Weiss R A, Weiss M A
Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Dermatol Surg. 1999 May;25(5):399-402. doi: 10.1046/j.1524-4725.1999.08268.x.
The 1064 nm wavelength penetrates tissue and blood vessels with little absorption by melanin.
To perform a study examining the effects of 1064 nm laser used in pulses from 4 msec to 16 msec on leg telangiectasias ranging in size from 0.5 to 3 mm.
In this initial trial, 50 sites on 30 patients were enrolled and treated with a multiple synchronized pulse laser at 1064 nm. The primary parameter utilized was a single 10-16 msec pulse. Improvement was judged by comparison of digital images at 1 month, 2 months, and 3 months posttreatment. Improvement was judged, based on size and number of vessels remaining. Side effects were noted as present or absent at each visit.
Immediate contraction or darkening followed by urtication and visible total vessel closure as indicated by absence of blanching and visual elimination of the vessel border occurred in most of the treated sites. Two 3 mm diameter vessels were confirmed to be closed without flow by Duplex ultrasound visualization, using a 10 MHz transducer. Bruising from vessel rupture was seen in approximately 50% of the cases. No epidermal injury was noted in any sites, even in Fitzpatrick skin Types IV. At 3 months follow-up, 75% improvement was noted at treatment sites.
Initial clinical results with a new multiple synchronized pulsed 1064 nm laser indicate that this longer wavelength supplied at pulses of up to 16 msec appears to be a valuable modality for immediate closure and subsequent elimination of leg ectatic veins. Epidermal injury is unlikely, as the near infrared wavelength has minimal interaction with melanin.
1064纳米波长能穿透组织和血管,且黑色素对其吸收极少。
开展一项研究,考察脉冲时长为4毫秒至16毫秒的1064纳米激光对大小在0.5至3毫米之间的腿部毛细血管扩张的疗效。
在这项初步试验中,纳入30例患者的50个部位,使用1064纳米的多同步脉冲激光进行治疗。使用的主要参数是单个10 - 16毫秒的脉冲。通过比较治疗后1个月、2个月和3个月的数字图像来判断改善情况。根据剩余血管的大小和数量来判断改善情况。每次就诊时记录有无副作用。
大多数治疗部位出现即刻收缩或变黑,随后出现风团,且由于无变白现象及血管边界视觉上消失表明血管完全闭合。使用10兆赫换能器的双功超声显像证实,两条直径3毫米的血管无血流通过。约50%的病例出现血管破裂导致的瘀斑。在任何部位均未观察到表皮损伤,即使是在菲茨帕特里克皮肤分型IV型的患者中。在3个月的随访中,治疗部位有75%的改善。
新型多同步脉冲1064纳米激光的初步临床结果表明,这种长达16毫秒脉冲的较长波长似乎是立即闭合并随后消除腿部扩张静脉的一种有效方式。由于近红外波长与黑色素的相互作用极小,因此不太可能造成表皮损伤。