State Key Laboratory of Multiphase Flow in Power Engineering, Xi'an Jiaotong University, Xi'an, 710049, Shaanxi, China.
Laser Treatment Center, Department of Dermatology, 2nd affiliated hospital, Medical School, Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, China.
Lasers Med Sci. 2020 Sep;35(7):1555-1566. doi: 10.1007/s10103-020-02981-9. Epub 2020 Feb 14.
Laser has been widely used in the treatment of vascular skin diseases, such as port wine stain, due to the effect of selective photothermolysis in laser on biological tissue. The 755 nm alexandrite laser was expected to achieve better curative effect than the commonly used 585 or 595 nm pulsed dye laser (PDL) because of its deeper tissue penetration. In this study, the dorsal chamber model and microscopic visualization system were used to observe morphology changes on 42 blood vessels before and after irradiation with the 755 nm laser. Results showed that thermal effects of blood vessels intensified with the increase in energy, and high energy was required to produce the same thermal effect as the extension of pulse width. Different from 595 and 1064 nm lasers, partial vessel contraction was dominant thermal effect caused by the 755 nm laser. The bleeding injury rate and thermal effect of the 755 nm laser were between those of 595 nm PDL and 1064 nm Nd:YAG laser. The simulation results proved that 595 nm PDLs were effective for small and shallow target blood vessels. The 755 nm alexandrite lasers were effective in the treatment of hypertrophic and resistant blood vessels to PDL in the skin with low or moderate melanin concentration. The 1064 nm Nd:YAG laser was effective in the treatment of deeply buried and enlarged target blood vessels in the skin with high melanin concentration. The simulation results were supported by published clinical observations.
激光已广泛应用于治疗血管性皮肤疾病,如葡萄酒色斑,这是由于激光对生物组织的选择性光热解作用。755nm 翠绿宝石激光由于其更深的组织穿透性,预计比常用的 585nm 或 595nm 脉冲染料激光(PDL)具有更好的疗效。在这项研究中,使用背腔室模型和显微镜可视化系统观察了 42 条血管在 755nm 激光照射前后的形态变化。结果表明,血管的热效应随能量的增加而增强,并且需要更高的能量才能产生与脉宽延长相同的热效应。与 595nm 和 1064nm 激光不同,755nm 激光的主要热效应是部分血管收缩。755nm 激光的出血损伤率和热效应介于 595nm PDL 和 1064nm Nd:YAG 激光之间。模拟结果证明,595nm PDL 对小而浅的靶血管有效。755nm 翠绿宝石激光对低或中等黑色素浓度皮肤中对 PDL 增生和耐药的血管有效。1064nm Nd:YAG 激光对高黑色素浓度皮肤中深埋和扩张的靶血管有效。模拟结果得到了已发表的临床观察结果的支持。