CAJ | 학술논문

目的评价脉冲CO2激光去除眼睑部先天性黑素痣的方法和美容效果.方法用脉冲CO2激光气化去除眼睑部先天性黑素痣46例,共58块.病损最小面积0.3 cm×0.3 cm,最大面积3.0 cm×6.0 cm,平均面积1.3 cm×2.0 cm.尽可能保护正常的皮肤和睫毛毛囊组织,勿受损伤.术中没有焦痂产生及出血.结果 46例患者中44例对激光手术效果满意,仅2例对激光手术效果欠满意.58块黑素损害,50块愈后创面瘢痕平整.欠平整6块,外眦粘连1块,内眦瘢痕收缩1块.疗效优84.5%(49/58),良10.3%(6/58),有改善5.2%(3/58).总有效率94.8%(55/58),部分患者睑缘仍有睫毛生长.结论高能量脉冲CO2激光是去除眼睑部先天性黑素痣的较好方法,具有去除彻底、创面愈后瘢痕平整、眼睑活动正常、外观影响小等优点.但对于面积较大的、侵犯多个解剖区域的病损,激光手术的选择仍需谨慎.
목적 평개맥충CO2격광거제안검부선천성흑소지적방법화미용효과.방법 용맥충CO2격광기화거제안검부선천성흑소지46례,공58괴.병손최소면적0.3 cm×0.3 cm,최대면적3.0 cm×6.0 cm,평균면적1.3 cm×2.0 cm.진가능보호정상적피부화첩모모낭조직,물수손상.술중몰유초가산생급출혈.결과 46례환자중44례대격광수술효과만의,부2례대격광수술효과흠만의.58괴흑소손해,50괴유후창면반흔평정.흠평정6괴,외자점련1괴,내자반흔수축1괴.료효우84.5%(49/58),량10.3%(6/58),유개선5.2%(3/58).총유효솔94.8%(55/58),부분환자검연잉유첩모생장.결론 고능량맥충CO2격광시거제안검부선천성흑소지적교호방법,구유거제철저、창면유후반흔평정、안검활동정상、외관영향소등우점.단대우면적교대적、침범다개해부구역적병손,격광수술적선택잉수근신.
Objective To valuate the effect of high energy ultrapulse CO2 laser on congenital melanocytic nevi of the orbit. Methods 46 patient with congenital melanocytic nevi of eyelid, 58 le-sions were vaporized with high energy ultrapulse CO2 laser. The area of the largest one was 3.0 cm×6.0 cm, and the smallest one was 0.3 cm×0.3 cm, with average of 1.3 cm×2.0 cm. The depth of the vaporizing reached the layer of lowest skin, even the orbicularis, aponeurosis and conjunctiva of tarsus, till no melanin on the wound in view, tried the best to reserve the normal follicle of eyelash. There was no eschar and bleeding on the wound during the procedure. Followed up lasted for 1 - 56 months, with average 12.9 months. Results 44 of 46 patients were satisfactory to the effect of the laser. The most of scars resulted from the vaporizing with the laser became evenness and smooth (50/58). The edge of eyelid looked normal after the laser. The excellent result was observed in 84.5 % (49/58) lesions, good in 10.3 % (6/58), and improved in 5.2 % (3/58). The overall effect was 94.8 % (55/58). And eyelashes were getting growth. Conclusion The treatment of con-genital melanocytic nevus of eyelid with high energy ultrapulse CO2 is a good method. But to be careful in selecting the lesions that may not he too large.