585 nm脉冲染料激光/1 064 nm Nd：YAG复合激光治疗102例感染/非感染脂囊瘤的疗效观察

Treatment of steatocystoma with a combined 585 nm pulsed dye laser/1 064 nm neodymium：yttrium-aluminum-garnet laser

摘要:

目的：观察585 nm脉冲染料激光（pulsed dye laser，PDL）/1 064 nm钕：钇铝柘榴石（neodymium：yttrium-aluminum-gar－net，Nd：YAG）复合激光治疗感染/非感染性脂囊瘤的疗效及安全性。方法：应用585 nm PDL /1 064 nm Nd：YAG复合激光对57例感染性脂囊瘤患者及４５例非感染性脂囊瘤患者进行治疗。５８５ nm PDL能量为5.0～8.0 J/cm2，1 064 nm Nd：YAG激光为10～30 J/cm2，前者脉宽为0.5 ms，后者为15 ms，２束光延迟时间为中，光斑大小为7 mm。结果：治疗后的第2周、第4周、第24周感染性脂囊瘤的痊愈率分别为89.5%、96.5%和98.2%；非感染性脂囊瘤的痊愈率分别为88.9%、95.6%和95.6%，两者之间的痊愈率在以上时间点均无统计学差异（P=1.000）。治疗后6～18个月的电话回访中，有2名非感染性脂囊瘤患者复发，复发率为1.96%。所有患者均出现一过性紫癜，并于1～3周内消失；43.1%的患者治疗后出现暂时性结痂。采用视觉模拟评分法（visual analogue score，ＶＡＳ）评估疼痛程度，平均为2.41±0.97，未见其他副作用。结论：585 nm PDL/1 064 nm Nd：YAG复合激光对感染/非感染性脂囊瘤痊愈率高，副作用小，在6～18个月的随访中显示该治疗方法复发率低，为治疗脂囊瘤提供了又一令人满意的新方法。

Abstract:

Objective：To present the results of a prospective study using a combined 585 nm pulsed dye laser（PDL）/1 064 nm neodymi－um：yttrium-aluminum-garnet（Nd：YAG） laser to treat steatocystoma. Methods：One hundred and two patients were enrolled in this study with 45 non-inflammatory lesions and 57 inflammatory lesions. The parameters were set as follows：energy densities of 5.0-8.0 J/cm2 with PDL and 10-30 J/cm2 with 1 064 nm Nd：YAG laser；pulse duration of 0.5 ms with 585 nm PDL and 15 ms with 1 064 nm Nd：YAG laser. Delaying time between 2 beams was medium and spot size was 7 mm. Results：The curative rates for inflammatory steatocystoma were 89.5%，96.5% and 98.2% in 2 weeks，4 weeks and 24 weeks respectively while those for non-inflammatory steato－cystoma were 88.9%，95.6% and 95.6% in 2 weeks，4 weeks and 24 weeks respectively，without differences between the two（P=1.000） Two non-inflammatory lesions relapsed with a recurrence rate of 1.96% during 6-18 months’ telephone follow-up. Transient purpura was present in all patients and was faded away within 1-3 weeks. The incrustation was observed in 43.1% patients. The severity of pain was assessed by visual analogue score（VAS） and the average score was 2.41±0.97. However，other adverse effects were limited. Conclusions：Combined 585 nm PDL/1064 nm Nd：YAG laser is a valuable treatment option for steatocystoma. It can eliminate both inflammatory and non-inflammatory steatocystoma with good healing and minimal adverse effects.