双波长激光联合纳晶微针治疗血管型黄褐斑的疗效观察  

Observation on the Effect of Dual-wavelength Laser Combined with Micro-needling in the Treatment of Vascular Chloasma

作　　者：郝丽娜 郝丽莎 沙晓伟[3] 高静 代玉柱 HAO Li-na;HAO Li-sa;SHA Xiao-wei;GAO Jing;DAI Yu-zhu(Chengdu Qingyang Phil Medical Beauty Clinic,Sichuan Province,610000,China;Affiliated Hospital of Southwest Medical University,Sichuan Province,646000,China;Department of Dermatology,Sichuan Provincial people's Hospital,,Sichuan Province,610000,China;Angel Children's Hospital in Chengdu,Sichuan Province,,Sichuan Province,610000,China)

机构地区：[1]成都青羊菲尔医疗美容诊所,四川成都610000 [2]西南医科大学附属医院,四川泸州646000 [3]四川省人民医院皮肤科,四川成都610000 [4]四川省成都市天使儿童医院,四川成都610000

出　　处：《中国医疗美容》2022年第5期47-51,共5页China Medical Cosmetology

摘　　要：目的观察双波长脉冲激光联合纳晶微针治疗血管型黄褐斑的临床疗效。方法收集2018年3月-2019年8月到成都青羊菲尔医疗美容诊所治疗黄褐斑患者共42例(血管型23例、血管优势型19例),均采用双波长脉冲激光(585nm脉冲染料激光和1064nm Nd:YAG激光)联合纳晶微针治疗,根据黄褐斑面积及严重程度(melasma area and severity index,MASI)进行评分比较,观察治疗后效果。结果随访6~12月。治疗后基本痊愈1例;效果显著36例;好转4例;无效1例,总有效率88.1%。患者满意度为69.1%(非常满意2例、满意27例、一般8例、不满意5例)。随访期间出现点状色素减退1例,反弹性色素沉着2例,短期内均自然消退。治疗过程中患者面部均有不同程度的烧灼疼痛感,治疗停止后,冰敷即刻缓解。治疗后6月的MASI评分(5.03±2.668)明显低于治疗前(16.27±7.062),差异具有统计学意义(t=10.449,P<0.01)。结论双波长脉冲染料激光联合纳晶微针治疗血管型黄褐斑,临床疗效明显,复发率低,值得临床推广。Objective the clinical efficacy of dual-wavelength pulsed dye laser combined with nanocrystalline micro-needling in the treatment of vascular chloasma.Methods From March 2018 to August 2019,42 patients with melasma(23 cases of vascular type and 19 cases of vascular dominant type)who were treated in Chengdu Qingyang Phil medical beauty clinic were collected,and all patients were treated with dual wavelength pulsed laser(585nm pulsed dye laser and 1064nm Nd:YAG laser)combined with nanocrystalline microneedle.The scores were compared according to melasma area and severity index(MASI),and the therapeutic effect was observed.Results The patients were followed up for 6~12 months.After treatment,1 case was basically cured,36 cases were significantly effective,4 cases were improved,1 case was ineffective,and the total effective rate was 88.1%.Patient satisfaction was 69.1%(2 cases were very satisfied,27 cases were satisfied,8 cases were general and 5 cases were dissatisfied).Punctate hypopigmentation occurred in 1 case and anti-elastic pigmentation in 2 cases,all of which disappeared naturally during the follow-up period.In the course of treatment,the patients had different degrees of burning pain on the face,and the ice compress relieved immediately after the treatment was stopped.Six months after treatment,the MASI score(5.03±2.668)was significantly lower than that before treatment(16.27±7.062).The difference was statistically significant(t=10.449,P<0.01).Conclusion The dual-wavelength pulsed dye laser combined with nanocrystalline microneedle treatment of vascular chloasma has obvious clinical effects and low recurrence rate,which is worthy of clinical promotion.

关 键 词：黄褐斑 双波长激光 氨甲环酸 纳晶微针 

分 类 号：R758.42[医药卫生—皮肤病学与性病学]