Ua hōʻoia ka laser long-pulsed 1064 Nd:YAG he lāʻau lapaʻau kūpono ia no ka hemangioma a me ka malformation vascular i nā poʻe maʻi ʻili ʻeleʻele me kona mau pono nui o ke kaʻina hana palekana, ʻae maikaʻi ʻia, kūpono i ke kumukūʻai me ka liʻiliʻi o ka manawa hoʻomaha a me nā hopena ʻaoʻao liʻiliʻi.
ʻO ka mālama ʻana i ka laser o nā aʻa wāwae superficial a me ka hohonu a me nā ʻeha vascular ʻē aʻe kekahi o nā hoʻohana maʻamau o nā lasers i ka dermatology a me ka phlebology. ʻO ka ʻoiaʻiʻo, ua lilo nā lasers i mea lapaʻau koho no nā hōʻailona hānau vascular e like me hemangiomas a me nā ʻili waina port a me ka mālama hope loa o ka rosacea. Ke hoʻomau nei ka laulā o nā ʻeha vascular benign congenital a loaʻa i mālama pono ʻia me nā lasers a ua wehewehe ʻia e ke kumumanaʻo o ka photothermolysis koho. I ke ʻano o nā ʻōnaehana laser kikoʻī vascular, ʻo ka pahuhopu i manaʻo ʻia ʻo ka oxyhemoglobin intravascular.
Ma ke kuhikuhi ʻana i ka oxyhemoglobin, hoʻoili ʻia ka ikehu i ka paia o ke kīʻaha koko a puni. I kēia manawa, hāʻawi nā mea hana 1064-nm Nd: YAG laser a me nā mea ʻike ʻia/kokoke i ka infrared (IR) intense pulsed light (IPL) i nā hopena maikaʻi. Eia naʻe, ʻo ka ʻokoʻa nui, hiki i nā lasers Nd: YAG ke komo hohonu a no laila ʻoi aku ka kūpono no ka mālama ʻana i nā kīʻaha koko nui a hohonu e like me nā aʻa koko wāwae. ʻO kekahi pono o ka laser Nd: YAG ʻo ia kona coefficient absorption haʻahaʻa no ka melanin. Me ka coefficient absorption haʻahaʻa no ka melanin, ʻaʻohe hopohopo no ka hōʻino epidermal collateral no laila hiki ke hoʻohana palekana ʻia e mālama i nā poʻe maʻi pigmented ʻeleʻele. Hiki ke hoʻemi hou ʻia ka pilikia no ka hyper pigmentation post inflammatory e nā mea hoʻoluʻu epidermal. He mea nui ka hoʻoluʻu epidermal e pale aku i ka hōʻino collateral mai ka absorption melanin.
ʻO ka hoʻōla ʻana i nā aʻa wāwae kekahi o nā kaʻina hana hoʻonaninani i noi pinepine ʻia. Loaʻa nā venules ecstatic ma kahi o 40% o nā wahine a me 15% o nā kāne. ʻOi aku ma mua o 70% he moʻolelo ʻohana. I ka manawa pinepine, pili ka hāpai ʻana a i ʻole nā mana hormonal ʻē aʻe. ʻOiai he pilikia hoʻonaninani nui, ʻoi aku ma mua o ka hapalua o kēia mau kīʻaha koko e lilo i mau hōʻailona. ʻO ka pūnaewele vascular kahi ʻōnaehana paʻakikī o nā kīʻaha koko he nui o nā ʻano like ʻole a me nā hohonu. ʻO ka hoʻokahe ʻana o ka venous o ka wāwae he ʻelua mau kahawai mua, ka plexus muscular hohonu a me ka plexus cutaneous superficial. Hoʻopili ʻia nā kahawai ʻelua e nā kīʻaha hohonu perforating. ʻO nā kīʻaha ʻili liʻiliʻi, e noho ana ma ka dermis papillary kiʻekiʻe, e kahe ana i nā aʻa reticular hohonu. Noho nā aʻa reticular nui i loko o ka dermis reticular a me ka momona subcutaneous. Hiki i nā aʻa superficial ke nui e like me 1 a 2 mm. Hiki i nā aʻa reticular ke 4 a 6 mm ka nui. Loaʻa i nā aʻa nui nā paia mānoanoa, ʻoi aku ka nui o ke koko deoxygenated, a hiki ke ʻoi aku ma mua o 4 mm ka hohonu. Hoʻopilikia nā ʻano like ʻole o ka nui o nā kīʻaha koko, ka hohonu, a me ka oxygenation i ke ʻano a me ka pono o ka lāʻau lapaʻau vein wāwae. Hiki ke ʻae ʻia nā mea kukui ʻike ʻia e kuhikuhi ana i nā piko o ka oxyhemoglobin absorption no ka mālama ʻana i nā telangiectasias superficial loa ma nā wāwae. ʻO nā lasers lōʻihi-nalu, kokoke-IR e ʻae i ka komo hohonu ʻana o ka ʻiʻo a hiki ke hoʻohana ʻia e kuhikuhi i nā veins reticular hohonu. Hoʻomehana like pū nā nalu lōʻihi ma mua o nā nalu pōkole me nā coefficients absorption kiʻekiʻe.
ʻO nā kiko hope o ka mālama ʻana i nā aʻa wāwae laser ka nalo koke ʻana o nā kīʻaha koko a i ʻole ka thrombosis intravascular a i ʻole ka haki ʻana. Hiki ke ʻike nui ʻia ka Microthrombi i loko o ka lumen kīʻaha koko. Pēlā nō, ʻike ʻia nā extravasations perivascular o ke koko mai ka haki ʻana o nā kīʻaha koko. I kekahi manawa, hiki ke lohe ʻia kahi pop me ka haki ʻana. Ke hoʻohana ʻia nā lōʻihi pulse pōkole loa, ʻaʻole iʻoi aku ma mua o 20 milliseconds, hiki ke loaʻa ka purpura nui. ʻO kēia paha ka lua o ka hoʻomehana wikiwiki ʻana o ka microvascular a me ka haki ʻana.
ʻO nā hoʻololi Nd: YAG me nā nui kiko loli (1-6 mm) a me nā fluences kiʻekiʻe e ʻae i ka hoʻopau ʻana i nā vascular focal me ka palena iki o ka hōʻino ʻana o nā ʻiʻo collateral. Ua hōʻike ʻia ka loiloi lapaʻau e hāʻawi ka lōʻihi o ka pulse ma waena o 40 a me 60 milliseconds i ka mālama kūpono loa o nā aʻa wāwae.
ʻO ka hopena ʻino maʻamau o ka mālama ʻana i nā aʻa wāwae ma ka laser, ʻo ia ka hyper pigmentation post inflammatory. ʻIke pinepine ʻia kēia me nā ʻano ʻili ʻeleʻele, ka lā, ka lōʻihi o ka pulse pōkole (<20 milliseconds), nā kīʻaha koko i haki, a me nā kīʻaha koko me ka hoʻokumu ʻana o thrombus. Hoʻopau ia me ka manawa, akā hiki ke hala i hoʻokahi makahiki a ʻoi aku paha i kekahi mau hihia. Inā hāʻawi ʻia ka wela nui e ka fluence kūpono ʻole a i ʻole ka lōʻihi o ka pulse, hiki ke hoʻomaka ka ulceration a me ka scarring ma hope.
Ka manawa hoʻouna: ʻOkakopa-31-2022