Long-pulsed 1064 Nd: YAG laser ua pov thawj tias yog kev kho mob zoo rau hemangioma thiab vascular malformation hauv cov neeg mob tawv nqaij tsaus nti nrog nws cov txiaj ntsig tseem ceeb ntawm kev ua ib qho kev nyab xeeb, zoo-tolerant, tus nqi-zoo txheej txheem nrog tsawg kawg downtime thiab tsawg kawg nkaus sab phiv.
Kev kho mob laser ntawm cov leeg ntshav ceg tob thiab tob nrog rau ntau yam kab mob ntawm cov hlab ntsha tseem yog ib qho ntawm cov kev siv lasers ntau dua hauv kev kho mob tawv nqaij thiab phlebology. Qhov tseeb, lasers feem ntau tau dhau los ua kev kho mob xaiv rau cov cim yug ntawm cov hlab ntsha xws li hemangiomas thiab port-wine stains thiab kev kho mob rosacea. Ntau yam ntawm cov kab mob benign thiab tau txais cov hlab ntsha benign uas tau kho zoo nrog lasers txuas ntxiv nthuav dav thiab piav qhia los ntawm lub hauv paus ntsiab lus ntawm kev xaiv photothermolysis. Hauv cov xwm txheej ntawm cov kab ke laser tshwj xeeb ntawm cov hlab ntsha, lub hom phiaj xav tau yog intravascular oxyhemoglobin.
Los ntawm kev tsom mus rau oxyhemoglobin, lub zog raug xa mus rau phab ntsa hlab ntsha ib puag ncig. Tam sim no, 1064-nm Nd: YAG laser thiab cov khoom siv pom / ze infrared (IR) lub teeb pom kev zoo (IPL) ob qho tib si muab cov txiaj ntsig zoo. Txawm li cas los xij, qhov sib txawv tseem ceeb yog tias Nd: YAG lasers tuaj yeem nkag mus tob dua thiab yog li ntawd tsim nyog dua rau kev kho cov hlab ntsha loj dua, tob dua xws li cov leeg ntshav ceg. Lwm qhov zoo ntawm Nd: YAG laser yog nws cov coefficient nqus qis dua rau melanin. Nrog rau cov coefficient nqus qis dua rau melanin, muaj kev txhawj xeeb tsawg dua rau kev puas tsuaj epidermal yog li nws yuav siv tau zoo dua los kho cov neeg mob tsaus ntuj. Qhov kev pheej hmoo rau kev mob hyper pigmentation tom qab tuaj yeem txo qis los ntawm cov khoom siv txias epidermal. Kev txias epidermal yog qhov tseem ceeb los tiv thaiv kev puas tsuaj los ntawm kev nqus melanin.
Kev kho mob cov hlab ntsha ceg yog ib qho ntawm cov txheej txheem kho kom zoo nkauj uas feem ntau xav tau. Cov hlab ntsha ecstatic muaj nyob rau hauv kwv yees li 40% ntawm cov poj niam thiab 15% ntawm cov txiv neej. Ntau tshaj 70% muaj keeb kwm tsev neeg. Feem ntau, cev xeeb tub lossis lwm yam kev cuam tshuam ntawm cov tshuaj hormones yog qhov ua rau. Txawm hais tias qhov teeb meem tseem ceeb yog qhov kho kom zoo nkauj, ntau tshaj ib nrab ntawm cov hlab ntsha no yuav dhau los ua cov tsos mob. Lub network vascular yog ib lub cev nyuaj ntawm ntau cov hlab ntsha ntawm qhov sib txawv thiab qhov tob. Venous drainage ntawm ceg muaj ob txoj kab tseem ceeb, qhov tob ntawm cov leeg nqaij plexus thiab superficial cutaneous plexus. Ob txoj kab txuas nrog cov hlab ntsha perforating tob. Cov hlab ntsha me me, uas nyob hauv lub dermis papillary sab saud, ntws mus rau cov hlab ntsha reticular tob dua. Cov hlab ntsha reticular loj dua nyob hauv reticular dermis thiab subcutaneous rog. Cov hlab ntsha superficial yuav loj li 1 txog 2 hli. Cov hlab ntsha reticular yuav loj li 4 txog 6 hli. Cov hlab ntsha loj dua muaj phab ntsa tuab dua, muaj cov ntshav deoxygenated ntau dua, thiab tuaj yeem tob dua 4 hli. Kev hloov pauv ntawm qhov loj ntawm cov hlab ntsha, qhov tob, thiab kev siv oxygen cuam tshuam rau hom kev kho mob thiab kev ua haujlwm ntawm cov hlab ntsha ceg. Cov khoom siv teeb pom kev uas tsom mus rau qhov siab tshaj plaws ntawm oxyhemoglobin yuav raug lees txais rau kev kho cov telangiectasias sab nraud ntawm ob txhais ceg. Cov lasers ntev dua, ze-IR tso cai rau kev nkag mus tob dua ntawm cov ntaub so ntswg thiab tej zaum yuav siv los tsom mus rau cov hlab ntsha reticular tob dua. Cov wavelengths ntev dua kuj ua kom sov ntau dua li cov wavelengths luv dua nrog cov coefficients nqus siab dua.
Cov ntsiab lus kawg ntawm kev kho cov hlab ntsha hauv ceg siv laser yog cov hlab ntsha ploj tam sim ntawd lossis pom cov ntshav txhaws hauv cov hlab ntsha lossis tawg. Tej zaum yuav pom cov ntshav me me hauv cov hlab ntsha. Ib yam li ntawd, cov ntshav ntws hauv cov hlab ntsha yuav pom tseeb los ntawm kev tawg ntawm cov hlab ntsha. Qee zaum, yuav muaj lub suab nrov nrov thaum tawg. Thaum siv lub sijhawm luv luv heev, tsawg dua 20 milliseconds, tej zaum yuav muaj cov ntshav me me. Qhov no tej zaum yog vim muaj cov hlab ntsha me me kub sai thiab tawg.
Cov kev hloov kho Nd: YAG nrog cov qhov loj me sib txawv (1-6 hli) thiab cov fluences siab dua tso cai rau kev tshem tawm cov hlab ntsha nrog kev puas tsuaj ntawm cov ntaub so ntswg tsawg dua. Kev ntsuam xyuas hauv tsev kho mob tau qhia tias lub sijhawm ntawm lub plawv dhia ntawm 40 thiab 60 milliseconds muab kev kho mob zoo tshaj plaws ntawm cov hlab ntsha ceg.
Qhov teeb meem tshwm sim tsis zoo tshaj plaws ntawm kev kho mob laser ntawm cov leeg ntawm ceg yog tom qab inflammatory hyper pigmentation. Qhov no pom ntau dua nrog cov tawv nqaij tsaus dua, raug tshav ntuj, lub sijhawm luv dua (<20 milliseconds), cov hlab ntsha tawg, thiab cov hlab ntsha uas muaj thrombus tsim. Nws ploj mus raws sijhawm, tab sis qhov no yuav siv sijhawm ib xyoos lossis ntev dua hauv qee kis. Yog tias cua sov ntau dhau los ntawm kev hloov pauv tsis raug lossis lub sijhawm tsis raug, qhov mob thiab tom qab ntawd yuav tshwm sim.
Lub sijhawm tshaj tawm: Lub Kaum Hli-31-2022