發(fā)布時間：2018-02-12 04:28

  本文關(guān)鍵詞： 斑痣 二氧化碳激光 二氧化碳點陣激光 Q開關(guān)Nd:YAG激光 療效　出處：《安徽醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：研究背景:色素痣是人類最常見的皮膚良性腫瘤,可分為先天性和獲得性兩種類型。不同類型的色素痣所在的皮膚層次各不相同�？煞譃榻唤琊搿⑵�(nèi)痣和混合痣。色素痣傳統(tǒng)的治療方法有冷凍治療、皮膚磨削術(shù)、化學(xué)剝脫術(shù)、微波電離子治療和手術(shù)等。這些治療方法通常效果不是很好,而且創(chuàng)傷很大,甚至?xí)粝掳毯酆蜕禺惓！ｋS著選擇性光熱作用理論的提出和Q開關(guān)技術(shù)的應(yīng)用,激光可以選擇性的作用于黑色素細(xì)胞而對周圍的組織損傷很小。激光已經(jīng)成為治療色素痣的主要方法。如今,有很多激光都可用來治療色素痣,包括:二氧化碳激光、Q開關(guān)摻釹釔鋁石榴石激光(QS Nd:YAG)、Q開關(guān)摻鉺釔鋁石榴石激光、Q開關(guān)紅寶石激光(QSRL)、Q開關(guān)翠綠寶石激光(QSAL)以及點陣激光等。目的:觀察Q開關(guān)Nd:YAG激光(Medlite C6激光)、超脈沖二氧化碳點陣激光、二氧化碳激光以及超脈沖二氧化碳點陣激光聯(lián)合Medlite C6激光治療面部色素性斑痣的療效和安全性。方法:將40例門診診斷為色素性斑痣患者隨機分成四組,A組:Q開關(guān)Nd:YAG激光(Medlite C6激光)治療組;B組:超脈沖二氧化碳點陣激光;C組:二氧化碳激光治療組和D組:超脈沖二氧化碳點陣激光聯(lián)合Medlite C6激光治療組。A組先用1064nm波長治療,再用532nm激光治療;B組用超脈沖二氧化碳點陣激光微剝脫模式治療;C組直接用二氧化碳激光碳化和氣化,逐層磨削;D組先用點陣激光微剝脫模式掃描后,用鹽水棉簽擦除被剝脫的色素痣組織,再用Medlite C6激光的1064nm和532nm分別掃描皮損處。術(shù)后三個月判定療效,分為六級標(biāo)準(zhǔn):0:無效;1:1-24%改善;2:25-49%改善;3:50-74%改善;4=75-89%改善;5=90-100%改善。結(jié)果:A組患者經(jīng)過1-3次(平均1.7次)的治療,其中1例患者皮損顏色改善50-74%,2例改善25-49%,4例改善1-24%,3例無效,未見疤痕形成,總有效率為10%;B組患者經(jīng)過1-3次(平均2.1次)的治療,其中2例患者皮損顏色改善75-89%,5例改善50-74%,3例改善25-49%,增生性疤痕2例,凹陷性疤痕1例,總有效率為40%;C組經(jīng)過1-2次(平均1.7次)的治療,其中1例患者皮損顏色改善90-100%,5例改善75-89%,3例改善50-74%,1例改善1-24%,增生性疤痕和凹陷性疤痕各3例,總有效率為30%;D組經(jīng)過1-5次(平均2.4次)的治療,其中6例患者皮損顏色改善90-100%,2例改善75-89%,2例改善50-74%,增生性疤痕一例,總有效率為90%。A組、B組、C組分別與D組比較差異顯著(P0.05)。結(jié)論:相比于其他三種治療方案,超脈沖二氧化碳點陣激光聯(lián)合Medlite C6激光治療色素性斑痣的皮損清除率最高、術(shù)后疤痕和色素改變的發(fā)生率最低,值得臨床應(yīng)用。
[Abstract]:Background: pigmented nevus is one of the most common benign skin tumors in humans. It can be divided into congenital and acquired types. Different types of pigmented nevus have different skin layers and can be divided into borderline nevus. Intradermal nevus and mixed nevus. Traditional treatments for pigmented nevus include cryotherapy, skin abrasions, chemical exfoliation, microwave electroion therapy and surgery. With the development of the theory of selective photothermal action and the application of Q-switch technology, Lasers can selectively act on melanocytes and do little damage to surrounding tissues. Lasers have become the main treatment for nevus. Nowadays, many lasers can be used to treat nevus pigmentosa. It includes: QS ND: yttrium aluminum garnet laser, QS ND: YAGG Q switch, er doped yttrium aluminum garnet laser switch, ruby laser, ruby laser, emerald laser and lattice laser, etc. Objective: to observe Q switch Nd:YAG. Light Medlite C6 laser, super pulse carbon dioxide lattice laser, The efficacy and safety of carbon dioxide laser and superpulse carbon dioxide lattice laser combined with Medlite C6 laser in the treatment of facial pigmented nevus were studied. Methods: forty outpatients diagnosed as pigmented nevus were randomly divided into four groups: group A: Q. Nd:YAG laser Medlite C6 laser) treatment group B: ultra pulse carbon dioxide lattice laser group C: carbon dioxide laser treatment group and group D: ultra pulse carbon dioxide lattice laser combined with Medlite C6 laser treatment group. Group A was treated with 1064nm wavelength. Then treated with 532nm laser, group B was treated with ultra-pulse carbon dioxide laser microstripping mode. Group C was treated directly with carbon dioxide laser carbonization and gasification, and group D was first scanned by dot array laser stripping mode after layer by layer grinding. The exfoliated nevus tissue was erased with a brine swab, and the lesions were scanned with Medlite C6 laser at 1064 nm and 532 nm respectively. The curative effect was evaluated three months after operation. Divided into six levels: 1: 1: 1: 24% improvement 1: 25-49% improvement 3: 50-74% improvement 75-89% improvement 590-100% improvement. Results the patients in group A were treated 1-3 times (1.7 times on average), of which 1 case was treated with improved skin color, 50%-7442 cases improved 25-4949%, 4 cases improved 1-2424% and 3 cases had no scar formation, 4 cases had no effect, no scar formation, no scar formation, no scar formation, no scar formation, no scar formation, no scar formation, no scar formation, no scar formation, no scar formation, no scar formation, no scar formation, no scar formation. The total effective rate was 1 to 3 times (average 2.1 times) in group B, of which 2 cases had improved skin color 75-89 and 5 cases had improved 50-7410%, 3 cases had improved 25-49%, 2 cases had proliferative scar, 1 case had sunken scar. The total effective rate was one or two times (1.7 times on average) in group C, in which 1 case had skin color improvement 90-100 and 5 cases had improved 75-893.One case had improved 50-74 and 1 case had improved 1-24g, 3 cases had proliferative scar and 3 cases had sunken scar, respectively, there were 3 cases of hyperplastic scar and 3 cases of sunken scar, respectively. The total effective rate was 1 to 5 times (average 2.4 times) in group D, in which 6 cases had skin color improvement 90-100 and 2 cases had improved 75-89 and 2 cases had improved 50-74 and hypertrophic scar in one case. The total effective rate was 90%. The difference between group C and group D was significant (P 0.05). Conclusion: compared with the other three treatments, the removal rate of skin lesions in group B and C is the highest, compared with the other three treatments, and the treatment of pigmented nevus with Medlite C6 laser is the highest in the treatment of pigmented nevus. The incidence of postoperative scar and pigment changes is the lowest, which is worthy of clinical application.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R758.51

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