长脉冲1064nmNd：YAG激光治疗婴儿血管瘤5年回顾分析  

Long-pulsed 1064-nm Nd：YAG laser in the treatment of infantile hemangioma： a 5-year retrospective analysis

作　　者：钟淑霞[1] 周俊峰[1] 陶育纯[2] 姚蕾[1] 宋洋[1] 刘媛媛[1] 闫冬雪[1] 李珊山[1] 

机构地区：[1]吉林大学第一医院皮肤科,长春130021 [2]吉林大学公共卫生学院流行病与卫生统计学教研室

出　　处：《中华皮肤科杂志》2016年第1期36-39,共4页Chinese Journal of Dermatology

摘　　要：目的 评价长脉冲1064 nm Nd：YAG激光治疗婴儿血管瘤的临床效果和特点。 方法 吉林大学第一医院皮肤科门诊接受1064 nm Nd：YAG激光治疗的资料完整的婴儿血管瘤病例共794例（900处血管瘤），回顾性分析患者临床资料，包括患者年龄、性别，血管瘤发生时间、病程、类型、位置、面积、并发症及治疗结果。不同性别间的疗效比较采用两组秩和检验；不同疗效患儿的年龄和血管瘤的面积采用中位数 ± 四分位数间距进行描述，组间比较采用多组秩和检验；不同血管瘤的位置和不同血管瘤分类间的疗效比较均采用多组秩和检验；影响血管瘤疗效的多因素分析方法采用有序多分类logistic回归法。 结果 794例患儿经1 - 5次激光治疗后，总有效率为87.56%（788/900）。疗效与患儿的性别（Z = -7.18，P 〉 0.05）和血管瘤的位置（χ^2 =2.34，P 〉 0.05）无关，而主要与患儿的年龄（χ^2 = 103.131，P 〈 0.001）和血管瘤类型（χ^2 = 107.709，P 〈 0.001）相关。年龄越大，疗效越好（OR = 1.21，95% CI 1.14 ～ 1.28，P 〈 0.001）；同单纯血管瘤比较，混合型血管瘤疗效最差（OR = 0.22，95% CI 0.17 ～ 0.29，P 〈 0.001），其次为深层血管瘤（OR = 0.30，95% CI 0.10 ～ 0.93，P = 0.037）。不良反应包括术后水疱、萎缩性瘢痕、色素沉着、色素减退、皮肤质地改变，未见增生性瘢痕。 结论 1064 nm Nd：YAG激光是治疗各种类型早期婴儿血管瘤的有效手段之一。Objective To evaluate the clinical efficacy and characteristics of long-pulsed 1064-nm Nd：YAG laser in the treatment of infantile hemangioma. Methods Totally, 794 cases of infantile hemangioma （including 900 hemangioma lesions） treated with long-pulsed 1064-nm Nd：YAG laser in the First Hospital of Jilin University were included into this study. Clinical data were collected from these patients, including age, gender, age at onset of hemangioma, disease course, clinical types, lesional location and area, complications and treatment outcome. A retrospective analysis was carried out. The Mann-Whitney test was performed to compare therapeutic effects between male and female patients, and the Kruskal-Wallis H test to compare those among hemangioma at different sites and of different types. The central tendency and variability in patients′ age and lesional area were expressed as median ± quartile range, and compared by the Kruskal-Wallis H test among hemangioma showing different therapeutic response. Factors influencing therapeutic response were analyzed by an ordinal multinomial logistic regression analysis. Results After 1 - 5 sessions of laser therapy, the total response rate was 87.56% （788/900） in the 794 patients with infantile hemangioma. There were significant differences in therapeutic response among patients of different ages （χ^2 = 103.131, P 〈 0.001）, among different types of hemangioma （χ^2 = 107.709, P 〈 0.001）, and among different areas of hemangioma （χ^2 = 59.35, P 〈 0.001）, but not between male and female patients （Z = -7.18, P 〉 0.05） or among hemangioma at different sites （χ^2 = 2.34, P 〉 0.05）. As the ordinal multinomial logistic regression analysis showed, the older the age, the better the therapeutic response （OR = 1.21, 95% CI： 1.14 - 1.28, P 〈 0.001）. In addition, the therapeutic response was worse in subcutaneous hemangioma than in superficial hemangioma （OR = 0.30, 95% CI： 0.10 - 0.93, P = 0.037）, and worst in mixed hemangioma （OR

关 键 词：血管瘤 激光 固体 治疗结果 年龄因素 性别因素 

分 类 号：R732.2[医药卫生—肿瘤]