强脉冲光和脉冲染料激光595nm治疗面部毛细血管扩张的比较研究
[摘要]目的：评价强脉冲光(Intense Pulsed Light，IPL) 560～1 200nm/590～1 200nm和脉冲染料激光595nm不同波长治疗面部毛细血管扩张症的临床有效性。方法：301例患者随机分为3组，A组(IPL560～1 200nm)124例，B组(IPL590～1 200nm)79例，C组(脉冲染料激光595nm)98例。分别治疗1～4次，间隔时间4～6周。观察其血管清除率。结果：A、B、C组术中血管完全消失分别为66例(53.23%)、34例(43.04%)、74例(75.51%)；治愈分别为79例(63.71%)、41例(51.90%)、81例(82.65%)；平均治愈次数分别为2.66次、 2.85次、1.65次。A、B、C三组总体比较差别具有统计学意义；A、B两组比较差别具有统计学意义；A、C两组和B、C两组比较差别具有统计学意义。结论：IPL560～1 200nm/590～1 200nm和脉冲染料激光595nm三种波长对面部毛细血管扩张均有可靠疗效，脉冲染料激光595nm波长治愈率优于IPL560～1 200nm/590～1 200nm波长。
[关键词]面部毛细血管扩张症；IPL；脉冲染料激光；疗效；临床研究
[中图分类号]R751 [文献标识码]A[文章编号]1008-6455(2009)02-0221-04
Comparison of intense pulsed light to 595nm pulsed dye laser for treatment of facial telangiectasia : a pilot study
WANG Yong-xian,YING Zhao-xia,LIU Ping,Wang Qiong-yu,GE Wen-yu,QIAO Li
(Department of Dermatology,the Second Hospitol,Xi'an Jiaotong University, Xi'an 710004,Shaanxi,China)
Abstract:Objective The aim of this study is to evaluate efficacy of intense pulsed light(IPL560～1 200nm/ 590～1 200nm) and pulsed dye laser(595nm) in treatment for facial telangiectasia. Methods301 consecutive patients with facial telangiectasia were randomly divided into three groups: group A(124) were treated with IPL560～1200nm; group B(79)were treated with IPL590～1200nm; group C(98) were treated with pulsed dye laser(595nm). They were treated one and to four times with IPL or PDL. The interval was four to six weeks between two treatments. The ratio of elangiectasia disappeared was observed. ResultsThe proportion of elangiectasia disappeared entirely from group A, group B and group C were 53.23%, 43.04% and 75.51% respectively. The cure rate were 63.71%(group A), 51.90%(group B) and 82.65%(group C) respectively. The advantage number of treatment times were 2.66(group A), 2.85(group B) and 1.65(group C) respectively. There is significant difference between group A and group C, or group B and group C. There is no difference between group A and group B.ConclusionThe three groups laser and light sources were both efficient to treat facial telangiectasia. This study suggested that PDL is the superior to IPL560～1200nm/590～1200nm in treatment for facial telangiectasia.
Key words:facial telangiectasia;IPL;，pulsed dye laser;curative effect; clinical study
面部毛细血管扩张症是常见美容缺陷皮肤病，常在冬季加重，它们来源于扩张的浅表静脉、毛细血管和动脉，直径约为0.1～3mm。大多数面部毛细血管扩张症的病因不明，但是日晒、局部或系统性应用糖皮质激素或激素替代治疗等共同作用可能导致其发生[1]。
2005年2月～2008年8月，我们分别应用IPL 560～1 200nm/590～1 200nm和脉冲染料激光595nm三种波长治疗301例面部毛细血管扩张、蜘蛛痣和酒糟鼻血管扩张，对术中血管收缩反应、后期临床疗效和不良反应进行了比较观察，现将结果报道如下。
1资料和方法
1.1 病例及分组：301例全部为本科激光中心门诊病例，其中毛细血管扩张203例，蜘蛛痣91例，酒糟鼻血管扩张7例。女249例，男52例，年龄2～65岁。皮损主要分布于颧部、两颊、鼻翼，血管直径约0.1～0.5mm，面积 约1cm×2㎝～10cm×10cm。按治疗波长随机分为3组：A组(IPL560～1 200nm)124例，B组(IPL590～1 200nm)79例，C组(脉冲染料激光595nm)98例。
1.2 设备：IPL (Quantum SR)由美国LUMENIS公司生产，脉冲染料激光仪由美国Candela激光公司生产。
1.3 治疗方法
1.3.1面部常规清洁、消毒，眼罩保护患者双眼，病变部位涂覆冷凝胶后，根据血管粗细和密度用较低能量密度测试1～2个光斑，观察血管收缩情况以调整参数。
1.3.2常用参数：IPL光斑34mm×8mm，能量密度26～30J/cm2，脉宽33.4～34.6ms，双脉冲(第一子脉冲2.8～3.2ms，延迟25ms，第二子脉冲5.6～6.4ms)。可调脉宽脉冲染料激光光斑7mm，脉宽3～10ms，能量密度10～13J/cm2。术后用冰袋冷敷约30min。疗程间隔时间4～6周。, http://www.100md.com(王永贤 应朝霞 刘 平 王琼玉 葛文娱 乔 莉)
[关键词]面部毛细血管扩张症；IPL；脉冲染料激光；疗效；临床研究
[中图分类号]R751 [文献标识码]A[文章编号]1008-6455(2009)02-0221-04
Comparison of intense pulsed light to 595nm pulsed dye laser for treatment of facial telangiectasia : a pilot study
WANG Yong-xian,YING Zhao-xia,LIU Ping,Wang Qiong-yu,GE Wen-yu,QIAO Li
(Department of Dermatology,the Second Hospitol,Xi'an Jiaotong University, Xi'an 710004,Shaanxi,China)
Abstract:Objective The aim of this study is to evaluate efficacy of intense pulsed light(IPL560～1 200nm/ 590～1 200nm) and pulsed dye laser(595nm) in treatment for facial telangiectasia. Methods301 consecutive patients with facial telangiectasia were randomly divided into three groups: group A(124) were treated with IPL560～1200nm; group B(79)were treated with IPL590～1200nm; group C(98) were treated with pulsed dye laser(595nm). They were treated one and to four times with IPL or PDL. The interval was four to six weeks between two treatments. The ratio of elangiectasia disappeared was observed. ResultsThe proportion of elangiectasia disappeared entirely from group A, group B and group C were 53.23%, 43.04% and 75.51% respectively. The cure rate were 63.71%(group A), 51.90%(group B) and 82.65%(group C) respectively. The advantage number of treatment times were 2.66(group A), 2.85(group B) and 1.65(group C) respectively. There is significant difference between group A and group C, or group B and group C. There is no difference between group A and group B.ConclusionThe three groups laser and light sources were both efficient to treat facial telangiectasia. This study suggested that PDL is the superior to IPL560～1200nm/590～1200nm in treatment for facial telangiectasia.
Key words:facial telangiectasia;IPL;，pulsed dye laser;curative effect; clinical study
面部毛细血管扩张症是常见美容缺陷皮肤病，常在冬季加重，它们来源于扩张的浅表静脉、毛细血管和动脉，直径约为0.1～3mm。大多数面部毛细血管扩张症的病因不明，但是日晒、局部或系统性应用糖皮质激素或激素替代治疗等共同作用可能导致其发生[1]。
2005年2月～2008年8月，我们分别应用IPL 560～1 200nm/590～1 200nm和脉冲染料激光595nm三种波长治疗301例面部毛细血管扩张、蜘蛛痣和酒糟鼻血管扩张，对术中血管收缩反应、后期临床疗效和不良反应进行了比较观察，现将结果报道如下。
1资料和方法
1.1 病例及分组：301例全部为本科激光中心门诊病例，其中毛细血管扩张203例，蜘蛛痣91例，酒糟鼻血管扩张7例。女249例，男52例，年龄2～65岁。皮损主要分布于颧部、两颊、鼻翼，血管直径约0.1～0.5mm，面积 约1cm×2㎝～10cm×10cm。按治疗波长随机分为3组：A组(IPL560～1 200nm)124例，B组(IPL590～1 200nm)79例，C组(脉冲染料激光595nm)98例。
1.2 设备：IPL (Quantum SR)由美国LUMENIS公司生产，脉冲染料激光仪由美国Candela激光公司生产。
1.3 治疗方法
1.3.1面部常规清洁、消毒，眼罩保护患者双眼，病变部位涂覆冷凝胶后，根据血管粗细和密度用较低能量密度测试1～2个光斑，观察血管收缩情况以调整参数。
1.3.2常用参数：IPL光斑34mm×8mm，能量密度26～30J/cm2，脉宽33.4～34.6ms，双脉冲(第一子脉冲2.8～3.2ms，延迟25ms，第二子脉冲5.6～6.4ms)。可调脉宽脉冲染料激光光斑7mm，脉宽3～10ms，能量密度10～13J/cm2。术后用冰袋冷敷约30min。疗程间隔时间4～6周。, http://www.100md.com(王永贤 应朝霞 刘 平 王琼玉 葛文娱 乔 莉)