Zamkatimu
Thandizo la PUVA
Kodi PUVA therapy ndi chiyani?
Tanthauzo la chithandizo cha PUVA
PUVA therapy imaphatikiza kukhudzana ndi gwero lopanga la radiation ya UVA ndi chithandizo chochokera ku psoralen, chinthu cholimbikitsa UV. Chifukwa chake mawu akuti PUVA: P akunena za Psoralen ndi UVA ku cheza cha ultraviolet A.
Mfundo
Kuwonekera kwa UVA kumayambitsa kutulutsidwa kwa zinthu zotchedwa ma cytokines, zomwe zizikhala ndi zochita ziwiri:
- zomwe zimatchedwa antimitotic action, zomwe zimachepetsa kuchuluka kwa maselo a epidermal;
- ndi immunological zochita, zomwe zimachepetsa kutupa.
Zizindikiro za PUVA-therapy
Chizindikiro chachikulu cha chithandizo cha PUVA ndi chithandizo cha psoriasis vulgaris (madontho, ma medalioni kapena zigamba) zomwe zimafalikira pakhungu lalikulu.
Monga chikumbutso, psoriasis ndi matenda otupa akhungu chifukwa cha kukonzanso mwachangu kwa maselo a epidermis, keratinocytes. Popeza khungu silikhala ndi nthawi yodzichotsera lokha, epidermis imakula, mamba amadziunjikira kenako amachoka, ndikusiya khungu lofiira ndi kutupa. Pochepetsa kutupa ndikuchepetsa kuchuluka kwa maselo amtundu wa epidermal, PUVAtherapy imathandizira kuchepetsa zotupa za psoriasis ndikuchepetsa kuphulika.
Zizindikiro zina zilipo:
- atopic dermatitis pamene miliri ndi yofunika kwambiri ndi kugonjetsedwa ndi chisamaliro chapafupi;
- siteji yoyambirira ya cutaneous lymphoma;
- photodermatoses, monga lucitis yachilimwe mwachitsanzo, pamene chithandizo cha photoprotective ndi chitetezo cha dzuwa sichikwanira;
- polycythemia pruritus;
- khungu lichen planus;
- matenda ena a alopecia areata.
PUVA therapy mukuchita
Katswiri
Magawo a PUVA-therapy amalembedwa ndi dermatologist ndipo amachitikira muofesi kapena m'chipatala chokhala ndi kanyumba kowunikira. Amaphimbidwa ndi Social Security pambuyo povomereza pempho la mgwirizano wam'mbuyomu.
Njira yophunzitsira
Ndikofunika kuti musagwiritse ntchito chilichonse pakhungu musanayambe gawoli. Maola awiri zisanachitike, wodwalayo amatenga psoralen pakamwa, kapena nthawi zambiri pamutu, pomiza gawo la thupi kapena thupi lonse mu njira yamadzi ya psoralen (balneoPUVA). Psoralen ndi photosensitizing wothandizira kuti athe kuwonjezera mphamvu ya UV mankhwala.
UVA imatha kuperekedwa thupi lonse kapena kwanuko (mmanja ndi kumapazi). Gawoli limatenga mphindi 2 mpaka 15. Wodwalayo ali maliseche, kupatula kumaliseche, ndipo ayenera kuvala magalasi akuda kuti adziteteze ku kuwala kwa UVA.
Pambuyo pa gawoli, ndikofunikira kuvala magalasi adzuwa ndikupewa kutenthedwa ndi dzuwa kwa maola 6.
Mafupipafupi a magawo, nthawi yawo ndi nthawi ya chithandizo amatsimikiziridwa ndi dermatologist. Kuyimba kwa magawo nthawi zambiri kumakhala magawo angapo pa sabata (nthawi zambiri magawo atatu amatalikirana ndi maola 3), ndikuwonjezera pang'onopang'ono Mlingo wa UV. Pafupifupi magawo 48 amafunikira kuti mupeze zotsatira zomwe mukufuna.
Ndizotheka kuphatikiza chithandizo cha PUVA ndi chithandizo china: corticosteroids, calcipotriol, retinoids (re-PUVA).
Contraindications
PUVA mankhwala contraindicated:
- pa mimba ndi mkaka wa m'mawere;
- pakugwiritsa ntchito mankhwala a photosensitizing;
- chiwindi ndi impso kulephera;
- matenda a khungu omwe amayamba kapena kuwonjezereka ndi kuwala kwa ultraviolet;
- khansa yapakhungu;
- kuwonongeka kwa chipinda cham'mbuyo cha diso;
- pachimake matenda.
Zotsatira zoyipa ndi zoopsa
Chiwopsezo chachikulu, pakachitika magawo angapo a chithandizo cha PUVA, ndicho kukhala ndi khansa yapakhungu. Chiwopsezochi chikuyembekezeka kuwonjezeka pamene chiwerengero cha magawo, kuphatikiza, chimaposa 200-250. Komanso pamaso mankhwala magawo, ndi dermatologist amachita wathunthu khungu kuwunika kuti azindikire mwa wodwala zotheka munthu chiopsezo khansa yapakhungu (mbiri ya khansa yapakhungu, kukhudzana yapita X-ray, pamaso pa chisanadze khansa zotupa pakhungu, etc.) . Panthawi imodzimodziyo, kuyang'anitsitsa dermatological pachaka kumalimbikitsidwa kwa anthu omwe adalandira maulendo oposa 150 a phototherapy, kuti azindikire zotupa za precancerous kapena khansa yoyambirira adakali aang'ono.
Zotsatira zofatsa zimawonedwa pafupipafupi:
- nseru chifukwa chotenga Psoralen;
- khungu dryness amafuna ntchito emollient;
- kuwonjezeka kwa tsitsi lomwe lidzazimiririka pamene magawowo asiya.