Enwemeka Chukuka S
School of Health Professions, New York Institute of Technology, Old Westbury, NY 11568, USA.
Photomed Laser Surg. 2009 Jun;27(3):387-93. doi: 10.1089/pho.2009.2503.
Inaccurate measurement and incorrect reporting of dosages are major shortcomings of phototherapy articles. As many as 30% of published reports in the field either lack relevant information needed to determine a dosage or report dosages that are altogether inaccurate. The high prevalence of dosage-related mistakes in published reports suggests that dosage determination errors are common among clinicians and other end-users. This special article is designed to advance understanding of the relevant parameters used in phototherapy for tissue repair and pain relief, particularly among clinicians and others who may not be completely familiar with the technology. I define and discuss five key parameters that influence dosage, including 1) radiant power, 2) radiant energy, 3) power density, 4) energy density, and 5) wavelength, and use hypothetical cases to demonstrate how factors such as beam spot size, size of lesion, mode of treatment (contact, noncontact, or scanning), frequency of treatment, dose per treatment, and cumulative dose affect dosages and treatment outcomes. The potential effects of patient-related factors, such as etiology, pathology, tissue optical density, depth of target tissue, and skin pigmentation are discussed concurrently and strategies are suggested to improve dosage determination.
光疗文章中剂量测量不准确和报告错误是主要缺点。该领域多达30%的已发表报告要么缺乏确定剂量所需的相关信息,要么报告的剂量完全不准确。已发表报告中与剂量相关错误的高发生率表明,剂量确定错误在临床医生和其他终端用户中很常见。这篇专题文章旨在增进对光疗用于组织修复和缓解疼痛时所使用的相关参数的理解,尤其是在那些可能不完全熟悉该技术的临床医生和其他人当中。我定义并讨论影响剂量的五个关键参数,包括1)辐射功率、2)辐射能量、3)功率密度、4)能量密度和5)波长,并使用假设案例来说明诸如光斑尺寸、病变大小、治疗模式(接触、非接触或扫描)、治疗频率、每次治疗剂量和累积剂量等因素如何影响剂量和治疗结果。同时讨论了患者相关因素(如病因、病理、组织光学密度、靶组织深度和皮肤色素沉着)的潜在影响,并提出了改善剂量确定的策略。