2016年1月18日 星期一

冷凍治療(CryoShape)

有效治療疤痕增生的方法:冷凍治療(CryoShape)

目前醫學界有多種治療瘢瘤的方法,惟未能全面徹底阻止組織增生,復發機會亦較高,容易長出更大的瘢痕。近年獲美國食品藥物管理局(FDA)確認其治療瘢瘤功效的冷凍治療(CryoShape),便能打破以往其他治療方法的限制。

透過溫度的改變破壞細胞,令壞死的細胞結痂脫落,減低復發機會。其實早在70至80年代,醫學界已採用冷凍治療,以液化氣體消除疣及痣等,直至90年代後期,醫學界更開始研究冷凍治療應用在瘢瘤上的可行性。

 

冷凍治療過程

手術約需時10至60分鐘,視乎個人情況及瘢瘤大小而定,並以局部麻醉方式進行。手術進行時,外科醫生先將長針插入瘢瘤內,小樽內的液態氮會灌入冷凍治療槍內,令長針急速變冷藉著超低溫度使細胞結晶,導致脫水,使細胞冷凍壞死,破壞瘢瘤內的深層組織。

外科醫生會在適當情況下,停止再輸入液態氮,讓瘢瘤解凍。患者在包紮傷口後,便可離開,不用留院,如常活動。一般情況下,傷口約在2至4星期內痊癒,壞死的細胞會結痂脫落。

 

冷凍治療的術後護理

術後部分患者的傷口會出現疼痛、紅斑、皮下水腫、皮下出血及色素減弱等,惟很快便會痊癒,患者只要每日清洗傷口及保持乾爽,防止傷口受感染便可。

 

冷凍治療的風險

對麻醉藥敏感, 傷口發炎等一般手術風險。




參考資料: http://keloid.com.hk/
以上所提供的資訊僅作為教育及參考用途,如果你有任何醫療問題,
應向外科醫生查詢,而不應單倚賴以上提供的資料 

2016年1月15日 星期五

How to prevent the growth of scars?

 






There aren’t any detection methods to prevent the growth of scars within medical community on patients regardless of gender and age. Patients who had scarring before or have a genetic background should prevent wounds arise, avoid piercing and clean acne scars with proper care. Whenever there is new wound, consider using silicone gel sheet and consult a doctor if necessary.









Reference information: http://keloid.com.hk/keloid-removal-english.html
The information aims to provide educational purpose only. Anyone reading it should consult Surgery Specialist before considering treatment and should not rely on the information above

2016年1月14日 星期四

Other Keloid Treatments




Steroid Injection: The injection of steroids can inhibit the growth of fibroblasts, causing the keloids to shrink. Results from patients vary and the success rate is only 50%, Long-term injections, usually once a month, are needed to be effective. Some patients need continuous injection, from few months to one year, in order to be effective. However, Long-term steroid injections will cause the skin to atrophy and sink in, and injection process also leads to pain in patients.
 

Surgical Removal: Keloid treatment by surgical removal method seems to a relatively simple method, its drawback is high recurrence rate of 80 to 100%. Since new wounds will be developed, it may stimulate keloid to grow back, and may even develop into a bigger keloid.
  

According to literature reviews, regular steroid injections after surgery can prevent the formation of keloid, but the recurrence rate can reach 50 to 80%, while postoperative radiotherapy can reduce the recurrence rate to 20 to 30%. Since radiotherapy is originally applied to treat cancer, if it is used to treat keloid that is grown in the neck and chest, thyroid cancer or breast cancer may be induced, thus radiotherapy is only limited to the area of hands, feet and ears.
  

Silicone Gel Sheet: It is regarded as preventive treatment, which is applied to new wounds after two weeks, and is associated with anti-scar ointment to reduce the growth of keloid and scars.
  

Interferons or anti-cancer drug: Research on their effects are still processing. Application of interferons or anti-cancer drug on eliminating keloid cannot sustain for a long time and may also cause side effects to the body.




Reference information: http://keloid.com.hk/hypertrophic-scar-treatment.html
The information aims to provide educational purpose only. Anyone reading it should consult Surgery Specialist before considering treatment and should not rely on the information above

2016年1月4日 星期一

Treatment for Keloid Scarring-Cryosurgery

Effective treatment for Keloid scarring

Different kinds of Keloid treatments nowadays cannot totally prevent the growth of scarring tissues, it may stimulate the keloid to grow back, and may even develop into a bigger keloid. In recent years, U.S. Food and Drug Administration (FDA) has verified the therapeutic efficacy of "Cryosurgery" on Keloids treatment, which overcomes the limitations of traditional and conventional treatment methods.

By damaging cells with the change in temperature, the destroyed cells will scab and fall off, thereby reducing recurrence rate. In fact, "Cryosurgery" has already been used in the early 1970s and 1980s to eliminate Keloids by contacting with liquid nitrogen. Medical professionals then started to investigate on the application of CryShape to treat Keloid and scarring tissues.

Process

"Cryosurgery" treatment takes around 10-60 minutes, depending on the size and location of the keloid. Local anesthesia will be performed before the treatment. During surgery, the doctor will first insert a needle into the Keloid, liquid nitrogen of very low temperatures contained will then be injected. The scar will rapidly decrease in temperature, causing the cells to crystallize, dehydrate and finally be frozen and destroyed.
The doctor will stop injecting liquid nitrogen at suitable time in order to let keloid thaw. After surgery and wound dressing, patients can return to daily activities without the need of hospitalization. Under normal circumstances, the wound can be recovered in 2 to 4 weeks and the destroyed cells will scab and fall off.

Postoperative care

After surgery, patients may experience different levels of pain, red spots, subcutaneous edema, subcutaneous hemorrhage and pigmentation, as well as other conditions. Most of these conditions will completely disappear. Therefore, patients must clean their wounds and keep them dry in order to prevent infections.

Risk

General surgical risks include sensitive to anesthetics, wound infection etc.






Reference information: http://keloid.com.hk/cryoshape-english.html
The information aims to provide educational purpose only. Anyone reading it should consult Surgery Specialist before considering treatment and should not rely on the information above

2015年12月29日 星期二

屬良性腫瘤 或影響吞咽 無創消融甲狀腺結節






甲狀腺結節在香港十分常見,大部分屬於良性腫瘤。由於甲狀腺位於頸部氣管兩旁,腫瘤可能會壓著食道或氣管,影響患者發聲、吞咽或呼吸,嚴重可致窒息。傳統 治療良性結節的手術都會於手術處留有疤痕,需留院數天;但今年引入的無創射頻消融術,不但傷口幾乎看不見,住院時間亦較短、手術費較便宜。

甲狀腺是位於頸部甲狀軟骨下方,氣管兩旁的內分泌器官。而甲狀腺結節是該部分組織細胞突然產生腫瘤或癌細胞等小腫塊,發病率非常高。外科專科醫生陳東飛指,本港有約五成成年人有甲狀腺結節良性腫瘤,女性患者較多,每三個女患者才有一個男患者。

陳東飛指,若腫瘤太小,一般人不會察覺患有腫瘤;但若感到有硬塊壓迫著食道或氣管,或外觀上有突起物,便應求診及照超聲波檢查,然後需抽取組織化 驗,判斷腫瘤屬良性或惡性。他說,有約三分二甲狀腺結節患者屬良性腫瘤,惡性腫瘤只屬少數;更強調只要化驗後肯定腫瘤是良性,便可進行甲狀腺結節手術。

現時,治療良性結節的手術有傳統切除及內窺鏡切除手術。傳統切除術需全身麻醉,不但會留有疤痕,亦因要切除部分甲狀腺,有機會使聲線轉變或造成吞咽問題;而內窺鏡切除術雖於腋下及兩邊乳暈進行微創手術,但仍會留有1至3厘米的傷口。

陳東飛表示,今年4月首次於本港應用無創甲狀腺腫瘤消融技術,利用微針震動的摩擦力產生高溫,使腫瘤細胞壞死收縮,使腫瘤體積於六個月內縮少85%,並不用切除任何的甲狀腺組織。消融技術的手術費約4.5萬元,比傳統手術便宜約四成半,術後只有約1毫米疤痕,毋須住院。

不過,他指手術存有風險,「施行手術的醫生必須非常熟悉組織結構,否則會因微針太熱而傷到附近組織,出現內出血或使喉返神經受傷。」

兩年前,李小姐(圓圖)發現頸部左邊近氣管位置有硬物突起,拖了年半,發覺硬物變大約直徑1厘米,才到醫生檢查,確診有甲狀腺結節良性腫瘤。但因 曾進行換腎手術,免疫力低而不適合進行有感染風險的傳統切除手術。最終選擇無創消融術,腫瘤體積由原本的約9mL降指現時的約1mL。醫生建議,術後患者 仍需複診至少半年,以便檢查腫瘤的變化。






參考資料:  www.genesis-surgery.com/
以上所提供的資訊僅作為教育及參考用途,如果你有任何醫療問題,
應向自己的外科醫生查詢,而不應單倚賴以上提供的資料。

2015年12月21日 星期一

男子穿緊身褲 或礙生殖能力



韓流興著緊身褲,男女皆然,但過緊不但影響雙腿,更可禍及男性生殖能力,夏天尤其危險。

外科專科醫生陳東飛表示,以往曾有醫學報告稱,緊身褲過緊會令睾丸溫度上升,從而令製造精子受影響。

泌尿科專科醫生葉維晉直言,臨床平均有每百名病人中,亦有7、8人「貪靚」穿緊身褲,影響精子量,惟大多本身已屬精子數量較低或其他疾病,並以年輕男子為主。

葉說:「普通人着緊身褲無問題的,但如果本身精子數量低,不育或睾丸附近的血管膨脹等問題,再穿緊身褲,就會令睾丸溫度提升,製造精子就較差。」

緊身褲影響不限於男子,葉維晉解釋,婦女常穿緊身褲,因褲襠位置不疏氣,如陰部衞生環境不好,細菌就會走入膀胱,致膀胱炎。他提醒,如出現上述問題,就應改穿鬆身褲,包括內褲,男士亦應戒煙戒酒,從而令精子數量回升。










参考资料: topick.hket.com/
以上所提供的资讯仅作为教育及参考用途,如果你有任何医疗问题,
应向自己的外科医生查询,而不应单倚赖以上提供的资料

2015年12月14日 星期一

新一代射頻消融術 治療甲狀腺結節 創傷性低 癒後無疤不是夢 (下)






甲狀腺結節消融 – 手術新趨勢?

改寫傳統手術局限的契機,在於最近十年出現的結節消融治療。此類治療利用激光、微波 (Micro Wave) 或射頻 (Radio Frequency) 的形式穿透皮膚,將能量直接傳遞到病變位置,將之加熱使其壞死。三者以不同機制運作,難言何者較優。結節消融治療的好處在於操作者可操控能量的釋出量,以及將釋放位置集中在要處理的一點,損傷到其他正常組織的機會便得以大幅減少。手術過程全程以超聲波監控,確保手術的安全性,亦不會在皮膚留下疤痕。

激光消融術在歐洲 (尤其意大利) 及接近地中海的地方較常採用,若以此法治療,組織接收的溫度可高達上千度,可有效的將組織消融。微波消融術好處是甚至不需用針刺入患者肌膚,而能透過調校儀器如天線般將能量集中釋出,如同隔空取物一樣,但技術並未成熟,暫未普及至香港。

不同前兩者,射頻消融術 (Radio Frequency Ablation, RFA) 較多為亞洲地方使用,尤以南韓居多,並已引入本港。射頻消融術當中的「射頻」乃為電磁波,原理乃將探針一部分刺進甲狀腺中,並以肉眼看不到的震動頻率產生熱力,使結節內的血管及組織在高溫下碳化、壞死,變為疤痕組織或纖維化組織,最後被身體吸收。射頻消融術的溫度不如激光般上千度,反而可以控制在100℃至120℃左右,耗材較便宜,故比激光消融術的手術費用便宜三分一甚至一半。由於手術以局部麻醉進行,故此患者不用留院,只需於完成治療後觀察一至兩小時,如無大礙便可歸家,另外亦需定期監測治療後之康復進展。一般經射頻消融術治療後約一個月,結節平均能縮小50%,半年則縮小約80%-90%。

激光、微波或射頻消融皆被歸類「無創」治療,對此,陳東飛醫生補充:「所謂無創是指傷口癒合之後完全看不見傷口,只剩下一個針孔。因為並非完全無創,但跟傳統手術比,創傷一定少得多。」

何人適用?


結節消融治療只適用於治療單一(或最多兩個)良性甲狀腺結節,對甲狀腺亢奮人士通常無效。因為甲亢患者的整個甲狀腺都腫脹,但不可能將整個甲狀腺「煮熟」,因此仍得靠藥物治療、放射性碘治療、或以手術將整個甲狀腺割除方有望改善問題。


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參考資料: http://www.genesis-surgery.com/img/RF-thyroid.pdf
以上所提供的資訊僅作為教育及參考用途,如果你有任何醫療問題,
應向自己的外科醫生查詢,而不應單倚賴以上提供的資料