强脉冲光治疗13例淤积性皮炎伴发色素沉着疗效观察(1)
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[摘要]目的：观察强脉冲光治疗淤积性皮炎伴发色素沉着的疗效及不良反应。方法：对13例淤积性皮炎伴发双下肢色素沉着患者行强脉冲光治疗，治疗1～4次，每次治疗间隔4周，疗程结束后随访3～6个月，治疗前后疗效对比观察并用χ2检验分析。结果：基本治愈9例，无效2例(均只治疗1次)，总有效率84.6%。疗效与治疗次数成正相关，未见其他不良反应及并发症。结论：强脉冲光治疗淤积性皮炎伴发色素沉着疗效满意、安全，是该病的较好治疗手段。
[关键词]淤积性皮炎；色素沉着；强脉冲光；疗效
[中图分类号]R730.57 [文献标识码]A [文章编号]1008-6455(2012)02-0268-02
Efficacy of lntense pulsed light on pigmentation due to stasis dermatitis: an analysis of 13 cases
WU Zhi-hong1，TU Ya-ting2，CHEN Hong-xiang2，ZHONG Jiang1,QIN Yong-jian1, ZHANG Xiu-ping1
(1.Department of Dermatology，The First Affiliated Hospital, Guangxi College of Traditional Chinese Medicine, Nanning 530023,China；2.Department of Dermatology ,Wuhan Union Hospital, Tong ji Medical College, Huazhong University of Science and Technology, Wuhan 430030,China)
Abstract： Objective To observe the therapertic effect and side-effect of Intense Pulsed Light in the treatment of pigmentation due to stasis dermatitis. Methods 13 cases of pigmentation due to stasis dermatitis were treated by Intense Pulsed Light methods. All subjects accepted therapy for one to four times. The average interval time was 4 weeks. The follow up was from 3 months to 6 months.The data obtained before and after treatment were statistieally analyzed using χ2 test. Results The number of cure was 9 cases，cure rate 69.2%,total effective 84.6%，no effect 2 cases(all treated by one).The therapeutic effect was positively related to the times of therpy. Conclusion IPL has obviously curative effect on pigmentation due to stasis dermatitis. There is almost no other side-effect and it is both effective and safe.
Key words：stasis dermatitis;pigmentation;IPL;efficacy
淤积性皮炎又称静脉曲张综合征，是由于下肢静脉曲张、 血栓性静脉炎等疾病使血液循环不良而导致的小腿皮肤炎症，好发于中老年女性。我国淤积性皮炎发病率高，临床表现为皮肤红斑丘疹、 糜烂、 渗出、 肥厚及色素沉着，易合并感染， 经久难愈且易复发。其中色素沉着机制为静脉的压力导致红细胞外渗，巨噬细胞吞噬含铁血黄素以及黑素沉积,尤其是表皮的黑素沉积[1-2]。以往采用外涂脱色剂和物理磨削技术等治疗方法，虽有不同程度的疗效， 但大多数疗效不太理想， 副作用严重。2006年8月～2010年6月，笔者科室应用强脉冲光治疗淤积性皮炎导致的色素沉着13例，取得了较好疗效，现将结果报道如下。
1 资料和方法
1.1一般资料：患者13例，均为女性，年龄37～54岁，病史2～18年。皮损分布：均为双下肢发病。患肢可见曲张的浅表静脉，小腿有深褐色色素沉着。入选标准:①病程持续半年未退者； ②色素沉着后未进行其他光学祛除色素治疗者。排除标准： ①妊娠期； ②之前2个月使用过氢醌、局部或者全身应用过维生素 A或维A酸、 使用过局部漂白剂的患者；③半年前接受过激光治疗或者化学剥脱治疗的患者。
1.2 激光器及参数：IPL Quantum 光子嫩肤仪( 美国科医人医疗激光公司生产)，波长550～1200nm，采用560nm的滤光片 ......
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