长脉宽Nd:YAG 1064nm激光对红色毛癣菌感染所致甲真菌病疗效的主要影响因素分析

发布时间：2018-03-11 14:48

本文选题：激光疗法　切入点：红色毛癣菌　出处：《中国皮肤性病学杂志》2017年09期 　论文类型：期刊论文

【摘要】：目的比较长脉宽Nd:YAG 1064nm激光不同治疗参数(能量密度、光斑直径、脉宽及治疗次数)治疗由红色毛癣菌感染引起的甲真菌病的疗效及安全性,探索影响该激光治疗甲真菌病疗效的主要因素。方法利用不同能量密度(35J/cm2,40J/cm2,45J/cm2),光斑直径(3mm,4mm,5mm),脉宽(25ms,30ms,35ms)及治疗次数(3次,4次,5次)等治疗参数正交设计A~I共9组治疗方案,将177例甲真菌病患者511个病甲随机分为9组,分别接受A~I组方案治疗,并于治疗结束后6个月及12个月进行随访,观察临床有效率、真菌学有效率及复发情况,记录观察治疗过程及随访中的不良反应。结果 A~I组患者接受不同方案治疗,治疗结束后各组患者的病甲有明显改善,各组的临床有效率与治疗结束时相比,各组病甲均有明显改善;多因素回归分析表明,治疗的能量密度越高(6个月Wald=5.129,P=0.024;12个月Wald=10.471,P=0.001),次数越多(6个月Wald=4.529,P=0.033;12个月Wald=4.021,P=0.045),其临床有效率及真菌学有效率越高。结论长脉宽Nd:YAG 1064nm激光是治疗红色毛癣菌感染引起的甲真菌病的一种安全有效的方法;在患者能够耐受的情况下,高能量密度、多次治疗可提高临床疗效。
[Abstract]:Objective to compare the efficacy and safety of Nd:YAG 1064nm laser with long pulse width in the treatment of onychomycosis caused by Trichophyton rubrum infection. To explore the main factors affecting the efficacy of laser in the treatment of onychomycosis, 9 groups were treated with different energy density of 35J / cm ~ (2 +) 40 J / cm ~ (2 +) 45J / cm ~ (2), light spot diameter of 3 mm ~ 4 mm ~ 5 mm ~ (5 mm), pulse width of 25 Ms ~ (30) Ms ~ (35) and times of treatment (3 times, 4 times, 5 times), and other parameters of 9 groups, such as different energy density (35 J / cm ~ (2)) and 40 J / cm ~ (2 +) 45 J / cm ~ (2)). A total of 177 patients with onychomycosis were randomly divided into 9 groups. The patients were treated with Agni regimen and followed up for 6 months and 12 months after treatment. The clinical effective rate, mycological efficacy and recurrence were observed. Results the patients in group A were treated with different regimens. After the treatment, the patients in each group improved obviously. The clinical effective rate of each group was compared with that at the end of treatment. The results of multivariate regression analysis showed that, The higher the energy density of treatment was (6 months Waldl 5.129 P0. 024; 12 months Waldl 10. 471 P0. 001), the more times of treatment (6 months Waldl 4. 529 P0. 033; 12 months Waldl 4. 021 P0. 045) its clinical effective rate and mycological efficiency were higher. Conclusion long pulse width Nd:YAG 1064nm laser is the treatment of onychomycosis caused by Trichoderma rubrum infection. A safe and effective method; In the case of patient tolerance, high energy density, multiple treatment can improve the clinical efficacy.
【作者单位】：南方医科大学附属深圳市龙华区人民医院皮肤科;
【基金】：深圳市科技创新委员会基金(201230280)
【分类号】：R756.4

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