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目的:应用不同设备不同方案评估激光治疗甲真菌病的疗效差异。方法:通过回顾性研究,观察2011—2014年北京友谊医院皮肤科门诊应用不同的激光设备对182例甲真菌病患者进行不同次数不同方案治疗后的疗效差异。Pinpointe~(TM) Footlaser~(TM)长脉宽Nd∶YAG1 064 nm激光(Laser M)治疗102例,分为4次治疗组、8次治疗组及12次治疗组;欧洲之星~(TM)靓甲~(TM) Nd:YAG1 064 nm长脉宽激光(Laser S)治疗59例,分为追加治疗组及8次治疗组;奇致~(TM)ML-3420型Nd∶YAG1 064 nm脉冲激光(laser N)治疗21例,均为4次治疗。结果:激光M:4次治疗组24周有效率为37.4%,8次治疗组24周有效率为44.0%,12次治疗组24周有效率为55.4%。激光S:追加治疗方案24周有效率为39%;8次治疗方案24周有效率62.5%。激光N:4次治疗方案24周有效率为52.6%。结论:3种激光设备治疗甲真菌病均有显著效果,且无不良反应;同一激光设备增加治疗次数可以提高有效率;相同的治疗方案,不同的激光治疗有效率有一定的差异,可能与医师操作手法及参数选择有关;治疗间隔不宜过长,应该在真菌恢复生长能力之前或增长至治病数量之前予以巩固治疗;轻中度甲真菌病患者或者病甲数目较少或患者有基础疾病伴有肝肾功能不良者可单纯选择激光治疗,重度甲真菌病或是病甲数目较多的患者应考虑药物和激光联合治疗。
OBJECTIVE: To evaluate the therapeutic effects of laser in the treatment of onychomycosis using different protocols of different devices. Methods: A retrospective study was conducted to observe the difference in curative effect of 182 cases of onychomycosis patients under different regimens with different laser devices in dermatology clinic of Beijing Friendship Hospital from 2011 to 2014. 102 cases of Pinpointe ~ (TM) Footlaser ~ (TM) long-pulse Nd: YAG1 064 nm laser (Laser M) were divided into 4 treatment groups, 8 treatment groups and 12 treatment groups; ) Liangliang ~ (TM) Nd: YAG1 064 nm laser S treatment of 59 cases, divided into additional treatment group and 8 treatment group; ~ ~ TM ML-3420 Nd:YAG1 064 nm Twenty-one patients were treated with laser N, all of which were treated 4 times. Results: Laser M: The effective rate of 24 weeks was 37.4% in 4 times treatment group, 44.0% in 24 weeks in 8 times treatment group and 55.4% in 24 weeks in 12 times treatment group. Laser S: additional treatment regimen 24 weeks effective rate was 39%; 8 treatment regimen 24 weeks effective rate 62.5%. Laser N: 4 treatment programs 24 weeks effective rate was 52.6%. Conclusion: Three kinds of laser treatment of onychomycosis have a significant effect, and no adverse reactions; the same laser device to increase the number of treatment can improve the efficiency; the same treatment, different laser treatment efficiency have some differences, and the doctor may Operation practices and parameter selection; treatment interval should not be too long, should be in the fungal growth capacity before or to be cured before the number to be cured; mild to moderate onychomycosis patients or patients with a smaller number of cases or patients with underlying diseases with Patients with liver and kidney dysfunction can simply choose laser treatment, severe onychomycosis, or a greater number of patients with disease should consider the combination of drugs and laser treatment.