摘要
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 determine the efficacies of different lasers and treatment plans for onychomycosis. Methods： The efficaeies of different lasers and treatment plans for onyehomycosis were retrospectively analyzed in 182 outpatients from the department of Beijng Friendship hospital from 2011 to 2014. 102 patients were treated with Pinpointe Footlaser long-pulse Nd ：YAG 1 064 nm laser（laser M） for 4, 8 or 12 times, respectively, 59 patients were treated with Dualis SP [[ Nd：YAG/Er： YAG laser System （laser S） for 8 times with or without additional treatment once monthly for 4 months. The rest 21 patients were given 4 treatments with QizhiTM ML-3420 Nd：YAG1 064 nm pulsed laser （laser N）. The efficacy was evaluated 24 weeks after the last treatment. Results： In patients treated with Laser M, the effective rates after 4, 8 and 12 treatments were 37.4%, 44.0%, and 55.4%, respectively. The effective rates after Laser S treatment for 8 times with or without additional 4-month treatment were 39% and 62.5%, respectively while Laser N treatment alone induced 52.6% of effective rates after 4 treat- ments. Conclusions： 1. All three lasers are effective and safe for onyehomycosis, 2. The effective rates are associated with the number of treatments, 3. The effective rates vary with the types of laser possibly due to the differences in operating proce- dures between physicians, 4. Treatment interval time should not be too long in order to prevent recurrence, 5. Patients with mild-to-moderate onychomyeosis or a fewer nails involved, or patients with dysfunction of liver and kidney should be treated with laser alone. Combination of drug and laser should be given to patients with severe onyehomyeosis or many nails involved.
出处
《临床皮肤科杂志》
CAS
CSCD
北大核心
2016年第1期15-19,共5页
Journal of Clinical Dermatology
基金
国家自然基金(81301385)资助项目
首都卫生发展科研专项项目(2011-1003-03)
