Laser yeLong-pulsed 1064 Nd:YAG inoratidza kuti inoshanda pakurapa hemangioma nekukanganisika kwetsinga dzeropa muvarwere vane ganda rakasviba, nekuda kwezvakanakira zvikuru zvekuva nzira yakachengeteka, inobvumirwa zvakanaka, isingadhuri uye ine nguva shoma yekuzorora uye migumisiro mishoma.
Kurapa mitsipa yemakumbo yakadzika neyapamusoro pamwe chete nezvimwe zvirwere zvetsinga neropa ne laser kuchiri chimwe chezvinhu zvinonyanya kushandiswa ne lasers mu dermatology ne phlebology. Kutaura zvazviri, lasers ndiyo inonyanya kushandiswa pakurapa micherechedzo yeropa yakadai se hemangiomas uye port-wine stains uye kurapwa kwe rosacea. Rudzi rwezvironda zveropa zvisina njodzi zvinoberekwa uye zvakawanikwa zvinorapwa zvinobudirira ne lasers rwuri kuramba ruchiwedzera uye runotsanangurwa nepfungwa ye selective photothermolysis. Kana iri vascular specific laser systems, chinangwa chayo i intravascular oxyhemoglobin.
Nekutarisa oxyhemoglobin, simba rinoendeswa kumadziro etsinga dzakapoteredza. Parizvino, laser ye1064-nm Nd: YAG uye zvishandiso zvinoonekwa/zvisiri zveinfrared (IR) intense pulsed light (IPL) zvese zvinopa mhedzisiro yakanaka. Musiyano mukuru ndewekuti laser yeNd: YAG inogona kupinda zvakadzika uye nekudaro yakakodzera kurapa tsinga dzeropa dzakakura, dzakadzika dzakadai setsinga dzemakumbo. Imwe mukana we laser yeNd: YAG ndeyekuti ine mwero wekudzikisa kupinza kwemelanin. Nemwero wekudzikisa kupinza kwemelanin, hapana kunetseka kwakanyanya nezvekukuvadzwa kwesimbi yesimbi saka inogona kushandiswa zvakachengeteka kurapa varwere vane ruvara rwakasviba. Njodzi yekuwedzera ruvara rwepigment mushure mekuzvimba inogona kuderedzwa nemidziyo inotonhorera yesimbi yesimbi. Kutonhodza kwesimbi yesimbi kwakakosha kudzivirira kukuvara kwesimbi kubva mukutorwa kwemelanin.
Kurapa netsinga dzemakumbo ndeimwe yenzira dzinonyanya kukumbirwa dzekushongedza. Mavenule emufaro anowanikwa muvanhukadzi vanosvika 40% uye varume vanosvika 15%. Vanhu vanopfuura 70% vane nhoroondo yemhuri. Kazhinji, pamuviri kana zvimwe zvinokanganisa mahormone zvinobatanidzwa. Kunyangwe iri dambudziko guru rekushongedza, inopfuura hafu yetsinga idzi dzinogona kuva zviratidzo. Network yetsinga ihurongwa hwakaoma hwetsinga dzakawanda dzakasiyana-siyana. Kubuda kwetsinga dzegumbo kune nzira mbiri huru, deep muscular plexus uye surface cutaneous plexus. Nzira mbiri idzi dzakabatana netsinga dzakadzika dzinoboora. Mitsinga midiki yeganda, inogara mu upper papillary dermis, inoyerera ichienda kumidzi ye reticular veins. Mitsinga mikuru ye reticular inogara mu reticular dermis ne subcutaneous fat. Mitsinga yepamusoro inogona kunge yakakura kusvika 1 kusvika 2 mm. Mitsinga ye reticular inogona kunge yakakura kubva 4 kusvika 6 mm. Mitsinga mikuru ine madziro akakora, ine huwandu hwakawanda hweropa risina mweya, uye inogona kunge yakadzika kupfuura 4 mm. Kusiyana kwehukuru hwetsinga, kudzika, uye oxygenation zvinopesvedzera maitiro uye kushanda kwekurapa kwetsinga dzemakumbo. Zvishandiso zvinooneka zvechiedza zvinonanga pakukwirira kweoxyhemoglobin zvinogona kugamuchirwa pakurapa telangiectasias yepamusoro-soro pamakumbo. Ma lasers marefu, ari pedyo neIR anobvumira kupinda kwakadzika kwenyama uye anogona kutoshandiswa kunanga tsinga dzakadzika dzereticular. Marefu ewavelength anopisawo zvakaenzana kupfuura marefu ewavelength mapfupi ane ma coefficients akakwira ekunyudzwa.
Kurapa kwetsinga dzemakumbo neLaser kunoitika nekunyangarika kwetsinga dzeropa kana kuputika kwetsinga dzeropa. Microthrombi inogona kuonekwa mu lumen yetsinga. Saizvozvowo, kubuda kweropa mutsinga dzeropa kunogona kuonekwa kubva pakuputika kwetsinga dzeropa. Dzimwe nguva, ruzha runogona kunzwika nekuputika. Kana kurova kwemoyo kwenguva pfupi, pasi pemamirisekonzi makumi maviri, kunoshandiswa, purpura yakakura semadonhwe inogona kuitika. Izvi zvinogona kunge zvichikonzerwa nekudziya nekukurumidza kwetsinga dzeropa.
Kugadziriswa kweNd: YAG nehukuru hwemapoinzi akasiyana (1-6 mm) uye kupenya kwepamusoro kunobvumira kubviswa kwetsinga dzeropa dzine kukuvara kushoma kwetsinga. Ongororo yekiriniki yakaratidza kuti nguva yekurova kwemoyo iri pakati pe40 ne60 milliseconds inopa kurapwa kwakanakisa kwetsinga dzemakumbo.
Mhedzisiro yakaipa inowanzoonekwa nekurapwa kwetsinga dzemakumbo ne laser ndeyekuva neruvara rwakanyanya mushure mekuzvimba. Izvi zvinowanzoonekwa neganda rakasviba, kupiswa nezuva, kurova kwemoyo kwenguva pfupi (<20 milliseconds), tsinga dzakaputika, uye tsinga dzine thrombus. Dzinopera nekufamba kwenguva, asi izvi zvinogona kutora gore kana kupfuura mune dzimwe nguva. Kana kupisa kwakanyanya kukaunzwa nekunyorova kusina kukodzera kana kurova kwemoyo kwenguva refu, maronda uye mavanga anotevera anogona kuitika.
Nguva yekutumira: Gumiguru-31-2022