摘要目的:1 064 nm PicoWay超皮秒激光联合强脉冲光治疗黄褐斑的临床疗效。方法:2022年5—8月，西安国际医学中心医院医学美容中心就诊的黄褐斑女性患者92例，年龄25～50(35.0±3.5)岁。采用随机数字表法分为两组：激光联合组46例，用精准强脉冲光联合1 064 nm PicoWay超皮秒激光治疗；激光组46例，用单一1 064 nm PicoWay超皮秒激光治疗。评估两组患者治疗前后黄褐斑皮损面积严重度指数(MASI)评分、VISIA评分及临床疗效。结果:治疗前激光联合组、激光组MASI评分分别为12.58(11.04，13.99)、13.16(11.47，14.14)分，治疗后激光联合组、激光组评分分别为5.75(3.79，7.19)、7.15(5.42，5.85)分；两组治疗后MASI评分较治疗前均下降，激光联合组治疗后评分低于激光组，差异有统计学意义( Z＝－4.05， P<0.001) 。治疗前激光联合组、激光组VISIA评分分别为(173.72±43.77)、(175.65±34.9)分，治疗后激光联合组、激光组评分分别为(135.46±41.63)、(145.26±33.33)分，两组治疗后VISIA评分均较治疗前下降，激光联合组治疗后评分低于激光组，差异有统计学意义( t＝－2.52， P<0.05)。激光联合组治疗后有效率(80.43%，37/46)高于激光组(69.56%，22/46)( P<0.05)。 结论:1 064 nm PicoWay超皮秒激光联合精准强脉冲光治疗黄褐斑的疗效优于单一1 064 nm PicoWay超皮秒激光治疗。

abstractsObjective:To investigate the clinical efficacy of a 1 064 nm picosecond laser combined with intense pulsed light in the treatment of melasma.Methods:From May to August 2022, ninety-two female patients with melasma were admitted to the Medical Cosmetology Center, Xi′an International Medical Center Hospital, aged 25-50 years, with an average age of (35.0±3.5) years. The were divided by random number table method. Forty-six cases were divided into laser combined group, which were treated with precise intense pulsed light combined with a 1 064 nm picosecond laser. Forty-six cases in the laser group were treated with a 1 064 nm picosecond laser. The area and severity score of melasma (MASI), VISIA score and clinical efficacy were evaluated.Results:The MASI scores of laser combined group were 12.58 (11.04, 13.99) before treatment, and the MASI scores of laser group were 13.16 (11.47, 14.14) before treatment. The MASI scores of laser combined group were 5.75 (3.79, 7.19), and the MASI scores of laser group were 7.15 (5.42, 5.85) after treatment. The MASI scores of the two groups were decreased compared with those before treatment, and the MASI score of the laser combined group was lower than that of the laser group. The difference was statistically significant ( Z=-4.05, P<0.01). The median VISIA scores of the laser combined group were (173.72±43.77), and the median VISIA scores of the laser group were (175.65±34.9) before treatment. The median VISIA scores of the laser combined group were (135.46±41.63), and the median VISIA scores ofthe laser group were (145.26±33.33) after treatment. The VISIA scores of the two groups were decreased compared with those before treatment. The scores of the laser combined group were lower than those of the laser group. The difference was statistically significant ( t=-2.52, P<0.05). The effective rate of the laser combined group (80.43%, 37/46) was higher than that of the laser group (69.56%, 22/46, P<0.05). Conclusions:The curative effect of 1 064 nm picosecond laser combined with precise intense pulsed light in the treatment of melasma is better than that of a 1 064 nm picosecond laser alone.