目的:探讨长脉宽1064nm Nd:YAG激光治疗黄褐斑的临床疗效和安全性.方法:选取12例面部黄褐斑患者,采用长脉宽1064nm Nd:YAG激光,光斑直径5mm,脉宽0.3-0.4ms,能量13～15J/cm2,频率7～10Hz,全面部每次扫描约6000～12000个脉冲,共治疗1 0次,每2周1次,术后严格防晒.每次治疗前采用MASI评分和前后照片比较改善效果.结果:12例经过10次治疗,黄褐斑患者均获得不同程度改善,其中3例的改善率达到了60％,5例达到50％以上的改善.无1例出现严重副反应,同时还有改善皮肤质地的作用,80％以上的患者表示满意.结论:长脉宽1064nm Nd:YAG激光治疗黄褐斑疗效确切,安全性高,无明显副作用,是一种治疗黄褐斑安全、有效的新方法.%Objective To evaluate the efficacy and safety of long pulsed 1064nm Nd:YAG laser for the treatment of melasma lesions. Methods 12 patients (Fitzpatrick skin types III -IV) with melasma lesions were enrolled. During each treatment, each zone received 6000-12000 pulses using the following laser parameters: 0.3-0.4 ms pulse duration, 13-15J/cm2, 7-10 Hz, 5 mm spot size. Ten treatment sessions were performed for each patient 2 weeks apart. After treatment.the clearance of melasma lesions was assessed by MASI scores and the satisfaction of treatment was recorded by patients. Based on the MASI scores of pretreatment and posttreatment, the improvement rate of melasma was calculated. Results 12 cases of melasma lesions obtained different degree of improvement were treated by 10 times , MASI scores declined significantly from the baseline to the follow up visits of each treatment. 3 (15%) patients obtained 60% improvements ,5 (41.6%) patients obtained 50% improvements, according to the over all evaluation by dermatologists . Over 80% patients considered their results satisfactory or very satisfactory. Conclusions long pulsed 1064nm Nd:YAG laser is effective and safe in the treatment of melasma lesions, the side effects was rare, without downtime almost, thereby long-pulsed 1064nm Nd.YAG laser providing the patients with melasma lesions an additional new therapeutic option.
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