强脉冲光联合Q开关倍频Nd:YAG激光治疗黄褐斑临床观察

The clinical observation of treating Melasma by combining intense pulse light with Q-switched Nd:YAG Laser

目的观察强脉冲光联合Q开关倍频Nd:YAG激光治疗黄褐斑的临床疗效。方法选取120例患者,随机均分为3组,治疗组使用IPL和Q开关倍频Nd:YAG激光联合治疗,对照组分为仅使用IPL治疗组和仅使用Q开关倍频Nd:YAG激光治疗组。以色素消退≥90%为痊愈,色素消退60%-89%为显效,色素消退30%-59%为有效,色素消退<30%为无效。结果联合治疗组中有效者18例,显效者17例;单纯IPL治疗组中痊愈者11例,显效者7例;单纯Q开关Nd∶YAG激光治疗组中痊愈者13例,显效者8例,3组总有效率分别为87.5%,45.0%,52.5%,差异具有显著统计学意义(χ2=17.415,P<0.001)。所有患者均未出现色素加重、瘢痕等,仅1例出现暂时性色素减退。结论强脉冲光联合Q开关倍频Nd:YAG激光可安全有效地治疗黄褐斑,且治疗效果优于单纯使用IPL及Q开关倍频Nd:YAG激光治疗效果。

Objective To investigate the clinical efficacy of treating Melasma by combining intense pulse light with Q switched Nd：YAG Laser.Methods Meet standards＇ 120 example patients were divide into three groups stochastically,including 40 cases of treating melasma by combining intense pulse light with Q-switched Nd：YAG Laser,40 cases of treating melasma by intense pulse light,40 cases of treating melasma by Q-switched Nd：YAG Laser.Pigment subsided by ≥90% was regarded as ＂cured＂,by 60%-89% as＂remarkably improved＂,by 30%-59% as＂effective＂,and by30% as＂ineffective＂.Results In combining treatment group,18 cases were crued and 17 cases were remarkably improved.In treatment group by intense pulse light,11 cases were crued and 7 cases were remarkably improved.In treatment group by Q-switched Nd：YAG Laser,13 cases were crued and 8 cases were remarkably improved.The efficacy rate in the three groups were 87.5%（35/40）,45.0%（18/40）,52.5%（21/40） respectively.The differences were statistically significant in three groups（χ2=17.415,P0.001）.No hyperpigment and scarring was observed and only one patient experienced a transient pigment loss.Conclusion Combined intense pulse light with Q-switched Nd：YAG Laser can be used to treat patients with melasma safely and effectively.It is the most effective in the three methods.