Vlachakis Ioannis, Gardikis Stefanos, Michailoudi Eleni, Charissis Georgios
Department of Paediatric Surgery, University Hospital of Heraklion, University of Crete - Medical School, Crete, Greece.
BMC Pediatr. 2003 Apr 12;3:2. doi: 10.1186/1471-2431-3-2.
Hemangiomas are the most common type of congenital anomaly in childhood. Although many resolve spontaneously, intervention is required when their growth could damage vital adjacent structures. Various therapeutic approaches to childhood hemangiomas with different types of laser have been described previously. The objective of this study was to determine whether the cooling of the epidermis during irradiation of hemangiomas with a Nd:YAG laser prevents thermal damage and decreases the number of sessions required to treat these lesions.
Between 1993 and 2001, 110 patients aged 3 months to 4 years, with cutaneous hemangiomas were treated with a Nd:YAG laser. The lesion was cooled with ice prior to, during, and after the irradiation. During each session the laser beam passed through the pieces of ice. The laser power was between 35-45 W with a pulse length of 2-10 seconds.
After 6 months of follow-up, from the first session of laser treatment, total resolution was obtained in 72 (65.5%) patients. A second or third session followed in 30 out of 38 patients in which, the initial results were good, moderate, or poor. The parents of the remaining eight children refused this second session and these patients excluded from the study Complications were seen in nine (8.8%) patients. One patient had postoperative bleeding which stopped spontaneously, while atrophic scars occurred in six (5.8%) patients, and hypertrophic scars in two (1.9%) patients.
Nd:YAG laser irradiation in conjunction with ice protection of the epidermis produces good cosmetic results for the treatment of cutaneous hemangiomas in children, and decreases the number of sessions for treatment of these lesions.
血管瘤是儿童期最常见的先天性异常类型。尽管许多血管瘤可自行消退，但当其生长可能损害相邻重要结构时，则需要进行干预。此前已描述了使用不同类型激光治疗儿童血管瘤的各种方法。本研究的目的是确定在用Nd:YAG激光照射血管瘤期间对表皮进行冷却是否能防止热损伤并减少治疗这些病变所需的疗程数。
1993年至2001年期间，对110例年龄在3个月至4岁的皮肤血管瘤患者使用Nd:YAG激光进行治疗。在照射前、照射期间和照射后用冰对病变部位进行冷却。在每次治疗过程中，激光束穿过冰块。激光功率为35 - 45瓦，脉冲长度为2 - 10秒。
随访6个月后，从首次激光治疗开始，72例（65.5%）患者实现了完全消退。在最初治疗效果良好、中等或较差的38例患者中，有30例进行了第二次或第三次治疗。其余8名儿童的家长拒绝了第二次治疗，这些患者被排除在研究之外。9例（8.8%）患者出现并发症。1例患者术后出血，自行停止；6例（5.8%）患者出现萎缩性瘢痕，2例（1.9%）患者出现增生性瘢痕。
Nd:YAG激光照射联合表皮冰敷保护对儿童皮肤血管瘤的治疗具有良好的美容效果，并减少了治疗这些病变所需的疗程数。
