自体吸疱表皮移植术结合搔刮术治疗白癜风的临床评价

Clinical Evaluation of Surgery Blister Grafting Combined with Curettage in the treatment of Vitiligo

目的:观察和比较搔刮术结合负压吸疱术和传统负压吸疱术对白癜风复色的疗效。方法:将90例稳定期白癜风患者随机分成搔刮术结合负压吸疱术组(45例)和传统负压吸疱术组(45例),分别给予搔刮术结合负压吸疱术和传统负压吸疱术治疗。治疗后,比较两组的复色情况,是否留有白斑缝隙,并进行白癜风疗效评价。进一步分析皮损部位、性别、临床类型对搔刮术结合负压吸疱术和传统负压吸疱术临床疗效的影响。结果:治疗后,搔刮术结合负压吸疱术组和传统负压吸疱术组在整体疗效无显著性差异(P>0.05)。搔刮术结合负压吸疱术组术后获得成片复色比例显著高于传统负压吸疱术组(88.9%vs. 4.4%,P<0.001)。不同性别患者接受搔刮术结合负压吸疱术和传统负压吸疱术的疗效比较均无统计学差异(P>0.05)。表皮移植术结合搔抓术组和单一表皮移植术组中,皮损发生在颈部、面部相比于躯干部、四肢、手足部的疗效明显更佳,局限型和节段型相比于散发型、肢端型的疗效更佳。结论:自体吸疱表皮移植术结合搔刮术用于稳定期白癜风的复色效果相比于传统自体吸疱表皮移植术疗效更佳。

Objective: To observe and evaluate the efficacy of autologous vitiligo surgery blister grafting combined with curettage and traditional autologous vitiligo surgery blister grafting in the repigmentation of vitiligo. Methods: Autologous vitiligo surgery blister grafting combined with curettage(including 45 patients) and traditional autologous vitiligo surgery blister grafting(including 45 patients)were applied to 90 cases of patients with stable vitiligo respectively. The efficacy was evaluated by the repigmentation and the presence of remnant white macules. Further analysis was used to evaluate the influence caused by lesional site, gender, clinical types of vitiligo patients. Results: There was no significant difference in the total curative effects between autologous vitiligo surgery blister grafting combined with curettage and traditional autologous vitiligo surgery blister grafting(P>0.05). The proportion of integral repigmentation after vitiligo surgery blister grafting combined with curettage was higher compared with that of traditional vitiligo surgery blister grafting(88.9% vs. 4.4%, P <0.001). In addition, there was no significant difference in the gender between autologous vitiligo surgery blister grafting combined with curettage and traditional autologous vitiligo surgery blister grafting(P >0.05). The curative effect of vitiligo patients located in neck and face was better than that in trunk, limb, hand and foot. The curative effects of localized vitiligo and segmental vitiligo were better than acrofacial vitiligo and generalised vitiligo. Conclusion: The efficacy of autologous vitiligo surgery blister grafting combined with curettage is better than traditional autologous vitiligo surgery blister grafting to stable vitiligo patients.