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目的探讨长脉宽1064 nm Nd:YAG激光治疗趾甲真菌病的疗效及安全性。方法对确诊的104例(461个趾甲)趾甲真菌病患者,根据年龄段分为Ⅰ组(≥60岁)和Ⅱ组(<60岁),按照SCIO评分及病甲位置的差异分为不同亚组;所有患者病甲均使用长脉宽1064 nm Nd:YAG激光进行每周1次、共10~12次的治疗,随访至初次治疗后的48周,观察疗效及不良反应。结果所有病人随访至48周,总体临床有效率为72.5%。Ⅱ组的临床有效率和真菌学治愈率均高于Ⅰ组,差异有统计学意义(P<0.05)。不同SCIO亚组之间的临床有效率无统计学差异(P>0.05)。第2~4趾甲亚组的临床有效率优于第1、第5趾甲亚组,差异有统计学意义(P<0.05);所有患者无明显不良反应。结论长脉宽1064 nm Nd:YAG激光是一种安全微创有效的治疗甲真菌病的方法,可在临床推广使用。
Objective To investigate the efficacy and safety of long-pulse 1064 nm Nd: YAG laser in the treatment of toenail fungal disease. Methods One hundred and forty-four (461 toenail) toenail mycosis patients were divided into group Ⅰ (≥60 years) and group Ⅱ (≤60 years) according to their age. According to the SCIO score and the difference of the position of disease A, Group. All patients were treated with long pulse width 1064 nm Nd: YAG laser once a week for 10 to 12 times. All the patients were followed up for 48 weeks after the initial treatment to observe the curative effect and adverse reactions. Results All patients were followed up for 48 weeks. The overall clinical response rate was 72.5%. The clinical effective rate and cure rate of mycosis in group Ⅱ were higher than that in group Ⅰ, the difference was statistically significant (P <0.05). There was no significant difference in clinical efficacy between different SCIO subgroups (P> 0.05). The clinical efficacies of the second to fourth nail family subgroups were better than those of the first and fifth nail family subgroups (P <0.05). No adverse reactions were found in all the patients. Conclusion The long pulse width 1064 nm Nd: YAG laser is a safe, minimally invasive and effective method for the treatment of onychomycosis and can be widely used clinically.