CO_2激光治疗局限型疣状痣23例临床观察

Clinical Observation on 23 Cases of Localized Verrucous Epidermal Nevi Treated by CO_2 Laser

目的观察CO2激光治疗局限型疣状痣的效果。方法局限型疣状痣患者23例,局部麻醉后,以波长为10.6μm、功率为3～5 W的CO2激光非接触式照射病灶,祛除疣状凸起部分后继续将病灶基底部烧灼至正常皮肤边缘下约1 mm,基底部呈平底锅状。间隔1～2个月治疗1次,直至祛除所有病灶。术后随访12～18个月,评定疗效。结果优良15例,占65.2%;中等6例,占26.1%;差2例,占8.7%。复发率17.4%。色素减退发生率21.7%,色素沉着发生率4.3%,瘢痕发生率13.0%。结论 CO2激光治疗局限型疣状痣复发率低,美容效果好,患者满意度高。术后主要不良反应为瘢痕、色素沉着和色素减退。控制好祛除深度既可减少复发又可防止增生瘢痕的形成,对色素沉着和色素脱失的防治措施尚需探究。

Objective To explore a safe and effective treatment for localized verrucous epidermal nevi. Methods All the 23 cases of lesions were defined the ablation range before the treatment, then vaporized the lesions with the CO2 laser under local anesthesia condition to make the basilar part as a pan-shaped and under the rim of the normal skin about 1 mm. Repeat the above steps times until dispel all target lesion. Results In all of the 23 patients 65. 2% showed good results, 26. 1% moderate results and 8.7% poor results. The recurrence rate, depigmentation rate ,pigmentation rate and scar rate were 17.4%, 21.7% ,4. 3% and 13.0% respectively. Conclusions We conclude that the CO2 laser in continuous wave mode have superior cosmetic result and low recurrent rate for local- ized verrucous epidermal nevi. The main side effects of postoperative are scarring, pigmentation and hypopigmentation. Control the dis- pel depth can reduce recurrence and to prevent the formation of hypertrophic scars, and subject to further explore the pigmentation and depigmentation of the control measures.