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血管瘤患者瘤内激光光凝术(ILP)的长期随访

Long term follow-up of intralesional laser photocoagulation (ILP) for hemangioma patients.

作者信息

Chang Cheng-Jen

机构信息

Department of Plastic Surgery, Chang Gung Memorial Hospital Chang Gung University, Taipei, Taiwan.

出版信息

Laser Ther. 2011;20(4):255-7. doi: 10.5978/islsm.11-or-03.

Abstract

BACKGROUND AND OBJECTIVES

Hemangiomas remain a challenge for patients and plastic surgeons. Promising results have been reported using intralesional photocoagulation (ILP) for treatment. The objective of our study is to review the long term results of a large series of hemangiomas in patients treated by ILP. Materials (Subjects) and Methods: A retrospective review of 684 hemangiomas in patients were treated by ILP with an Nd:YAG (neodymium-yttrium-aluminium-garnet) (1064 nm) laser over a period of 10 years (January 1996-January 2005). Patients' ages ranged from one month to 11 years 5 months (mean, 1 year 10 months). The patient group consisted of 474 females and 210 males.

RESULTS

Patients were treated with an Nd:YAG laser delivered through a 600 m optical fiber. Laser power was set at 7 to 15 watts (W) and delivered with pulse duration of 7 to 15 seconds (s). The results showed 603 (88.6%) patients had more than 50% reduction of the volume in hemangiomas at 3 months after one treatment; and 663 (96.9%) patients had more than 50% reduction of the volume at 3 months after two treatments. Patients who had continuous ILP achieved excellent results.

CONCLUSIONS

Postoperative complications have been related to photocoagulation that has been delivered too extensively or superficially, with resultant ulceration, infection, bleeding, and scarring. These complications can be avoided if this potential for harm is kept in mind.

摘要

背景与目的

血管瘤对患者和整形外科医生而言仍是一项挑战。据报道,病灶内光凝术(ILP)治疗取得了不错的效果。我们研究的目的是回顾接受ILP治疗的大量血管瘤患者的长期治疗结果。材料(研究对象)与方法:回顾性分析1996年1月至2005年1月期间,使用钕钇铝石榴石(Nd:YAG)(1064纳米)激光通过ILP治疗的684例血管瘤患者。患者年龄从1个月至11岁5个月不等(平均为1岁10个月)。患者组包括474名女性和210名男性。

结果

患者使用通过600米光纤传输的Nd:YAG激光进行治疗。激光功率设定为7至15瓦(W),脉冲持续时间为7至15秒(s)。结果显示,603例(88.6%)患者在一次治疗后3个月时血管瘤体积缩小超过50%;663例(96.9%)患者在两次治疗后3个月时体积缩小超过50%。接受持续ILP治疗的患者取得了优异的效果。

结论

术后并发症与光凝范围过大或过浅有关,可导致溃疡、感染、出血和瘢痕形成。如果牢记这种潜在危害,这些并发症是可以避免的。

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