20尿素封包病甲板对长脉冲1064nmNd:YAG激光治疗甲真菌病疗效的影响

摘要

Objective To observe the effect of long-plus Nd:YAG1064nm laser combined with occlusive dressing with 20%urea in the treatment of onychomycosis. Methods 101 nails coming from Sixty one cases with onychomycosis randomly divided into the treatment group(31 cases,52 nails) and control group(30 cases,49 nails).The entities in the treatment group were treated with long-plus Nd:YAG1064nm laser with occlusive dressing with 20% urea, once a week for 8 weeks, those in control group were treated with the same laser only. All patients were evaluated in 24 weeks. Results The effective rate were 78.9%in the treatment group, were 57.2% in the control group after the treatment. The efficacy in the treatment group were better than that in the control group (χ2=10.678, P=0.014). Conclusion There is more effective with long pulsed 1064nm Nd:YAG laser combined with occlusive dressing with 20% urea in the treatment of onychomycosis ,especially for toenail.%目的:观察甲真菌病甲板预处理对长脉冲1064nmNd:YAG激光治疗甲真菌病疗效的影响.方法:选择皮肤科门诊61例甲真菌病患者,101个全甲营养不良甲真菌病(TDO)型拇趾甲,随机分组实验组和对照组.实验组:52个病甲,20%尿素软膏封包病甲板2~4h,锉刀充分处理,长脉冲1064nmNd:YAG,采用光斑4mm,脉宽35ms,能量密度30~40J/cm2,频率1.0~2.0Hz照射2min,每周1次,共8周;对照组49个病甲,激光治疗,方法同实验组.24周后复诊进行评价.结果:实验组:病甲共52个,痊愈29个(55.8%),显效12个(23.1%),总有效率78.9%;对照组:病甲共49个,痊愈12个(24.5%),显效16个(32.7%),有效率57.2%,实验组疗效优于对照组(χ2=10.678,P=0.014).结论:甲真菌病甲板预处理可以显著提高长脉冲1064nmNd:YAG激光治疗甲真菌病的疗效,为甲真菌病局部治疗提供了良好条件,尤其适合老年人等特殊人群患者甲真菌病的治疗.