机械磨削联合铒激光磨削治疗泛发性表皮痣临床观察

Clinical observation about the treatment for general epidermal nevi by grinding with machinery and Er:YAG laser

目的:观察机械磨削联合铒激光磨削治疗泛发性表皮痣的疗效与安全性。方法:2008年3月～2010年3月,笔者对19例泛发性表皮痣患者先采用不锈钢磨头行真皮网状层浅层磨削治疗,2～3个月后对复发的表皮痣再联合铒(Er:YAG)激光磨削治疗,末次治疗后6个月复诊;根据表皮痣复发程度,分别评定为"无效、轻度改善、中度改善、显著改善"四级;有效率以轻度改善+中度改善+显著改善计,满意率以中度改善+显著改善计。结果:19例患者均有疗效,其中轻度改善2例(10.53%),中度改善6例(31.58%),显著改善11例(57.89%),有效率为100%,满意率为89.47%;继发并发症中色素沉着19例(100%)、色素减退4例(21.05%)、瘢痕增生1例(5.26%)。结论:机械磨削联合铒激光磨削是一种目前治疗泛发性表皮痣安全、有效的方法。

Objective To observe the efficacy and safety about the treatment for general epidermal nevi by grinding with machinery and Er： YAG laser. Methods From March 2008 to March 2010, 19 patients with general epidermal nevus were treated with grinding from superficial layer of stratum reticulare cutis by stainless steel bistrique first and then combining with Er： YAG laser grinding for those cases whose epidermal nevus recurred in 2-3 months. Six months post last therapy, the return visit was taken. According to recrudescent degree of epidermal nevus, the evaluation for therapeutic effect was divided into four grades： no, slight, midrange and significant improvement. The effective power of treatment was consisted of the ratio for slight, midrange and significant improvement. The satisfactory proportion was consisted of the percentage for midrange and significant improvement. Results 19 patients all showed curative efficacy, 2 cases （10.53%） manifested slight improvement, 6 cases （31.58%） midrange improvement and 11 case （57.89%） significant improvement, indicating 100% percentage in effective power and 89.47% percentage in satisfactory proportion. 19 cases （100%） all complicated differential hyperpigmentation, 4 cases （21.05%） depigmentation and 1 case （5.26%）hyperplastic scar post treatment. Conclusion The way to grind with machinery and Er： YAG laser is an effective and safe method to treat general epidermal nevus presently.