LT DA VI HA CHT

Trnh by:Bs H Th Ngc Khng

Bnh vin Da Liu

NI DUNG
I/Khi nim
II/Ch nh-Chng ch nh
III/Phn loi
IV/ S lc v lt da
V/Mt s hnh nh
VI/Tc dng ph-Bin chng
VII/ Chm sc sau lt

I. Khi nim
Dng 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 BN
Thi gian lm ty vo su: 10 pht 1h
Tc dng ko di vi thng 10, 20 nm
Nu 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 ming
Np nhn do nh sng, tui tc v mt s
di truyn
So nh
Mt s loi mn
Xm: do tui tc, tn nhang, mng sm do
thai k, thuc nga thai
Tin 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 da

Ty theo mc tn thng, xm
nhp ca thuc vo da c 3 loi:

1. Lt da nh
Gy lt lp thng b (epidermic):gm
AHA ( 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 va
Gy lt ti hoc qua chn b
nh(papillary dermis) gm:
Trichlosacetid acid (TCA): 35% - 50%
Solid CO & TCA 35%
Jessers solotion & TCA 35%
Glycolic acid 70%& TCA 35%
Phenol 88%
2

3. Lt su
Gy lt qua chn b li (reticular
dermis) dd phenol ca Baker-gordon:
Phenol USP: 88% 3ml
croton oil: 3 git
hexachlorophehe (Septisol)
liquide savon: 8 git
Nc ct: 2ml

IV/S lc lt da vi ha cht

A/Lt da nh : AHAs,TCA 10-25%

Tin trnh lm ngn, an ton

Khng cn gy t ,gim au
i lm ngay Khng cn nm li
AHAs 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 ngy
K 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 va
TCA 35 50% : quan trng nht
TCA50% cho p ng khng d on vi s

sc t lin tc, ng kinh ngc

Lt nng(dd Jessner ,Glycolic acid) trc 1m
TCA 35% kt qu mong i v tnh an ton
Thi gian lm 15 pht, KQ km hn v khng
ko di# Phenol
Dng: vt nhn nh,vt bn nh, cc ri lon
sc t
K 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 su
Phenol l cht thng dng lm ng
lp sng
Hiu qu tt trong:
-vt nhn th, su
-vt bn do+ tui tc
+ Txc qu mc AS mt tri

-tin K
So 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

C/ Lt su(tt)
-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 ngy hn 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 ngy
Vi ngy sau lt ,da hng rm nng
sau vi ngy
Trnh nng,dng kem chng nng c SPF
cao
i lm sau 1- 2 tun,kt qu tt,duy tr
10-20 nm.

vi/ Tc dng ph- Bin

chng
Thng 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 trng
Cm 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 >2-3ws
Nhim 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 lt
Vaselin, kem mm da/mi ngy/10ngy u

Cm gic bng, Hb, sng ph, nga ,chm chch,

au
Lt phenol dng bng khng thm nc che
khp mt 1-2 ngy u nhim trng,lnh vt
thng
Thuc au, nga vi ngy u, KS d phng
Quan trng I :trnh nng ti a #8ws u,2ws
sau lt :kem chng nng SPF cao
Khng ht thuc ,ung ru
n nh, t ni trong vi ngy u

Lt = Phenol

LT = PHENOL

 AHA PEEL

LT =AHA SAU 6T

LT =TCA

LT=TCA

Kt lun
Mt cch lm tr ha da
C th lt so mn

Gam sm
thm phng tin BN chn

THANKS YOUR

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