595nm脉冲染料激光治疗皮肤血管性疾病的疗效

目的 探讨595 nm脉冲染料激光（pulsed dye laser,PDL）治疗皮肤血管性疾病的疗效和不良反应,并分析与疗效相关的因素.方法 采用595 nm PDL治疗血管瘤、鲜红斑痣、毛细血管扩张、酒糟鼻、蜘蛛痣等各类皮肤血管性疾病572例,对比不同病变的治疗效果及不良反应,分析疗效与患者性别、年龄、病变类型、病灶部位等因素的相关性.结果 治疗疗效与患者年龄、疾病性质、部位等因素相关（P＜0.05）,与性别无明显相关性;治疗后不良反应率为2.27％.结论 595 nmPDL治疗皮肤血管性疾病安全性高,疗效良好,不良反应低,是目前较为理想的治疗方法.     

595nm脉冲染料激光治疗皮肤良性血管异常性疾病疗效分析

目的:探讨595nm脉冲染料激光治疗皮肤良性血管异常性疾病的临床疗效和安全性。方法:使用595nm脉冲染料激光(Vbeam血管激光治疗仪)治疗479例皮肤良性血管异常性疾病,其中血管瘤267例,微静脉畸形132例,毛细血管扩张症24例、蜘蛛痣45例,血管角皮瘤11例,根据不同的病变选择相应的参数进行治疗。结果:595nm脉冲染料激光治疗皮肤良性血管异常性疾病的有效率分别为血管瘤92.1%、微静脉畸形79.5%、毛细血管扩张症95.8%、蜘蛛痣100%、血管性角皮瘤90.9%。12例(2.5%)患者出现暂时性色素沉着,无1例发生瘢痕。结论:595nm脉冲染料激光治疗皮肤良性血管异常性疾病安全、有效。     

595 nm可调脉宽染料激光治疗小儿皮肤血管瘤

目的 探讨595nm可调脉宽染料激光治疗小儿皮肤血管瘤的疗效和不良反应。方法 用595nm可调脉宽染料激光治疗小儿各类皮肤血管瘤76例。结果 595nm可调脉宽染料激光治疗小儿各类皮肤血管瘤的有效率分别为：鲜红斑痣83．2％、草莓状血管瘤86．63％、海绵状血管瘤疗效不佳；总体不良反应发生率为7．9％。结论 595nm可调脉宽染料激光治疗小儿各类皮肤血管瘤的临床疗效好，不良反应发生率低。     

595 nm可调脉冲染料激光治疗皮肤血管异常性疾病疗效分析

目的观察595nm可调脉冲染料激光治疗皮肤血管异常性疾病(血管畸形与血管瘤)的临床疗效。方法应用595nm可调脉冲染料激光治疗396例皮肤血管异常性疾病,观察临床疗效。结果毛细血管扩张和蜘蛛痣疗效最好,有效率为100%,其次是草莓状血管瘤,有效率为92.4%,鲜红斑痣为82.8%。面积越小,年龄越小,疗效越好(P<0.05);性别与疗效无明显差异。术中疼痛较轻,术后副作用少。结论595nm可调脉冲染料激光治疗皮肤血管异常性疾病安全性高,疗效确切。     

595nm脉冲染料激光联合平阳霉素治疗微静脉畸形疗效观察

目的:探讨595nm脉冲染料激光联合平阳霉素注射治疗微静脉畸形(鲜红斑痣、葡萄酒样痣)的临床疗效。方法:选择2013年7月-2017年10月笔者科室收治的50例微静脉畸形患者(以面部为主)为研究对象,随机分为三组,A组:23例,单用595nm脉冲染料激光治疗;B组:6例,单用平阳霉素治疗;C组:21例,采用595nm脉冲染料激光联合平阳霉素治疗。结果:联合治疗组与单用激光或单用平阳霉素治疗效果比较明显增高,差异有统计学意义(P0.05)。结论:595nm脉冲染料激光联合平阳霉素治疗微静脉畸形,能显著提高疗效。     

595nm脉冲染料激光治疗婴幼儿微静脉畸形疗效观察

目的:观察595nm脉冲染料激光治疗婴幼儿微静脉畸形的临床疗效。方法:2014年12月-2016年12月,笔者科室采用595nm脉冲染料激光治疗微静脉畸形患儿45例,其中男21例,女24例,年龄40d~3岁,平均1.8岁。治疗间隔期1.5~2个月,治疗次数2~16次,平均8次。结果:按皮损颜色和增生的情况分组:粉红型32例,紫红型8例,增厚型5例。总有效率84.7%,年龄越小,疗效越好。而且,结果证明粉红型疗效优于紫红型,增厚型最差。结论:595nm脉冲染料激光治疗婴幼儿微静脉畸形安全、有效,并且患者年龄越小,皮损颜色越浅,疗效越好,提倡尽早治疗。     

595nm脉冲染料激光治疗皮肤血管异常性疾病

目的 观察595 nm脉冲染料激光治疗皮肤血管异常性疾病的临床疗效及不良反应.方法 自2008年1月至2010年1月,应用595 nm脉冲染料激光治疗皮肤血管异常性疾病患者362例,其中鲜红斑痣者147例、婴幼儿血管瘤者109例、毛细血管扩张者45例、蜘蛛痣者12例、血管痣者33例、血管角皮瘤者16例,并观察及判定其疗效.结果 毛细血管扩张、血管痣和蜘蛛痣患者的治疗有效率达100%;鲜红斑痣的有效率为72.1%;婴幼儿血管瘤的有效率为86.2%;血管角皮瘤的有效率为93.8%.治疗中疼痛较轻,不良反应发生率约为3.0%.治疗后随访317例患者1～2年,对治疗效果均较满意.结论 595 nm脉冲染料激光治疗皮肤血管异常性疾病临床疗效确切,不良反应较少,值得推广应用.     

双波长（595nm和1064nm）脉冲激光治疗血管性皮肤病429例

目的：观察595nm和1064nm双波长脉冲激光治疗血管瘤、微静脉畸形、蜘蛛痣、毛细血管扩张的临床疗效及影响疗效的因素。方法：总结双波长595nm和1064nm激光器治疗血管性皮肤病患者的资料429例,评价其疗效和安全性,比较不同类型血管性皮肤病的治疗参数、治疗次数及相关影响因素。结果：治疗的总有效率为94．2％,血管瘤愈显率为63．6％,微静脉畸形52．7％,随着治疗次数增多,两者有效率达94．8％、91．9％;蜘蛛痣有效率为100％,毛细血管扩张症为80％。蜘蛛痣所需治疗次数最少,治疗参数较高;微静脉畸形需4次以上治疗才能达到较好疗效,所有血管性皮肤病治疗间隔3～5周时疗效显著。结论：双波长激光治疗血管性皮肤病安全、有效,其中蜘蛛痣和血管瘤疗效好,且治疗次数少,疗程短,不良反应发生率低。微静脉畸形需多次治疗,毛细血管扩张症选择双波长激光联合IPL治疗更好。     

长脉冲1064nm Gentle YAG激光联合595nm脉冲染料激光治疗增厚型微静脉畸形回顾性分析

目的：观察长脉冲1064nm Gentle YAG激光联合595nm脉冲染料激光治疗增厚型微静脉畸形的临床疗效和不良反应。方法：使用长脉冲1064nm Gentle YAG激光和595nm脉冲染料激光对14例患者进行治疗,其中长脉冲1064nm Gentle YAG激光能量密度150～240J/cm2,光斑直径3mm,脉宽20～40ms;595nm脉冲染料激光能量密度12～15J/cm2,光斑直径7mm,脉宽6～20ms;共治疗2～7次,间隔时间4～8周。结果：痊愈6例（6/14）,显效5例（5/14）,好转3例（3/14）,无效0例。治疗后出现轻度色素沉着3例（3/14）,均在数月后恢复,遗留增生性瘢痕1例（1/14）,凹陷性瘢痕1例（1/14）。结论：长脉冲1064nm Gentle YAG激光联合595nm脉冲染料激光是目前比较安全、高效的治疗增厚型微静脉畸形的方法。     

脉冲染料激光治疗婴幼儿面部血管性疾病近期疗效观察

目的:探讨采用595nm脉冲染料激光(pulsed dye laser,PDL)治疗婴幼儿面部血管性疾病的临床疗效。方法:共收集2016年6月-2017年6月笔者科室就诊的78例婴幼儿面部血管性疾病患者,其中微静脉畸形15例,血管瘤31例,静脉畸形24例,混合型血管瘤8例,采用595nm PDL进行治疗,分析其疗效与不良反应。结果:术后随访6个月,所有患者均恢复良好,微静脉畸形、血管瘤、静脉畸形、混合型血管瘤总有效率分别为73.3%、90.3%、87.5%、62.5%,不同性别之间采用595nm PDL治疗差异无统计学意义(P0.05),4例患者出现局部色素沉着,其余均未出现明显并发症,术后效果良好。结论:应用595nm PDL治疗婴幼儿面部血管性疾病的近期疗效确切,并发症较少,术后效果满意,值得临床推广应用。     

Vbeam脉冲染料激光治疗皮肤葡萄酒色斑的疗效分析

目的 评价595 nm Vbeam脉冲染料激光治疗皮肤葡萄酒色斑(Pint wine stains,PWS)的临床疗效.方法 共114例PWS患者接受595 nm Vbeam脉冲染料激光治疗,脉宽3～10 ms,光斑直径7mm,能量密度10-15 J/cm2,动态冷却喷射30～40 ms,间隔10～30 ms,治疗间隔4～8周.根据皮损消退,将疗效分为4级:Ⅰ级为＞75%,Ⅱ级为50%～74%,Ⅲ级为25%～49%,Ⅳ级为＜25%.结果 114例经过1～10次治疗(平均5.9次),取得很好临床效果,其中Ⅰ级74例(64.9%),Ⅱ级29例(25.4%),Ⅲ级9例(7.9%),Ⅳ级2例(1.8%).并分析治疗次数、年龄大小、发生部位、颜色特点和疗效的关系,年龄小、发生于颈面部位、粉红型病损者疗效显著.随访6个月至2年,无复发,治疗部位无瘢痕形成.结论 595 nm波长Vbeam脉冲染料激光治疗皮肤PWS效果良好,并发症少,是目前一种很安全、较可靠的治疗方法.     

脉冲染料激光联合外用咪喹莫特在难治性鲜红斑痣中的应用

目的：评估脉冲染料激光（pulseddyelaser,PDL）联合外用咪喹莫特治疗难治性鲜红斑痣（紫红型、肥厚型）的疗效。方法：将28例采用脉冲染料激光治疗5次后颜色改变不明显甚至颜色加深的鲜红斑痣患者随机分为治疗组和对照组。治疗组：采用脉冲染料激光治疗后外用咪喹莫特,每天1次,持续1月,间隔1．5月后重复治疗,2次激光治疗后观察疗效;对照组：继续采用脉冲染料激光治疗2次后观察效果。结果：采用脉冲染料激光联合外用咪喹莫特治疗效果明显好于原来单用脉冲染料激光的治疗效果。结论：基于本试验初步研究的结果,脉冲染料激光加咪喹莫特在难治性鲜红斑痣治疗上有很好的临床应用前景。     

Thickness of Healthy and Affected Skin of Children with Port Wine Stains: Potential Repercussions on Response to Pulsed Dye Laser Treatment

Background. Response of port wine stain to pulsed dye laser therapy is variable and dependent on treatment settings used and anatomic site as well as on size and depth of ectatic vessels.
Objective. Our purpose was to evaluate skin thickness in different anatomic areas and in port wine stain to thus assess its possible role in the response to pulsed dye laser.
Materials and methods. Twenty-one children with port wine stain underwent high-frequency ultrasound evaluation (20 MHz). Eighteen unaffected areas were considered in each patient and an additional measure was taken from the symmetric affected skin when present (50 areas).
Results. Skin was thicker in the centrofacial area, dermatome V1 (followed by dermatome V2, dermatome V3, and dermatomes C1-2), and with increasing age. No substantial difference between affected and symmetric nonaffected skin was found.
Conclusion. Thicker cutaneous areas fit with those that typically respond worse to pulsed dye laser. Differences in skin thickness related to age support the fact that better responses are achieved in younger patients.     

Multifocal Basal Cell Carcinoma Developing in a Facial Port Wine Stain Treated with Argon and Pulsed Dye Laser: A Possible Role for Previous Radiotherapy

BACKGROUND: Basal cell carcinoma occurring in port wine stain is extremely rare but has been reported after radiotherapy for port wine stain. OBJECTIVE: The objective was to present 55-year-old man with a facial port wine stain who had multiple treatment sessions with both the argon laser and the pulsed dye laser and subsequently developed a recurrent multifocal basal cell carcinoma and highlight the treatment carried out and its effects on the outcome. METHODS: We describe the history of the patient's port wine stain treatment, the development of skin cancer within it, and the different modalities of therapy carried out. RESULTS: The patient developed basal cell carcinoma in his port wine stain. The possibility of a causal link between laser treatment and this skin cancer was considered but it was discovered that he had had radiotherapy treatment of his birthmark at age 9. The basal cell carcinoma was successfully treated. CONCLUSION: This case of a clinically indistinct multifocal basal cell carcinoma arising within facial port wine stain was most likely due to previous radiotherapy treatment as a child, rather than laser treatment. Careful treatment history should identify such patients who should be followed-up for development of skin cancer.     

595nm可调脉宽染料激光与强脉冲光治疗毛细血管扩张

目的：评价595nm可调脉宽染料激光与强脉冲光（IPL）治疗毛细血管扩张的疗效和不良反应。方法：用595nm可调脉宽脉冲染料激光仪与强脉冲光分组治疗毛细血管扩张共326例,按照就诊时间随机单盲将患者分为两组,A组：164例,应用595nm可调脉宽染料激光治疗;B组：162例,应用强脉冲光治疗。根据血管的粗细适当选择脉宽及能量密度,照射病变部位,观察局部治疗皮肤反应,即以照射部位皮肤变为紫灰色,扩张血管消失为适度。每月治疗1次,共治疗1～3次,分析两组患者的疗效和不良反应。结果：164例毛细血管扩张患者,经过595nm可调脉宽V-beam激光1～3次治疗后,85例痊愈,63例显效,总有效率90.2%;IPL组的总有效率在第1、2、3次治疗后分别为3.1%、21.6%和43.2%。与IPL组比较,595nm可调脉宽V-beam激光组的疗效要明显优于IPL组,两者的差异性有明显统计学差异（P〈0.01）。同一类型皮肤与IPL组比较,595nm可调脉宽V-beam激光组的疗效要明显优于IPL组,两者的差异性有明显统计学差异（P〈0.05）。两组治疗后皮肤反应轻微,595nm激光组治疗后会暂时出现局部水肿和紫癜,两组术后色素改变发生率无显著性差异（P〈0.05）。结论：595nm可调脉宽脉冲染料激光治疗毛细血管扩张疗效明显优于强脉冲光,且皮肤反应轻微,疗效确切,临床效果满意。     

强脉冲光和脉冲染料激光595nm治疗面部毛细血管扩张的比较研究

目的：评价强脉冲光（Intense Pulsed Light,IPL）560～1200nm／590～1200nm和脉冲染料激光595nm不同波长治疗面部毛细血管扩张症的临床有效性。方法：301例患者随机分为3组,A组（IPL560～1 200nm）124例,B组（IPL590～1200nm）79例,C组（脉冲染料激光595nm）98例。分别治疗1～4次,间隔时间4～6周。观察其血管清除率。结果：A、B、C组术中血管完全消失分别为66例（53．23％）、34例（43．04％）、74例（75．51％）;治愈分别为79例（63．71％）、41例（51．90％）、81例（82．65％）;平均治愈次数分别为2．66次、2．85次、1．65次。A、B、C三组总体比较差别具有统计学意义;A、B两组比较差别具有统计学意义;A、C两组和B、C两组比较差别具有统计学意义。结论：IPL560～1200nm／590～1200nm和脉冲染料激光595nm三种波长对面部毛细血管扩张均有可靠疗效,脉冲染料激光595nm波长治愈率优于IPL560～1200nm／590～1200nm波长。     

Adverse effects reported in pulsed dye laser treatment for port wine stains

A retrospective study was conducted over a 762-day period to investigate the incidence of adverse effects following pulsed dye laser treatment for port wine stains using the Chromos 585 nm pulsed dye laser (PDL). Treatment energy densities typically ranged from 4.0 J/cm² to 7.5 J/cm². Treatment was predominantly delivered as a 7 mm-diameter pulse of laser light, although a 5 mm pulse was occasionally used. Nine patients experienced one adverse event each, with scabbing, blistering (prolonged in one case that persisted for more than 2 months), hypopigmentation or hyperpigmentation; one of the nine patients developed both blistering and hypopigmentation. The incidence of adverse effects per treatment was 1.4% (1.7% for adults and 0.6% for children). The lower leg was the most common site for an adverse effect; four out of 22 patients (18%) receiving PDL treatment for lower leg port wine stains (PWSs) suffered an adverse effect (three cases of hyperpigmentation and one of hypopigmentation and blistering). Four patients suffered an adverse effect following an increase in the energy density of the laser treatment. There was no statistically significant correlation between laser performance and the occurrence of adverse effects.