组织工程与重建外科杂志

组织工程与重建外科杂志 ›› 2018, Vol. 14 ›› Issue (3): 143-147.doi: 10.3969/j.issn.1673-0364.2018.03.007

• 论著 • 上一篇    下一篇

肢体部葡萄酒色斑血流灌注量与脉冲染料激光治疗效果的关系：前瞻性自身对照研究

朱佳芳，马刚，于文心，王天佑，陈怡洁，常雷，林晓曦   

  1. 上海市上海交通大学医学院附属第九人民医院整复外科激光美容科
  • 收稿日期:2018-03-20 发布日期:2020-07-23
  • 作者简介:林晓曦（E-mail：linxiaoxi@126．com）。

Correlation Analysis Between Blood Perfusion and Pulsed Dye Laser(PDL)Effectiveness of Port-Wine Stains(PWS)on Extremities:A Prospective Self-Control Study

ZHU Jiafang,MA Gang,YU Wenxin,WANG Tianyou,CHEN Yijie,CHANG Lei,LIN Xiaoxi   

  1. Department of Plastic and Reconstructive Surgery; Department of Laser and Aesthetic Medicine, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine
  • Received:2018-03-20 Published:2020-07-23
  • Contact: 国家自然科学基金青年项目(81602777)

摘要： 目的探讨肢体部葡萄酒色斑(Port-wine stains,PWS)血流灌注量,与脉冲染料激光(Pulsed dye laser,PDL)治疗效果的关系。方法入组尚未治疗的患有肢体部PWS的患者,选取患者上臂/大腿和手/足两块大小相等区域,利用激光散斑成像(Laser Speckle Image,LSI)的方法,对选定区域及对照区域进行血流灌注量的探测,并进行3次PDL治疗。激光治疗后3个月对比疗效,分析疗效和血流灌注量之间的相关性。结果共入组19例肢体部PWS患者,其中17例分布在上肢,2例分布在下肢。病灶侧肢体远心端的血流灌注量为(155.68±71.86)PU,显著高于肢体近心端的(80.51±16.96)PU(P<0.001)。光度计评价及VAS评分显示,肢体近心端疗效显著优于肢体远心端疗效(P<0.05)。皮尔森相关系数证实,疗效与血流灌注量呈负相关(r=-0.351,P=0.031)。结论肢体近心端PWS的疗效显著优于肢体远心端,这可能与肢体部不同亚解剖部位的血流灌注量相关。

关键词: 葡萄酒色斑, 脉冲染料激光, 血流灌注量, 流速, 散斑成像

Abstract: Objective To explore the relationship between blood perfusion and pulsed dye laser(PDL)effectiveness of port-wine stains(PWS)on extremities.Methods Patients with untreated PWS on extremities were selected.Blood perfusion of the selected sites on both proximal and distal limbs as well as control sites was detected by laser speckle image(LSI)before treatment.Then the patients were treated with PDL for 3 sessions in total.After 3 months of treatment,the therapeutic effect was evaluated,and the relationship between blood perfusion and therapeutic effect was analyzed.Results Nineteen patients were included,17 on upper limb and 2 on lower limb.The mean Speckle Flow Image(SFI)value of the PWS on upper arm/thigh was significantly lower(80.51 ±16.96)PU than the SFI on hand/feet(155.68 ±71.86)PU.According to photometric evaluation and VAS score,the PDL efficacy on proximal limbs was significantly better than distal limbs(P<0.05).Significant correlations existed between blood perfusion and PDL efficacy(r=-0.351,P=0.031).Conclusion PWS on the proximal limb responds better to PDL,compared with PWS on the distal limb.This variation in efficacy may attribute to differences in blood perfusion.

Key words: Port-wine stains, Pulsed dye laser, Blood flow, Perfusion, Speckle flow imaging

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