双波长脉冲染料激光治疗儿童蜘蛛痣的临床观察

Dual.wavelength pulsed dye laser for the treatment of spider angioma in children： an observational clinical study

目的探讨双波长脉冲染料激光治疗儿童蜘蛛痣的临床疗效、不良反应及复发等情况。方法585nm／1064nm双波长脉冲染料激光治疗儿童蜘蛛痣233例并随访6个月以上，分析其临床疗效与病程、肤色、年龄、性别等的相关性及不良反应与复发情况等。结果双波长脉冲染料激光治疗儿童蜘蛛痣疗效确切，痊愈率可达87．1％，有效率为100％。疗效与蜘蛛痣的病程呈负相关。不同肤色患儿疗效差异无统计学意义，但Ⅳ型较Ⅲ型肤色患儿达痊愈所需治疗次数相应增加。患儿年龄、性别在疗效方面比较差异无统计意义。术后即刻可出现紫癜、水泡、红肿等，短期内有色素沉着、色素减退等，无明显远期不良反应。9．4％患儿在术后2个月至2年出现复发，复发间隔时间为（7．3±3．4）个月。结论双波长脉冲染料激光治疗蜘蛛痣疗效较好，安全性高，可作为儿童蜘蛛痣的首选治疗方法。

Objective To evaluate the clinical efficacy and adverse effect of dual- wavelengthpulsed dye laser for the treatment of spider angioma in children, and to observe recurrence of spider angioma after treatment with it. Methods A dual-wavelength approach with 585-nm and 1 064-nm pulsed- dye lasers was used to treat 233 children with spider angioma, who were followed up for at least 6 months. Correlations of the clinical efficacy with disease duration, skin complexion, age, gender and so on were analyzed, and adverse reactions and recurrence were evaluated. Results The clinical efficacy of the dual- wavelength pulsed dye laser was good in the treatment of spider angioma in children, with the recovery rate and response rate being 87.1% and 100% respectively, and was negatively correlated with the disease duration. There was no significant difference in the clinical efficacy among children with different skin complexions, but treatment sessions for recovery increased in children with Fitzpatrick skin type IV compared with those with Fitzpatrick skin type Ⅲ. Additionally, no significant difference in the clinical efficacy was observed among children of different age and gender. After the laser treatment, purpura, blisters and swelling occurred instantly, hyperpigmentation and hypopigmentation occurred in a short-term period, and no obvious long-term adverse reactions were observed. Of 233 children, 21 （9.4%） experienced recurrence between 6 months and 2 years after the laser treatment, with a mean recurrence interval of 7.3 ± 3.4 months. Conclusion The dual-wavelength pulsed dye laser is effective and safe for the treatment of spider angioma, and can serve as the first-line therapeutic method for childhood spider angioma.