两种高能量超脉冲CO<sub>2</sub>点阵激光模式治疗脂溢性角化病的疗效比较与分析

王怀湘; 李建明

doi:doi:10.3969/j.issn.1007-7146.2018.04.009

激光生物学报, 2018, 27 (4): 345, 网络出版: 2018-11-25

两种高能量超脉冲CO₂点阵激光模式治疗脂溢性角化病的疗效比较与分析

Comparison and Analysis of the Therapeutic Effects of Two High Energy Ultra-pulsed CO₂ Fractional Laser Modes in the Treatment of Seborrheic Keratosis

论文大纲

王怀湘李建明 ^*

作者单位

火箭军总医院礼士路门诊部皮肤科, 北京 100045

脂溢性角化病超脉冲CO2激光点阵激光疗效 seborrheic keratosis ultra pulsed CO2 laser fractional laser effect

摘要

为评价两种高能量超脉冲CO2激光模式对脂溢性角化病(SK)的治疗效果, 本文对81例患者共146处皮损, 随机分为A、B两组, 每组73处。A组给予超脉冲模式治疗, B组给予点阵模式治疗, 观察并对比两组患者疗效、治疗时的疼痛程度、平均治疗次数、痂皮完全脱落时间、遗留红斑消退时间及不良反应。治疗结束后, A、B两组总治愈率分别为100%、95.89%, 差异无统计学意义(P＞0.05); 痂皮完全脱落时间、遗留红斑持续时间、平均治疗次数对比, 差异均有统计学意义(P＜0.05); 经秩和检验可知, 两组患者总不良反应比较, 差异有统计学意义(Z=-3.129, P=0.002), 但进一步单一不良反应间比较, 差异均无统计学意义(P＞0.05)。结果表明, 高能量超脉冲CO2激光点阵模式与超脉冲模式治疗SK均具有较好疗效, 但点阵模式创伤小, 愈合快, 平均治疗次数多, 不良反应少, 较超脉冲模式更加安全。

Abstract

A total of 146 skin lesions were reported in 81 patients were used to evaluate the therapeutic effect of two high energy ultra-pulsed CO2 laser modes on seborrheic keratosis(SK), which were randomly divided into A and B groups, with 73 sites in each group. Group A was treated with ultra-pulsed mode, group B was treated with lattice laser mode. The efficacy, the degree of pain during treatment, the average number of treatments, the time of scab off, the duration of residual erythema retreat, and the adverse reactions were observed and compared between the two groups. After the treatment, the total cure rates of A and B were 100% and 95.89%, respectively, with no significant difference(P＞0.05). Comparison of the time of scab off, the duration of residual erythema retreat, and average number of treatments were statistically significant(P＜0.05). According to the rank sum test, the total adverse reactions of the two groups were statistically significant(Z=-3.129, P=0.002), but there was no significant difference in the further single adverse reaction(P＞0.05). It is found that the lattice mode and ultra-pulsed mode of high energy ultra-pulsed CO2 laser are effective in treating SK, but it is safer than ultra-pulsed mode with less trauma, faster healing, less adverse reactions.

参考文献

[1] 林佩怡, 袁定芬. 脂溢性角化病的治疗现状［J］. 应用激光, 2015, 35(3): 391-394.

LIN Peiyi, YUAN Dingfen. Present therapies for seborrheic keratosis［J］. Applied Laser, 2015, 35(3): 391-394.

[2] 方惠君, 梅册芳, 孔德涛. 调Q532nm激光和脉冲式CO2激光治疗面部脂溢性角化疣疗效对比［J］. 中国医疗美容, 2017, 7(4): 43-46.

FANG Huijun, MEI Cefang, KONG Detao. Comparison of therapeutic effects of Q-switch 532 nm laser and pulsed CO2 laser in treatment of facial seborrheic keratosis［J］. China Medical Cosmetology, 2017, 7(4): 43-46.

[3] 赵辨. 中国临床皮肤病学［M］. 南京: 江苏科学技术出版社, 2010: 1513-1514.

ZHAO Bian. Chinese clinical dermatology［M］. Nanjing: Jiangsu Science and Technology Press, 2010: 1513-1514.

[4] HEIDENREICH B, DENISOVA E, RACHAKONDA S, et al. Genetic alterations in seborrheic keratosis［J］. Oncotarget, 2017, 8(22): 36639-36649.

[5] MINAGAWA A. Dermoscopy-pathology relationship in seborrheic keratosis［J］. Journal of Dermatology, 2017, 44(5): 518-524.

[6] BRAUN R P, LUDWIG S, MARGHOOB A A. Differential diagnosis of seborrheic keratosis: clinical and dermoscopic features［J］. Journal of Drugs in Dermatology, 2017, 16(9): 835-842.

[7] 张晓燕, 马杰, 吕永靖, 等. 反射式共聚焦显微镜在不典型脂溢性角化病诊断中的应用［J］. 实用皮肤病学杂志, 2017, 10(6): 324-327.

ZHANG Xiaoyan, MA Jie, LV Yongjing, et al. The application of reflectance confocal microscopy in the diagnosis of atypical seborrheic keratosis［J］. Journal of Practical Dermatology, 2017, 10(6): 324-327.

[8] CHEN T Y, MORRISON A O, COCKERELL C J. Cutaneous malignancies simulating seborrheic keratosis: an underappreciated phenomenon［J］. Journal of Cutaneous Pathology, 2017, 44(9): 747-748.

[9] 朱薇, 曹兰, 赵万润, 等. 脂溢性角化症286例临床病理分析［J］. 昆明医科大学学报, 2016, 37(8): 75-78.

ZHU Wei, CAO Lan, ZHAO Wanrun, et al. Clinical and pathological analysis on 286 cases of seborrheic keratosis［J］. Journal of Kunming Medical University, 2016, 37(8): 75-78.

[10] 陈峰, 陈吉荣, 张文峰. 面颈部脂溢性角化病169例临床病理分析［J］. 临床口腔医学杂志, 2014, 30(11): 670-671.

CHEN Feng, CHEN Jirong, ZHANG Wenfeng. Clinicopathologic analysis of 169 cases of seborrheic keratosis in the face and neck［J］. Journal of Clinical Stomatology, 2014, 30(11): 670-671.

[11] 孟琪, 周同葵, 曹玲. 高能超脉冲CO2激光治疗面部脂溢性角化病630例［J］. 中国医疗美容, 2014, 4(4): 93-93.

MENG Qi, ZHOU Tongkui, CAO Ling. Ultra-high-energy pulsed CO2 laser treatment of facial seborrheic keratosis 630 cases［J］. China Medical Cosmetology, 2014, 4(4): 93-93.

[12] BRODSKY J. Management of benign skin lesions commonly affecting the face: actinic keratosis, seborrheic keratosis, and rosacea［J］. Current Opinion in Otolaryngology Head and Neck Surgery, 2009, 17(4): 315-320.

[13] 蒋海娟. 超脉冲二氧化碳激光治疗脂溢性角化病80例临床观察［J］. 交通医学, 2014, 28(3): 264-265.

JIANG Haijuan. Clinical observation of 80 cases of seborrheic keratosis treated by ultra pulse CO2 laser［J］. Medical Journal of Communications, 2014, 28(3): 264-265.

[14] 韩兰芹, 张锤, 张佳钰. 超脉冲CO2激光联合调Q开关532nm激光治疗脂溢性角化病的疗效观察［J］. 河北医科大学学报, 2016, 37(4): 400-403.

HAN Lanqin, ZHANG Chui, ZHANG Jiayu. The therapeutic effect observation of the ultrapulsed CO2 laser in combination with Q-switch 532 nm laser on the treatment of the seborrheic keratosis［J］. Journal of Hebei Medical University, 2016, 37(4): 400-403.

[15] 李娟, 李磊, 翟弘峰, 等. 不同能量参数CO2点阵激光联合A型肉毒毒素对眶周皮肤老化改善效果比较［J］. 中国医学前沿杂志(电子版), 2016, 8(11): 139-142.

LI Juan, LI Lei, ZHAI Hongfeng, et al. Comparison of the effects of different energy parameters CO2 dot matrix laser combined with botulinum toxin type A on orbital skin aging［J］. Chinese Journal of the Frontiers of Medical Science (Electronic Version), 2016, 8(11): 139-142.

[16] GUREL M S, ARAL B B. Effectiveness of erbium: YAG laser and cryosurgery in seborrheic keratosis: randomized, prospective intraindividual comparison study［J］. Journal of Dermatological Treatment, 2015, 26(5): 477-480.

王怀湘, 李建明. 两种高能量超脉冲CO₂点阵激光模式治疗脂溢性角化病的疗效比较与分析[J]. 激光生物学报, 2018, 27(4): 345. WANG Huaixiang, LI Jianming. Comparison and Analysis of the Therapeutic Effects of Two High Energy Ultra-pulsed CO₂ Fractional Laser Modes in the Treatment of Seborrheic Keratosis[J]. Acta Laser Biology Sinica, 2018, 27(4): 345.

两种高能量超脉冲CO₂点阵激光模式治疗脂溢性角化病的疗效比较与分析

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