Q开关翠绿宝石激光和强脉冲光治疗面部雀斑的疗效和安全性

目的 比较Q开关翠绿宝石激光(Q-switched Alexandrite Laser,QSAL)和OPT(Optimal Pulse Technology)强脉冲光治疗面部雀斑的临床疗效和安全性. 方法 将100例单纯面部雀斑患者随机分为QSAL组50例,OPT组50例.QSAL组以Q755nm激光仪治疗1次,OPT组以OPT治疗2次,每次间隔4周.治疗结束后第4、12、24周判定临床疗效,第4周统计PIH发生率以判定安全性,24周进行满意度评价. 结果 QSAL组患者治疗后第4周,治愈率82％,显效率14％,进步为4％；治疗后第12周,治愈率84％,显效率14％,进步为2％；治疗后第24周,治愈率86％,显效率14％.OPT组治疗1次后第4周治愈率30％,显效率60％,进步为10％;经过2次OPT治疗后第12周治愈率70％,显效率24％,进步为6％；2次治疗后第24周治愈率70％,显效率24％,进步为6％.患者对治疗的满意度评价,QSAL组非常满意率和满意率分别为78％和20％,轻度满意率2％.OPT组非常满意率和满意率分别为80％和20％.QSAL组有2例患者于术后2～4周开始患处出现炎症后色素沉着(Postinflammatory Hyperpigmentation,PIH),占总例数的4％,于6～24个月内消退；OPT组无PIH的病例出现. 结论 Q开关翠绿宝石激光和强脉冲光(OPT)均能很好地治疗雀斑,QSAL组激光治疗效果优于OPT组,而OPT的安全性优于QSAL.

Comparison of efficacy and safety between Q-switched alexandrite laser and intense pulsed light for the treatment of facial freckles

Objective To compare the efficacy and safety of Q-switched alexandrite laser （QSAL） and intense pulsed light （IPL） with optimal pulse technology for the treatment of facial freckles. Methods 100 cases of facial freckles were randomly grouped into 50 cases of group QSAL and 50 cases of group OPT. Patients of group QSAL were treated by QSAL once, while patients of group OPT were treated by OPT twice, with a 4 week interval. The efficacy and safety of the two groups were compared. Curative effect was observed after 4 weeks, 12 weeks and 24 weeks. The rate of postinflammatory hyperpigmentation （PIH） was observed after 4 weeks. The satisfaction rate after 24 weeks was investigated. Results Both of the groups of QSAL and OPT acquired obviously improvement. The improvement rate of group QSAL was 96% 4 weeks after treatment while it was 98% 12 weeks after treatment. 24 weeks after treatment the improvement rate was 100%. The improvement rate of group OPT was 90% 4 weeks after the first treatment, while it was 94% 12 weeks after the second treatment. 24 weeks after the second treatment the improvement rate remained 94%. Ac- cording to the satisfaction rate, the rates of very satisfied and satisfied of group QSAL were 78%and 20%.The rate of slightly satisfied was 2% and no patients dissatisfied. The rates of very satisfied and satisfied of group OPT were 80% and 20%. There were no patients slightly satisfied and dissatis- fied. There were 2 cases of patients out of 50 cases of group QSAL developed PIH （4%）, which subsided in 6 -24 months while no PIH occured after OPT therapy. Conclusion Both of QSAL and OPT can treat facial freckles well. The efficacy of QSAL is better than that of OPT, while the safety of OPT is better than that of QSAL.