Phototherapy thiab Tsev Phototherapy rau Vitiligo 3
64. Yuav tsum xaiv thawj koob tshuaj twg rau 308nm UVB? Puas muaj qhov sib txawv ntawm cov neeg sib txawv?
Tam sim no, tsis muaj cov lus qhia qhia meej meej qhov tseeb thawj koob tshuaj rau 308nm UVB phototherapy. Clinically siv 308nm UVB kuj belongs rau nqaim band UVB (NB-UVB), yog li nws thawj koob tshuaj tuaj yeem zoo ib yam li ntawm 311nm UVB. Nws raug nquahu kom siv 70% ntawm qhov tsawg kawg nkaus erythema koob tshuaj (MED) ua thawj koob tshuaj. Txawm li cas los xij, thaj chaw irradiation ntawm 308nm phototherapy cov cuab yeej feem ntau yog me me, yog li qee cov kws kho mob yuav tau txais cov koob tshuaj ntau dua, xws li 300mJ / cm². Rau cov neeg mob menyuam yaus, cov koob tshuaj pom zoo yog 70% MED.
65. Puas yog thawj zaug irradiation koob tshuaj tib yam rau ntawm daim tawv nqaij qhov chaw ntawm lub cev sib txawv?
Tib qhov pib irradiation koob tshuaj ntawm 200mJ / cm² tuaj yeem siv rau qhov sib txawv ntawm lub cev, lossis 70% ntawm MED ntawm lub cev tshwj xeeb tuaj yeem siv los ua thawj zaug irradiation. Txij li thaum lub photosensitivity ntawm tej thaj chaw xws li daim tawv muag thiab cov mucous daim nyias nyias yog 4-6 lub sij hawm siab dua li ntawm cov cheeb tsam acral, irradiation koob tshuaj rau daim tawv muag thiab mucous daim nyias nyias yuav tsum tau qis dua qhov chaw acral tom qab ib lub sij hawm ntawm kev kho mob.
66. Puas yog irradiation koob tshuaj rau menyuam yaus zoo ib yam li cov neeg laus?
Cov koob tshuaj irradiation rau cov menyuam yaus yog qhov pib zoo ib yam li cov neeg laus. Cov koob tshuaj thawj zaug yog 200mJ / cm², thiab 70% ntawm MED ntawm lub cev tshwj xeeb kuj tuaj yeem siv los ua thawj koob tshuaj irradiation.
67. Puas yog ntau dua irradiation koob tshuaj zoo dua rau kev kho mob phototherapy?
Ib koob tshuaj irradiation ntau dua tsis zoo dua rau kev kho mob. Cov koob tshuaj irradiation yuav tsum tau nce ntxiv thaum lub sij hawm phototherapy. Thaum cov koob tshuaj ntau tshaj irradiation tau teev tseg rau thaj chaw lub hom phiaj tau mus txog, tsis pub ntxiv ntxiv, thiab kev kho mob yuav tsum txuas ntxiv nrog cov koob tshuaj ntau tshaj irradiation. Yog tias cov koob tshuaj irradiation tau nce mus rau qib siab dhau lawm, nws yuav ua rau mob photodamage, thiab ntev - lub sij hawm siab - koob tshuaj irradiation tuaj yeem ua rau muaj teeb meem xws li daim tawv nqaij photoaging.
68. Puas yuav ua raws li kev kho mob txhua hnub yuav ua rau muaj txiaj ntsig zoo dua?
Tsis yog. Qhov ua tau zoo ntawm kev kho mob yog nyob ntawm tag nrho cov koob tshuaj irradiation. Cov kev tshawb fawb tau pom tias qhov ua tau zoo ntawm kev siv tshuaj kho mob 5 zaug hauv ib lub lis piam yog tib yam li 3 zaug hauv ib lub lis piam. Txawm li cas los xij, kev siv yees duab ntau dhau yuav ua rau cov koob tshuaj ntau ntxiv thiab ua rau muaj kev pheej hmoo ntawm kev tsis zoo xws li kev yees duab (Daim duab 3-7). (Daim duab 3-7: Tam sim no, kev kho mob feem ntau pom zoo kom tsis tu ncua phototherapy txhua hnub. Lub vaj huam sib luag sab laug qhia tau hais tias "kev kho txhua hnub tsis pom zoo," thiab lub vaj huam sib luag sab xis qhia tau hais tias "kev kho mob txhua hnub yog kev tshawb fawb ntau dua.")
69. Muaj pes tsawg zaus hauv ib lub lis piam yog qhov tsim nyog rau kev kho 311nm UVB?
Nws raug nquahu kom kho 2-3 zaug hauv ib lub lis piam. Cov nyhuv ntawm repigmentation nyob ntawm tag nrho cov kev kho mob. Piv txwv li, qhov zaus ntawm 3 zaug hauv ib lub lis piam yuav ua rau rov ua dua tshiab, uas ua rau cov neeg mob muaj kev ntseeg siab. Pawg Neeg Ua Haujlwm Vitiligo pom zoo 3 zaug hauv ib lub lis piam raws li qhov kev kho mob zoo tshaj plaws. Yog li ntawd, rau kev kho mob hauv tsev, kev kho mob yuav tsum tau ua 3 zaug hauv ib lub lis piam; rau tsev kho mob-raws li kev kho mob, kev kho mob yuav tsum tau ua tsawg kawg 2 zaug hauv ib lub lis piam.
70. Muaj pes tsawg zaus hauv ib lub lis piam yog tsim nyog rau kev kho 308nm UVB?
Rau 308nm UVB kev kho mob hauv tsev kho mob, qhov zaus feem ntau yog 1-2 zaug hauv ib lub lis piam vim yog siv ntau npaum li cas. Rau tsev-raws li 308nm UVB phototherapy, nws raug nquahu kom siv ntau zaus ntawm 2-3 zaug hauv ib lub lis piam.
71. Puas yog qhov yuav tsum tau nce koob tshuaj irradiation txhua zaus piv rau yav dhau los? Vim li cas?
Nws tsis yog ib txwm tsim nyog los nce koob tshuaj; kuj yuav tsum tau txo koob tshuaj. Cov koob tshuaj irradiation rau qhov kev kho mob tam sim no yuav tsum tau txiav txim siab raws li cov tshuaj tiv thaiv ntawm daim tawv nqaij tom qab kev sib kho dhau los. Mob erythema tom qab phototherapy uas txo qis hauv 24 teev qhia qhov kev pom zoo, uas ua tiav qhov kev ua tau zoo tshaj plaws thaum txo qis qhov tsis zoo. Ib koob tshuaj tsawg dhau yuav tsis ua rau erythema thiab yog li tsis ua tiav cov txiaj ntsig kho mob; koob tshuaj ntau dhau yuav ua rau muaj kev phiv xws li mob thiab hlwv. Yog li, koob tshuaj yuav tsum tau hloov kho raws li cov tshuaj tiv thaiv ntawm daim tawv nqaij tom qab irradiation yav dhau los: (1) Yog tias tsis muaj erythema tshwm sim los yog erythema kav ntev dua 24 teev tom qab 4 zaug sib law liag nrog tib koob tshuaj, cov tshuaj kho yuav tsum tau nce li 10% -20% kom txog rau thaum ib zaug irradiation koob tshuaj mus txog qhov siab tshaj plaws ntawm daim tawv nqaij (hom IV). (2) Yog tias erythema kav ntev li 24-72 teev, thawj koob tshuaj irradiation yuav tsum tau khaws cia rau kev kho mob tom ntej. (3) Yog tias erythema kav ntev dua 72 teev lossis hlwv tshwm sim, kev kho mob yuav tsum tau ncua kom txog thaum cov tsos mob tshwm sim, thiab cov koob tshuaj rau kev sib kho tom ntej yuav tsum raug txo los ntawm 10% -50%. Yog hais tias lub toj siab theem (piv txwv li, tsis muaj repigmentation tshwm sim tom qab 20-30 sib law liag irradiation zaug), kev kho mob yuav tsum tau nres, thiab ib tug 3-6 lub hlis so yuav tsum tau soj ntsuam. Tom qab ntawd, kev kho mob tuaj yeem rov pib dua nrog koob tshuaj MED (qhov txawv ntawm 70% MED siv rau kev kho thawj zaug). Kev kho mob yuav tsum raug tso tseg yog tias tsis pom qhov ua tau zoo tom qab 3 lub hlis. Phototherapy tuaj yeem txuas ntxiv mus ntev li ntev tau pom tias kev rov ua dua tshiab tas li.
72. Puas muaj qhov txwv siab tshaj plaws rau ib koob tshuaj irradiation? Dab tsi yog cov koob tshuaj ib zaug rau 311nm UVB thiab 308nm UVB?
Muaj qhov txwv siab tshaj plaws rau ib koob tshuaj irradiation. Clinically, ob qho tib si 311nm thiab 308nm UVB belongs rau NB-UVB, yog li qhov siab tshaj plaws NB-UVB irradiation koob teev hauv cov lus qhia tuaj yeem siv tau zoo ib yam. Raws li daim tawv nqaij typing, feem ntau cov neeg hauv Suav teb muaj cov tawv nqaij hom III thiab IV. Rau cov neeg mob vitiligo nrog cov tawv nqaij no, qhov siab tshaj plaws ib zaug irradiation koob tshuaj yog 1500mJ / cm² rau lub ntsej muag thiab 3000mJ / cm² rau cov ceg thiab lub cev.
73. Yog tias tsis muaj erythema tshwm rau ntawm daim tawv nqaij tom qab ob peb zaug kev kho mob sib law liag, yuav tsum tau kho cov koob tshuaj li cas rau kev sib kho tom ntej?
Raws li cov hauv paus ntsiab lus ntawm kev hloov koob tshuaj, rau cov kab mob vitiligo, yog tias tsis muaj erythema tshwm sim los yog erythema kav ntev dua 24 teev tom qab 4 zaug sib law liag nrog tib koob tshuaj, koob tshuaj rau kev sib kho tom ntej yuav tsum tau nce 10% -20%. Qhov kev hloov kho no yuav tsum tau rov ua dua kom txog rau thaum cov koob tshuaj irradiation ib zaug nce mus txog qhov kev pom zoo siab tshaj plaws rau lub hom phiaj.
74. Yog hais tias erythema tshwm nyob rau hnub tom qab phototherapy tab sis kav ntev dua 24 teev, yuav tsum tau kho cov koob tshuaj li cas rau kev sib kho tom ntej?
Hauv qhov no, koob tshuaj rau kev sib tham tom ntej tuaj yeem nce ntxiv los ntawm 10% -20%.
75. Yog tias erythema tshwm nyob rau hnub tom qab phototherapy thiab kav ntev li 24-72 teev, yuav tsum tau kho cov koob tshuaj li cas rau kev sib kho tom ntej?
Yog hais tias erythema tshwm nyob rau hnub tom qab phototherapy thiab txuas ntxiv mus rau 24-72 teev, tib koob tshuaj irradiation raws li qhov kev sib kho tam sim no yuav tsum tau khaws cia rau kev kho mob tom ntej.
76. Yog hais tias erythema tshwm nyob rau hnub tom qab phototherapy thiab kav ntev tshaj 72 teev, yuav tsum tau kho cov koob tshuaj li cas rau kev sib kho tom ntej?
Qhov tshwm sim ntawm qhov xwm txheej no qhia tau tias koob tshuaj irradiation siab dhau lawm. Tom ntej no phototherapy kev kho mob yuav tsum tau ua tsuas yog tom qab lub erythema tau tag lawm, thiab cov koob tshuaj yuav tsum tau txo los ntawm 10% -50% piv rau yav dhau los kev sib kho.
77. Dab tsi yog vim li cas thiaj tsis rov ua dua tom qab lub sij hawm ntev ntawm ib leeg -session phototherapy?
Qhov no yuav qhia tau tias qhov kev kho mob phototherapy tau mus txog theem toj siab. Cov theem toj siab yog hais txog ib theem uas tsis muaj kev rov ua dua tshiab ntawm thaj ua rau thaj dawb tshwm sim tom qab 20-30 qhov sib law liag phototherapy. Lub toj siab theem tshwm sim vim lub photosensitivity ntawm lub hom phiaj ntawm daim tawv nqaij qhov chaw txo nrog qhov nce nyob rau hauv tus naj npawb ntawm irradiation zaug thiab lub tsub zuj zuj ntawm kev kho mob lub sij hawm. Nyob rau lub sijhawm no, phototherapy yuav tsum raug ncua rau 3-6 lub hlis, tom qab ntawd kev kho mob tuaj yeem rov pib dua.
78. Dab tsi yog vim li cas rau cov tawv nqaij ib puag ncig ntawm qhov chaw kho mob darkening tom qab phototherapy thaum lub thaj ua rau dawb tsis hloov?
Qhov tsis muaj qhov tsaus ntuj hauv thaj tsam dawb thaum pigmentation tshwm nyob rau hauv cov tawv nqaij ib txwm yog ib qho tshwm sim nyob rau hauv thawj theem ntawm vitiligo phototherapy, thiab nws yuav yog ib qho kev tshwm sim ntawm marginal repigmentation qauv. Muaj peb tus qauv ntawm kev rov ua dua tshiab rau cov kab mob vitiligo: (1) Perifollicular repigmentation pattern (punctate type): Punctate pigment islands form centered on hair follicles and maj expand outward, qhia tias melanocytes rau repigmentation los ntawm cov hauv paus plaub hau. (2) Marginal hom: Repigmentation pib ntawm ntug ntawm qhov txhab thiab maj mam cog lus mus rau qhov chaw. Thaum pib, nws manifests li darkening nyob ib ncig ntawm lub qhov txhab, uas maj mam sib cog lus mus rau qhov lesion, ua rau ib tug maj mam txo nyob rau hauv lub cheeb tsam ntawm lub dawb thaj. (3) Uniform hom: Cov xim ntawm qhov chaw qhov txhab darkens uniformly tom qab kev kho mob kom txog rau thaum tiav repigmentation tiav.
79. Dab tsi yog vim li cas rau kev txhim kho cov kab mob hauv cheeb tsam irradiated tom qab phototherapy thaum cov thaj ua rau dawb tshiab tshwm nyob rau lwm qhov chaw?
Qhov tshwm sim ntawm thaj ua rau thaj dawb tshiab qhia tias vitiligo nyob rau theem zuj zus. Cov kev tshawb fawb tau lees paub tias vitiligo yog kab mob autoimmune, thiab nws feem ntau cuam tshuam nrog lwm yam kab mob autoimmune, xws li kab mob thyroid. Yog li ntawd, thaum lub sij hawm kev loj hlob, yog tias tsis muaj lwm yam tshuaj siv los tswj kev tiv thaiv kab mob rau melanocytes, txawm tias melanocytes hauv thaj chaw kho mob rov zoo, melanocytes hauv lwm qhov chaw ntawm daim tawv nqaij yuav raug puas tsuaj ib txhij. Qhov no tuaj yeem ua rau kev txhim kho ntawm qee qhov mob vitiligo thaum cov kab mob tshiab tshwm sim.
80. Yog tias thaj chaw kho mob zoo dua tom qab kev kho mob phototherapy tab sis cov kab dawb tshiab tshwm sim hauv lwm qhov chaw, yuav ua li cas ntxiv kev kho mob phototherapy?
Kev txhim kho ntawm thaj chaw irradiated qhia tau hais tias phototherapy yog qhov zoo. Txawm li cas los xij, qhov tshwm sim ib txhij ntawm cov kab dawb dawb qhia tau hais tias tus kab mob tseem nyob rau theem zuj zus. Nyob rau lub sijhawm no, phototherapy ib leeg yog qhov nyuaj los tswj tus kab mob, yog li cov neeg mob yuav tsum nrhiav kev kho mob sai. Tej zaum lawv yuav tsum tau kho nrog qhov ncauj lossis txhaj tshuaj glucocorticoids kom tswj tau tus kab mob sai li sai tau. Tsis tas li ntawd, thawj koob tshuaj irradiation rau cov thaj ua rau thaj dawb tshiab yuav tsum yog 100mJ / cm², thiab cov koob tshuaj tom ntej yuav tsum tau ua raws li cov cai ntawm kev hloov tshuaj.
81. Yog tias qhov rov ua dua tshiab ntawm thaj ua rau thaj dawb sib txawv hauv ntau qhov chaw tom qab kev kho mob phototherapy, yuav hloov kho li cas?
Vim qhov sib txawv ntawm daim tawv nqaij thickness thiab photosensitivity ntawm txawv lub cev qhov chaw, lub repigmentation ceev ntawm vitiligo txawv nyob rau hauv ntau qhov chaw, thiab qhov ceev ntawm koob tshuaj nce rau irradiation kuj txawv. Nyob rau ntawm lub sijhawm no, koob tshuaj irradiation yuav tsum tau hloov kho nyias raws li cov lus teb ntawm txhua cheeb tsam rau kev kho mob phototherapy: rau thaj chaw uas muaj kev ua haujlwm tsis zoo thiab rov ua dua tshiab, qhov ceev ntawm koob tshuaj tuaj yeem ua kom nrawm me ntsis. Thaum qhov siab tshaj plaws irradiation koob tshuaj rau thaj tsam lub hom phiaj yog mus txog, tsis muaj kev nce ntxiv, thiab kev kho mob yuav tsum txuas ntxiv nrog qhov siab tshaj plaws ib zaug irradiation. Yog li ntawd, lub sij hawm irradiation ib zaug yuav txawv ntawm ntau qhov chaw thaum lub sij hawm phototherapy. Yog li ntawd, cov neeg mob yuav tsum khaws cov ntaub ntawv kho mob kom ntxaws, nrog rau cov chaw kho mob thiab cov koob tshuaj irradiation siv, kom ntseeg tau tias muaj kev kho mob thiab tsis tu ncua.
82. Kev kho mob toj siab txhais li cas?
Rau cov neeg mob vitiligo uas tau txais NB-UVB phototherapy, tom qab qee qhov kev kho mob (feem ntau yog 20-30 zaug sib law liag), tsis muaj kev nce ntxiv hauv kev rov ua dua tshiab ntawm thaj ua rau dawb tshwm sim txawm tias kev kho txuas ntxiv. Qhov no qhia tau hais tias kev kho mob tau nkag mus rau theem toj siab. Yog hais tias lub toj siab theem yog mus txog, nws raug pom zoo kom ncua kev kho mob phototherapy rau 3-6 lub hlis, uas yuav pab tau cov tawv nqaij rov qab nws photosensitivity. Lub caij no, txoj kev npaj kho mob tuaj yeem hloov pauv raws li kev qhia ntawm tus kws kho mob.
83. Puas yog yuav tsum tau kho cov phiaj xwm kho mob tom qab mus txog theem toj siab?
Yog lawm, kev hloov kho yog tsim nyog. Yog tias phototherapy nkag mus rau theem toj siab, phototherapy yuav tsum raug ncua, thiab cov phiaj xwm kho mob yuav tsum raug hloov raws li tus kws kho mob qhia. Tom qab 3-6 lub hlis, phototherapy tuaj yeem rov pib dua nrog MED raws li thawj koob tshuaj.
84. Yuav ua li cas yog tias qhov pib ua tau zoo ntawm kev kho mob phototherapy yog pom tseeb tab sis tsis ntev los no tau hloov pauv?
Qhov teeb meem no tej zaum yuav yog vim daim tawv nqaij ua insensitive rau phototherapy. Nyob rau hauv cov ntaub ntawv no, ua ke kev kho mob xws li tshuaj kho mob los yog fractional laser therapy yuav siv tau. Nws kuj tseem yuav qhia tau tias kev kho mob tau nkag mus rau theem toj siab. Nyob rau hauv rooj plaub no, phototherapy tuaj yeem raug ncua rau 3-6 lub hlis thiab rov pib dua nrog MED raws li thawj koob tshuaj.
85. Dab tsi yog vim li cas tsis muaj txiaj ntsig tom qab ze li 2 xyoos ntawm kev kho mob phototherapy?
Yog tias tsis pom qhov ua tau zoo tom qab ze li 2 xyoos ntawm kev kho mob phototherapy, nws qhia tau tias kev kho mob tsis zoo rau tus neeg mob. Nyob rau lub sijhawm no, lwm txoj kev kho mob yuav tsum tau txais, xws li tshuaj pleev xim, tshuaj noj qhov ncauj, kho laser, lossis kev kho mob phais.
86. Puas muaj qhov txwv siab tshaj rau tag nrho cov kev kho mob phototherapy?
Tam sim no, tsis muaj kev cai nyob rau sab sauv ntawm tag nrho cov kev kho mob phototherapy, thiab tsis muaj cov cai ntawm cov kev sib law liag sib law liag lossis lub sijhawm ntawm NB- siv UVB. Kev kho mob yuav tsum tau txiav txim siab txiav tawm thaum tus mob zoo dua lossis tsis pom kev txhim kho ntxiv. Qee tus neeg mob yuav muaj kev rov tshwm sim dua tom qab kho los ntawm kev kho mob phototherapy. Txawm hais tias lawv tau dhau los ua ntau qhov kev kho duab kho mob ua ntej, lawv tseem tuaj yeem xaiv siv phototherapy dua tom qab rov tshwm sim dua, yam tsis muaj kev txwv los ntawm cov kev sib tham dhau los.
87. Thaum twg phototherapy yuav tsum nres?
Kev kho mob tuaj yeem raug tso tseg hauv ob qhov xwm txheej: ib qho yog thaum phototherapy tsis muaj txiaj ntsig, thiab lwm qhov yog thaum cov kab mob tau ua tiav rov ua tiav. Txoj hauv kev los txiav txim qhov tsis zoo ntawm kev kho duab phototherapy: Raws li cov txheej txheem kho duab kho mob thoob ntiaj teb tshiab kawg, tsawg kawg 18-36 lub sijhawm kho duab kho mob yuav tsum tau ntsuas cov lus teb kho. Kev paub txog kev kho mob qhia tias cov neeg mob feem ntau yuav tsum tau ua kom tiav tsawg kawg 48 NB-UVB zaug ua ntej ntsuas seb puas yuav txiav tawm kev kho mob vim tsis muaj txiaj ntsig. Rau qee cov neeg mob uas muaj cov lus teb qeeb rau kev kho mob phototherapy, lub sijhawm ntsuam xyuas tuaj yeem txuas ntxiv mus rau 72 zaug ua ntej txiav txim siab seb puas yuav txiav tawm kev kho mob vim tsis muaj txiaj ntsig. Phototherapy tuaj yeem raug tso tseg tom qab ua tiav cov txheej txheem rov ua dua. Qee cov kws tshawb fawb kuj pom zoo kom kho kev kho mob tom qab ua tiav cov txheej txheem rov ua dua, piv txwv li, txo cov koob tshuaj phototherapy thiab zaus kom tsis txhob rov tshwm sim.
88. Dab tsi yog qhov kev kho mob hauv tsev rau cov neeg mob vitiligo?
Cov chav kawm ntawm kev kho duab hauv tsev yog tib yam li hauv tsev kho mob -raws li kev kho duab phototherapy. Txoj kev kho tus qauv yog 2-3 zaug hauv ib lub lis piam, nrog lub sijhawm tsawg kawg 24 teev ntawm txhua qhov kev sib kho, thiab kev kho mob yog tsawg kawg 3 lub hlis. Nyob ntawm qhov xwm txheej rov ua dua tshiab, kev kho duab thaij duab tuaj yeem txuas ntxiv mus ntev dua. Hauv luv luv, phototherapy tuaj yeem txuas ntxiv mus ntev li ntev tau pom tias muaj kev rov ua dua tshiab.
89. Puas yog nws yuav tsum tau kho cov duab txuas ntxiv tom qab cov kab dawb ploj lawm?
Muaj cov kev xav sib txawv hauv tsev thiab txawv teb chaws txog seb puas yuav txuas ntxiv kev kho mob tom qab ua tiav cov txheej txheem ntawm cov kab mob. 2018 tsab ntawm lubSuav Clinical Consensus on Vitiligo Diagnosis and Treatmenttsis pom zoo kom kho cov duab kho mob rau cov neeg mob vitiligo. Txawm li cas los xij, NB-UVB Phototherapy Consensus ntawm Vitiligo Working Group qhia tias kev kho cov duab kho mob tuaj yeem ua tau tom qab rov ua dua cov thaj ua rau dawb kom txo tau qhov kev pheej hmoo ntawm kev rov tshwm sim dua. Qhov kev pom zoo pom tau hais tias ib zaug qhov kev pom zoo rov ua tiav tiav, NB-UVB koob tshuaj tuaj yeem raug txo qis raws li cov phiaj xwm hauv qab no: thawj lub hlis tom qab rov ua dua, kev kho duab yog ua 2 zaug hauv ib lub lis piam; qhov zaus raug txo mus rau ib zaug ib lub lim tiam hauv lub hlis thib ob; thiab txo mus rau ib zaug txhua lub lim tiam hauv lub hlis thib peb thiab plaub. Yog tias tsis muaj qhov tshwm sim tshwm sim, phototherapy tuaj yeem nres.
90. Puas yuav tsis ua raws li kev kho mob ntau zaus cuam tshuam rau kev ua haujlwm ntawm phototherapy?
Yog lawm. Ua raws li txoj kev npaj kho mob tuaj yeem txhim kho kev kho mob tau zoo, piv txwv li, kev kho mob 2 lossis 3 zaug hauv ib lub lis piam. Cov ntaub ntawv qhia tias kev cuam tshuam kev kho mob (tso ntau dua 2 qhov kev kho mob hauv 4 lub lis piam) tuaj yeem cuam tshuam rau kev ua tau zoo.
91. Yuav kho cov koob tshuaj li cas tom qab kev kho mob cuam tshuam?
Cov neeg mob yuav tsum ua raws li txoj kev npaj kho mob rau kev kho mob kom tau txais txiaj ntsig zoo tshaj plaws. Yog tias phototherapy cuam tshuam, txoj kev npaj kho mob yuav tsum tau hloov kho raws li kev hloov pauv ntawm daim tawv nqaij photosensitivity. Kev hloov koob tshuaj sib txawv raws li lub sijhawm ntawm kev cuam tshuam: yog tias qhov cuam tshuam tau ntev li 4-7 hnub, thawj koob tshuaj yuav tsum tau khaws cia; yog tias nws kav li 8-14 hnub, thawj koob tshuaj yuav tsum raug txo los ntawm 25%; yog tias nws kav li 15-21 hnub, thawj koob tshuaj yuav tsum raug txo los ntawm 50%; thiab yog tias nws kav ntev dua 3 lub lis piam, kev kho mob yuav tsum tau rov pib dua nrog thawj koob tshuaj.
92. Dab tsi yog qhov txawv ntawm cov phiaj xwm kev kho mob ntawm cov theem zuj zus thiab theem ruaj khov ntawm vitiligo?
Thawj koob tshuaj irradiation rau theem ceev ceev yuav tsum qis dua qhov ntawd rau theem ruaj khov, feem ntau 1/3-1/2 ntawm cov koob tshuaj siv nyob rau theem ruaj khov. Cov koob tshuaj tom ntej yuav tsum tau nce ntxiv raws li tus neeg mob cov lus teb erythema tom qab phototherapy. Qhov no yog vim hais tias yog tias cov koob tshuaj irradiation siab dhau lawm thaum lub sijhawm ua haujlwm, nws yuav ua rau tawv nqaij kub hnyiab thiab ua rau Koebner tshwm sim, uas ua rau mob hnyav dua.
93. Dab tsi yog qhov zoo ntawm kev sib txuas nrog kev kho mob nrog lwm cov kev kho mob vitiligo?
Kev sib xyaw ua ke feem ntau yog siv rau kev kho mob vitiligo. Piv nrog rau kev kho mob monotherapy, kev sib koom ua ke ntawm phototherapy nrog lwm cov kev kho mob muaj qhov zoo hauv qab no: (1) Kev ua tau zoo dua thiab ua tau zoo dua, uas tuaj yeem tsim cov teebmeem sai dua thiab txhim kho cov neeg mob kev ntseeg siab thiab ua raws li kev kho mob. (2) Kev kho duab sib xyaw ua ke tuaj yeem txo cov koob tshuaj ntawm kev kho duab kho mob thiab txo cov kev mob tshwm sim ntev - xws li kev yees duab. (3) Piv nrog rau kev siv tshuaj ib zaug, kev sib txuas nrog kev siv tshuaj phototherapy tuaj yeem txo cov tshuaj ntau npaum li cas thiab lawv cov kev cuam tshuam tsis zoo.
94. Cov tshuaj pleev ib ce twg feem ntau ua ke nrog kev kho mob phototherapy?
Kev kho mob rau vitiligo tuaj yeem ua ke nrog ntau yam tshuaj pleev ib ce, xws li glucocorticoid cov tshuaj pleev (dexamethasone, betamethasone, halometasone, fluticasone tshuaj pleev, thiab lwm yam), calcineurin inhibitors (tacrolimus, pimecrolimus cream), qis-cov ntsiab lus tincture phosphoricum, common zips (common phosensitizers), D₃ derivatives (calcipotriol, tacalcitol tshuaj pleev). Hauv qee qhov kev tswj hwm ntawm daim tawv nqaij o,liab teeb kho pob txuvkuj tseem tuaj yeem ua ib qho kev sib txuas los daws cov kev tshaj tawm -phototherapy localized o, thaumliab LED teeb khoyog qee zaum siv los txhawb kev kho tawv nqaij;xiav lub teeb kho tom tsevtuaj yeem ntxiv tom tsev rau pob txuv{{0} zoo li cov tshuaj tiv thaiv, thiabkev kho mob ultraviolettseem yog txoj hauv kev tseem ceeb.
95. Dab tsi yog lub sijhawm ua ntu zus ntawm kev kho duab kho mob thiab tshuaj pleev ib ce thaum lawv siv ua ke?
Cov tshuaj uas muaj petrolatum los yog lanolin tuaj yeem ua rau kom cov tuab ntawm cov tawv nqaij txheej txheej thiab cuam tshuam rau kev nqus ntawm ultraviolet rays. Nws feem ntau pom zoo kom tsis txhob siv tshuaj, tshuaj pleev ib ce, lossis cov khoom tu tawv nqaij hauv 4 teev ua ntej irradiation kom tsis txhob cuam tshuam rau kev nkag mus ntawm ultraviolet rays. Qee cov roj ntxhia tshaj lij tuaj yeem siv los txhawb kev nkag mus rau lub teeb thiab tseem ua lub luag haujlwm hauv moisturizing thiab tiv thaiv daim tawv nqaij. Cov tshuaj pleev xim tuaj yeem siv tom qab phototherapy. Txawm li cas los xij, qee tus kws tshaj lij ntseeg tias cov tshuaj pleev uas yuav ua rau tawv nqaij khaus, xws li calcipotriol ointment thiab retinoic acid cream, yuav tsum tsis txhob siv tam sim ntawd tom qab kev kho mob, thiab ib ntus ntawm 2 teev raug pom zoo ua ntej thov. Tam sim ntawd tom qabkev kho mob ultraviolet, sivliab LED teeb khotuaj yeem ntxiv soothe tawv nqaij.
96. Kev kho duab hauv tsev puas tuaj yeem ua ke nrog cov tshuaj pleev ib ce xws li cov tshuaj sib xyaw kaliziran tincture?
Kev sib xyaw ua ke ntawm ob yog tsis pom zoo. Cov lus qhia phau ntawv ntawm compound kaliziran tincture qhia tias hnub ci raug yuav tsum tau ua tom qab nws daim ntawv thov kom ua tiav cov txiaj ntsig kho. Txawm li cas los xij, lub spectrum ntawm lub tsev ultraviolet phototherapy feem ntau yog NB-UVB, uas txawv ntawm lub hnub ci spectrum. Yog tias tus kws kho mob tau sau cov tshuaj sib xyaw kaliziran tincture thiab tus neeg mob tseem tab tom kho lub tsev kho mob ultraviolet, nws raug nquahu kom siv ob qho tib si, piv txwv li, tsis txhob siv cov tshuaj sib xyaw kaliziran tincture rau hnub ntawm kev kho mob. Thaum tsim nyog,xiav lub teeb kho tom tsevtuaj yeem ua ke hauv tsev los tswj cov tshuaj tiv thaiv photosensitivity, lossisliab teeb kho pob txuvtuaj yeem siv los txo qhov tsis xis nyob hauv zos;kev kho mob ultraviolettseem yuav tsum tau ua raws li nruj me ntsis raws li kev noj tshuaj.
