Chang C J, Fisher D M, Chen Y R
Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan.
Br J Plast Surg. 1999 Apr;52(3):178-81. doi: 10.1054/bjps.1998.3056.
Vascular anomalies remain a challenge for patients and reconstructive surgeons. Recently, promising results have been reported using intralesional photocoagulation (ILP) to treat large, deep vascular lesions. We report our experience in treating 12 patients with vascular anomalies of the tongue (10 venous malformations and two haemangiomas) using intralesional photocoagulation. All patients were treated with a Nd:YAG (neodymium:yttrium-aluminium-garnet) (1064 nm) laser (Sharplan, Inc., NJ, USA) delivered with a 600 microns optical fibre. Laser power was set at 7 or 10 W, delivered with a pulse duration of 10 s. Laser energy was delivered to all areas of the vascular lesion. Heat, visible shrinkage and firmness of the lesion signalled the end-point of treatment. The mean follow-up period was 9.5 months (range 3-20 months). All patients demonstrated improvement as judged by a clinical assessment of the reduction in lesion size (mean reduction = 87%, range 60-100%). Three patients (25%) had complications attributed to photocoagulation. Energy delivered too superficially resulted in ulceration or scarring. These complications should be avoidable if this potential for harm is kept in mind.
血管异常对患者和重建外科医生来说仍然是一个挑战。最近，有报道称使用病灶内光凝术（ILP）治疗大型深部血管病变取得了令人鼓舞的结果。我们报告了使用病灶内光凝术治疗12例舌部血管异常患者（10例静脉畸形和2例血管瘤）的经验。所有患者均使用Nd:YAG（钕:钇铝石榴石）（1064纳米）激光（美国新泽西州Sharplan公司）通过600微米光纤进行治疗。激光功率设置为7或10瓦，脉冲持续时间为10秒。激光能量传递至血管病变的所有区域。病变部位发热、可见收缩和变硬表明治疗结束。平均随访期为9.5个月（范围3 - 20个月）。根据临床评估病变大小的缩小情况判断，所有患者均有改善（平均缩小率 = 87%，范围60 - 100%）。3例患者（25%）出现了与光凝相关的并发症。能量传递过浅导致溃疡或瘢痕形成。如果牢记这种潜在危害，这些并发症应该是可以避免的。
