755nm皮秒激光仪平光透镜与Focus蜂巢透镜联合应用治疗黄褐斑

The effectiveness of 755 nm picosecond laser flat lens combined with Focus lens array in the treatment of melasma

目的:观察755 nm皮秒激光仪平光透镜与Focus蜂巢透镜联合应用治疗黄褐斑的临床疗效及不良反应。方法:对36例黄褐斑患者,联合应用755 nm皮秒激光仪平光透镜和Focus蜂巢透镜治疗,每4周治疗1次,6次为1个疗程。先用平光透镜对黄褐斑区域治疗1遍,能量密度0.4 J/cm^2,光斑直径8 mm,频率5 Hz, 后用Focus蜂巢透镜以同样参数再治疗1遍。治疗后随访12周。疗程结束后进行黄褐斑面积及严重程度指数(MASI)评分与患者自我满意度评价,记录不良反应,观察随访情况,并进行统计学分析。结果:治疗前、治疗6次后及治疗结束后12周MASI评分分别为(11.17±5.29)、 (4.63±3.05)、 (5.11±3.23);治疗6次后MASI评分下降率为(64±7)%,治疗结束后12周为(61±6)%;治疗6次后与结束后12周的平均MASI评分均低于治疗前,差异有统计学意义(P<0.05);治疗结束后12周平均MASI评分比治疗6次后略有升高,但差异无统计学意义(P>0.05)。Fitzpatrick III型皮肤患者MASI评分下降率为(68±8)%,高于IV型患者的(56±6)%,差异有统计学意义(P<0.05)。治疗6次后患者满意率为94.4%,治疗结束后12周为88.9%。而且绝大多数患者皮肤肤质比治疗前更细腻紧致,细纹和毛孔粗大得到改善。所有患者均无明显不良反应发生。结论:755 nm皮秒激光仪平光透镜与Focus蜂巢透镜联合应用治疗黄褐斑起效快,不良反应少,复发率低,患者满意度高,是有效的治疗新方案。

Objective: To observe the clinical efficacy and adverse effects of 755 nm picoseconds laser flat lens combined with focus lens array in the treatment of melasma. Methods: Totally 36 outpatients with melasma were treated with 755 nm picosecond laser flat lens combined with focus lens array for 6 treatment sessions at 4-week intervals. The patients were first treated with 755 nm picosecond laser flat lens. The treatment parameters: 0.4 J/cm^2 of fluence, 8 mm of spot size and 5 Hz of frequency. Then they were treated with 755 nm picosecond laser focus lens array with the same parameters. Patients were all followed up for 12 weeks. Melasma area and severity index (MASI) scores were calculated after treatment, and related adverse reactions and patient satisfaction survey were recorded at the same time with statistical analysis followed. Results: The mean MASI scores before treatment, after 6 treatments and after 12-week follow up were (11.17±5.29),(4.63±3.05) and (5.11±3.23) respectively. The decreasing ration of the MASI score was (64±7)% after 6 treatments and (61±6)% after 12-week follow up. The mean MASI scores after 6 treatments and 12-week follow up were both lower than before treatment, and the difference was statistically significant (P<0.05). The mean MASI score after 12-week follow up was slightly higher than that after 6 treatments. The difference was not statistically significant (P>0.05). The decreasing ration of the MASI score in Fitzpatrick type III patients was (68±8)%, higher than that in Fitzpatrick type IV patients (56±6)%, and the difference was statistically significant (P<0.05). Patient satisfaction rate was 94.4% after 6 treatments and 88.9% after 12-week follow up respectively. Skintexture was finer and firmer, fine lines and coarse pores were obviously improved in most patients. No adverse reactions occurred in all patients. Conclusion: The combination ofpicosecond 755 nm laser flat lens with focus lens array is effective and safe with lower recurrence rate and higher patient satisfaction in the treatment of melasma and thus worthy of promotion.