LT DA VI HA CHTTrnh by:Bs H Th Ngc KhngBnh vin Da Liu

NI DUNGI/Khi nimII/Ch nh-Chng ch nhIII/Phn loiIV/ S lc v lt daV/Mt s hnh nhVI/Tc dng ph-Bin chngVII/ Chm sc sau lt

I. Khi nimDng ha cht ci to cu trc da tr ha da gim bt cc np nhn v mt s so mn.Dng #4000 nm nay ph bin v kt qu nhanh Phenol,Trichloroacetic(TCA), alpha hydroxy acid(AHAs) thng dng, cng thc theo nhu cu BNThi gian lm ty vo su: 10 pht 1h Tc dng ko di vi thng 10, 20 nmNu c t vn k, tun th ng,ngi lm chuyn nghip t tai bin

II. Ch nh Chng ch nh ** Ch nh:Np nhn nh di mt, xung quanh mingNp nhn do nh sng, tui tc v mt s di truynSo nhMt s loi mnXm: do tui tc, tn nhang, mng sm do thai k, thuc nga thaiTin K

** Chng ch nh :+C a so li,+Tin s iu tr, chiu tia mt+Bnh tim mch, gan ,thn.** Hn ch: + khng thay i kch thc cc l chn lng +Da qu sm mu,so su: hiu qu km

** i tng:- Ngi da sng, tc sng ,Da sm mu cng lm c ty theo mc tiu.:

III. Phn loi lt daTy theo mc tn thng, xm nhp ca thuc vo da c 3 loi:

1. Lt da nhGy lt lp thng b (epidermic):gmAHA ( Hydroxy acid)Trichloroacetic acid 10% - 25%Jessners solotion: - Lacticd acid 14g - Salicyloc acid 14g - Resorcinol 14g - Ethanol 95%/100ml Modified Unnas resorcinol past Solid carbon dioxide Saluylic acid Tretinon Solution

2. Lt vaGy lt ti hoc qua chn b nh(papillary dermis) gm:Trichlosacetid acid (TCA): 35% - 50%Solid CO2 & TCA 35%Jessers solotion & TCA 35%Glycolic acid 70%& TCA 35%Phenol 88%

3. Lt suGy lt qua chn b li (reticular dermis) dd phenol ca Baker-gordon:Phenol USP: 88% 3mlcroton oil: 3 githexachlorophehe (Septisol) liquide savon: 8 gitNc ct: 2ml

IV/S lc lt da vi ha chtA/Lt da nh : AHAs,TCA 10-25%Tin trnh lm ngn, an tonKhng cn gy t ,gim aui lm ngay Khng cn nm liAHAs dng vi nhiu nng trn vi m phm dng da hng ngy dng n c Kt qu nh nhng, da trng khe mnh, ti sng ci tin ng k nu lp li nhiu ln /mi tun 4-6 tun,sau mi thng

TCA mnh v lt su rng hn AHA - c bit c hiu qu trn da sm mu - lt su ,ph thuc : nng pha ,ngi lt - Lt vi AHA, RetinA TCA t hiu qu, tnh an ton - Lt su hn c kt qu sau 2 3 ngyK thut: ra sch vng lm bng x bng bi cht lt # 10-15pht ra sch da s ng hng hoc trng nht cc ri lon sc t, vt bn s m dn # 1 2h

B. Lt vaTCA 35 50% : quan trng nht TCA50% cho p ng khng d on vi s sc t lin tc, ng kinh ngcLt nng(dd Jessner ,Glycolic acid) trc 1m TCA 35% kt qu mong i v tnh an tonThi gian lm 15 pht, KQ km hn v khng ko di# PhenolDng: vt nhn nh,vt bn nh, cc ri lon sc tK thut: - Lau sch vng lm =x bng st trng ancohol & aceton

- Bi dd Jessner 1 2 lp b mt da xm nht # vi pht bi ddTCA 35% quan st : c s sng gi protein lp sng b hy lt xong gc lnh v kem mm da triu chng sau lt (sng ph,bng,chm chch) mt sau 1h.Da s hi phc sau 7-10 ngy. 5 -6 ngy sau lt da sm vi nhng vt trng nga v bt u lt da sng hng hng ti sut 3 6 ws lp li mi thng t mc ch, duy tr mi 6- 12 thng

C/Lt suPhenol l cht thng dng lm ng lp sngHiu qu tt trong:-vt nhn th, su-vt bn do+ tui tc + Txc qu mc AS mt tri-tin KSo mn

-Phenol chuyn ha gan,thi qua thn Truyn Lactat Ringer trc, trong khi lt, gy c tim Monitor theo di sut, sau lm.-Dd phenol :mi, khy lin tc sut qu trnh lm.-Tin hnh: +Ra mt, st trng +Che vng : mt, chn my, mi,vng khng lm + Gam nhn =hexachorophen(septisol)+lm khp mt gy t vng, thuc gim au, thuc an thn nh

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-Bi thuc ln mt # 10-15 pht = tampon,cha khong trng cch ra phn ranh gii thuc lan ra vng khng lm ,ra sch,bi thuc m dy,che kn vt thng # 1-2 ngyhn ch nhim trng,to so,kch thch to biu m nhanh hn(7-10 ngy)2 ngy u: mt sng sau vi ngy, nga # 7 ngyVi ngy sau lt ,da hng rm nng sau vi ngyTrnh nng,dng kem chng nng c SPF cao i lm sau 1- 2 tun,kt qu tt,duy tr 10-20 nm.C/ Lt su(tt)

vi/ Tc dng ph- Bin chngThng xy ra BN khng tm hiu k, khng tun th tt li dn sau lt.t xy ra cht lt nng. cc cht lt su, him khi c bin chng trm trngCm gic bng,Hb,sng ph, nga ,chm chch,ausau vi gi,ht sau vi : gi,ngy.AHA: vi gi vi ngy,TCA vi ngy 2 ws, phenol >2-3wsNhim trng, so, thay i trng lc, mt sc t vnh vin, tim mch,L chn lng to hn Mt vi trng hp lt khng hiu qu

Sn sc da sau ltVaselin, kem mm da/mi ngy/10ngy u Cm gic bng, Hb, sng ph, nga ,chm chch, auLt phenol dng bng khng thm nc che khp mt 1-2 ngy u nhim trng,lnh vt thngThuc au, nga vi ngy u, KS d phngQuan trng I :trnh nng ti a #8ws u,2ws sau lt :kem chng nng SPF caoKhng ht thuc ,ung run nh, t ni trong vi ngy u

Lt = Phenol

LT = PHENOL

AHA PEEL

LT =AHA SAU 6T

LT =TCA

LT=TCA

Kt lunMt cch lm tr ha daC th lt so mn Gam smthm phng tin BN chn

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