王宏伟;黄文慧;赵永亮;
WANG Hong-wei,HUANG Wen-hui,ZHAO Yong-liang Department of Dermatology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College,Beijing 100730,China

• 1:中国医学科学院 北京协和医学院 北京协和医院皮肤科

摘要(Abstract)：

目的评估新型剥脱性饵:钇钪镓石榴石(erbium-doped yttrium scandium gallium garnet,Er:YSGG)2790nm激光治疗不同深度的表皮和真皮组织获得的剥脱效果。方法收集手术切除的16例新鲜离体人体皮肤标本,包括面部、颈部、胸部、上肢屈侧部位各4例,采用Er:YSGG2790nm激光照射聚焦于300μm直径光斑大小,能量为每光斑60～160mJ,扫描面积10mm×10mm,在离体皮肤上形成微阵列模式。通过HE染色观察损伤的深度和宽度,评估不同的脉冲能量对不同皮肤组织的治疗效果。结果 Er:YSGG2790nm激光可在离体人体皮肤上形成剥脱性热损伤微阵列,用不同能量可选择性到达皮肤的不同深度(99～456μm),包括表皮、真皮浅层、中层和深层,腔隙间距为294～405μm,腔隙焦化内壁厚度为22～77μm。结论新型剥脱性Er:YSGG2790nm激光以点阵方式操作,可在人体不同组织中产生热反应。使用不同的脉冲能量治疗,可以在表皮和真皮层形成不同深度的微阵列模式。
Objective To evaluate the ablative effects of a noval ablative erbium-doped yttrium scandium gallium garnet (Er:YSGG) 2790-nm laser treatment at different depths of the epidermis and dermis tissue.Methods Freshly isolated human skin specimens were obtained from surgically resected face,neck,chest,and upper limb flexor side tissues in 16 patients.The specimens were irradiated with Er:YSGG 2790-nm laser,with a focused spot diameter of 300 μm,an energy of 60-160 mJ,and a scanning area of 10 mm×10 mm.Microarray mode was established in the skin in vitro.The depth and width of the damage were assessed by HE staining.The therapeutic effectiveness of different pulse energies on different skin tissues were evaluated.Results After the irradiation of Er:YSGG 2790-nm laser,ablative fractional heat damage microarrays formed in the human skin in vitro.Different depths of skin (99-456 μm),including the epidermis,superficial dermis,and deep dermis,were selectively reached when the laser was applied at different pulse energies.The cavities were separated for 294-405 μm,and the inner coking walls of cavity ranged 22-77 μm.Conclusions The noval ablative Er:YSGG 2790-nm laser,when applied in fractional operations,can create thermal reaction in different body tissues.Treatment with different pulse energies,the microarray mode can be formed in the epidermis and dermis layers of different depths.

关键词(KeyWords)： 饵:钇钪镓石榴石;剥脱式点阵激光;微治疗区
erbium-doped yttrium scandium gallium garnet;ablative fractional laser;microscopic treatment zones

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 王宏伟;黄文慧;赵永亮;
WANG Hong-wei,HUANG Wen-hui,ZHAO Yong-liang Department of Dermatology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences & Peking Union Medical College,Beijing 100730,China

Email:

DOI:

参考文献(References)：

• [1]Hantash BM,Bedi VP,Kapadia B,et al.In vivo histologi-cal evaluation of a novel ablative fractional resurfacing device[J].Lasers Surg Med,2007,39:96-107.
• [2]Lapidoth M,YAGima Odo ME,Odo LM.Novel use of erbi-um:YAG(2,940-nm)laser for fractional ablative photo-thermolysis in the treatment of photodamaged facial skin:a pilot study[J].Dermatol Surg,2008,34:1048-1053.
• [3]Dierickx CC,Khatri KA,Tannous ZS,et al.Micro-fraction-al ablative skin resurfacing with two novel erbium laser sys-tems[J].Lasers Surg Med,2008,40:113-123.
• [4]Munavalli GS,Turley A,Silapunt S,et al.Combining con-fluent and fractionally ablative modalities of a novel2790nm YSGG laser for facial resurfacing[J].Lasers Surg Med,2011,43:273-282.
• [5]Metelitsa AI,Alster TS.Fractionated laser skin resurfacing treatment complications:A review[J].Dermatol Surg,2010,36:1-8.
• [6]Ross EV,Swann M,Soon S,et al.Full-face treatments with the2790-nm Erbium:YSGG laser system[J].J Drugs Dermatol,2009,8:248-252.
• [7]DiBernardo B.Assessment of the impact of high-fluence,high-overlap settings on full face treatments with the2,790nm Pearl YSGG laser[J].Laser Surg Med,2008,40(S20):91.
• [8]Campo-Voegeli A,Arboles MP.Multi-wavelength single treatment rejuvenation program[J].Laser Surg Med,2009,41(S21):599.
• [9]Perez M,Lupo M.Improvement after minimally ablative re-surfacing with the confluent2,790nm YSGG laser:A survey of44fee-for-service patients and their treating physicians[J].Laser Surg Med,2009,41(S21):603.
• [10]Yu C,Negishi K,Shek S,et al.A prospective multi-centerclinical study of photo rejuvenation in Asian skin using2,790nm infrared laser[J].Laser Surg Med,2009,41(S21):120.
• [11]Yoo KH,Kim BJ,Kim MN.Enhanced efficacy of photody-namic therapy with methyl5-aminolevulinic acid in recalci-trant periungual warts after ablative carbon dioxide fractional laser:a pilot study[J].Dermatol Surg,2009,35:1927-1932.
• [12]Hedelund L,Bjerring P,Egekvist H,et al.Ablative versus non-ablative treatment of perioral rhytides.A randomized controlled trial with long-term blinded clinical evaluations and non-invasive measurements[J].Lasers Surg Med,2006,38:129-136.
• [13]Tanzi EL,Alster TS.Single-pass carbon dioxide versus mul-tiple-pass Er:YAG laser skin resurfacing:a comparison of postoperative wound healing and side-effect rates[J].Der-matol Surg,2003,29:80-84.
• [14]Ross EV,Miller C,Meehan K,et al.One-pass CO2versus multiple-pass Er:YAG laser resurfacing in the treatment of rhytides:a comparison side-by-side study of pulsed CO2and Er:YAG lasers[J].Dermatol Surg,2001,27:709-715.