强脉冲光联合Q开关1064nm激光治疗黄褐斑疗效观察
发布时间：2018-10-12 17:21
【摘要】：目的:探讨强脉冲光(Intense Pulsed Light,IPL)及Q开关1064nm(Nd:YAG)激光联合治疗黄褐斑临床疗效及安全性。方法:收集2013年5月至2015年1月于成都天使之翼美天整形美容医院就诊,要求治疗黄褐斑并能按要求定期接受治疗和随访的患者资料。分别采用辉煌360工作平台的强脉冲光(IPL以色列Alma飞顿公司生产)及Q开关1064nm(Nd:YAG)激光MedLiteC6(美国HoYa_conBio公司出产)及二者联合对87例黄褐斑患者进行治疗。87例均为女性,其中IPL组32例,Q开关1064nm(Nd:YAG)激光组25例,IPL联合Q开关1064nm(Nd:YAG)激光组30例;患者的平均年龄为29.7岁,平均病程为7.4年。根据患者皮肤Fitzpatrick分型、肤色、色斑颜色及色斑面积选择不同的波长、能量密度、脉冲宽度、光斑大小及频率。疗程为10次,每次间隔4周。选择某一固定位置作为观察部位,以VISIA皮肤检测仪分别记录每次治疗前的照片以及斑点的特征计数,分值,百分位数进行定量检测[1],在每次治疗前及第10次治疗后1个月由同一医护人员对观察部位拍照采集影像资料并存档。疗程结束后随访3个月观察疗效以及不良反应:同时评定医生及患者对黄褐斑疗效的主观满意程度。结果:所有黄褐斑治疗后斑点绝对值均随治疗次数增加而下降,差异具有统计学意义(P0.05);IPL组及Q开关1064nm激光组每次治疗后色斑变化率比较发现,IPL组的色斑变化率前五次均显著高于Q开关1064nm激光组,但10次治疗后,两者的有效率差异不具有显著性。IPL及Q开关1064nm激光联合治疗组色斑变化率均显著高于单独应用。随访3个月,所有患者均无不良反应发生。单纯应用IPL组基本治愈率为50.0%,总有效率为78.1%;单纯应用Q开关1064nm激光组基本治愈率72.0%,总有效率为84.0%;IPL联合Q开关1064nm激光组基本治愈率为86.7%,总有效率为93.3%。差异有统计学意义(P0.05)。各组的医生满意度:IPL组总满意率为71.9%,Q开关1064nm激光组总满意率为84.0%,IPL联合Q开关1064nm激光组总满意率为93.3%。各组的患者满意度:IPL组总满意率为75.0%,Q开关1064nm激光组总满意率为88.0%,IPL联合Q开关1064nm激光组总满意率为96.7%。两者差异无统计学意义(P0.05)。结论:联合应用强脉冲光及Q开关1064nm(Nd:YAG)激光治疗黄褐斑疗效显著优于其单独应用、且安全无副作用,色斑变化率与其治疗次数、皮肤颜色、治疗前色斑颜色,面积有关,医生和患者均满意。
[Abstract]:Objective: to investigate the clinical efficacy and safety of intense pulsed light (Intense Pulsed Light,IPL) and Q-switched 1064nm (Nd:YAG) laser in the treatment of chloasma. Methods: from May 2013 to January 2015, we collected the data of patients who were treated with chloasma and who could be treated and followed up regularly. 87 cases of chloasma were treated with high-power pulse light (produced by IPL Israel Alma Fiden), Q-switch 1064nm (Nd:YAG) laser MedLiteC6 (produced by HoYa_conBio Company of USA) and the combination of the two methods. 87 cases were female. There were 32 cases in IPL group, 25 cases in Q-switched 1064nm (Nd:YAG) laser group and 30 cases in IPL combined with Q-switched 1064nm (Nd:YAG) laser group. The average age of the patients was 29.7 years and the average course of disease was 7.4 years. Different wavelengths, energy density, pulse width, light spot size and frequency were selected according to the skin Fitzpatrick classification, skin color, color and area of the spot. The course of treatment was 10 times, with an interval of 4 weeks. A fixed position was selected as the observation site, and the VISIA skin detector was used to record the photographs before each treatment and the characteristic count and score of the spots, respectively. The percentile was measured quantitatively [1]. Before each treatment and 1 month after the 10th treatment, the same medical staff took pictures of the observation site and collected the image data and archived them. The therapeutic effects and adverse reactions were observed at the end of the course of treatment. The subjective satisfaction of doctors and patients with chloasma was evaluated at the same time. Results: the absolute value of spots decreased with the increase of treatment times. The difference was statistically significant (P0.05) in); IPL group and Q-switched 1064nm laser group. The results showed that the change rate of color spot in IPL group was significantly higher than that in Q-switched 1064nm laser group in the first five times, but after 10 times of treatment, the change rate of color spot in IPL group was significantly higher than that in Q-switched 1064nm laser group. There was no significant difference in the effective rate between the two groups. The change rate of color spot in IPL and Q-switched 1064nm laser combined treatment group was significantly higher than that in single treatment group. All patients were followed up for 3 months without adverse reactions. The basic cure rate of IPL group was 50.0, the total effective rate was 78.1%, the basic cure rate was 72.0 in Q switch 1064nm laser group, the total effective rate was 84.0%, and the total effective rate was 86.7% and 93.3% in 1064nm laser group. The difference was statistically significant (P0.05). The total satisfaction rate of IPL group was 71.9 Q switch 1064nm laser group. The total satisfaction rate of 1064nm laser group was 84.0%. The total satisfaction rate of 1064nm laser group was 93.3%. The total satisfaction rate of IPL group was 75.0 Q switch 1064nm laser group. The total satisfaction rate of 1064nm laser group was 88.0%. The total satisfaction rate of 1064nm laser group was 96.7%. The difference was not statistically significant (P0.05). Conclusion: the combined use of intense pulsed light and Q-switched 1064nm (Nd:YAG) laser in the treatment of chloasma is more effective than that in the treatment of chloasma alone, and the change rate of macula is related to the times of treatment, the color of skin, the color and area of macula before treatment. Both the doctor and the patient were satisfied.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R758.42
本文编号：2266957
[Abstract]:Objective: to investigate the clinical efficacy and safety of intense pulsed light (Intense Pulsed Light,IPL) and Q-switched 1064nm (Nd:YAG) laser in the treatment of chloasma. Methods: from May 2013 to January 2015, we collected the data of patients who were treated with chloasma and who could be treated and followed up regularly. 87 cases of chloasma were treated with high-power pulse light (produced by IPL Israel Alma Fiden), Q-switch 1064nm (Nd:YAG) laser MedLiteC6 (produced by HoYa_conBio Company of USA) and the combination of the two methods. 87 cases were female. There were 32 cases in IPL group, 25 cases in Q-switched 1064nm (Nd:YAG) laser group and 30 cases in IPL combined with Q-switched 1064nm (Nd:YAG) laser group. The average age of the patients was 29.7 years and the average course of disease was 7.4 years. Different wavelengths, energy density, pulse width, light spot size and frequency were selected according to the skin Fitzpatrick classification, skin color, color and area of the spot. The course of treatment was 10 times, with an interval of 4 weeks. A fixed position was selected as the observation site, and the VISIA skin detector was used to record the photographs before each treatment and the characteristic count and score of the spots, respectively. The percentile was measured quantitatively [1]. Before each treatment and 1 month after the 10th treatment, the same medical staff took pictures of the observation site and collected the image data and archived them. The therapeutic effects and adverse reactions were observed at the end of the course of treatment. The subjective satisfaction of doctors and patients with chloasma was evaluated at the same time. Results: the absolute value of spots decreased with the increase of treatment times. The difference was statistically significant (P0.05) in); IPL group and Q-switched 1064nm laser group. The results showed that the change rate of color spot in IPL group was significantly higher than that in Q-switched 1064nm laser group in the first five times, but after 10 times of treatment, the change rate of color spot in IPL group was significantly higher than that in Q-switched 1064nm laser group. There was no significant difference in the effective rate between the two groups. The change rate of color spot in IPL and Q-switched 1064nm laser combined treatment group was significantly higher than that in single treatment group. All patients were followed up for 3 months without adverse reactions. The basic cure rate of IPL group was 50.0, the total effective rate was 78.1%, the basic cure rate was 72.0 in Q switch 1064nm laser group, the total effective rate was 84.0%, and the total effective rate was 86.7% and 93.3% in 1064nm laser group. The difference was statistically significant (P0.05). The total satisfaction rate of IPL group was 71.9 Q switch 1064nm laser group. The total satisfaction rate of 1064nm laser group was 84.0%. The total satisfaction rate of 1064nm laser group was 93.3%. The total satisfaction rate of IPL group was 75.0 Q switch 1064nm laser group. The total satisfaction rate of 1064nm laser group was 88.0%. The total satisfaction rate of 1064nm laser group was 96.7%. The difference was not statistically significant (P0.05). Conclusion: the combined use of intense pulsed light and Q-switched 1064nm (Nd:YAG) laser in the treatment of chloasma is more effective than that in the treatment of chloasma alone, and the change rate of macula is related to the times of treatment, the color of skin, the color and area of macula before treatment. Both the doctor and the patient were satisfied.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R758.42
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