Q开关Nd:YAG激光治疗皮肤色素损害的临床应用和动物实验  

The clinical Practice and Animal Experiment of Treatment of Pigmented Lesions of Skin by Q-Switched Nd:YAG Laser

作　　者：朱健[1] 张树标[2] 张滨岳[3] 李晓原[4] 梁敏仪[5] 曹浩财[1] 李顺好[1] 邵颖文[4] 张锦宏[5] 

机构地区：[1]广州医学院第一附属医院激光室 [2]广州医学院第一附属医院颌面外科 [3]广州医学院第一附属医院皮肤科 [4]中山大学中山医学院激光医学研究室 [5]广州医学院医学遗传与细胞生物学教研室,510120

出　　处：《应用激光》2005年第5期351-354,共4页Applied Laser

基　　金：广东省医学科学基金资助项目(编号:A20022262)

摘　　要：目的观察并比较Q开关Nd:YAG1064nm和532nm波长激光照射治疗不同皮肤色素损害的临床疗效;并探讨Q开关激光去除皮肤色素细胞的机理.方法皮肤色素损害患者227例,其中太田痣142例、雀斑9例、文身(黑色)76例;针对不同病变类型,采用不同波长和工作参数进行激光褪色治疗;用2种不同的Q开关激光作用于豚鼠的有色皮肤区,观察其结果.结果经过1～9次临床治疗,不同皮肤色素损害的有效率分别为:太田痣82.1%、雀斑66.6%、文身96.0%.所有病例在治疗后均未遗留瘢痕;动物实验所见:Q开关激光治疗后皮肤色素即被气化或碎裂、色素病变消失,色素细胞呈空泡状,但色素细胞轮廓的框架仍可完整保留,色素细胞周围组织并未受损伤,仍可存活.结论应用Q开关Nd:YAG激光治疗皮肤色素损害文身的褪色效果最好,对太田痣、雀斑的褪色效果较好;Q开关激光只破坏色素颗粒或色素细胞,而邻近的正常细胞不被破坏,是目前治疗皮肤色素性疾病较有效副作用较小的方法.Objective： To observe and compare the clinical effectiveness of Q- switched Nd： YAG Laser irradiation with wavelength of 1064nm ＆532nm in the treatment of pigmentary lesions of skin and probe into the mechanism of Q-Switched in the treatment of skin pigmented diseases Methods： Two hundred and twenty - seven patients were treated with the laser system. The cutaneous pigmentary lesions in cluding： 142 cases of nevus of Ota .9 casesof freckles,75cases of tattoos .In accordance with different kinds of pathological changes,using Q-Switched Nd.. YAG laser.use different wave length and working parameter in fading treatment by laser,2 kinds of Q-Switch laser were used in the treatment of pigmented skin of guinea pings and observe the results. Results：After 1 to 9 times of clinical treatment,the effective rates were as follows respectively： nevas of on Ota82.1%, freckles 66.6 %,tattoos 96.0 %. No scar formation was observed in all patients treated. As seen in the animal experiment,after Q-Switched laser treatment . the pigmented granules were gasified and smashed, the coloring matters were cleared away,cells were in a vacuole state and its framework was well preserved. The neighbouring tissue around the cells were wot injured and could still survive. Conclusion：The best fading effect can be achieved in the treatment of pigmentary lesions of skin by using Q-switched. Nd： YAG laser,and comparatively good ones for nevus of Ota and freckles. Q-Switched laser only destroys the pigmented granules and cells without destroying the nearby normal cells. It is a comparatively effective and less side -effect method in treating skin pigmented diseases.

关 键 词：激光 皮肤色素沉着 

分 类 号：TN248.13[电子电信—物理电子学] TS218[轻工技术与工程—粮食、油脂及植物蛋白工程]