755 nm皮秒翠绿宝石激光治疗黄褐斑的疗效观察

Effectiveness of Picosecond 755 nm Alexandrite Laser for the Treatment of Melasma

目的观察755 nm皮秒翠绿宝石激光治疗黄褐斑的临床疗效、不良反应及复发率。方法对51例黄褐斑患者进行每三周1次,总疗程为5次的755 nm皮秒翠绿宝石激光治疗。采用Focus蜂巢模式,能量密度0.4 J/cm2,光斑直径8 mm,频率5 Hz,脉宽550×10-12 sec。治疗后随访8周。所有患者每次激光治疗前以及末次治疗结束后3、8周面部拍照,进行黄褐斑面积及严重程度评分(MASI)评分,记录相关不良反应发生情况,对治疗影响因素进行统计分析,并观察复发情况。结果 5次激光治疗后平均MASI评分由(12.04±6.54)下降至(6.82±5.63),下降率为47.22%;治疗8周后,评分略上升至(7.67±5.63)。所有51例患者均无明显不良反应发生。经统计分析,病程、Wood灯分型、Fiztpatrick分型、治疗前严重程度以及家族史,对黄褐斑激光治疗的疗效及愈后有一定影响。结论 755 nm皮秒翠绿宝石激光治疗黄褐斑安全、有效、复发率低,值得临床推广应用。

Objective To evaluate the clinical efficacy, safety and recurrence rate of picosecond 755 nm alexandrite laser in the treatment of melasma. Methods All 51 patients with melasma were treated with picosecond 755 nm alexandrite laser combined with a focus lens array for 5 treatment sessions every 3 weeks. The treatment parameter： 0.4 J/cm^2 of fluence, 8 mm of spot size, 5 Hz of frequency and 550×10^-12 see of pulse duration. Patients were all followed up for 8 weeks. Outcomes assessments including photography, melasma area and severity index （MASI） score and related adverse reactions were recorded. The factors affecting the treatment were analyzed. Results The mean MASI score decreased dramatically from （12.04±6.54） to （6.82±5.63） after 5 laser treatment sessions, the decreasing ration of the MASI score was about 47.22%. But after 8-week follow up, the mean MASI score slightly increased to （7.67±5.63）. No obvious side effect was observed. Through the statistical analysis, disease duration, severity, wood＇s lights typing, Fiztpatrick typing, and family history of melasma had impact on the prognosis of melasma. Conclusion The novel picosecond 755 nm alexandrine laser is effective and safe with lower recurrence rate in the treatment of melasma, and is worthy of promotion.