Kelly Kristen M, Nanda Vandana S, Nelson J Stuart
Department of Surgery, Beckman Laser Institute and Medical Clinic, University of California, Irvine 92612, USA.
Dermatol Surg. 2002 Apr;28(4):309-13. doi: 10.1046/j.1524-4725.2002.02071.x-i1.
The majority of port-wine stain (PWS) patients treated with the pulsed dye laser (PDL) do not achieve complete blanching. Safe administration of higher fluences has been proposed as a means of improving treatment efficacy.
To determine the safety and efficacy of PWS treatment with the 1.5-msec PDL at high fluences in conjunction with cryogen spray cooling.
Twenty PWS patients were treated with the PDL in combination with cryogen spray cooling utilizing a 7 or 10 mm spot size and fluences ranging from 6 to 15 J/cm2. Before and after treatment photographs were compared on a blinded basis.
No scarring or skin textural changes occurred. Blanching scores were as follows: 20% of patients achieved 75% or greater blanching after an average of 3.3 treatments, 30% achieved 50-74% blanching, 20% achieved 25-49% blanching, and 30% achieved less than 25% blanching.
In conjunction with cryogen spray cooling, the PDL can be safely used at high fluences. At this time it is not clear that the use of higher fluences improves treatment efficacy; however, as other aspects of PWS laser treatment are optimized, safe administration of higher fluences is likely to be advantageous.
大多数接受脉冲染料激光（PDL）治疗的葡萄酒色斑（PWS）患者并未实现完全褪色。有人提出安全使用更高能量密度作为提高治疗效果的一种方法。
确定在使用1.5毫秒脉冲染料激光并结合冷冻喷雾冷却的情况下，高能量密度治疗葡萄酒色斑的安全性和有效性。
20名葡萄酒色斑患者接受了脉冲染料激光与冷冻喷雾冷却联合治疗，光斑尺寸为7或10毫米，能量密度范围为6至15焦耳/平方厘米。在不知情的情况下比较治疗前后的照片。
未出现瘢痕形成或皮肤质地改变。褪色评分如下：20%的患者在平均3.3次治疗后实现了75%或更高的褪色，30%的患者实现了50%-74%的褪色，20%的患者实现了25%-49%的褪色，30%的患者实现了低于25%的褪色。
结合冷冻喷雾冷却，脉冲染料激光可以在高能量密度下安全使用。目前尚不清楚使用更高能量密度是否能提高治疗效果；然而，随着葡萄酒色斑激光治疗的其他方面得到优化，安全使用更高能量密度可能会有优势。
