CN100591298C - 利用光能的图案治疗皮肤的方法和设备 - Google Patents

利用光能的图案治疗皮肤的方法和设备 Download PDF

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CN100591298C
CN100591298C CN200380103604A CN200380103604A CN100591298C CN 100591298 C CN100591298 C CN 100591298C CN 200380103604 A CN200380103604 A CN 200380103604A CN 200380103604 A CN200380103604 A CN 200380103604A CN 100591298 C CN100591298 C CN 100591298C
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puva
skin
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CN1728970A (zh
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林·迪本尼蒂克锑斯
乔治·沃沃德金
迈克尔·布雷克
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/44Detecting, measuring or recording for evaluating the integumentary system, e.g. skin, hair or nails
    • A61B5/441Skin evaluation, e.g. for skin disorder diagnosis
    • A61B5/444Evaluating skin marks, e.g. mole, nevi, tumour, scar
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/20Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/20Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
    • A61B18/203Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser applying laser energy to the outside of the body
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/0059Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017Electrical control of surgical instruments
    • A61B2017/00022Sensing or detecting at the treatment site
    • A61B2017/00057Light
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00315Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00452Skin
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/20Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
    • A61B2018/2035Beam shaping or redirecting; Optical components therefor
    • A61B2018/20351Scanning mechanisms
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/20Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
    • A61B2018/2035Beam shaping or redirecting; Optical components therefor
    • A61B2018/205545Arrangements for particular spot shape, e.g. square or annular
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/20Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
    • A61B2018/2065Multiwave; Wavelength mixing, e.g. using four or more wavelengths
    • A61B2018/2075Multiwave; Wavelength mixing, e.g. using four or more wavelengths mixing three wavelengths
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/20Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
    • A61B2018/208Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser with multiple treatment beams not sharing a common path, e.g. non-axial or parallel

Abstract

皮肤设备包括多个光源和光路连接。每个光源能够通过其连接的光路把光束传递到人体皮肤的目标部分。皮肤设备还包括选择并控制所述光源以不连续图案传送多个光束的控制系统,和把所述传送的光束的能量聚焦到位于所述目标部分的外表面以下达1.5毫米的多个离散治疗区的聚焦部件。所述离散治疗区的尺寸为10微米~1000微米。

Description

利用光能的图案治疗皮肤的方法和设备
技术领域
本发明一般涉及利用光能的生物组织的治疗。更具体地说,本发明涉及利用光能的图案治疗皮肤的方法和设备。
背景技术
对于皮肤和其它生物组织的治疗来说,光能具有许多有用的用途。例如,激光已被用于治疗皮肤状况,例如血管瘤,鲜红斑痣,红斑痤疮,表皮色素沉积病变,和细纹。
目前的皮肤激光方法和设备一般在治疗期间,照射皮肤的较大的连续区域。但是,这种大面积的治疗会对皮肤造成过度的外损,以及导致并发症,例如色素减退或白斑的产生。此外,目前的治疗较大区域的范例会妨碍皮肤的正常恢复过程,以及营养物流向被治疗区,这不仅会使愈合变慢,还会导致坏死和结疤。目前的一些方法和设备已试图通过引入复杂的冷却系统来冷却皮肤,企图减少在皮肤表面的导致损伤皮肤表皮层的过多热量形成,来克服这些负面影响。但是,这种冷却系统增大了实现的复杂性,通常要求激光功率被增大,另外不能提供所需的或者均匀的冷却,以及皮肤损伤的减少。冷却不均匀性和激光功率增大的组合会使皮肤受到更大的损伤风险。并且,目前的方法所规定的调整激光传递的流量(fluence)通常提供并不充分的控制,常常导致治疗过度或治疗不足。治疗过度会导致结疤,治疗不足会导致被治疗的皮肤状况改进不大。由于治疗后数周到数月变化可能不明显,存在与治疗过度或治疗不足相关的重大临床问题。
正是基于该背景,需要开发这里描述的方法和设备。
发明内容
在一个方面,本发明的目的在于一种皮肤设备。在一个实施例中,皮肤设备可包括多个光源和光路连接。所述多个光源和光路连接中的每个光源能够通过其连接的光路把光束传递到人体皮肤的目标部分。皮肤设备还包括选择并控制光源以不连续的图案传送多个光束的控制系统,和把传送的光束的能量聚焦到位于目标部分的外表面以下达1.5毫米的多个离散治疗区的聚焦部件。离散的治疗区的尺寸为10微米~1000微米。
在另一实施例中,皮肤设备可包括多个光源和光路连接。所述多个光源和光路连接中的每个光源能够通过其连接的光路把光束传递到人体皮肤的外部部分。该皮肤设备还包括选择并控制光源以不连续的图案传送多个光束的控制系统,和把传送的光束的能量聚焦到位于外部部分,从而形成分布在外部部分内上的多个离散孔穴的聚焦部件。离散孔穴的尺寸为10微米~1000微米。
在另一实施例,皮肤设备可包括光学传递系统。光学传递系统可包括一个光源和与所述光源光学耦接的一个聚焦部件。光源被配置成提供波长为400~20000纳米的光能,聚焦部件被配置成以不连续的图案把光能引向皮肤的目标部分。
在另一实施例,皮肤设备可包括光学传递系统。光学传递系统可包括一个光源和与所述光源光学耦接的一个聚焦部件。聚焦部件被配置成把光能从光源引向皮肤的目标部分。聚焦部件可包括数值孔径为0.15~1.5的光学透镜,光学透镜被配置成把光能聚焦到目标部分的真皮层。
在另一实施例,皮肤设备可包括外壳,所述外壳的尺寸便于人手操作,位于外壳内的光源,和与外壳耦接的聚焦部件。光源被配置成提供光能,聚焦部件被配置成把光能引向皮肤的目标部分,使得目标部分内的多个治疗区被暴露在光能下。在目标部分内,治疗区相互分隔开。
在另一实施例,皮肤设备可包括光学传递系统。光学传递系统被配置成以某一图案把光能引向皮肤的目标部分,使得目标部分内的多个离散治疗区被暴露在光能下。离散治疗区的尺寸为10微米~1000微米。
在另一方面,本发明的目的在于一种治疗人体皮肤的方法。在一个实施例中,该方法可包括提供光能。所述光能具有为人体皮肤的目标部分产生皮肤(dermatological)效果的光学参数。该方法还可包括把光能引向目标部分,使得目标部分内的多个离散治疗区基本上同时暴露在光能之下。
在另一实施例中,该方法还包括提供光能,并把光能引向人体皮肤的外部部分,从而形成分布在外部部分内上的离散孔穴。所述离散孔穴的尺寸为10~1000微米。
附图说明
结合附图,根据下面的详细说明,将理解本发明的目的和优点,其中:
图1图解说明根据本发明的一个实施例的皮肤设备的方框图;
图2图解说明可被射向人体皮肤的目标部分的光能的图案的一个例子;
图3图解说明可被射向人体皮肤的目标部分的光能的图案的另一例子;
图4图解说明可被射向人体皮肤的目标部分的光能的图案的又一例子;
图5图解说明根据本发明的另一实施例的皮肤设备的方框图;
图6图解说明根据本发明的一个实施例的光学传递系统;
图7图解说明根据本发明的另一实施例的光学传递系统。
具体实施方式
本发明的实施例提供可被用于功效更大地治疗皮肤,同时减少并发症和康复时间的改进的皮肤设备(dermatological apparatus)和方法。特别地,本发明的实施例可被用于治疗各种皮肤状况,例如(但不限于)痤疮,胎记,毛发过多,血管瘤,黄褐斑,色素病变,红斑痤疮,疤痕,纹身,血管病,皱纹等。尽管上面给出了皮肤状况的具体例子,但是本发明的实施例事实上可被用于治疗任意类型的皮肤状况(condition)。
图1图解说明根据本发明的一个实施例的皮肤设备100。皮肤设备100包括光学传递系统102,光学传递系统102包括光源104。光源104提供可被射向皮肤,例如人体皮肤的目标部分108的光能。在本实施例中,光源104以一个或多个光束的形式提供光能,所述光束可以是相干或不相干的脉冲波或连续波。
在本实施例中,光源104可至少部分利用一个或多个光源,例如激光源来实现。对于某些应用,光源104最好包括多个激光源,所述多个激光源可被排列成阵列,例如一维阵列或二维阵列。激光源可提供具有特定光学参数,例如光学流量,功率,计时,脉冲持续时间,脉冲间持续时间,波长等等的一个或多个光束,从而产生想得到的关于目标部分108的皮肤效果。例如,激光源能够提供具有介于大约400纳米-20000纳米之间,例如介于大约600纳米-4000纳米之间的波长或波长范围的光束。对于目标部分108的真皮层112的非烧蚀凝结,激光源能够提供具有约为1500纳米波长和入射在皮肤外表面上的介于约0.001焦耳/平方厘米和10000焦耳/平方厘米,例如介于约0.1焦耳/平方厘米和100焦耳/平方厘米之间的光学流量的光束。对于某些应用,光束的脉冲持续时间可以大约等于或小于与目标部分108相关的热扩散时间常数,所述常数近似正比于目标部分108内的焦斑的尺寸的平方。大于热扩散时间常数的脉冲持续时间效率不那么高,由于热扩散导致焦斑不合乎需要地增大。
激光源的例子包括(但不限于)二极管激光器,二极管泵浦固体激光器,Er:YAG激光器,Nd:YAG激光器,氩离子激光器,He-Ne激光器,二氧化碳激光器,准分子激光器,红宝石激光器等。对于某些实施例来说,激光源最好是二极管激光器,例如红外二极管激光器。但是,应认识到光学传递系统102中特定类型的激光源的选择取决于要利用皮肤设备100治疗的皮肤状况的类型。光源104可包括能够提供一个波长或波长范围的一种特定类型的激光源。另一方面,光源104可包括提供各种不同波长或波长范围的两种或更多种不同的激光源。来自不同激光源的光束可被分别或者同时射向目标部分108。
参见图1,光学传递系统102还包括与光源104光学耦接的聚焦部件106。聚焦部件106用于把光能从光源104射向目标部分108。在本实施例中,通过把光能的能量聚焦到目标部分108内的一个或多个治疗区,聚焦部件106把光能射向目标部分108。理想地,多个治疗区被同时或者顺序地暴露在光能下。多个治疗区可被相互分开,从而形成离散的治疗区。另一方面或者相结合,多个治疗区可以相互交叉或重叠。
在本实施例中,聚焦部件106引导呈某一图案,例如不连续或者微观图案的光能,从而一个或多个治疗区被暴露在光能下。通过能够控制暴露在光能下的目标部分108的百分率,光能的图案的使用提供更高的治疗功效。不同的图案可提供各种不同的暴露百分率,可根据要治疗的皮肤状况的类型选择特定的图案。例如,就敏感的皮肤状况,例如黄褐斑或浓重的色素病变来说,光能图案的使用使得能够在多个治疗区内有效治疗。同时,通过控制暴露于光能下的目标部分108的百分率,能够减少疼痛,免疫系统反应、外伤和其它并发症。通过使治疗区邻近于健康的并且基本不受损伤的细胞,目标部分108的康复更快,因为减少了恢复过程的充血或损伤的可能性。光能的图案的使用还能够便于多次治疗,所述多次治疗可能是通过允许单个较适度的治疗产生完美的所需效果所需要的,同时降低患者的风险。此外,通过利用其中单个治疗区的尺度与皮肤本身的正常可视组织或组成相同或更小的治疗模式,能够减少治疗的可视痕迹。
图2、3和4图解说明了可用于治疗皮肤的光能的图案的各种例子。具体地说,图2、3和4分别图解说明不同的光能图案射向的目标部分200、30和400的顶视图。
参见图2,光能以“点图案”的形式射向目标部分200,使得目标部分200内的多个治疗区,例如治疗区202、204和206暴露于光能之下。从图2的顶视图可看出,治疗区一般是圆形的,大小介于10~1000微米之间,例如介于50~500微米之间。如图2中所示,治疗区相互分隔开,并且基本上规则地分布在目标部分200中,例如在假想网格的交点。在本例中,两个相邻的治疗区,例如治疗区202和204间隔介于大约30~2000微米之间,例如大约100~1000微米之间的距离。暴露于光能下的目标部分200的百分率(fraction)可利用填充因数,即,如图2的顶视图所示,治疗区所占的暴露部分200的面积的百分率来测量。一般来说,填充因数可以是0~1之间的任意数。对于某些应用来说,填充因数一般大约在0.05~0.95之间,例如大约在0.1~0.5之间。
根据要治疗的特定皮肤状况,通过调整光能的图案,与治疗区相关的形状,大小,分布或者填充因数可不同于图2中所示的。治疗区可由各种规则或不规则形状,例如(但不限于)圆形,半圆形,菱形,六边形,多瓣形,八边形,椭圆形,五边形,矩形,正方形,星形,三角形,梯形,楔形等形成。一般来说,治疗区可具有相同或不同的形状或大小。治疗区可间隔规则或者不规则的距离均匀地或者不均匀地分布在目标区200内。例如,代替图2中所示的治疗区的基本规则的分布,治疗区可随机地分布在目标部分200内。另外,治疗区在目标部分200的边缘或其附近更稀疏地分布,以产生“羽化效果”,羽化效果降低边缘的可见性,并且当重叠邻接的治疗区时,产生更均匀的结果。这类似于获得与背景和邻接的笔触混合的外观的气刷。另外,治疗区可呈弧形,圆形,线形,螺旋形或它们的组合地分布在目标部分200内。
下面参见图3,光能呈“线形图案”地被射向目标部分300,从而目标部分300内的多个治疗区,例如治疗区302、304和306暴露在光能下。从图3的顶视图可看出,治疗区一般为细长,宽度和长度分别介于大约10~1000微米和1~30毫米之间。治疗区基本上规则地相互分隔开,两个相邻的治疗区,例如治疗区302和304间隔大约介于30~2000微米,例如大约介于100~1000微米之间的距离。按照如上所述的相似方式,可利用填充因数测量暴露在光能下的目标部分300的百分率。根据要治疗的特定皮肤状况,通过调整光能的图案,与治疗区相关的形状,宽度,长度,分布或者填充因数可不同于图3中所示的。例如,代替图3中所示的一般呈线形的治疗区,一个或多个治疗区可呈弧形,圆形或螺旋形。一般来说,治疗区可具有相同或不同的形状,宽度或长度,并且可间隔规则或者不规则的距离均匀地或者不均匀地分布在目标区300内。
如图4中所示,光能呈“交叉线图案”地被射向目标部分400,从而目标部分400内的多个相交治疗区,例如治疗区402、404、406和408暴露在光能下。从图4的顶视图可看出,治疗区一般为细长,包括以一定的角度与第二组治疗区相交的第一组治疗区。在本例中,治疗区可具有和图3中图解说明的治疗区相似的宽度,长度和间隔。根据要治疗的特定皮肤状况,通过调整光能的图案,与治疗区相关的形状,宽度,长度,分布或者填充因数可不同于图4中所示的。例如,十字形图案或蜂窝形图案的光能被射向目标部分400,从而改变不同于图4中所示的治疗区的分布。
返回参见图1,聚焦部件106至少可部分利用一个或多个光学元件,例如反射镜,光学透镜,光学窗口等来实现,把一个或多个光束的能量聚焦到目标部分108内的一个或多个治疗区。由于皮肤设备100可被用于治疗各种皮肤状况,因此应认识以聚焦部件106可被用于把一个或多个光束聚焦到目标部分108内的任意区域或结构,例如目标部分108的表皮层110或真皮层112。
如图1中所示,皮肤设备100还包括控制系统114。控制系统114通过任何有线或无线传输通道和功能元件与光学传递系统102电耦接,从而控制光学传递系统102,包括光源104,聚焦部件106,或者这两者的操作。例如,控制系统114能够启动光源104的一个或多个激光源,以及控制与启动的激光源相关的各种光学参数。作为另一例子,控制系统114能够控制聚焦部件106,从而控制或调整射向目标部分108的光能的图案。借助例如电动机或者能够定位光学元件的任何其它设备,聚焦部件106可由控制系统114控制。虽然表示了与控制系统114耦接的一个光学传递系统102,不过多个光学传递系统可与控制系统114耦接并由控制系统114控制。
在本实施例中,控制系统114至少可部分利用(1)配置成例如可编程门阵列的专用硬件或逻辑部件;(2)可从例如Intel公司获得的典型的微处理器或中央处理器;或者(3)任意典型的个人计算机,web设备或者个人数字助理产品来实现。对于某些应用,控制系统114还可包括与光源104连接并驱动光源104的激光器驱动器系统,和允许用户对控制系统114编程的用户接口。
下面参见图5,表示了根据本发明的另一实施例的皮肤设备500。皮肤设备500包括光学传递系统502,光学传递系统502包括光源504。光源504用于提供可被射向皮肤的目标部分508的光能,并且可按照关于光源104所述的类似方式来实现。
如图5中所示,光学传递系统502还包括与光源504耦接的扫描部件516。扫描部件516用于越过目标部分508扫描来自光源504的光能。在本实施例中,扫描部件516与光源504光学耦接,并越过目标部分508扫描光能,从而光能以某一图案,例如不连续的图案被射向目标部分508中的一个或多个治疗区。特别地,扫描部件516越过目标部分508扫描一个或多个光束,使得多个治疗区依次暴露在光能下。在本实施例中,扫描部件516至少部分可利用扫描仪,例如一维扫描仪或者二维扫描仪来实现。
参见图5,光学传递系统502还包括与扫描部件516光学耦接的聚焦部件506。聚焦部件506用于通过把光能的能量聚焦到目标部分508内的一个或多个治疗区,把光能射向目标部分508。聚焦部件506可按照关于聚焦部件106所述的类似方式来实现。应认识到聚焦部件506可被用于把一个或多个光束聚焦到目标部分508内的任意区域或结构,例如目标部分508的表皮层510或真皮层512。虽然图5中分离地表示扫描部件516和聚焦部件506,不过扫描部件516和聚焦部件506可组合地实现成扫描/聚焦部件。
在本实施例中,光学传递系统502还包括一个用于使目标部分508变形的皮肤变形部件518。例如,皮肤变形部件518可按照基本平直的方式,基本凹陷的方式,或者基本凸起的方式使目标部分508变形。通过这样使目标部分508变形,皮肤变形部件518提供更平滑的治疗表面,并且使得能够对目标部分508的光能的传递的更佳精度和控制。理想地,皮肤变形部件518用于对目标部分508施加压力。压力的施加能够用于压挤目标部分508,强制以光学方式把间质液从目标部分508吸出,从而便于光能更大地穿透目标部分508。
在本实施例中,皮肤变形部件518至少可部分利用使目标部分508变形的一个或多个结构,例如皮肤接触部件,真空系统,或者皮肤拉伸部件来实现。虽然图5中分离地表示聚焦部件506和皮肤变形部件518,不过聚焦部件506和皮肤变形部件518可组合地实现成聚焦/皮肤变形部件。例如,由于聚焦部件506构成皮肤设备500的一部分,把聚焦部件506用于聚焦以及用于皮肤变形,会减少皮肤设备500中的部件的数目。
参见图5,皮肤设备500还包括控制系统514。控制系统514通过任何有线或无线传输通道和功能元件与光学传递系统502电耦接,从而控制光学传递系统502,包括光源504,扫描部件516,聚焦部件506,皮肤变形部件518,或者它们的组合的操作。例如,控制系统514能够控制扫描部件516,控制或调整射向目标部,508的光能的图案。在本实施例中,可按照关于控制系统114所述类似的方式实现控制系统514。
如图5中所示,本实施例的光学传递系统502包括用于检测光学传递系统502相对于目标部分508的移动和位置任意之一或者这两者的传感元件520。具体地说,传感元件520能够向控制系统514提供移动和位置数据任意之一或者这两者,从而允许基本实时地控制射向目标部分508的光能的图案。特别地,传感元件520提供的移动数据可使得控制系统514恰当地控制光学传递系统502的操作,以便补偿光学传递系统502相对于目标部分508的移动。例如,根据这种移动数据,控制系统54能够控制光源504或者扫描部件516,以保证射向目标部分508的光能的图案的完整性和基本均匀性。在本实施例中,传感元件520至少可部分利用移动或位置检测器,例如机械鼠标或光学鼠标来实现。
现在参见图6,图6图解说明了根据本发明的一个实施例的光学传递系统600。光学传递系600包括大小便于人手操作的外壳602。具体地说,外壳602大小为允许光学传递系统600被手动扫描越过(across)人体皮肤的目标部分612,例如沿着箭头A的方向。应认识到为了便于表示,图6中放大地图解说明了目标部分612。
光源604和聚焦部件606位于外壳602内并与外壳602耦接。光源604可通过电缆616与控制系统(未示出)耦接。在本实施例中,光源604最好是可变(anamorphic)光源,利用二极管激光器,例如红外二极管激光器来实现。更具体地说,二极管激光器最好是能够提供沿着垂直于箭头A的方向,例如垂直于图6的平面的方向展开的基本均匀的光束的线性阵列二极管激光器。通过结合光能的脉冲或间歇施加,手动扫描光学传递系统600,光能的“线形图案”可被射向目标部分612。另外,通过沿着和箭头A呈一定角度的方向手动重新扫描光学传递系统600,光能的“交叉线图案”可被射向目标部分612。
虽然图6中表示了一个二极管激光器,不过光学传递系统600可包括排列成阵列,例如一维阵列或二维阵列的多个二极管激光器。例如,就一维阵列的情况来说,可结合光能的脉冲或间歇施加,手动扫描光学传递系统600,使得光能的“点图案”被射向目标部分612。另外光学传递系统600可包括越过目标部分612,扫描来自光源604的一个或多个光束的扫描部件。例如,就一维扫描仪的情况来说,可结合扫描仪的操作手动扫描光学传递系统600,使得光能的“点图案”或“线图案”被射向目标部分612。虽然光源604被表示成位于外壳602内,不过光源604可位于其它地方,并且通过例如光波导或者包含一个或多个光纤的光缆与聚焦部件606光学耦接。
参见图6,聚焦部件606用于通过光学窗口622,把光能从光源604射向目标部分612。理想地,出于光学接触,折射率匹配和舒适性的目的,一层材料可被涂敷到目标部分612上。在本实施例中,聚焦部件606包括第一和第二光学透镜608和610。但是,本领域的技术人员会认识到聚焦部件606可包括把光能射向目标部分612的其它光学元件(未示出)。第一光学透镜608用于调节和准直来自光源604的光束。第一光学透镜608可利用例如平凸圆柱形的非球面透镜来实现。
第二光学透镜610用于把准直光束的能量聚焦到治疗区,例如治疗区614。在本实施例中,第二光学透镜610具有大约介于0.15和1.5之间,例如大约介于0.5和1之间的数值孔径,并且可利用例如具有平凸圆柱形的光学透镜来实现。在本实施例中,第二光学透镜610允许具有足够能量的光束被聚焦到目标部分612的真皮层620内的治疗区,同时基本避免损伤目标部分612的表皮层618。特别地,光学流量,从而在表皮层618引起的温升能够显著小于在目标部分612内更深的焦平面,例如在真皮层620中的光学流量和引起的温升。如图6中所示,第二光学透镜610把光束的能量聚焦到相互分离并且至少在某一维上尺度较小或者微观的治疗区。这种实现允许功效更高的治疗,同时减少对治疗区周围的组织,以及在到达治疗区之前,被光束穿过的组织的损伤。此外,这种实现减轻了治疗的可视痕迹,因为单个治疗区的尺度等于或小于皮肤本身的正常可视组织或组成。
在本实施例中,治疗区可位于皮肤外表面下面1.5毫米左右,例如在外表面以下大约0.15毫米和1毫米之间。虽然治疗区被表示在目标部分612的真皮层620中,不过聚焦部件606可被用于把光束聚焦到目标部分612内的任意区域或结构。例如,聚焦部件606可被用于把光束聚焦到目标部分612的外表面或其附近,用于皮肤再生治疗,例如表面烧蚀过程。理想地,使用具有高组织吸收性和低穿透深度的波长或波长范围,比如介于大约1400~14000纳米之间,一般介于大约1400~3400纳米之间的波长或波长范围。组织吸收性可随着波长而变化,对于某些应用,最好选择组织吸收性最高的波长或波长范围,例如1450纳米或其附近和高于2500纳米。皮肤大约70%是水,吸水曲线可以是查找理想的治疗波长或波长范围的有用参考。对于某些应用,可以使用两个或更多不同的波长或波长范围,例如具有低组织吸收性和高的穿透深度的第一波长或波长范围,和具有高组织吸收性和低的穿透深度的第二波长或波长范围。例如,具有第一波长或波长范围的光束可被射向目标部分612,以便实现预加热效果,以及产生下至目标部分612的真皮层620的组织的凝结,具有第二波长或波长范围的光束可被射向目标部分612,以便实现表皮层618的表面烧蚀。
对于皮肤再生治疗来说,在暴露于光束的位置,可在目标部分612的外表面上形成一个或多个孔穴(hole)。可形成深度大约介于10~1000微米之间,比如大约介于10~300微米之间的多个孔穴。对于某些应用,最好形成尺寸大约介于10~1000微米之间,比如大约介于50~500微米之间的孔穴。多个孔穴可相互分隔开,以便形成离散(discrete)孔穴。另一方面或者相结合,多个孔穴可交叉或相互重叠。根据特定的治疗程度和使用的波长,代替或者结合一个或多个孔穴,可形成一个或多个区域的热变性组织,所述变性组织可被完全脱离或者被身体吸收,从而获得如上所述的类似皮肤再生效果。特别地,理想的结果是用新鲜组织及新的胶原质和改进皮肤的质量、外观和年轻特征的其它有益蛋白质的相关刺激替换变性的组织。
虽然图6中未示出,不过光学传递系统600可包括能够用于检测光学传递系统600相对于目标部分612的移动和位置任意之一或者这两者的传感元件。例如,当使光学传递系统600扫描越过目标部分612,以使光能受控地射向目标部分612时,传感元件可检测光学传递系统600的移动。特别地,传感元件提供的移动数据可允许恰当编程的控制系统变更一个或多个光学参数,例如计时,以保证射向目标部分612的光能的图案的完整性和基本均匀性。
下面参见图7,图7图解说明了根据本发明的另一实施例的光学传递系统700。光学传递系统700包括光源704和与光源704光学耦接的聚焦部件706。在本实施例中,光源704包括排列成阵列的多个光源702A、702B、702C、702D和702E。光源702A-702E可包括一种特定类型的激光源或两种或者更多种不同类型的激光源。虽然图7中表示了五个光源702A-702E,不过根据具体应用,可以使用更多或更少的光源。
在本实施例中,光源702A-702E分别与光路708A、708B、708C、708D和708E连接,如图7中所示。对于这样的实现来说,每个光源702A-702E能够通它自己的光路,把光束传送到人体皮肤的目标部分710。由于光源702A-702E被分别与光路708A-708E连接,因此光能的图案可被提供并被传递到目标部分70。为了实现这种图案,控制系统(未示出)可与光源702A-702E电耦接,以便选择和启动光源702A-702E中的一个或多个,以及控制与启动的光源相关的各种光学参数。在本实施例中,光路708A-708E最好是直径介于单模光纤直径到大约1毫米之间的光纤。但是,光路708A-708E并不局限于光纤,例如可以是任意类型的光波导。另外还在本实施例的上下文内,诸如反射镜或光学透镜之类的光学元件可被用于提供光路708A-708E的功能。
参见图7,聚焦部件706用于把通过光路708A-708E传递的光束的能量聚焦到目标部分710内的多个治疗区712A、712B、712C、712D和712E。在本实施例中,治疗区721A-712E最好具有大约介于10~1000微米之间,比如介于50~500微米之间的尺寸,并且相互分隔开,以便形成离散的治疗区。治疗区721A-712E可位于皮肤外表面之下达(up to)约1.5毫米之处,例如大约介于外表面之下0.15~1毫米之间。对于某些应用,通过相对于聚焦部件706,把光路708A-708E布置在不同的位置,不同的治疗区可被定位于皮肤外表面之下的不同深度。虽然治疗区721A-712E被表示成在目标部分710的真皮层716中,不过聚焦部件706可被用于把一个或多个光束聚焦到目标部分710内的任意区域或结构,例如目标部分710的表皮层714。聚焦部件706可按照结合图6说明的类似方式,被用于把光束聚焦到目标部分710的外表面或其附近,用于皮肤再生治疗,例如表面烧蚀程序。
虽然图7把聚焦部件706图解说明成包括一个光学透镜,不过本领域的技术人员将认识到聚焦部件706可包括把光能引向目标部分710的其它光学元件(未示出)。例如,聚焦部件706可包括两个或更多的光学透镜。可使用例如从2毫米直径光学透镜到2英寸直径光学透镜的不同光学透镜尺寸。对于某些应用,可用用于每个光路708A-708E的光学元件(未示出)延伸聚焦部件706。
应认识到上面讨论的本发明的具体实施例是作为例子提供的,本发明包含各种其它的实施例。
例如,皮肤设备的一些实施例可包括观察系统,记录系统,显示系统或者它们的组合。观察系统可允许用户观察皮肤的目标部分,并且可以利用例如与光学传递系统耦接或者包括在光学传递系统内的观察窗来实现。记录系统可用于记录来自目标部分的反射光,可利用例如记录红外或可见光光谱中的反射的照相机或电荷耦合器件(CCD)成像器来实现。一旦记录了红外或可见光反射,记录的反射可由控制系统处理,并利用显示系统显示成红外或可见光数据。显示系统可利用例如计算机屏幕,平板显示器,个人数字助理或者允许显示数据的无线通信设备来实现。
皮肤设备的一些实施例可包括能够用于向恰当编程的控制系统提供数据,从而允许治疗皮肤的光能的图案的基本实时的导向。特别地,这样的实施例利用颜色或其它可检测的光学性质来区分正常皮肤和需要治疗的皮肤,自动地治疗皮肤,从而在治疗需要治疗的微观相邻的组织时,使正常组织免受不必要的损伤。传感元件可利用例如在Black的美国专利No.5531740,“Automatic Color-Activated Scanning Treatment ofDermatological Conditions by Laser”中描述的辨色检测器来实现,该专利的公开内容在此整体引为参考。
作为另一例子,皮肤设备的一些实施例可包括冷却系统。冷却系统可用于在治疗期间或之后,动态或者静态地控制皮肤的目标部分的温度,可利用例如流体输出设备或低温皮肤接触部件来实现。
作为另一例子,本发明的一些实施例涉及利用光能的图案的各种生物组织的治疗。具体地说,具有和皮肤的表皮层对应的上皮保护层的生物组织也可按照这里所述的类似方式来治疗。例如,光能的图案可被应用于软腭,用于治疗打鼾和睡眠呼吸暂停。
下面的例子描述本发明的具体方面,以举例说明并向本领域的普通技术人员提供本发明的描述。该例子不应被理解为对本发明的限制,因为该例子仅仅提供有助于理解和实践本发明的具体方法。
例子
体外皮肤(样本尺寸=4毫米~6毫米)被放置成贴近具有防反射涂层的玻璃板,并用较小的重量稍微压挤。来自激光源的光能(波长=1500纳米;脉冲持续时间=10毫秒;脉冲功率=1000毫瓦)利用光纤传送,随后利用光束准直仪和聚焦物镜(数值孔径=0.53)聚焦透过玻璃板,并聚焦到皮肤内。通过调整聚焦物镜和玻璃板之间的距离,暴露在光能下的治疗区的深度可在皮肤外表面之下大约500微米~700微米之间变化。透明洗液被用作玻璃板和皮肤之间的指数匹配材料。该洗液还帮助使皮肤保持湿润,并改进自治疗区的过多热能的导出。单激光脉冲被射向每个治疗区,按照这种方式,皮肤内的各个治疗区被暴露在光能下。治疗区分布在矩形网格的交点处,并且间隔大约500微米的距离。治疗区通常是细长的,宽度约为200微米。
上面根据几个例证实施例说明了本发明,所述几个例证实施例只是对本发明的举例说明,而不是对本发明的限制。从而,在详细的实现中,本发明能够产生许多变化,本领域的普通技术人员可从这里包含的描述得到这些变化。所有这样的变化被认为在由下述权利要求及其合法等同物限定的本发明的范围和精神之内。

Claims (27)

1、一种皮肤治疗设备,包括:
光学传递系统,所述光学传递系统包括:
光源,所述光源被配置成提供波长在400纳米和20000纳米之间的光能;和
与所述光源光学耦接的聚焦部件,所述聚焦部件被配置成把所述光能引向皮肤的目标部分的外表面,所述光能产生通过所述皮肤的未治疗部分彼此隔开的热变性组织的离散治疗区的二维图案,其中每个所述离散治疗区宽度为10微米~1000微米并且从所述目标部分的所述外表面延伸通过所述皮肤的表皮层并进入所述皮肤的真皮层,
传感元件,其用于检测所述光学传递系统相对于所述目标部分的移动和位置的任意之一或二者;以及
控制系统,其中所述传感元件提供移动数据给所述控制系统,所述数据允许所述控制系统补偿所述光学传递系统相对于所述目标部分的移动。
2、按照权利要求1所述的皮肤治疗设备,其中在邻近多个离散治疗区中的治疗区的目标部分的外表面上形成一个或多个孔穴。
3、按照权利要求1所述的皮肤治疗设备,其中所述光学传递系统还包括外壳,所述外壳的尺寸便于人手操作,所述光源和所述聚焦部件位于所述外壳之内。
4、按照权利要求1所述的皮肤治疗设备,其中所述光源包括多个激光源。
5、按照权利要求1所述的皮肤治疗设备,其中所述聚焦部件被配置成以多个光束的形式,把所述光能引向所述目标部分。
6、按照权利要求1所述的皮肤治疗设备,其中所述光学传递系统还包括与所述光源光学耦接并与所述聚焦部件光学耦接的扫描部件,所述扫描部件被配置成越过所述目标部分扫描所述光能。
7、按照权利要求1所述的皮肤治疗设备,其中所述聚焦部件被配置成以所述二维图案引导所述光能以便在下至目标部分的所述真皮层上进行凝结。
8、按照权利要求7所述的皮肤治疗设备,其中所述离散治疗区的尺寸为50微米~500微米。
9、按照权利要求7所述的皮肤治疗设备,其中所述二维图案是不规则间隔的。
10、按照权利要求7所述的皮肤治疗设备,其中所述控制系统被配置成控制或调整被引向目标部分的所述光能的图案。
11、按照权利要求7所述的皮肤治疗设备,其中所述聚焦部件包括扫描部件,该扫描部件耦合到所述光源并在目标部分上扫描来自所述光源的光能。
12、按照权利要求7所述的皮肤治疗设备,还包括组合的聚焦/皮肤变形部件。
13、按照权利要求1所述的皮肤治疗设备,其中所述传感元件包括机械鼠标。
14、按照权利要求1所述的皮肤治疗设备,其中所述传感元件包括光学鼠标。
15、按照权利要求7所述的皮肤治疗设备,其中所述光源包括排列成阵列的多个红外激光二极管。
16、按照权利要求7所述的皮肤治疗设备,其中所述光源包括线性阵列二极管激光器。
17、按照权利要求7所述的皮肤治疗设备,其中所述光源包括多个光源。
18、按照权利要求7所述的皮肤治疗设备,其中所述光源包括至少两个不同波长的激光器,其中第一激光器对目标部分中的组织进行凝结,以及第二激光器对目标部分中的组织进行烧蚀。
19、按照权利要求7所述的皮肤治疗设备,还包括用于观察目标部分的窗口。
20、按照权利要求7所述的皮肤治疗设备,还包括观察系统,其包括用于对目标部分进行成像的CCD成像器。
21、按照权利要求20所述的皮肤治疗设备,其中所述CCD成像器能够记录红外频谱中的图像。
22、按照权利要求7所述的皮肤治疗设备,其中所述控制系统被配置成允许治疗皮肤的光能的图案的基本实时的导向,以及所述传感元件被配置成给控制系统提供用于区分正常皮肤和需要治疗的皮肤的数据。
23、按照权利要求22所述的皮肤治疗设备,其中所述传感元件包括辨色检测器。
24、按照权利要求7所述的皮肤治疗设备,还包括用于降低目标部分的温度的冷却系统。
25、按照权利要求1所述的皮肤治疗设备,其中所述聚焦部件包括第一光学透镜,该第一光学透镜被配置成调节和校准来自光源的光能。
26、按照权利要求25所述的皮肤治疗设备,其中所述聚焦部件包括第二光学透镜,该第二光学透镜被配置成聚焦所述光能到每个所述治疗区。
27、按照权利要求26所述的皮肤治疗设备,其中所述第二光学透镜位于所述第一光学透镜和所述皮肤的所述目标部分的所述外表面之间。
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AU2003284336B2 (en) 2009-08-13
EP1571972A4 (en) 2010-05-12
JP2006503681A (ja) 2006-02-02
CN1728970A (zh) 2006-02-01
AU2003284336A1 (en) 2004-05-13
JP4335209B2 (ja) 2009-09-30
WO2004037068A2 (en) 2004-05-06
US20030216719A1 (en) 2003-11-20
CA2502619A1 (en) 2004-05-06
EP1571972A2 (en) 2005-09-14
BR0314913A (pt) 2005-08-30
WO2004037068A3 (en) 2005-09-01

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