van Gemert M J, Welch A J, Amin A P
Lasers Surg Med. 1986;6(1):76-83. doi: 10.1002/lsm.1900060116.
Optimization of laser treatment of port wine stains (PWS) is discussed from the standpoint of heat production. Laser wavelength, irradiation time, heat conduction, and external epidermal cooling are the variables considered in conjunction with absorbing and scattering behavior of a PWS-model consisting of epidermis, dermis, and ectatic blood vessel. Ideal treatment is defined as minimal heating of the epidermis and upper dermis, but with irreversible damage to the capillary wall. The analysis shows that irradiation times of 1-10 ms in conjunction with external epidermal cooling may give optimal results. The wavelength of choice is 577 nm, followed by 540, 415, 560, and 500 nm (argon laser). The ruby and Nd-YAG lasers are predicted to damage the epidermis and dermis at all times when the capillary is coagulated. Concurrent cooling to prevent epidermal-dermal damage is also recommended here. The CO2 laser is predicted to be the worst laser and, according to our analysis, should not be used to treat PWS. Both upper dermal and capillary destruction can only result from heat conduction from the damaged epidermis and external cooling cannot be applied here.
从热量产生的角度探讨了葡萄酒色斑（PWS）激光治疗的优化问题。激光波长、照射时间、热传导和外部表皮冷却，是结合由表皮、真皮和扩张血管组成的PWS模型的吸收和散射行为所考虑的变量。理想的治疗定义为表皮和真皮上层的加热最小化，但对毛细血管壁造成不可逆损伤。分析表明，1-10毫秒的照射时间结合外部表皮冷却可能会产生最佳效果。首选波长为577纳米，其次是540、415、560和500纳米（氩激光）。预计红宝石激光和钕钇铝石榴石激光在凝固毛细血管的所有时间都会损伤表皮和真皮。在此也建议同时进行冷却以防止表皮-真皮损伤。预计二氧化碳激光是最差的激光，根据我们的分析，不应用于治疗PWS。真皮上层和毛细血管的破坏只能由受损表皮的热传导导致，此处无法应用外部冷却。
