Pixel激光治疗黄褐斑的疗效和安全性分析(1)
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[摘要]目的:评估Pixel激光治疗黄褐斑的疗效及安全性。方法:采用Pixel激光治疗黄褐斑患者72例,3～4周治疗1次,3～5次为一个疗程,每次复诊由医生和患者共同评定疗效和安全性。结果:72例患者中,痊愈17例(23.61%),显效18例(25.0%),有效率48.61%。轻度组:痊愈率45.45%(15例),显效率36.36%(12例),有效率81.81%;重度组:痊愈率5.13%(2例),显效率15.38%(6例),有效率20.51%;两组比较有显著性差异。病程小于2年者,有效率68.42%,疗效高于病程大于2年者。21例患者术后出现轻度色素沉着,均于术后3个月消退。结论:Pixel激光治疗黄褐斑安全有效,病程短、颜色浅者疗效更佳。
[关键词]Pixel激光;黄褐斑;疗效;安全性
[中图分类号]R758.4+2[文献标识码]A[文章编号]1008-6455(2010)08-1186-02
Efficacy and safety of Pixel laser for melasma
XU Yang, WANG Dan-dan, YANG Rong-ya
(Department of Dermatology, General Hospital of Beijing Military Region, Beijing 100125, China)
Abstract: Objective To assess the efficacy and safety of Pixel Laser for melasma. MethodsWe treated 72 patients with Pixel laser.Three to five sessions were performed at an interval of 3～4weeks.Efficacy and safety were evaluated after each session by doctors and patients.ResultsAmong the 72 patients,17 patients (23.61%) were cured,18 patients(25.0%) were remarkably improved.35 patients(48.61%)were effective. The rates of "cured" and "remarkably improved"were 45.45% and 36.36% among patients with the mild group and 5.13% and 15.38% among patients with the severe group (P<0.05). In patients with a disease history of less than 2 years, effective rate was 68.42%, which was significantly better than the treatment results of patients with a disease history of more than 2 years (P<0.05).Only mild pigmentation was found in 21 patients, which were disappeared after 3 months.ConclusionsPixel laser can be used to treat patients with melasma safely and effectively. The patients of light brown and shorter disease course of melasma achieve better effect.
Key words:Pixel laser; melasma; efficacy; safety
黄褐斑的治疗一直是困扰皮肤科医师的问题。近年来,运用新型激光、强脉冲治疗黄褐斑取得了一定疗效。以往报道应用调Q激光器及强脉冲光治疗较多,pixel激光应用于黄褐斑治疗的报道较少。2009年1月～2009年9月,我们运用Pixel激光治疗黄褐斑患者72例,取得了满意疗效,现将其疗效及安全性分析如下。
1 对象和方法
1.1研究对象:共72例黄褐斑患者,均为Ⅲ 、Ⅳ型皮肤,其中男9例,女63例,年龄23～51岁,平均31.7岁。病程3月～14年,其中2年以内19例,2年以上53例。按皮损颜色分为轻度组33例和重度组39例,浅褐色为轻度,主要病理分型为表皮型,灰色和深褐色为重度,病理分型表现为真皮型和混合型。色斑以颧部、面颊、鼻背部为主,对称分布,有的甚至泛发全面部。
1.2 纳入标准:符合2003年中国中西医结合学会制定的《黄褐斑的临床诊断和疗效判定标准》[1],即:①面部淡褐色至深褐色,界限清楚的斑片,通常对称性分布,无炎症表现及鳞屑;②无明显自觉症状;③女性多发,主要发生于青春期后;④病情可有季节性,常夏重冬轻;⑤排除其他疾病引起的色素沉着 ......
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