射频消融显微微切面部难治性色素痣58例疗效分析(1)
[摘要]目的：观察XL-射频皮肤治疗仪显微消融微切面部难治性色素痣的疗效。方法：显微镜下，消融微切58例(80个)面部难治性色素痣，病变大小：直径6～8mm的40个，直径8～10mm的30个，直径10～20mm的10个。随访观察12～60个月。结果：58例患者，80个病变，其中69个病灶完全消失，无复发，无肉眼可见的手术瘢痕；7个病灶完全消失，随访期内可见手术瘢痕，但不明显；1个有部分黑色残留，2个病灶完全消失但有较明显的手术瘢痕，1個复发。治愈率达95%，有效率达98.8%，复发率为1.2%。所有患者均无缝合，术后均未使用抗生素，均无感染等并发症。结论：XL-射频皮肤治疗仪显微消融微切治疗面部难治性色素痣精准度高、疗效显著，且瘢痕轻、并发症少，是一种有别于传统手术或物理治疗的新疗法，值得临床推广应用。
[关键词]射频消融；显微；微切；色素痣
[中图分类号]R758.5+1 [文献标志码]A [文章编号]1008-6455(2018)09-0018-03
, 百拇医药
Successful Eradication of Facial Protruding Pigmented Nevi of 58 Patients by Radiofrequency Ablation under a Microscope
XIE Hui-min1， WANG Shuo2， JIA Zi-shan1，ZHANG Li-ning1，WANG Xing-lin1
(1.Department of Rehabilitation Medicine， PLA General Hospital， Beijng 100853， China；2.Department of Orthopedics， Beijing Shijitan Hospital， Beijng 100036， China)
Abstract： Objective To observe the clinical effects of XL-radiofrequency ablation skin apparatus (invented by Rehabilitation medicine， PLA General Hospital) in micro-resecting the facial protruding pigmented nevi. Methods XL-radiofrequency ablation skin apparatus was performed on 58 cases(80 lesions). There were 40 of them were 6-8mm in diameter，30 of them were 8-10mm and 10 of them were in 10-20mm. The postoperative follow-up durations ranged from 12 to 60 months. Results 69 cases were cured successfully without relapse or scar.7cases were cured successfully，but with slight scars.1 case was partial resected.2 cases were cured successfully but with obvious scars. Unfortunately，there was 1 relapsed case. The cure rate was 95%， the effective rate was 98.8%， and the recurrence rate was 1.2%. Conclusion Icro-resecting the facial protruding pigmented nevi using the XL-radiofrequency ablation skin apparatus has several advantages such as high accuracy rate， good effect，scarless， fewer complication and quicker recovery，which is a new medical technology.
, 百拇医药
Key words： radiofrequency ablation；minimally invasive treatment；pigmented nevi； micro-resecting； nevi
色素痣是一种常见的皮肤良性肿瘤，大多数学者认为应采用手术切除可避免诱导恶变，手术切除色素痣时不可避免地切除了部分正常组织，易产生瘢痕。特别是皮损直径>6mm[1]的难治性色素痣的切除，易产生瘢痕及变形，患者难以接受。因此，创建一种在病变与正常组织之间切除病变组织，即达到去除病变，又不损伤过多的正常组织，降低了瘢痕的发生率及变形的方法是非常重要的。为此，笔者团队研究创建了在显微镜下采用射频皮肤治疗仪，于病变与正常组织之间采用显微微切消融面部难治性色素痣，很好地保留了正常组织，由于消融形成了保护层不需要缝合，有效地降低了瘢痕的发生率及变形，复发率低，取得了显著的临床疗效。
1 资料和方法
1.1 一般资料：选取2011年10月-2017年3月笔者医院就诊的色素痣患者58例(共80个皮损)，其中男23例，女35例。年龄12～68岁，病程4～56年。单发大色素痣患者50例，多发患者8例。其中4例患者本次治疗前曾行激光治疗，3例无效，1例病变面积增大；1例曾行手术切除后复发；1例行药物治疗无效。病变大小：直径6～8mm者40个，8～10mm者30个，10～20mm者10个。病变部位：额颞部18个，两颊6个，眼周11个，鼻唇部30个，下颌及颏部15个，其中包括危险三角区16个，人中5个，唇缘9个，眉间11个。见表1。纳入标准：①临床诊断为黑色素痣；②位于面部明显部位；③直径≥6mm，且凸出于皮肤，可伴异常毛发生长；④无其他影响射频治疗的器质性病变。, 百拇医药(谢惠敏 王硕 贾子善 张立宁 王兴林)
[关键词]射频消融；显微；微切；色素痣
[中图分类号]R758.5+1 [文献标志码]A [文章编号]1008-6455(2018)09-0018-03
, 百拇医药
Successful Eradication of Facial Protruding Pigmented Nevi of 58 Patients by Radiofrequency Ablation under a Microscope
XIE Hui-min1， WANG Shuo2， JIA Zi-shan1，ZHANG Li-ning1，WANG Xing-lin1
(1.Department of Rehabilitation Medicine， PLA General Hospital， Beijng 100853， China；2.Department of Orthopedics， Beijing Shijitan Hospital， Beijng 100036， China)
Abstract： Objective To observe the clinical effects of XL-radiofrequency ablation skin apparatus (invented by Rehabilitation medicine， PLA General Hospital) in micro-resecting the facial protruding pigmented nevi. Methods XL-radiofrequency ablation skin apparatus was performed on 58 cases(80 lesions). There were 40 of them were 6-8mm in diameter，30 of them were 8-10mm and 10 of them were in 10-20mm. The postoperative follow-up durations ranged from 12 to 60 months. Results 69 cases were cured successfully without relapse or scar.7cases were cured successfully，but with slight scars.1 case was partial resected.2 cases were cured successfully but with obvious scars. Unfortunately，there was 1 relapsed case. The cure rate was 95%， the effective rate was 98.8%， and the recurrence rate was 1.2%. Conclusion Icro-resecting the facial protruding pigmented nevi using the XL-radiofrequency ablation skin apparatus has several advantages such as high accuracy rate， good effect，scarless， fewer complication and quicker recovery，which is a new medical technology.
, 百拇医药
Key words： radiofrequency ablation；minimally invasive treatment；pigmented nevi； micro-resecting； nevi
色素痣是一种常见的皮肤良性肿瘤，大多数学者认为应采用手术切除可避免诱导恶变，手术切除色素痣时不可避免地切除了部分正常组织，易产生瘢痕。特别是皮损直径>6mm[1]的难治性色素痣的切除，易产生瘢痕及变形，患者难以接受。因此，创建一种在病变与正常组织之间切除病变组织，即达到去除病变，又不损伤过多的正常组织，降低了瘢痕的发生率及变形的方法是非常重要的。为此，笔者团队研究创建了在显微镜下采用射频皮肤治疗仪，于病变与正常组织之间采用显微微切消融面部难治性色素痣，很好地保留了正常组织，由于消融形成了保护层不需要缝合，有效地降低了瘢痕的发生率及变形，复发率低，取得了显著的临床疗效。
1 资料和方法
1.1 一般资料：选取2011年10月-2017年3月笔者医院就诊的色素痣患者58例(共80个皮损)，其中男23例，女35例。年龄12～68岁，病程4～56年。单发大色素痣患者50例，多发患者8例。其中4例患者本次治疗前曾行激光治疗，3例无效，1例病变面积增大；1例曾行手术切除后复发；1例行药物治疗无效。病变大小：直径6～8mm者40个，8～10mm者30个，10～20mm者10个。病变部位：额颞部18个，两颊6个，眼周11个，鼻唇部30个，下颌及颏部15个，其中包括危险三角区16个，人中5个，唇缘9个，眉间11个。见表1。纳入标准：①临床诊断为黑色素痣；②位于面部明显部位；③直径≥6mm，且凸出于皮肤，可伴异常毛发生长；④无其他影响射频治疗的器质性病变。, 百拇医药(谢惠敏 王硕 贾子善 张立宁 王兴林)
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