I-long-pulsed 1064 Nd:I-LAG laser ifakazela ukuthi iyindlela yokwelapha esebenzayo ye-hemangioma kanye nokukhubazeka kwemithambo ezigulini zesikhumba esimnyama ngezinzuzo zayo ezinkulu zokuba inqubo ephephile, ebekezelelwa kahle, engabizi kakhulu enesikhathi esincane sokuphumula kanye nemiphumela emibi emincane.
Ukwelashwa nge-laser kwemithambo yomlenze engaphezulu nejulile kanye nezinye izilonda emithanjeni ehlukahlukene kusalokhu kungenye yezicelo ezivame kakhulu zamalaser ku-dermatology kanye ne-phlebology. Eqinisweni, ama-laser asephenduke indlela yokwelapha ekhethwayo yezimpawu zokuzalwa zemithambo ezifana ne-hemangiomas namabala ewayini e-port-wine kanye nokwelashwa okuqinisekile kwe-rosacea. Ububanzi bezilonda ze-benign ze-vascular zokuzalwa nezitholwe zelashwa ngempumelelo ngama-lasers ziyaqhubeka nokwanda futhi zichazwa ngomgomo we-photothermolysis ekhethiwe. Endabeni yezinhlelo ze-laser ethize yemithambo, okuhlosiwe okuhlosiwe yi-intravascular oxyhemoglobin.
Ngokuqondisa i-oxyhemoglobin, amandla adluliselwa odongeni lomkhumbi oluzungezile. Okwamanje, i-1064-nm Nd: i-laser ye-YAG kanye ne-infrared infrared (eduze (IR) amadivayisi we-intense pulsed light (IPL)) womabili anikeza imiphumela emihle. Umehluko omkhulu, nokho, ukuthi i-Nd: Ama-lasers e-YAG angangena ajule kakhulu ngakho-ke afaneleka kakhulu ekwelapheni imithambo yegazi emikhulu, ejulile njengemithambo yomlenze. Enye inzuzo ye-Nd: I-laser ye-YAG yi-coefficient yayo ephansi yokumuncwa kwe-melanin. Nge-coefficient ephansi yokumunca ye-melanin, kukhona ukukhathazeka okuncane ngokulimala kwe-epidermal eyisibambiso ngakho ingase isetshenziselwe ngokuphepha kakhulu ukwelapha iziguli ezinemibala emnyama. Ingozi ye-hyper pigmentation yangemuva kokuvuvukala ingancishiswa nakakhulu ngamadivaysi okupholisa e-epidermal. Ukupholisa kwe-epidermal kubalulekile ukuze kuvikelwe emonakalweni oyisibambiso ekumuncwani kwe-melanin.
Ukwelashwa kwemithambo yomlenze kungenye yezinqubo zezimonyo ezicelwa kakhulu. Ama-Ecstatic Venules atholakala cishe ku-40% wabesifazane kanye no-15% wabesilisa. Bangaphezu kuka-70% abanomlando womndeni. Ngokuvamile, ukukhulelwa noma amanye amathonya ama-hormone ahilelekile. Nakuba ngokuyinhloko inkinga yezimonyo, ngaphezu kwengxenye yale mikhumbi ingase ibe nezimpawu. Inethiwekhi ye-vascular uhlelo oluyinkimbinkimbi lwemikhumbi eminingi yezinga elihlukile nokujula. I-venous drainage yomlenze iqukethe imigudu emibili eyinhloko, i-plexus yemisipha ejulile kanye ne-superficial cutaneous plexus. Lezi ziteshi ezimbili zixhunywe yimikhumbi ejulile ye-perforating. Imikhumbi emincane enesikhumba, ehlala ku-papillary dermis engenhla, idonsela emithanjeni ejulile ye-reticular. Imithanjeni emikhulu ye-reticular ihlala ku-dermis ye-reticular namafutha angaphansi kwesikhumba. Imithambo engaphezulu ingase ibe mikhulu ngo-1 kuya ku-2 mm. Imithambo ye-reticular ingaba ngosayizi ongu-4 kuye ku-6 mm. Imithambo emikhulu inezindonga eziwugqinsi, inegazi eliningi elingenayo umoya-mpilo, futhi ingaba ngaphezu kuka-4 mm ukushona. Ukwehluka kosayizi womkhumbi, ukujula, kanye ne-oxygenation kuthonya indlela yokusebenza nokusebenza ngempumelelo kokwelashwa kwemithambo yomlenze. Imishini ebonakalayo yokukhanya eqondise iziqongo zokumunca i-oxyhemoglobin ingase yamukeleke ekwelapheni ama-telangiectasia angaphezulu kakhulu emilenzeni. Amaza amaza amade, amalaser aseduze ne-IR avumela ukungena okujulile kwethishu futhi angase asetshenziswe ngisho nokukhomba imithambo ye-reticular ejulile. Amaza amade amade nawo ashise ngokufana kakhulu kunamaza wamaza amafushane anama-coefficient aphakeme wokumunca.
Amaphuzu okuphela kokwelashwa kwe-Laser leg vein ukunyamalala komkhumbi ngokushesha noma ukubonakala kwe-intravascular thrombosis noma ukuphuka. I-Microthrombi ingase ibonakale ku-lumen yomkhumbi. Ngokufanayo, ukuphuma kwegazi kwe-perivascular kungase kubonakale ekuqhekekeni komkhumbi. Kwesinye isikhathi, i-pop ezwakalayo ingase ithokozelwe ngokuphuka. Lapho kusetshenziswa ukushaya kwenhliziyo okufushane kakhulu, ngaphansi kwama-millisecond angama-20, kungenzeka i-purpura yosayizi wendawo. Lokhu cishe kungokwesibili ekushiseni okusheshayo kwe-microvascular kanye nokuphuka.
I-Nd: Ukulungiswa kwe-YAG okunosayizi bamabala abahlukahlukene (1-6 mm) kanye nokuguquguquka okuphezulu kuvumela ukuqedwa kwemithambo egxile ngokulimala okulinganiselwe kwezicubu ezibambisana. Ukuhlolwa komtholampilo kubonise ukuthi ubude be-pulse phakathi kwama-40 kanye nama-millisecond angu-60 kunikeza ukwelashwa okuphelele kwemithambo yomlenze.
Umphumela omubi ovame kakhulu wokwelashwa nge-laser emithanjeni yomlenze i-post inflammatory hyper pigmentation. Lokhu kubonakala ngokuvamile ngezinhlobo zesikhumba ezimnyama, ukuchayeka elangeni, ubude be-pulse emifushane (<20 millisecond), imikhumbi ephukile, kanye nemikhumbi ene-thrombus formation. Iyaphela ngokuhamba kwesikhathi, kodwa lokhu kungase kube unyaka noma ngaphezulu kwezinye izimo. Uma ukushisa okudlulele kulethwa ngokushelela okungalungile noma ubude be-pulse, kungase kuvele izilonda kanye nezibazi ezilandelayo.
Isikhathi sokuthumela: Oct-31-2022