长脉冲1 064nm Nd:YAG激光治疗面部激素依赖性皮炎伴发的毛细血管扩张(1)
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[摘要]目的：观察长脉冲1 064nm Nd:YAG激光治疗面部激素依赖性皮炎伴发毛细血管扩张的临床治疗效果。方法：治疗参数选用：光斑直径3mm，平均脉宽(13.5±3.4)ms,平均能量密度(267.2±3.1)J/cm2。结果：37例女性患者，平均治疗2.3次，面部毛细血管扩张平均密度由(2.76±1.03) 根/cm2下降至(0.42±0.27)根/cm2，临床疗效显著。治疗后，皮肤恢复至基本正常状态，无瘢痕、色素改变，皮炎反复发作的现象消失。结论：长脉冲1 064nm Nd:YAG激光治疗面部激素依赖性皮炎伴有的毛细血管扩张具有较好临床治疗效果，方法值得进行更广泛的临床实践与深入研究。
[关键词]激素依赖性皮炎；激光；毛细血管扩张
[中图分类号]R616.4 [标识码]A [文章编号]1008-6455(2011)01-0103-02
Treatment of Treatment of Facial Telangiectasia Associated with Hormone-dependent Dermatitisby Long-pulsed 1064nm Nd: YAG Laser
JIN Yan, GUO Yong-gang, Li Wen-zhi
(Department of Plastic Surgery and Laser Medicine, Beijing Anzhen Hospital of Capital Medical University, Beijing 100029, China)
Abstract：Objective To observe the clinic therapeutic effect of facial Telangiectasia Associated with Hormone-dependent Dermatitisby long-pulsed 1064nm Nd: YAG laser.MethodsThe facial telangiectasia were treated by laser with 3mm spot diameter,the average pulse width (13.5±3.4) ms and the average energy density (267.2±3.1) J/cm2. Results 37 cases of female patients were cured by 2.3 average treatment times. The average density of facial telangiectasia were decreased from (2.76±1.03) vessels / cm2 to (0.42± 0.27) root / cm2. The clinical effect is significant. After treatment, no scars, no pigmentation occurred andthe dermatitisdisappeared.Conclusion There is a good result with facial Telangiectasia Associated with Hormone-dependent Dermatitis treated by long pulse 1064nm Nd:YAG laser. This approach deserves more extensive clinical practice and in-depth study.
Key words: hormone-dependent dermatitis；laser；telangiectasia
激素依赖性皮炎是由于长期反复外用皮质类固醇激素停药后皮肤出现的炎症性皮肤病，可导致皮肤毛细血管扩张、多毛、灼热、瘙痒等不良反应。该病的治疗方法较多，多采用综合疗法 [1]。本文介绍一种应用长脉冲1 064nmNd:YAG激光治疗面部激素依赖性皮炎伴发毛细血管扩张的方法，现报道如下。
1 资料和方法
1.1 一般资料：本组面部激素依赖性皮炎伴毛细血管扩张患者37例，均为女性，年龄18～53岁，平均(35.17±8.22)岁。病史2.3～14.9年，平均(5.4±3.2)年，临床存在反复发作的面部灼热、充血、瘙痒、水肿，均存在毛细血管扩张，平均密度为2.76 根/cm2。
1.2 诊断标准[2]：①局部曾反复外用糖皮质激素，皮损对激素依赖，停用激素皮损会复发或加重；②面部存在毛细血管扩张；③皮损部位有灼热、疼痛、干燥等自觉症状；④面部有红斑、水肿、丘疹等局部体征；⑤皮损区表面无明显色素沉着覆盖，无光过敏现象。本组病例激光治疗的最低入选标准为第①、②、⑤项，治疗时可存在第③项临床症状，但主要是治疗面部毛细血管扩张，存在第④项临床症状的患者应用皮科药物治疗。
1.3 仪器及相关参数：分别应用美国Altus公司CoolGlide excel长脉冲1 064nm Nd:YAG激光器，最大峰值功率4700W，能量密度5～300J/cm2 ......
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