本文選題：雀斑 + Q開關(guān)1064nm��； 參考：《濟南大學》2017年碩士論文

【摘要】：研究背景:雀斑是一種常見的皮膚色素沉著性疾病,在遺傳背景基礎(chǔ)上,受日光照射的影響,一般發(fā)病年齡在4-5歲,也可在青春期早期發(fā)病,密集或散在分布于面部等曝光部位,影響患者的社交活動和整體形象。雀斑的組織病理學特征是表皮黑素增多而黑色素細胞數(shù)量沒有明顯的增加。傳統(tǒng)的冷凍、532nm Q開關(guān)KTP激光或強脈沖光都可以治療雀斑,但治療后患者皮損會出現(xiàn)結(jié)痂或是紫癜瘀斑,恢復時間較長以及色素沉著等風險的存在降低了患者的依從性,臨床上需求能有效治療雀斑而不影響患者日常工作或?qū)W習的治療方法。2008年韓國學者首先提出了大光斑低能量Q開關(guān)1064nm Nd:YAG(QSNY)激光模式治療黃褐斑,淡化黃褐斑的同時,治療后僅有一過性紅斑反應(yīng),不影響患者日常工作或?qū)W習,受到臨床醫(yī)生和患者的青睞,得以迅速普及。雀斑和黃褐斑類似,也是表皮色素沉著性皮膚病,理論上這種大光斑低能量激光治療模式也有效,因而,我們做了前瞻性的研究設(shè)計,設(shè)計了減少雀斑患者停工時間的治療方案。目的:本研究旨在探討大光斑低能量模式QSNY激光治療雀斑的安全性和有效性,以期為臨床提供安全有效,不影響日常工作或?qū)W習的雀斑新型治療方法。方法:將2013年2月至2016年4月來我院門診的15名成年雀斑患者作為本次研究的對象�；颊咴敢饨邮芪覀兲峁┑闹委煼桨�,并簽署知情同意書,治療參數(shù)為:波長1064nm,光斑7mm,脈寬10ns,能量密度1.5-2.5J/cm2;治療頻率為2-3周一次,治療次數(shù)3-5次,每次治療前拍照,末次治療結(jié)束后隨訪6個月。由2名臨床醫(yī)生根據(jù)患者治療前后照片評價療效,患者自我評價也納入結(jié)果分析。結(jié)果:所有患者中8名患者取得了極好的效果(76-100%),4名患者有較好改善(51-75%),3名患者效果一般(26-50%)。在患者的自我評估中,9名患者覺得有非常明顯的改善(76 100%),6名患者自覺色斑適度改善(51-75%)。其中兩名患者治療半年后有復發(fā)傾向,所有患者治療后僅有輕微紅斑,數(shù)小時內(nèi)消退,不影響第二天工作,治療后未報告色沉發(fā)生。結(jié)論:大光斑低能量模式QSNY激光治療雀斑安全有效。
[Abstract]:Background: freckles are a common skin pigmentation disease. Based on genetic background and affected by sunlight, freckles usually occur at the age of 4-5 years and can also occur in the early puberty. Dense or scattered in the face and other exposure areas, affecting the patient's social activities and overall image. Histopathological features of freckles were increased in epidermal melanin but no significant increase in the number of melanocytes. The traditional cryopreservation Q-switched KTP laser or intense pulse light can treat freckles, but after treatment, scab or purpura ecchymosis will appear in the lesions of the patients. The long recovery time and the presence of the risk of pigmentation have reduced the compliance of the patients. In 2008, Korean scholars first proposed the 1064nm ND: YAGQSNY laser mode for the treatment of chloasma, while desalinating chloasma. Only a transient erythema response after treatment does not affect patients' daily work or study, and is popular with clinicians and patients. Freckles are similar to chloasma and are also epidermal pigmentation dermatoses. Theoretically, this kind of low-energy laser treatment mode for large spot is also effective. Therefore, we have made a prospective research design. A treatment scheme was designed to reduce the stop time of patients with freckles. Objective: to investigate the safety and efficacy of low energy mode QSNY laser in the treatment of freckles in order to provide a safe and effective method for the treatment of freckles without affecting daily work or study. Methods: from February 2013 to April 2016, 15 adult patients with freckles were enrolled in this study. The patients were willing to accept the treatment plan we provided, and signed the informed consent letter. The parameters of the treatment were: wavelength 1064nm, spot 7mm, pulse width 10ns, energy density 1.5-2.5J / cm 2, treatment frequency 2-3 weeks, treatment times 3-5 times, before treatment. All patients were followed up for 6 months after the last treatment. The therapeutic effect was evaluated by two clinicians according to the photos of the patients before and after treatment, and the self-evaluation of the patients was also included in the analysis of the results. Results: among all the patients, 8 patients achieved excellent results. In the self-assessment of the patients, 9 patients felt that there was a very significant improvement. Two of the patients had a tendency to recur after six months of treatment, all of them had only mild erythema after treatment, subsided within a few hours, did not affect the work of the next day, and did not report the occurrence of chroma after treatment. Conclusion: large spot low energy mode QSNY laser is safe and effective in the treatment of freckles.
【學位授予單位】：濟南大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R758.43

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