双波长激光联合药物皮损内注射治疗儿童皮肤血管瘤的临床研究  

Comparing treatment effects among dual wavelength laser,triamcinolone acetonide injection and combined two methods for infantile hemangioma

作　　者：魏芳[1] 周自广[1] 李彦锋[1] 马晓焕[1] 勾爱丽 

机构地区：[1]河南省郑州市第一人民医院皮肤科,河南郑州450004

出　　处：《中国现代医学杂志》2015年第26期90-93,共4页China Journal of Modern Medicine

摘　　要：目的探讨585 nm/1 064 nm双波长激光联合曲安奈德皮损内注射治疗儿童皮肤血管瘤的疗效。方法收集该院门诊皮肤血管瘤患儿210例,随机分为A、B、C 3组,分别给予双波长激光、曲安奈德皮损内注射及两者联合治疗,3个月后评价疗效,比较各组有效率。结果 A、B、C 3组的有效率分别为82.9%、75.7%和97.1%,其中C组有效率高于A组和B组（χ2=7.937和13.702,P〈0.017）。C组中草莓状、海绵状及混合型血管瘤的有效率分别为100.0%、87.5%和95.0%。年龄〈6个月、6个月～2岁及〉2岁年龄段的有效率分别为100.0%,93.3%和87.5%。不良反应包括色素减退或沉着、皮肤萎缩。结论采用双波长激光联合曲安奈德皮损内注射治疗儿童皮肤血管瘤较单一疗法效果好,且不良反应少。联合治疗方法对草莓状血管瘤的疗效要优于海绵状及混合型血管瘤,且建议尽早治疗。【Objective】 To observe treatment results of infantile hemangioma by dual-wavelength laser（585 nm / 1,064 nm）, triamcinolone acetonide and combination of the two above methods.【Methods】 A total of210 infant hemangioma cases were collected in the outpatient clinic. Theses cases were randomly divided into groups A, B and C. The group A was treated with 585 nm/1064 nm dual-wavelength laser only. The group B was treated with triamcinolone acetonide injection only. The group C was treated with dual-wavelength laser as well as triamcinolone acetonide injection. Clinical effectiveness was observed three months after treatment and compared among the groups. 【Results】 Clinical improvement was shown in 82.9% of the group A, 75.7%of the group B and 97.14% of the group C. The group C demonstrated significant clinical improvement rate compared to the group A（χ2= 7.937, P〈 0.017） and the group B（χ2= 13.702, P 〈0.017）. Within the group C, different hemagioma types and age groups also showed different results. In the group C strawberry hemangioma showed 100.0% clinical improvement, while cavernous 87.5% and mixed hemangioma 95.0% respectively. The patients with the age of less than 6 months showed 100.0% clinical improvement, which was 93.3%in those with the age from 6 months to 2 years and 87.5% in the cases with the age over 2 years. The adverse reactions of hypopigmentation, hyperpigmentation and skin atrophy were noticed in all the methods with fewer in the the combined method. 【Conclusions】 The combined method of dual-wavelength laser and triamcinolone acetonide is more effective than any single therapy in treatment of infantile hemangioma. This combined method is especially more effective for strawberry hemangioma in patients under 6 months.

关 键 词：血管瘤 激光疗法 曲安奈德 

分 类 号：R758.5[医药卫生—皮肤病学与性病学]