Naran Sanjay, Gilmore John, Deleyiannis Frederic W-B
Department of Surgery, The Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Ann Plast Surg. 2008 Apr;60(4):426-30. doi: 10.1097/SAP.0b013e3180959e74.
The purpose of this study was to compare 3 methods of assessment of pediatric port wine stains (PWSs) following multiple pulsed-dye laser (PDL) treatments; (i) parental evaluation, (ii) objective evaluation utilizing Lab* color measurement, and (iii) the visual inspection of serial photographs by blinded observers. Twenty-one children who had received at least 4 prior PDL treatments were prospectively enrolled. Following additional PDL treatment, 72.5% of the parental responses indicated a lighter PWS; 85% said that they would continue with further treatment. According to the assessments by 3 observers, only 33.3% to 61.9% (correlation coefficients: 0.41 and 0.54; P < 0.01) of the PDL treatments resulted in a perceived lightening. Lab* measurements were not significantly correlated with the observers' perceptions. Lab* assessment is not a clinically useful method to evaluate PDL response in the PWS previously treated. Relying solely on parental assessment may lead to overtreatment without a demonstrable benefit.
本研究的目的是比较多次脉冲染料激光(PDL)治疗后评估小儿葡萄酒色斑(PWS)的3种方法;(i)家长评估,(ii)利用Lab颜色测量进行客观评估,以及(iii)由不知情的观察者对系列照片进行视觉检查。前瞻性纳入了21名此前至少接受过4次PDL治疗的儿童。在额外接受PDL治疗后,72.5%的家长反馈表明PWS颜色变浅;85%的家长表示他们会继续接受进一步治疗。根据3名观察者的评估,只有33.3%至61.9%(相关系数:0.41和0.54;P<0.01)的PDL治疗导致色斑明显变浅。Lab测量结果与观察者的感知没有显著相关性。Lab*评估不是评估先前治疗过的PWS中PDL反应的临床有用方法。仅依靠家长评估可能会导致过度治疗而无明显益处。