Q开关激光1064nm联合532/1064nm混合波长治疗颧部褐青色痣(1)
[摘要]目的：观察Q开关Nd:YAG激光1064nm联合532/1064nm混合波长治疗颧部褐青色痣(Naevus Fuscocaendeus Zygomaticus，NFZ)的疗效分析。方法：选择1064nm联合532/1064nm混合波长治疗NFZ 158例，每次治疗间歇期为3～6月，平均治疗4次。结果：3例治疗2次，86例治疗3～4次，61例治疗超过4次，8例中途放弃治疗。最后一次治疗后6～12个月后复诊，有效率可达100%，治愈率为61.3%。约10%的患者术后产生较严重的色素沉着，多为可逆性，一般6～10月后会自行变淡。术后无一例产生瘢痕或色素脱失等不良反应。结论：Q开关激光1064nm联合532/1064nm混合波长治疗NFZ能有效降低术后色素沉着的发生，并大大的提高治愈率，是目前治疗该病较为理想的一种方法。
[关键词]褐青色痣；Q开关Nd:YAG多波长激光
[中图分类号]R751 [文献标识码]A [文章编号]1008-6455(2009)03-0356-02
Efficacy of Q-switched laser 1064nm combining 532/1064nm mixing wave length: treatment on Naevus Fuscocaendeus Zygomaticu
AN Li-sha,LI Da-tie,TANGH Zheng-xi,WANG Jing,XIE Yong-hong,HUANG Chi-kai
(Department of Cosmetic Laster, the Cosmetic Hospital of Affiliated Hospital of Zunyi Medical College, Zunyi 563000,Guizhou,China)
Abstract: Objective To observe the therapeutic effect of Q-switched Nd: YAG laser irradiation of 1064nm combining 532/1064nm mixing wave length for Naevus Fuscocaendeus Zygomaticus (NFZ). Methods A total of 158 NFZ cases were treated with 1064nm combine 532/1064nm mixing wave length. The interval duration between treatments is 3～6 months,totally 4 treatments in average. Results 3 cases cured by 2 treatments,86 cases cured by 3～4 treatments, 61 cases cured by exceed 4 treatments,8 cases quit the treatment in the middle way. The therapeutic effect rate achieves 100% with further therapeutic 6～12 months after the last therapy, while cured rate is 61.3%. Among those cases, approximately 10% of sufferers would produce a distinct pigmentation after operation,however it mostly attributed from the reversibility and it will be cleaned out gradually itself in general.There is no any case leading to ill effect of scar or pigment fadeout occurring after therapy. Conclusion Q-switched laser irradiation of 1064nm combine 532/1064nm mixing wave length for NFZ has therapeutic effect to reduce the occurring of pigmentation after operation, as well as to increase significantly the cured rate. It proves to be regarded as the most ideal method to remedy NFZ at present.
Key words:Naevus Fuscocaendeus Zygomaticus( NFZ);Q-switched Nd: YAG wave length laser
NFZ是近来被研究报道的临床上常见的一种后天的真皮色素增加性疾病。该皮损常对称分布于双侧颧部，为散在圆形(黑)褐色斑点，或可集簇成片，边界清楚，女性好发。一般临床上可分为3型，轻型：皮损局限颧部，呈浅褐色颗粒状；中型：颗粒稍大，呈黑褐色，严重可成片状；重型：皮损面积较大成斑块状，呈黑色，常累及到双侧额颞部、下眼睑或鼻翼。
早在1997年，在国内卫连坤等就已相继对该病进行了报道。该病发病晚且病程长，曾采用过冷冻等方法治疗，但都因效果较差且容易遗留瘢痕而不被患者接受。近来使用的Q开关激光1 064nm对该病进行治疗，却因为术后会产生暂时性的色素沉着，使得很多患者中途放弃了治疗。近年，我科采用Q开关激光1 064nm联合 532/1 064nm混合波长对该病治疗100余例，不仅有助于减少术后色素沉着的发生，治疗的有效率也得以提高，也使患者更易接受治疗。现对该组病例报道如下。
1资料和方法
1.1临床资料：本组患者共计158例，均为女性，年龄17～48岁，其中轻型44例，中型99例，重型15例。中、重型患者年龄在30～48岁，这部分患者中90%曾使用过剥脱性祛斑产品。
1.2治疗仪器及参数选择： Q开关Nd：YAG多波长激光机(重庆京渝激光公司)：治疗时根据患者的年龄、皮肤的健康程度等选择合适的治疗参数。轻、中型者，首次治疗宜选择波长1064nm,光斑1.5～2mm, 能量800～900mJ(目的使位于真皮的色素颗粒得以充分爆破)，再次治疗时改用532/1 064nm混合波长，光斑2～3mm，能量250～300mJ进行治疗。重型者可直接选用混合波长，光斑2～3mm，能量400～450mJ进行治疗。
1.3治疗方法：每次术前要求在相同的环境、角度及相同的相机模式设置下对治疗部位进行拍照并存档。用1‰新洁尔灭消毒皮肤，根据皮肤延时反应调整能量，以皮肤出现轻度红肿(1 064nm)或表皮出现炭化现象发白(532/1 064nm)为宜。术后立即冰敷20～30min，降温镇痛，局部外抹细胞生长肽类软膏5～7天。术后一月内严格防晒，口服VitC片剂200mg/Bid连服4～8周。术后3～4周配合使用深圳蕙尔瑞生物科技有限公司生产的优白素，时间为4～6周，它有助于减轻术后产生的色素沉着。, http://www.100md.com(安丽莎 李大铁 唐正喜 王 晶 谢永红 黄束力凯)
[关键词]褐青色痣；Q开关Nd:YAG多波长激光
[中图分类号]R751 [文献标识码]A [文章编号]1008-6455(2009)03-0356-02
Efficacy of Q-switched laser 1064nm combining 532/1064nm mixing wave length: treatment on Naevus Fuscocaendeus Zygomaticu
AN Li-sha,LI Da-tie,TANGH Zheng-xi,WANG Jing,XIE Yong-hong,HUANG Chi-kai
(Department of Cosmetic Laster, the Cosmetic Hospital of Affiliated Hospital of Zunyi Medical College, Zunyi 563000,Guizhou,China)
Abstract: Objective To observe the therapeutic effect of Q-switched Nd: YAG laser irradiation of 1064nm combining 532/1064nm mixing wave length for Naevus Fuscocaendeus Zygomaticus (NFZ). Methods A total of 158 NFZ cases were treated with 1064nm combine 532/1064nm mixing wave length. The interval duration between treatments is 3～6 months,totally 4 treatments in average. Results 3 cases cured by 2 treatments,86 cases cured by 3～4 treatments, 61 cases cured by exceed 4 treatments,8 cases quit the treatment in the middle way. The therapeutic effect rate achieves 100% with further therapeutic 6～12 months after the last therapy, while cured rate is 61.3%. Among those cases, approximately 10% of sufferers would produce a distinct pigmentation after operation,however it mostly attributed from the reversibility and it will be cleaned out gradually itself in general.There is no any case leading to ill effect of scar or pigment fadeout occurring after therapy. Conclusion Q-switched laser irradiation of 1064nm combine 532/1064nm mixing wave length for NFZ has therapeutic effect to reduce the occurring of pigmentation after operation, as well as to increase significantly the cured rate. It proves to be regarded as the most ideal method to remedy NFZ at present.
Key words:Naevus Fuscocaendeus Zygomaticus( NFZ);Q-switched Nd: YAG wave length laser
NFZ是近来被研究报道的临床上常见的一种后天的真皮色素增加性疾病。该皮损常对称分布于双侧颧部，为散在圆形(黑)褐色斑点，或可集簇成片，边界清楚，女性好发。一般临床上可分为3型，轻型：皮损局限颧部，呈浅褐色颗粒状；中型：颗粒稍大，呈黑褐色，严重可成片状；重型：皮损面积较大成斑块状，呈黑色，常累及到双侧额颞部、下眼睑或鼻翼。
早在1997年，在国内卫连坤等就已相继对该病进行了报道。该病发病晚且病程长，曾采用过冷冻等方法治疗，但都因效果较差且容易遗留瘢痕而不被患者接受。近来使用的Q开关激光1 064nm对该病进行治疗，却因为术后会产生暂时性的色素沉着，使得很多患者中途放弃了治疗。近年，我科采用Q开关激光1 064nm联合 532/1 064nm混合波长对该病治疗100余例，不仅有助于减少术后色素沉着的发生，治疗的有效率也得以提高，也使患者更易接受治疗。现对该组病例报道如下。
1资料和方法
1.1临床资料：本组患者共计158例，均为女性，年龄17～48岁，其中轻型44例，中型99例，重型15例。中、重型患者年龄在30～48岁，这部分患者中90%曾使用过剥脱性祛斑产品。
1.2治疗仪器及参数选择： Q开关Nd：YAG多波长激光机(重庆京渝激光公司)：治疗时根据患者的年龄、皮肤的健康程度等选择合适的治疗参数。轻、中型者，首次治疗宜选择波长1064nm,光斑1.5～2mm, 能量800～900mJ(目的使位于真皮的色素颗粒得以充分爆破)，再次治疗时改用532/1 064nm混合波长，光斑2～3mm，能量250～300mJ进行治疗。重型者可直接选用混合波长，光斑2～3mm，能量400～450mJ进行治疗。
1.3治疗方法：每次术前要求在相同的环境、角度及相同的相机模式设置下对治疗部位进行拍照并存档。用1‰新洁尔灭消毒皮肤，根据皮肤延时反应调整能量，以皮肤出现轻度红肿(1 064nm)或表皮出现炭化现象发白(532/1 064nm)为宜。术后立即冰敷20～30min，降温镇痛，局部外抹细胞生长肽类软膏5～7天。术后一月内严格防晒，口服VitC片剂200mg/Bid连服4～8周。术后3～4周配合使用深圳蕙尔瑞生物科技有限公司生产的优白素，时间为4～6周，它有助于减轻术后产生的色素沉着。, http://www.100md.com(安丽莎 李大铁 唐正喜 王 晶 谢永红 黄束力凯)