优化强脉冲光联合长脉宽Nd∶YAG1064nm激光治疗痤疮瘢痕疗效研究

目的 观察优化强脉冲光联合长脉宽Nd：YAG1064nm激光治疗痤疮瘢痕及其伴发色素沉着、红斑、毛孔粗大临床疗效. 方法 痤疮瘢痕患者共162例,采用随机分组其中78例运用优化强脉冲光联合长脉宽Nd：YAG 1064nm激光治疗,48例运用优化强脉冲光治疗,36例运用长脉宽Nd：YAG 1064nm激光治疗.治疗参数：强脉冲光滤光片640nm,能量密度20～24J/cm2,脉宽4ms,脉冲3个,延迟时间30ms.Nd：YAG1064nm激光,9mm光斑治疗头,能量密度单脉冲58～64J/cm2,脉宽20ms.一疗程5次,每次间隔1个月. 结果 162例患者3种治疗方式ECCA评分差异有统计学意义（P＜0.05）;治疗方式中优化强脉冲光联合长脉宽Nd：YAG1064nm激光治疗组与优化强脉冲治疗组ECCA评分差异有统计学意义（P＜0.05）,优化强脉冲光联合长脉宽Nd：YAG1064nm激光治疗组与长脉宽Nd：YAG1064nm激光治疗组ECCA评分差异有统计学意义（P＜0.05）.痤疮瘢痕及其伴发色素沉着有效率71.19％（95％CI：59.40％～82.98％）,红斑有效率88.14％ （95％CI：79.91％～96.37％）,毛孔粗大有效率71％（95％CI：60.45％～81.97％）.所有患者治疗中未发现任何严重的副作用. 结论 优化强脉冲光联合长脉宽Nd：YAG1064nm激光治疗对痤疮瘢痕及伴有局部色素沉着,红斑,毛孔粗大等都有较好的疗效.     

Q开关Nd∶YAG 1 064 nm激光治疗改善黑眼圈的效果

观察Q开关Nd∶YAG 1064 nm激光治疗棕黑色黑眼圈的效果。2014年8月至2016年11月,杭州整形医院激光科治疗黑眼圈患者89例,其中女68例,男21例,年龄26~55岁。89例患者给予Q开关Nd∶YAG 1064 nm激光治疗,脉宽300μs,光斑直径8 mm,能量密度800~1200 m J/cm²,局部扫描2遍。治疗间隔1个月,3~4次为1个疗程。治疗后随访3~6个月。Q开关Nd∶YAG 1064 nm激光治疗黑眼圈有效率88%,不良反应少。Q开关Nd∶YAG 1064 nm激光治疗黑眼圈安全有效。     

可调脉宽倍频Nd：YAG激光和点阵CO_2激光综合治疗瘢痕的临床应用

目的：探讨综合应用可调脉宽倍频Nd：YAG532nm激光和点阵CO2激光分别治疗面颈部早期红色瘢痕和晚期浅表性瘢痕的临床效果。方法：采用可调脉宽倍频Nd：YAG 532nm波长激光治疗面颈部红色增生期瘢痕,采用点阵CO2激光治疗面颈部浅表性瘢痕,并且根据疗效评定标准对治疗效果进行评价。结果：98个早期红色增生期瘢痕每次经激光治疗后症状和体征都减轻,4次治疗后手术切口条形瘢痕的总有效率为100%,显效率为96%,挫伤及烧烫伤后片状瘢痕的总有效率为91%,显效率为70%。80例浅表性瘢痕一次治疗后的总显效率为65%。结论：综合应用可调脉宽倍频Nd：YAG532nm激光和点阵CO2激光分别治疗面颈部早期增生性瘢痕和晚期浅表性瘢痕的治疗方案可行,值得临床推广应用。     

Q开关和长脉宽1064nm Nd:YAG激光真皮胶原重建疗效的比较性研究

目的:本研究拟定量地比较Q开关和长脉宽1064 nm掺钕:钇-铝石榴石(neodymium-yttrium-aluminum garnet,Nd:YAG)激光诱导真皮胶原重建的疗效。方法:应用Q开关和长脉宽1064 nm Nd:YAG激光分别对36只雌性昆明小鼠左侧后背皮肤进行连续4次治疗,每次间隔1周,右侧相应的部位作为自身对照。分别于第1次治疗后1h、1天、7天、21天、30天和60天对小鼠皮肤行活组织取材。应用免疫组化方法分别对皮肤组织样品中真皮I、III型胶原进行检测,染色结果应用Motic医学数字图像分析系统进行定量分析。结果:与正常对照组相比,Q开关1064 nm Nd:YAG激光治疗后7天、21天、30天和60天,真皮I型胶原及III型胶原水平明显增高(均P0.01)。长脉宽1064 nm Nd:YAG激光治疗后21天、30天和60天,真皮I型胶原水平明显增高(均P0.01);激光治疗后7天、21天、30天和60天,真皮III型胶原水平明显增高(分别为P0.01、P0.05、P0.01、P0.01)。两组激光的比较:激光治疗后7天、21天和30天,Q开关1064nm Nd:YAG激光治疗组真皮I型胶原水平较长脉宽1064nm Nd:YAG激光治疗组明显增高(均P0.01),而激光治疗后60天明显降低(P0.05);激光治疗后7天和21天,Q开关1064nm Nd:YAG激光治疗组较长脉宽1064nm Nd:YAG激光治疗组真皮III型胶原水平明显增高(分别为P0.05、P0.01)。结论:Q开关和长脉宽1064nm Nd:YAG激光均可引起真皮胶原重建,但二者的作用效果不尽相同。     

长脉冲1064nm Nd:YAG激光治疗化脓性肉芽肿临床观察

目的:评价长脉冲1 064nm Nd:YAG激光治疗化脓性肉芽肿的疗效及安全性。方法:总结化脓性肉芽肿102例患者的临床资料,采用长脉冲1 064nm Nd:YAG激光治疗,单脉冲脉宽13.5ms,双脉冲脉宽7.5m,脉冲延迟25ms,能量80~120J/cm~2;1个月后复查,疗效不佳者再次治疗直到皮损消失。结果:患者发病年龄以20~40岁青壮年居多,发病部位主要为手和面部;长脉冲1 064nm Nd:YAG激光治疗化脓性肉芽肿的1次治愈率为87.3%,总治愈率为99%;治疗过程疼痛评分(VAS评分)以中重度为主,与年龄和性别无关,与治疗部位相关,轻中度疼痛主要发生于头面部,而重度疼痛多出现于手足。治疗过程中,无1例患者出现增生性瘢痕,随访3个月无复发。结论:长脉冲1 064nm Nd:YAG激光治疗化脓性肉芽肿安全、有效,且美容效果较理想。     

Q-开关Nd:YAG激光治疗太田痣疗效观察

目的观察Q－开关Nd：YAG（1064nm）激光对太田痣的治疗效果方法用波长1064nm、脉宽10ns的激光治疗200例太田痣,治疗次数最少1次,最多5次,平均治疗间隔时间4.26月。结果：治疗1次有效率为65．00％,治疗2次、3次显效率分别为53．06％、82．05％,治疗4次、5次治愈率分别为44.44、80．00％,显示治愈率随治疗次数增加而提高。结论：Q－开关Nd：YAG（1064nm）激光治疗太田痣近期疗效可靠,安全、无瘢痕,美容效果显著,操作简便,是目前较理想的治疗方法     

长脉宽Nd:YAG激光治疗皮肤血管性病变的临床研究

目的 探讨波长为1064nm的长脉宽Nd:YAG激光治疗皮肤血管性疾病的疗效.方法 采用长脉宽Nd:YAG激光治疗鲜红斑痣、蜘蛛痣、毛细血管扩张等皮肤血管性病变,根据病变的不同选择不同的治疗参数,并对疗效进行分析.结果 本组患者215例获随访1年,长脉宽Nd:YAG激光治疗鲜红斑痣的痊愈率为15.4%,显效率为53.8%;治疗蜘蛛痣的痊愈率为76.8%,显效率为17.9%;治疗毛细血管扩张的痊愈率为18.6%,显效率为60.2%;治疗其他血管性病变的痊愈率为18.2%,显效率为54.5%.12例(5.6%)患者在术后发生了短暂性色素沉着;5例(2.3%)患者在术后发生了轻度瘢痕,无严重并发症发生.结论 长脉宽Nd:YAG 激光是一种治疗皮肤血管性病变安全、有效的方法.     

匐行性血管瘤10例的激光治疗

目的：探讨可调长脉冲1064nm Nd：YAG激光治疗匐行性血管瘤的有效性。方法：10例匐行性血管瘤患者均有典型的临床表现,其中3例皮损泛发,累及躯干和四肢,其余患者的皮损较局限。6例患者的组织病理检查均符合匐行性血管瘤的改变。所有患者均用可调长脉冲1064nm Nd：YAG激光治疗。结果：10例患者经1064nm Nd：YAG激光治疗1～2次后,均取得了满意疗效。结论：可调长脉冲1064nm Nd：YAG激光是一种治疗匐行性血管瘤的有效方法。     

Q开关Nd:YAG激光治疗文身329例临床观察

目的:观察Q开关Nd:YAG激光治疗文身的临床效果及并发症。方法:用Q开关Nd:YAG激光治疗不同部位、颜色、类型的文身,根据颜色选择1064nm、532nm或1064nm&532nm复合波长,根据深浅选择不同能量密度。结果:经过2～5次治疗,治愈率达60%,显效占38%,有效占2%。结论:Q开关Nd:YAG激光治疗文身无明显副作用,不留瘢痕,痛苦小,恢复快,治愈率高。     

Q-开关Nd:YAG激光治疗外源性皮肤色素性病变124例

目的：观察Q-开关Nd：YAG激光治疗外源性皮肤色素性病变的临床效果。方法：用Q-开关Nd：YAG激光1064nm波长治疗黑色、灰色或蓝色皮肤色素性病变；532nm波长治疗红色色素性病变，共计124例。结果：此方法可明显去除外源性皮肤色素性病变，效果好、无瘢痕产生，但需多次治疗。结论：Q-开关Nd：YAG激光治疗外源性皮肤色素性病变安全有效。     

单用强脉冲光、长脉宽Nd:YAG激光以及低能量下两者联合使用治疗微静脉畸形的临床疗效比较

目的:观察单用强脉冲光、长脉宽1064nm Nd:YAG激光以及低能量下两者联合使用治疗微静脉畸形的临床疗效和不良反应。方法:联合应用590～1200nm强脉冲光(能量密度12～16J/cm2,脉宽3.0～5.0ms)以及长脉宽1064nm Nd:YAG激光(能量密度80～90J/cm2,脉宽10～20ms)治疗51例微静脉畸形患者;并与单独应用强脉冲光(能量密度13～20J/cm2)及长脉宽Nd:YAG激光(能量密度120～145J/cm2)治疗结果比较。结果:强脉冲光、长脉宽1064nmNd:YAG激光及低能量下联合使用治疗微静脉畸形的有效率分别为33.1%、40.3%和56.9%,瘢痕发生率分别为0%、10.7%和5.9%。结论:低能量下联合使用强脉冲光及长脉宽1064nm Nd:YAG激光提高了微静脉畸形的有效率,且不良反应小。     

长脉冲1064nm Nd：YAG激光治疗面部激素依赖性皮炎伴发的毛细血管扩张

目的：观察长脉冲1 064nm Nd：YAG激光治疗面部激素依赖性皮炎伴发毛细血管扩张的临床治疗效果。方法：治疗参数选用：光斑直径3mm,平均脉宽（13.5±3.4）ms,平均能量密度（267.2±3.1）J/cm2。结果：37例女性患者,平均治疗2.3次,面部毛细血管扩张平均密度由（2.76±1.03）根/cm2下降至（0.42±0.27）根/cm2,临床疗效显著。治疗后,皮肤恢复至基本正常状态,无瘢痕、色素改变,皮炎反复发作的现象消失。结论：长脉冲1 064nm Nd：YAG激光治疗面部激素依赖性皮炎伴有的毛细血管扩张具有较好临床治疗效果,方法值得进行更广泛的临床实践与深入研究。     

Long-Term Results with a Multiple Synchronized-Pulse 1064 nm Nd:YAG Laser for the Treatment of Leg Venulectasias and Reticular Veins

BACKGROUND: The long-pulsed Nd:YAG (1064 nm) laser has been shown to be effective in the treatment of blue venulectasias and reticular veins. OBJECTIVE: The present study examined the clinical efficacy and long-term follow-up (12 months) of patients treated with the 1064 nm Nd:YAG laser technology. METHODS: Twenty-five female patients (mean age 37.6 years, Fitzpatrick skin types II-V) were treated with up to three treatment sessions at 6-week intervals on a 5 cm2 surface area of vessels utilizing the 1064 nm Nd:YAG laser with a circulating cooling device. Treatment parameters were vessel size 0.2-2.0 mm treated with a double pulse of 7 msec at 120 J/cm2 and vessel size 2.0-4.0 mm treated with a single pulse of 14 msec, fluence 130 J/cm2, with a spot size of 6 mm. Improvement was judged by double-blinded observer evaluation, macrophotographic imaging, optical chromatography, and a patient evaluation scale. RESULTS: Sixty-four percent of patients treated in the present study achieved 75% or greater clearing of vessels after a maximum of three treatment sessions. Optical chromatography revealed statistically significant decreased chromophore intensity (mean blueness reduction index of 41.2b-). Sixty-four percent of patients were greatly satisfied with the results of the laser treatment. Two patients manifested vessel recurrence when examined at 6 and 12 months, respectively. CONCLUSION: The 1064 nm Nd:YAG laser can produce effective long-term photosclerosis of blue venulectasia and reticular veins. The potential for recurrence should be recognized by the vascular laser surgeon.     

A side-by-side comparative study of 1064 nm Nd:YAG, 810 nm diode and 755 nm alexandrite lasers for treatment of 0.3-3 mm leg veins.

BACKGROUND: Laser and intense pulsed light device treatments of leg veins have generally yielded disappointing results. Use of longer wavelengths, longer pulse widths, and better cooling devices have recently sparked renewed interests in these methods. OBJECTIVE: To prospectively compare, side by side, a 3-msec cryogen spray-equipped 755 nm alexandrite, a sapphire window cooled super-long-pulse 810 nm diode, and a variable pulse width, cryogen spray-equipped 1064 nm Nd:YAG laser for the treatment of 0.3-3mm leg veins. METHODS: Thirty female volunteers, skin types I-V, age 32-67 years with comparable sets of leg veins were treated with the Nd:YAG laser and either the diode laser, alexandrite laser, or both. In most patients two to three sets of comparable sites were treated. Treatment parameters varied with each laser and according to the size of veins being treated. Patients were examined 1 week after each treatment and at 1, 2, and 3 months after the last treatment. Pre- and posttreatment 35mm photographs were taken. Improvement was judged by two experienced physicians both visually on patients and by comparison of pre- and posttreatment photographs. Results were graded as percent resolution, in five groups, 0%, 0-25%, 25-50%, 50-75%, and 75-100%. RESULTS: In the 22 patients completing the study, 36 leg vein sites were treated with the Nd:YAG laser, 18 leg vein sites were treated with the diode laser, and 12 leg vein sites were treated with the alexandrite laser. Greater than 75% improvement was observed at 88% of the Nd:YAG laser-treated sites, 29% of the diode laser-treated sites, and 33% of the alexandrite laser-treated sites. Greater than 50% improvement was observed at 94% of the Nd:YAG laser-treated sites, 33% of the diode laser-treated sites, and 58% of the alexandrite laser-treated sites. Less than 25% improvement was observed at 6% of the Nd:YAG laser-treated sites, 39% of the diode laser-treated sites, and 33% of the alexandrite laser-treated sites. Pain during treatment was variably perceived by patients, but occasionally sufficient for patients to decline further treatment. Posttreatment purpura and telangiectatic matting were a significant drawback for the alexandrite laser. Transient hemosiderin pigmentation, as seen with sclerotherapy, was common with larger vessels. CONCLUSION: The cryogen spray-equipped 1064 nm Nd:YAG laser was remarkably effective and safe for the treatment of 0.3-3 mm leg veins. The use of topical anesthesia may be needed for some patients. The super-long-pulse 810 nm diode laser gave unpredictable results. Additional refinements of fluence and pulse width could improve its performance. The 3-msec, 755 nm alexandrite laser at fluences of 60-70 J/cm2 and an 8 mm spot can be effective, but inflammatory response, purpura, and matting limit its usefulness. Longer pulse widths might decrease these problems. For leg vein treatment, the 1064 nm wavelength is very safe for type V skin, the 810 nm wavelength at super-long pulse widths of 400-1000 msec is very safe for type IV and marginal for type V skin, and the 755 nm wavelength is limited to nontanned type I-III skin.     

Laser Treatment With a 1064-nm Laser for Lower Extremity Class I–III Veins Employing Variable Spots and Pulse Width Parameters

BACKGROUND: The long-pulsed 1064-nm Nd:YAG laser (employing varying spot sizes, pulse widths, and fluences) has gained popularity for treating lower extremity blue and red vessels that are less than 4 mm in diameter. OBJECTIVE: To evaluate the efficacy of high-power 50-ms 1064 Nd:YAG laser in the treatment of class I-III lower extremity vessels. METHODS: Ten female patients (mean age of 39 years) had a 5-cm2 area of veins measuring 0.2 to 3 mm in diameter treated with up to three treatment sessions using a new 1064 Nd:YAG laser, with the end point being 100% vessel clearing after three treatments. Red vessels were treated with a spot size of 1.5 mm, a fluence of 400 to 600 J/cm2, a pulse width of 30 to 50 ms; blue vessels of 1 to 3 mm were treated with a spot size of 3 mm, a fluence of 250 to 370 J/cm2, and a pulse width of 50 to 60 ms. Macrophotographic imaging evaluations by blinded observers using a quartile scale and a patient satisfaction scale were employed to evaluate results. RESULTS: At month 3 after the final treatment session, 20% of all vessel types had 50% to 75% improvement. Equal clearing was noted for blue and red vessels. At month 6, 80% of patients had a greater than 75% clearing. Ninety percent of patients were highly satisfied with the treatment results at 6 months. CONCLUSION: By varying spot size, fluence, and pulse duration, a long-wavelength 1064-nm Nd:YAG laser can achieve excellent results for treating both blue and red lower extremity vessels that are less than 3 mm in diameter.     

An In Vivo Trial Comparing the Clinical Efficacy and Complications of Q-Switched 755 nm Alexandrite and Q-Switched 1064 nm Nd:YAG Lasers in the Treatment of Nevus of Ota

BACKGROUND: Q-switched 755 nm alexandrite (QS alex) and Q-switched 1064 nm Nd:YAG lasers are effective in the treatment of nevus of Ota. Our previous in vivo study indicated that patients better tolerate QS alex than QS 1064 nm Nd:YAG laser. However, in terms of clinical efficacy and long-term complications, the study did not indicate which laser is superior. Although both machines may appear to be similar in effectiveness, the low number of treatment sessions may contribute to this apparent lack of difference. OBJECTIVE: The aim of this study was to compare the clinical efficacy and complications of QS 755 nm alex and QS 1064 nm Nd:YAG lasers in the treatment of nevus of Ota after three or more treatment sessions. METHOD: Forty patients were recruited for this study and all had received three or more laser treatment sessions with an interval of at least 2 months between each. Half of the lesion was treated with QS alex and the other half with QS 1064 nm Nd:YAG laser. The degree of lightening was assessed subjectively by the patient using a visual analog scale and objectively by two independent clinicians. Patients were called back to be examined for evidence of complications. RESULTS: In terms of subjective degree of lightening, QS 1064 nm Nd:YAG laser was found to be significantly more efficacious than QS alex (P = 0.018). Both clinicians also found QS 1064 nm Nd:YAG laser to be more effective, but statistical significance was only detected in one, not both of their scores (P = 0.005 and 0.414 for observers 1 and 2, respectively). More patients that received QS Alex developed complications (4 for QS alex and 2 for QS Nd:YAG), but the difference was not statistically significant. CONCLUSION: QS 1064 nm Nd:YAG laser appears to be more effective than QS alex in the lightening of nevus of Ota after three or more laser treatment sessions. However, the majority (55%) of the patients reported no differences in results between the two lasers, and only one of the two observers noted statistically significant improvement of QS 1064 nm Nd:YAG over QS alex.     

Q-开关Nd:YAG 1064nm激光联合谷胱甘肽凝胶治疗黄褐斑的疗效观察

目的:评估Q-开关Nd:YAG 1 064nm激光联合谷胱甘肽凝胶对黄褐斑的治疗效果。方法:选26例黄褐斑患者,随机分为两组。治疗组13例,接受Q-开关Nd:YAG激光联合谷胱甘肽凝胶治疗;对照组13例,仅采用Q-开关Nd:YAG激光治疗,每14天治疗1次,6~10次为1个疗程,疗程结束后判断疗效。结果:治疗组有效率为100%,对照组为84.6%,两组疗效比较有统计学意义(P0.05)。结论:临床对比观察Q-开关Nd:YAG 1 064nm激光联合谷胱甘肽凝胶治疗黄褐斑较单用Q-开关Nd:YAG 1 064nm激光治疗有明显优势,适合推广应用。     

Millisecond 1064-nm Neodymium:YAG Laser Treatment of Facial Telangiectases

BACKGROUND: Millisecond pulse duration 1064-nm Neodymium:YAG (Nd:YAG) lasers have been shown to be effective in the treatment of some lower leg telangiectases. OBJECTIVE: To evaluate the efficacy and complication rate of a millisecond pulse duration 1064-nm Nd:YAG laser in the treatment of facial telangiectases. METHODS: Fifteen subjects were evaluated. RESULTS: Moderate to significant improvement was seen in 73% patients at day 30 and in 80% of patients at 3 months. These results were seen in the treatment of both blue/red and red facial telangiectases. CONCLUSION: The millisecond pulse duration 1064-nm Nd:YAG laser is effective for treatment of facial telangiectases.