Intralesional photocoagulation of periorbital hemangiomas.
Intralesional photocoagulation of periorbital hemangiomas.
复制标题
眶周血管瘤病灶内光凝术。
DOI：
10.1097/00006534-199901000-00003
复制
发表时间：
1999
影响因子：
3.6
通讯作者：
A. Boyko
中科院分区：
文献类型：
--
作者：
B. Achauer;Cheng;V. Vanderkam;A. Boyko
本研究的目的是探讨KTP和Nd：YAG激光联合裸露纤维光凝治疗婴儿期眶周血管瘤的疗效。ApFelberg和Gregory的初步报告表明，肿瘤内激光治疗可能在血管瘤的治疗中发挥作用。由于几个原因，病灶内光凝可能比表面激光治疗更受欢迎。它可能会减少皮肤损伤，更有效地减少笨重的深部损伤。治疗眶周血管瘤23例，其中KTP 7例，NdYAG16例。一根18克的血管导管被放入病变中，以通过纤维。激光能量通过0.6 mm的裸光纤传输，能量为10~15J(KTP)或7J(Nd：YAG)。治疗是在全身麻醉下进行的。对患者进行为期1个月的密切随访，然后每月进行疗效评估和并发症评估。结果如下：61%的患者在3个月内表现出50%或以上的下降；22%的患者在3-8个月内表现出50%或以上的下降，即83%的患者在8个月内表现出50%或以上的下降。为了达到这些结果，两名患者需要两种治疗方法。其余17%的人在1到3个月内减少了10%到14%。其中两名患者接受了两种治疗。一组患者有非常戏剧性的反应。35%(8/23)的人在1个月内减少了50%到90%。目前还不清楚为什么这些患者的反应如此戏剧性。我们预计在愈合阶段会有一些溃疡。17%的人出现了溃疡。并发症仅限于一个伤口感染(4%)。采用KTP激光和NdYAG光凝区内光凝治疗大多数眼眶周围血管瘤安全有效，并发症少。有必要进行进一步的研究，以确定导致戏剧性或有限反应的因素。
The purpose of this study was to examine the effects of intralesional bare fiber photocoagulation with the KTP and Nd:YAG lasers on periorbital hemangiomas of infancy. Initial reports by Apfelberg and Gregory suggest that intralesional laser therapy may have a role in the treatment of hemangiomas. Intralesional photocoagulation may be preferred to superficial laser treatment for several reasons. It may decrease cutaneous skin damage and more effectively reduce bulky, deep lesions. Twenty-three patients with periorbital hemangiomas were treated (KTP, n = 7; Nd:YAG, n = 16). An 18-g Angiocath was placed into the lesion to pass the fiber through. Laser energy was delivered by means of a 0.6-mm bare fiber at 10 to 15 J (KTP) or 7 J (Nd:YAG). Treatments were done under general anesthesia. Patients were followed closely for 1 month and then monthly to assess results and complications. Results are as follows: 61 percent demonstrated 50-percent or more reduction at 3 months; 22 percent demonstrated 50-percent or more reduction in 3 to 8 months, i.e., 83 percent of patients had 50-percent or more reduction within 8 months. To achieve these results, two patients required two treatments. The remaining 17 percent had 10- to 14-percent reduction at 1 to 3 months. Two of these patients had two treatments. A subgroup of patients had a very dramatic response. Thirty-five percent (8 of 23) had 50- to 90-percent reduction in 1 month. It is unclear why these patients responded so dramatically. We expected some ulceration during the healing phase. Seventeen percent developed ulceration. Complications were limited (4 percent) to one wound infection. Intralesional photocoagulation treatment with the KTP and Nd:YAG lasers is effective and safe for the treatment of periorbital hemangiomas in the majority of patients with minimal complications. Further study is necessary to identify factors that result in dramatic or limited responses.