穩定性白斑症表皮色素移植術與自動表皮微移植術的比較研究

摘 要：

自動吸疱表皮微移植術（ABEM）是一種新引入的難治性白斑症的外科移植方法，然而，對其他外科方法的比較分析仍然缺乏。我們進行了一項回顧性研究，將ABEM與傳統吸疱表皮移植術（SBEG）的療效、安全性和操作經驗進行比較。研究共納入了75名患者的118個解剖部位的白斑症病變。主要評估結果為再色素沉著的程度，並評估了患者和操作人員的經驗。根據醫師綜合評估（PGA），SBEG在再色素沉著的發生率方面顯著更高（p < 0.001），尤其是在面部/頸部區域（p < 0.001），並且在白斑症面積評分指數（VASI）上也有顯著改善。相反，ABEM具有較短的供皮區採集時間，更好的患者手術體驗以及更顯著的皮膚病生活質量指數（DLQI）改善。 在10名患者的38個病變中，同時接受了SBEG和ABEM，發現在相同的受體區域內再色素沉著的程度沒有差異。總體而言，SBEG的再色素沉著程度高於ABEM，特別是在活動區域，而且成本更低。相反，ABEM需要較少的操作學習曲線，可以提供更大的移植區域，並且供皮區恢復時間較短。了解這兩種吸疱移植術的優缺點對於白斑症移植的最佳手術結果至關重要。

The automated blister epidermal micrograft (ABEM) is a newly introduced surgical transplantation for refractory vitiligo. Comparative analysis of other surgical methods is lacking. We conducted a retrospective study to compare the efficacy, safety, and experience of ABEM with conventional suction blister epidermal graft (SBEG). A total of 118 anatomically based vitiligo lesions from 75 patients were included. The primary outcome was the degree of repigmentation; the patient and operator experience were evaluated. SBEG had a significantly greater incidence of repigmentation (p < 0.001), as measured by the Physician Global Assessment, as well as improvements in the Vitiligo Area Scoring Index, particularly on the face/neck area (p < 0.001). ABEM, on the contrary, had reduced donor harvest time, a better patient operative experience, and more significant Dermatology Life Quality Index improvements. In a subgroup of 38 lesions from ten patients who received both SBEG and ABEM concomitantly, there was no difference in the degree of repigmentation in the same recipient area. Overall, the degree of repigmentation for SBEG is higher than ABEM, especially in the mobilized region, and the cost is less expensive. On the contrary, ABEM requires less procedure learning curve and can supply a greater transplanting zone with shorter donor site recovery. Understanding the benefits and drawbacks of two blister grafting procedures is essential for optimal surgical outcomes for vitiligo grafting.