Keloids na hypertrophic scars: nkọwa, ụdị, na-akpata na ọgwụgwọ

Mgbe ọ bụla mmerụ ahụ nke a na onye a ncheta ịrịba ama n'ụdị onya, nke si sụgharịa German pụtara "onya." Mgbe ụfọdụ, ndị a akara na-adịghị eme ka nsogbu n'ihi na ma na-adịghị na a ma ama na ebe, ma ọ fọrọ nke nta indistinguishable si n'akụkụ akpụkpọ. Ma e nwere ọnọdụ mgbe scars oke ma ama, convex, ọchịchịrị, mgbe ụfọdụ, na ukwuu corrugated n'elu. Ndị a bụ hypertrophic na keloid scars. N'ezie, ha na-a ịrịba ịchọ mma ntụpọ, karịsịa ma ọ bụrụ na dị na ihu, n'olu, obi. Tufuo ya abụghị nnọọ mfe na ha, n'ihi na nke a ụdị onya nwere a pụrụ iche Ọdịdị nke ahụ emep uta eri, ọ bụ ike ka a gbazie.

ụdị scars

Ụfọdụ ndị na-emerụ tightened ngwa ngwa na ọ fọrọ nke nta painlessly. N'ihi na ndị ọzọ, nke a gbatịrị karịrị otu izu, na mgbe, n'ikpeazụ, gwọọ ọnyá, n'ebe ha na ndị jọrọ njọ ike ike akara. Ihe dị iche iche "omume" nke anụ ahụ na-adabere na ọtụtụ ihe, e.g., emerụ na-efe efe, ha na ọnọdụ (mobile ọdụ ma ọ bụ), na size na omimi nke mmebi na onye ahụ nwere ikike ịdị na-agbanwe, ikpa ụdị na na. The ozuzu oke nke niile ihe ndị a na-eduga ná eziokwu na ụfọdụ ndị scars nwetara dị ka ma ọ bụrụ na aba ime (akpọ atrophic), na ndị ọzọ - na-na otu larịị na akpụkpọ (normotroficheskie).

The kasị mfịna si ele ihe anya nke cosmetology bụ hypertrophic scars. Ha ime mgbe anụ ahụ na-agwọ ọnyá kwa fibroblasts na-arụ ọrụ na-amalite enwekwukwa njikọ nke collagen. Mgbe a enzyme bụ collagenase, ebibi ngafe collagen, emepụta ezughi oke quantities. Dị ka a N'ihi ya, ndị ọhụrụ anụ ahụ a kpụrụ ukwuu. Izere gabigara ókè na mberede, na ha protrude n'elu zazhivshim mmerụ. The elu nke ndị dị otú ahụ n'ichihịa nwere ike iru 10 mm. Ha na agba bụ ukwuu n'ime darker n'akpụkpọ ahụ na ndị agbata obi ebe, na n'elu bụ mgbe ike ike teren.

keloids

Ndị a formations anya yiri nnọọ ka hypertrophic scars, ma a ọnụ ọgụgụ nke wetara iche. Ndị isi ihe bụ na keloid scars, idem ke ọnya site, mụbaa na-emebibeghị anụ. A akpalite na ha nwere ike ịghọ dị ka a nnukwu ịkpụ ma ọ bụ ọkụ, na a nta prick, ọbụna ahụhụ aru, nke ọtụtụ ndị na-aṅa ntị. Keloid onya amalite itolite na a ọnwa ma ọ bụ karịa mgbe ọnya gwọọ. Uto nwere ike buru ruo afọ abụọ, ndị a stabilization nzọụkwụ. Histological ọmụmụ ekpughe kwa ifịk keloids fibroblasts ibu, mgbe niile na-amị collagen. Ma ọ bụrụ na hypertrophic scars, ọ jọrọ njọ ma enweghi mgbu, na keloid nwere ike ime ka itching, ihe mgbu, mụbara akpụkpọ uche. Ịmata Ọdịiche ụgha keloids, pụtara na saịtị nke ọjọọ, na eziokwu na-erukwa na ebe anụ ahụ na-adịghị emebi externally.

Ọgwụgwọ nke keloids na hypertrophic scars

Ndị na-esonụ ụzọ nke mgbazi nke ike ike scars na-eji taa:

• mkpakọ;
• silicone ngwaahịa (efere, jel);
• Laser ọgwụ;
• ịwa ahụ;
• radieshon ọgwụ;
• oyi na-atụ omume;
• usoro ọgwụ;
• corticosteroids.

Onye ọ bụla n'ime ha nwere ya uru na ọghọm. Na nke usoro iji, na nke ọ bụla ga-esi kpebie site dọkịta. Clean hypertrophic na keloid scars ọbụna ihe, nke na-emekarị chọpụtara dị ka dermatofibroma na ọbụna akụzi cancer, naanị mkpa pụrụ iche clinics.

ịwa aka

Hypertrophic na keloid scars na-adịkarịghị wepụrụ surgically, n'ihi na mgbe mgbazi dị otú ahụ bụ fọrọ nke nta mgbe a ọzọ. Ka ihe atụ, ọ bụrụ na anyị na-ekwu banyere keloids, ntụpọ laghachi na-ewe ebe 80-90% niile kọrọ ikpe ma na-egosipụta na e guzobere onya anụ ahụ bụ ka ibu karịa ka ọ bụ tupu mwepụ. N'ihe banyere hypertrophic n'ichihịa sikwuoro ọnụego bụ ubé ala. Ịwa mgbazi kasị mma na-ebu scars adịghị obosara na nkọ n'ọnụ. N'oge ha na-arụ ọrụ, ndị dọkịta na-awa excised, bee n'ọnụ tụnyere ka inseam obere kwesiri ngosi. Nke a na ime ihe a rụrụ n'okpuru obodo Nkụnwụ. Ụlọ ọgwụ bụ chọrọ.

Ọ bụrụ na usoro nke ịwa ahụ wepụrụ ọtụtụ n'ichihịa, dị ka keloids, ime patchwork akpụkpọ anụ plastic (transplant).

mkpakọ

Hypertrophic scars n'ụzọ dị otú a bụ ihe fọrọ nke ziri ezi, ma na ikpe nke keloid ọ na-enye na-eju afọ na-arụpụta. The usoro na-etinyere na-edebe n'apa uko bandeeji, nke onye ọrịa wears, bụghị wepụ, si ọnwa 3 na a afọ. Mgbe ụfọdụ, ọ ga-ebo a bandeeji ọ bụla 12 awa. N'ihi na mgbali arịa n'apa akwụsị ike ya. N'otu oge abịakọrọ na n'ọnụ nke onya anụ ahụ, nke na-egbochi ya n'ihu escalation.

radieshon ọgwụ

Usoro a bụ ndị kasị dị irè na-eji na gburugburu ụwa. Mwepụ nke hypertrophic scars, keloids, na ndị ọzọ formations na akpụkpọ a rụrụ site na-akpọ Bucky ụzarị (X-ụzarị site elu-nkenke beta applicators). N'ihi ya, agbaji ma ọ bụ kwụsị ha ibu fibroblasts, collagen njikọ na-kwụsị. Ka a ga-eji ìhè nke dị iche iche intensities.

Na nke ọ bụla, 90% nke ha banye elu n'ígwé nke anụ ahụ, na a 10% ọdịda na dermis. Ọtụtụ mgbe usoro a na-eji na njikọ na-awa ahụ mwepụ nke onya. Ugboro mgbe ọgwụ ndị dị otú ahụ aha na 50% nke ikpe. Na echiche nke atụmatụ nke X-ray ikpughe usoro a na-eji wepụ scars na isi, olu na obi. contraindications:

• oncology;
• arịa ọrịa shuga;
• obi na vaskụla ọrịa;
• exacerbation nke ọrịa dị iche iche.

cryotherapy

Nke a bụ otu n'ime ndị kasị dịrị nchebe na ụzọ dị irè. Keloids enweghị nlọghachi azụ via oyi kpamkpam akwụsị na 51% nke ikpe. Na na 76% nke ikpe na-ewepụ hypertrophic scars. Ọgwụgwọ kwesịrị mgbagwoju (cryotherapy na ndị ọzọ na usoro - ojiji nke ointments, silicone), mgbe ahụ ọ na-eme uche na-atụ anya ka ihe fọrọ nke nta ezu (90%) nke ofufe nke scars, na-enweghị nsogbu na nlọghachi. The usoro mejupụtara edo n'apa mmiri mmiri nitrogen (okpomọkụ nke banyere -196 ° C). O tinyere a pụrụ iche applicator na mpe mpe akwa. N'ihi ya, mkpụrụ ndụ kpụrụ ice kristal, cytoplasm na organelles anwụ. Ya mere agbaji fibroblasts, collagen njikọ na-kwụsị. N'ebe nitrogen dịruru a kacha nke 30 sekọnd, ma ọtụtụ mgbe ezuru, na 5 sekọnd. Iji n'ụzọ zuru ezu wepu n'apa ahụ, ọ bụ zuru ezu ọtụtụ usoro. ọghọm:

• usoro ihe mgbu;
• ekwe omume nke na-akpụ a ọnya na saịtị nke n'apa;
• hyperpigmentation mgbe omume.

silicone ọgwụgwọ

Ugbu a na-emepụta ọgwụ na ụlọ ọrụ ndị mepụtara a jel nwere sịlịkọn, na pụrụ iche silicone efere. Ụkpụrụ nke ime ihe na ihe dị ka otu ọgwụ - ha na-ejere jirichaa wetting na softening nke scars ahụ, overlapping ohere nke oxygen iji belata ya emep uta eri na collagen njikọ.

Nke a na usoro na-ewepu atrophic na hypertrophic scars. ọ bụghị kwesịrị ekwesị maka ọgwụgwọ nke keloids. The efere na-emepụta dị iche iche na shapes na nha. Na otu aka ha nwere a nnyapade mkpuchi na-enye kacha adhesion ka oké onya. Ha mebere atumatu bụ dị otú ahụ na ikuku ka akpụkpọ ha na-agafe, ịbụ otú mmiri ghara ịba n'ime. Uru nke usoro iso na ala nke iji, dịtụ ala na-eri, enweghi mgbu na-enweghị nsogbu, allergies, mmetụta. Ọghọm: usoro oge (a ọnwa ole na ole) na ala mmetụta.

corticosteroids

Ọtụtụ mmadụ na-ajụ, esi wepụ hypertrophic onya ngwa ngwa na na a kwesiri ngosi mmetụta. Ebusa injection (na a ogologo oge nke edinam) corticosteroids eme ihe ndị a ọchịchọ nke ọrịa na-arụpụta ezi ihe na-enweta na ọgwụgwọ nke keloids. Taa eji corticosteroids "Kenalog" na "Diprosan". Ha usoro nke edinam bụ mkpokọta otu na mejupụtara na mbenata ọnụ ọgụgụ nke mkpụrụ ndụ ọbara ọcha na cytokine inhibiting ibu na-akpata necrosis na proliferation, fibroblast braking ọrụ, mwepụ nke nfụkasị Jeremaya, a ọnụ ke collagen etoju. Usoro a rụrụ 1 oge 10-14 ụbọchị. Mmetụta:

• hypopigmentation;
• igba obara-site ntupu nke capillaries n'akpụkpọ;
• ọdịdị steroid otutu;
• thinning nke anụ;
• n'ozuzu mmetụta ọjọọ n'ahụ na ahu.

Iji belata mmetụta nke corticosteroids prick ọnụ na lidocaine (1: 5), saline, pentoxifylline. Ihe magburu onwe N'ihi enye a usoro na njikọ na cryotherapy.

laser ọgwụ

Egweri hypertrophic onya ma ọ bụ keloid laser enye kacha mmetụta. Ihe kachasi mkpa n'ime usoro bụ nnọọ ezi na kpọmkwem mwepụ nke elu oyi akwa nke anụ ahụ na onya anụ ahụ. The akpụkpọ a na-emelite, na-emeso na mpaghara na-etolite a ọhụrụ elastin na collagen mbelata onya okpomọọkụ, ọ fọrọ nke nta tụnyere na gburugburu mkpuchite. Mgbe n'itinye usoro a hypertrophic scars kpamkpam akwụsị na 80-95%, na keloid - na 60-70% nke ikpe. Nsogbu mgbe usoro:

• ozizi;
• flushing;
• ụba akpụkpọ uche ìhè anyanwụ;
• erythema;
• Hyperpigmentation (na-agba na-enweghị ọgwụgwọ);
• otutu;
• ahu otutu guzobere.

Laser ikpughe bụ amblyatsionnoe (miri) na neamblyatsionnoe (nwayọọ). Nke abụọ ahụ nke nsogbu, na-emekarị na-erughị, ma ogologo oge nke ọgwụgwọ.

aṅụ ọgwụ

E nwere elu na ọgwụgwọ site anamde ibọ ọgwụ na ahụ nke onya. N'ihi injection iji formulations dabeere hyaluronidase (ihe enzyme adịru hypertrophic scars ibu obere aza, adụ, esisịt ha enyemaka). A na-agụnye "Lidaza", "Alidaza", "Longidaza", "Vilidaza" na ndị ọzọ. Ọgwụ ga-eme kwa ụbọchị ma ọ bụ ọ bụla 2 ụbọchị maka 1-2 izu. ọghọm:

• akwusighi nke enzyme;
• oghom Jeremaya mere;
• allergenicity.

N'ihi Nde ọgwụgwọ nke ointments, lotions, sprays. The pharmacies nwere a dịgasị iche iche nke ọgwụ ọjọọ, na-ewepu scars. The kasị ewu ewu "Kontraktubeks", "Dermatiks", "Kelo-Cote", "Kelobibraza". Uru nke usoro bụ ya lightness, ekwe omume nke ọgwụgwọ n'ụlọ, enweghị mmetụta. Ọghọm - na ala arụmọrụ.

Against keloids obere enyemaka na ointments, na injections, na ọgwụgwọ bụ naanị mgbagwoju.

Olee otú iji zere ọdịdị ike ike scars

Ọ bụrụ na ndị ọnya bụ oke buru ibu, n'apa ahụ, otu ụzọ ma ọ bụ ọzọ, ga-anọgide. Ma mgbe ụfọdụ ọ bụ omume na-na-agbalị na-ebelata ya anya. Ya mere, hypertrophic onya mgbe ahumachi mwepụ na-fọrọ nke nta mgbe a kpụrụ ma ọ bụrụ na usoro ịrụ cryotherapy, electrocautery, laser-aka. Riri ahumachi wepụrụ site usiakidem, n'apa mgbe niile na-anọgide. Na mgbe ị na-ewepụ ya onwe gị, n'ụlọ, o nwere ike na-amalite mkpali usoro, nke ga-eme ka exacerbate ọnọdụ ahụ.

Maka ihe ọ bụla mmerụ nke anụ ahụ, na ọnya gwọọ mma na ngwa ngwa, ị ga-eso ụfọdụ iwu:

• Ekwela ka unyi na merụrụ ahụ akpụkpọ eke;
• zere esemokwu na-emetụ ọnya elu (e.g., uwe);
• Na ọ bụrụ na-adịghị dọkapụ jikọrọ ọnụ kpụrụ;
• ekpuchi ọnya si kpọmkwem ìhè anyanwụ;
• iji a pụrụ iche ude na-enyere ngwa ngwa na-agwọ ọrịa ma mbenata ihe ize ndụ nke n'ichihịa (onye nke kasị mma n'etiti ndị dị otú ọgwụ ọjọọ bụ "Kontraktubeks").