目的探讨脉冲染料激光(Pulsed dye laser,PDL)治疗溃疡性血管瘤的临床疗效和安全性。方法创面清洁的溃疡性血管瘤患儿,采用脉冲染料激光治疗(波长585 nm,脉宽0.45 ms,光斑5 mm,能量密度6.0～6.5 J/cm2),治疗间隔时间2～3周。治疗后随访观察溃疡完全再上皮化时间、疼痛缓解时间,以及溃疡创面的出血、感染等情况。结果本组共15例溃疡性血管瘤患儿,治疗前及治疗过程中均未接受其他治疗。14例(93.3%)仅接受1次PDL治疗,1～2周内溃疡创面完全再上皮化;1例(6.7%)接受2次PDL治疗后,溃疡创面再上皮化。溃疡的平均完全再上皮化时间为(1.68±0.23)周。所有患儿均在治疗后1～2 d内疼痛得到缓解。治疗后无一例出现溃疡创面扩大,未发生出血、感染等并发症。结论PDL能加快溃疡性血管瘤的创面愈合,缓解疼痛,治疗后无出血、感染及溃疡加重等并发症,可作为溃疡性血管瘤早期治疗的安全有效的方法。

Objective To explore the clinical efficacy and safety of pulsed dye laser for the treatment of ulcerated hemangiomas.Methods Children with ulcerated hemangiomas were enrolled in the outpatient department.All patients with clean wound were treated with Cynosure pulsed dye laser(wave length: 585 nm;pulse width: 0.45 ms;spot size: 5 mm;energy density: 6.0-6.5 J/cm2).Lesions were treated in a sequential pattern at 2-3 week intervals until cutaneous healing.The time of reepithelialization,pain relief and side effects such as bleeding and infection were evaluated after laser procedure.Results Fifteen infants with ulcerated hemangiomas were included.All patients didn’t received other treatments before and during the laser procedure.Fourteen of 15 patients(93.3%) required laser treatment for one time with the healing time of ulceration ranged from 1 to 2 weeks.Only one patient(6.7%) required two times of laser treatment.The average time of complete ulceration healing was(1.68±0.23) weeks.Pain was controlled within 1-2 days after the laser treatment in all patients.Bleeding,infection and ulceration worsening were not observed.Conclusion Low-fluence pulsed dye laser is safe and effective for the treatment of ulcerated hemangiomas.It can accelerate the healing of ulceration and release the pain.