像素铒激光配合果酸治疗黄褐斑的疗效观察(1)
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[摘要]目的：观察像素铒激光(2940nm)联合羟基乙酸(果酸)治疗黄褐斑的临床疗效和安全性，掌握像素铒激光和果酸换肤的治疗方法。方法：应用质量浓度20%、35%的果酸对30例黄褐斑患者进行治疗，2～3周1次，5次为1个疗程；应用短脉宽像素铒激光对30例黄褐斑患者进行治疗，每2～3周1次，4次为1个疗程。两种方法交替使用，15天治疗1次。结果：随着治疗次数的增加，褐色斑逐渐变淡，MASI评分逐渐下降，有效率为60%。30例患者完成一个疗程的治疗，有效率表皮型黄褐斑83.33%，混合型44.44%，表皮型比混合型患者MASI下降更显著(P<0.05)。结论：像素铒激光联合果酸治疗黄褐斑是一种安全性好，修复快，不良反应少的方法，对于表皮型黄褐斑比混合型效果更明显。
[关键词]像素铒激光；果酸；黄褐斑
[中图分类号]R758.4+2 [文献标识码]A [文章编号]1008-6455(2012)03-0455-02
Pixel Erbium laser treatment of melasma with the efficacy of acid
LIU Mei,WANG Juan,ZHANG Jie,ZHNG Yuan-feng
(Department of Beijing Skin Disease Hospital of acne,Beijing 100192,China)
Abstract： Objective Observed pixel erbium laser (2940) joint-hydroxy acid (AHA) in the treatment of melasma clinical efficacy and safety,master pixel erbium laser and chemical peel treatments. Methods The concentration of 20%, 35% of the acid were 30 cases of chloasma treated 2～3 weeks time, 5 times for a course of treatment. Application of short-pulse erbium laser pixels were 30 cases of melasma treatment, once every 2～3 weeks, four times for one course, two methods are used interchangeably, 15 days of treatment time.There are two doctors on fixed lesions in patients with melasma area and severity index (MASI) score, for the use of self-efficacy before and after treatment were observed and recorded the response of patients after treatment. Results The number of treatments increases, the brown spots gradually fades, MASI score decreased, the effective rate of 60%. 30 patients completed a course of treatment, efficiency: epidermal melasma was 83.33%, 44.44% mixed type, skin type than the mixed type decreased more significantly in patients with MASI (P<0.05). Conclusion Pixel Erbium laser and acid treatment of melasma, is a safe and good, quick repair, adverse reaction method; for epidermal melasma is more effective than the mixed type.
Key words: Pixel Erbium Laser;acid;chloasma
黄褐斑是常见于面部的色素性疾病。发病机制尚未清楚，多数认为与内分泌、遗传、日晒、化妆品、精神因素、睡眠状态及机体系统疾病，皮肤的微生态失衡有关，多见于中年女性。2010年1月～2011年1月，我院门诊采用像素铒激光联合果酸治疗黄褐斑患者,取得了一定效果，现报道如下。
1 资料和方法
1.1病例选择：30例患者均来自门诊，根据中国中西医结合学会皮肤性病学专业委员会色素性疾病学组的诊断标准，参照wood's灯诊为表皮型、混合型黄褐斑患者。其中男2例，女28例，年龄24～50岁，平均36.6岁，病程1～7年，平均3.6年。
1.2排除标准：①瘢痕体质者；②严重糖尿病、高血压患者；③活动性病毒感染：单纯疱疹、疣，近期手术史(有正在愈合的伤口)，近期接受过放射治疗；④精神病患者或对治疗有过高期望值者；⑤活动期白癜风和银屑病、系统性红斑狼疮；⑥妊娠期或哺乳期；⑦光过敏者；⑧曾行化学剥脱术、磨削术及其他换肤术者；⑨近期内使用维甲酸药物者；⑩不愿意治疗后进行防晒及治疗后有风险的患者 ......
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