摘要
目的建立阴茎头静脉畸形(Venous malformation of glans penis,GPVM)的分型体系,评价长脉宽1064 nm Nd:YAG(LP-Nd:YAG)激光治疗阴茎头静脉畸形的疗效和安全性。方法2013年8月至2018年2月,纳入在本中心诊疗的GPVM患者26例。根据受累面积和勃起功能分为孤立型(Ⅰ型)、泛发型(Ⅱ型)和全阴茎头型(Ⅲ型),其中Ⅲ型又分为无勃起功能障碍(Ⅲa型)和有勃起功能障碍(Ⅲb型)。本组中25例采用LP-Nd:YAG激光治疗,并将治疗结果分为5个等级。于每次治疗后记录严重和轻微不良反应。结果26例患者中有1例成年患者放弃治疗,另1例未成年患者中止治疗,其余24例患者完成LP-Nd:YAG激光治疗。平均(2.4±1.1)次治疗后,4例(16.7%)患者达到“优(清除率75%~90%)”,20例(83.3%)患者达到“近治愈(清除率>90%)”。24例患者治疗后随访6~14个月,平均(9.0±2.6)个月,均无复发。轻微并发症:黏膜质地改变8例、暂时性色素沉着4例、水泡及薄痂2例、暂时性纤维结节2例、暂时性色素减退1例、浅表瘢痕1例、轻度感觉减退1例;严重并发症:组织缺损及局部凹陷1例、不消退纤维结节2例。结论LP-Nd:YAG激光治疗对GPVM清除率较高,安全性良好。本分型方法在一定程度上能够预测激光治疗的疗效和安全性,不同类型的GPVM可能出现不同的不良反应。
Objective To propose a classification system for venous malformations of glans penis(GPVM)and evaluate the efficacy and safety of long-pulse 1064 nm Nd:YAG(LP-Nd:YAG)laser therapy for GPVM.Methods Twenty-six patients with GPVM were included in this study.They were classified into three types according to involved area and erectile function:Solitary type(TypeⅠ),extensive type(TypeⅡ),and full glans penis type without(TypeⅢa)or with(TypeⅢb)erectile dysfunction.Twenty-five of them were treated by LP-Nd:YAG laser,and the outcomes were converted into a five grading scales.The major and minor complications were recorded after each session.Results Twenty-four patients completed LP-Nd:YAG laser treatment.Four patients(16.7%)achieved“excellent(clear rate 75%-90%)”results and 20 patients(83.3%)achieved“nearly cured(clear rate>90%)”after an average of 2.4±1.1 sessions(1-5 sessions)of treatment.All treated patients were followed up for 6-14 months[average(9.0±2.6)months],and no recurrence was observed.The minor complications included mucosa texture change(n=8),temporary hyperpigmentation(n=4),blister and thin scab(n=2),temporary fibrous nodules(n=2),temporary hypopigmentation(n=1),superficial scar(n=1),slight hypoesthesia(n=1).And the minor complications included tissue defect and local depression(n=1)and permanent fibrous nodules(n=2).Conclusion LP-Nd:YAG laser has rather high clearance rate of GPVM and major complications are rare.This classification system is valuable to predict outcomes and safety of laser therapy to a certain degree.Different type of GPVM is likely to be related to different complications.
作者
段琼
胡丽
林晓曦
陈辉
DUAN Qiong;HU Li;LIN Xiaoxi;CHEN Hui(The Fifth Clinical Medical College of Henan University of Chinese Medicine/Zhengzhou People’s Hospital,Zhengzhou 450003,China;Shanghai Ninth People’s Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China)
出处
《组织工程与重建外科》
CAS
2023年第6期535-540,共6页
Journal of Tissue Engineering and Reconstructive Surgery
