595nm和1064nm双波长激光治疗浅表性婴儿血管瘤的疗效评价

Efficacy of pulsed dual-wavelength 595 and 1064 nm laser in treatment of superficial infantile hemangioma

目的观察595nm和1064nm双波长激光治疗浅表性婴儿血管瘤的临床效果及安全性。方法共选抒260例患者的270处皮损进行治疗，包括头皮41处、面颈部88处、躯干79处、四肢62处。所有皮损均选择双波长模式脉冲组1和（或）脉冲组4参数进行治疗。治疗1～6次，间隔为4周。结果总有效率95．56％。遗留凹陷性瘢痕8．15％，继发严重溃疡0．00％。（1）采用脉冲组1参数治疗，与脉冲组4相比，发生凹陷性瘢痕的概率差异无统计学意义（X^2=1．870，P〉0．05）；（2）不同部位皮损产生凹陷性瘢痕的概率差异有统计学意义（X^2=15．743，P〈0．01），面部遗留瘢痕的概率最高；（3）不同部位皮损的治疗次数和疗效间差异均无统计学意义（X^2=21．164，P〉0．05和X^2=11．597，P〉0．05）；（4）皮损大小、厚度与治疗次数差异有统计学意义（X^2=58．17I，P〈0．01和X^2=11．583，P〈0．05）。结论595nm和1064nm双波长激光治疗浅表性婴儿血管瘤安全性好，疗效明显。治疗参数的选择要根据皮损本身的性质而定。

Objective To determine the clinical value of pulsed dual-wave-ength 595 and 1064 nm laser in treating superficial infantile hemangioma. Methods The treatments were conducted in 260 patients with 270 lesions. The location of the lesions were 41 cases in scalp, 88 in face and neck, 79 in trunk and 62 in arms and legs. All lesions were treated several times with 595 nm （Group 1） and/or 1064 nm （Group 4） multiplex mode until the treatrnent was finished. The frequency of treatment was one to six times. The interval of the treatment was four weeks. Results The total ef- fective rate was 95.56 %, with atrophic scar （8.15 %） but without severe ulcer. No significance was found as compared Group 1 parameter with Group 4 in formation of atrophic scars （X2 = 1. 870, P〉 0.05）. Significant difference in the incidence of atrophic scars was found among different location of lesions （X2 = 15. 743, P〈0.01）： lesion in face had the highest probability. No obvious difference was found between different location of lesion and the frequence of treatment （X^2=21. 164, P〉0.05）, and so did with the efficacy （X^2 =11. 597, P〉0.05）. The size and the thickness of lesion had significant difference in the time of treatment （X^2= 58. 171, P〈0.01 and X^2= 11.583, P〈0.05, respectively）. Conclusions 595nm/1064 nm dual-wavelength laser is a safe and effective tool for treating superficial infantile hemangioma. Choice of treatment parameter in the mode depends on the features of vascular lesions.