眼睑良性病变的个体化超脉冲CO_(2)激光治疗  

Individualized super pulse CO_(2) laser therapy for benign eyelid lesions

作　　者：宋一帆[1] 柯享函 田彦杰[1] SONG Yifan;KE Xianghan;TIAN Yanjie(Department of Ophthalmology,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学第三医院眼科,北京100191

出　　处：《中华实用诊断与治疗杂志》2025年第1期45-49,共5页Journal of Chinese Practical Diagnosis and Therapy

摘　　要：目的 探讨超脉冲CO_(2)激光治疗眼睑良性病变的效果和安全性。方法 2019年12月—2022年12月北京大学第三医院行超脉冲CO_(2)激光治疗的眼睑良性病变患者76例。对无需行组织病理检查的病灶,应用磨削手具采用连续脉冲模式进行磨削,初始能量设定为5 W/mm^(2),暴露时间10~50 ms。对需行组织病理检查的病灶,先使用FS-50手柄采用连续脉冲模式沿病灶基底部将病灶完整切除,设定初始功率为5 W,暴露时间为0.05 s,然后应用磨削手具对切割边缘和底部进行热光凝治疗。治疗过程中根据组织反应情况调整脉冲频率、光斑大小、能量、暴露时间等参数。随访观察创面愈合情况、并发症发生情况以及患者的满意度。结果 76例治疗过程中均无不可耐受的疼痛或不适,治疗结束时创面均无活动性出血,治疗后均未发生创面感染。1例眼睑疣数量较多,分2次进行治疗,2次间隔时间为10周。1例眼睑疣治疗后6个月复发,再次行超脉冲CO_(2)激光治疗。随访至2024年6月,5例失访,余71例随访(26.2±5.8)个月,伤口完全上皮化时间为(1.14±0.42)周,外观恢复至患者满意的时间为(3.17±1.91)周。末次随访时均未见睑缘切迹、皮肤明显瘢痕、眼睑畸形或睫毛脱落。3例病灶临近泪小点区域者均未发生泪点损伤、干眼症或继发性溢泪等并发症。3例治疗后1~4周随访时见治疗区域局部皮肤色素沉着,12周随访时色素沉着消失,色素消退时间为(8.33±1.53)周。结论 眼睑良性病变患者采用超脉冲CO_(2)激光治疗效果满意,安全性高,美容效果好。Objective To investigate the efficacy and safety of super pulse CO_(2) laser in the treatment of benign eyelid lesions.Methods From December 2019 to December 2022,76 patients with benign eyelid lesions were performed super pulse CO_(2) laser therapy in Peking University Third Hospital.For lesions with no need for histopathologic examination,the grinding tool was applied in continuous pulse mode with an initial energy setting of 5 W/mm^(2) and an exposure time of 10 to 50 ms.For lesions with a need for histopathologic examination,the FS-50 handle was first used to completely remove the lesion along the base in continuous pulse mode,with an initial power setting of 5 W and an exposure time of 0.05 s;and then the grinding tool was applied to the cutting margin and bottom for thermal photocoagulation therapy.The pulse frequency,spot size,energy,exposure time and other parameters were adjusted according to the tissue response during therapy.Wound healing,complications and patient satisfaction were observed during follow-up.Results No intolerable pain or discomfort during therapy,no active bleeding at the end of the therapy,and no wound infection after therapy developed in 76 patients.One patient with a large number of eyelid verruca was treated twice,with an interval of 10 weeks.Another patient with eyelid verruca recurred 6 months after therapy and was treated with super pulse CO_(2) laser again.The follow-up was conducted till June 2024.Five patients were lost to follow-up,and the remaining 71patients were followed up for(26.2±5.8)months.The wound got complete epithelialization in(1.14±0.42)weeks,and the wound appearance was satisfactory in(3.17±1.91)weeks.No palpebral margin incisura,obvious skin scar,eyelid deformity or eyelash loss was found at the latest follow-up.No complications such as puncta lacrimalis injury,dry eye disease or secondary epiphora occurred in 3 patients with lesions near the puncta lacrimalis area.Local skin pigmentation in the treated area was observed in 3 patients in 1 to 4 weeks of fol

关 键 词：眼睑良性病变 超脉冲CO_(2)激光 美容治疗 多发眼睑肿物 

分 类 号：R779.63[医药卫生—眼科]