平削法治疗脂溢性角化病的临床观察

Treatment of seborrheic keratosis by flat-cutting： a clinical observation

目的比较平削法和液氮冷冻疗法对脂溢性角化病的疗效、患者满意度和不良反应。方法68例脂溢性角化病确诊患者，随机分A组32例，B组36例。A组用液氮点喷的方法，以冻融为度，未完全消除者可重复治疗，直至全部脱落，经过3次治疗未能完全消除者停止治疗。B组采用局部麻醉下用刀片沿皮损基部将皮损平削切尽，用油纱加压止血，5d后去除敷料、观察皮损。治疗结束3个月后评判疗效、患者满意度、记录疗程中的不良反应。结果B组的疗效明显优于A组（P〈0．01），患者满意度高于A组（P〈0．01），不良反应发生率明显低于A组（P〈0．05）。结论与液氮冷冻相比，平削法治疗脂溢性角化病具有疗效好、患者满意度高和不良反应少的优点。

Objective To compare the curative effect, patient＇s satisfaction degree, and adverse reaction on seborrheic keratosis by level cutting and frozening with liquid nitrogen. Methods 68 cases were randomly divided into liquid nitrogen frozening group （32 cases, group A） and flat-cutting group （36 cases, group B）. Liquid nitrogen was spurted until freeze-thaw status in group A, and the remnant skin lesion needed for other treatments, but no more than 3 times. The skin lesion in group A was completely resected with scalpel following its basilar part after local anesthesia, and elaeoyarn was pressurized to stop bleeding on wound, which was removed afer 5 days. The effects, satisfactory degree and adverse reaction were analyzed after 3 mouths of treatment. Results The effect and satisfactory degree in group B was significantly better than that in group A （P〈0.01）, but the adverse reaction in group B was significantly lower than that in group A （P〈0.05）. Conelusion Compared with liquid nitrogen frozening, the therapy of flat-cutting has advantages to seborrheie keratosis, with good efficacy, high patient＇s satisfaction and low adverse reaction.