脉冲染料激光联合长脉冲Nd∶YAG激光序贯发射治疗婴儿血管瘤患者37例

Combined Therapy of Pulse Dye Laser and Long Pulse Nd∶YAG in Treating 37 Cases of Strawberry Hemangioma

目的观察脉冲染料激光联合长脉冲Nd∶YAG激光序贯发射治疗婴儿血管瘤的疗效和安全性。方法选择符合条件的婴儿草莓状血管瘤患者37例,随机分为治疗组19例,即脉冲染料激光联合长脉冲Nd∶YAG激光序贯发射治疗;对照组18例,即脉冲染料激光治疗。治疗间隔每4～6周治疗1次,直至祛除所有目标病灶。术后随访12个月,通过观察两组患者术后的平均治疗次数、平均愈合天数、色素改变情况和瘢痕形成情况,比较其疗效和安全性。结果脉冲染料激光联合长脉冲Nd∶YAG激光序贯发射治疗患者17例,平均治疗次数3.18次,平均愈合天数12.9 d。出现瘢痕者2例(占11.76%),出现色素沉着和色素减退者5例(占29.41%)。脉冲染料激光治疗患者15例,平均治疗次数5.33次,平均愈合天数8.67 d,出现瘢痕者1例(占6.67%),出现色素沉着和色素减退改者3例(占20.0%)。两组平均治疗次数、平均愈合天数和色素改变情况差异有显著意义(P<0.05),而两组瘢痕形成情况差异无显著意义(P>0.05)。结论脉冲染料激光联合长脉冲Nd∶YAG激光序贯发射治疗方式治疗婴幼儿草莓状血管瘤与脉冲染料激光方式相比,具有治疗次数少的优点,但存在伤口愈合时间长,术后色素改变发生率高的缺点。临床上应根据患者的实际情况选择适当的治疗方法以达到最佳的治疗效果。

Objective To observe the efficacy and safety of pulse dye laser combined with long pulse Nd ： YAG laser in treating strawberry heman- gioma. Methods Patients with qualified strawberry hemangioma were treated with pulse dye laser and long pulse Nd ： YAG laser once every 4- 6 weeks until all the target lesions disappeared. The efficacy and safety was evaluated after follow-up of 12 months.Results For the 17 lesions treated jointly with pulse dye laser and long pulse Nd ： YAG laser, the average treatment amount was 3.18, the healing duration lasted for 12. 9 days on average, scars occurred to 2 cases （ 11.8% ）, and pigment changes were found in 5 cases （29.4%）. On the other hand, as to the 15 patients treated solely with pulse dye laser, the average treatment amount was 5. 33, the healing duration lasted for 8. 67 days on average, scars occurred to 1 case （6. 67% ）, and pigment changes were found in 3 cases （20.0%）. While no obvious difference was found in scar formation, the differences between the two groups in average treatment a- mount and healing days and pigment changes were significant. Conclusions Compared with the pure treatment of pulse dye laser, the combined therapy of pulse dye laser and long pulse Nd ： YAG laser features less treatments, despite of a longer healing period and a higher pigment change rate. Therefore, it is highly recommended to take account of patients＇personal conditions seriously when making a choice between them.