I-long-pulsed 1064 Nd: i-LAG laser ibonakalisa ukuba yonyango olusebenzayo lwe-hemangioma kunye ne-vascular malformation kwizigulane ezimnyama zesikhumba kunye neenzuzo zayo eziphambili zokuba yinkqubo ekhuselekileyo, enyamezelwayo, eneendleko eziphantsi kunye nemiphumo encinci yecala.
Unyango lweLaser lwemithanjana yomlenze ongaphezulu kunye nonzulu kunye nezinye izilonda ezahlukeneyo zemithambo zihlala zisesinye sezona zicelo zixhaphakileyo zelaser kwidermatology kunye nephlebology. Ngapha koko, iilaser ubukhulu becala zibe lunyango olukhethwayo lweempawu zokuzalwa zemithambo ezifana nehemangiomas kunye namabala ewayini echweba kunye nonyango oluqinisekileyo lwerosacea. Uluhlu lwezilonda ze-vascular benign kunye ne-benign ezifunyenwe ngokufanelekileyo kunye ne-lasers ziyaqhubeka zanda kwaye zichazwe ngumgaqo we-photothermolysis ekhethiweyo. Kwimeko ye-vascular specific laser systems, ekujoliswe kuyo yi-oxyhemoglobin ye-intravascular.
Ngokujolisa kwi-oxyhemoglobin, amandla adluliselwa kudonga lwenqanawa olujikelezileyo. Okwangoku, i-1064-nm Nd: i-LAG ye-laser kunye ne-infrared ebonakalayo / kufuphi ne-infrared (IR) i-intense pulsed light (IPL) izixhobo zombini zinika iziphumo ezilungileyo. Umahluko oyintloko, nangona kunjalo, kukuba i-Nd: i-lasers ye-YAG inokungena ngokunzulu kwaye ngoko ke ifanelekile ngakumbi kunyango lwemithambo yegazi emikhulu, enzulu njengemithambo yomlenze. Enye inzuzo ye-Nd: I-LAG ye-laser yi-coefficient yayo ephantsi yokufunxa i-melanin. Ngomlinganiselo ophantsi wokufunxa we-melanin, kukho inkxalabo encinci yomonakalo owenziwe ngesibambiso kwi-epidermal ngoko ke inokusetyenziswa ngokukhuselekileyo ukunyanga izigulana ezinemibala emnyama. Umngcipheko we-post inflammatory hyper pigmentation unokuncitshiswa ngakumbi zizixhobo zokupholisa ze-epidermal. Ukupholisa kwe-epidermal kunyanzelekile ukukhusela kumonakalo onokubanjiswa ekufunxweni kwe-melanin.
Unyango lwemithambo yomlenze yenye yeenkqubo zokuthambisa ezicetywayo. Iivenuli ezichwayitileyo zikhona malunga ne-40% yabasetyhini kunye ne-15% yamadoda. Ngaphezu kwama-70% anembali yosapho. Ngokuqhelekileyo, ukukhulelwa okanye ezinye iimpembelelo zehomoni zichaphazelekayo. Nangona eyona ngxaki inkulu, ngaphezu kwesiqingatha sezi nqanawa zinokuba ngumqondiso. Inethiwekhi ye-vascular yinkqubo eyinkimbinkimbi yeenqanawa ezininzi ze-caliber ezahlukeneyo kunye nobunzulu. Ukukhutshwa kwe-venous emlenzeni kuqulethe iziteshi ezimbini eziphambili, i-plexus ye-muscular enzulu kunye ne-superficial cutaneous plexus. Imijelo emibini idityaniswe yimikhumbi enzulu yokugqobhoza. Iinqanawa ezincinci zesikhumba, ezihlala kwi-papillary dermis ephezulu, zikhupha kwimithanjeni enzulu ye-reticular. Imithanjeni emikhulu ye-reticular ihlala kwi-dermis ye-reticular kunye namafutha angaphantsi. Imithambo engaphezulu inokuba mikhulu ukuya kutsho kwi-1 mm. Imithambo ye-reticular ingaba yi-4 ukuya kwi-6 mm ngobukhulu. Imithambo emikhulu ineendonga ezityebileyo, inoxinzelelo oluphezulu lwegazi eline-deoxygenated, kwaye ingaba ngaphezulu kwe-4 mm ubunzulu. Ukwahluka kobukhulu bomkhumbi, ubunzulu, kunye ne-oxygenation ichaphazela indlela kunye nokusebenza konyango lomlenze wemilenze. Izixhobo zokukhanya ezibonakalayo ezijolise kwiincopho zokufunxa i-oxyhemoglobin zinokwamkeleka ukunyanga i-telangiectasias engaphezulu kakhulu emilenzeni. Ubude obude, iilaser ezikufutshane ne-IR zivumela ukungena nzulu kwethishu kwaye zisenokusetyenziselwa ukujolisa kwimithambo enzulu ye-reticular. Amaza amade amade nawo ashushu ngokufanayo kunobude obufutshane bobude obunomlinganiselo ophezulu wokufunxa.
Amanqaku okuphela konyango lwe-Laser leg vein kukunyamalala kwesitya ngokukhawuleza okanye ukubonakala kwe-intravascular thrombosis okanye ukuphuka. I-Microthrombi inokuxabiswa kwi-lumen yomkhumbi. Ngokunjalo, ukuphuma kwegazi kwi-perivascular kunokubonakala ngokuphuka kwenqanawa. Ngamanye amaxesha, i-pop evakalayo inokuthakazelelwa ngokugqabhuka. Xa ixesha lokubetha kwepulse lifutshane kakhulu, ngaphantsi kwe-20 millisecond, lisetyenzisiwe, i-purpura enobungakanani bendawo inokwenzeka. Oku kunokwenzeka ukuba kukwesibini ukufudumeza ngokukhawuleza kwe-microvascular kunye nokuphuka.
I-Nd: Ukuguqulwa kwe-YAG kunye nobukhulu bamabala aguquguqukayo (1-6 mm) kunye neempembelelo eziphezulu zivumela ukupheliswa kwe-vascular egxininisekile kunye nomonakalo owenziwe kancinci we-collateral tissue. Uvavanyo lweklinikhi lubonise ukuba ubude be-pulse phakathi kwe-40 kunye ne-60 milliseconds ibonelela ngonyango olufanelekileyo lwemilenze yomlenze.
Isiphumo esibi esixhaphakileyo sonyango lwe-laser lwemithambo yomlenze yi-post inflammatory hyper pigmentation. Oku kubonakala ngokuqhelekileyo kunye neentlobo zesikhumba ezimnyama, ukukhanya kwelanga, ubude obufutshane be-pulse (<20 millisecond), iinqanawa eziqhekekileyo, kunye neenqanawa ezinokwakheka kwe-thrombus. Iyaphela ngokuhamba kwexesha, kodwa oku kungathatha unyaka okanye ngaphezulu kwezinye iimeko. Ukuba ukufudumeza okugqithisileyo kuhanjiswe mhlawumbi ngokutyibilika okungafanelekanga okanye ixesha lokubetha kwentliziyo, isilonda kunye nokwenzakala okulandelayo kunokuvela.
Ixesha lokuposa: Oct-31-2022