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目的:探讨激光联合口服皮质激素治疗婴幼儿血管瘤的可行性,并对其疗效作初步评价。方法:对102例处于增殖期的血管瘤患儿,分别给予激光治疗、激光与皮质激素联合治疗。治疗前超声检查病灶深度,按深度是否超过1cm,分为深部型与表浅型。激光为1064nm长脉冲可调脉宽激光,治疗1～3次,皮质激素服用一个疗程。采用SAS6.12软件包对所得数据进行Ridit分析。结果:100例完成治疗,随访率为98%。激光治疗治愈12例(24.00%)、显效18例(36.00%),有效率为60.00%;激光与皮质激素联合治疗治愈14例(26.92%)、显效27例(51.92%),有效率为78.84%,2种治疗方法疗效具有显著差异(P<0.05)。在表浅病灶组,激光治疗治愈8例(34.78%)、显效10例(43.48%),有效率为78.26%;激光与皮质激素联合治疗治愈7例(33.33%)、显效8例(38.10%),有效率为71.43%,2种治疗方法疗效无显著差异(P>0.05)。在深部病灶组,激光治疗治愈4例(14.81%)、显效8例(29.63%),有效率为44.44%;激光与皮质激素联合治疗治愈7例(22.58%)、显效19例(61.29%),有效率为83.87%,2种治疗方法疗效具有显著差异(P<0.05)。结论:长脉冲1064nm激光与口服皮质激素联合治疗深部型增殖期血管瘤是一种有效的方法。
Objective: To investigate the feasibility of laser combined with oral corticosteroids in the treatment of infantile hemangiomas, and evaluate its curative effect. Methods: 102 cases of proliferative phase of hemangioma were given laser treatment, laser and corticosteroid combination therapy. Ultrasound examination before treatment depth of the lesion, according to the depth is more than 1cm, divided into deep type and superficial type. The laser is 1064nm long pulse adjustable pulse laser, treatment 1 to 3 times, taking a course of corticosteroids. Ridit analysis of the data using SAS6.12 software package. Results: 100 patients completed the treatment, the follow-up rate was 98%. Laser treatment was cured in 12 cases (24.00%), markedly effective in 18 cases (36.00%) and effective rate was 60.00%. Laser and corticosteroid treatment were cured in 14 cases (26.92%), markedly effective in 27 cases (51.92%), effective rate was 78.84 %, Two kinds of treatment methods have significant differences (P <0.05). In the superficial lesion group, laser treatment was cured in 8 cases (34.78%), effective in 10 cases (43.48%) and effective rate was 78.26%. Laser and corticosteroid treatment cured 7 cases (33.33%), markedly effective in 8 cases ), The effective rate was 71.43%, no significant difference between the two treatment methods (P> 0.05). In the deep lesion group, laser treatment was cured in 4 cases (14.81%), markedly effective in 8 cases (29.63%) and effective rate was 44.44%. Laser and corticosteroid treatment in 7 cases (22.58% , The effective rate was 83.87%. There was significant difference between the two treatment methods (P <0.05). Conclusion: The combination of long pulse 1064nm laser and oral corticosteroid in the treatment of deep proliferative hemangioma is an effective method.