长脉宽1064nm激光联合平阳霉素治疗静脉畸形(1)
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[摘要]目的：研究长脉宽1064nm激光瘤周照射联合平阳霉素瘤体注射治疗静脉畸形的方法，并评价其优缺点。方法：96例患儿，均为静脉畸形，随机分为三组：联合组、单纯注射组及单纯激光治疗组，各32例，并对治疗效果进行观察分析。结果：联合治疗组的治疗次数少于单纯注射组，而治愈率明显高于单纯注射组(P<0.05)和单纯激光治疗组(P<0.01)，单纯激光治疗组治愈率亦明显低于单纯注射组。结论：激光瘤周照射联合平阳霉素瘤体注射治疗静脉畸形，可明显提高治愈率、缩短疗程，效果更佳。
[关键词]激光；平阳霉素；静脉畸形
[中图分类号]R732.2[文献标识码]A [文章编号]1008-6455(2011)09-1420-02
Long-pulsed 1064nm laser combing with pingyangmycin in the treatment of venous malformations
YANG Yu-cheng, GUO Zhi-hui
(Laser Treatment Center of Plastic Surgery Department, Fujian Medical University Union Hospital, Fuzhou 350001, Fujian， China)
Abstract： Objective To study long pulse width 1064 nm laser tumor weeks with joint pingyang tumors illuminate injection is the nature of the venous malformations vascular disease, the advantages and disadvantages of the evaluation method. Methods 96 cases venous malformations, all of the nature of the vascular sexual diseases, three groups: the joint group, pure, pure injection group laser treatment group of each 32 cases, and the treatment effect to observe the analysis.Results The treatment of combination group number less than pure injection group, and the cure rate is obviously higher than pure injection group (P<0.05) and pure laser treatment group (P<0.01),simple laser treatment group cure rate also obviously lower than pure injection group.ConclusionLaser tumor weeks with joint pingyang tumors on the nature of the venous malformations injections of vascular disease, can obviously increase the cure rate,shorten the period of treatment,the effect is much better.
Key words:laser;pingyangmycin; venous malformations
脉管性疾病是临床常见的婴幼儿疾病，发生率可达10% [1]，男女之比约为 1:3，可发生在颌面、头颈、四肢及躯干等任何部位。传统的脉管性疾病的治疗方法很多，包括外科手术切除、激光治疗、局部注射硬化剂治疗、口服激素治疗及冷冻治疗等，但各有其局限性。2009年笔者科室试用新款长脉宽1064nm激光瘤周照射联合平阳霉素瘤体注射治疗静脉畸形患者，疗效较满意，现总结如下。
1资料和方法
1.1 一般资料：96例均为静脉畸形患儿，其中男38例，女58例，年龄最小10天，最大8个月，平均年龄为5个月。其中头皮8例，额部3例，眉部3例，眼睑13例，面颊6例，颞部3例，鼻部6例，耳2例，口唇6例，下颌2例，肩部3例，臂部5例，胸部3例，腹部3例，背部2例，臀部3例，手指5例，脚趾3例，膝部1例，大腿3例，外阴7例，乳房6例，瘤体面积2cm×3cm～3cm×5cm，所有患儿均未接受过其他治疗，瘤体表面无破溃。
1.2 手术方法
1.2.1 设备及参数：采用美国赛诺秀公司生产的长脉宽Nd:YAG激光，波长1064nm，光班5mm，脉宽30ms，能量130～160J/cm2，治疗间隔1个月。
1.2.2 治疗方法：单纯激光治疗组：术前先清洗面部，然后用1‰新洁尔灭对病灶范围内皮肤常规消毒。启动激光器，根据患儿皮损的色泽和深浅，采用适当的能量进行治疗，沿病变周边照射一圈，以治疗部位病变出现苍白或发黑的即刻反应为准 ......
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