Q开关1064nm激光联合长脉宽1064nmNd：YAG激光治疗黄褐斑临床观察

Clinical observation of Q-switch 1064 nm Nd： YAG laser combined with long-pulsed 1064 nm Nd： YAG laser in treatment of melasma

目的探讨Q开关1064nm激光联合长脉宽1064nm激光治疗黄褐斑的疗效及安全性。方法将80例黄褐斑患者随机分为两组，每组40例。治疗组：采用Q开关1064nm激光联合长脉宽1064nm激光治疗；对照组：单独使用Q开关1064nm激光治疗。连续治疗10个周期，治疗过程中记录不良反应，治疗前后进行mMASI评分，并对患者满意度进行调查。结果两组间治疗前后mMASI评分下降率均有统计学意义（P〈0．05）；且与对照组相比，治疗组患者治疗后mMASI下降更明显，差异有统计学意义（分别为3．96±2．35和6．03±3．57，P=0．003）。治疗组满意率85．0％，对照组满意率60．6％，两组间的满意率比较有统计学意义（P〈0．05）。所有患者未见严重不良反应。结论Q开关1064nm激光联合长脉宽1064nm激光治疗黄褐斑优于单纯采用Q开关1064nm激光，能明显提高治疗有效率和患者的满意度。

Objective To explore the clinical efficacy and safety of Q-switch 1064 nm Nd： YAG Laser combined with Long-pulsed 1064 nm Nd ： YAG Laser on treatment of melasma. Methods Eighty patients with melasma were randomly divided into the treatment group （40 cases） and the control group （40 cases）, respectively. The cases in the treatment group were given Q-switch 1064 nm Nd： YAG Laser combined with Longpulsed 1064 nm Nd： YAG Laser, while those in the control group was only treated with Long-pulsed 1064 nm Nd： YAG Laser. All patients received 10 consecutive courses of treatment. Side effects were observed. The clinical efficacy and patient satisfaction rates were assessed by mMASI score. Results The mMASI score was decreased in both the treatment and control groups and showed significant difference after treatment （ P 〈 0.05 ）. Compared with control group, the mMASI score after treatment was lower in treatment group （3.96 ± 2.35 and 6.03 ±3.57 respectively, P = 0. 003 ）, Satisfaction rate of the treatment group was 85.0%, while in control group it was 60.6%, there were statistically significant between the two groups （ P 〈 0.05 ）. No severe adverse reactions were founded. Conclusion Combining therapy can promote the efficacy and patient satisfaction rates of melasma without severe slde-effects.