Expert consensus on the clinical application of narrow-band intense pulsed light (2024 edition)
-
摘要: 医疗美容技术的不断创新，推动了医疗美容行业的快速发展。窄谱强脉冲光，是在传统强脉冲光的基础上发展而来的，其在临床应用方面具有更精准、更高效、更安全的特性。为了促使窄谱强脉冲光在临床应用的更专业化和规范化，由整复外科、皮肤科等领域的临床专家组成的编写组基于目前的循证医学证据、临床实践和其他相关学科权威指南制订了该共识。该共识探讨了窄谱强脉冲光临床应用的适应证、治疗参数、禁忌证及注意事项等，供从事整形美容相关工作的临床医师、护理人员及相关教学、科研人员参考。Abstract: The continuous innovation of medical cosmetology technology promotes the rapid development of aesthetic medicine. Narrow-band intense pulsed light (NB-IPL), which is developed based on conventional intense pulsed light, is a more accurate, efficient, and safer technique on clinical application. In order to promote more professionalization and standardization of the clinical application of NB-IPL, a panel of clinical experts in plastic surgery, dermatology and other fields developed the consensus based on the evidence-based medicine, clinical practice, and authoritative guidelines of other disciplines. The consensus panel discussed the indications, treatment parameters, contraindications, and precautions for the clinical application of NB-IPL and would serve as a reference for clinicians, nurses, teaching and research personnels engaged in plastic and cosmetics related work.
-
参考文献
(50) [1] SalesA, PandolfoIL, de Almeida CruzM, et al. Intense Pulsed Light on skin rejuvenation: a systematic review[J]. Arch Dermatol Res, 2022,314(9):823-838. DOI: 10.1007/s00403-021-02283-2. [2] 中国医师协会皮肤科医师分会皮肤激光与理疗亚专业委员会. 强脉冲光临床应用专家共识(2017)[J].中华皮肤科杂志,2017,50(10):701-705. DOI: 10.3760/cma.j.issn.0412-4030.2017.10.001. [3] 杨翠霞, 侯文婕, 杨帅, 等. 窄谱强脉冲光治疗面部毛细血管扩张症疗效评价[J].中国美容医学,2014,23(9):745-747. [4] 王岚, 迟国庆, 李承新, 等. 短波理疗仪联合精准强脉冲光修复面部敏感性皮肤的疗效观察[J].实用皮肤病学杂志,2019,12(2):71-74. DOI: 10.11786/sypfbxzz.1674-1293.20190203. [5] 蒋亚楠, 赵德梅, 高宇, 等. 窄谱强脉冲光治疗早期颜面部创伤性瘢痕的疗效评价[J].中国美容医学,2021,30(5):35-37. [6] 张亚茹.窄谱强脉冲光超光子滑动模式在面部浅表色素性疾病治疗中的临床应用[J].中国激光医学杂志,2021,30(1):39. [7] 张嘉文, 刘子菁, 王小燕, 等. 玫瑰痤疮的光电治疗研究进展[J].中国美容医学,2019,28(5):159-162. [8] MoyWJ, YakelJD, OsorioOC, et al. Targeted narrowband intense pulsed light on cutaneous vasculature[J]. Lasers Surg Med, 2015,47(8):651-657. DOI: 10.1002/lsm.22393. [9] KnightJM. Combined 400-600nm and 800-1200nm intense pulsed phototherapy of facial acne vulgaris[J]. J Drugs Dermatol, 2019,18(11):1116-1122. [10] LeeY, JangJH, NamS, et al. Investigation of prognostic factors for intense pulsed light treatment with a vascular filter in patients with moderate or severe meibomian gland dysfunction[J]. J Clin Med, 2022,11(16):4724. DOI: 10.3390/jcm11164724. [11] SeagoM, ShumakerPR, SpringLK, et al. Laser treatment of traumatic scars and contractures: 2020 international consensus recommendations[J]. Lasers Surg Med, 2020, 52(2):96-116. DOI: 10.1002/lsm.23201. [12] BitterP.Intense pulsed light: where we are now?[J].Dermatological Reviews, 2021, 2:60-68.DOI: 10.1002/der2.63. [13] RaulinC, HellwigS, SchönermarkMP. Treatment of a nonresponding port-wine stain with a new pulsed light source (PhotoDerm VL)[J]. Lasers Surg Med, 1997,21(2):203-208. DOI: 10.1002/(sici)1096-9101(1997)21:2<203::aid-lsm13>3.0.co;2-f. [14] FodorL, RamonY, FodorA, et al. A side-by-side prospective study of intense pulsed light and Nd:YAG laser treatment for vascular lesions[J]. Ann Plast Surg, 2006,56(2):164-170. DOI: 10.1097/01.sap.0000196579.14954.d6. [15] TanghettiEA. Split-face randomized treatment of facial telangiectasia comparing pulsed dye laser and an intense pulsed light handpiece[J]. Lasers Surg Med, 2012,44(2):97-102. DOI: 10.1002/lsm.21151. [16] PetersonJD, FriedmannDP, AbdoK, et al. Efficacy and safety of intense pulsed light with a KTP/PDLlike filter for the treatment of facial telangiectasias[J]. J Drugs Dermatol, 2020,19(9):844-850. DOI: 10.36849/JDD.2020.10.36849/JDD.2020.4834. [17] GardenBC, GardenJM, GoldbergDJ. Light-based devices in the treatment of cutaneous vascular lesions: an updated review[J]. J Cosmet Dermatol, 2017,16(3):296-302. DOI: 10.1111/jocd.12370. [18] BennardoL, PatrunoC, ZappiaE, et al. Combination of specific vascular lasers and vascular intense pulsed light improves facial telangiectasias and redness[J]. Medicina (Kaunas), 2022, 58(5):651.DOI: 10.3390/medicina58050651. [19] GanH, YueB, WangY, et al. Treatment of facial telangiectasia with narrow-band intense pulsed light in Chinese patients[J]. J Cosmet Laser Ther, 2018,20(7/8):442-446. DOI: 10.1080/14764172.2018.1427871. [20] 段鳕芸, 周舟, 刘太华, 等. 宽谱与窄谱强脉冲光治疗红斑毛细血管扩张型玫瑰痤疮疗效比较[J].中国美容医学,2021,30(12):75-78. [21] ZhaoL, YouC, ChenH, et al. Retrospective study of factors affecting efficacy of therapy with dye pulsed light for erythematotelangiectatic rosacea[J]. Dermatol Ther (Heidelb), 2020,10(6):1273-1283. DOI: 10.1007/s13555-020-00440-5. [22] 贾婕, 张荣, 鲁东平, 等. 精准脉冲光联合长脉冲1064 nm Nd:YAG激光治疗玫瑰痤疮的疗效观察[J].中国皮肤性病学杂志,2021,35(12):1359-1364. DOI: 10.13735/j.cjdv.1001-7089.202106057. [23] FuX, DongJ, WangS, et al. Advances in the treatment of traumatic scars with laser, intense pulsed light, radiofrequency, and ultrasound[J/OL]. Burns Trauma, 2019,7:1[2023-09-18]. https://pubmed.ncbi.nlm.nih.gov/30723753/. DOI: 10.1186/s41038-018-0141-0. [24] KligmanDE, ZhenY. Intense pulsed light treatment of photoaged facial skin[J]. Dermatol Surg, 2004,30(8):1085-1090. DOI: 10.1111/j.1524-4725.2004.30332.x. [25] DiBernardoBE, PoznerJN. Intense pulsed light therapy for skin rejuvenation[J]. Clin Plast Surg, 2016,43(3):535-540. DOI: 10.1016/j.cps.2016.03.008. [26] ChanCS, SaediN, MickleC, et al. Combined treatment for facial rejuvenation using an optimized pulsed light source followed by a fractional non-ablative laser[J]. Lasers Surg Med, 2013,45(7):405-409. DOI: 10.1002/lsm.22162. [27] VarugheseN, KellerL, GoldbergDJ. Split-face comparison between single-band and dual-band pulsed light technology for treatment of photodamage[J]. J Cosmet Laser Ther, 2016,18(4):213-216. DOI: 10.1080/14764172.2016.1177188. [28] 潘永正. 激光与强脉冲光对皮肤光老化作用机制研究进展[J].中国美容医学,2013,22(1):220-222. DOI: 10.3969/j.issn.1008-6455.2013.01.090. [29] 雷德军, 丁欣强, 朱自荣. 窄谱强脉冲光联合调Q激光治疗痤疮后红斑、色素沉着的临床效果及对患者生活质量的影响[J].陕西医学杂志,2018,47(7):839-842. DOI: 10.3969/j.issn.1000-7377.2018.07.007. [30] 秦高平, 孙要文, 韩峰, 等. 中药涂擦联合窄谱强脉冲光治疗烧伤后皮肤色素异常临床疗效分析[J].中国美容医学,2021,30(9):129-131. [31] 向芳, 张祥月, 丁媛, 等. DPL联合果酸治疗面颈部毛囊性红斑黑变病疗效观察[J].中国皮肤性病学杂志,2021,35(6):4. DOI: 10.13735/j.cjdv.1001-7089.202007193. [32] 田怡, 张文红, 金岚. Starlux晶钻光LuxG对面部雀斑的临床疗效分析[J].激光杂志,2012,33(4):53-54. DOI: 10.3969/j.issn.0253-2743.2012.04.025. [33] 莫金雪, 方锐华, 罗佩瑜, 等. DPL精准光治疗雀斑疗效分析[J].皮肤性病诊疗学杂志,2020,27(2):104-107. DOI: 10.3969/j.issn.1674-8468.2020.02.009. [34] KligmanDE, ZhenY. Intense pulsed light treatment of photoaged facial skin[J]. Dermatol Surg, 2004,30(8):1085-1090. DOI: 10.1111/j.1524-4725.2004.30332.x. [35] ButlerEG2nd, McClellanSD, RossEV. Split treatment of photodamaged skin with KTP 532 nm laser with 10 mm handpiece versus IPL: a cheek-to-cheek comparison[J]. Lasers Surg Med, 2006,38(2):124-128. DOI: 10.1002/lsm.20222. [36] VarugheseN, KellerL, GoldbergDJ. Split-face comparison between single-band and dual-band pulsed light technology for treatment of photodamage[J]. J Cosmet Laser Ther, 2016,18(4):213-216. DOI: 10.1080/14764172.2016.1177188. [37] KimJ, LeeJ, ChoiH. Intense pulsed light attenuates UV-induced hyperimmune response and pigmentation in human skin cells[J]. Int J Mol Sci, 2021, 22(6):3173. DOI: 10.3390/ijms22063173. [38] BraunM. Intense pulsed light versus advanced fluorescent technology pulsed light for photodamaged skin: a split-face pilot comparison[J]. J Drugs Dermatol, 2007,6(10):1024-1028. [39] 李牧桑, 祁薇, 周沁, 等. AOPT强脉冲光在轻度面部皮肤松弛中的应用[J].中国医疗美容,2022,12(1):40-44. DOI: 10.19593/j.issn.2095-0721.2022.01.011. [40] 陈媛, 刘建, 李孝建. DPL在防治儿童烧伤后早期增生性瘢痕中应用的研究进展[J].组织工程与重建外科杂志,2021,17(6):497-502. DOI: 10.3969/j.issn.1673-0364.2021.06.010. [41] 王棽, 金锐, 米晶, 等. 窄谱强脉冲光治疗烧伤瘢痕的疗效评价[J].组织工程与重建外科杂志,2015,11(3):196-198. DOI: 10.3969/j.issn.1673-0364.2015.03.022. [42] 刘勇, 孙苗, 杜迎, 等. 超光子强脉冲光400~600nm联合800~1200nm治疗痤疮的疗效观察[J].中国现代药物应用,2022,16(8):41-43. DOI: 10.14164/j.cnki.cn11-5581/r.2022.08.014. [43] ChenS, WangY, RenJ, et al. Efficacy and safety of intense pulsed light in the treatment of inflammatory acne vulgaris with a novel filter[J]. J Cosmet Laser Ther, 2019,21(6):323-327. DOI: 10.1080/14764172.2019.1605450. [44] GaoL, QuH, GaoN, et al. A retrospective analysis for facial telangiectasia treatment using pulsed dye laser and intense pulsed light configured with different wavelength bands[J]. J Cosmet Dermatol, 2020,19(1):88-92. DOI: 10.1111/jocd.13179. [45] 缪嘉颖 窄谱强脉冲光联合二氧化碳点阵激光改善增生性瘢痕颜色的临床评估 上海 上海交通大学 2019 DOI: 10.27307/d.cnki.gsjtu.2019.000261 缪嘉颖. 窄谱强脉冲光联合二氧化碳点阵激光改善增生性瘢痕颜色的临床评估[D].上海:上海交通大学, 2019. DOI: 10.27307/d.cnki.gsjtu.2019.000261.
[46] AdamičM, PavlovićMD, Troilius RubinA, et al. Guidelines of care for vascular lasers and intense pulse light sources from the European Society for Laser Dermatology[J]. J Eur Acad Dermatol Venereol, 2015,29(9):1661-1678. DOI: 10.1111/jdv.13177. [47] ZelicksonZ, SchramS, ZelicksonB. Complications in cosmetic laser surgery: a review of 494 Food and Drug Administration Manufacturer and User Facility Device Experience Reports[J]. Dermatol Surg, 2014,40(4):378-382. DOI: 10.1111/dsu.12461. [48] WannerM, SakamotoFH, AvramMM, et al. Immediate skin responses to laser and light treatments: therapeutic endpoints: how to obtain efficacy[J]. J Am Acad Dermatol, 2016,74(5):821-833; quiz 834, 833. DOI: 10.1016/j.jaad.2015.06.026. [49] SuQ, WangF, ChaiY, et al. A prospective study on the treatment of immediate post-operative scar with narrowband intense pulsed light under polarized dermoscopy[J]. J Cosmet Laser Ther, 2021,23(5/6):137-141. DOI: 10.1080/14764172.2021.2016844. [50] WatH, WuDC, RaoJ, et al. Application of intense pulsed light in the treatment of dermatologic disease: a systematic review[J]. Dermatol Surg, 2014,40(4):359-377. DOI: 10.1111/dsu.12424. -
表1 2011版牛津循证医学证据等级标准和本专家共识推荐强度标准
表1. The 2011 Oxford Centre for Evidence-Based Medicine Levels of Evidence and the grade of recommendations in this expert consensus
项目与类别 具体描述 证据级别 1级 基于随机对照试验或单人交叉临床试验的系统性文献回顾，对随机性研究的系统综述 2级 随机对照试验或效果显著的观察性研究 3级 非随机性、对照性队列研究或随访研究 4级 病例系列、病例对照研究或历史对照研究 5级 基于机制的推论 推荐强度 强 意见为“强烈同意”的专家人数比例过半 中 意见为“强烈同意”的专家人数比例未过半，但“强烈同意”+“同意”的专家人数比例过半 弱 意见为“强烈同意”+“同意”的专家人数比例未过半 
下载: 导出CSV
-
图(1) / 表(1)
计量
- 文章访问数: 1230
- HTML全文浏览量: 137
- PDF下载量: 279
- 被引次数: 0
