595 nm PDL/1064 nm Nd:YAG双波长激光联合平阳霉素局部注射治疗婴幼儿血管瘤的效果分析  

Clinical effects of 595 nm pulsed dye laser/1064 nm neodymium-doped yttrium alummlum garnet dual wavelength laser combined with local injection of pingyangmycin in treatment of infantile hemangioma

作　　者：狄奇 李三林 张高磊[2] 曹佳捷 熊祎 张靖 王昊[4] 刘景[4] 申刚 Di Qi;Li Sanlin;Zhang Gaolei;Cao Jiajie;Xiong Yi;Zhang Jing;Wang Hao;Liu Jing;Shen Gang(Department of Hemangioma Intervention,Children's Hospital,Capital Institute of Pediatrics,Beijing 100020,China;Department of Dermatology,Childrenis Hospital Affiliated to Capital Institute of Pediatrics,Beijing 100020,China;Department of Hemangioma Intervention,Guangdong Provincial People's Hospital,Guangzhou 510000,China;Department of Radiology,Children's Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]首都儿科研究所附属儿童医院介入血管瘤科,北京100020 [2]首都儿科研究所附属儿童医院皮肤科,北京100020 [3]广东省人民医院介入血管瘤科,广州510000 [4]郑州大学附属儿童医院放射科,郑州450000

出　　处：《中华临床医师杂志（电子版）》2023年第4期391-397,共7页Chinese Journal of Clinicians(Electronic Edition)

基　　金：国家自然科学基金资助项目(81974473)

摘　　要：目的探讨595 nm脉冲染料激光/1064 nm钇铝石榴石晶体(595 nmPDL/1064 nm Nd:YAG)双波长激光联合平阳霉素(PYM)局部注射治疗婴幼儿血管瘤(IH)的临床效果。方法选取2021年1月至2021年8月在首都儿科研究所附属儿童医院治疗的48例IH患儿为研究对象,将其随机分为对照组(n=24)与观察组(n=24)。对照组使用595 nmPDL/1064 nm Nd:YAG双波长激光治疗,观察组在此基础上进行PYM局部注射治疗,均1次/月,共治疗3次。分析2组治疗前后的血管瘤面积与厚度变化、治疗后的临床疗效、治疗过程中的不良反应发生率及疗效的影响因素。结果治疗后2组的血管瘤面积、厚度均显著低于治疗前(P<0.05),且观察组显著低于对照组(P<0.05);2组治疗效果的等级比较差异具有统计学意义(P<0.05),且观察组治疗的总有效率及显效率均显著高于对照组(P<0.05);2组的不良反应发生率比较差异无统计学意义(P>0.05);疗效良好组患儿的年龄、血管瘤厚度及血管瘤分期及治疗方式均具有统计学差异(P<0.05);多因素分析患儿年龄较小、血管瘤厚度较低及联合治疗方式是疗效良好的独立影响因素(P<0.05)。结论595 nmPDL/1064 nm Nd:YAG双波长激光联合平阳霉素治疗IH的临床效果较好。Objective To evaluate the clinical effects of 595 nm pulsed dye laser/1064 neodymium-doped yttrium alummlum garnet(595 nm PDL/1064 nm Nd:YAG)dual wavelength laser combined with local injection of pingyangmycin(PYM)in the treatment of infantile hemangioma(IH).Methods A total of 48 children with IH treated at Children's Hospital affiliated to Capital Institute of Pediatrics from January 2021 to August 2021 were selected as the research subjects,and they were randomly divided into either a control groups(n=24)or an observation groups(n=24).Both groups were treated with 595 nm PDL/1064 nm Nd:YAG dual wavelength laser,and the observation group was additionally treated with local injection of PYM,once a month for a total of 3 times.The changes of hemangioma area and thickness before and after treatment,clinical efficacy after treatment,incidence of adverse reactions during treatment,and influencing factors of curative effects were compared between the two groups.Results After treatment,the area and thickness of hemangioma in the two groups were significantly lower than those before treatment(P<0.05),and they were significantly lower in the observation group than in the control group after treatment(P<0.05).There were statistically significant differences in the grade of treatment effects between the two groups(P<0.05),and the total effective rate and the rate of significant improvement in the observation group were significantly higher than those of the control group(P<0.05).There was no difference in the incidence of adverse reactions between the two groups(P>0.05).There were statistically significant differences in age,hemangioma thickness,hemangioma stage,and treatment mode between patients with good curative effects and those without(P<0.05).Multivariate analysis showed that younger age,lower thickness of hemangioma,and combination therapy were independent influencing factors of good efficacy(P<0.05).Conclusion 595 nm PDL/1064 nm Nd:YAG dual wavelength laser combined with pingyangmycin has good clinical effects in

关 键 词：婴幼儿血管瘤 595 nm脉冲染料激光 1064 nm Nd:YAG激光 平阳霉素 

分 类 号：R732.2[医药卫生—肿瘤]