长脉宽Nd:YAG激光治疗酒渣鼻毛细血管扩张疗效及相关分析

Analysis of clinical efficacy of long-pulsed Nd:YAG laser for Rosacea assosciated telangiectasia

目的:探讨单次长脉宽Nd:YAG激光治疗酒渣鼻毛细血管扩张的疗效、影响因素及安全性。方法:47例酒渣鼻毛细血管扩张患者接受单次长脉宽Nd:YAG激光治疗,根据毛细血管粗细、即刻反应调整治疗参数,通过术前术后照片对比评估其疗效。结果:47例患者中,痊愈13例(28.3%),显效11例(23.9%),有效16例(34.8%),无效7例(13.0%)。根据血管扩张的程度和血管的直径大小,将其分为弥漫潮红组、轻度血管扩张组和重度血管扩张组,单次治疗后有效率弥漫潮红组为16.7%(2/12),轻度血管扩张组53.3%(8/15),重度血管扩张组为73.8%(14/19)(P<0.05)。大多数患者出现一过性红肿和紫癜,仅1例由于冷却不充分出现水疱遗留浅表瘢痕。结论:毛细血管扩张直径越大,单次治疗治愈率越高,采用正确的治疗措施和患者筛选,长脉宽Nd:YAG激光治疗酒渣鼻毛细血管扩张安全性好,有效性高,值得推广。

Objective The aim of this study was to discuss the effectiveness and safety of long- pulsed Nd：YAG laser for Rosacea assosciated telangiectasia. Methods Forty seven patients presenting with telangiectasia owing to facial rosacea were treated with a single treatment of long- pulsed Nd：YAG Laser. The treatment parameter was changed with vessel diameters and the immediate vessel responses. Objective assessment was based on the clinical photography. Results All 47 patients completed this study. Thirteen of 47 patients had more than 90% improvement, Another eleven of 47 had 70% to 90% improvement, and sixteen of 47 patients had 30% to 70% improvement, seven of 47 patients had less than 30% improvement or got scarring. The patients were divided into three groups according to telangiectasis and the vessel diameter. A statistically significant improvement was observed in larger vessels after a single treatment of long-pulsed Nd： YAG Laser. Adverse effects include transient erythema and purpura. Only one patient got blister and scar because the cooling was insufficiency. Conclusion The clearance of Larger vessels were higher than smaller ones. Long-pulsed Nd：YAG Laser can be considered as another effective and safe treatment modality for assosciated telangiectasia, if applied cautiously and picked the right patients.