595 nm脉冲染料激光联合长脉冲Nd∶YAG 1064 nm激光治疗增生性瘢痕  

Curative effect of 595 nm pulsed dye laser combined with long-pulsed Nd∶YAG 1064 nm laser in the treatment of hypertrophic scars

作　　者：邓林[1] 陈平[1] 黎咏璇[1] 苏瑞香 

机构地区：[1]佛山市第一人民医院整形美容科,广东佛山528000

出　　处：《中国美容整形外科杂志》2016年第11期651-654,共4页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的 探讨595 nm脉冲染料激光联合长脉冲Nd∶YAG1064 nm激光治疗增生性瘢痕的疗效.方法 将162例增生性瘢痕患者随机分为3组,其中A组52例,采用595 nm脉冲染料激光治疗;B组57例,采用长脉冲Nd∶YAG 1064 nm激光治疗;C组53例,采用595 nm脉冲染料激光联合长脉冲Nd∶YAG1064 nm激光治疗.治疗参数：595 nm脉冲染料激光脉宽为1.50 ms,光斑为7、10 mm,能量密度为7～11 J/cm2;长脉冲Nd∶YAG 1064 nm激光脉宽为15.00 ms,光斑直径为6mm,能量密度为60～80 J/cm2.每次治疗间隔4周,连续4次.根据温哥华瘢痕量表评价治疗后的瘢痕色泽、厚度、血管分布、柔软度、治愈率和有效率.结果 4次治疗后,C组每次治疗瘢痕评分明显低于A组和B组,差异有统计学意义（P＜0.05）.A组治疗后每次的治愈率分别为7.7％、25.0％、38.5％、67.3％,有效率分别为51.9％、67.3％、82.7％、96.2％;B组治疗后每次的治愈率分别为10.5％、22.8％、36.8％、66.7％,有效率分别为47.4％、64.9％、86.0％、93.0％;A组和B组比较,治愈率、有效率差异无统计学意义（P＞0.05）.C组治疗后每次的治愈率分别为20.8％、32.1％、69.8％、94.3％,有效率分别为71.7％、94.3％、100％、100％,C组与A、B组比较,治愈率和有效率差异均有统计学意义（P＜0.05）.结论 595 nm脉冲染料激光联合长脉冲Nd∶YAG 1064 nm激光治疗增生性瘢痕治疗次数较少、效果较好,可推广应用.Objective To investigate the curative effect of hypertrophic scars treated by 595 nm pulsed dye laser combined with long-pulsed Nd： YAG 1064 nm laser. Methods One hundred sixty-two patients with hypertrophic scars were randomly divided into 3 groups. Group A （ n = 52） accepted 595 nm pulsed dye laser treatment, group B （ n = 57 ） was treated by long-pulsed Nd： YAG 1064 nm laser and group C （ n = 53 ） un- derwent 595 nm pulsed dye laser combined with long-pulsed Nd： YAG 1064 nm laser treatment. The parameters of the treatment were as follows ： 595 nm pulsed dye laser with the 1.50 ms pulse width, 7, 10 mm spot sizes and 7 - 11 J/cm^2 energy density; long-pulsed Nd： YAG 1064 nm laser with 6 ram spot diameter, 15 ms pulse width and 60-80 J/cm^2 energy density. The patients accepted the laser treatments 4 successive times with a 4 week interval between treatments. The pigmentation, thickness, vascular distribution, scratehability, cure rate and effective rate of the post-treatment scars were evaluated with the Vancouver scar scale. Results The scar score of group C after each of the four treatments was significantly lower than those of group A or group B, and the difference was statistically significant （ P 〈0. 05 ）. The cure rate of group A after each treatment was 7.7%, 25.0% , 38.5% and 67.3% , respectively, and the efficiency was 51.5% , 67.3%, 82.7% and 96.2%, while the cure rate of group B after each treatment was 10.5% , 22.8%, 36.8% and 66.7%, respectively, and the efficiency was 47.4% , 64.9%, 86.0% and 93.0% , There was no statistical significance in the differences of the cure rate and efficiency between group A and group B. The cure rate of group C was 20.8%, 32.1%, 69.8%, 94.3%, the efficiency was 71.7%, 94.3%, 100% and 100%. Compared with group C and group A or B, there was statistical significance in the cure rate and effective rate. It is worth applying more broadly in clinic. Conclusion This method is much more effective to treat hypertrophic scars with 595 nm pulsed dye l

关 键 词：595 nm脉冲染料激光 长脉冲Nd:YAG 1064 nm激光 增生性瘢痕 激光治疗 

分 类 号：R619.6[医药卫生—外科学]