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钕钇铝石榴石(Nd:YAG)激光手术后口腔白斑的三年随访

Three-year follow-up of oral leukoplakia after neodymium:yttrium aluminum garnet (Nd:YAG) laser surgery.

作者信息

Vivek V, Jayasree R S, Balan Anita, Sreelatha K T, Gupta A K

机构信息

PMS College of Dental Science and Research, Vattapara, Trivandrum-695028 Kerala, India.

出版信息

Lasers Med Sci. 2008 Oct;23(4):375-9. doi: 10.1007/s10103-007-0500-8. Epub 2007 Oct 27.

Abstract

Oral leukoplakia is a relatively common lesion with a significant proportion of cases changing into cancer. Since most leukoplakias are asymptomatic, the primary objective of treatment must aim at the prevention of such malignant transformation. The main objectives of the study are to observe (1) the efficacy, safety and acceptability of the neodymium:yttrium aluminum garnet (Nd:YAG) laser in the management of oral leukoplakia; (2) the nature of postoperative complications, if any, associated with laser ablation, and (3) the 3-year prognosis of oral leukoplakia treated with laser. Twenty-eight patients with histologically proven leukoplakia were treated with Nd:YAG laser. From this study, we observed that the patients treated with Nd:YAG laser had only mild to moderate pain, swelling and restricted mouth opening, which peaked between 72 h and 1 week. In a majority of the patients the healing was prolonged, to a maximum of 5 weeks, and there was no clinical evidence of scarring in 26 out of 28 cases. In this study we achieved a cure rate of 92.86% in a 6-month period. Further follow-up after 3 years yielded almost the same result, except that one patient was not available for follow-up. We concluded that Nd:YAG laser is an effective device in the management of oral leukoplakia, which is one of the major pre-cancerous lesions in our country.

摘要

口腔白斑是一种相对常见的病变,相当一部分病例会恶变为癌症。由于大多数白斑无症状,治疗的主要目标必须是预防这种恶性转化。本研究的主要目的是观察:(1)钕钇铝石榴石(Nd:YAG)激光治疗口腔白斑的疗效、安全性和可接受性;(2)激光消融术后并发症(如有)的性质;(3)激光治疗口腔白斑的3年预后。28例经组织学证实为白斑的患者接受了Nd:YAG激光治疗。通过本研究,我们观察到接受Nd:YAG激光治疗的患者仅有轻至中度疼痛、肿胀和张口受限,在72小时至1周达到高峰。大多数患者愈合时间延长,最长达5周,28例中有26例无瘢痕形成的临床证据。在本研究中,我们在6个月内的治愈率为92.86%。3年后的进一步随访结果几乎相同,只是有1例患者无法进行随访。我们得出结论,Nd:YAG激光是治疗口腔白斑的有效设备,口腔白斑是我国主要的癌前病变之一。

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