双波长染料激光联合局部注射聚桂醇治疗婴幼儿混合性血管瘤疗效观察

Observation of clinical efficacy of Dual Wavelength Dye Laser combined with lauromacrogol local injection in treatinginfantile mixed hemangioma

目的：探讨585/1 064nm染料激光联合聚桂醇注射治疗混合性血管瘤的疗效及影响因素。方法：混合性血管瘤患儿165例,用双波长染料激光联合聚桂醇注射治疗,激光能量密度PDL6.0~9.0/YAG30~45J/cm2,脉宽0.5~40/10~40ms,脉冲间隔为：中或长,光斑直径5~7mm。激光对病灶进行点状照射,术后冰块局部物理降温20min,聚桂醇0.5~3ml局部注射,抗生素药膏涂抹于患处,并观察其局部热反应和疗效,6~8周复诊,治疗1~4个疗程。结果：165例皮损的治愈率78.18%,有效率98.18%。各因素对疗效的影响：皮损厚度越薄,有效率越高（P〈0.05）,皮损部位不同对疗效无影响（P〉0.05）。随访观察3~6个月,治愈病例无1例复发。结论：双波长染料激光联合聚桂醇照射治疗混合性血管瘤安全有效,不良反应少,患儿痛苦小。随着治疗后时间的延长,治疗部位与周围皮肤颜色无明显差异。

Objective To explore the efficacy and its influential factors of Dual Wavelength Dye Laser tunable pulsed dye laser combined with lauromacrogol local injection radiation on infantile mixed hemangioma. Methods A retrospective review was conducted with 165 vascular lesions. The treatment was developed by the 585/1064 nm tunable pulsed dye laser combined with lauromacrogol local Injection from August 2008 to December 2010. The working parameters, influencing factors,were PDL6.0-9.0/YAG30-45J/cm2,pulse duration 0.5-40/10-40 ms and spot size（5-7mm） which was based on the size,color and depth of lesions and according to the immediate reaction of lesions produce adjustments. Combined using Lauromacrogol in 0.5-3ml tumor with injection in the treatment of 165 cases of mixed type hemangioma,the second step was completed.Then the physical hypothermia came into apply the ice bags after operation.The parti affectase applicetur needed compound polymyxin B ointment, then the last step was to observe the local thermal reaction and curative effect. Results Of the 165 lesions,the cure rat and effective rat were 78.18% and 98.18%.The depth of lesions had effect on the efficacy（P0.05）.The simpth lesions showed a better response to the treatment than the deeper ones.The sites had no effect on the efficacy（P0.05）.All cure of cases were followed up for 3 months to 6 months,none of them was recurred. Conclusions The 585/1064 nm tunable pulsed dye laser combined with lauromacrogol local Injection treatment for mixed hemangioma was characterized by simplicity, low complication occurrence and high cure rate. It deserves to be recommended.