Q开关1064 nm Nd∶YAG激光联合氢醌乳膏治疗黄褐斑的疗效及安全性分析

Clinical Efficacy and Safety of Q-Switched 1064 nm Nd︰YAG Laser Combined with Hydroquinone Cream in the Treatment of Moderate to Severe Chloasma

目的:探讨Q开关1064 nm Nd︰YAG激光联合氢醌乳膏治疗黄褐斑的临床疗效及安全性。方法:按随机数字表法将2019年1月-2020年12月江汉油田总医院收治的82例女性黄褐斑患者分为对照组和观察组,每组41例。对照组给予氢醌乳膏治疗,观察组在对照组的基础上给予Q开关1064 nm Nd:YAG激光治疗。比较两组患者治疗前及治疗后1、2、3个月的黄褐斑面积和严重程度指数(Melasmaareaseverityindex,MASI)评分,记录两组临床疗效、不良反应发生情况、复发情况及治疗满意度情况。结果:两组患者治疗后的MASI评分均降低(治疗3个月<治疗2个月<治疗1个月),且观察组患者治疗1、2、3个月的MASI评分低于对照组(P<0.05)。观察组的临床总有效率(92.68%)高于对照组(75.61%),差异有统计学意义(P<0.05);观察组的不良反应率(4.88%)低于对照组(19.52%),观察组复发率(2.44%)低于对照组(14.63%),差异均具有统计学意义(P<0.05)。观察组治疗满意度(95.12%)高于对照组(78.05%),差异具有统计学意义(P<0.05)。结论:Q开关1064 nm Nd:YAG激光联合氢醌乳膏治疗中重度黄褐斑的临床效果良好,能够降低不良反应及复发率,安全系数高。

Objective To investigate the clinical efficacy and safety of 1064 nm laser combined with hydroquinone cream in the treatment of patients with moderate or severe chloasma.Methods A total 82 female patients with moderate or severe chloasma treated in Jianghan Oilfield General Hospital from January 2019 to December 2020 were randomly divided into control group and observation group,with 41 cases in each group.The cases in the control group were treated with hydroquinone cream,and the cases in the observation group were treated with Q-switched 1064 nm Nd:YAG laser on the basis of the control group.The melasma area and severity index(MASI)scores of the two groups before treatment and 1,2 and 3 months after treatment were compared,and the clinical efficacy,adverse reactions,recurrence and treatment satisfaction of the two groups were recorded.Results The MASI scores of the two groups were decreased after treatment(3 months<2 months<1 month),and the MASI scores of the observation group were lower than those of the control group at 1,2 and 3 months(P<0.05).The total clinical efiective rate of the observation group(92.68%)was higher than that of the control group(75.61%)(P<0.05).The adverse reaction rate of the observation group(4.88%)was lower than that of the control group(19.52%)(P<0.05),and the recurrence rate of the observation group(2.44%)was lower than that of the control group(14.63%)(P<0.05).The treatment satisfaction of the observation group(95.12%)was higher than that of the control group(78.05%)(P<0.05).Conclusion The clinical efiect of Q-switch 1064 nm Nd:YAG laser combined with hydroquinone cream in the treatment of moderate and severe chloasma is good,which can reduce the adverse reaction and recurrence rate with high safety.