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比较585纳米与595纳米波长脉冲染料激光联合冷冻喷雾冷却治疗鲜红斑痣的疗效。

Comparing the effectiveness of 585-nm vs 595-nm wavelength pulsed dye laser treatment of port wine stains in conjunction with cryogen spray cooling.

作者信息

Chang Cheng-Jen, Kelly Kristen M, Van Gemert Martin J C, Nelson J Stuart

机构信息

Department of Plastic Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan.

出版信息

Lasers Surg Med. 2002;31(5):352-8. doi: 10.1002/lsm.10102.

Abstract

BACKGROUND AND OBJECTIVES

The objective of this study was to compare the efficacy and safety of cryogen spray cooled laser treatment (CSC-LT) at wavelengths of 585 nm vs. 595 nm for port wine stain (PWS) birthmarks in a large series of patients.

STUDY DESIGN/MATERIALS AND METHODS: A retrospective review was conducted of 64 patients with PWS treated with the ScleroPLUS [Candela (Wayland, MA)] pulsed dye laser (lambda = 585 or 595 nm wavelength; spot size 7 mm, tau(p) = 1,500 microseconds) over a 3-year period. Subjects' ages ranged between 3 months and 64 years; there were 42 females and 22 males, all of whom were Asian. Number of treatments ranged from 1 to 6. Duration of treatment ranged from 6 months to 2 years 11 months, with a mean of 12 months. Patients (n = 32) received CSC-LT (585 nm) using radiant exposures of 7-10 J/cm(2). A second group of patients (n = 32) received CSC-LT (595 nm) using radiant exposures of 7-10 J/cm(2). The primary efficacy measurement was the quantitative assessment of blanching response scores for CSC-LT (585 nm) versus CSC-LT (595 nm). Patients were monitored for adverse effects.

RESULTS

Based on chi-squared analysis, there were clinical, and statistically significant, differences in blanching response scores favoring PWS receiving CSC-LT (585 nm) as compared to CSC-LT (595 nm) (P <.001). Transient hyperpigmentation was noted in 43.7% (n = 14) and 37.5% (n = 12) of patients in the CSC-LT (585 nm) and CSC-LT (595 nm) groups, respectively. In both groups, transient hyperpigmentation resolved in all patients within 1 year. Permanent hypopigmentation or scarring was not observed in either group.

CONCLUSIONS

CSC-LT (585 nm) resulted in superior blanching as compared to CSC-LT (595 nm). Further study is required to optimize wavelength selection on an individual patient basis during PWS therapy in order to improve treatment results.

摘要

背景与目的

本研究的目的是比较在大量患者中,波长为585nm与595nm的冷冻喷雾冷却激光治疗(CSC-LT)用于葡萄酒色斑(PWS)胎记的疗效和安全性。

研究设计/材料与方法:对64例接受ScleroPLUS[康德拉(马萨诸塞州韦兰)]脉冲染料激光(波长λ = 585或595nm;光斑大小7mm,脉宽τ(p)=1500微秒)治疗的PWS患者进行了为期3年的回顾性研究。受试者年龄在3个月至64岁之间;有42名女性和22名男性,均为亚洲人。治疗次数为1至6次。治疗持续时间为6个月至2年11个月,平均为12个月。32例患者接受了波长为585nm的CSC-LT治疗,辐射剂量为7 - 10J/cm²。另一组32例患者接受了波长为595nm的CSC-LT治疗,辐射剂量为7 - 10J/cm²。主要疗效指标是对波长为585nm的CSC-LT与波长为595nm的CSC-LT的皮肤变白反应评分进行定量评估。对患者的不良反应进行了监测。

结果

基于卡方分析,与波长为595nm的CSC-LT相比,波长为585nm的CSC-LT在皮肤变白反应评分上存在临床及统计学上的显著差异(P <.001)。波长为585nm的CSC-LT组和波长为595nm的CSC-LT组分别有43.7%(n = 14)和37.5%(n = 12)的患者出现短暂性色素沉着。两组中所有患者的短暂性色素沉着均在1年内消退。两组均未观察到永久性色素减退或瘢痕形成。

结论

与波长为595nm的CSC-LT相比,波长为585nm的CSC-LT能产生更好的皮肤变白效果。在PWS治疗期间,需要进一步研究以便根据个体患者情况优化波长选择,从而改善治疗效果。

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