Nellis Family Medicine Residency, Nellis Air Force Base, NV, USA.
Am Fam Physician. 2012 Dec 15;86(12):1118-24.
Cutaneous cryosurgery refers to localized application of freezing temperatures to achieve destruction of skin lesions. It can be used to treat a broad range of benign and premalignant skin conditions, and certain malignant skin conditions, with high cure rates. Cellular destruction is accomplished by delivery of the cryogen via dipstick, probe, or spray techniques. It is widely used in primary care because of its safety, effectiveness, low cost, ease of use, good cosmetic results, and lack of need for anesthesia. Cryosurgery is as effective as alternative therapies for most cases of molluscum contagiosum, dermatofibromas, keloids, and plantar or genital warts. It is a more effective cure for common warts than salicylic acid or observation. Cryosurgery is generally the treatment of choice for actinic keratosis. Contraindications to cryosurgery include cryofibrinogenemia, cryoglobulinemia, Raynaud disease, agammaglobulinemia, and multiple myeloma. Complications from cryosurgery include hypopigmentation and alopecia, and can be avoided by limiting freeze times to less than 30 seconds. Referral to a dermatologist should be considered in cases of diagnostic uncertainty or for treatment of skin cancer, which requires larger amounts of tissue destruction, resulting in higher complication rates.
皮肤冷冻手术是指将冷冻温度局部应用于皮肤病变以达到破坏的目的。它可以用于治疗广泛的良性和癌前皮肤病变，以及某些恶性皮肤病变，治愈率高。细胞破坏是通过棒状、探针或喷雾技术输送冷冻剂来实现的。由于其安全性、有效性、低成本、易用性、良好的美容效果和无需麻醉的特点，它在初级保健中得到广泛应用。冷冻手术对于大多数传染性软疣、皮肤纤维瘤、瘢痕疙瘩和足底或生殖器疣的病例与替代疗法一样有效。对于常见疣，它比水杨酸或观察更有效。冷冻手术通常是光化性角化病的治疗选择。冷冻手术的禁忌症包括冷纤维蛋白原血症、冷球蛋白血症、雷诺病、丙种球蛋白缺乏症和多发性骨髓瘤。冷冻手术的并发症包括色素减退和脱发，可以通过将冷冻时间限制在 30 秒以内来避免。在诊断不确定或需要更大程度的组织破坏以治疗皮肤癌的情况下，应考虑转介给皮肤科医生，因为这会导致更高的并发症发生率。
