双波长激光治疗33例儿童血管角化瘤的效果观察  

A clinical study on evaluating the treatment effect of 33 children angiokeratoma with a combined laser

作　　者：刘励[1] 侯倩[1] 倪思利[1] 谭春花[1] 张建[1] 万毅 甘立强[1] Liu Li;Hou Qian;Ni Sili;Tan Chunhua;Zhang Jian;Wan Yi;Gan Liqiang(Department of Dermatology,Children’s Hospital of Chongqing Medical University,Ministry of Education Key Laboratory of Child Development and Disorders,National Clinical Research Center for Child Health and Disorders,China International Science and Technology Cooperation Base of Child Development and Critical Disorders,Chongqing Key Laboratory of Pediatrics,Chongqing 400014,China)

机构地区：[1]重庆医科大学附属儿童医院皮肤科,儿童发育疾病研究教育部重点实验室,国家儿童健康与疾病临床医学研究中心,儿童发育重大疾病国家国际科技合作基地,儿科学重庆市重点实验室,重庆400014

出　　处：《医药前沿》2020年第12期32-34,共3页Journal of Frontiers of Medicine

基　　金：重庆市卫生计生委医学科研项目(项目编号:2016MSXM038)。

摘　　要：目的:观察585nm脉冲染料(Pulsed dye laser,PDL)/1064nm Nd:YAG双波长激光治疗儿童不同类型血管角化瘤33例的疗效和不良反应。方法:采用585nm PDL/1064nm Nd:YAG双波长激光治疗儿童不同类型的血管角化瘤一共33例,PDL能量为7.0~8.0J/cm^2,1064nm Nd:YAG激光为10~30 J/cm^2,PDL脉宽为0.5~40ms,Nd:YAG激光为15~300ms,两束光之间的延迟时间为中,光斑大小为7mm。结果:585nm脉冲染料/1064nm Nd:YAG双波长激光治疗儿童不同类型血管角化瘤的总体有效率为57.6%,其中丘疹性及肢端性血管角化瘤的有效率分别为65%和66.7%。局限性血管角化瘤有效率为40%,低于其他两种类型血管角化瘤,三种类型有效率比较无统计学差异。对不同类型血管角化瘤平均治疗次数进行分析,丘疹性经过3.6±1.57次治疗,局限性经过3.9±2.18次治疗,肢端性经过4.33±2.08次治疗后可达到痊愈和显效,三组间无显著差异。常见的副作用有紫癜、暂时性色素改变、水疱、出血,无一例出现瘢痕。结论:585nm脉冲染料/1064nm Nd:YAG双波长激光对儿童不同类型血管角化瘤治疗有效,为达到良好的治疗效果需重复多次治疗,其不良反应发生率低,是较好的治疗手段。Objective To present the results of a retrospective study using a combined 585 nm pulsed dye laser(PDL)/1064 nm Nd:YAG laser to treat angiokeratoma.Methods 33 patients were enrolled in this study with 33 lesions.The laser parameters were set as follows:energy densities of 7.0~8.0 J/cm^2 with PDL and 10~30 J/cm^2 with 1064 nm Nd:YAG laser;pulse duration of 0.5~40 ms with PDL and 15~300 ms with 1064 nm Nd:YAG laser.Results The overall effective rate of combined 585 nm PDL/1064 nm Nd:YAG laser in the treatment of children angiokeratoma reached 57.6%,The effective rate of the solitary or multiple papular angiokeratoma and angiokeratoma of Mibelli were 65%and 66.7%,respectively.The effective rate of angiokeratoma circumscriptum was 40%,which lower then other two types slightly.Whereas,the three groups had no statistical difference.The average treatment in different types of angiokeratoma were analyzed.Patients with solitary or multiple papular angiokeratoma improved evidently after 3.6±1.57 treatments.Patients with angiokeratoma circumscriptum and patients with angiokeratoma of Mibelli required 3.9±2.18 treatments and 4.33±2.08 treatments respectively to reach the same treatment effect.Nevertheless,there was no significant difference among the three groups.Common side effects were purpura,pigmentation,blisters,scar,and hemorrhage.Conclusion The treatment of angiokeratoma by 585 nm PDL/1064 nm Nd:YAG laser is a valuable treatment option to eliminate lesions of angiokeratoma with good effect and minimal adverse effects.In order to achieve better therapeutic effect,repeated treatment is required.

关 键 词：585nm脉冲染料/1064nm Nd:YAG双波长激光 血管角化瘤 

分 类 号：R751[医药卫生—皮肤病学与性病学]