585nm脉冲染料激光治疗鲜红斑痣2317例回顾性分析

Flashlamp-pumped Pulsed Dye Laser (585 nm) in the Treatment of Port-wine Stains-A Retrospective Study of 2317 Chinese Patients

目的 评价585nm脉冲染料激光治疗鲜红斑痣的疗效。方法 回顾性分析我科用585nm脉冲染料激光治疗鲜红斑痣患者2317例，总结其治疗次数、皮损性质、是否用同位素等其他治疗与疗效的关系以及不良反应的发生。结果 2317例患者分别经过11-3次治疗，治疗间隔2-3个月，中位治疗次数为4．93次，中位治疗能量密度为8．29J／cm^2，治疗8次后，总有效率为84％。皮损表现为增生型紫红色斑块或结节者以及在治疗前曾行同位素、冷冻、CO2激光等治疗者，最终治疗的有效率与总体治疗的有效率相比，疗效较差（P〈0．05）。2317例患者中，5．2％出现浅表瘢痕，其中94．2％为婴儿和儿童；4．0％出现色素减退；2．5％出现色素增加。结论 585nm脉冲染料激光治疗鲜红斑痣疗效好、不良反应发生率低，是治疗血管性疾病首选。

Objective To evaluate the efficacy and soOty of 585 nm flashlamp-pumped pulsed dye lasers （PDL） in the treatment of port-wine stains （PWS）. Methods A retrospective review was performed in 2 317 patients with PWS who visited the Dermatology Laser Centre of PUMC Hospital and accepted treatment with 585 nm PDL The eorralation between the treatment efficacy and the treatment sessions, lesion types, and usage of other therapies were analyzed. The adverse effects were also observed. Results All the 2 317 patients with PWS received 1-13 consecutive treatments with PDL at 2-3-month intervals. The median number of treatment was 4.93 and the median energy density was 8.29 J/cm^2 . The response rate after 8 treatments sessions were 84%. The response rate in patients whose lesions are characterized as purple plaques with proliferation and treated with isotope, CO2 , eryotherapy, and other treatments was significantly lower than the total response rate （P〈0. 05）. Superficial scar, hyperpigmentation, and hypopigmentation were found in 5.2%, 2.5%, and 4.0% of these patients, respectively. Conclusion 585 nm PDL is effective and safe in treating PWS.