高能脉冲激光治疗色素性和血管性皮肤病临床观察

Clinical survey of the pigmented and hyperplastic vascular dermatosis treated by the high energy pulse laser

目的:探讨多波长高能脉冲激光治疗色素性及血管性皮肤病的临床疗效及其影响因素。方法:使用多波长高能脉冲激光治疗色素性及血管性患者1 072例。浅表性色素损害如雀斑、咖啡斑和老年斑采用Q532 nm和Q755 nm治疗;太田痣和文身采用Q1 064 nm和Q755 nm;血管性疾病如血管瘤、鲜红斑痣和蜘蛛痣采用VPW532nm激光治疗。结果:本组患者痊愈率38.34%(411/1 072),有效率87.41%(937/1 072),经过1～8次治疗,雀斑、太田痣、文刺、老年斑、毛细血管扩张及蜘蛛痣的总有效率高达90%以上。血管瘤、太田痣和咖啡斑有效率分别为84.38%、71.05% 及45.00%。多因素分析结果显示:治疗效果与治疗次数、病程、激光强度和光斑大小有关(OR>1,P<0.05),术后出现暂时性色素沉着和色素减退23例(2.14%),无瘢痕发生。结论:多波长高能脉冲激光治疗色素性及血管性皮肤病疗效较好,安全性高。

Objective To observe the clinical effects and the related factors of the pigmented and hyperplasic vascular dermatosis treated by multi-wavelength high energy pulse laser. Methods 1072 cases were treated with multi-wavelength high energy pulse laser.The superficial lesions of pigmented dermatosis were treated with wavelength of 532nm or 755nm such as freckle,café-au-lait spots and verruca senilis while the nevus of Ota and tattoos were treated with wavelength of 755nm or 1064nm.Hyperplasic vascular dermatosis such as hemangioma, port-wine stains,spider nevus was treated with VPW 532nm. Results The results showed that the curative rate and the effective rate were 38.34%(411/1072)and 87.41%(937/1072)respectively after 1~8 time treatments.The effective rate were more than 90% for freckle,tattoos,verruca senilis and spider nevus.The effective rate were 84.38%?71.05% and 45.00% for hemangioma,nevus of Ota and café-au-lait spots respectively.The results of multi-factor analysis showed that the clinical effects were related to the treatment times, period of disease,energy and spot-size of laser (OR>1,P<0.05). 23 cases (2.14%) appeared pigmented disorder temporary after treatment and no scar formation. Conclusion The multi-wavelength high energy pulse laser has been proven to be effective and safe in the treatment of pigmented and hyperplasic vascular dermatosis.