窄谱强脉冲光联合长脉冲1064nm Nd:YAG激光用于婴幼儿鲜红斑痣的疗效观察

Efficacy of narrow band intense pulsed light combined with long pulse 1064nm Nd:YAG laser for infant port wine stain

目的:探讨窄谱强脉冲光DPL(500~600 nm)联合长脉冲1 064 nm Nd∶YAG激光用于婴幼儿鲜红斑痣的疗效及安全性。方法:纳入98例婴幼儿鲜红斑痣患者,随机分为两组:观察组58例,采用DPL联合长脉冲1 064 nm Nd∶YAG激光治疗;对照组40例,仅采用DPL治疗。连续治疗3~5次,每次间隔4周。所有治疗结束后1个月门诊随访观察。结果:观察组治愈13例(22.41%),显效16例(27.58%),有效12例(20.68%),总有效率70.69%;对照组治愈2例(5.00%),显效8例(20.00%),有效5例(12.50%),总有效率37.50%,两组总有效率差异有统计学意义(χ2=10.65,P<0.05)。观察组中有5例(8.62%)出现水疱、结痂反应,对照组有3例(7.50%)出现水疱、结痂反应,两组间不良反应发生率比较,差异无统计学意义(χ2=0.04,P=0.842)。结论:DPL联合长脉冲1 064 nm Nd∶YAG激光治疗婴幼儿鲜红斑痣效果良好,不良反应无明显增加,值得临床推广应用。

Objective:To investigate the efficacy and safety of narrow band intense pulsed light(DPL) combined with long pulse 1 064 nm Nd∶YAG laser for infant port wine stain. Methods:A total of 98 patients with infant port wine stain were randomly divided into two groups. The treatment group(58 cases) was treated with DPL and long pulse 1 064 nm Nd∶YAG laser for 3~5 treatment session at 4-week interval, while 40 patients treated with DPL alone served as controls. Follow-up was performed 1 month after the last treatment. Results:Combination of DPL and long pulse 1 064 nm Nd∶YAG laser displayed a total effective rate of 70.69%, including complete clearance(13 cases, 22.41%), marked improvement(16 cases, 27.58%), and some improvement(12 cases, 20.68%). In contrast, only 37.50% of patients treated with DPL alone showed improvement, including 2 cases of complete clearance(5.00%), 8 cases of marked improvement(20.00%), and 5 cases of some improvement(12.50%). Total effective rates differed significantly between the two groups( χ2=10.65,P<0.05). Blisters and scabs were observed in 5 cases(8.62%) in the treatment group, and 3 cases(7.50%) in patients treated with DPL alone( χ2=0.04,P=0.842).Conclusion:DPL combined with long pulse 1 064 nm Nd∶YAG laser is effective and safe for infant port wine stains.