超脉冲CO_2激光磨削和滚轮磨削法在白癜风表皮移植中的应用比较

An efficacy comparison of ultra pulse CO_2 laser grinding and roller grinding for epidermal grafting treatment of vitiligo

目的:观察两种磨削方法在表皮移植术治疗白癜风中的应用效果。方法:采用随机对照(RCT)试验研究方法,将57例筛选合格的稳定期白癜风患者随机分成两组,采用超脉冲CO_2激光磨削色素脱失区31例(A组),滚轮磨削色素脱失区26例(B组),然后进行负压吸疱自体表皮移植术,观察表皮移植后的疗效及手术的便利性和手术操作时间等。结果:A组和B组的痊愈率分别为46.79%和44.57%,有效率分别为77.06%和73.91%。A、B组在操作时间上差异有统计学意义,超脉冲CO_2激光磨削法更节约时间,此外色素恢复时间上前者也比较快,但是到第6个月时恢复率差异无统计学意义。结论:两组在疗效上差异无统计学意义,超脉冲CO_2激光磨削法在手足等较厚的部位手术时间更短,不平坦的皮面更便于精细操作,色素恢复更均匀更快,值得推广。

Objective： To compare two grinding methods for epidermal grafting treatment of vitiligo. Methods： Fifty-seven patients with stable vitiligo were randomly divided into 2 groups using random control trial（RCT） method. Group A（31 cases） and group B （26 cases） were treated with ultra pulse CO2 laser grinding and roller grinding, respectively, followed by suction blister epidermal autograft. The efficacy and operational feasibility were compared between these two methods. Results： The cure rates in groups A and B were 46.79% and 44.57%, respectively, while their effective rates were 77.06% and 73.91%, respectively（P〉0.05 for both cure and effective rates）. However, the operation time was significant shorter in group A than in group B （P〈0.05）. Although repigmentation developed faster in group A than in group B at beginning, this differences in repigmentation were not evident between these two groups sixth months after operation（P〉0.05）. Conclusions： It takes shorter time using ultra pulse CO2 laser to grind skin for treating vitiligo involved in the sites with thicker skin, such as hands and feet, and unflattened surface. Using ultra pulse CO2 laser can also induce a faster and uniform repigmentation. Thus, this method should be widely deployed in the clinics.