目的 探讨595 nm与1064 nm双波长激光治疗溃疡性婴儿血管瘤的疗效及安全性.方法 选择40例患者进行治疗,包括臀部、肛周13例,阴唇7例,腹股沟、股内侧5例,阴囊4例,颈部3例,头皮2例,唇部2例,躯干、四肢4例.所有溃疡及非溃疡皮损第1次均选择595 nm染料激光治疗,以后依皮损厚度继续选择595 nm激光治疗或选择双波长模式脉冲组1或脉冲组2参数治疗,直至结束.治疗1～6次,间隔为4周.结果 39例(97.5％)患者经1次治疗后1～2周,平均9.5d溃疡面逐渐愈合；第1次治疗后4周溃疡面完全愈合,痊愈率97.5％.非溃疡皮损经过1～6次治疗后,痊愈13例(32.5％),显效19例(47.5％),有效率(痊愈十显效)80.0％.35例(87.5％)伴疼痛,患儿于第1次激光术后2～7 d,平均3.5d疼痛缓解,疼痛评分从治疗前平均1.875分下降为治疗后0.125分,差异有统计学意义(P＜0.05).患者对治疗耐受性好,未见明显不良反应.结论 595 nm与1064 nm双波长激光治疗溃疡性婴儿血管瘤疗效好,不良反应小.%Objective To observe the efficacy of pulsed dual-wavelength 595 and 1064 nm laser in treating ulcerated infantile hemangioma.Methods Lesions from 40 patients were treated with the laser.The distribution of lesion sites was in buttuck and perianal area (13 patients),vulvar lips (7),groin and inside thigh (5),scrotum (4),neck (3),scalp (2),lip (2),trunk and limbs (4).All lesions including ulcer and non-ulcer were conducted with 595 nm plused dye leaser at the first therapy.Later,595 nm pulsed dye leaser was continued or performed with Group 1 or Group 2 parameter of 595 and 1064 nm multiplex mode until the treatment was finished according to the thickness of the lesion.The frequency of treatment was one to six times.The interval of the treatment was four weeks.Results The ulcer from 39 lesions healed gradually in 1 to 2 weeks (average 9.5 days) after the first treatment.These ulcer lesions were healed four weeks after the first time of therapy.The recovery rate of ulcerated lesion was 97.5 ％.For the whole lesion,after 1 to 6 treatments,13 lesions showed excellent result,19 lesions showed good result,and the effective rate was 80 ％.Pain relieved 2 to 7days (average 3.5 days) after the first laser therapy in 35 patients who accompanied with pain.Pain score decreased from 1.875 to 0.125 before and after treatment,with significant difference(P＜0.05).The tolerance of the treatment was good and no side effect was observed.Conclusions 595and 1064 nm dual-wavelength laser is a safe and effective tool for treating ulcerated infantile hemangioma.
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