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目的观察Q开关Nd:YAG激光联合维A酸霜治疗面部脂溢性角化病的疗效和安全性。方法 63例患者随机分为两组,治疗组39例,采用Q开关Nd:YAG激光联合维A酸霜,激光治疗波长532 nm,光斑直径2~3 mm,频率1、2或5 Hz;能量密度0.9~1.6 J/cm~2,激光治疗区脱痂后每晚外用维A酸霜,未治愈患者可二次激光治疗,两次激光治疗间隔时间6周;对照组患者24例,采用外用维A酸霜治疗。术后6、12、18周随访,观察两组患者的疗效和不良反应发生情况。结果两组患者6、12和18周时治疗有效率分别为治疗组74.4%、84.6%、94.9%;对照组37.5%、58.3%和75.0%;两组间疗效比较差异有统计学意义(P<0.05)。至少半年的随访中,所有患者均未出现创面感染、瘢痕、皮肤质地改变及永久色素异常。结论 Q开关Nd:YAG激光联合维A酸霜治疗面部脂溢性角化病疗效确定,安全性高。
Objective To observe the efficacy and safety of Q-switched Nd: YAG laser combined with Vitamin A acid cream in the treatment of facial seborrheic keratosis. Methods Sixty-three patients were randomly divided into two groups. The treatment group consisted of 39 patients. The Q-switched Nd: YAG laser combined with retinoic acid cream was used. The laser wavelength was 532 nm, the spot diameter was 2 to 3 mm, the frequency was 1, 2 or 5 Hz. Density 0.9 ~ 1.6 J / cm ~ 2, laser treatment area scab off every night after external use of vitamin A acid cream, not cured patients can be secondary laser treatment, two laser treatment interval of 6 weeks; control group of 24 patients, Vitamin A acid cream treatment. After 6, 12, 18 weeks of follow-up, the curative effect and adverse reactions of two groups were observed. Results The effective rates of two groups were 74.4%, 84.6% and 94.9% at 6, 12 and 18 weeks respectively, while those in control group were 37.5%, 58.3% and 75.0% respectively. There was significant difference between the two groups (P <0.05). At least six months of follow-up, no wounds, scarring, altered skin texture, and permanent pigmentary abnormalities occurred in all patients. Conclusion Q-switched Nd: YAG laser combined with Vitamin A acid cream for the treatment of facial seborrheic keratosis is effective and safe.