595nm脉冲染料激光治疗155例婴幼儿鲜红斑痣疗效回顾性分析

Efficacy of 595-nm pulsed dye laser in the treatment of port‐wine stains in 155 infants and toddlers:a retrospective analysis

目的探究595nm脉冲染料激光(PDL)治疗婴幼儿鲜红斑痣(PWS)的临床疗效。方法回顾性分析四川大学华西医院自2013年1月至2023年10月共155例经595 nm PDL治疗的婴幼儿PWS的临床资料,根据治疗前及治疗后的照片进行疗效评价。将患儿分别按性别、年龄、皮损颜色、皮损面积、皮损部位、治疗次数分组,比较各组间的差异,进一步分析PDL治疗PWS的影响因素,并统计患者治疗后不良反应。分别采用Mann-Whitney U检验和Kruskal-Wallis H检验分析单向有序R×C列联表资料,采用Bonferroni法进行组间比较,有序多分类logistic回归分析进行多因素分析。结果595 nm PDL治疗后共有135例(87.1%)婴幼儿PWS有效。单因素分析结果显示,疗效与婴幼儿PWS患者皮损面积(P=0.016)和治疗次数(P<0.001)有关,与年龄(P=0.340)、性别(P=0.164)、皮损颜色(P=0.530)、皮损部位(P=0.077)无关。其中,皮损面积越小,治疗次数越多,疗效越好。有序多分类logistic回归分析结果进一步证实疗效与婴幼儿PWS患者皮损面积(P=0.010)和治疗次数(P<0.001)相关。共有5例(3.2%)PWS患儿发生不良反应,其中色素脱失2例(1.3%),色素沉着2例(1.3%),瘢痕形成1例(0.6%)。结论595 nm PDL治疗婴幼儿PWS安全有效,且不良反应少,是一种安全可靠的治疗方法。

Objective To investigate the clinical efficacy of 595-nm pulsed dye laser(PDL)in the treatment of port-wine stains(PWS)in infants and toddlers.Methods A retrospective analysis was conducted based on clinical data from 155 infants and toddlers with PWS treated with 595-nm PDL at West China Hospital of Sichuan University from January 2013 to October 2023,and the efficacy was evaluated according to pre-and post-treatment photographs.The children were grouped according to gender,age,lesion color,lesion area,lesion sites,and number of treatment sessions,separately,and the differences were analyzed between different groups.Further analysis was conducted to determine factors affecting efficacy of PDL for PWS.Adverse reactions after treatment were recorded.The Mann-Whitney U test and Kruskal-Wallis H test were used to analyze unidirectional ordered R×C contingency table data,the Bonferroni approach was used for multiple comparisons,and multivariate ordered logistic regression analysis was performed for multifactorial analysis.Results After the treatment with 595-nm PDL,135 infants and toddlers with PWS showed good response,with an overall response rate of 87.1%.Univariate analysis indicated that the efficacy was associated with the lesion area(P=0.016)and the number of treatment sessions(P<0.001),but not with age(P=0.340),gender(P=0.164),lesion color(P=0.530),or lesion sites(P=0.077),and the smaller the lesion area,the more the treatment sessions,the better the therapeutic effect.Multivariate ordered logistic regression analysis further confirmed the correlations of efficacy with lesion area(P=0.010)and number of treatment sessions(P<0.001).Adverse reactions occurred in 5(3.2%)cases of PWS,including 2(1.3%)of hypopigmentation,2(1.3%)of hyperpigmentation,and 1(0.6%)of scar formation.Conclusion The 595-nm PDL was safe and effective for the treatment of PWS in infants and toddlers with few adverse reactions,making it a reliable therapeutic option.