SilkTouch激光磨削后自体表皮移植治疗非平整部位白癜风疗效观察

Treatment of uneven lesions of vitiligo with a combination of autologous epidermal grafting and SilkTouch CO_2 laser resurfacing

目的:观察自体表皮移植结合SilkTouch激光磨削治疗非平整部位白癜风的疗效。方法:118例稳定期白癜风患者共有白斑245片,白斑分布于面部五官周围,颈部,腕、肘关节以及手、足等非平整部位。每例患者先在其面积最大的1片皮损中随机选取4个象限中1个象限的部分皮损,用凹凸型吸盘负压发疱法去除表皮作为对照,其余白斑部位均采用SilkTouch激光磨削法去除表皮,制备自体表皮移植的受区;供区则用负压发疱法制备表皮,然后将供区表皮移植于受区,并加压包扎7d。结果:全部患者均连续观察1年以上,激光磨削组245片皮损痊愈53片(21.6%),显效171片(69.8%),有效率91.4%,对照组118片皮损痊愈30片(25.4%),显效80片(67.8%),有效率93.2%,两组疗效统计学上差异无显著性,激光磨削组较对照组白斑处色素恢复均匀。结论:自体表皮移植结合SilkTouch激光磨削治疗白癜风不受部位限制,操作简便,术后疗效满意。

Objective: To investigate the clinical efficacy of the combination of autologous epidermal grafting and SilkTouch CO2 laser resurfacing of transplantation bed preparation in treatment of uneven lesions of vitiligo. Methods: SilkTouch CO2 laser resurfacing method was used to make transplantation beds for a total of 245 lesions of 118 vitiligo patients located at face, neck, elbow joint, wrist joint, hand and foot were, used in the study. A white patch of each patient was selected randomly as control group in which transplantation bed was made by negative pressure suction. Results: All patients were observed more than 1 year. The cure rate, marked improvement rate and total effective rate of 245 lesions in the laser resurfacing group was 21.6%, 69.8% and 91.4%, respectively, while the result in the control group of 118 lesions was 25.4%, 67.8% and 93.2%, respectively. There was no statistically significant difference between two groups. Yet the pigment recovery of the laser resurfacing group was better distributed than the control group. Conclusions: There is no location limitation for the combination of autologous epidermal grafting and SilkTouch CO2 laser resurfacing, so it is a simple and highly effective method for the treatment of uneven lesions of vitiligo.