长脉冲1064nm激光联合口服皮质激素治疗婴幼儿血管瘤的疗效评价

Treatment of infantile hemangiomas with long pulsed 1064nm laser and oral corticosteroids

目的:探讨激光联合口服皮质激素治疗婴幼儿血管瘤的可行性,并对其疗效作初步评价。方法:对102例处于增殖期的血管瘤患儿,分别给予激光治疗、激光与皮质激素联合治疗。治疗前超声检查病灶深度,按深度是否超过1cm,分为深部型与表浅型。激光为1064nm长脉冲可调脉宽激光,治疗1～3次,皮质激素服用一个疗程。采用SAS6.12软件包对所得数据进行Ridit分析。结果:100例完成治疗,随访率为98%。激光治疗治愈12例(24.00%)、显效18例(36.00%),有效率为60.00%;激光与皮质激素联合治疗治愈14例(26.92%)、显效27例(51.92%),有效率为78.84%,2种治疗方法疗效具有显著差异(P<0.05)。在表浅病灶组,激光治疗治愈8例(34.78%)、显效10例(43.48%),有效率为78.26%;激光与皮质激素联合治疗治愈7例(33.33%)、显效8例(38.10%),有效率为71.43%,2种治疗方法疗效无显著差异(P>0.05)。在深部病灶组,激光治疗治愈4例(14.81%)、显效8例(29.63%),有效率为44.44%;激光与皮质激素联合治疗治愈7例(22.58%)、显效19例(61.29%),有效率为83.87%,2种治疗方法疗效具有显著差异(P<0.05)。结论:长脉冲1064nm激光与口服皮质激素联合治疗深部型增殖期血管瘤是一种有效的方法。

PURPOSE： To evaluate the clinical therapeutic efficacy on infantile hemangiomas using long pulsed 1064nm laser and oral corticosteroid.METHODS： One hundred and two infantile hemangiomas in the proliferating phase state were treated with long pulsed 1064nm laser,long pulsed 1064nm laser and oral corticosteroid.Color Doppler was used to detect the depth of tumor.Laser treatment was conducted for 1 to 3 sessions,and oral corticosteroid was one course for 12 weeks.The results were analyzed with SAS6.12 software package for Ridit test.RESULTS： Total response treated with long pulsed 1064nm laser,long pulsed 1064nm laser and oral corticosteroid were achieved in 12 cases（24.00%） and 14 cases（26.92%）respectively,good response were achieved in 18 cases（36.00%） and 27 cases（51.92%）.There was significant difference between the two groups（P〈0.05）.Total response in patients with superficial lesions treated with long pulsed 1064nm laser,long pulsed 1064nm laser and oral corticosteroid were achieved in 8 cases（34.78%） and 7 cases（33.33%）respectively,while good response were achieved in 10 cases（43.48%） and 8 cases（38.10%）.There was no significant difference between two groups（P〉0.05）.Total response in patients with deep lesions treated with long pulsed 1064nm laser,long pulsed 1064nm laser and oral corticosteroid were achieved in 4 cases（14.81%） and 7 cases（22.58%）respectively,good response were achieved in 8 cases（29.63%） and 19 cases（61.29%）.There was significant difference between the two groups（P〈0.05）.CONCLUSION： Combined therapy with long pulsed 1064nm laser and oral corticosteroid is effective for infantile deep-seated hemangiomas in the proliferating stage.