中波高能紫外线联合点阵CO_(2)激光治疗难治性白癜风的疗效及皮肤镜指标评估分析

Analysis of the Effect of Dualight Targeted Phototherapy System Combined with Fractional Carbon Dioxide Laser in the Treatment of Refractory Vitiligo and Its Evaluation of Dermatoscopic Index

目的:分析中波高能紫外线联合点阵CO_(2)激光治疗难治性白癜风的疗效及对皮肤镜指标的影响。方法:回顾性分析2018年5月-2021年5月笔者医院收治的86例(共156处靶皮损)难治性白癜风患者临床资料,按照治疗方式的不同分为联合组和对照组。其中联合组44例,共85处靶皮损;对照组42例,共71处靶皮损。对照组给予中波高能紫外线治疗,联合组给予点阵CO_(2)激光联合中波高能紫外线治疗。治疗前后,分别在肉眼和皮肤镜下观察皮损毛囊周围毛细血管扩张、色素岛形成、皮损周围色素加深情况,对比两组不良反应发生率。结果:治疗后3个月、治疗后6个月联合组显效率均显著高于对照组,差异有统计学意义(P<0.05)。皮肤镜下及肉眼观察,治疗后两组毛囊周围毛细血管扩张、色素岛形成及皮损周围色素加深均明显改善,且联合组优于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:中波高能紫外线联合点阵CO_(2)激光治疗难治性白癜风疗效显著,值得临床推广应用。皮肤镜可以作为评估白癜风疗效的有效手段,可在早期准确而科学地评价治疗效果。

Objective To analyze the eff ect of Dualight Targeted Phototherapy System combined with fractional carbon dioxide laser in the treatment of refractory vitiligo and its eff ect on dermatoscopic index.Methods Clinical data of 86 patients with refractory vitiligo(156 target lesions)admitted to our hospital from May 2018 to May 2021 were retrospectively analyzed and divided into combined group and control group according to the diff erence of treatment methods.In the combined group,44 patients had 85 target lesions.In the control group,there were 42 cases with 71 target lesions.The control group was treated with Dualight Targeted Phototherapy System,and the combined group was treated with both Dualight Targeted Phototherapy System and fractional CO_(2) laser.Perifollicular telangiectasia,reserviors of pigmentation and perilesional hyperpigmentation before and after treatment were all observed by dermoscopy.And the incidence of adverse reactions was compared between the two groups.Results After 3 months and 6 months,the signifi cant effi ciency of combined group was higher than that of control group(P<0.05).Under dermoscopy and naked eye observation,telangiectasia,pigment island formation and pigment deepening around hair follicle were signifi cantly improved in the two groups after treatment,and the combined group was better than the control group(P<0.05).There was no statistical signifi cance in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The treatment of refractory vitiligo by Dualight Targeted Phototherapy System combined with fractional carbon dioxide laser is eff ective and is worthy of popularization.Dermoscopy can be used as eff ective means of vitiligo therapy assessment,which could provide accurate and scientifi c evaluation of treatment eff ect in early period.