双脉冲、低能量1064 nm Nd:YAG激光治疗婴幼儿唇部血管瘤的疗效观察

The Effection of Double Pulse and Low Fluence of 1 064 nm Nd:YAG Laser in the Treatment of Infantile Lip Hemangiomas

目的探讨双脉冲、低能量1 064 nm Nd:YAG激光治疗婴幼儿唇部血管瘤的疗效和不良反应。方法19例唇部血管瘤患儿接受长脉冲1 064 nm Nd:YAG激光治疗,双脉冲,脉宽4~6 ms,脉冲间隔20~25 ms,能量密度80~100 J/cm2,光斑直径6 mm,接触式同步冷却技术,治疗1~11次,间隔2~4周,末次治疗后6个月电话随访受试者复发及不良反应情况。结果19例患儿全部治疗有效,其中12例浅表性皮损经3~4次治疗后有10例(83.33%)都达到了治愈或显效,有2例经6次治疗达到治愈;7例深在型或混合型皮损治疗6~7次治愈4例(57.14%),1例患者经9次治疗后治愈,1例患者经11次治疗后治愈,1例患者4次治疗有效后自行终止治疗。治疗过程中未出现明显即刻或远期不良反应。结论唇部血管瘤影响美观及存在影响功能的风险,因此需要早期治疗。双脉冲、低能量1 064 nm Nd:YAG激光治疗婴幼儿唇部血管瘤疗效确定且较安全。

Objective To investigate the clinical efficacy and adverse effects of double pulse and low fluence of 1 064 nm Nd:YAG laser in the treatment of infantile hemangiomas on the lip.Methods Total 19 cases were treated with long-pulsed 1 064 nm Nd:YAG laser of double pulse,pulse width was 4 to 6 ms,pulse delay was 20 to 25 ms,energy density was 80 to 100 J/cm2,the spot diameter was 6 mm,contact synchronous cooling technology,treatment 1 to 11 times,interval 2 to 4 weeks,telephone follow-up of relapse and adverse reactions for six months after the last treatment.Results All the 19 cases were effectively treated,among which 10 cases (83.33%) of the 12 cases with superficial skin lesions were cured or effective after 3 to 4 times of treatment,and 2 cases were cured after 6 times of treatment.Seven cases of deep type or mixed skin lesions were cured after 6 to 7 times (57.14%),one case was cured after 9 times of treatment,one case was cured after 11 times of treatment,and one case stop the treatment after four effective therapies.There were no obvious immediate or long-term adverse reactions occurred.Conclusion Infantile lip hemangioma is associated with beauty and has the risk of malfunction,and therefore requires early treatment.Long-pulsed 1 064 nm Nd:YAG laser of double pulse and low fluence is an effective and safe treatment for infantile hemangiomas on the lip.