Department of Dermatology, Norwegian University of Science and Technology, 7006, Trondheim, Norway.
Lasers Med Sci. 1997 Dec;12(4):320-7. doi: 10.1007/BF02767154.
Pulsed dye lasers permit effective treatment of port-wine stains without a significant risk of complications. However, epidermal damage manifested by weeping or crusting of the treated area have been reported in 48-83% of patients, and transient hyperpigmentation after treatment is observed in 10-57%. Theoretically, the epidermis can be protected from thermal damage with the use of the concept of selective epidermal cooling.This study examined the clinical effects of rapid cooling of the epidermis with a liquid refrigerant R-134a (boiling point - 26.5 double daggerC) during pulsed dye laser therapy. In 23 patients with port-wine stains, a 50-ms-long cooling pulse delivered immediately prior to laser irradiation with a fluence of 6.0 J cm(-2) significantly reduced the pain, and shortened the period with purpura without compromising the clinical blanching. Cooling periods longer than 60 ms, as well as additional cooling pulses immediately after laser exposure, reduced the blanching in areas irradiated with 6.0 J cm(-2).Post-treatment hyperpigmentation was not prevented with dynamic cooling.
脉冲染料激光治疗鲜红斑痣安全有效，不会产生严重的并发症。然而，有 48%至 83%的患者在治疗后会出现表皮损伤，表现为治疗区域的渗出或结痂，10%至 57%的患者在治疗后会出现短暂的色素沉着过度。理论上，可以使用选择性表皮冷却的概念来保护表皮免受热损伤。本研究在脉冲染料激光治疗过程中使用液体制冷剂 R-134a（沸点-26.5°C）对表皮进行快速冷却，观察其临床效果。在 23 例鲜红斑痣患者中，在激光照射前立即给予 50ms 长的冷却脉冲，激光能量密度为 6.0J/cm²，可显著减轻疼痛，缩短紫癜期，同时不影响临床即刻白瘢。冷却时间超过 60ms，以及在激光照射后立即给予额外的冷却脉冲，会降低 6.0J/cm² 照射区域的即刻白瘢。动态冷却并不能预防治疗后的色素沉着过度。
