口腔疾病防治2024，Vol.32Issue(1)：36-42,7.DOI:10.12016/j.issn.2096-1456.2024.01.006
调Q激光与手术切除治疗口腔黏膜黑斑后的复发率比较:一项回顾性队列研究
Recurrence rate of oral melanotic macule treated with Q-switched alexandrite laser versus surgical excision:a retrospective cohort study
摘要
Abstract
Objective To compare the recurrence rates between 755 nm Q-switched alexandrite laser(QSAL)treat-ment and surgical excision of oral melanotic macules(OMM).Methods This study was reviewed and approved by the Ethics Committee,and informed consent was obtained from the patients.A retrospective cohort study was designed to collect demographic and clinical characteristics and follow-up data from patients with OMM.Patients who received QSAL or surgical excision in the Department of Oral Medicine,Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine from January 2019 to August 2021 were included.The one-year recurrence rate was in-vestigated as the primary outcome.Long-term adverse reaction rates were investigated as safety indicators.Kaplan-Mei-er analyses were performed to analyze the recurrence-free rates between the groups.Results A total of 57 patients were enrolled in this study.16 patients underwent surgical excision,and 41 underwent QSAL.The baseline demograph-ic and clinical characteristics between the groups were not significantly different.No recurrence(0%)of OMM was ob-served in the surgical excision group,while in the QSAL group,the macule recurred in 12 patients(29.27%).The aver-age duration of recurrence was 6.08 months after treatment.Recurrence was not found to be associated with smoking(P = 1.000),gastrointestinal polyps(P = 1.000),longitudinal melanonychia(P = 0.187),family history(P = 0.552),treat-ment sessions(P = 0.567)or multiple macule lesions(P = 0.497).Compared with treatment with surgical excision,the odds ratio of recurrence for treatment with QSAL was 4.41,with a 95%confidence interval of 1.27-15.24(P = 0.020).In the surgical excision group,3 patients(18.75%)reported depressions and scars on the lesion,while no long-term ad-verse reactions(0%)were reported in the QSAL group(P = 0.019).Conclusion Compared with surgical excision,the advantage of QSAL is the low long-term adverse reaction rate,while the disadvantage is the relatively high one-year re-currence rate.It is necessary to communicate the advantages and disadvantages of the two methods with OMM patients to assist in clinical decision-making.关键词
口腔黏膜黑斑/调Q激光/手术切除/随访/复发/不良反应/凹陷/疤痕Key words
oral melanotic macule/Q-switched alexandrite laser/surgical excision/follow-up/recurrence/adverse reaction/depression/scar分类
医药卫生引用本文复制引用
孙凯,施琳俊,沈雪敏..调Q激光与手术切除治疗口腔黏膜黑斑后的复发率比较:一项回顾性队列研究[J].口腔疾病防治,2024,32(1):36-42,7.基金项目
上海市科委"科技创新行动计划"医学创新研究专项(20Y11903700) （20Y11903700）
上海交通大学医工交叉基金(YG2021QN58) （YG2021QN58）
上海交通大学医学院附属第九人民医院、上海交通大学口腔医学院研究型学科基金(KQYJXK2021)This study was supported by the Medical Innovation Research Project of Science and Technology Innovation Action Plan of Shanghai Science and Technology Committee(No.20Y11903700),Interdisciplinary Program of Shanghai Jiao Tong University(No.YG2021QN58),Research Discipline Fund from Ninth People's Hospital,Shanghai Jiao Tong Uni-versity School of Medicine and College of Stomatology,Shanghai Jiao Tong University(No.KQYJXK2021). （KQYJXK2021）
