【摘要】 目的探讨点阵式CO₂激光治疗外阴硬化性苔癣的疗效及副作用。方法选择北京大学人民医院妇科门诊外阴硬化性苔癣（vulvar lichen sclerosus,VLS）患者31例,采用CO₂激光治疗仪治疗VLS,共3⁴次,每次间隔1个月。采用视觉模拟评分法（visual analogue scale,VAS）评估患者治疗前后外阴瘙痒、干燥皲裂、性交痛程度,并比较评分结果。结果 31例患者中,第3次治疗后1个月外阴瘙痒的改善率为90.32%（28/31）。第1、3次治疗后1个月外阴瘙痒程度评分[（3.43±0.94）分,（1.93±0.62）分]与治疗前[（8.07±1.97）分]比较,差异有统计学意义（P<0.001）;外阴干燥皲裂评分[（1.36±1.22）分,（0.64±0.84）分]与治疗前[（3.50±1.79）分比较,差异均有统计学意义（P<0.05）;第3次治疗后1个月性交疼痛评分[（1.14±0.95）分]与治疗前[（4.29±2.70）分]比较,差异有统计学意义（P<0.05）。治疗后12 h轻度疼痛2例,48 h局部轻度充血水肿6例,均无需治疗,无其他严重不良反应发生。随访时间3⁷个月,9例皲裂全部改善。皮肤颜色变化4例（12.9%）;6例因VLS不能性生活者,2例恢复。治疗后总体满意率96.77%（30/31）。结论点阵式CO₂激光可作为外阴硬化性苔癣治疗的新方法,可明显改善瘙痒、皮肤皲裂症状,操作简单,患者满意度高,值得临床推广。更多还原

【Abstract】 Objective To investigate the efficacy and side effects for fractional CO₂ laser in the treatment of vulvar lichen sclerosus（VLS）. Methods 31 patients with VLS symptoms were enrolled prospectively from July 2015 to April 2016 in Peking University People’s Hospital. The fractional CO₂ laser was used for VLS lesions,a total of 3 5 times, each time per-month. Visual analogue scale（VAS） was assessed the degree of vulvar pruritus, skin chapping, dyspareunia before and after treatment. After the treatment, satisfaction survey was done. Results The rate improvement of VLS symptoms was 90.32%（28/31） with fractional CO₂ laser（P <0.001）. Compare with before treatment, there were significant difference in pruritus score at the first and the third after treatment one month（8.07±1.97 vs. 3.43±0.94 and 1.93±0.62,P < 0.001）, vulvar skin chapping score（3.50±1.79 vs. 1.36±1.22 and 0.64±0.84,P < 0.05）, respectively. The dyspareunia score（4.29±2.70 vs.1.14±0.95,P < 0.05） were improved significantly at the third after treatment one month. After treatment 48 h,there were 2 cases with mild pain, 6 cases with local mild hyperemia, 4 cases with mild swelling. No adverse events due to fractional CO₂ laser treatment occurred. During 3 7 months follow-up, 4 cases（12.9%） with the skin color from white to gray, 2 cases recovered sex from 6 cases. The overall satisfaction rate was 96.77%（30/31）. Conclusions The fractional CO₂ laser is effective, minimal injury and acceptable side effects for vulvar lichen sclerosus, and may be a new treatment for it.更多还原