Q开关Nd：YAG激光治疗皮肤色素增加性疾病的疗效观察

目的：探讨倍频Nd：YAG激光治疗皮肤色素增加性疾病（太田痣、雀斑、脂溢性角化病）的临床疗效,并进行比较。方法：采用调Q开关Nd：YAG激光美容仪,治疗时根据不同的病变特点,选择不同的治疗参数。色素性病变患者180例,其中雀斑60例,太田痣60例,脂溢性角化60例。三个病种分别分为治疗组（30例）和对照组（30例）,雀斑、脂溢性角化病治疗组采用532nm激光治疗,太田痣治疗组采用1064nm治疗,各对照组均采用1064nm和532nm两种激光组合治疗;各组分别治疗4次后,每次间隔1～3个月,观察疗效。结果：雀斑治疗组和对照组疗效差异无统计学意义（χ^2=1.23,P〉0.05）,太田痣治疗组和对照组疗效差异有统计学意义（χ^2=5.4,P〉0.05）,脂溢性角化治疗组和对照组疗效差异有统计学意义（χ^2=4.27,P〉0.05）。结论：Q开关Nd：YAG激光仪治疗皮肤色素增加性疾病,个性化治疗有重要意义。     

Nd:YAG泪道激光加甲基纤维素留置治疗先天性鼻泪管阻塞

目的探讨Nd:YAG泪道激光加甲基纤维素留置治疗先天性鼻泪管阻塞的临床效果。方法对69例(81眼)新生儿泪囊炎患儿行Nd:YAG泪道激光加甲基纤维素留置治疗。结果随访6~12个月,68例(80眼)一次治愈,1例(1眼)经再次治疗后痊愈。结论Nd:YAG泪道激光加甲基纤维素留置是治疗新生儿泪囊炎一种较为理想的方法。     

激光治疗面部雀斑疗效的定量判定

目的：通过计算机数字化分析，对激光治疗面部雀斑前后进行定量判定，探索一种客观、科学的疗效评定方法。方法：随机入选30名雀斑患者，治疗前在恒定的光强度下用图像采集系统摄取局部雀斑图像，用Q开关Nd：YAG激光治疗面部雀斑。分别让患者于治疗后2、4、6、8、15周进行复诊，再次摄取同一部位的局部皮损图像。将所荻取的图像在特定的图像分析系统下逐个进行分析，荻取各自的检测值，评判治疗效果。结果：运用色斑检测系统分析图像采集结果显示：经Q开关Nd：YAG激光治疗后，30名雀斑患者治愈率为53．3％，有效率为90％。结论：通过色斑检测系统对激光治疗面部雀斑前后的变化进行定量判定，提高了评价方法的客观性和科学性。     

非剥脱性Q开关Nd:YAG 1 064 nm激光对黄褐斑的治疗效果

目的 观察非剥脱性Q开关Nd:YAG 1 064 nm激光对黄褐斑的治疗效果.方法 应用Q开关Nd:YAG 1 064 nm激光对23例黄褐斑患者进行治疗,其光斑直径6 mm,脉宽5～7 ns,频率10 Hz,能量密度1.8～2.0 J/cm2.一般需8～10次治疗,每次治疗间隔1周.结果 23例经8～10次治疗后,黄褐斑明显淡化或消失,局部出现轻度充血,无水泡和结痂形成,基本治愈率达52.17%.5例出现眼睑紫癜,3 d后自行消退,无色素沉着及瘢痕发生.术后随访6个月以上,其中7例(占30.4%)出现复发,继续治疗仍然有效.结论 非剥脱性Q开关Nd:YAG 1 064 nm激光治疗黄褐斑虽有复发,仍不失为一种比较可行的治疗方法 ,有一定效果,操作简单、安全,不影响患者的工作和生活.     

Q开关Nd:YAG激光不同波长治疗面部毛细血管扩张疗效比较

目的：观察Q开关Nd：YAG激光不同波长治疗面部毛细血管扩张的疗效及副反应。方法：128例病人按治疗波长随机分为532nm组75例，585nm组53例，治疗光斑2．0mm，能量密度2．2-6．8J／cm。，脉宽10ns；术后3个月根据术前照片判定疗效，标准分为Ⅳ级。结果：治疗次数1-4次，间隔时间3-5个月，两组共治愈71例(55，47％)，疗效与治疗次数成正相关。其中532nm组治愈36例(48．00％)，平均治愈次数2．64次；585nm组治愈35例(66．04％，)，平均治愈次数2．40次，两组痊愈率及副反应差异无显性。结论：Q开关Nd:YAG激光倍频532／nm和585nm两种波长对密度较低、直径较细的面部毛细血管扩张均有可靠疗效，术后除色素沉着发生较高外，其他不良反应较少。     

Primary Cavernous Hemangioma of the Glans Penis: Rare Case Report with a Review of the Literature

Hemangiomas of the urinary tract are rare lesions, and those of the glans penis are even rarer. A 23-year-old man with a hemangioma of the glans penis treated successfully with intralesional sclerotherapy is presented. Other options for the management of this disorder are discussed.     

Nd:YAG laser clinical assisted in class II furcation treatment

The Nd:YAG laser efficacy associated with conventional treatment for bacterial reduction has been investigated throughout literature. The purpose of this study was to evaluate the bacterial reduction after Nd:YAG laser irradiation associated with scaling and root planning in class II furcation defects in patients with chronic periodontitis. Thirty-four furcation lesions were selected from 17 subjects. The control group received conventional treatment, and the experimental group received the same treatment followed by Nd:YAG laser irradiation (100 mJ/pulse; 15 Hz; 1.5 W, 60 s, 141.5 J/cm²). Both treatments resulted in improvements of most clinical parameters. A significant reduction of colony forming unit (CFU) of total bacteria number was observed in both groups. The highest reduction was noted in the experimental group immediately after the treatment. The number of dark pigmented bacteria and the percentage of patients with Porphyromonas gingivalis, Prevotella intermedia, and Actinobacillus actinomycetemcomitans reduced immediately after the treatment and returned to values close to the initial ones 6 weeks after the baseline for both groups. The Nd:YAG laser associated with conventional treatment promoted significant bacterial reduction in class II furcation immediately after irradiation, although this reduction was not observed 6 weeks after the baseline.     

Role of Nd:YAG laser for prevention of neuroma formation: an in vivo experimental study

Nerve transection is commonly followed by the development of neuroma at the proximal stump. It can be very painful especially at exposed sites. It may arise spontaneously or after mechanical irritation. Neuroma and its high recurrence rate might be resisting problems to treat. Various treatment modalities for neuroma and its recurrence have been proposed, but none has provided satisfactory results. The present study was conducted to evaluate the neodymium:yttrium aluminum garnet (Nd:YAG) laser (1,064 nm) nerve transection technique for prevention of neuroma formation. There were 48 facial nerves out of 24 Rex rabbits divided into two equal groups. The 24 left-sided facial nerves at group A were subjected to Nd:YAG laser for nerve transection, while the 24 right-sided facial nerves at group B were subjected to scalpel nerve transection. The results were grossly and histopathologically evaluated. Grossly, laser-transected nerves showed an infrequent incidence of neuroma formation. Histopathologically, laser-transected nerves showed photothermal degenerative changes of the axons and myelin sheaths with intact perineurium and endoneurium. No Schwann cell hyperactivity could also be elicited among laser-transected nerves. Nd:YAG laser was found to be an effective tool that could be applied, whenever it is possible, for division of major nerves to prevent the formation of the subsequent stump neuroma. Moreover, this technique should be considered during treatment of well-established neuroma to prevent the challenging reported high incidence of recurrence.     

强脉冲光治疗浅表(皮肤)血管瘤临床观察

目的：观察强脉冲光（IPL）治疗浅表（皮肤）血管瘤的疗效。方法：选择60例浅表（皮肤）血管瘤患者,随机分为治疗组和对照组,治疗组用535nm、580nm强脉冲光治疗皮损,每三周治疗一次,三次为一个疗程;对照组采用波长为532nm的Q开关Nd：YAG激光治疗,每两周治疗一次,三次为一个疗程。观察两组皮损的治愈率、并发症等情况,并行统计学处理。结果：治疗组皮损三次治愈率明显高于对照组（P〈0.01）,患处瘢痕形成及炎症性色素沉着发生率均低于对照组。结论：强脉冲光（IPLTM）治疗浅表（皮肤）血管瘤效果满意。     

长脉冲Nd:YAG激光非侵入性治疗皮肤浅表静脉畸形

目的前瞻性研究长脉冲1064nm Nd:YAG激光非侵入性治疗皮肤浅表静脉畸形的疗效。方法22例不同部位皮肤浅表静脉畸形患者接受长脉冲1064nm Nd:YAG激光治疗,6mm直径光斑,7～8ms双脉宽,脉冲间隔20ms,140～150J/cm2能量,接触式冷却,治疗间隔3周至1个月,治疗后1、6个月随访,评价病灶清除率分为五级。结果22例患者完成治疗,最多治疗5次。随访6个月,96.3%浅表静脉畸形获得76%～100%的清除,37%获得病灶的完全清除,未见复发。治疗部位无一例发生紫癜,治疗后8例(38.1%)出现红斑,1d至1个月消退。无色素改变和形成。结论长脉冲1064nm Nd:YAG激光能有效安全地治疗皮肤浅表静脉畸形,选择性地清除浅表血管,并使用接触冷却系统保护表皮,减少紫癜发生及色素改变和瘢痕的形成,达到理想的美容效果。