[摘要]目的：探讨口服氨甲环酸联合超脉冲点阵CO2激光治疗面部脂溢性角化病患者的疗效。方法：按照随机数字表法将2019年3月-2024年3月宝鸡市人民医院收治的90例患有面部脂溢性角化病患者分配到对照组和观察组，对照组采用超脉冲点阵CO2激光治疗，观察组在对照组的基础上联合氨甲环酸口服治疗，每组45例，均治疗2周。比较两组患者治疗总有效率和病愈率、创面结痂时间和创面愈合时间、皮肤病生活质量评分（DLQI）和不良反应状况。结果：治疗2周后，对照组的有效率（80.00%）低于观察组的（95.56%），差异具有统计学意义（P＜0.05）；观察组创面结痂时间、创面愈合时间分别为（2.36±0.37）d、（5.04±0.82）d，均短于对照组的[（3.45±0.86）d、（6.89±1.54）d，（P＜0.05）]，治疗后，两组患者的DLQI总分较治疗前下降（P＜0.05），且观察组的（5.13±0.11）分较对照组的（10.65±2.77）分低（P＜0.05）；观察组在色素沉着和总不良反应方面的发生率分别为4.44%、8.89%，均低于对照组的20.00%、26.67%（P＜0.05）。结论：口服氨甲环酸联合超脉冲点阵CO2激光疗法可以有效治疗面部脂溢性角化病，促进创面愈合，提高患者生活质量，降低不良反应发生率，有临床应用价值。

[关键词]氨甲环酸；超脉冲点阵CO2激光；面部脂溢性角化病；生活质量

[中图分类号]R739.5" " [文献标志码]A" " [文章编号]1008-6455（2025）06-0111-04

Effect of Tranexamic Acid Combined with Ultra-Pulsed Fractional CO2 Laser in the Treatment of Facial Seborrheic Keratosis

LIN Hui1， WANG Xiaoxin1， MIAO Xin2

（ 1.Department of Dermatology， 2.Department of Plastic and Cosmetic Trauma， Baoji People's Hospital， Baoji 721000，

Shaanxi ，China ）

Abstract： Objective" To explore the therapeutic effect of oral tranexamic acid combined with ultra-pulsed fractional CO2 laser therapy on patients with facial seborrheic keratosis. Methods" According to the random number table method， 90 patients with facial seborrheic keratosis in Baoji People’ s Hospital from March 2019 to March 2024 were assigned to control group and observation group. The control group was treated with ultra-pulsed fractional CO2 laser， whereas the observation group was combined with oral tranexamic acid on the basis of the control group， with 45 cases in each group. All patients were treated for 2 weeks. The total effective rate of treatment and cure rate， wound scabbing time and wound healing time， Dermatology Life Quality Index （DLQI） and adverse reactions were compared between groups of patients. Results" After 2 weeks of treatment， the effective rate in control group （80.00%） was lower than that in observation group （95.56%）， with a statistical significance （P＜0.05）. The time of wound scabbing and time of wound healing in observation group with （2.36±0.37） d and （5.04±0.82） d were shorter than （3.45±0.86） d and （6.89±1.54） d in control group （P＜0.05）. After treatment， the total score of DLQI in both groups was decreased compared with that before treatment （P＜0.05）， and the score with （5.13±0.11） points in observation group was lower than （10.65±2.77） points in control group （P＜0.05）. The incidence rate of pigmentation and total incidence rate of adverse reactions in observation group were 4.44% and 8.89%， which were lower than 20.00% and 26.67% in control group （P＜0.05）. Conclusion" Oral tranexamic acid combined with ultra-pulsed fractional CO2 laser therapy can effectively treat facial seborrheic keratosis， promote wound healing， enhance quality of life of patients， and reduce incidence rates of adverse reactions. Additionally， it has clinical application value.

Key words： tranexamic acid; ultra-pulsed fractional CO2 laser; facial seborrheic keratosis; quality of life

脂溢性角化病（Seborrheic keratosis，SK）又称基底细胞乳头状瘤，是一种良性表皮增生性肿瘤，多发于中老年人群[1]。该病病程时间长，组织病理学表现主要为黑色素增多、乳头瘤样增生、角化过度、棘层肥厚等，若不及时进行治疗，会导致患者病变部位随病情发展出现色素沉着、水疱等现象，对患者身心健康造成负面影响[2]。……