脉冲染料激光（585nm）治疗单侧痣样毛细血管扩张症18例疗效观察

目的：探讨585nm脉冲染料激光治疗单侧痣样毛细血管扩张症的有效性。方法：18例单侧痣样毛细血管扩张症患者均有典型的临床表现,其中4例皮损双侧分布,其余14例患者的皮损单侧分布。结果：18例患者均用脉冲染料激光（585nm）治疗,治疗1～3次后,均取得了满意疗效。结论：585nm脉冲染料激光是一种治疗单侧痣样毛细血管扩张症安全有效的方法。不良反应为部分患者治疗后局部会遗留暂时性的紫癜、色素沉着和色素减退斑。     

双波长（595nm和1064nm）脉冲激光治疗血管性皮肤病429例

目的：观察595nm和1064nm双波长脉冲激光治疗血管瘤、微静脉畸形、蜘蛛痣、毛细血管扩张的临床疗效及影响疗效的因素。方法：总结双波长595nm和1064nm激光器治疗血管性皮肤病患者的资料429例,评价其疗效和安全性,比较不同类型血管性皮肤病的治疗参数、治疗次数及相关影响因素。结果：治疗的总有效率为94．2％,血管瘤愈显率为63．6％,微静脉畸形52．7％,随着治疗次数增多,两者有效率达94．8％、91．9％;蜘蛛痣有效率为100％,毛细血管扩张症为80％。蜘蛛痣所需治疗次数最少,治疗参数较高;微静脉畸形需4次以上治疗才能达到较好疗效,所有血管性皮肤病治疗间隔3～5周时疗效显著。结论：双波长激光治疗血管性皮肤病安全、有效,其中蜘蛛痣和血管瘤疗效好,且治疗次数少,疗程短,不良反应发生率低。微静脉畸形需多次治疗,毛细血管扩张症选择双波长激光联合IPL治疗更好。     

595nm脉冲染料激光治疗皮肤血管异常性疾病

目的 观察595 nm脉冲染料激光治疗皮肤血管异常性疾病的临床疗效及不良反应.方法 自2008年1月至2010年1月,应用595 nm脉冲染料激光治疗皮肤血管异常性疾病患者362例,其中鲜红斑痣者147例、婴幼儿血管瘤者109例、毛细血管扩张者45例、蜘蛛痣者12例、血管痣者33例、血管角皮瘤者16例,并观察及判定其疗效.结果 毛细血管扩张、血管痣和蜘蛛痣患者的治疗有效率达100%;鲜红斑痣的有效率为72.1%;婴幼儿血管瘤的有效率为86.2%;血管角皮瘤的有效率为93.8%.治疗中疼痛较轻,不良反应发生率约为3.0%.治疗后随访317例患者1～2年,对治疗效果均较满意.结论 595 nm脉冲染料激光治疗皮肤血管异常性疾病临床疗效确切,不良反应较少,值得推广应用.     

强脉冲光和倍频Nd：YAG激光联合治疗面部毛细血管扩张症656例临床分析

目的：评价强脉冲光（Int ense Pul sed Li ghtI,PL）和可变脉宽倍频Nd：YAG激光（Vari abl e-pul se iW dt h Nd：YAG Laser,VPW532）联合应用治疗面部毛细血管扩张症（Tel angi ect asi s）的临床疗效和安全性。方法：纳入2001年7月～2004年4月采用IPL及VPW532激光治疗面部毛细血管扩张症的患者656例,术后随访观察疗效和不良反应。结果：所有患者经过治疗后,有效率98.9%,治愈率91.9%;不良反应发生率为37.5%,无严重并发症出现。结论：两者联合应用治疗面部毛细血管扩张症是一种疗效确切、安全的治疗策略。     

PhotoGenica V脉冲染料激光治疗浅表性皮肤血管性疾病

目的观察波长为585 nm脉冲染料激光治疗浅表性皮肤血管性疾病的临床疗效.方法采用PhotoGenica V脉冲染料激光,波长为585 nm,对鲜红斑痣、草莓样血管瘤、皮肤毛细血管扩张及充血性增生瘢痕等皮肤血管性疾病,根据皮损的不同性质选定不同能量的光束进行照射.结果对100例患者进行激光治疗并随访观察,满意率达100%.毛细血管瘤经3～5次治疗瘤体有不同程度的缩小,面部毛细血管扩张早期经多次治疗可去除或减轻,瘢痕皮肤经2～6次治疗可使瘢痕软化、皮肤变平、色素沉着变淡.结论波长为585 nm脉冲染料激光治疗浅表性皮肤血管性疾病无创伤、瘢痕及色素沉着等并发症出现,是行之有效的治疗方法.     

强脉冲光联合长脉宽Nd:YAG激光治疗面部毛细血管扩张症疗效观察

目的:观察强脉冲光联合长脉宽Nd:YAG激光治疗面部毛细血管扩张症的临床疗效和安全性。方法:将106例面部毛细血管扩张症就医者随机分为三组,强脉冲光治疗组给予560～1 200nm强脉冲光治疗,Nd:YAG激光组使用1 064nm长脉宽Nd:YAG激光治疗,联合治疗组采用强脉冲光与Nd:YAG激光联合治疗,各组均每4～8周治疗1次,共治疗1～5次,治疗结束后4周评价治疗疗效并记录不良反应。结果:按照毛细血管扩张7点评分标准进行评分,联合治疗组Nd:YAG激光组强脉冲光治疗组;治疗次数对比,强脉冲光治疗组Nd:YAG激光组联合治疗组。三组间红斑、水肿、色素沉着的不良反应发生率对比,差异无统计学意义。Nd:YAG激光组及联合治疗组紫癜的发生率高于强脉冲光治疗组。结论:强脉冲光联合长脉宽Nd:YAG激光治疗面部毛细血管扩张症疗效好且治疗次数少,无严重不良反应,值得临床推广。     

强脉冲光子嫩肤仪治疗面部毛细血管扩张症

目的探讨强脉冲光子嫩肤仪治疗面部毛细血管扩张症的临床疗效.方法应用强脉冲光子嫩肤仪对300例面部毛细血管扩张症的患者行3～5次治疗,每次治疗间隔3周,并观察临床疗效.结果随访观察治疗后的300例患者2～4个月,治愈者164例占54.7%,显效者96例占32.0%,有效者25例占8.3%,无效者15例占5.0%,总有效率为95.0%.结论强脉冲光子嫩肤仪治疗面部毛细血管扩张症,其方法操作简单、无损伤,治疗后无色素沉着及瘢痕等并发症,是一种安全有效较新的面部美容方法.     

595nm可调脉宽染料激光与强脉冲光治疗毛细血管扩张

目的：评价595nm可调脉宽染料激光与强脉冲光（IPL）治疗毛细血管扩张的疗效和不良反应。方法：用595nm可调脉宽脉冲染料激光仪与强脉冲光分组治疗毛细血管扩张共326例,按照就诊时间随机单盲将患者分为两组,A组：164例,应用595nm可调脉宽染料激光治疗;B组：162例,应用强脉冲光治疗。根据血管的粗细适当选择脉宽及能量密度,照射病变部位,观察局部治疗皮肤反应,即以照射部位皮肤变为紫灰色,扩张血管消失为适度。每月治疗1次,共治疗1～3次,分析两组患者的疗效和不良反应。结果：164例毛细血管扩张患者,经过595nm可调脉宽V-beam激光1～3次治疗后,85例痊愈,63例显效,总有效率90.2%;IPL组的总有效率在第1、2、3次治疗后分别为3.1%、21.6%和43.2%。与IPL组比较,595nm可调脉宽V-beam激光组的疗效要明显优于IPL组,两者的差异性有明显统计学差异（P〈0.01）。同一类型皮肤与IPL组比较,595nm可调脉宽V-beam激光组的疗效要明显优于IPL组,两者的差异性有明显统计学差异（P〈0.05）。两组治疗后皮肤反应轻微,595nm激光组治疗后会暂时出现局部水肿和紫癜,两组术后色素改变发生率无显著性差异（P〈0.05）。结论：595nm可调脉宽脉冲染料激光治疗毛细血管扩张疗效明显优于强脉冲光,且皮肤反应轻微,疗效确切,临床效果满意。     

强脉冲光联合长脉冲1064nmNd:YAG激光治疗面部毛细血管扩张症疗效观察

目的:观察强脉冲光联合长脉冲l 064nm Nd:YAG激光治疗面部毛细血管扩张症的临床疗效及安全性。方法:将86例面部毛细血管扩张症患者随机分为A、B两组,每组各43例,其中A组单纯采用强脉冲光治疗,B组采用强脉冲光联合长脉冲1 064nm Nd:YAG激光治疗,观察两组间的疗效及安全性。结果:在适合的脉宽及能量密度下,经过3~5次治疗,A组痊愈率74.4%,有效率86.0%;B组痊愈率90.7%,有效率100.0%,两组间痊愈率及有效率比较差异有统计学意义(P0.05)。总体不良反应发生率11.6%,主要表现为一过性红肿,两组间不良反应发生率无统计学差异。结论:强脉冲光联合长脉冲1 064nm Nd:YAG激光治疗面部毛细血管扩张症疗效满意,不良反应轻,值得临床推广应用。     

PhotoGenica V脉冲染料激光治疗浅表性皮肤血管性疾病

目的　观察波长为 5 85nm脉冲染料激光治疗浅表性皮肤血管性疾病的临床疗效。方法　采用Photo GenicaV脉冲染料激光 ,波长为 5 85nm ,对鲜红斑痣、草莓样血管瘤、皮肤毛细血管扩张及充血性增生瘢痕等皮肤血管性疾病 ,根据皮损的不同性质选定不同能量的光束进行照射。结果　对 10 0例患者进行激光治疗并随访观察 ,满意率达 10 0 %。毛细血管瘤经 3～ 5次治疗瘤体有不同程度的缩小 ,面部毛细血管扩张早期经多次治疗可去除或减轻 ,瘢痕皮肤经 2～ 6次治疗可使瘢痕软化、皮肤变平、色素沉着变淡。结论　波长为 5 85nm脉冲染料激光治疗浅表性皮肤血管性疾病无创伤、瘢痕及色素沉着等并发症出现 ,是行之有效的治疗方法     

多磺酸粘多糖乳膏辅助治疗痤疮的临床疗效观察

目的：观察多磺酸粘多糖乳膏辅助治疗痤疮的临床疗效和安全性,掌握多磺酸粘多糖乳膏的使用方法.方法：选择寻常性痤疮患者60例,随机分成治疗组和对照组,两组患者均口服盐酸米诺环素胶囊50mg每天2次,配合面部护理1周1次,双波长595nm/1064nm脉冲燃料激光,2～3周/次.对照组无外用药,治疗组外用多磺酸乳膏粘多糖,2次/天,4周为1个疗程.由两名皮肤科医生对患者进行痤疮皮损面积和严重程度指数评分,红斑消退及瘢痕形成的观察,采用自身前后对照进行疗效观察,记录患者出现的不良反应.结果：治疗组1周后,丘疹、脓疱大部分消退,随着疗程的增加,丘疹、脓疱消退,红色印迹明显变淡,未见瘢痕形成.有效率83.33％;对照组1周后丘疹、脓疱明显减少,4周后丘疹大部分消退,脓疱变小.有明显的红色印迹,未见瘢痕形成,有效率为63.33％.结论：多磺酸粘多糖乳膏配合双波长595nm/1064nm激光治疗面部寻常性痤疮快捷、安全、有效.     

脉冲染料激光治疗婴幼儿体表血管瘤150例疗效分析

目的：研究595nm可调脉宽染料激光治疗体表婴幼儿血管瘤的疗效和适应证。方法：150例婴幼儿体表血管瘤接受595nm脉冲染料激光治疗,采用参数：能量7～14J/cm2,光斑直径7mm,脉宽0.5～10ms,治疗间隔15～30天,随访6个月以上。随机选择130例患儿不做任何治疗,跟踪观察瘤体变化1年,作为对照。结果：激光治疗组133例（88.7%）瘤体获得75%以上的消退,治疗后仅10例（6.7%）出现水疱,另1例（0.6%）破溃后遗留瘢痕;对照组130例仅13例（10%）获得75%以上的瘤体消退,增大109例（83.8%）,破溃后遗留瘢痕16例（12.5%）。结论：595nm脉冲染料激光治疗早期体表婴幼儿血管瘤,创伤小、疗效高,瘢痕形成等不良反应低,可达到理想的美容治疗效果,适宜在临床推广使用。     

Fungicidal effect of diode laser irradiation in patients with denture stomatitis

BACKGROUND AND OBJECTIVE: Denture stomatitis (DS) is a common inflammatory condition that affects denture wearers. The aim of this study was to examine, in vivo, the effect of diode laser irradiation on fungal growth in both the palatal mucosa and in denture base materials, in denture wearing patients. STUDY DESIGN/MATERIALS AND METHODS: In total, 70 patients with clinical study design evidence of DS participated in this parallel, single blind, and placebo controlled study. The subjects were randomly assigned to one of four different treatment regimens: (1) irradiation with a 685 nm wavelength laser for 10 minutes (30 mW); (2) irradiation with a 830 nm wavelength laser for 5 minutes (60 mW). A semiconductor diode laser, BTL-2000 (BTL-2 Dravotnicka Technika, Prague, Czech Republic), was used in both treatment cases using an energy density of 3.0 J/cm(2) and a continuous working mode for five consecutive days; (3) placebo-sham irradiation of patients; (4) antimicotic-self treatment of patient's palatal mucosa with an antifungal oral gel and the use of an antiseptic solution for their dentures. The effect of laser light on fungal growth in vivo was evaluated after final treatment using the swab method and a semi-quantitative estimation of Candida albicans colonies cultivated on agar plates. RESULTS: A fungicidal effect was achieved in the laser treated and antimicotic treated groups, whereas most subjects in the placebo group were found to have unchanged conditions on both their palate (P = 0,004) and dentures (P < 0,001). CONCLUSIONS: Light from a low-power laser (LLLT) may be valuable in the treatment of DS. This is of great importance since the rate of recurrence of disease is high, whereas an optimal treatment modality has not yet been found.     

大光斑低能量Q开关激光治疗褐青色痣疗效观察

目的:探讨大光斑低能量Q开关Nd:YAG激光治疗褐青色痣的临床疗效。方法:采用Q开关Nd:YAG激光治疗20例褐青色痣患者,波长1 064nm,光斑直径6mm,脉冲频率5~10Hz,能量密度2.2~3.0J/cm2,每3周1次,10次1个疗程。结果:20例患者经过1个疗程治疗后,4例皮损消失,恢复正常肤色;16例效果明显,皮损明显减退,总有效率达100%,所有患者未见明显色素沉着。结论:大光斑、低能量模式治疗颧部褐青色痣效果好,术后炎症性色素沉着概率低,患者依从性好,该方法值得推广。     

Treatment of telangiectasias with the 532-nm and the 532/940-nm diode laser

Recently, a dual-wavelength 532/940-nm laser has become available for treatment of facial vascular lesions as an alternative to the flashlamp pumped-dye lasers. Most facial vascular lesions will respond to the 532-nm wavelength. However, some of the larger and deeper lesions are resistant to this laser. The 940-nm wavelength can be used to treat these resistant lesions. Sixteen patients with 532-nm laser-resistant vascular lesions were treated with the 940-nm laser. Fourteen of these 16 patients had improvement in their telangiectasia in response to these treatments. Most facial l telangiectasias respond well to treatment with the 532-nm laser. However, some of the larger and deeper lesions will not respond well to this laser. The 940-nm wavelength laser can be used to treat these 532-nm laser resistant lesions.     

2μm铥激光尿道内切开治疗男性尿道狭窄及尿道闭锁(附23例报告)

目的探讨2μm铥激光尿道内切开治疗男性尿道狭窄及尿道闭锁的手术方法。方法使用德国LISA公司RevoLix 2μm连续波医用铥激光手术治疗系统,最大功率40 W,行手术治疗男性尿道狭窄17例,男性尿道闭锁6例。手术均在尿道镜直视下配以寻光法引导进行。后续治疗采用传统的尿道扩张方法,每周1次尿道扩张,连续10次以上,之后每月1次尿道扩张持续1年以上。结果平均手术时间52(35~70)min,术后4~8周拔除导尿管,患者均排尿通畅,术后配合尿道扩张巩固疗效。1例患者术后4个月时尿道扩张困难,再次行经尿道狭窄激光内切开术,术后排尿通畅。结论 2μm铥激光尿道内切开术治疗尿道狭窄及尿道闭锁操作简便,创伤小,并发症少,疗效可靠且安全性高。     

Q开关Nd:YAG激光低能量祛除21例文身疗效观察

目的:探讨Q开关Nd:YAG激光多次低能量祛除文身的临床疗效观察。方法:临床选取21例文身患者,治疗采用自身对比:A区为试验区,使用Q开关1064nm波长激光,光斑直径4～6mm,能量密度为2.0～4.0J/cm2,平行均匀照射1遍,术后即刻反应皮损变白霜,无皮肤出血点,每天治疗1次,连续治疗3～4次;B区为对照区,使用Q开关1064nm波长激光,光斑直径3～4mm,能量密度为5.0～8.0J/cm2,均匀照射1遍,即刻反应皮损灰白或皮肤出血。两组病例均于术后6个月观察疗效。结果:术后6个月观察,试验区:治愈9例(42.8%),显效12例(57.2%),无瘢痕形成;对照区:治愈3例(14%),显效5例(24%),好转13例(62%),2例(9.5%)出现轻度增生性瘢痕。结论:采用Q开关Nd:YAG激光多次低能量治疗文身的方法可加快文身消退病程,减少文身治疗中能量密度过大形成瘢痕或色素脱失的风险,为文身治疗提供一种新的治疗方法。     

Variable pulse erbium:YAG laser skin resurfacing of perioral rhytides and side-by-side comparison with carbon dioxide laser

BACKGROUND AND OBJECTIVE: Laser resurfacing of facial rhytides has become a popular treatment option for many patients with wrinkles, photoaging, and acne scarring. Laser wavelength/pulse duration options and new techniques continue to shorten the healing phase associated with laser skin resurfacing while maintaining clinical efficacy. Variable pulse erbium:YAG (Er:YAG) laser systems are now available that offer the surgeon the ability to vary the Er:YAG pulse duration from a pulse that is primarily ablative to one that is more thermal. The objective of this study was to evaluate the histologic effects created with a variable pulse Er:YAG laser. To study prospectively the clinical effects on upper lip rhytides with a variable pulse Er:YAG laser when compared side by side with pulsed carbon dioxide (CO(2)) laser resurfacing. STUDY DESIGN/MATERIALS AND METHODS: Forty-two treatment sites on 21 patients were randomized and evaluated after treatment of the upper lip region with CO(2) laser resurfacing on one side and a variable pulse Er:YAG laser on the other. Patient diaries were maintained to assess erythema, crusting, pain, and pigmentary changes. Blinded objective grading of improvement was performed. Chromometer measurements were obtained to analyze erythema. RESULTS: The variable pulse Er:YAG laser treatment reduced the duration of crusting on average from 7.7 days with CO(2) to 3.4 days. Chromometer measurements noted decreased postoperative erythema. Grading by physicians in a blinded manner showed 63% improvement for the CO(2) treatment site and 48% improvement in the variable pulse Er:YAG site. No cases of permanent hyperpigmentation, hypopigmentation, or scarring occurred. CONCLUSION: The variable pulse Er:YAG laser resurfacing is a safe and effective resurfacing tool, which combines ablative and thermal modalities. The protocol used in this study approaches but does not equal the results we have traditionally seen with CO(2) laser resurfacing.     

Differenzierter Lasereinsatz zur Narbenbehandlung

In the past few years skin-ablative laser systems such as erbium:YAG laser and carbon dioxide laser and vascular destroying laser systems such as dye laser and neodymium:YAG laser have established themselves in the difficult treatment of scars. Special fields of application are atrophic and hypertrophic scars as well as keloids. Applications depend on wavelength of the emitted laser light and the associated biological effect in the tissue. Accordingly, different types of laser systems are used for special indications such as reduction of scar tissue or of proliferation. In many cases a combined laser treatment is required. Intensive supplementary therapy is essential to protect the good postoperative result. Our results clearly demonstrate that the laser systems available to date are a promising supplementation to the already established conservative and operative procedures in the treatment of striking scars.     

A Comparison of Four Frequency-Doubled Nd:YAG (532 nm) Laser Systems for Treatment of Facial Telangiectases

BACKGROUND: Telangiectases are cosmetically concerning for millions of individuals who develop them on the face as they mature. The causative factors are numerous. Lasers have recently become the focus for treating small facial telangiectases because of their ability to selectively target vessels. OBJECTIVE: The purpose of this study was to compare the efficacy of four different frequency-doubled neodymium:yttrium-aluminum-garnet (FD Nd:YAG) laser (532 nm) systems for the treatment of facial arteriolar telangiectases. METHODS: Forty adult subjects with Fitzpatrick skin phenotypes I and II were randomly assigned to four treatment groups. Each group, consisting of 10 subjects, had telangiectases less than 1000 microm in diameter treated with one of four different FD Nd:YAG laser systems with a wavelength of 532 nm. Patients were treated once and clinical improvement and potential adverse effects were assessed at 1 and 8 weeks after treatment. RESULTS: All treated patients showed improvement after one laser session. No patients were seen to have scarring or pigmentary changes. There was no significant difference in the clinical response following treatment with each laser. CONCLUSION: The four different FD Nd:YAG lasers performed equally well in treating facial telangiectases. With a wavelength of 532 nm and pulse durations in the millisecond range, vessels can be selectively targeted with a minimal incidence of post-operative complications.