Comparison study of a traditional pulsed dye laser versus a long-pulsed dye laser in the treatment of early childhood hemangiomas
Comparison study of a traditional pulsed dye laser versus a long-pulsed dye laser in the treatment of early childhood hemangiomas
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DOI：
10.1002/lsm.20257
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发表时间：
2006-02-01
影响因子：
2.4
通讯作者：
Nozaki, M
中科院分区：
文献类型：
--
作者：
Kono, T;Sakurai, H;Nozaki, M
背景和目的：由于血管瘤的固有特性以及脉冲染料激光的副作用，脉冲染料激光在治疗儿童血管瘤中的作用仍存在争议。最近，长脉冲染料激光（LPDL）与冷冻剂喷雾冷却（CSC）已被发现在治疗鲜红斑痣和毛细血管扩张症相对更有效和更安全的PDL。本研究的目的是比较PDL与LPDL治疗儿童血管瘤的疗效和并发症发生率。研究设计/材料和方法：我们做了一个前瞻性的，随机的，对照试验，我们招募了52名亚洲婴儿，年龄1-3个月，早期血管瘤。这些婴儿被分配到PDL治疗（n = 26）或LPDL治疗（n = 26），并随访至1岁。使用波长为585 nm、光斑尺寸为7 mm的PDL和波长为595 nm、光斑尺寸为7 mm的LPDL。PDL组中的每名患者都接受了6至7 J/cm（2）的能量通量和0.45毫秒的脉冲持续时间的治疗，而没有表皮冷却。LPDL组中的每名患者都接受了9至15 J/cm（2）的能量通量和10-20毫秒的脉冲持续时间的治疗，利用CSC保护表皮。每组每隔4周治疗一次，直至病灶清除。当每个病人达到一年的年龄，结果的措施，如清除率，最大增殖的时间段，并发症进行了assessed.Results：在我岁的病变显示完全清除或最小的残留迹象的儿童人数为14（54%）在PDL组和17（65%）在LPDL组（P = 0.397）。与LPDL相比，PDL治疗的儿童有更多的色素减退（3.12% vs. 8.31%; P = 0.001），更多的色素沉着（2.8% vs. 4.15%; P = 0.005）和更多的纹理变化（1.4% vs. 6.23%; P = 0.001）。LPDL组最大增殖时间（106 d）明显短于PDL组（177 d），差异有统计学意义（P = 0.01）。
Background and Objective: The role of pulsed dye laser (PDL) in the treatment of childhood hemangiomas is still controversial because of the inherent characteristics of hemangiomas as well as the side effects of the PDL. Recently, the long pulsed dye laser (LPDL) with cryogen spray cooling (CSC) has been found relatively more effective and safer than the PDL in the treatment of port-wine stains and telangiectasia. This study was designed to compare the efficacy and complication rate of PDL versus LPDL for treating childhood hemangiomas.Study Design/Materials and Methods: We did a prospective, randomized, controlled trial in which we enrolled 52 Asian infants, aged 1-3 months, with early hemangiomas. These infants were assigned to PDL treatment (n = 26) or LPDL treatment (n = 26) and followed to age 1 year. A PDL with a wavelength of 585 nm and spot size of 7 mm and a LPDL with a wavelength of 595 nm and spot size of 7 mm were used. Each patient in the PDL group was treated with energy fluence between 6 and 7 J/cm(2) and a pulse duration of 0.45 milliseconds without epidermal cooling. Each patient in the LPDL group was treated with energy fluence between 9 and 15 J/cm(2) and a pulse duration of 10-20 milliseconds, utilizing CSC to protect the epidermis. Each group was treated at 4-week intervals until the lesion cleared. When each patient reached an age of I year, outcome measures such as clearance rate, time period of maximum proliferation, and complications were assessed.Results: The number of children whose lesions showed complete clearance or minimal residual signs at I year of age was 14 (54%) in the PDL group and 17 (65%) in the LPDL group (P = 0.397). Compared with the LPDL, PDL treated children had more hypopigmentation (3, 12% vs. 8, 31%; P = 0.001), more hyperpigmentation (2, 8% vs. 4,15%; P = 0.005), and more textural changes (1, 4% vs. 6, 23%; P = 0.001). The average time period of maximum proliferation in the LPDL group was significantly shorter than that of the PDL group (106 days vs. 177 days; P = 0.01).Conclusion: Early treatment of childhood hemangiomas with the LPDL is safer and more effective than the PDL.