长脉宽532nm KTP激光治疗黄褐斑临床疗效观察

Clinical effects observation of long pulse width KTP 532nm laser in the treatment of melasma

目的观察长脉宽532nm KTP(Potassium titannyl phosphate钛酰磷酸钾)激光治疗黄褐斑的临床疗效和安全性。方法选取40例面部黄褐斑患者,并根据伍氏灯及玻片压诊法将40例黄褐斑分为四型:单纯色素型(M),单纯血管型(V)、M>V型及V>M型,均采用长脉宽532nm KTP激光治疗,光斑10mm,脉宽15ms,能量(6~7.5)J/cm^2,扫描(2~3)次,共治疗4次,每4周1次,治疗后严格防晒。根据患者MASI评分(黄褐斑面积及严重程度评分)降低值对疗效进行评价。结果 40例经过4次治疗,黄褐斑患者均得到不同程度的改善,其中12例(30%)达到了痊愈(改善率>75%),17例(42.5%)达到显著改善(改善率>50%),所有患者的平均MASI值由治疗前的17.10±2.68降至7.70±2.97(P<0.05),差异有统计学意义。且V、M>V型及V>M型的疗效均优于M型。除2例发生色素沉着外没有色素减退等严重副作用。结论长脉宽532nm KTP激光治疗黄褐斑疗效确切,安全性高,无明显副作用,且血管型黄褐斑较单纯色素型疗效更好,为治疗黄褐斑提供了一个新手段。

Objective To observe the clinical efficacy and safety of long pulse width KTP 532 nm laser in the treatment of melasma. Methods 40 cases of facial chloasma were selected according to wood＇ s light examination and diascopic examination method. 40 cases of melasma was divided into four types：simple pigmentary type（M）, simple vascular type（V）, M V and V M type were treated with 532 nm KTP laser, with spot 10 mm, pulse width 15 ms,energy（6 ~ 7.5） J/cm, scan（2~3） times, 4 times a total, 1 times every 4 weeks, after treatment. After treatment, sunscreen was applied strictly. The efficacy was evaluated according to the MASI score of the patients. Results 40 cases after treatment, patients with melasma were improved to different degrees, in which 12 cases（30%）, improvement rate 75%, and 17 cases（ 42.5%） improvement rate 50%,there was significant improvement. The mean MASI of all patients decreased from 17.10 ＋ 2.68 before treatment to 7.70 ＋ 2.97 after treatment. And the efficacy of V, MVtype and VM type were better than those of M type. Except for 2 cases of pigmentation, no severe side effects such as hypopigmentation were found. Conclusion Long pulsed KTP532 nm laser is effective and safe in the treatment of melasma, and has no obvious side effect. And the vascular type has better curative effect than pure pigments, provides a new method for the treatment of the melasma.