皮肤病治疗中激光蚀除和选择性光热解的光热作用研究
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摘要
作为蚀除性和非蚀除性皮肤疾病激光治疗的理论基础,激光蚀除和选择性光热解(selective photothermolysis,SP)的光热作用研究是国内外激光医学研究领域的热点和难点问题。本文采用理论分析、数值模拟和离体、活体动物实验相结合的方法对CO2激光蚀除皮肤组织和SP的光热作用机理以及各种因素影响下的量效关系进行了探索性研究。
本文建立了CO2激光蚀除皮肤组织多层结构动态光热作用数理模型,并对蚀除过程中各层组织厚度、组织吸收的激光能量分布和温度场等主要物理量的时空演化规律,以及激光功率、环境参数等相关参数的影响规律进行了理论分析和数值模拟。对激光照射过程中组织吸收的激光能量分布、温度场和各层组织厚度(对应于组织物性参数)的相互耦合作用,以及激光照射停止后剩余热的影响进行了分析讨论。
本文建立了考虑组织热物性参数和血液灌注率动态变化及汽化潜热影响的三维SP光热作用数理模型,并对激光照射过程中和停止激光照射后组织中的温度场和热损伤分布的时空演化规律,以及黄色人种皮肤内血管参数、表皮冷却方式等相关参数的影响规律进行了理论分析和数值模拟。研究结果表明,与“选择性的激光能量分布”相比,用“选择性的温度分布”能更有利于揭示选择性光热解的作用机理,通过强化组织温度分布的选择性可优化SP治疗。本文还对考虑汽化温度和压力动态变化的SP光热作用数理模型进行了初步探讨。
本文对CO2激光蚀除离体猪皮组织时蚀除弹坑直径和深度与激光功率的量效关系、532 nm和1064 nm激光照射活体小鼠皮肤组织时热损伤厚度与激光能量密度的量效关系以及用578 nm激光对活体兔眼视网膜的热损伤阂值进行了实验研究,实验结果与数值结果符合较好。
本文研究成果有助于进一步深入认识对皮肤疾病进行激光治疗过程中的临床现象和规律,对提高治疗的安全性和有效性具有参考价值和指导意义。
Researches on the photo-thermal interactions of laser ablation and selective photothermolysis(SP),which are the bases of ablative and non-ablative laser treatments of skin diseases, are the focal topics in the field of laser surgery and medicine.The photo-thermal interactions of CO2 laser skin ablation and SP were comprehensively studied here using theoretical analysis method, numerical simulation method and experimental method.
A multi-zone, dynamic photo-thermal model of CO2 laser skin ablation was developed to simulate the temporal evolutions of the boundary positions of the zones, the deposited laser energy distribution, the temperature distribution and the thermal damage extent. The effects of laser power and environmental parameters, the interactions of the temperature field, the energy field and the dynamic changes in the optical and thermal properties as well as the blood perfusion rate during laser irradiation, and the effects of residual heat after laser irradiation were numerically analyzed based on the model.
A 3D photo-thermal model for SP was developed using a modified 3D Monte Carlo method to simulate the laser transport in the tissue, the 3D Pennes bioheat transfer equation with variable thermal properties and latent heat effects at the vaporization temperature to calculate the temperature distribution, and the Arrhenius equation to predict the thermal damage.Numerical simulations for the temporal evolutions of the temperature distribution and the thermal damage extent were performed. The effects of blood vessel parameters within the yellow-race patients and epidermal cooling methods on the clinical outcomes of SP were analyzed.It was concluded that the term of "selective temperature distribution" provides a more comprehensive description of the mechanisms of SP than the term of "selective light distribution".According to this opinion, the feasibility and methods of improving the therapeutic outcomes of SP by increasing the selectivity of the temperature distribution were researched. Furthermore, a novel photo-thermal model of SP with dynamic changing vaporization temperature was proposed and discussed preliminarily.
Experimental measurements for the dose-effect relationship of laser power and the diameter/depth of the ablation crater of ex vivo pigskin irradiated with CO2 laser, for the dose-effect relationship of laser energy and the thermal damage width of in vivo skin of white mice irradiated with 532 nm and 1064 nm laser, and for the threshold energy density of thermal damage of in vivo rabbits retina with 578 nm laser were performed. The experimental results were in agreement with the results obtained with the models proposed in chapters 2 and 3.
The achievements of this project supplied scientific basis for therapy parameters selection, accurate control and effects improvement of laser treatments of skin diseases in clinical practice.
本文建立了CO2激光蚀除皮肤组织多层结构动态光热作用数理模型,并对蚀除过程中各层组织厚度、组织吸收的激光能量分布和温度场等主要物理量的时空演化规律,以及激光功率、环境参数等相关参数的影响规律进行了理论分析和数值模拟。对激光照射过程中组织吸收的激光能量分布、温度场和各层组织厚度(对应于组织物性参数)的相互耦合作用,以及激光照射停止后剩余热的影响进行了分析讨论。
本文建立了考虑组织热物性参数和血液灌注率动态变化及汽化潜热影响的三维SP光热作用数理模型,并对激光照射过程中和停止激光照射后组织中的温度场和热损伤分布的时空演化规律,以及黄色人种皮肤内血管参数、表皮冷却方式等相关参数的影响规律进行了理论分析和数值模拟。研究结果表明,与“选择性的激光能量分布”相比,用“选择性的温度分布”能更有利于揭示选择性光热解的作用机理,通过强化组织温度分布的选择性可优化SP治疗。本文还对考虑汽化温度和压力动态变化的SP光热作用数理模型进行了初步探讨。
本文对CO2激光蚀除离体猪皮组织时蚀除弹坑直径和深度与激光功率的量效关系、532 nm和1064 nm激光照射活体小鼠皮肤组织时热损伤厚度与激光能量密度的量效关系以及用578 nm激光对活体兔眼视网膜的热损伤阂值进行了实验研究,实验结果与数值结果符合较好。
本文研究成果有助于进一步深入认识对皮肤疾病进行激光治疗过程中的临床现象和规律,对提高治疗的安全性和有效性具有参考价值和指导意义。
Researches on the photo-thermal interactions of laser ablation and selective photothermolysis(SP),which are the bases of ablative and non-ablative laser treatments of skin diseases, are the focal topics in the field of laser surgery and medicine.The photo-thermal interactions of CO2 laser skin ablation and SP were comprehensively studied here using theoretical analysis method, numerical simulation method and experimental method.
A multi-zone, dynamic photo-thermal model of CO2 laser skin ablation was developed to simulate the temporal evolutions of the boundary positions of the zones, the deposited laser energy distribution, the temperature distribution and the thermal damage extent. The effects of laser power and environmental parameters, the interactions of the temperature field, the energy field and the dynamic changes in the optical and thermal properties as well as the blood perfusion rate during laser irradiation, and the effects of residual heat after laser irradiation were numerically analyzed based on the model.
A 3D photo-thermal model for SP was developed using a modified 3D Monte Carlo method to simulate the laser transport in the tissue, the 3D Pennes bioheat transfer equation with variable thermal properties and latent heat effects at the vaporization temperature to calculate the temperature distribution, and the Arrhenius equation to predict the thermal damage.Numerical simulations for the temporal evolutions of the temperature distribution and the thermal damage extent were performed. The effects of blood vessel parameters within the yellow-race patients and epidermal cooling methods on the clinical outcomes of SP were analyzed.It was concluded that the term of "selective temperature distribution" provides a more comprehensive description of the mechanisms of SP than the term of "selective light distribution".According to this opinion, the feasibility and methods of improving the therapeutic outcomes of SP by increasing the selectivity of the temperature distribution were researched. Furthermore, a novel photo-thermal model of SP with dynamic changing vaporization temperature was proposed and discussed preliminarily.
Experimental measurements for the dose-effect relationship of laser power and the diameter/depth of the ablation crater of ex vivo pigskin irradiated with CO2 laser, for the dose-effect relationship of laser energy and the thermal damage width of in vivo skin of white mice irradiated with 532 nm and 1064 nm laser, and for the threshold energy density of thermal damage of in vivo rabbits retina with 578 nm laser were performed. The experimental results were in agreement with the results obtained with the models proposed in chapters 2 and 3.
The achievements of this project supplied scientific basis for therapy parameters selection, accurate control and effects improvement of laser treatments of skin diseases in clinical practice.
引文
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