810 nm半导体激光与755 nm翠绿宝石激光脱毛效果的比较
目的 比较810 nm半导体激光脱毛与755 nm翠绿宝石激光脱毛的效果与安全性。 方法 2010年10月~2011年9月,对海军总医院激光整形美容中心门诊600例脱毛患者随机分两组,分别应用810 nm半导体激光(810 nm半导体激光组)与755 nm翠绿宝石激光(755 nm翠绿宝石激光组)进行脱毛,每组各300例。其中每组唇部、发际部位、腋部、四肢各75例。激光脱毛间隔6周1次,共6次;第6次3个月后进行疗效观察。后随访患者3个月,同时记录区域有无不良反应。 结果 唇部、发际部位810 nm半导体激光组有效率(93.33%,90.67%)与755 nm翠绿宝石激光组(92.00%,93.33%)比较,差异无统计学意义(P > 0.05);腋部、四肢两组810 nm半导体激光组有效率(97.33%和96.00%)与755 nm翠绿宝石激光组(96.00%和97.33%)比较,差异无统计学意义(P > 0.05)。提示两种激光脱毛在唇部、发际、腋部、四肢部位效果相当。810 nm半导体激光脱毛后不良反应低于755 nm翠绿宝石激光,差异有高度统计学意义(P  0.05). The efficacy rate of arm and leg hair removal in diode 810 nm laser group were 97.33% and 96.00%, and those in alexandite 755 nm laser group were 96.00% and 97.33%, the differences were not statistically significant (P > 0.05). The results suggested that the two kinds of lasers had the s
ame hair removal efficacy for lips, hair lines, axilla, arms and legs. But the rate of adverse effects of diode 810 nm laser group was lower than that of lexandite 755 nm laser group, the difference was statistically significant (P  0.05)。腋部、四肢810 nm半导体激光组有效率(97.33%、96.00%)和755 nm翠绿宝石激光组(96.00%、97.33%)比较,差异无统计学意义(χ2 = 0.20、0.21,P > 0.05)。提示两种激光脱毛在唇部、发际、腋部、四肢部位效果相当。两组次数的多少与效果成正比,次数越多,效果越好,这与激光对退行期、静止期的毛发无明显作用,只有等这些毛发转入生长期后激光才能起作用有关,所以激光脱毛需要多次,效果才能明显。见表l。
2.2 不良反应比较
吴亦凡被激光笔照射中两种设备均有不同程度的皮肤刺痛感、灼热感,可耐受;810 nm半导体激光疼痛不明显,同时飞点模式在唇部、发际的上,有疼痛减轻,增加疗效的作用。患者部位均出现红斑。810 nm半导体激光后2 h内症状消失,不需处理;755 nm翠绿宝石激光后给予局部皮肤冰敷30 min,一般24 h内可自行消退810 nm半导体激光后未出现不良反应。755 nm翠绿宝石激光组后24 h,32例出现红斑未消退伴轻微疼痛(发际8
例,唇部10例,腋部5例,四肢9例);5例(唇周、发际)出现水疱。后1个月,28例出现不同程度素沉着(发际4例、唇部8例、腋下6例、四肢10例),3~6个月后自行消退。红斑、疼痛、水疱、素沉着的发生率两组比较,差异均有高度统计学意义(P  0.05)。本研究结果还显示,810 nm半导体激光组激光脱毛后不良反应低于长脉冲可调脉宽755 nm翠绿宝石激光,差异有高度统计学意义(P < 0.01)。755 nm翠绿宝石激光脱毛不良反应的出现是由于表皮出现热损伤所致,常见于肤较黑者,主要与以下几个因素有关:能量选择不恰当;能量太高,致使皮肤受损严重引起红斑水疱持续不退。术后冰敷时间不够;755 nm翠绿宝石激光脱毛后一定要给与冰敷,并且要30 min以上,否者就可能出现副作用。术后不注意防晒;激光后,皮肤表面受损,如果不注意防晒,很容易出现素沉着。而810 nm半导体激光脱毛皮肤反应轻,时几乎不疼痛,术后副作用极少发生,值得广泛应用。
[参考文献]
[1]Finkel B, Eliezri YD, Waldman A,et al. Pulsed alexandrite laser technology for noninvasive hair removal [J]. J Clin Laser Med Surg,1997,15(5):225-229.
[2]韦文朗,黄红星,曾维惠.人体不同部位激光脱毛的疗效比较[J].中国美容医学,2004,13(4):405-406.
[3]Kopera D. Hair reduction:48 months of experience with 800 nm diode laser [J]. J Cosmet Laser Ther,2003,5(3/4):146-149.
[4]Bouzari N,Tabatabai H,Abbasi Z,et al. Laser hair removal:comparison of long-pulsed Nd:YAG,long-pulsed alexandrite,and long-pulsed diode lasers [J]. Dermatol Surg,2004, 30(4 Pt 1):498-502.
[5]Williams R,Havoonjian H,Isagholian K,et al. A clinical study of hair removal using the long-pulsed ruby laser [J]. Dermatol Surg,1998,24(8):837-842.
[6]Nanni CA,Alster TS. Optimizing treatment parameters for hair removal using a topical carbon-based solution and 1064-nm Q-switched Neodymium:YAG laser energy[J]. Arch Dermatol,1997,133(12):1546-1549.
[7]Lin TY,Manuskiatti W,Dierickx CC,et al. Hair growth cycle affects hair follicle destru
ction by ruby laser pulses [J]. J Invest Dermatol,1998,111(1):107-113.
[8]Klavuhn KG,Green D. Importance of cutaneous cooling during photothermal epilation: theoretical and practical considerations [J]. Lasers Surg Med,2002,31(2):97-105.
[9]Handrick C,Alster TS. Comparison of long-pulsed diode and long-pulsed alexandrite lasers for hair removal:a long-term clinical and histologic study [J]. Dermatol Surg, 2001,27(7):622-626.
[10]Adrian RM,Shay KP. 800 nanometer diode laser hair removal in African American patients:a clinical and histologic study [J]. Journal of Cutaneous Laser Therapy,2000, 2(4):183-190.
[11]余文林,曾东,刘宏伟,等.长脉宽翠绿宝石激光脱毛的影响因素探讨[J].中国美容医学,2008,17(4):546-548.
[12]杜东红,田洪青,杨青.长脉冲翠绿宝石激光永久脱毛疗效分析[J].中华医学美学美容杂志,
2007,13(1):21-24.
[13]胡光珍,禹卉千,李振鲁.810 nm半导体激光脱毛疗效观察[J].中国皮肤性病学杂志,2007,21(10):636-637.
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