超脉冲CO2激光治疗睑黄瘤

刘岩 张炼 刘毅

[摘要]目的：探讨超脉冲CO2激光治疗睑黄瘤的疗效。方法：采用超脉冲CO2激光对58例睑黄瘤患者进行治疗。选择超脉冲模式，波长10 600nm，能量3～5W，治疗前局部用2%盐酸利多卡因注射液浸润麻醉，治疗后创面外涂表皮生长因子凝胶。结果：58例患者中，一次治愈率100%，随访1年，无1例复发。结论：超脉冲CO2激光治疗睑黄瘤，具有精确治疗深度，对周围组织的热损伤小，术后创面愈合快，不易形成瘢痕等优点，是一种较为理想的治疗睑黄瘤的方法，临床上值得推广使用。

[关键词]超脉冲CO2激光;睑黄瘤;气化;疗效

[中图分类号]R777.1    [文献标志码]A    [文章编号]1008-6455（2021）03-0006-02

Treatment of Xanthoma of Eyelid by Ultra-pulsed CO2 Laser

LIU Yan1，ZHANG Lian2，LIU Yi3

（1.Department of Health Care;2.Department of Spinal Surgery;3.Department of Burn and Plastic Surgery，940 Hospital，Joint Logistics Support Force，Lanzhou 730050，Gansu，China）

Abstract： Objective  To evaluate the therapeutic effect of ultra-pulsed CO2 laser on eyelid xanthoma. Methods  58 patients with eyelid xanthoma were treated by ultra-pulsed CO2 laser. The wavelength was 10 600nm， the energy was 3-5W，  and 2% lidocaine hydrochloride injection was used to infiltrate locally before treatment. After anesthesia and treatment， epidermal growth factor gel was applied to the wound surface. Results  Among the 58 patients， the one-time cure rate was 100%， and no recurrence occurred after one year of follow-up. Conclusion  Ultra-pulsed CO2 laser treatment of eyelid xanthoma has accurate treatment depth， less thermal damage to surrounding tissues， and healing of postoperative wound surface. It is an ideal method for the treatment of eyelid xanthoma and is worth popularizing clinically.

Key words： ultra-pulsed CO2 laser; xanthoma of eyelid; gasification; curative effect

瞼黄瘤，又称睑黄疣，好发于双侧上眼睑和内眦周围，病情进展较为缓慢，患者多无自觉症状，无法自行消退，对生理功能几乎无影响，但会对患者的面部容貌产生影响[1]。笔者科室2017年10月-2020年3月对58例睑黄瘤患者行超脉冲CO2激光治疗，取得了满意的临床疗效。

1  资料和方法

1.1 一般资料：本组共58例患者，女36例，男22例;年龄26～68岁，平均42岁;瘤体分布于上睑48例，下睑2例，上下睑均有8例;病灶面积0.25～4cm2;黄色瘤生长速度较慢，生成黄色瘤部分皮肤与周围正常皮肤分界明显，本组患者黄色瘤均未见自行吸收。

1.2 治疗方法：睑黄瘤患者一般同时存在不同程度眼睑松弛现象，临床上可通过对黄色瘤形态分布情况的观察，拉展皮肤充分暴露瘤体。采用波长为10 600nm超脉冲CO2激光，能量3～5W，治疗前看清瘤体波及范围，用2%盐酸利多卡因注射液浸润麻醉，麻醉范围比瘤体面积相对大一些。……