Remlova Eva, Dostalová Tatjana, Michalusová Iva, Vránová Jana, Navrátil Leoš, Rosina Jozef
Ave Laser Centrum , Olomouc, Czech Republic.
Photomed Laser Surg. 2011 Dec;29(12):815-25. doi: 10.1089/pho.2011.3058. Epub 2011 Jul 27.
Hemangioma is a mesenchymal benign tumor formed by blood vessels. Anomalies affect up to 10% of children and they are more common in females than in males. The aim of this study was to evaluate hemangioma treatment using four different types of lasers, namely, alexandrite, Er:YAG, CO(2), and pulsed dye laser (PDL).
The argon laser was the first to be used for dermatological patients, namely, with port wine stains (PWS) in the late 1960s and early 1970s. A variety of different lasers and light sources were useful in the treatment of vascular lesions, e.g., KTP, Nd:YAG, CO(2), PDL, and Er:YAG.
A group of 869 consecutive patients with hemangioma was retrospectively reviewed. The patients including in our study were divided into four groups according to the type of laser used: Alexandrite laser (n=85, 58 women and 20 men), CO(2) laser (n=78, 58 women and 20 men), Er:YAG laser (n=105, 87 women and 18 men), and PDL laser (n=601, 453 women and 148 men). All patients were treated in one session without anesthesia application. The ablative systems vaporized the tissues until the hemangioma was removed. The non-ablative systems used one shot, which destroyed the hemangioma blood vessels.
For the treatment efficacy analysis, the following factors were evaluated: therapeutic effect (yes vs. no), loss of pigment (yes vs. no), and appearance of scar (yes vs. no). From results it was evident that the therapeutic effect of all the lasers except alexandrite was very high; almost 100%. In the CO(2) and the Er:YAG laser groups a high percentage of side effects was also observed. Exposure to these lasers caused loss of pigment and scar formation in many cases. The best therapeutic effect, with only minor side effects, has been achieved with the PDL laser.
It was confirmed that PDL (595 nm, 1.5 ms, 7 mm, 9 - 11 J/cm(2)) had optimal effect without scars. Er:YAG or CO(2) laser radiation with specific characteristics was also useful for small superficial lesions.
血管瘤是一种由血管构成的间叶组织良性肿瘤。多达10%的儿童会出现此类异常，且女性比男性更为常见。本研究的目的是评估使用四种不同类型激光，即翠绿宝石激光、铒：钇铝石榴石激光、二氧化碳激光和脉冲染料激光（PDL）治疗血管瘤的效果。
氩激光是20世纪60年代末70年代初首个用于皮肤病患者，即治疗葡萄酒色斑（PWS）的激光。多种不同的激光和光源可用于治疗血管病变，如倍频Nd:YAG激光、钕：钇铝石榴石激光、二氧化碳激光、脉冲染料激光和铒：钇铝石榴石激光。
对一组连续的869例血管瘤患者进行回顾性研究。根据所使用的激光类型，将纳入本研究的患者分为四组：翠绿宝石激光组（n = 85，58名女性和20名男性）、二氧化碳激光组（n = 78，58名女性和20名男性）、铒：钇铝石榴石激光组（n = 105，87名女性和18名男性）和脉冲染料激光组（n = 601，453名女性和148名男性）。所有患者均在未使用麻醉的情况下接受单次治疗。消融系统汽化组织直至血管瘤被清除。非消融系统使用单次照射，破坏血管瘤血管。
对于治疗效果分析，评估了以下因素：治疗效果（是与否）、色素脱失（是与否）和瘢痕形成（是与否）。从结果可以明显看出，除翠绿宝石激光外，所有激光的治疗效果都非常高；几乎达到100%。在二氧化碳激光组和铒：钇铝石榴石激光组中也观察到了较高比例的副作用。在许多情况下，暴露于这些激光会导致色素脱失和瘢痕形成。脉冲染料激光取得了最佳治疗效果，且副作用较小。
已证实脉冲染料激光（595纳米，1.5毫秒，7毫米，9 - 11焦/平方厘米）具有最佳效果且无瘢痕。具有特定特性的铒：钇铝石榴石激光或二氧化碳激光辐射对小的浅表病变也有效。
