CAJ | 학술논문

目的对比观察常规外科切除缝合手术及CO2激光切除焊接切口治疗面部皮脂腺囊肿(sebaceous cyst,SC)的疗效及美容效果.方法 200例面部SC患者随机分为CO2激光手术治疗组(激光组)和常规外科手术治疗组(对照组),每组各100例.激光组采用CO2激光(功率20 W、光斑直径0.2 cm、功率密度637 W/cm2)切割皮肤及摘除囊肿,如囊壁破裂则汽化残留囊壁,清洁皮肤创口后,采用激光焊接皮肤吻合器对合皮缘,行CO2激光(功率1W、光斑直径0.2 cm、功率密度32 W/cm2)扫描式焊接；对照组经皮肤切口、摘除囊肿及囊壁后采用1-0丝线全层间断缝合切口.结果激光组治愈97例,占97％,好转3例,占3％；对照组治愈89例,占89％,好转9例,占9％,无效2例,占2％,激光组治愈率高于对照组(P＜0.05)；创口愈合后外观效果激光组明显好于对照组(P＜0.01)；激光组皮肤切口焊接成功率100％.结论采用CO2激光手术切除面部SC并焊接皮肤切口,可有效地减少SC的复发和瘢痕形成的概率,尤其是CO2激光焊接皮肤切口法,建立了一种新的无缝线皮肤切口修复方法,对美容整形外科具有重要的应用价值.
목적 대비관찰상규외과절제봉합수술급CO2격광절제한접절구치료면부피지선낭종(sebaceous cyst,SC)적료효급미용효과.방법 200례면부SC환자수궤분위CO2격광수술치료조(격광조)화상규외과수술치료조(대조조),매조각100례.격광조채용CO2격광(공솔20 W、광반직경0.2 cm、공솔밀도637 W/cm2)절할피부급적제낭종,여낭벽파렬칙기화잔류낭벽,청길피부창구후,채용격광한접피부문합기대합피연,행CO2격광(공솔1W、광반직경0.2 cm、공솔밀도32 W/cm2)소묘식한접；대조조경피부절구、적제낭종급낭벽후채용1-0사선전층간단봉합절구.결과 격광조치유97례,점97％,호전3례,점3％；대조조치유89례,점89％,호전9례,점9％,무효2례,점2％,격광조치유솔고우대조조(P＜0.05)；창구유합후외관효과격광조명현호우대조조(P＜0.01)；격광조피부절구한접성공솔100％.결론 채용CO2격광수술절제면부SC병한접피부절구,가유효지감소SC적복발화반흔형성적개솔,우기시CO2격광한접피부절구법,건립료일충신적무봉선피부절구수복방법,대미용정형외과구유중요적응용개치.
Objective To compare the effectiveness of CO2 laser treatment and routine scalpel procedure for facial sebaceous cyst (SC),and to compare cosmetic effect of laser welding and routine suture skin incision.Methods Two hundred patients with SC were randomly divided into two groups:CO2 laser operative treatment group (laser group),and routine scalpel operative treatment control group (control group),with 100 patients in each group.For the laser group,skins of SC were incised and cyst were extirpated using CO2 laser beam (power 20 W,diameter of light spot 0.2 cm and power density 637 W/cm2).If cyst wall was broken,then CO2 laser was used to gasify the residual.After cleaning skin incision,both border of incision with anastomat of laser welding skin was performed,next to welding skin incision with CO2 laser (power 1 W,diameter of light spot 0.2 cm and power density 32 W/cm2) scanning radiating 2 mm/s.For the control group,skins of SC were incised and cyst or residual wall were extirpated with single-use scalpel,and skin incisions were sutured with 1-0 silk thread by whole layer interrupted suture.Results For the laser group,97 cases (97 ％) were cured,3 cases (3 ％) improved.For the control group,87 cases (87 ％) were cured,9 cases (9 ％)improved and 2 cases (2 ％) had no improvement.Cure rate of laser group was obviously higher than that of the control group (P＜0.05).The cosmetic effect of the laser group was also better than that of the control group (P＜0.01).For the laser group,successful rate of welding skin incision was 100 ％.Conclusions Surgical removal of SC on face and welding skin incision with CO2 laser is very effective.The chances of recurrence and cicatrisation are greatly reduced.In particular,laser welding skin incision establishes a new non-suture reparable method of skin incision,which has important value for the cosmetic and plastic surgery.