Q-开关Nd:YAG激光1064nm联合还原型谷胱甘肽治疗黄褐斑的临床疗效分析

目的:探讨Q-开关Nd:YAG激光1 064nm联合还原型谷胱甘肽治疗黄褐斑的临床疗效。方法:选取黄褐斑患者62例。将患者随机分为治疗组及对照组各31例。对照组单纯应用Q-开关Nd:YAG激光1 064nm治疗;治疗组在应用Q-开关Nd:YAG激光1064nm治疗的同时联合应用还原型谷胱甘肽(GSH)0.9g,加入生理盐水250ml静滴,每日1次,每次激光治疗后连续点滴5日。结果:治疗组基本治愈12例,显效16例,好转3例,无效0例,总有效率为90.3%,对照组基本治愈9例、显效13例、好转7例、无效2例,总有效率70.9%,两组疗效比较(P0.05),差异有统计学意义。结论:Q-开关Nd:YAG激光1 064nm联合还原型谷胱甘肽治疗黄褐斑疗效确切,安全性高,无明显副作用,是一种安全、有效的治疗方法。     

大光斑低能量Q开关Nd:YAG激光联合强脉冲光治疗黄褐斑临床观察

目的:探讨大光斑低能量Q开关Nd:YAG激光联合强脉冲光治疗黄褐斑的临床疗效。方法:收集笔者科室2015年6月-2017年1月收治的109例黄褐斑患者,随机分为四组:A组:27例,采用大光斑低能量Q开关1 064nm Nd:YAG激光治疗,1次/月,共6次;B组:25例,采用大光斑低能量Q开关1 064nm Nd:YAG激光联合强脉冲光治疗,激光治疗1次/月,共6次,中间穿插3~4次IPL治疗(治疗间隔2周);C组:31例,采用大光斑低能量Q开关、长脉宽1 064nm Nd:YAG激光治疗,1次/月,共6次;D组:26例,采用大光斑低能量Q开关、长脉宽1 064nm Nd:YAG激光联合强脉冲光治疗,长脉宽激光治疗1次/月,共6次,中间穿插3~4次IPL治疗(治疗间隔2周)。结果:D组临床效果明显优于A组(P0.05),D组疗效与B组、C组比较无统计学差异(P0.05),但在临床上疗效仍好于B组、C组。结论:采用大光斑低能量Q开关、长脉宽1 064nm Nd:YAG激光联合强脉冲光治疗,能显著提高黄褐斑的临床疗效。     

Q-开关Nd:YAG 1064nm激光联合谷胱甘肽凝胶治疗黄褐斑的疗效观察

目的:评估Q-开关Nd:YAG 1 064nm激光联合谷胱甘肽凝胶对黄褐斑的治疗效果。方法:选26例黄褐斑患者,随机分为两组。治疗组13例,接受Q-开关Nd:YAG激光联合谷胱甘肽凝胶治疗;对照组13例,仅采用Q-开关Nd:YAG激光治疗,每14天治疗1次,6~10次为1个疗程,疗程结束后判断疗效。结果:治疗组有效率为100%,对照组为84.6%,两组疗效比较有统计学意义(P0.05)。结论:临床对比观察Q-开关Nd:YAG 1 064nm激光联合谷胱甘肽凝胶治疗黄褐斑较单用Q-开关Nd:YAG 1 064nm激光治疗有明显优势,适合推广应用。     

Q开关Nd:YAG 1064nm激光联合中药面膜治疗黄褐斑疗效观察

目的:观察Q开关Nd:YAG 1 064nm激光联合中药面膜治疗黄褐斑的临床疗效。方法:对符合黄褐斑临床诊断的105例患者均使用Q开关Nd:YAG 1 064nm激光治疗,其中治疗组53例加用中药面膜外敷,对照组52例单纯1 064nm激光治疗。连续治疗3个周期,评价临床疗效及色素沉着的发生率。结果:治疗结束后,治疗组总有效率92.45%,明显高于对照组的76.92%。随访1年后,治疗组总有效率87.79%明显高于对照组69.23%,有显著性差异(P0.05);治疗组色素沉着发生率3.77%明显低于对照组17.31%(P0.05)。结论:Q开关Nd:YAG 1 064nm激光联合中药面膜治疗黄褐斑疗效显著,不良反应少,值得临床推广应用。     

强脉冲光联合Q开关倍频Nd：YAG激光治疗婴幼儿血管瘤临床观察

目的：观察强脉冲光联合Q开关倍频Nd：YAG激光治疗婴幼儿血管瘤的疗效和安全性。方法：选择100例1岁以内婴幼儿血管瘤患者,随机分为治疗组和对照组,治疗组使用IPL和Q开关倍频Nd：YAG激光联合治疗,对照组仅使用IPL治疗,每3周治疗1次,5次为1个疗程。疗程结束后分析疗效及安全性,并行统计学处理。结果：治疗组皮损痊愈率明显高于对照组（P〈0.05）,总有效率两组间无明显差异（P〉0.05）。两组不良反应均轻微,未见明显色素沉着、色素减退及瘢痕形成。结论：IPL联合Q开关倍频Nd：YAG激光治疗婴幼儿血管瘤安全、有效,临床效果优于单独IPL治疗。     

Q开关Nd:YAG1064nm激光联合强脉冲光治疗56例颧部褐青色痣临床疗效探讨

目的 观察Q 开关Nd:YAG1064nm激光与强脉冲光570～950nm 联合治疗颧部褐青色痣的临床疗效.方法 采用Q 开关Nd:YAG1064nm激光与强脉冲光570～950nm对56例颧部褐青色痣患者行联合治疗;每次治疗前根据皮损状况的不同,选用不同的治疗方式,不同的治疗参数;治疗间隔期积极采用促进色素代谢及组织修复等辅助疗法.结果 56例患者总有效率为100%.痊愈39例,显效13例,有效4例,无效0例..所有患者中Q开关激光治疗1次者18例,2次者31例,3次者7例.结论 Q 开关Nd:YAG1064nm激光与强脉冲光联合治疗颧部褐青色痣疗效可靠,且减少了炎症后色素沉着的发生率,缩短了治疗时间,患者满意度明显提高.     

强脉冲光/Q开关Nd∶YAG激光联合左旋维C治疗黄褐斑的疗效评价

目的：观察强脉冲光（Intense?pulsed?light,IPL）和Q开关Nd∶YAG1?064?nm激光分别联合左旋维C治疗对黄褐斑患者黑色素沉积、皮损情况及血清氧化应激指标的影响。方法：选取2018年1月-2020年10月笔者医院收治的150例黄褐斑患者,随机分组为IPL组和Q开关Nd∶YAG激光组各75例,IPL组采用IPL联合左旋维C治疗,Q开关Nd∶YAG激光组采用激光联合左旋维C治疗。比较两组疗效、黑色素沉积[黄褐斑面积及严重程度评分（Melanin?area?and?severity?index,MASI）]、皮损情况及血清氧化应激指标[丙二醛（Malondialdehyde,MDA）、谷胱甘肽过氧化物酶（Glutathione?peroxidase,GSH-px）、超氧化物歧化酶（Superoxide?dismutase,SOD）]变化、不良反应发生情况、复发率、满意度。结果：治疗后,IPL组总有效率为78.67%,Q开关Nd∶YAG激光组总有效率82.67%。两组MASI评分和皮损积分均显著低于治疗前（P<0.05）。治疗后,两组MDA显著低于同组治疗前,G...     

强脉冲光联合长脉宽Nd:YAG激光治疗面部毛细血管扩张症疗效观察

目的:观察强脉冲光联合长脉宽Nd:YAG激光治疗面部毛细血管扩张症的临床疗效和安全性。方法:将106例面部毛细血管扩张症就医者随机分为三组,强脉冲光治疗组给予560～1 200nm强脉冲光治疗,Nd:YAG激光组使用1 064nm长脉宽Nd:YAG激光治疗,联合治疗组采用强脉冲光与Nd:YAG激光联合治疗,各组均每4～8周治疗1次,共治疗1～5次,治疗结束后4周评价治疗疗效并记录不良反应。结果:按照毛细血管扩张7点评分标准进行评分,联合治疗组Nd:YAG激光组强脉冲光治疗组;治疗次数对比,强脉冲光治疗组Nd:YAG激光组联合治疗组。三组间红斑、水肿、色素沉着的不良反应发生率对比,差异无统计学意义。Nd:YAG激光组及联合治疗组紫癜的发生率高于强脉冲光治疗组。结论:强脉冲光联合长脉宽Nd:YAG激光治疗面部毛细血管扩张症疗效好且治疗次数少,无严重不良反应,值得临床推广。     

窄谱强脉冲光联合长脉宽1064nm激光治疗皮肤血管性病变的疗效分析

目的:探讨窄谱强脉冲光(500～600nm)联合长脉宽1 064nm激光治疗皮肤血管性病变的疗效。方法:使用窄谱强脉冲光(500～600nm)联合Nd:YAG激光长脉宽1 064nm治疗214例血管性病变患者,根据血管性病变的厚度,先用长脉宽1 064nm Nd:YAG激光,然后用窄谱强脉冲光(500～600nm),照射病变部位,治疗1～6次,治疗间隔1个月,门诊随访3～6个月。结果:治愈87例(40.65%),显著消退115例(53.73%),有效9例(4.20%),总有效率94.38%。治疗后出现水疱13例,紫癜10例,色素沉着6例,色素脱失2例,随时间逐渐恢复。结论:窄谱强脉冲光(500～600nm)联合长脉宽1 064nm激光治疗皮肤血管性病变,发挥了强脉冲光和激光的优点,疗效显著,不良反应轻,值得临床推广应用。     

Q开关Nd:YAG 532nm点阵激光治疗黄褐斑的疗效及安全性分析

目的:评估Q开关Nd:YAG 532nm点阵激光治疗黄褐斑的疗效及安全性。方法:采用Q开关Nd:YAG 532nm点阵激光治疗41例黄褐斑患者,4周治疗1次,4次为1个疗程,每次复诊由医生和患者共同评定疗效和安全性。结果:41例患者,痊愈9例(21.95%),显效13例(31.71%),有效率53.66%。其中表皮型:痊愈率33.33%,显效率47.62%,有效率80.95%;真皮型:痊愈率11.11%,显效率11.11%,有效率22.22%;混合型:痊愈率9.09%,显效率18.18%,有效率27.27%。表皮型疗效与真皮型及混合型比较均有显著性差异,真皮型与混合型疗效比较无统计学意义。2例患者治疗后出现轻度色素沉着,3个月后随访自行消退。结论:Q开关Nd:YAG 532nm点阵激光治疗黄褐斑安全、有效,表皮型疗效更佳。     

强脉冲光及Nd:YAG(1064nm)激光治疗皮肤血管瘤疗效观察

目的:评价应用强脉冲光及Nd:YAG(1064nm)激光治疗皮肤血管瘤的临床效果。方法:回顾并随访2006年1月～2010年12月在笔者科室采用强脉冲光及Nd:YAG(1064nm)激光治疗的476例皮肤血管瘤患者,对其疗效进行分析。结果:随访2年,皮肤浅表血管瘤治愈率为88.4%,有效率为10.7%,深浅混合血管瘤联合药物注射治疗的治愈率为78.4%、有效率为17.6%,副作用轻微。结论:强脉冲光及Nd:YAG(1064nm)激光治疗皮肤血管瘤疗效好、治疗次数少、安全性高,值得推广。     

单用强脉冲光、长脉宽Nd:YAG激光以及低能量下两者联合使用治疗微静脉畸形的临床疗效比较

目的:观察单用强脉冲光、长脉宽1064nm Nd:YAG激光以及低能量下两者联合使用治疗微静脉畸形的临床疗效和不良反应。方法:联合应用590～1200nm强脉冲光(能量密度12～16J/cm2,脉宽3.0～5.0ms)以及长脉宽1064nm Nd:YAG激光(能量密度80～90J/cm2,脉宽10～20ms)治疗51例微静脉畸形患者;并与单独应用强脉冲光(能量密度13～20J/cm2)及长脉宽Nd:YAG激光(能量密度120～145J/cm2)治疗结果比较。结果:强脉冲光、长脉宽1064nmNd:YAG激光及低能量下联合使用治疗微静脉畸形的有效率分别为33.1%、40.3%和56.9%,瘢痕发生率分别为0%、10.7%和5.9%。结论:低能量下联合使用强脉冲光及长脉宽1064nm Nd:YAG激光提高了微静脉畸形的有效率,且不良反应小。     

Efficacy of the Nd YAG Laser in the treatment of superficial cutaneous vascular lesions

On the basis of accumulated clinical experience, there is some information available about the treatment of vascular lesions with lasers especially the pulse dye laser. Our study aims to assess the efficacy of Nd YAG lasers in the management of cutaneous vascular lesions and compare results with previously published work on the Nd YAG laser, the Pulse Dye Laser, and Intense Pulsed Light (IPL). The apparatus used was the Combined IPL–Nd YAG Laser system from AK lasers. Fifteen patients volunteered with thread veins, spider naevi, and telangectasia. The treatments were given on an outpatient basis, and results were reassessed at 1 month. The results were generally disappointing at 1 month. Ten patients had no improvement. Five patients treated on the face had minimal to moderate improvement. Although the Nd YAG laser showed dramatic immediate results, in the long run, its use proved disappointing for cutaneous venous lesions of the lower limbs, although the results for facial lesions are better and in keeping with previous studies.     

Q开关Nd：YAG激光治疗色素性皮肤病5000例疗效观察

目的：观察Q开关Nd：YAG激光治疗色素性皮肤病的疗效、影响因素及副反应。方法：使用Q开关Nd：YAG激光治疗色素性皮肤病患者5000例,浅表性色素损害雀斑、咖啡斑和老年斑采用Q532nm波长,太田痣和文身采用Q1064nm波长。结果：本组患者经1～6次治疗,总有效率达96．14％,术后出现暂时性色素沉着269例（5．38％）,无瘢痕发生。结论：Q开关Nd：YAG激光治疗色素性皮肤病疗效较好,安全性高。     

Laser Treatment With a 1064-nm Laser for Lower Extremity Class I–III Veins Employing Variable Spots and Pulse Width Parameters

BACKGROUND: The long-pulsed 1064-nm Nd:YAG laser (employing varying spot sizes, pulse widths, and fluences) has gained popularity for treating lower extremity blue and red vessels that are less than 4 mm in diameter. OBJECTIVE: To evaluate the efficacy of high-power 50-ms 1064 Nd:YAG laser in the treatment of class I-III lower extremity vessels. METHODS: Ten female patients (mean age of 39 years) had a 5-cm2 area of veins measuring 0.2 to 3 mm in diameter treated with up to three treatment sessions using a new 1064 Nd:YAG laser, with the end point being 100% vessel clearing after three treatments. Red vessels were treated with a spot size of 1.5 mm, a fluence of 400 to 600 J/cm2, a pulse width of 30 to 50 ms; blue vessels of 1 to 3 mm were treated with a spot size of 3 mm, a fluence of 250 to 370 J/cm2, and a pulse width of 50 to 60 ms. Macrophotographic imaging evaluations by blinded observers using a quartile scale and a patient satisfaction scale were employed to evaluate results. RESULTS: At month 3 after the final treatment session, 20% of all vessel types had 50% to 75% improvement. Equal clearing was noted for blue and red vessels. At month 6, 80% of patients had a greater than 75% clearing. Ninety percent of patients were highly satisfied with the treatment results at 6 months. CONCLUSION: By varying spot size, fluence, and pulse duration, a long-wavelength 1064-nm Nd:YAG laser can achieve excellent results for treating both blue and red lower extremity vessels that are less than 3 mm in diameter.     

Long-Pulsed 1064-nm Nd:YAG Laser-Assisted Hair Removal in All Skin Types

BACKGROUND: Although there are several different laser systems available for the reduction of unwanted hair, no single system has been shown to be superior in providing safe and effective hair removal in every skin type. The purpose of this study was to evaluate the safety and efficacy of a high-energy, long-pulsed, 1064-nm Nd:YAG laser with a contact cooling device for hair removal in skin phototypes I-VI. METHODS: Thirty-six adult patients (skin phototypes I-VI) with dark terminal facial or nonfacial hair were treated with a long-pulsed Nd:YAG laser (1064 nm, 10-mm spot size, fluence of 30 to 60 J/cm2). The selected pulse duration was dependent on the skin type of the patient: Skin types I/II, III/IV, and V/VI received 10, 20, and 30 ms, respectively. Three consecutive laser treatments were delivered to 36 skin sites at 4- to 6-week intervals. Hair counts and photographic evaluations of skin sites were obtained at baseline, immediately before each treatment session, and at 1, 3, and 6 months after the final laser treatment. RESULTS: Peak hair reduction was observed 1 month after the series of laser treatments with a mean hair reduction ranging from 58% to 62% on facial sites and 66% to 69% on nonfacial sites. At 6 months after a series of three long-pulsed Nd:YAG laser treatments, a mean hair reduction of 41% to 46% on the face and 48% to 53% on the body was found depending on the skin phototype. Adverse reactions included mild to moderate treatment pain, short-term erythema, and rare occurrences of transient pigmentary alteration without scarring. CONCLUSION: The long-pulsed 1064-nm Nd:YAG laser with contact cooling is a safe and effective method of hair reduction in patients of all skin types. Side effects were limited and transient.     

A side-by-side comparative study of 1064 nm Nd:YAG, 810 nm diode and 755 nm alexandrite lasers for treatment of 0.3-3 mm leg veins.

BACKGROUND: Laser and intense pulsed light device treatments of leg veins have generally yielded disappointing results. Use of longer wavelengths, longer pulse widths, and better cooling devices have recently sparked renewed interests in these methods. OBJECTIVE: To prospectively compare, side by side, a 3-msec cryogen spray-equipped 755 nm alexandrite, a sapphire window cooled super-long-pulse 810 nm diode, and a variable pulse width, cryogen spray-equipped 1064 nm Nd:YAG laser for the treatment of 0.3-3mm leg veins. METHODS: Thirty female volunteers, skin types I-V, age 32-67 years with comparable sets of leg veins were treated with the Nd:YAG laser and either the diode laser, alexandrite laser, or both. In most patients two to three sets of comparable sites were treated. Treatment parameters varied with each laser and according to the size of veins being treated. Patients were examined 1 week after each treatment and at 1, 2, and 3 months after the last treatment. Pre- and posttreatment 35mm photographs were taken. Improvement was judged by two experienced physicians both visually on patients and by comparison of pre- and posttreatment photographs. Results were graded as percent resolution, in five groups, 0%, 0-25%, 25-50%, 50-75%, and 75-100%. RESULTS: In the 22 patients completing the study, 36 leg vein sites were treated with the Nd:YAG laser, 18 leg vein sites were treated with the diode laser, and 12 leg vein sites were treated with the alexandrite laser. Greater than 75% improvement was observed at 88% of the Nd:YAG laser-treated sites, 29% of the diode laser-treated sites, and 33% of the alexandrite laser-treated sites. Greater than 50% improvement was observed at 94% of the Nd:YAG laser-treated sites, 33% of the diode laser-treated sites, and 58% of the alexandrite laser-treated sites. Less than 25% improvement was observed at 6% of the Nd:YAG laser-treated sites, 39% of the diode laser-treated sites, and 33% of the alexandrite laser-treated sites. Pain during treatment was variably perceived by patients, but occasionally sufficient for patients to decline further treatment. Posttreatment purpura and telangiectatic matting were a significant drawback for the alexandrite laser. Transient hemosiderin pigmentation, as seen with sclerotherapy, was common with larger vessels. CONCLUSION: The cryogen spray-equipped 1064 nm Nd:YAG laser was remarkably effective and safe for the treatment of 0.3-3 mm leg veins. The use of topical anesthesia may be needed for some patients. The super-long-pulse 810 nm diode laser gave unpredictable results. Additional refinements of fluence and pulse width could improve its performance. The 3-msec, 755 nm alexandrite laser at fluences of 60-70 J/cm2 and an 8 mm spot can be effective, but inflammatory response, purpura, and matting limit its usefulness. Longer pulse widths might decrease these problems. For leg vein treatment, the 1064 nm wavelength is very safe for type V skin, the 810 nm wavelength at super-long pulse widths of 400-1000 msec is very safe for type IV and marginal for type V skin, and the 755 nm wavelength is limited to nontanned type I-III skin.