张倩 王焱 赵亮

[摘要]目的：探讨机械磨削术在皮肤外科手术中的应用及临床效果。方法：选笔者科室2017年8月-2018年11月收治的机械磨削术治疗的患者107例，包括白癜风68例，酒渣鼻19例，疣状痣、炎性线状表皮痣16例，痤疮凹陷性瘢痕4例。术后随访1年，观察外观改善效果、皮损复发及瘢痕形成情况。结果：本组107例患者，非常满意率为77%（82/107），满意率为23%（25/107）。白癜风患者达80%复色52例，50%～80%复色16例;52例（76%）非常满意，16例（24%）满意。酒渣鼻患者均为鼻赘期，15例（79%）对外观改善非常满意，4例（21%）满意。疣状痣、炎性线状表皮痣患者12例（75%）非常满意，4例（25%）满意;1例炎性线状表皮痣位于手足的皮损约30%复发。痤疮凹陷性瘢痕患者3例（75%）非常满意，1例（25%）满意。结论：机械磨削术在皮肤外科应用于治疗白癜风、酒渣鼻、疣状痣、凹陷性瘢痕的临床及美学效果显著，满意度高。

[关键词]皮肤磨削术;机械磨削;白癜风;酒渣鼻;瘢痕;疣状痣

[中图分类号]R622    [文献标志码]A    [文章编号]1008-6455（2020）04-0010-03

Abstract： Objective  To discuss the application and clinical effect of mechanical dermabrasion in dermatologic surgery. Methods  A total of 107 patients were recuited from our department from August 2017 to November 2018， including 68 cases of vitiligo， 19 cases of rhinophyma， 16 cases of verrucous nevus， 4 cases of atrophic acne scar. The patients were followed for 1 year， observed the effect of appearance improvement， recurrence and scar formation of patients. Results  There were 107 patients in this group， the very satisfied rate was 77%（82/107）， the satisfied rate was 23%（25/107）. There were 68 cases of vitiligo， 52 cases recovered 80%， 16 cases recovered 50%-80%， 52 cases were extremely satisfied for clinical effect，16 cases were satisfied. There were 19 cases of rhinophyma， 15 cases were extremely satisfied for clinical effect， 4 cases were satisfied. There were 15 cases of verrucous nevus， one case of inflammatory linear epidermal nevus. 12 cases were extremely satisfied for clinical effect， 4 cases were satisfied. There was 30% recurrence on inflammatory linear epidermal nevus lesions located on hand and foot. In 4 cases of atrophic acne scar， 3 cases were extremely satisfied， one case was satisfied. Conclusion  The clinical and aesthetic effect of mechanical dermabrasion is wonderful and satisfied on vitiligo， rhinophyma， verrucous nevus， atrophic acne scar.

Key words： dermabrasion; mechanical dermabrasion; vitiligo; rhinophyma; scar; verrucous nevus

皮膚磨削术是一项历史悠久的医学美容换肤技术，该项技术随着科学技术的更新不断发展，包括传统的砂纸磨削、Kurten金属刷磨削、钻石或金属磨头磨削、微晶磨削和激光磨削（包括脉冲二氧化碳激光磨削和铒激光磨削）[1]。笔者科室主要采用金属磨头，进行机械磨削治疗。机械磨削术是用安装有各种形状磨头的高速转动的电动磨削机对表皮和真皮浅层进行可控制的机械物理性磨削手术。磨头转速为8 000～30 000r/min，操作时掌握磨削的深浅程度极为重要。打磨过深会造成正常皮肤组织的过度破坏，形成新的瘢痕[2]。……