多爱肤联合爱康肤银敷料用于睑黄瘤激光术后创面的效果

目的：观察多爱肤联合爱康肤银敷料治疗睑黄瘤激光术后创面的临床效果。方法选择睑黄瘤激光术后患者114例,随机分为3组,均按相同方法清洗创面,根据创面情况按需换药。观察组（n＝39）创面内敷料为爱康肤银,外敷料为多爱肤敷料,待渗液减少后粘贴多爱肤敷料;对照1组（n＝37）创面单纯敷盖多爱肤敷料;对照2组（ n＝38）创面采用传统换药法,用无菌纱布覆盖,保持清洁干燥。比较3组患者创面肉芽生长时间、治愈时间、瘢痕增生及治愈率情况。结果观察组患者创面肉芽生长时间（5．35±2．18）d,愈合时间（11．15±2．24）d,均优于对照组,差异有统计学意义（F值分别为9．000,5.717;P＜0．05）;观察组患者无一例瘢痕增生,治愈率为100％,均优于对照组,差异有统计学意义（χ2值分别为13．515,21．351;P＜0．01）。结论多爱肤联合爱康肤银敷料治疗睑黄瘤激光术后创面的临床效果优于单纯多爱肤敷料和传统纱布换药,值得临床推广应用。     

眼睑黄色瘤的手术治疗

在彻底切除黄色瘤的同时，增强眼睑形态美感。根据眼睑黄色瘤多发生在中老年人，均伴有不同程度的上睑皮肤松弛这一特点，在充分切除黄色瘤病变区的同时，行上睑松弛矫治术。手术采取超过黄色瘤边缘至少１ｍｍ作梭形切除，清除皮下组织及切口边缘之脂肪成分，通过保留病灶外侧邻近预定切除的相应面积皮肤，利用上睑皮肤移动度大的特点，直接间断缝合黄色瘤切除区缺损。其下方以缝合压线法，外侧皮肤切除区以切开法作成重睑皱襞。笔者自１９９３年以来对２１例（４０只眼）施行该手术。随访１９例，均获满意效果。手术彻底清除病灶的同时，行上睑松弛矫治术，合理设计，可获得理想的治疗、美容双重效果。     

皮损内注射肝素钠与超脉冲CO2 激光治疗睑黄瘤的临床效果比较

目的 探讨皮损内注射肝素钠与超脉冲CO2激光治疗睑黄瘤的临床效果。方法 选取2019年 10月-2021年10月于我院就诊的60例睑黄瘤患者作为研究对象,按随机数字表法分为观察组和对照组, 各30例。观察组给予肝素钠皮损内注射治疗,对照组给予超脉冲CO2激光治疗,比较两组临床疗效以及 局部并发症发生情况。结果 观察组治疗总有效率为93.33%,低于对照组的96.67%,但差异无统计学意 义（P ＞0.05）;观察组并发症发生率低于对照组,差异有统计学意义（P ＜0.05）。结论 肝素钠治疗与 CO2激光治疗均对睑黄瘤有一定效果,但肝素钠注射治疗后并发症发生率较低,临床可根据患者实际需 求进行选择。     

KTP‐Laser‐Koagulation bei Xanthelasma palpebrarum

Background: Xanthelasma palpebrarum is a benign skin disorder of unknown etiology appearing as one or multiple yellowish plaques around the eyelids. Hyperlipidemia, thyroid dysfunction, and diabetes mellitus are possible pathogenetic triggers. Removal of xanthelasma is desired for aesthetic reasons. While there are many treatment options, search continue for newer methods with less scarring and post‐inflammatory hyperpigmentation. Patients and Methods: We employed for the first time KTP laser (532 nm) for the treatment of 14 patients with xanthelasma palpebrarum on 33 eyelids. Results: More than 70 % of the patients tolerated KTP laser irradiation without any analgesia. 85.7 % showed respectable reduction of xanthelasma palpebrarum after one to three treatment sessions without side effects. Conclusions: KTP laser irradiation represents a minimally invasive, safe and effective treatment option for the reduction of xanthelasma palpebrarum without undesired side effects.     

CO2激光照射联合湿润烧伤膏治疗睑黄瘤的临床观察

目的:探讨CO2激光照射与湿润烧伤膏联合治疗睑黄瘤的疗效.方法:64例病变先运用CO2激光气化治疗,根据照射创面处理方法分为两组:湿润烧伤膏组:烧灼后创面外涂湿润烧伤膏;传统组:创面采用外科换药法治疗(外用0.5%碘伏),观察它们的创面愈合时间、创面恢复后的外观形态等.结果:湿润烧伤膏组创面平均愈合时间7.8天±1天,外观理想;传统组创面平均愈合时间13.0天±1.5天,15例29处创面出现扁平瘢痕.结论:CO2激光照射与湿润烧伤膏联合治疗睑黄瘤疗效肯定,使用方便.     

风筝皮瓣修复眼睑黄色瘤切除后的眼睑前层缺损

目的 探讨风筝皮瓣在修复眼睑黄色瘤切除后所致的眼睑前层缺损中的应用.方法 黄色瘤切除后,于缺损颞侧皮肤松弛部位沿皮纹方向设计风筝皮瓣,按设计线切开皮肤,在眼轮匝肌下剥离形成以眼轮匝肌为皮下蒂的风筝皮瓣,推进至皮肤缺损区,用5-0尼龙线缝合切口.自2005年以来共应用16例,20只眼,年龄34～68岁,缺损面积为5mm×10mm～10mm×22mm.结果 皮瓣全部成活,切口Ⅰ期愈合,随访时间3个月至3年,眼睑外形双侧对称,切口瘢痕不明显.结论 对于眼睑较大黄色瘤切除后直接缝合会导致眼睑畸形的眼睑前层缺损,用风筝皮瓣进行修复简单易行,效果可靠.皮瓣转移后局部平整,无须去除多余皮肤组织,手术后恢复时间短,具有取材方便、便于推广等优点.     

Argon laser versus erbium:YAG laser in the treatment of xanthelasma palpebrarum

Background

Xanthelasma palpebrarum is the most common of the xanthomas with asymptomatic, symmetrical, bilateral, soft, yellow, polygonal papules around the eyelids. Though it is a benign lesion causing no functional disturbance, it is esthetically annoying. The surgical laser offers an extremely elegant and powerful solution to this problem.

Objective

To evaluate the effectiveness of erbium:YAG and argon lasers in the treatment of xanthelasma lesions.

Patients and methods

Forty patients were included in the study. Twenty patients (15 patients were bilateral with 30 eyes either in the upper or lower lid and 5 patients were unilateral) were treated with erbium:YAG laser. Another 20 patients (10 patients were bilateral with 20 eyes and 10 patients were unilateral) were treated with argon laser.

Results

In the majority of treated patients (either treated with erbium:YAG or argon laser), xanthelasma lesions were completely disappeared or significantly decreased in size. Two patients showed pigmentary changes in the form of hypopigmentation with erbium:YAG laser (one case), another case showed hyperpigmentation. No intraoperative complication was observed. No significant scar or recurrence was observed.

Conclusion

Argon laser in xanthelasma is an easy, effective, and safe method of treatment for small lesions and YAG laser is more better for large lesions than argon laser.