Keloids ndi zipsera hypertrophic: maonekedwe, mitundu, zimayambitsa ndi mankhwala

Pambuyo choipa chilichonse kwa khungu la munthu ndi chizindikiro chikumbutso mawonekedwe a chilonda, amene anawamasulira kuchokera ku njira German "chipsyera." Nthawi zina zizindikiro izi mavuto chifukwa mwina simuli malo otchuka, kapena pafupifupi osiyana khungu pafupi. Koma pali zochitika pamene zipsera ndi yaikulu kwambiri, otukukira kunja, mdima, nthawi zina pamwamba kwambiri corrugated. Awa hypertrophic ndi keloid zipsera. Kumene, iwo ndi chidwi zodzikongoletsera chilema, makamaka ngati ili pa nkhope khosi ndi chifuwa. Tayani si mophweka pa iwo, chifukwa mtundu uwu wa pachilondacho wayamba kuoneka ali ndi dongosolo wapadera wa ulusi, n'zovuta kudzudzulidwa.

mitundu ya zipsera

Anthu ena bala omangika mofulumira ndipo pafupifupi popanda kumva ululu uliwonse. Kwa ena, mnjira kukupitirira sabata, ndipo pamene potsiriza, kuchiritsa mabala, malo awo ndi yonyansa zizindikiro akhakula. Zina Zambiri "khalidwe" minofu kumatengera zifukwa zambiri, mwachitsanzo, matenda chilonda, malo awo (mafoni siteshoni kapena ayi), kukula ndi kuya kuwonongeka luso payekha thupi buluzi, mtundu khungu ndi zina zotero. Kuchotsedwa mfundo zonsezi kumabweretsa mfundo yakuti nthaŵi zina mabala analandira ngati olowa (otchedwa atrophic), ndipo ena - ali pa mlingo ofanana ndi khungu (normotroficheskie).

The mabvuto kwambiri pamaso pa cosmetology ndi hypertrophic zipsera. Zidzachitika pamene zimakhala mu kuchiritsa mabala kwambiri fibroblasts adamulowetsa ndi kuyamba kaphatikizidwe kumatheka ya kolajeni. Pamene enzyme izi collagenase kuwononga kolajeni muyeso, opangidwa zedi osakwanira. Chifukwa, minofu latsopano aumbike kwambiri. Kuthawa zobwera paliponse, ndipo iwo protrude pamwamba choipa zazhivshim. Kutalika kwa amamuyambitsa timabala ngati angafikire 10 mm. mtundu wawo ndi ambiri akuda kuposa khungu pa malo oyandikana ndi nyemba zambiri akhakula mtunda.

keloids

formations awa awoneka zofanana kwambiri ndi zipsera hypertrophic, koma ndi chiwerengero kusiyana zosasangalatsa. Chinthu chachikulu ndi zipsera keloid, kuwonekera mu bala malo, kukuza pa khungu wawo. A choyambitsa kwa iwo akhoza kukhala ngati kudula lalikulu kapena kuwotcha, ndipo pokha pang'ono, ngakhale tizilombo kuluma, ambiri samapereka tcheru. Keloid chilonda akuyamba kukula mu mwezi kapena zambiri pambuyo chilonda chakuwangisa. Growth zingatenge zaka ziwiri, ndi olimba sitepe. maphunziro Histological awulule kwambiri yogwira keloids fibroblasts chimphona, zonse kubala kolajeni. Ndipo ngati mabala hypertrophic, ngakhale yonyansa koma sabweretsa chisoni, ndi keloid akhoza kuyambitsa kuyabwa, kupweteka, kuchuluka khungu tilinazo. Kusiyanitsa keloids onyenga, kuwonekera pa malo kuvulazidwa, ndipo choonadi zimene zimachitika pamene khungu si kuonongeka kunja.

Chithandizo cha keloids ndi zipsera hypertrophic

The njira zotsatirazi chilango cha mabala akhakula ntchito lero:

• psinjika;
• mankhwala silikoni (mbale, gel osakaniza);
• Laser mankhwala;
• opaleshoni;
• cheza mankhwala;
• chithandizo ozizira;
• mankhwala;
• corticosteroids.

Aliyense wa iwo ali ndi ubwino ndi kuipa. Njira yomwe ntchito, mu nkhani iliyonse ayenera anaganiza ndi dokotala. Woyera hypertrophic ndi keloid zipsera kwambiri, zimene zimachizidwa amawapeza dermatofibroma ndipo ngakhale kulowerera khansa, anafunika yekha mu zipatala apadera.

alowererepo opaleshoni

Hypertrophic ndi zipsera keloid kawirikawiri kuchotsedwa opaleshoni, chifukwa malangizo oterowo ndi pafupifupi nthawi zonse kusuta. Mwachitsanzo, ngati tikukamba za keloids, chilema kubwerera chimachitika 80-90% milandu polisi ndipo anawonetseredwa mu mapangidwe minofu yovulazidwa akadali zazikulu kuposa kale kuchotsa. Pankhani ya hypertrophic amamuyambitsa timabala mlingo Vuto ndi pang'ono m'munsi. Opaleshoni kukonzedwa bwino kunyamula zipsera si lonse m'mbali lakuthwa. Pa ntchito zawo, dokotalayo excised, kudula m'mphepete akuyerekeza amachita inseam wamng'ono noticeable. Opaleshoni imeneyi imagwiridwa pansi mankhwala oletsa ululu pamalopo. M'chipatala si chofunika.

Ngati njira ya opaleshoni kuchotsedwa amamuyambitsa timabala yaikulu, monga keloids, kuchita patchwork chikopa pulasitiki (kumuika).

psinjika

zipsera Hypertrophic motere pafupifupi zolondola, koma mu nkhani ya keloid likupereka zotsatira zokhutitsa. njira umagwiritsidwa kuika chilonda zolimba bandeji, lomwe wodwalayo amavala, osati kuchotsa, kuyambira miyezi 3 chaka. Nthawi zina zoika bandeji mawola 12. Chifukwa zipangizo kuthamanga pachilonda mabasi mphamvu yake. Pa nthawi yomweyo wothinikizidwa ndi m'mbali mwa minofu yovulazidwa, amene kumathandiza escalation ake zina.

mankhwala cheza

Njira imeneyi ndi yabwino kwambiri ndi ntchito padziko lonse. Kuchotsa zipsera hypertrophic, keloids, ndi dongosolo zina pakhungu imagwiridwa ndi anthu otchedwa Bucky cheza (X-ray mwa mkulu-mwatsatanetsatane beta applicators). Motero, kunyema kapena kusiya kukula fibroblasts awo, kolajeni kaphatikizidwe ndi kutsazikana. Angagwiritsidwe ntchito kuwala kwa intensities osiyana.

Mulimonsemo, 90% ya iwo kuwaphunzira zigawo kumtunda kwa khungu, ndi 10% kugwa mu dermis lapansi. Nthawi zambiri njira imeneyi ntchito molumikizana ndi kuchotsa opaleshoni kwa chilonda. Recurrences pambuyo mankhwala amenewa mayina 50% ya milandu. Polingalira za maonekedwe a kukhudzana njira X-ray ntchito kuchotsa zipsera pa mutu, khosi ndi chifuwa. contraindications:

• Oncology;
• shuga;
• mtima ndi mtima matenda;
• exacerbation la matenda osiyanasiyana.

cryotherapy

Ichi ndi chimodzi mwa njira otetezeka komanso zothandiza. Keloids popanda muyambirenso kudzera ozizira kwathunthu kutha m'zaka 51% ya milandu. Ndipo 76% milandu amachotsedwa hypertrophic zipsera. Chithandizo ayenera kukhala zovuta (cryotherapy ndi njira zina - kugwiritsa ntchito mafuta, silikoni), ndiye n'zomveka kuti akuyembekezera pafupifupi (90%) ya kutha kwa mabala, popanda mavuto ndiponso musabise. njira tichipeza cha kugonjera ndi chilonda madzi asafe (kutentha pafupifupi -196 ° C). Anagwiritsa ntchito yapadera applicator PAD. Chifukwa, maselo anapanga timibulu ayezi, cytoplasm ndi organelles kufa. Kotero kuswa fibroblasts, kolajeni kaphatikizidwe ndi kutsazikana. Ndinakumana ndi asafe zimatha pazipita masekondi 30, koma nthawi zokwanira, ndi masekondi 5. Kuchotsa bwinobwino chilonda, ndi okwanira njira zingapo. kuipa:

• ululu ndondomeko;
• kuthekera kupanga chithuza pa malo chilonda;
• hyperpigmentation mankhwala.

chithandizo silikoni

Tsopano makampani mankhwala apanga gel osakaniza munali pakachitsulo, ndi mbale wapadera silikoni. Mfundo ntchito pa pafupifupi mankhwala yemweyo - akutumikira kudzapeza wetting ndi olimbikitsa a zipsera thupi toyalana mwayi kwa mpweya kuchepetsa ulusi wake ndi kolajeni kaphatikizidwe.

Njira amachotsa atrophic ndi zipsera hypertrophic. si abwino zochizira keloids. mbale The amapangidwa ndi akalumikidzidwa osiyana ndi makulidwe. Pa dzanja limodzi ali ndi ❖ kuyanika yomata kupereka guluu wolimba pazipita kwa chilonda wandiweyani. Kapangidwe awo ndi chotero kuti mpweya khungu akamadutsa, kukhala Choncho watertight. Ubwino wa njira MUKACHULUKIDWE chomasuka ntchito, mtengo wotsika, sabweretsa chisoni ndi wopanda mavuto, chifuwa, mavuto. Kuipa: ndondomeko nthawi (a miyezi ingapo) mvetsetsa otsika.

corticosteroids

Anthu ambiri amafunsa kuti, mmene kuchotsa chilonda hypertrophic mofulumira ndi zotsatira noticeable. Depot jekeseni (ndi nthawi yaitali kanthu) corticosteroids kuchita zokhumba izi odwala ndi zotsatira zabwino akwaniritsa mankhwalawa keloids. Today ntchito corticosteroids "Kenalog" ndi "Diprosan". limagwirira zochita pafupifupi chimodzimodzi ndi tichipeza mu kuchepetsa chiwerengero cha maselo oyera ndi cytokine inhibiting kukula chinthu necrosis ndi kuchulukana, fibroblast braking opareshoni, kuchotsa thupi lawo siligwirizana, kuchepa madzi a kolajeni. Ndondomeko anachita 1 nthawi mu masiku 10-14. Zotsatira zoyipa za mankhwalawa:

• hypopigmentation;
• magazi-mu thumba la capillaries pakhungu;
• maonekedwe a ziphuphu zakumaso steroid;
• kupatulira wa khungu;
• akukhudzidwira zoyipa pa thupi.

Kuchepetsa mbali zotsatira za corticosteroids pokha pamodzi ndi lidocaine wa (1: 5), saline, pentoxifylline. An chifukwa kwambiri amapereka njirayi molumikizana ndi cryotherapy.

mankhwala laser

Akupera hypertrophic chilonda kapena laser keloid amapereka zotsatira pazipita. Akamanena za ndondomeko ndi zolondola kwambiri ndi kuchotsa yeniyeni wosanjikiza chapamwamba khungu ndi minofu yovulazidwa. Khungu kusinthidwa, zigawo ankachitira kupanga elastin latsopano ndi kolajeni amachepetsa chilonda convexity, ndi pafupifupi ofanana ndi chimakwirira ozungulira. Pambuyo kutsatira njira imeneyi mabala hypertrophic kwathunthu kutha mu 80-95% ndipo keloid - mu 60-70% ya milandu. Zovuta pambuyo ndondomeko:

• kutupa;
• ankatenthetsa;
• kuchuluka khungu kudziwa dzuwa;
• erythema;
• Hyperpigmentation (akuthamanga popanda mankhwala);
• ziphuphu zakumaso;
• chotupa mapangidwe.

Laser kukhudzana ndi amblyatsionnoe (chozama) ndi neamblyatsionnoe (modekha). Pankhani chachiwiri matendawo, kawirikawiri zochepa, koma nthawi yaitali mankhwala.

mankhwala

Pali akunja ndi chithandizo ndi kugwiritsira mankhwala mu thupi kwa chilonda. Jekeseni ntchito formulations zochokera hyaluronidase (puloteni umene zipsera hypertrophic kukhala zochepa kutupa, zofewa, flattened mpumulo awo). Zikuphatikizapo "Lidaza", "Alidaza", "Longidaza", "Vilidaza" ndi ena. Majekeseni zizichitidwa tsiku lililonse kapena masiku 2 kwa masabata 1-2. kuipa:

• Kusakhazikika kwa enzyme ndi;
• zochita chowawa;
• allergenicity.

Mankhwala apakhungu a zodzola, lotions, opopera. pharmacies ali zosiyanasiyana mankhwala, amachotsa zipsera. Wotchuka kwambiri "Kontraktubeks", "Dermatiks", "Kelo-Cote", "Kelobibraza". Ubwino wa njira ndi lightness ake, n'zotheka mankhwala kunyumba, pakalibe mavuto. Kuipa - mu dzuwa otsika.

Against thandizo keloids pang'ono ndi zodzola, ndi jekeseni, ndi chithandizo ndi zovuta zokha.

Kodi kupewa kuoneka zipsera akhakula

Ngati chilonda chachikulu kwambiri, chilonda, mwanjira ina, adzatsala. Koma nthawi zina n'zotheka kuyesa kuchepetsa maonekedwe ake. Choncho, hypertrophic chilonda pambuyo kuchotsa Mole pafupifupi konse anapanga ngati ndondomeko kuchita cryotherapy, electrocautery, laser-anathandiza. Anadya Mole kuchotsedwa ndi opaleshoni, ndi chilonda nthawi chikhalire. Ndipo pamene inu kuchotsa nokha, kunyumba, akhoza kuyamba yotupa ndondomeko, amene zidzalimbikitsa zimawonjezera vutoli.

Wovulalayu aliyense wa khungu chilondacho bwino ndipo mofulumira, muyenera kutsatira malamulo:

• Musalole dothi kuti anavulala khungu tsoka;
• kupewa mikangano ndi wokhudza bala padziko (mwachitsanzo, zovala);
• Palibe musati kunyenga ndi kutumphuka likakhazikitsidwa;
• kuphimba bala kwa dzuwa;
• ntchito kirimu wapadera kuthandiza mofulumira machiritso ndi kuchepetsa chiopsezo cha amamuyambitsa timabala (imodzi yabwino mwa mankhwala amenewa ndi "Kontraktubeks").