激光与强脉冲光基础李建钢_培训课件.ppt

* * In lasers, often the permissible energy is restricted in small tips, as the energy density increases in small areas. In IPL, the same fluence used with a smaller light guide may be less painful, as total energy delivered is smaller in small areas. * Selectivity is achieved by different temperatures in the epidermis (below 60oC) and in the target (above 80oC). With each pulse, the epidermis which contains less pigment than the lesion, will heat up moderately and will cool down to normal body temperature during the delay. At the same time, the lesion, which has a higher pigment concentration, will heat up more, will cool down only partially during the delay, and will build up heat with each additional pulse. Each target is destroyed at different temperatures. Hemoglobin is destroyed at 120degrees. Melanin needs higher temperatures than 120 because we need to mechanically break down the particles into smaller bits. However, we tend to say that over 80 degrees and between 80 and 150 degrees is required for effective photothermolysis. 光子嫩肤 I型光子嫩肤 II 型光子嫩肤 适应症 良性血管病变，包括： 毛细血管扩张Telangiectasias 红斑痤疮Symptoms of Rosacea 红脸Flushing 皮肤色素改变Dyschromia 激光磨削后红斑 阳光性色素斑Pigmentary sun damage 色素斑Mottled pigmentation 色素沉着Hyperpigmentation 光老化Photoaging 痣Lentigines 表皮及真皮结构改变 皱纹Rhytides 皮肤弹性改变Elastotic changes 胶原和结缔组织改变 毛孔粗大Large pores 通过光热效应刺激真皮胶原纤维增生和重新分布，以改善皮肤弹性和瘢痕，并消除使皮肤表面的色斑，毛细血管扩张等。 光子嫩肤的目的： 光热效应 强脉冲光能转化为热量，影响皮肤表面深部的胶原纤维和弹力纤维，使之重新排列，并恢复弹性，从而达到消除皱纹，缩小毛孔的治疗效果 Energy Penetration of Commonly Used Cutaneous Lasers IPL的灵活性:不同穿透深度 IPL的灵活性:不同穿透深度 通过光斑改变 IPL的灵活性:不同穿透深度 通过能量改变 IPL的有效性:作用于多个吸收峰 波长 (Microns) 1.0 0.2 10 20 100,000 10,000 1,000 100 10 1.0 0.1 0.01 0.001 0.0001 Water Melanin Hemoglobin Oxyhemoglobin 吸收系数 (per centimeter) CO2 Er:YAG 3.0 脉冲发射时, 光的能量被传出 脉冲延迟时, 组织冷却下来 更多的能量可被安全地传导到靶组织中 IPL的有效性:多同步脉冲 Pulse 1 Pulse 2 Pulse 3 Delay 1 Delay 2 IPL的有效性:多同步脉冲 Pulse duration Pulse duration Pulse duration Pulse delay