皮秒激光与Q开关Nd:YAG激光治疗顽固性黄褐斑疗效比较

Clinical Efficiency Analysis on the Treatment of Regractory Melasma Using Picosecond Laser and Nd:YAG Laser

目的:比较皮秒激光和Q开关Nd:YAG激光治疗顽固性黄褐斑患者的临床疗效,对两种激光的疗效和安全性进行评估。方法:收集2017年9月-2018年9月在笔者医院美容皮肤科就诊的140例黄褐斑患者资料,随机分为皮秒激光组和Q开关Nd:YAG激光两组,分别采用波长为755nm的皮秒激光和波长为1064nm的Q开关Nd:YAG激光进行治疗。1次/月,共治疗6次。分别在治疗前、治疗后6个月观察两组患者的疗效、MASI评分及不良反应,并由患者进行满意度测评。结果:治疗后,两组患者均有明显的好转,患者面部色斑变浅、面积变小;Q开关Nd:YAG激光组的治疗有效率低于皮秒激光组(P<0.05);Q开关Nd:YAG组和皮秒激光组患者的MASI评分均明显低于治疗前(P<0.001),Q开关Nd:YAG组治疗后MASI评分明显高于皮秒激光组MASI评分(P=0.001);两组患者的满意度和不良反应发生率比价无显著性差异。结论:与1064nm Q开关Nd:YAG激光治疗相比,用755nm皮秒激光治疗有更好疗效,有效率显著高于Q开关Nd:YAG激光组,医师的MASI评估分数也低于Q开关Nd:YAG激光组。

Objective To compare the data of patients with melasma treated by picosecond laser and 1064 nm QS-Nd:YAG laser to evaluate the efficacy and safety of the two lasers.Methods The data of 140 patients with melasma who were treated in the Department of Aesthetic Dermatology in our hospital from September 2017 to September 2018 were collected.It was divided into two groups and treated with picosecond laser with a wavelength of 755nm and QS-Nd:YAG laser with a wavelength of 1064nm.1 time/month,a total of 6 treatments.The efficacy,MASI score,and adverse reactions of the two groups of patients were observed before treatment and after 6 months of treatment,and the patients were evaluated for satisfaction.Results The two groups of patients showed significant improvement after treatment,and the patients'facial spots became lighter and the area became smaller.QS-Nd:YAG group:the treatment efficiency of the QS-Nd:YAG group was lower than that of the picosecond laser group(P<0.05).The MASI scores of patients in the QS-Nd:YAG group and the picosecond laser group were significantly lower than before treatment(P<0.001),and the MASI scores after treatment in the QS-Nd:YAG group were significantly higher than those in the picosecond laser group(P=0.001)There was no difference in the satisfaction and adverse reaction rates between the two groups.Conclusion Compared with treatment with 1064 nm QS-Nd:YAG laser,treatment with 755 nm picosecond laser has better efficacy,and the effective rate is significantly higher than that of QS-Nd:YAG laser treatment group.The physician’s MASI evaluation score Also lower than QS-Nd:YAG laser treatment group.