非剥脱性Q开关Nd：YAG 1 064 nm激光对黄褐斑的治疗效果

Elimination of melasma with nonablative Q-switched Nd ：YAG 1 064 nm laser

目的 观察非剥脱性Q开关Nd：YAG 1 064 nm激光对黄褐斑的治疗效果.方法 应用Q开关Nd：YAG 1 064 nm激光对23例黄褐斑患者进行治疗,其光斑直径6 mm,脉宽5～7 ns,频率10 Hz,能量密度1.8～2.0 J/cm2.一般需8～10次治疗,每次治疗间隔1周.结果 23例经8～10次治疗后,黄褐斑明显淡化或消失,局部出现轻度充血,无水泡和结痂形成,基本治愈率达52.17%.5例出现眼睑紫癜,3 d后自行消退,无色素沉着及瘢痕发生.术后随访6个月以上,其中7例（占30.4%）出现复发,继续治疗仍然有效.结论 非剥脱性Q开关Nd：YAG 1 064 nm激光治疗黄褐斑虽有复发,仍不失为一种比较可行的治疗方法 ,有一定效果,操作简单、安全,不影响患者的工作和生活.

Objective To evaluate the elimination of melasma with nonablative Q-switched Nd ： YAG1 064 nm laser. Methods 23 cases of melasma were treated with Q-switched Nd ：YAG 1 064 nm laser using the following parameters： spot size, 6 mm; pulse duration, 5-7 ns; frequency, 10 Hz, and flu-ence, 1.8-2. 0 J/cm2. The procedure was repeated weekly. Results The treatment was well tolerated without the use of topical anesthetic. There was slight congestion, no blister and crust after treatment. Routine clean and make-up can be done after treatment. The melasmas were obviously lighten or fully eliminated after 8-10 treatments and 52. 17 % of patients showed excellent results. Only 5 cases experienced an episode of purpura on eyelid after treatment and disappeared spontaneously without post-inflammatory hyperpigmentation and scarring. Followed up over 6 months, there was recurrence in 7 patients who were effective by additional treatment. Conclusions Nonablative Q-switched Nd ：YAG 1 064 nm laser is a more ideal method to eliminate melasma because of the credible effect, safe, simple operation, and no downtime, in despite of recurrence.