双波长Cynergy激光治疗婴幼儿血管瘤疗效评估

Treatment of superficial hemangioma of the skin in infants with dual-wavelength cynergy laser

目的探讨双波长Cynergy激光治疗婴幼儿血管瘤的临床疗效及安全性。方法应用双波长Cynergy激光治疗仪治疗婴幼儿血管瘤452例，激光参数为；闪光灯泵浦脉冲染料激光（PDL）10～12J／cm2＋钕：钇-铝-石榴石（Nd：YAG）激光35～60J／cm2，脉冲持续时间；PDL 10ms和Nd：YAG15ms。光斑直径7mm。脉冲延迟：长延迟。采用Cynosure冷风机动态冷却设备（smartcool），2～4个疗程，间隔为1个月。结果治愈（病灶清除〉75％）326例，占72．12％；显效（病灶清除50％～75％）94例，占20．80％；有效（病灶清除25％～〈50％）32例，占7．08％，无效（病灶消除〈25％）为0。12个月内复发9例，复发率2％。出现瘢痕29例（6．42％），色素沉着53例（11．73％）；色素脱失24例（5．31％）；色素改变均在4～6个月后自然恢复。头部血管瘤采用两种治疗模式，PDL＋Nd：YAG疗效明显优于PDL，但两种治疗模式的脱发率差异无统计学意义。结论顺序发射波长585DmPDL及1064nmNd：YAG激光的双波长Cynergy激光，是治疗婴幼儿血管瘤的有效方法，起效快、不良反应小。

Objective To evaluate clinical therapeutic efficacy and safety on infant hemangioma of the skin by using dual-wavelength Cynergy laser. Methods A total of 452 cases infant hemangioma of the skin were treated by using dual-wavelength Cynergy laser. Laser parameters were that energy for pulsed dye laser （PDL） ranged from 10-12 J/cm2, and Nd ： YAG 35-60 J/cm2 , pulse duration for PDL was 10 ms and for Nd ： YAG 15 ms, and pulse delay was the long-ext. The spot size was 7 mm. Laser was coupled to chilled air-cooling apparatus （Smartcool, Cynosure ）. The frequency of treat- ment was two to four times. The interval of the treatment was 1 month. Results Total response was achieved in 326 cases （72.12 %）, good response in 94 cases （20.80 % ）, fair response was achieved in 30 cases （7. 08 %） and poor response was 9 cases had recurrence accounting for 2 %within 12 months. Temporary side effects included scar formation in 29 cases （6.42 %）, hyper-pigmentation in 53 cases （11.73 %）, hypo-pigmentation in 24 cases （5.31 ~%）, and they disappeared after 4 to 6 months. Scalp hemangioma was treated using dual-wavelength Cynergy laser. PDL and Nd ： YAG was more effective than PDL alone in the treament of scalp hemangioma. No significant differences were found in hair loss between the two models. Conclusions Cynergy multiplex pulsed laser systerm emitting both pulsed dye 585 nm and Nd ： YAG 1064 nm wavelength, is a good tool to treat infant he- mangioma of the skin. It has the advantage of fast efficacy and less side effects.