Prospective study of pulsed dye laser in conjunction with cryogen spray cooling for treatment of port wine stains in Chinese patients
Prospective study of pulsed dye laser in conjunction with cryogen spray cooling for treatment of port wine stains in Chinese patients
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DOI：
10.1046/j.1524-4725.2003.29255.x
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发表时间：
2003-09-01
影响因子：
2.4
通讯作者：
Nelson, JS
中科院分区：
文献类型：
--
作者：
Chiu, CH;Chan, HHL;Nelson, JS
背景脉冲染料激光（PDL）联合冷冻剂喷雾冷却（CSC）治疗白人鲜红斑痣（PWSs）可有效提高疗效和安全性。然而，对于深肤色患者（如中国人），仅进行了回顾性研究。前瞻性比较PDL单用和PDL-CSC治疗中国PWSs患者的发白和急性及长期不良反应的临床疗效。招募了35名中国患者（13名男性和22名女性），进行了131次治疗。PWS上的一半测试区域仅用PDL处理，对侧一半用PDL-CSC处理。用分光光度计客观评价PWS的漂白程度。用皮肤硬度计检测皮肤质地变化。所有测量均在基线和每次后续激光治疗前进行。患者在治疗后立即接受采访，并在接下来的一周再次使用视觉模拟量表问卷评估疼痛和肿胀的程度。在每次随访访视期间观察到水疱的发生。在三次治疗后，对患者的长期不良反应（如色素沉着和瘢痕形成）进行了评估。PDL-CSC治疗组使用了统计学显著更高的通量。使用PDL-CSC时，分光光度计a* 值的百分比变化显著更大，表明处理后PWS变白更多。三次单独使用PDL或PDL-CSC治疗后，皮肤纹理变化的发生率无显著差异。PDL单药治疗的即刻疼痛评分显著高于PDL-CSC。与PDL-CSC相比，单独使用PDL治疗的部位的水疱明显更常见。PDL单独治疗和PDL-CSC治疗之间长期不良反应的总体发生率无显著差异。PDL-CSC也是大多数患者的首选治疗方式。PDL-CSC对中国患者PWS的漂白比单独PDL更有效。此外，PDL-CSC的耐受性更好，导致急性不良反应（如水疱）的发生率更低。
BACKGROUND. Pulsed dye laser (PDL) in conjunction with cryogen spray cooling (CSC) is effective in improving efficacy and safety for treatment of port wine stains (PWSs) in whites. However, for dark-skinned patients such as Chinese, only retrospective studies have been performed.OBJECTIVES. To compare prospectively clinical efficacy in terms of blanching and acute and long-term adverse effects of PDL alone and PDL-CSC for treatment of PWSs in Chinese patients.METHODS. Thirty-five Chinese patients ( 13 males and 22 females) were recruited, and 131 treatments were performed. Half of the test area on the PWS was treated with PDL alone, and the contralateral half was treated with PDL-CSC. The degree of PWS blanching was objectively assessed by spectrophotometer. Skin textural changes were detected by cutometer. All measurements were taken at baseline and before each subsequent laser treatment. Patients were interviewed immediately after treatment and again the following week using a visual analog scale questionnaire to assess the degree of pain and swelling. Occurrence of blisters was noted during each follow-up visit. Patients were evaluated for evidence of long-term adverse effects such as dyspigmentation and scarring after three treatments.RESULTS. Statistically significant higher fluences were used on the PDL-CSC-treated group. The percentage change in the spectrophotometer a* value was significantly greater using PDL-CSC, indicating that there was more PWS blanching after treatment. There was no significant difference in the incidence of skin textural changes after three treatments with PDL alone or PDL-CSC. The immediate pain scores were significantly higher for PDL alone than with PDL-CSC. Blisters were significantly more common on the area treated using PDL alone than PDL-CSC. The overall incidence of long-term adverse effects was not significantly different between the PDL alone and PDL-CSC treatments. PDL-CSC was also the preferred treatment modality for most patients.CONCLUSIONS. PDL-CSC was more effective than PDL alone for blanching of PWS in Chinese patients. Moreover, PDL-CSC was better tolerated and resulted in a lower incidence of acute adverse effects such as blistering.