Long-pulsed 1064 Nd: YAG laser imatsimikizira kuti ndi mankhwala othandiza kwa hemangioma ndi kuwonongeka kwa mitsempha kwa odwala khungu lakuda ndi ubwino wake waukulu wokhala njira yotetezeka, yolekerera, yotsika mtengo yokhala ndi nthawi yochepa komanso zotsatira zochepa.
Kuchiza kwa laser pamitsempha yapang'onopang'ono komanso yakuzama komanso zotupa zina zam'mitsempha kumakhalabe imodzi mwazinthu zomwe zimagwiritsidwa ntchito kwambiri ndi laser mu dermatology ndi phlebology. M'malo mwake, ma lasers asanduka njira yochizira matenda obadwa m'mitsempha monga hemangiomas ndi madontho a vinyo wa port-vinyo komanso chithandizo chotsimikizika cha rosacea. Mitundu yosiyanasiyana ya zilonda zam'mimba komanso zopezeka bwino zomwe zimathandizidwa bwino ndi ma laser zikupitilizabe kukula ndipo zimafotokozedwa ndi mfundo ya kusankha photothermolysis. Pankhani ya mitsempha yeniyeni ya laser, cholinga chake ndi intravascular oxyhemoglobin.
Mwa kulunjika oxyhemoglobin, mphamvu imasamutsidwa ku khoma la chotengera chozungulira. Pakadali pano, zida za 1064-nm Nd: YAG laser komanso zida zowoneka / pafupi ndi infrared (IR) intense pulsed light (IPL) zonse zimapereka zotsatira zabwino. Kusiyana kwakukulu, komabe, ndikuti Nd: lasers ya YAG imatha kulowa mozama kwambiri ndipo motero ndi yoyenera kuchiza mitsempha yayikulu, yozama kwambiri monga mitsempha ya m'miyendo. Ubwino wina wa Nd: LAG laser ndiye kutsika kwake kocheperako kwa melanin. Pokhala ndi mayamwidwe ocheperako a melanin, palibe vuto lililonse pakuwonongeka kwa epidermal kotero kuti zitha kugwiritsidwa ntchito bwino pochiza odwala akuda. Chiwopsezo cha post inflammatory hyper pigmentation chitha kuchepetsedwanso ndi zida zoziziritsa za epidermal. Kuzizira kwa epidermal ndikofunikira kuti muteteze ku kuwonongeka kwa mayamwidwe a melanin.
Thandizo la mitsempha ya mwendo ndi imodzi mwa njira zodzikongoletsera zomwe zimafunidwa kwambiri. Mitsempha yosangalatsa imakhala pafupifupi 40% ya akazi ndi 15% mwa amuna. Oposa 70% ali ndi mbiri ya banja. Nthawi zambiri, mimba kapena mphamvu zina za mahomoni zimakhudzidwa. Ngakhale vuto lalikulu lodzikongoletsa, zopitilira theka la ziwiyazi zimatha kukhala zizindikiro. The vascular network ndi dongosolo lovuta la ziwiya zingapo zamitundu yosiyanasiyana komanso kuya. Kutuluka kwa venous mwendo kumakhala ndi njira ziwiri zoyambira, plexus yakuya yaminofu ndi plexus yapamwamba kwambiri. Njira ziwirizi zimalumikizidwa ndi zombo zozama zakuya. Tizilombo tating'onoting'ono tating'ono, tomwe timakhala pamwamba pa papillary dermis, timapita ku mitsempha yakuya ya reticular. Mitsempha yayikulu ya reticular imakhala mu dermis ya reticular ndi mafuta ocheperako. Mitsempha yapamwamba imatha kukhala yayikulu 1 mpaka 2 mm. Mitsempha ya reticular imatha kukhala 4 mpaka 6 mm kukula. Mitsempha ikuluikulu imakhala ndi makoma okhuthala, imakhala ndi magazi ambiri opanda okosijeni, ndipo imatha kuzama kupitilira 4 mm. Kusiyanasiyana kwa kukula kwa chotengera, kuya, ndi okosijeni kumakhudza machitidwe ndi mphamvu ya chithandizo cha mitsempha ya mwendo. Zida zowoneka bwino zoyang'ana pamwamba pa mayamwidwe a oxyhemoglobin zitha kukhala zovomerezeka pochiza telangiectasias wapang'onopang'ono pamiyendo. Utali wautali, ma lasers apafupi ndi IR amalola kulowa mkati mwa minofu ndipo amatha kugwiritsidwa ntchito kuloza mitsempha yakuya ya reticular. Mafunde aatali amatenthetsanso mofanana kuposa mafunde amfupi omwe ali ndi mayamwidwe apamwamba.
Laser mwendo mtsempha mankhwala mapeto mfundo ndi yomweyo chotengera kuzimiririka kapena kuonekera intravascular thrombosis kapena kupasuka. Microthrombi ikhoza kukhala yovomerezeka mu lumen ya chotengera. Momwemonso, kutuluka kwa magazi m'mitsempha kumatha kuwonekera chifukwa cha kupasuka kwa chotengera. Nthawi zina, phokoso lomveka likhoza kuyamikiridwa ndi kuphulika. Mukagwiritsidwa ntchito kwakanthawi kochepa kwambiri, osakwana ma milliseconds 20, purpura yokulirapo imatha kuchitika. Izi mwina zimakhala zachiwiri pakutentha kwapang'onopang'ono kwa microvascular ndi kuphulika.
The Nd: Zosintha za YAG zokhala ndi mawanga osinthika (1-6 mm) ndi ma fluence apamwamba amalola kuti mitsempha ichotsedwe ndikuwonongeka kochepa kwa minofu. Kuwunika kwachipatala kwawonetsa kuti kugunda kwapakati pakati pa 40 ndi 60 milliseconds kumapereka chithandizo choyenera cha mitsempha ya mwendo.
Zotsatira zoyipa kwambiri za chithandizo cha laser cha mitsempha ya mwendo ndi post inflammatory hyper pigmentation. Izi zimawoneka kawirikawiri ndi mitundu ya khungu lakuda, dzuwa, nthawi yayitali (<20 milliseconds), ziwiya zowonongeka, ndi zotengera zomwe zimakhala ndi thrombus. Zimazirala pakapita nthawi, koma izi zitha kukhala chaka kapena kupitilira nthawi zina. Ngati kutentha kwakukulu kumaperekedwa ndi kumveka kosayenera kapena kugunda kwamtima kosayenera, chilonda ndi zipsera zotsatira zimatha.
Nthawi yotumiza: Oct-31-2022