可调脉宽Nd：YAG激光联合Nlite脉冲染料激光对婴幼儿草莓状血管瘤早期临床干预的研究  

Early clinical treatment of the infantile hemangiomas with long pulsed turnable Nd. YAG laser and pulsed dye laser

作　　者：肖和[1] 肖琴[1] 陈南希[1] 单淑如 李小妹[1] 杨志强[1] 

机构地区：[1]广州医科大学附属第二医院整形外科,广东广州510260

出　　处：《中国美容整形外科杂志》2014年第7期388-391,共4页Chinese Journal of Aesthetic and Plastic Surgery

基　　金：广东省科学技术厅社会发展基金资助项目（20108080701028）

摘　　要：目的评价长脉冲可调脉宽Nd：YAG激光联合Nlite脉冲染料激光早期治疗婴幼儿草莓状血管瘤的疗效与安全性。方法回顾性分析采用长脉冲可调脉宽Nd：YAG激光与脉冲染料激光早期联合治疗1个月至2岁的婴幼儿草莓状血管瘤患儿46例。根据患儿皮损的性质，选择适当的参数（脉宽、脉冲、能量密度等），观察皮肤反应。先经Nd：YAG激光治疗1～3次，再用脉冲染料激光治疗2、3次，治疗间隔2个月，共治疗5次。Nd：YAG激光以皮肤HPN变灰白色或苍白色为度；脉冲染料激光以皮肤变紫色或灰紫色为度。观察其临床疗效与不良反应的发生情况。结果46例患儿中，痊愈37例，痊愈率为80．43％；显效9例，显效率为19．57％；总有效率为100％。与以往单用Nd：YAG激光或脉冲染料激光相比，疗效有所提高。46例患儿中，7例（15．22％）出现色素沉着，3～6个月明显减退；4例（8．70％）出现轻度色素减退，6～12个月基本恢复；1例（2．17％）出现瘢痕，经治疗后，基本控制。结论长脉冲可调脉宽Nd：YAG激光联合Nlite脉冲染料激光早期治疗婴幼儿草莓状血管瘤疗效显著，起效快，并发症少，是治疗婴幼儿草莓状血管瘤的好方法，宜推广应用。Objective To evaluate the efficacy and salty of long pulsed turnable Nd：YAG laser and pulsed dye lasers（PDL） in the treatment of infantile hemangiomas. Methods A retrospective review was performed in 46 patients with infantile hemangiomas who were one months to two years and accepted treatment of pulsed Nd：YAG laser and pulsed dye laser. The treatment parameters were adjusted according to lesion types and cutaneous reaction, we observed the skin reactions. First, the patients were treated by Nd： YAG laser 1 to 3 times, then treated by pulsed dye laser 2 to 3 times, the treatment interval was 2 months, and treatment for 5 times. When the skin colour became white or pale color, we stopped Nd： YAG laser treatment. When the skin eolour became purple or gray purple, we stopped pulsed dye laser treatment. Both the treatment effect and the adverse effects were observed. Results All the 46 patients with infantile hemangiomas received 5 consecutive treatments with pulsed Nd ： YAG laser and pulsed dye laser at 2 months intervals. The cure rate and total effective rate after five treatments were 80.43% and 100% respectively. The obviously effective rate of treatment infantile hemangiomas using pulsed Nd ： YAG laser and pulsed dye laser was higher than it of using pulsed Nd ： YAG laser or pulsed dye laser single. Hyperpigmentation and hypopigmentation were found in 15.22 % and 8.7 % of 46 patients respectively. A patient accompanied of scar was observed. Conclusion Long pulsed turnable Nd ： YAG laser and pulsed dye laser is effective and safe in early chnical treatment of infantile hemangiomas with these advantages, like fast efficacy and fewer side effects. It is worthy of wide application in clinic.

关 键 词：Nd YAG激光 脉冲染料激光 婴幼儿血管瘤 疗效 

分 类 号：R454.2[医药卫生—治疗学]