叶振杰　周　峻　陈　黎　李　榕　吕　萍1.福建医科大学省立临床学院，福建福州　350001；.福建省立医院皮肤科，福建福州　350001

脉冲染料激光治疗儿童面颈部鲜红斑痣72例疗效分析

叶振杰1，2周峻1，2陈黎1，2李榕2吕萍1，2
1.福建医科大学省立临床学院，福建福州350001；2.福建省立医院皮肤科，福建福州350001

目的 探讨PhotoGenica V闪光灯泵浦脉冲染料激光治疗儿童面颈部鲜红斑痣的有效性与安全性，为临床选择最佳治疗方案提供可靠证据。方法运用PhotoGenica V闪光灯泵浦脉冲染料激光治疗儿童面颈部鲜红斑痣。单次治疗后1～3个月随访时进行视觉评估，比较脉冲染料激光治疗前后的色差，评估临床褪色率和不良反应发生率。脉冲染料激光参数设置：脉冲染料激光仪（PhotoGenica V，美国Cynosure公司生产），输出波长为585 nm，脉宽450 μs，脉冲频率固定1/s，光斑直径为5 mm。结果 经过3～8次治疗，72例患者中治愈28例（38.9%），显效21例（29.2%），好转22例（30.6%），无效1例（1.4%）。不良反应：暂时性色素沉着为8例（11.1%），暂时性色素脱失为5例（6.9%），均在治疗后3～6个月消退，萎缩性瘢痕为3例（4.2%）；目前尚未发现复发患者。结论 应用PhotoGenica V闪光灯泵浦脉冲染料激光治疗儿童面颈部鲜红斑痣，疗效满意，副作用少，安全可靠，该疗法明显优于同位素敷贴、冷冻术等。

PhotoGenica V；闪光灯泵浦脉冲染料激光；儿童面颈部鲜红斑痣

［Abstract］Objective To discuss the effectiveness and safety of PhotoGenica V flashlamp-pumped pulse dye laser in treatment of children's faciocervical nevus flammeus and to provide optimal therapy for clinical choice.Methods PhotoGenica V flashlamp-pumped pulse dye laser was conducted in treatment of children's faciocervical nevus flammeus. After 1-3 months of a single treatment，the patients were followed up for vision assessment to compare the chromatic aberration before and after treatment and to evaluated the rate of fading and incidence rate of adverse reactions.Parameter setting of pulse dye laser：pulse dye laser instrument（PhotoGenica V，Cynosure，USA），output wavelength：585 nm，pulse width：450 μs，fixed impulse frequency：1/s，and spot diameter：5 mm.Results After 3-8 times of treatment，28 patients（38.9%）among the 72 cases showed significant efficacy，21 patients（29.2%）achieved favorable efficacy，22 pa tients（30.6%）achieved fair efficacy，and 1 patient（1.4%）gained poor efficacy.Adverse reactions：there were 8 cases （11.1%）of transient hyperpigmentation，5 cases（6.9%）of transient depigmentation，which were all relieved at 3-6 months after treatment，and 3 cases（4.2%）of atrophic scar.No recurrence was observed.Conclusion PhotoGenica V flashlamp-pumped pulse dye laser has satisfactory effect in treatment of children's faciocervical nevus flammeus，with low incidence of side effects and reliable safety，which is significantly superior to isotope application and cryosurgery. ［Key words］PhotoGenica V；Flashlamp-pumped pulse dye laser；Children's faciocervical nevus flammeus

鲜红斑痣，也称之为葡萄酒样痣，多位于面颈部，约占总比例的75%～80%，是临床一种常见病和多发病，由于位于面颈部，对患者的自信心会产生严重影响，可能使其产生严重的自卑心理。同时，鲜红斑痣涉及眼神经与上颌神经，合并难治性青光眼的危险性较大，由于病损部位达到了真皮层，冷冻治疗、同位素等常规治疗方法难以祛除［1］。……