Long-pulsed 1064 nm Nd:YAG laser improves hypertrophic port-wine stains
Long-pulsed 1064 nm Nd:YAG laser improves hypertrophic port-wine stains
复制标题
DOI：
10.1111/jdv.12021
复制
发表时间：
2013-11-01
影响因子：
9.2
通讯作者：
Wolkerstorfer, A.
中科院分区：
文献类型：
--
作者：
van Drooge, A. . M.;Bosveld, B.;Wolkerstorfer, A.
背景肥厚性鲜红斑痣（PWS）通常对脉冲染料激光治疗反应较差。长脉冲1064nm Nd：YAG激光可以靶向更深的血管，因此可能更有效。目的评价Nd：YAG激光治疗肥厚性PWS的疗效和安全性。方法在一项回顾性队列研究中，对2005年至2011年期间接受Nd：YAG激光治疗的所有肥厚性PWS患者进行随访。使用医生总体评估（PhGA）和患者总体评估（PGA）评估临床改善。结果44例符合条件的患者中有32例（平均年龄51.4岁）在平均2.8（SD 2.1）次Nd：YAG激光治疗后获得评估。PhGA（91%）和PGA（93%）均在大多数患者中发现了肥大的良好或极好改善。PhGA发现63%的患者颜色改善良好或出色，PGA发现87%的患者颜色改善良好或出色。3例患者出现肥大复发。除两名患者外，所有患者均建议其他患者接受Nd：YAG治疗。7例患者出现轻度至中度瘢痕，14例患者出现色素减退。结论1064nm Nd：YAG激光治疗肥厚性PWS疗效显著，治疗次数少。在所有患者中有一半出现了轻微的副作用。肥大的反应似乎比颜色好。为了进一步改善颜色，建议结合脉冲染料激光治疗。使用Nd：YAG激光时，观察即刻临床终点非常重要，可优化结局并减少副作用。
Background Hypertrophic port-wine stains (PWS) usually respond poorly to pulsed dye laser treatment. The long-pulsed 1064nm Nd:YAG laser can target deeper situated vessels and may therefore be more effective. Objective To evaluate the efficacy and safety of the Nd:YAG laser for the treatment of hypertrophic PWS. Methods In a retrospective cohort study, all hypertrophic PWS patients treated with the Nd:YAG laser between 2005 and 2011 were invited for follow-up. Clinical improvement was assessed using Physician Global Assessment (PhGA) and Patient Global Assessment (PGA). Results Assessment was obtained in 32 of 44 eligible patients (mean age 51.4years), after a mean of 2.8 (SD2.1) Nd:YAG laser treatments. Good or excellent improvement of hypertrophy was found in a majority of patients, both by PhGA (91%) and PGA (93%). Good or excellent improvement of colour was found in 63% of patients by PhGA, and in 87% by PGA. Recurrence of hypertrophy was seen in three patients. All but two patients would recommend Nd:YAG treatment to other patients. Mild to moderate scars were seen in seven patients, hypopigmentation in 14 patients. Conclusion The 1064nm Nd:YAG laser is highly effective in the treatment of hypertrophic PWS with only a few treatments needed. Mostly mild side effects were seen in half of all patients. Hypertrophy seems to respond better than colour. To further improve colour, a combination with pulsed dye laser treatment is advisory. Observation of immediate clinical endpoints is important when using the Nd:YAG laser, to optimize outcomes and reduce side effects.