满意度并记录不良反应。结果：术前两组ECCA评分无统计学差异(p > 0.05)；术后1、3个月两组评分均显著降低(p < 0.001)，组间无差异(p > 0.05)；术后6个月实验组评分(38.83 ± 2.81)显著低于对照组(45.33 ± 3.01) (p < 0.001)，且实验组治疗前后差异仍具统计学意义(p < 0.001)，对照组无(p = 0.085)。实验组满意度(93.3%)高于对照组(50%) (p < 0.001)，两组均无严重不良反应。结论：两种方案均安全有效，PRP联合脂肪长期疗效更稳定、满意度更高，可作为临床优选方案。

Abstract: Objective: To compare the efficacy of platelet-rich plasma (PRP) combined with autologous fat and PRP combined with hyaluronic acid (HA) in the treatment of facial atrophic scars. Methods: Sixty patients from the outpatient department of our hospital from January 2023 to December 2024 were randomly divided into an experimental group (PRP + fat) and a control group (PRP + HA), with 30 cases in each group. All patients received combined filling treatment. The efficacy was evaluated using the ECCA scale before the operation and at 1, 3, and 6 months after the operation. The satisfaction rate at 6 months after the operation and adverse reactions were recorded. Results: There was no statistically significant difference in the ECCA score between the two groups before the operation (p > 0.05); the scores of both groups were significantly reduced at 1 and 3 months after the operation (p < 0.001), with no difference between the groups (p > 0.05); at 6 months after the operation, the score of the experimental group (38.83 ± 2.81) was significantly lower than that of the control group (45.33 ± 3.01) (p < 0.001), and the difference in the experimental group before and after treatment was still statistically significant (p < 0.001), while there was no difference in the control group (p = 0.085). The satisfaction rate of the experimental group (93.3%) was higher than that of the control group (50%) (p < 0.001), and no serious adverse reactions occurred in either group. Conclusion: Both of the two schemes are safe and effective. PRP combined with fat injection has a more stable therapeutic effect and higher satisfaction rate within 6 months. It can be regarded as the preferred clinical option for patients who require a long-lasting therapeutic effect and are willing to undergo liposuction surgery.