激光凝固加气化切割治疗前列腺增生症

１９９４年１２月－１９９５年１０月采用ＤｏｒｎｉｅｒＭｅｄｉｌａｓ Ｆｉｂｅｒｔｏｍ６０４０型激光治疗机械行激光腺体内组织凝固及接触式激光气化切割联合治疗良性前列腺增生症（ＢＰＨ）５８例，取得满意疗效，随访３－８个月，前列腺症状ＩＰＳＳ评分平均９．５分，最大尿流率平均１５．４ｍｌ／ｓ，残余尿量平均２４ｍｌ，均未出现严重的并发症。认为本方法具有操作简便、术中术后出血少、创伤小和并发症少等优点，为高危     

阻断肿瘤血供后微波凝固治疗肝癌的临床研究(附120例临床分析)

目的探讨阻断肿瘤血供后微波凝固治疗肝癌的疗效。方法120例经组织学证实的肝癌病人，104例为原发性肝癌，16例为转移癌，共289个肿瘤结节，分为两个治疗组：（1）经导管动脉化疗栓塞（TACE）后1～2d内行超声引导下微波热凝固治疗（PMCT）70例；（2）手术中暂时阻断肝门血流后行肝癌微波热凝固治疗（MCT）50例。结果治疗中B超监测微波凝固范围显示：单电极60w、180S时，TACE＋PMCT组和术中阻断肝门血流＋MCT组肿瘤凝固体积分别为20～92CITI。和18～85cm^2，明显超过单纯的微波热疗时8～15cm^2。的凝固体积；治疗后随访6～36个月，98例病人AFP转为正常水平，占81．7％；59例病人再活检，其中肿瘤完全坏死者为48例，占81．4％；TACE＋PMCT组有66例肿瘤不同程度缩小（94.2％）；术中阻断肝门血流＋MCT组有43例肿瘤不同程度缩小（86％）；两组半年，1，2年生存率分别为96．5％、89．3%、79．9％和95．5％、85．5％、63．3％。结论无论是TACE联合PMCT，还是术中阻断肝门血流联合MCT治疗肝癌，两种方法均可显著地增强微波热疗的局部作用，扩大肿瘤凝固坏死范围，从而更加有效地杀灭肝癌细胞。     

三种红外波长激光治疗面部草莓状血管瘤的疗效

目的对比观察3种红外波长激光治疗小儿面部草莓状血管瘤（strawberry hemangiogila．SH）的疗效及容貌结果。方法5～12岁面部SH患儿300例．随机分为半导体激光组,Nd：YAG激光组和CO2激光组,每组100例。3组治疗参数相同（功率10W、光斑直径0．2cm、功率密度318W／cm2）,根据皮损面积大小,半导体激光组和Nd：YAG激光组分别行非接触式扫描凝固术．CO2激光组行气化术。治疗后6个月复查评定疗效及容貌结果。结果治愈率半导体激光组89％,Nd：YAG激光组83％。CO2激光组69％（P〈0．05）;容貌优良率CO2激光组87．0％,半导体激光组86．5％,Nd：YAG激光组57．8％（P〈0．01）;平均治疗次数、治疗时间和治疗中出血量半导体激光组均少于Nd：YAG激光组和CO2激光组（P〈0．01）。结论波长830nm的半导体激光（功率密度318W／cm2）,治疗小儿面部SH具有1次治愈率高、治疗时间短、治疗中出血少和容貌结果好等优点,为治疗小儿面部SH的首选方法。     

半导体激光痔凝固术对Ⅲ度内痔疗效的探讨

目的探讨半导体激光痔凝固术对Ⅲ度内痔的治疗效果。方法将2004年3月至12月收治的86例Ⅲ度内痔患者分为激光组与痔切除组，进行疗效对比观察。结果激光组术后第1天及第7天疼痛评分均明显低于痔切除组。排便时两组均有少量出血，其中激光组12例，切除组35例，均无需止血治疗。6个月后门诊随访，两组患者痔核脱出均得以纠正，无复发，无肛门失禁，满意度评分激光组患者平均2．8分，痔切除组平均2．6分。结论半导体激光痔凝固术治疗Ⅲ度内痔方法简单、疼痛轻微、安全有效。     

前列腺组织间质内激光凝固治疗前列腺增生平76例报告

１９９３年１１月－１９９５年７月对７６例良性前列腺增生（ＢＰＨ）病人进行间质组织内激光凝固治疗，随访６－１８个月，症状和ＭＦＲ改善达７０％，效果满意。结果认为。：本方法简单、安全，尤其适合于高危的病人，治疗效果与手术者的经验和插入前殂腺侧叶的点数有关。     

氩离子凝固术在糖尿病酮症酸中毒并急性上消化道出血治疗中的应用

目的探讨氩离子凝固术在糖尿病酮症酸中毒并急性上消化道出血治疗中的应用价值。方法87例糖尿病酮症酸中毒并急性上消化道出血患者,内镜下氩离子凝固术配合局部用药为治疗组（46例）,内镜下单纯局部用药为对照组（41例）,比较两组疗效。结果治疗组有效率为95．7％（44／46）,2例（4．3％）再出血,对照组有效率为78．0％（32／41）,9例（22．0％）再出血,两组有效率比较差异有统计学意义（P〈0．05）。结论氩离子凝固术在糖尿病酮症酸中毒并急性上消化道出血治疗中效果明显,有推广价值。     

经尿道激光凝固加电切治疗前列腺增生症(附80例报告)

为探讨前腺增生症（ＢＰＨ）的有效治疗方法，本文介绍用经尿道激光颖固加电切治疗ＢＰＨ８０例的经验。结果：术中平均失血７０ｍｌ，无电切事征发生；８０例随访６个月，效果满意，均排尿通畅，并发症少，ＩＰＳＳ评分从术前２３．５分降至１２．７５分，最大尿流率从术前９．５ｍｌ／ｓ增加至１７ｍｌ／ｓ，作者认为本法具有凝固消融止血和切割的双重作用，切割速度较快，出血少，能扩大手术适应证，是一种安全性高、并发症少、疗     

肝肿瘤间质内激光凝固(综合报道)

自1983年引进肝肿瘤间质内激光凝固措施以来．它已成为不能切除肿瘤损伤性较小的一种治疗方法，本文对其机理、原则、目前的应用情况和展望作一介绍。     

自制吸管点状切口抽吸法治疗腋臭研究

目的：寻找一种可以根治腋臭、且创伤小、操作方便、外观及肩关节功能不受影响的方法。方法：采用自制的直径２．５ｍｍ的腋臭 抽吸管，取两处点状切口抽吸治疗腋臭。结果：治疗的１０８例患者中，仅２例复发，治愈率９８．１５％。结论：本吸管设计科学，结构合理，综合了吸和刮的作用，治疗效果可靠。     

下肢静脉曲张疾病腔内激光治疗并发症的防治

目的：探讨激光治疗下肢静脉曲张疾病的并发症原因及防治方法。方法：回顾性分析420例（525条肢体）下肢大隐静脉曲张患者的临床资料。其中单纯性大隐静脉曲张324例(422条肢体)，下肢深静脉瓣膜功能不全96例(103条肢体)。采用单纯激光治疗263条肢体，激光加小切口静脉团点状剥脱159条肢体，激光治疗联合股浅静脉戴戒术25条肢体和激光加小切口静脉团点状剥脱联合股浅静脉戴戒术78条肢体。 结果：有331条肢体（占63.1%）术后出现与激光治疗有关的并发症，其包括：皮下淤斑268条肢体（占51.1%）, 隐神经损伤198条（占37.7%），腿部皮下血栓性静脉炎33条（占6.3%），小腿轻度皮肤灼伤26条（占5.0%）。全组无切口感染发生，无术后深静脉血栓形成的病例。术后380例(90.5%)获随访3~40个月，单纯性大隐静脉曲张者术后有27条肢体复发（复发率6.4%），下肢深静脉瓣膜功能不全者术后有8条肢体复发（复发率7.8%）。结论：在应用激光治疗下肢静脉曲张疾病过程中应重视对其并发症的预防和治疗，以充分体现激光治疗安全和微创的特点。     

The Nd: YAG laser in the treatment of colonic polyps

The result of Nd: YAG laser therapy in 31 patients with pathologically verified rectosigmoid polyps was presented. Except one case with large adenomatous polyp recurring two months after the primary treatment, all other patients were cured clinically on their first therapy. There were no severe complications, and the longest follow-up period was 14 months. The authors came to the conclusion that compared with other modalities, Nd: YAG laser therapy is safe, effective, and low recurrence rate.     

调Q开关Nd：YAG激光治疗165例颧部褐青色痣疗效观察

目的：观察调Q开关Nd：YAG激光治疗颧部褐青色痣的临床疗效和安全性。方法：应用Q开关Nd：YAG激光治疗颧部褐青色痣患者165例,选用波长1064nm,能量密度4.5～6.0J/cm2,光斑直径3mm,频率1～10Hz;532nm波长能量密度为1.8～2.2J/cm2,光斑直径3mm,频率1～10Hz,共治疗2～5次,术后3个月复诊判定疗效和不良反应。结果：共治愈45例,平均治疗2.6次,总有效率74.1%。术后发生色素沉着89例,无瘢痕发生。结论：调Q开关Nd：YAG激光治疗颧部褐青色痣疗效好,安全性高,不良反应较轻。     

Treatment of cervical dentin hypersensitivity using neodymium: Yttrium-aluminum-garnet laser. Clinical evaluation

BACKGROUND AND OBJECTIVE: The incidence of cervical dentinal hypersensitivity is related to the high number of non-carious cervical lesions. This clinical research was developed in order to evaluate the Nd:YAG laser treatment of cervical dentin hypersensitivity after attempting the removal and control of etiologic factor after two different stimuli. STUDY DESIGN/MATERIALS AND METHODS: Twenty patients participated in this study in a total of 145 teeth, where 104 received the Nd:YAG laser treatment and 41 remained as control. RESULTS: The results showed that there was statistically significant reduction of hypersensitivity as for the groups that received the treatment with Nd:YAG laser, as for the control teeth. However, the reduction of cervical dentinal hypersensitivity was statistically greater when there was the association of the removal of etiologic factors with the application of Nd:YAG laser. CONCLUSIONS: We concluded that the laser irradiation was effective in the treatment of cervical dentin hypersensitivity after 6 months.     

An In vivo Trial Comparing the Use of Different Types of 532 nm Nd:YAG Lasers in the Treatment of Facial Lentigines in Oriental Patients

BACKGROUND: Versapulse is a system that consists of four laser modalities and was developed with the aim of increasing cost-effectiveness. However, as these lasers share a common power supply, for the Q-switched (QS) Nd:YAG 532 nm laser a large spot diameter is necessary to lower the fluence to a suitable level. This can increase the risk of hyperpigmentation when used for the treatment of lentigines in dark-skinned patients. OBJECTIVE: The aim of our study was to access the clinical efficacy and the complication rate of the Versapulse QS Nd:YAG 532 nm laser, the Versapulse long-pulsed Nd:YAG 532 nm laser (without the chill tip), and a conventional QS Nd:YAG 532 nm laser in the treatment of lentigines in Chinese patients. METHODS: Thirty-four Chinese patients with lentigines were randomized to receive laser surgery, with one side of the face treated by one laser and the other side treated by a different system. Patients were monitored for 6 weeks to assess the degree of clearing, hyperpigmentation, hypopigmentation, and erythema. Assessments involved patients interviewed using a visual analog questionnaire and two blinded observers who evaluated the pre- and posttreatment clinical photographs. RESULTS: The Versapulse QS Nd:YAG 532 nm laser was associated with a statistically higher risk of complications. The Versapulse long-pulsed Nd:YAG 532 nm laser was compatible with the conventional QS Nd:YAG 532 nm laser in terms of clinical efficacy and complication rates. CONCLUSION: The Versapulse long-pulsed 532 nm laser is more effective and should be used instead of the Versapulse QS Nd:YAG 532 nm laser for the treatment of lentigines in dark-skinned patients.     

An In Vivo Trial Comparing the Clinical Efficacy and Complications of Q-Switched 755 nm Alexandrite and Q-Switched 1064 nm Nd:YAG Lasers in the Treatment of Nevus of Ota

BACKGROUND: Q-switched 755 nm alexandrite (QS alex) and Q-switched 1064 nm Nd:YAG lasers are effective in the treatment of nevus of Ota. Our previous in vivo study indicated that patients better tolerate QS alex than QS 1064 nm Nd:YAG laser. However, in terms of clinical efficacy and long-term complications, the study did not indicate which laser is superior. Although both machines may appear to be similar in effectiveness, the low number of treatment sessions may contribute to this apparent lack of difference. OBJECTIVE: The aim of this study was to compare the clinical efficacy and complications of QS 755 nm alex and QS 1064 nm Nd:YAG lasers in the treatment of nevus of Ota after three or more treatment sessions. METHOD: Forty patients were recruited for this study and all had received three or more laser treatment sessions with an interval of at least 2 months between each. Half of the lesion was treated with QS alex and the other half with QS 1064 nm Nd:YAG laser. The degree of lightening was assessed subjectively by the patient using a visual analog scale and objectively by two independent clinicians. Patients were called back to be examined for evidence of complications. RESULTS: In terms of subjective degree of lightening, QS 1064 nm Nd:YAG laser was found to be significantly more efficacious than QS alex (P = 0.018). Both clinicians also found QS 1064 nm Nd:YAG laser to be more effective, but statistical significance was only detected in one, not both of their scores (P = 0.005 and 0.414 for observers 1 and 2, respectively). More patients that received QS Alex developed complications (4 for QS alex and 2 for QS Nd:YAG), but the difference was not statistically significant. CONCLUSION: QS 1064 nm Nd:YAG laser appears to be more effective than QS alex in the lightening of nevus of Ota after three or more laser treatment sessions. However, the majority (55%) of the patients reported no differences in results between the two lasers, and only one of the two observers noted statistically significant improvement of QS 1064 nm Nd:YAG over QS alex.     

Long-Pulsed Nd:YAG Laser Treatment of Venous Lakes: Report of a Series of 34 Cases

BACKGROUND: Some venous lakes do not respond well to traditional vascular lasers. The Nd:YAG laser output at 1,064 nm is less well absorbed by hemoglobin but penetrates more deeply into tissue. OBJECTIVE: This study was undertaken to assess the effectiveness of the long-pulsed Nd:YAG on venous lakes. METHODS: Thirty-five consecutive adult patients presenting with a venous lake were studied. Four patients had failed to respond to polidocanol 1% sclerotherapy, and 1 patient to pulsed dye laser. Long-pulsed Nd:YAG was administered via a water-cooled tip. Either a 3-mm spot at 250 J/cm(2) and 55 ms or a 5-mm spot at 140 to 180 J/cm(2) was used depending on the size of the lesion. Clinical end points were characterized by hardening of the lesion, central blackening, minimal whitening of the periphery, and in most cases, an audible popping sound. Responses were assessed visually in 50% of cases or by phone contact in the remaining 50% if the lesion had completely disappeared. One patient was lost to follow-up. RESULTS: After a single treatment, 94% cleared completely; incomplete clearance occurred in 6%. There were no reported complications. CONCLUSIONS: The long-pulsed Nd:YAG laser is highly effective treatment for venous lakes of the lip and cheeks.     

In-situ irradiation of keloid scars with Nd:YAG laser

In-situ coagulation of keloid with Nd:YAG laser irradiation was carried out in in a cohort study of 17 patients, each with one keloid scar situated on either the sternum (six), abdomen (seven), shoulder (two), hip (one), or ear lobe (one). The duration of scarring was three to 17 years and size varied from 3-8 cm long. One to two doses of laser irradiation was required for complete coagulation. At three months, 10 (58.8%) keloids had completely healed; but in seven (41.1%), 25-50% of residual keloid persisted. Intralesional triamcinolone injection, once in four patients and twice in three patients, produced complete resolution in all seven patients. At 18 months to five years follow-up, 14 patients remain keloid-free but in three keloid recurred and was re-treated with laser coagulation with complete resolution. The treatment was carried out as an outpatient procedure under local anaesthesia. There were no complications. The results of this initial study suggest that Nd:YAG laser irradiation coagulation is effective treatment for keloid scarring.     

周围静脉畸形281例手术治疗分析

目的：分析周围静脉畸形的手术治疗经验。方法：1996年12月至2004年4月共手术治疗周围静脉畸形28l例。根据临床观察及磁共振(MRI)检查结果分为局限性非浸润型、局限性浸润型、弥漫性非浸润型及弥漫性浸润型等4型，按不同分类，采用不同的手术方式，如病变切除术、病变手术翻瓣联合Nd：YAG激光治疗术及病变手术切除联合Nd：YAG激光治疗术。结果：经随访3月～7．5年，局限性非浸润型总有效率为98．1％。复发率为1．9％。并发症发生率为1．9％，而弥漫性浸润型总有效率为85．2％，复发率为14．9％，并发症发生率为21．0％。结论：静脉畸形的治疗仍是临床难题之一，根据病变分类采用不同的手术方式是必要的，对于弥漫性病变，手术联合Nd：YAG激光治疗术是一种安全、有效、并发症少的新术式。     

The Use of Variable Pulse Width Frequency Doubled Nd:YAG 532 nm Laser in the Treatment of Port-Wine Stain in Chinese Patients

BACKGROUND: Variable pulse width frequency doubled Nd:YAG 532 nm laser has previously been shown to be effective in the treatment of vascular lesions in Caucasians. For dark-skinned patients, such as Asians, its role has not been determined. OBJECTIVE: To assess the clinical efficacy and complication rate of the 532 nm Nd:YAG laser in the treatment of port-wine stain in Chinese patients. METHODS: Chinese patients with port-wine stain who had undergone Nd:YAG laser treatment were called for questionnaire assessment of their degree of clearing and clinical examination for complications by two independent observers. For 22 patients with pre- and posttreatment photographs, the two independent observers further assessed the degree of clearing. RESULTS: Assessment of the questionnaire indicated that 62.9% of the patients subjectively considered that they had more than 25% clearing, with 33.3% having more than 50% clearing. For those with pre- and posttreatment photographs, the objective degree of improvement was less impressive with 18.1% of patients having at least 25% improvement and only 13.6% having more than 50% improvement. Pigmentary and texture changes were seen in both groups (33% in group I and 11% in group II). The number of treatment sessions rather than previous use of pulsed dye laser therapy was an important risk factor for complications. CONCLUSION: Nd:YAG laser is only partially effective for the treatment of port-wine stain in Chinese patients. Although most patients recorded some degree of subjective improvement, many did not improve by objective assessment. High fluence is necessary to achieve the desirable clinical response, and while contact cooling reduces the risk of epidermal damage, texture changes can still occur. Further study is necessary to compare its use with other similar devices, such as a pulsed dye laser with cryogen spray cooling.     

A 4-year follow-up of a randomized prospective study comparing transurethral electrovaporization of the prostate with neodymium: YAG laser therapy for treating benign prostatic hyperplasia

OBJECTIVE: To compare the safety, efficacy and durability of neodymium (Nd):YAG laser prostatectomy with transurethral electrovaporization of the prostate (TUVP) for treating benign prostatic hyperplasia (BPH). PATIENTS AND METHODS: From March 1995 to March 1997, 180 patients with bladder outlet obstruction secondary to BPH were randomized equally either to Nd:YAG laser therapy or TUVP. Laser therapy combined two different techniques, side-fire coagulation of the lateral lobes and contact vaporization of the median lobe. Before treatment the two groups had a comparable International Prostate Symptom Score (IPSS), quality-of-life score (QoL), maximum urinary flow rate (Qmax), postvoid residual urine volume (PVR), and prostate and adenoma volume. In all, 62 and 78 patients completed the 1, 2, 3 and 4-year follow-up from the laser and TUVP groups, respectively. RESULTS: At each follow-up, the IPSS, QoL, Qmax and PVR were significantly better and more durable in the TUVP than in the laser group. In the TUVP and laser groups respectively, at the 4-year follow-up the mean value of the IPSS was 3.7 vs 11.9, the QoL 1.3 vs 3.1, the Qmax 21.4 vs 13.6 mL/s and the PVR 25.1 vs 64.6 mL (all P < 0.001). The mean prostate and adenoma volume were significantly lower after TUVP than after laser therapy (P < 0.001) at the 1- and 4-year follow-up, with final values of 27.9 vs 35.9 and 11.7 vs 20 mL (both P < 0.001) for the TUVP and laser groups, respectively. Retrograde ejaculation was significantly more common after TUVP (63%) than after laser therapy (18%; P < 0.001). Impotence was reported in 8% of men after TUVP and in none after laser therapy (P = 0.040). The re-operation rate was 12% after TUVP and 38% after laser treatment (P < 0.001). CONCLUSION: These 4-year follow-up results confirm that TUVP is significantly more effective and durable than the Nd:YAG laser for treating BPH. Residual obstructing adenoma was the main cause of failure in the laser group, which reflects the inadequacy of laser therapy for removing the adenoma.