Tan O T, Sherwood K, Gilchrest B A
Laser Center, Boston University Medical Center, MA 02118.
N Engl J Med. 1989 Feb 16;320(7):416-21. doi: 10.1056/NEJM198902163200702.
Thirty-five children, three months to 14 years of age, with disfiguring port-wine stains were treated with a flashlamp-pulsed tunable dye laser. All had complete clearing of the stains after an average of 6.5 laser treatments to each lesional area; skin over bony prominences required approximately half as many sessions as skin on the cheek. Children less than seven years old required fewer sessions (mean +/- SD, 5.8 +/- 1.1) than older children (7.1 +/- 1.1; P less than 0.05). Treated skin was identical in texture and color to adjacent normal skin in 33 (94.3 percent) of the children, whereas 2 (5.7 percent) had small, isolated, depressed scars in areas accidentally traumatized soon after laser treatment. The only other side effect was transient hyperpigmentation, which occurred in 20 patients (57 percent). These results can be attributed to two distinguishing characteristics of the flashlamp-pulsed tunable dye laser: an emission wavelength of 577 nm, theoretically ideal for selective absorption by the intravascular target oxyhemoglobin, and a pulse duration of 360 microseconds, which closely matches the thermal relaxation time for dermal blood vessels and hence avoids diffuse nonspecific thermal necrosis with subsequent scarring of the treated skin.
35名年龄在3个月至14岁之间、患有毁容性葡萄酒色斑的儿童接受了闪光灯脉冲可调染料激光治疗。每个皮损区域平均接受6.5次激光治疗后，所有患儿的色斑均完全消退；骨隆突部位的皮肤所需治疗次数约为脸颊皮肤的一半。7岁以下儿童所需治疗次数（均值±标准差，5.8±1.1）少于大龄儿童（7.1±1.1；P<0.05）。33名（94.3%）儿童治疗后的皮肤质地和颜色与相邻正常皮肤相同，而2名（5.7%）儿童在激光治疗后不久意外受伤的部位出现了小的、孤立的凹陷性瘢痕。唯一的其他副作用是20例患者（57%）出现了短暂性色素沉着。这些结果可归因于闪光灯脉冲可调染料激光的两个显著特性：发射波长为577nm，理论上是血管内目标氧合血红蛋白选择性吸收的理想波长；脉冲持续时间为360微秒，与真皮血管的热弛豫时间紧密匹配，从而避免了弥漫性非特异性热坏死以及随后治疗皮肤的瘢痕形成。
