Yakareba-pulsed 1064 Nd: YAG laser inoratidza kuva mushonga unoshanda we hemangioma uye vascular malformation mune yakasviba ganda varwere vane mabhenefiti ayo makuru ekuva yakachengeteka, inotenderwa zvakanaka, inodhura-inoshanda maitiro ane kushoma kuderera uye kushoma kwemhedzisiro.
Laser kurapwa kwepamusoro uye yakadzika gumbo tsinga pamwe nemamwe akasiyana maronda evascular inoramba iri imwe yeanowanzo shandiswa lasers mune dermatology uye phlebology. Muchokwadi, ma lasers akanyanya kuve kurapwa kwesarudzo kune vascular birthmarks senge hemangiomas uye port-waini stains uye kurapa kwechokwadi kwerosacea. Mhando yekuberekwa uye yakawanikwa benign vascular maronda akanyatsorapwa ne lasers inoramba ichiwedzera uye inotsanangurwa nemutemo wekusarudza photothermolysis. Panyaya yevascular specific laser systems, chinangwa chinotarirwa ndeye intravascular oxyhemoglobin.
Nekunongedza oxyhemoglobin, simba rinotamirwa kumadziro emidziyo yakapoteredza. Parizvino, iyo 1064-nm Nd: YAG laser uye inooneka/pedyo infrared (IR) yakanyanya pulsed light (IPL) zvishandiso zvese zvinopa mhedzisiro yakanaka. Musiyano mukuru, zvisinei, ndewekuti Nd: YAG lasers inogona kupinda zvakadzika zvakanyanya uye saka inonyanya kukodzera kurapwa kweakakura, akadzika tsinga dzeropa semakumbo emakumbo. Imwe mukana weNd: YAG laser ndiyo yakaderera yekunyudza coefficient ye melanin. Iine yakaderera absorption coefficient ye melanin, pane kushoma kunetseka nezve collateral epidermal kukuvara saka inogona kushandiswa zvakachengeteka kurapa yakasviba pigment varwere. Ngozi yemashure ekuzvimba hyper pigmentation inogona kuderedzwa ne epidermal kutonhora michina. Epidermal kutonhora kwakakosha kuchengetedza kubva kune collateral kukuvara kubva pakunyura melanin.
Leg vein therapy ndeimwe yeanowanzo kukumbirwa zvizorwa maitiro. Ecstatic venules inowanikwa mune inenge 40% yevakadzi uye 15% yevarume. Vanopfuura 70% vane nhoroondo yemhuri. Kazhinji, pamuviri kana mamwe maitiro ehomoni anobatanidzwa. Kunyangwe iri dambudziko rekushongedza, inopfuura hafu yemidziyo iyi inogona kuve chiratidzo. Iyo vascular network ndiyo yakaoma system yemidziyo yakawanda yakasiyana-siyana uye yakadzika. Venous drainage yegumbo ine nzira mbiri dzekutanga, iyo yakadzika tsandanyama plexus uye yepamusoro cutaneous plexus. Nzira mbiri idzi dzakabatanidzwa nemidziyo yakadzika perforating. Midziyo midiki yeganda, iyo inogara mupamusoro papillary dermis, inodonhedza kune yakadzika reticular tsinga. Iyo yakakura reticular tsinga inogara mune reticular dermis uye subcutaneous mafuta. Idzo tsinga dzepamusoro dzinogona kunge dzakakura se 1 kusvika 2 mm. Reticular tsinga dzinogona kuva 4 kusvika 6 mm muhukuru. Matsinga mahombe ane madziro akakora, ane huwandu hwepamusoro hweropa re deoxygenated, uye anogona kudzika kudarika 4 mm. Kusiyana kwehukuru hwemudziyo, kudzika, uye oxygenation inokanganisa maitiro uye kushanda kwegumbo vein therapy. Midziyo yemwenje inooneka inonangana nepamusoro-soro yekunyudza oxyhemoglobin inogona kugamuchirwa pakurapa zvakanyanya pamusoro pe telangiectasias pamakumbo. Yakareba-wavelength, padyo-IR lasers inobvumira kudzika kwakadzika kwetishu uye inogona kushandiswa kunanga yakadzika reticular tsinga. Hurefu hwavelength zvakare hunopisa zvakanyanya kufanana pane mapfupi ewavelength ane akakwira absorption coefficients.
Laser gumbo tsinga kurapwa magumo pfungwa vari pakarepo mudziyo kunyangarika kana kuoneka intravascular thrombosis kana kuputika. Microthrombi inogona kuve yakakosha mumudziyo lumen. Saizvozvo, perivascular extravasations yeropa inogona kuoneka kubva pakutsemuka kwemudziyo. Dzimwe nguva, pop inonzwika inogona kufarirwa nekuputika. Kana nguva pfupi pfupi yekupuruzira, isingasviki 20 milliseconds, inoshandiswa, saizi saizi purpura inogona kuitika. Izvi zvingangove zvechipiri kune nekukurumidza microvascular kupisa uye kuputika.
Iyo Nd: YAG gadziriso ine akasiyana mavara saizi (1-6 mm) uye yakakwirira fluences inobvumira kunangana kwevascular kubviswa nekumwe kushoma collateral tishu kukuvara. Kuongororwa kwekiriniki kwakaratidza kuti pulse durations pakati pe40 uye 60 milliseconds inopa yakakwana kurapwa kwemakumbo emakumbo.
Iyo inonyanya kuipa yakashata mhedzisiro yelaser kurapwa kwegumbo tsinga ndeye post inflammatory hyper pigmentation. Izvi zvinoonekwa zvakanyanya nemhando dzakasvibirira dzeganda, kuratidzwa kwezuva, kupfupika kwemhepo (<20 milliseconds), midziyo inoputika, uye midziyo ine thrombus formation. Inopera nekufamba kwenguva, asi iri rinogona kunge riri gore kana kureba mune dzimwe nguva. Kana kupisa kwakanyanya kuchiunzwa nerunyerekupe rusina kufanira kana nguva yekufema, maronda uye mavanga anozotevera anogona kuitika.
Nguva yekutumira: Oct-31-2022