I-Keloid kunye neengxube ze-hypertrophic: inkcazo, iintlobo, izizathu kunye nonyango

Emva kweyiphi intlungu ekhumbeni, umntu unomqondiso ongenakulibaleka ngolu hlobo, ebhalwe ngesiJamani ngokuthi "utywala". Ngamanye amaxesha amanqaku awabangeli iingxaki, nokuba azikho kwindawo evelelekileyo, okanye ziphantse zichazwe kwiindawo zesikhumba eziseduze. Kodwa kukho iimeko xa izibazi zibonakala zibonakala, zidibanisa, zimnyama, ngamanye amaxesha zinobunzulu obuphezulu. Ezi zixhobo zengxube kunye ne- keloid. Ewe, ziyimpembelelo ebaluleke kakhulu, ingakumbi ukuba ikhona ebusweni, entanyeni, esifubeni. Ukuzilahla akulula, kuba olu hlobo lwezikbazi lunesakhiwo esikhethekileyo sefiber esilungele ukulungisa.

Iintlobo zezikrakra

Kwamanye abantu, amanxeba aphuculwa ngokukhawuleza kwaye aphantse athathaka. Kwabanye, le nkqubo isetyenziselwa iiveki, kwaye ekugqibeleni, amanxeba aphilisa, endaweni yamagqabi abo amabi. Ukuziphatha okuhlukeneyo kwezicubu kuxhomekeke kwiimeko ezininzi, umzekelo, ukususela kwintsholongwane yamanxeba, indawo yawo (indawo yeselula okanye ayikho), ubungakanani kunye nokunyaniseka komonakalo, amandla omzimba ngamnye wokuvuselela, uhlobo lolusu njalonjalo. Ukuhlanganiswa kwazo zonke ezi zinto kubangela ukuba kwezinye iimeko, iicyaha zifunyenwe njengokuba zitshisiwe (zibizwa ngokuba yi-atrophic), kwaye kwezinye zikwinqanaba elifanayo kunye neengqinamba zesikhumba (normotrophic ones).

Iyona nkathazo kakhulu, ukusuka kwindawo ye-cosmetology, yimiba yecala. Ziyabonakala, xa zikhona izicubu zokuphilisa i-fibroblasts enxeba kwaye ziqala ukuqinisa ukuhlanganiswa kwe-collagen. Kule meko, i-enzyme collagenase, eyonakalisa i-collagen engaphezulu, iveliswa ngokwaneleyo. Ngenxa yesiphumo esitsha, kuninzi kakhulu. Ukuya kwiiyadluli akukho ndawo, kwaye banamathela ngaphandle kwendawo ephulukisiwe yomonakalo. Ukuphakama kwezikhonkwane ezinokuthi zifikelele kwi-10 mm. Umbala wabo ubumnyama ngaphezu kwesikhumba kwiindawo ezikufutshane, kwaye ngokuqhelekileyo umphezulu unendawo enzima.

Keloids

Ezi ziko zixhomekeke ngaphandle zifana nezikhonkwane ze-hypertrophic, kodwa zineenkalo ezahlukeneyo ezingafaniyo. Into ephambili kukuba izikrakra ze-keloid, ezibonakala kwindawo yokulimala, zanda kwiindawo ezincinci zesikhumba. Indlela yokuqala kubo ingaba yinqununu enkulu okanye itshise, okanye inkunkuma encinci, nokuba yinkomo yezilwanyana, apho abaninzi abangayithobeli ingqalelo. Ubunzima obunqabileyo buqala ukukhula inyanga okanye ngaphezulu emva kokuphulukiswa kwesilonda. Ukhula luya kufikelela kwiminyaka emibili, emva koko isigaba sokuzinza siqala. Kwizifundo ze-hertological kwi-keloids, i-fibroblast ephawulekayo, eqhubekayo ivelisa i-collagen, ifunyanwa. Yaye ukuba iinqwelo ezinobungozi, nangona zimbi, kodwa zingenabuhlungu, i-keloid ingabangela ukubetha, intlungu, ukwanda kwesikhumba. Ukwahlula i-keloids yamanga ebonakala kwisiza soxinzelelo, kwaye yinyani, eyenzeka apho isikhumba siphumele ngaphandle.

Unyango lweengqungquthela ze-keloid kunye ne-hypertrophic scars

Kuze kube ngoku, iindlela ezilandelayo zokulungiswa kwezikhonkwane ezigqithisiweyo zisetyenzisiweyo:

• Ukunyanzeliswa;
• Amalungiselelo e-silicone (amacwecwe, i-gel);
• Unyango lwe laser;
• Ingenelelo yokuphanda;
• Unyango lwezaphulo;
• Ukunyanga kwamayeza;
• Ukusetyenziswa kweziyobisi;
• Corticosteroids.

Naluphi na lwayo luncedo kunye nokungahleleki. Yiziphi iindlela zokufaka isicelo, kwimeko nganye kufuneka ugqitywe ngugqirha. Ukususa i-hypertrophic, kunye nezinye izikhwama ze-keloid, ezivame ukuxilongwa ngokuthi i-dermatofibroma kunye nomhlaza wokungena ngaphakathi, ziyimfuneko kwiikliniki ezizodwa kuphela.

Inyango yokuphanda

Amacwecwe e-hypertrophic and keloid ayasuswanga ngokukhawuleza, ngenxa yokuba emva kokulungiswa oko kukho phantse njalo. Ngokomzekelo, ukuba sithetha nge-keloids, ukubuyiswa kwesiphene kwenzeka kwi-80-90% yazo zonke iimeko ezichazwe kwaye zibonakaliswe ekubunjweni kwezicubu ezinobunzima nangaphezulu kunokuba zisuswe. Kwimeko yesikhumba se-hypertrophic, ipesenti yeengxaki ziyancipha. Ukulungiswa kokuvuthwa kukugqithiseleyo ngamacangca amancinci anemida ehlukeneyo. Ngenkqubo yokuhlinzwa, ugqirha ugqirha, uyayithelekisa imida ye-incision, yenza i-internal seam, engabonakaliyo. Olu msebenzi lwenziwa phantsi kwe-anesthesia yendawo. Izibhedlele azifunwa.

Ukuba izicathulo ezinkulu zisuswe kwinkqubo yokucoca, umzekelo, ukutshisa, yenza i-patchwork yolusu (ukufakelwa).

Ukunyanzeliswa

Amacembe e-Hypertrophic ngendlela engazange alungise, kodwa kwimeko ye-keloids inika iziphumo eziyanelisayo. Ingundoqo yendlela iquka ukufaka ibhande eliqinileyo kwindawo yesikhumba, isiguli esigqobileyo, singasusi, ukususela kwiinyanga ezintathu ukuya kunyaka. Ngamanye amaxesha ukugqoka kungasetyenziswa nganye iiyure ezili-12. Ngenxa yoxinzelelo kwiinqanawa zeRumen, ukutya kwayo kuphelile. Ngexesha elifanayo, imida yeengcambu ezibomvu zinyanyisiwe, nto leyo ekhusela ukukhula kwayo.

Unyango

Le ndlela ithathwa njengeyona ndlela isebenzayo kwaye isetyenziswe kuwo wonke umhlaba. Ukususwa kweengxube ze-hypertrophic, i-keloids kunye nezinye izinto ezenziwe ngesikhumba eqhutyelwa yi-ray ye-beech (i-ray ray ye-X ngoncedo lwabasebenzisi be-beta-precision-applicators). Ngenxa yoko, i-fibroblasts iyachithwa okanye ivalwe, ukuhlanganiswa kwe-collagen kuphelile. Iimitha zamandla ahlukeneyo zingasetyenziswa.

Kwimeko nayiphi na imeko, i-90% yazo ibamba iindawo eziphezulu zesikhumba, kwaye i-10% kuphela iwela kwi-dermis. Ngokuqhelekileyo le ndlela isetyenziswe ngokubambisana nokukhutshwa kolu hlobo. Ubuyela emva kokuba unyango olunjalo lubhaliswe kwi-50% yamatyala. Ngenxa yeempembelelo ezizodwa ze-X-ray imisebe, le ndlela ayisetyenziswanga ukususa izikhonkwane entloko, entanyeni nasesibondeni. Ukungqinelana:

• Oncology;
• Isifo sikashukela;
• Intliziyo kunye nesifo se-vascular;
• Ukukhushulwa kwezifo ezahlukahlukeneyo.

Cryotherapy

Le ngenye yeendlela ezikhuselekileyo nezona zintle. I-Keloids ngaphandle kokubuya kwakhona ngoncedo olubandayo luphele ngokupheleleyo kwi-51% yamatyala. Kwaye ngo-76% wamatyala, izikhwama ze- hypertrophic zisuswa . Unyango kufuneka ube lunzima (i-cryotherapy kunye nezinye iindlela - ukusetyenziswa kwamathambo, i-silicone), ngoko kuyacaca ukuba nethemba elipheleleyo (90%) linyamalale, lube lukhuni kwaye luphinde lubuyele. Ingundoqo yendlela ibangelwa kwinqaba ye -nitrojeni yamanzi (ubushushu malunga -196 ° C). Ifakwe kwisitampu okanye kunye nesicelo esisodwa. Ngenxa yoko, ama-crystal afakwe kwiiseli, i-cytoplasm kunye ne-organelles ziyafa. Ngoko i-fibroblasts iyachithwa, ukuhlanganiswa kwe-collagen kuyayeka. Ukubonakaliswa kwitrojeni kuthatha imizuzu engama-30, kodwa ngokuqhelekileyo kuthatha imizuzwana emihlanu. Ukususa ngokupheleleyo inqabileyo, iinkqubo ezininzi zanele. Iingxaki zendlela:

• Inkqubo ebuhlungu;
• Ubunokwenzeka bokubunjwa kwe-blister kwisiza se-rumen;
• Ukuchithwa kwe-Hyperpigmentation emva kwenkqubo.

Unyango nge silicone

Ngoku iinkampani zonyango ziye zavelisa i-gels equkethe i-silicone, kunye namacwecwe e-silicone akhethekileyo. Umgaqo wesenzo sonyango ufana nanjalo - usebenzela ukwandisa i-hydration kunye nokunciphisa umzimba, uvimba ukufikelela kwe-oksijini kwimiguqo yayo kunye nokunciphisa ukuhlanganiswa kwe-collagen.

Le ndlela iyakususa izikhonkwane ze-atrophic and hypertrophic. Ukuze unyango lwe-keloids, aluhambelani. Iiplati ziveliswa ngeendlela ezihlukeneyo kunye nobukhulu. Ngakolunye uhlangothi, banemibandela yokubambisana, ukubonelela ngokubambelela kunene kwibala. Isakhiwo sabo sinjalo ukuba badlula umoya kwesikhumba, ngelixa bengenawo amanzi. Iinjongo zeendlela zilula ukusetyenziswa, ixabiso elincinane, ukungabi nantlungu kunye nokungabikho kweengxaki, ukunyamezela, iziphumo ezibi. Iingxaki: ubude benkqubo (inyanga eziliqela) kunye nomphumo ophantsi.

Corticosteroids

Abantu abaninzi bacela ukuba basuswe njani isiqhwa se-hypertrophic fast and effect. Izigulane zexesha elide (kunye nexesha elide lezenzo) i-corticosteroids izalisekisa le miqweno yezigulane, kunye neziphumo ezilungileyo ziyafumaneka nakwonyango lwe-keloids. Ukwangoku, i-corticosteroids "iKenalog" kunye ne "DiPisan" isetyenziswe. Indlela yokusebenza kwayo ifana nayo kwaye iqulethe ukunciphisa inani lama-leukocytes kunye nama-cytokines, ukucima inkqubela yokukhula kunye necrosis yokukhula, ukuvimbela umsebenzi we-fibroblasts, ukususa ukuphendulwa kwemizimba, ukunciphisa izinga le-collagen. Inkqubo yenziwa kanye emva kweentsuku ezili-10 ukuya kwe-14. Imiphumo emibi:

• I-Hypopigmentation;
• Ukungena kwe-reticulum yama-capillari ekhumbeni;
• Ukubonakala kwe-acne steroid;
• Ukucocwa kwesikhumba;
• Igalelo elibi lilonke kumzimba.

Ukunciphisa imiphumo emibi, i-corticosteroids ifakwe kunye ne-lidocaine (1: 5), i-saline, i-pentoxifylline. Isiphumo esihle kakhulu sinikezelwa yinkqubo ngokubambisana ne-cryotherapy.

ITraer Therapy

Ukutshaya i-hypertrophic scar okanye i-keloid nge-laser kunika umphumo omkhulu. Ingundoqo yenkqubo iqulethwe ngokufanelekileyo kunye nokuchithwa ngokuchanekileyo kwendawo engaphezulu kwesikhumba kunye nezicubu ezinqabileyo. Ngenxa yoko, isikhumba sihlaziywa, i-elastin entsha kunye ne-collagen zenziwe kwindawo ephathwayo, ukuxubusha komnxeba kuncitshisiwe, kuya kuqhathaniswa nokuthelekiswa nemibhobho engqongileyo. Emva kokusebenzisa le ndlela, iziqholo ze-hypertrophic zinyamalala ngokupheleleyo kuma-80-95%, kunye nezikhenkce zetekisi kwi-60-70% yamatyala. Iingxaki emva kwenkqubo:

• Edema;
• Hyperemia;
• Ukwenyuka kwengqondo kwesikhumba ukuya ekukhanyeni kwelanga;
• Erythma;
• Ukuchithwa kwamanzi (kudlula ngaphandle kwonyango);
• Acne;
• Ukuqulunqwa kwama-cysts.

Impembelelo ye-laser i-ambulatory (enzulu) kwaye engekho-ablative Kwimeko yesibini, iingxaki zihlala ziphantsi, kodwa ubude bonyango bude.

Unyango

Kukho unyango lwangaphandle kunye nokufakwa kwamachiza kumzimba weRumen. Ngamajekesti, amalungiselelo asekelwe kwi-hyaluronidase (i-enzyme, ngenxa yokuba izicumba ze-hypertrophicity are less edematous, soft, i-relief relief) ziyasetyenziswa. Ezi ziquka "uLidase", "Alidaza", "Longidasa", "Volidaz" kunye nabanye. Izifungo kufuneka zenziwe imihla ngemihla okanye iintsuku ezimbini kwiiveki ezi-1-2. Iingxaki zendlela:

• Ukukhubazeka kwe-enzyme;
• Impendulo engalunganga;
• Allergenicity.

Ukusetyenziswa kwonyango lwangaphandle, amafutha, iiprafu. Kwii-pharmacy, kukho ukhetho olubanzi lwezonyango ezisusa amacwecwe. Izona zithandwa kakhulu yi-Kontraktubeks, iDermatics, uKelo-Kot, iKelobibraza. Iingenelelo zendlela ziyanakho, ukukwazi ukuphathwa ekhaya, ukungabikho kwemiphumo emibi. Iingxaki - ngokusebenza kakuhle.

Izilonda ze-keloid, i-ointments kunye neejojo zincinci, kwaye unyango luyinkimbinkimbi.

Indlela yokuphepha ukubonakala kweempawu ezimbi

Ukuba isilonda sikhulu kakhulu, inxeba, enye indlela okanye enye, iya kuhlala. Kodwa kwezinye iimeko, ungazama ukunciphisa ukubonakala kwayo. Ngoko ke, utywala lwe-hypertrophic emva kokususwa kwe-birthmark alunakuze wenziwe, ukuba inkqubo iya kwenziwa nge-cryotherapy, i-electrocoagulation, usebenzisa i-laser. Ukuba i- markmark yokuzalwa ikhutshwe ngokugqithiseleyo, isiqabana sihlala sisoloko. Yaye ukuba uyisusa wena, ekhaya, inkqubo yokuvuvukala ingaqala, eya kuqhubela phambili imeko.

Naluphi na ukulimala kwesikhumba, ukwenzela ukuba isilonda siphulule ngakumbi kwaye siphumelele, kufuneka ulandele imithetho ethile:

• Musa ukuvumela ukungcola kufike kwikhuba elimele;
• Gwema ukuxubana kunye nokuthintela isilonda (umzekelo, iimpahla);
• Akunjalo na ukuba ungabhubhisi i-crusts;
• Gubungela isilonda kwilanga elithe ngqo;
• Sebenzisa iimveliso ezikhethekileyo ezikunceda ukuphulukisa ngokukhawuleza kunye nokunciphisa umngcipheko wesicatshulwa (enye yezona zinto zilungileyo phakathi kwezi zonyango "Kontraktubeks").