长脉冲可调脉宽Gentle YAG 1064nm激光治疗颌面部血管瘤113例效果评估  

Treatment of 113 oral and maxillofacial hemangiomas with long pulsed turnable 1064nm Gentle YAG laser

作　　者：周国瑜[1] 沈玲悦[1] 田克斌[1] 张志愿[1] 梁军艳[2] 朱玉兰[2] 陈锦安[2] 

机构地区：[1]上海交通大学医学院附属第九人民医院.口腔医学院口腔颌面外科,上海200011 [2]上海交通大学医学院附属第九人民医院.口腔医学院激光治疗中心,上海200011

出　　处：《上海口腔医学》2006年第3期250-253,共4页Shanghai Journal of Stomatology

基　　金：上海市科学技术委员会科研基金(014119026);上海市重点学科建设项目(Y0203)

摘　　要：目的:长脉冲可调脉宽GentleYAG1064nm激光是新问世的医疗激光设备,探讨用其治疗颌面部血管瘤113例,对其效果进行评估。方法:自2005年4月至8月,应用美国Candela激光公司生产的GentleYAG1064nm激光治疗口腔颌面部血管瘤113例。采用最小激光凝固剂量方法,激光能量参数为170～240J/cm2,光斑直径1.5mm,脉宽30￣60ms。激光脉冲前动态冷却(DCD)10～20次,脉冲后DCD10～15次。疗程1￣2个(9例为2个疗程,104例1个疗程)。随访3￣6个月,随访率96%。结果:全部病灶清除85例,占75.22%;有效清除(50%￣75%病灶清除)28例,占24.78%;部分清除(病灶清除<50%)0例,无效率为0。伴色素沉着11例(9.73%),色素脱失2例(1.77%),色素改变均自然恢复,历时4￣5个月。瘢痕7例,占6.19%。结论:长脉冲GentleYAG1064nm激光小剂量照射是口腔颌面部血管瘤治疗的有效手段,具有起效快、疗程短、副作用小的显著优点,宜推广应用。PURPOSE： To evaluate the clinical therapeutic efficacy on hemangioma of oral maxillofacial regions using pulsed Gentle YAG laser. METHODS： Since April 2005 to August 2005, 113 cases of oral and maxillofacial hemangiomas were treated using pulsed Gentle YAG laser 1064 nm wavelength in our department. Minimal coagulation laser dosage was defined and used to avoid side effects such as thermal skin damage. The laser dosage was 170-240J/cm^2, with 1.5mm in diameter spot and pulse wide of 30-60ms. Dynamic cooling device set was used 10-20 times and 10-15 times pre- and post-pulse respectively. 9 of 113 cases had two sessions of treatment, 104 underwent only one session. 96% cases were followed up for 4-6 months. RESULTS： Total response was achieved in 85 cases （75.22%）, good response in 28 cases （24.78%）, fair response and poor response was 0. Temporary side effects included hyper- pigmentation in 11 cases （9.73%）, hypo-pigmentation in 2 cases （1.77%）, and they disappeared after 4 to 6 months. 7 cases had scar formation accounting for 6.19%. CONCLUSION： The minimal coagulation dosage pulsed Gentle YAG laser is a good tool to treat hemangioma in oral and maxillofacial regions. It has the advantage of fast efficacy, short term sessions and fewer side effects. It is worthy of wide clinical application. Supported by Research Fund of Science and Technology Committee of Shanghai Municipality （Grant No. 014119026） and Shanghai Leading Academic Discipline Proiect （Grant No.Y0203）.

关 键 词：血管瘤 长脉冲激光 可调脉宽 GENTLE YAG 

分 类 号：R739.8[医药卫生—肿瘤]