强脉冲光联合595nm脉冲染料激光治疗痤疮后色素沉着和瘢痕的临床疗效

目的探讨强脉冲光（intense pulsed light,IPL）联合595 nm脉冲染料激光（pulse dye laser,PDL）治疗痤疮后色素沉着及瘢痕的疗效和安全性。方法痤疮后色素沉着和瘢痕患者126例,随机分为三组：A组,PDL激光治疗组患者48例,波长595 nm,光斑直径7 mm,能量密度7-8 J/cm^2,脉宽3-6 ms;B组,联合治疗组患者42例,选用560-1200 nm波长,能量密度16-25 J/cm^2;C组,对照组患者36例,每晚外用2%氢醌乳膏治疗,连续使用8-12周。A、B组每2-4周治疗1次,共治疗3次。根据治疗前后患者面部照片判断疗效。结果 A、B两组患者3次治疗后4周随访的总有效率分别为59.5%、72.9%,两组患者总有效率比较,差异有显著意义（P〈0.05）;C组患者治疗后12周随访,总有效率为33.3%。A组与B组比较,差异无显著意义（P〉0.05）;B组与C组比较,差异有显著意义（P〈0.01）。A、B组患者治疗后出现轻微的红斑,但均在几个小时内消退,未见其他不良反应;C组3例患者出现皮肤过敏。结论强脉冲光联合595 nm脉冲染料激光治疗痤疮后色素沉着及瘢痕无创、有效,值得推广使用。

Clinical Observation on Hyperpigmentation and Scars after Combined Acne Treatment with Intense Pulsed Light and 595 nm Pulse Dye Laser

Objective To explore and evaluate the curative effect and safety of intense pulsed light （IPL） combined with 595 nm PDL in the treatment of hyperpigmentation and sears of acnes. Methods Altogether 126 patients with acne-cansed hyperpigmentation and scars were randomly divided into 3 groups. 48 patients were treated jointly with Intense pulsed light （IPL） and 595 nm PDL and 42 patients solely with 595 nm pulse dye laser. All these 90 patients underwent 3 sessions of treatment at an interval of 2-4 weeks. The rest 36 patients, consisting of the control group, were treated with 2% topical hydroquinone cream every night. The treatment continued 8-12 weeks. The therapeutic effect was judged by comparing the photographs taken before and after the treatment respectively. Results The curative effect of the treatment group of IPL combined with 595 nm PDL, the treatment group of 595 nm PDL and the control group were 72. 9%, 59. 5% and 33.3% respectively. The therapeutic effect and efficacy rates of the treatment groups were significandy higher than that of the control group （ P 〈 0. 01 ）. The treatment groups reported mild erythema after laser treatment, but it was resolved within several hours after the treatment in all eases. Side effects were also observed. Erythema and skin itching occurred at a rate of 8. 33% in the control goup. Conclusions The combined treatment of intense pulsed light （IPL） and 595 nm PDL on can-caused hyperpigmentation and scars is an innovative, noninvasive and effective beauty technique.