目的：探讨308 nm准分子激光治疗白癜风发生水疱的原因与防治措施。方法回顾我科2005年1月—2014年2月308 nm准分子激光治疗白癜风3152例中发生水疱181例的临床资料，分析水疱发生原因及防治措施。结果本组水疱的总发生率为5.74%。头面部治疗水疱发生率为5.07%，口角及唇部治疗水疱发生率14.01%，颈部治疗水疱发生率5.80%，躯干部治疗水疱发生率2.92%，四肢部治疗水疱发生率5.56%。本组发生水疱后均立即停止308 nm准分子激光局部照射，给予局部对症处理，水疱恢复正常时间平均为7.36 d。结论308 nm准分子激光治疗白癜风时，治疗剂量应从最小红斑量开始，逐渐递增剂量，根据红斑反应调整治疗剂量，避免单次照射剂量过大或在光敏性患者身上照射，以减少或避免水疱的发生。%Objective To discuss the cause and preventive methods of blister reaction and its precaution after 308 nm excimer laser treatment of vitiligo. Methods Clinical data of 3152 patients were studied. This retrospective study involved the records of patients admitted to our department undergoing 308 nm excimer laser treatments during January 2005 and Febru-ary 2014. 181 adverse cases of local blister reaction and precaution methods were analyzed. Results During 308 nm excimer laser treatment, local skin blister reaction rate of the vitiligo patients in the research group was 5. 74%. In the group, blister reactions occurred on the head and face with a rate of 5. 07%, on and around the lips with a rate of 14. 01%, on the neck with a rate of 5. 80%, on the body with a rate of 2. 92%, and on the limbs with a rate of 5. 56%. After the occurrence of blister, all the patients suspended 308 nm excimer laser treatment for symptomatic treatment, and the average healing time of blisters was 7. 36 days. Conclusion With the minimal erythema, dose treatment dosage should be adjusted according to ery-thema reaction at the beginning of medication. Single overdose and direct irradiation on the patient's photosensitive skin should be avoided so as to reduce and prevent blister reaction.
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