Ma Jun, Chen Bin, Zhang Yue, Li Dong, Xing Zhuang Lin
State Key Laboratory of Multiphase Flow in Power Engineering, Xi'an Jiaotong University, Xi'an, Shaanxi, 710049, China.
Lasers Med Sci. 2017 Aug;32(6):1321-1335. doi: 10.1007/s10103-017-2244-4. Epub 2017 Jun 3.
Port-wine stains (PWSs) usually respond poorly to pulsed dye laser treatment because of the shallow penetration and light absorption of melanin in the epidermis. Multiple laser pulses (MLPs) Nd:YAG laser in conjunction with an optical clearing agent can help to reduce the total laser energy required for blood coagulation. The quantitative optical clearing effect (OCE) of glycerol was investigated by using a tissue-like phantom. Thereafter, an in vitro capillary tube experimental system and an in vivo hamster dorsal skin chamber experiment for the laser treatment of PWSs were established to visually obtain the quantitative relationship between the OCE and the blood coagulation properties under the irradiation of 1064 nm MLPs. Diffuse reflection coefficient decreases by 36.69% and transmission coefficient increases by 38.73% at 1064 nm, after applying 0.5 mL anhydrous glycerol for 10 min on the surface of the tissue-like phantom. The number of laser pulses required for blood coagulation decreases by 25% after the application of 0.5 mL anhydrous glycerol for 4 min, thrombosis appears after 10 min, and the 0.0854 clotting area completely blocks the capillary tubes in 6 pulses. For 10 min, the incident energy can be reduced by 35.09 and 29.82%. When the 0.3-mm vessel's buried depths are 1 and 0.5 mm, the pulse number can be reduced from 11 to 8 and from 6 to 4, respectively. Adding anhydrous glycerol directly on the hamster dorsal skin is an effective way to reduce the number of laser pulses from 4∼5 to 2∼3 for similar capillary tube diameter. Therefore, the MLPs of 1064 nm Nd:YAG demonstrates a substantial curative effect for large capillary tubes. In conjunction with glycerol, this approach may treat deeply buried cutaneous capillary tubes and prevent the unwanted thermal damage of normal dermal tissue.
鲜红斑痣(PWSs)通常对脉冲染料激光治疗反应不佳,这是因为表皮中黑色素的浅穿透性和光吸收性。掺钕钇铝石榴石(Nd:YAG)激光与光学透明剂联合使用的多个激光脉冲(MLPs)有助于降低凝血所需的总激光能量。通过使用组织模拟体模研究了甘油的定量光学透明效果(OCE)。此后,建立了用于PWSs激光治疗的体外毛细管实验系统和体内仓鼠背部皮肤腔室实验,以直观地获得在1064 nm MLPs照射下OCE与凝血特性之间的定量关系。在组织模拟体模表面涂抹0.5 mL无水甘油10分钟后,1064 nm处的漫反射系数降低36.69%,透射系数增加38.73%。涂抹0.5 mL无水甘油4分钟后,凝血所需的激光脉冲数减少25%,10分钟后出现血栓形成,0.0854的凝血面积在6个脉冲内完全阻塞毛细管。持续10分钟时,入射能量可分别降低35.09%和29.82%。当0.3 mm血管的埋藏深度为1 mm和0.5 mm时,脉冲数可分别从11个减少到8个和从6个减少到4个。对于类似的毛细管直径,直接在仓鼠背部皮肤上添加无水甘油是将激光脉冲数从4至5个减少到2至3个的有效方法。因此,1064 nm Nd:YAG的MLPs对大毛细管显示出显著的治疗效果。结合甘油,这种方法可以治疗深埋的皮肤毛细管,并防止正常真皮组织受到不必要的热损伤。