Long-pulsed 1064 Nd: Hōʻike ka laser YAG i kahi lapaʻau maikaʻi no ka hemangioma a me ka malformation vascular i nā poʻe maʻi ʻeleʻele me kāna mau pōmaikaʻi nui o ke kaʻina hana palekana, ʻae maikaʻi, kumukūʻai me ka liʻiliʻi o ka downtime a me nā hopena ʻaoʻao liʻiliʻi.
ʻO ka hoʻomaʻamaʻa ʻana i ka laser o nā veins wāwae a hohonu a me nā maʻi vascular ʻē aʻe kekahi o nā noi maʻamau o nā lasers i ka dermatology a me ka phlebology. ʻO kaʻoiaʻiʻo, ua lilo nā lasers i mea lapaʻau i koho ʻia no nā hōʻailona hānau vascular e like me hemangiomas a me nā stains port-wine a me ka mālama ʻana i ka rosacea. Ke hoʻomau nei ka hoʻonui ʻia ʻana o nā maʻi vascular benign congenital a loaʻa me ka lasers a wehewehe ʻia e ke kumu o ka photothermolysis koho. I ka hihia o nā ʻōnaehana laser kikoʻī, ʻo ka mea i manaʻo ʻia he intravascular oxyhemoglobin.
Ma ka huli ʻana i ka oxyhemoglobin, hoʻoneʻe ʻia ka ikehu i ka paia moku a puni. I kēia manawa, ʻo ka laser 1064-nm Nd: YAG a me ka ʻike ʻia/kokoke infrared (IR) ikaika pulsed light (IPL) nā mea ʻelua e hāʻawi i nā hopena maikaʻi. ʻO ka ʻokoʻa nui naʻe, ʻo ia ʻo Nd: YAG lasers hiki ke komo i ka hohonu a no laila ʻoi aku ka kūpono no ka mālama ʻana i nā kīʻaha koko nui a hohonu e like me nā veins wāwae. ʻO kekahi pono ʻē aʻe o ka laser Nd: YAG ʻo ia ka helu haʻahaʻa absorption no ka melanin. Me ka haʻahaʻa absorption coefficient no ka melanin, ʻaʻohe hopohopo no ka hōʻino ʻana i ka epidermal collateral no laila hiki ke hoʻohana palekana ʻia e mālama i nā maʻi ʻeleʻele. Hiki ke hoʻemi ʻia ka pilikia o ka hyper pigmentation post inflammatory e nā mea hoʻoluʻu epidermal. Pono ka hoʻoluʻu epidermal e pale aku i ka hōʻino ʻana mai ka melanin absorption.
ʻO ka leg vein therapy kekahi o nā kaʻina hana hoʻonaninani maʻamau. 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. ʻO ka manawa pinepine, pili ʻia ka hāpai ʻana a i ʻole nā hopena hormonal ʻē aʻe. ʻOiai he pilikia koʻikoʻi, ʻoi aku ma mua o ka hapalua o kēia mau moku e lilo i hōʻailona. He ʻōnaehana paʻakikī ka ʻupena vascular o nā moku he nui o nā ʻokoʻa like ʻole a me ka hohonu. ʻO ka hoʻokahe ʻana o ka wāwae he ʻelua awāwa mua, ʻo ka plexus muscular hohonu a me ka plexus cutaneous superficial. Hoʻopili ʻia nā awāwa ʻelua e nā moku perforating hohonu. ʻO nā kīʻaha liʻiliʻi liʻiliʻi, e noho ana ma ka papillary dermis luna, e kahe i nā veins reticular hohonu. Noho nā veins reticular nui i loko o ka reticular dermis a me ka momona subcutaneous. ʻO ka nui o nā veins superficial e like me 1 a 2 mm. He 4 a 6 mm paha ka nui o nā veins reticular. ʻOi aku ka mānoanoa o nā pā, ʻoi aku ka kiʻekiʻe o ke koko deoxygenated, a ʻoi aku ka hohonu ma mua o 4 mm. Hoʻololi ka nui o ka moku, ka hohonu, a me ka oxygenation i ke ʻano a me ka pono o ka lāʻau vein wāwae. Hiki ke ʻae ʻia nā mea māmā ʻike ʻia e pili ana i ka oxyhemoglobin absorption peaks no ka mālama ʻana i nā telangiectasias pāpaʻu loa ma nā wāwae. ʻOi aku ka lōʻihi o ka nalu, kokoke i ka IR lasers e ʻae i ke komo hohonu ʻana o ka ʻiʻo a hiki ke hoʻohana ʻia no ka huli ʻana i nā veins reticular hohonu. ʻOi aku ka wela o nā nalu lōʻihi ma mua o nā hawewe pōkole me nā coefficient absorption kiʻekiʻe.
ʻO nā helu hope o ka mālama ʻana i nā wāwae laser he nalo koke ʻana o ka moku a i ʻole ʻike ʻia ka thrombosis intravascular a i ʻole naha. Hiki ke ʻike ʻia ka microthrombi i loko o ka lumen moku. Pēlā nō, ʻike ʻia ka hoʻonui ʻia ʻana o ke koko mai ka haki ʻana o ka moku. I kekahi manawa, mahalo ʻia kahi pop audible me ka rupture. Ke hoʻohana ʻia ka lōʻihi o ka pulse pōkole loa, ʻaʻole ma mua o 20 milliseconds, hiki ke loaʻa ka purpura nui. He lua paha kēia i ka hoʻomehana microvascular wikiwiki a me ka haki ʻana.
ʻO ka hoʻololi ʻana o Nd: YAG me ka nui o nā wahi ʻokoʻa (1-6 mm) a me nā fluence kiʻekiʻe aʻe e ʻae i ka hoʻopau ʻia ʻana o ka vascular focal me ka liʻiliʻi o ka pōʻino o ka ʻiʻo collateral. Ua hōʻike ʻia ka loiloi maʻi i ka lōʻihi o ka pulse ma waena o 40 a me 60 milliseconds e hāʻawi i ka mālama maikaʻi ʻana i nā veins wāwae.
ʻO ka hopena maʻamau maʻamau o ka hoʻomaʻamaʻa ʻana i ka laser o nā veins wāwae he post inflammatory hyper pigmentation. ʻIke pinepine ʻia kēia me nā ʻano ʻili ʻeleʻele, ka ʻike ʻana o ka lā, ka lōʻihi o ka pulse (<20 milliseconds), nā moku naha, a me nā moku me ka hoʻokumu ʻana o ka thrombus. E mae ia me ka manawa, akā he makahiki a ʻoi paha kēia i kekahi mau hihia. Inā hāʻawi ʻia ka wela nui ma muli o ke ʻano kūpono ʻole a i ʻole ka lōʻihi o ka pulse, hiki mai ka ulceration a me ka maʻi maʻi ma hope.
Ka manawa hoʻouna: ʻOkakopa-31-2022