丁娜娜,麦 跃,杨 鹏,孙林潮,陈瑞红

[摘要]目的：探讨Q开关Nd：YAG激光多次低能量祛除文身的临床疗效观察。方法：临床选取21例文身患者，治疗采用自身对比:A区为试验区，使用Q开关1064nm波长激光，光斑直径4～6mm，能量密度为2.0～4.0J/cm2，平行均匀照射1遍，术后即刻反应皮损变白霜，无皮肤出血点,每天治疗1次，连续治疗3～4次；B区为对照区，使用Q开关1064nm波长激光，光斑直径3～4mm，能量密度为5.0～8.0J/cm2，均匀照射1遍，即刻反应皮损灰白或皮肤出血。两组病例均于术后6个月观察疗效。结果：术后6个月观察，试验区：治愈9例（42.8%），显效12例（57.2%），无瘢痕形成；对照区：治愈3例（14%），显效5例（24%），好转13例（62%），2例（9.5%）出现轻度增生性瘢痕。结论：采用Q开关Nd：YAG激光多次低能量治疗文身的方法可加快文身消退病程，减少文身治疗中能量密度过大形成瘢痕或色素脱失的风险，为文身治疗提供一种新的治疗方法。

[关键词]文身；Q开关Nd：YAG激光；低能量

[中图分类号]R730.57 [文献标识码]A[文章编号]1008-6455(2012)04-0621-02

Application of the multiple low-energy Q-switched laser for the treatment of tattoos in 21 cases

DING Na-na，MAI Yue，YANG Peng，SUN Lin-chao，CHEN Rui-hong

(Department of Dermatology,Shenzhen Sun Hospital Affiliated of Dalian Medical University,Shenzhen 518000, Guangdongm,China)

Abstract: Objective To evaluate the efficacy of multiple low-energy Q switched laser treatment for tattoo patients. Methods21 patients (skin typeIV-V, mean age 21.4) with tattoos were enrolled,and the tattoo lesions were divided into two parts on one person.: Lesions in part A (the experimental group) were treated with Q-switched laser (wavelength 1064nm ,spotsize 4～6mm, fluence 2.0～4.0J/cm2 ,pulse repetition rate 10 Hz). The lesions became white-frosting after irradiation .The treatment was performed once a day for 3 days.Lesions in part B (the control group) were treated with Q-switched laser (wavelength 1064nm, spotsize 3～4mm, fluence 5.0～8.0J/cm2 , pulse repetition rate 10 Hz) for one session. The evaluation was performed 6 months after treatment.ResultsIn group A, all cases achieved different degree of improvement :42.8% of the tattoos were cured, 57.2% of the tattoos were excellent, without scar formation. In group B: all case achieved different degree of improvement :14.0% of the tattoos were cured, 24.0% of the tattoos were excellent and 62.0% of them were improved. Slightly hypertrophic scar formation occurred to 2 cases in group B. ConclusionApplication of the multiple low-energy Q-switched laser is effective and safe in the treatment oftattoos ,and the side effects was rare, thereby it give a new choice for the patients with tattoos .

Key words: Tattoo;Q switched Nd：YAG laser;low-energy

近年来,随着美容性文身的兴起，文身人群逐渐增多，随之由于不同原因要求祛除这类皮肤文身者也逐渐增多。既往文身祛除非常困难，一般采用电烧、冷冻、磨皮植皮、药物腐蚀、普通二氧化碳激光、外科手术等治疗，但这些治疗方法都难以彻底将文身祛除干净，而且治疗后常会遗留色素不均匀、瘢痕等副作用[1]。随着美容激光技术的进步，Q开关Nd：YAG激光的出现，给文身的治疗带来革命性的变化，文身治疗效果明显提高，瘢痕形成降低[2]。但因近年来文刺技术的发展，文刺染料的改进和文刺深度的增加，专业性文身数量增多，给临床治疗上增加难度，需要进行的治疗次数增多，能量加大，瘢痕形成、色素脱失、治疗局部肤色不均匀等副作用也相应增多。……