Keloids thiab hypertrophic nti: hauj lwm, hom, ua thiab kev kho mob

Tom qab tej kev raug mob rau ntawm daim tawv nqaij ntawm ib tug neeg yog ib tug memorial kos npe rau hauv daim ntawv ntawm cov caws pliav, uas txhais los ntawm German txhais tau tias "caws pliav." Tej zaum cov cim tsis ua teeb meem vim hais tias yog tsis nyob rau hauv ib tug muaj koob qhov chaw, los yog yuav luag indistinguishable los ntawm nyob ib sab daim tawv nqaij. Tab sis muaj tej yam teeb meem thaum lub nti yog heev tseem ceeb, convex, tsaus ntuj nti, tej zaum nrog mas corrugated nto. Cov no yog cov hypertrophic thiab keloid nti. Ntawm cov hoob kawm, lawv yog ib tug tseem ceeb kom hniav zoo nkauj kho raws, tshwj xeeb tshaj yog yog hais nyob rau lub ntsej muag, caj dab, hauv siab. Muab tshem ntawm nws tsis yog li ntawd ib qho yooj yim rau lawv, vim hais tias qhov no zoo ntawm caws pliav muaj ib tug tshwj xeeb tsa ntawm lub fibers, nws yog ib qhov nyuaj yuav tsum tau kho.

hom nti

Ib txhia neeg lub qhov txhab nruj sai sai thiab yuav luag painlessly. Rau lwm tus neeg, tus txheej txheem no extends tshaj ib lub lim tiam, thiab thaum twg, thaum kawg, kho wounds, nyob rau hauv lawv qhov chaw yog dab tuag ntxhib tias. Lwm Yam "tus cwj pwm" cov ntaub so ntswg nyob ntawm ntau yam, e.g., qhov txhab mob, lawv qhov chaw nyob (mobile chaw nres tsheb los yog tsis), qhov luaj li cas thiab qhov tob ntawm kev puas tsuaj rau ib tug neeg lub cev kev muaj peev xwm tsim dua tshiab, daim tawv nqaij hom thiab thiaj li nyob. Lub totality ntawm tag nrho cov yam ua rau lub fact tias nyob rau hauv tej rooj plaub lub nti tau li, yog hais tias sunken (hu ua atrophic), thiab lwm tus neeg - yog nyob rau tib theem nrog daim tawv nqaij (normotroficheskie).

Qhov tseem problematic los ntawm lub standpoint ntawm cosmetology yog hypertrophic nti. Lawv tshwm sim thaum ntaub so ntswg nyob rau hauv kho qhov txhab dhau fibroblasts yog tshuab txais thiab pib kho kom zoo synthesis ntawm collagen. Thaum zoo li no enzyme yog collagenase, kev rhuav tseg cov tshaj collagen, ua nyob rau hauv tsis txaus ntau. Raws li ib tug tshwm sim, tus tshiab cov ntaub so ntswg yog tsim ntau dhau lawm. Kev khiav excesses nowhere, thiab lawv protrude saum toj no zazhivshim raug mob. Lub qhov siab ntawm tej caws pliav yuav ncav cuag 10 hli. Lawv yog xim feem ntau ib tsos tsaus tsawv tshaj ntawm daim tawv nqaij nyob rau hauv lub zos nyob sib ze thaj chaw, thiab qhov chaw yog feem ntau ntxhib struts.

keloids

Cov formations zoo heev uas zoo sib xws rau hypertrophic nti, tiam sis yuav tau ib tug xov tooj ntawm tsis kaj siab sib txawv. Qhov loj tshaj plaws yog tias keloid nti, tshwm nyob rau hauv lub qhov txhab qhov chaw, nthuav rau lawm daim tawv nqaij. Ib tug txhais rau lawv muaj peev xwm ua raws li ib tug loj txiav los yog hlawv, thiab ib tug me ntsis prick, txawm ib tug kab tom, uas muaj ntau yam tsis them sai sai. Keloid caws pliav pib loj hlob nyob rau hauv ib lub hlis los yog ntau tshaj tom qab lub qhov txhab kho. Kev loj hlob yuav siv sij hawm txog li ob lub xyoo, raws li los ntawm ib tug stabilization kauj ruam. Histological kev tshawb fawb qhia heev active keloids fibroblasts giant, lossi ua collagen. Thiab yog hais tias hypertrophic nti, tab sis yog dab tuag tab sis tsis mob, lub keloid yuav ua rau khaus, mob, muaj daim tawv nqaij rhiab heev. Paub qhov txawv cuav keloids, tshwm ntawm qhov chaw ntawm kev raug mob, thiab qhov tseeb uas tshwm sim nyob qhov twg hauv daim tawv nqaij yog tsis puas externally.

Kev kho mob ntawm keloids thiab hypertrophic nti

Cov nram qab no txoj kev kho ntawm ntxhib nti yog siv niaj hnub no:

• compression;
• silicone khoom (daim hlau, gel);
• Laser txoj kev kho;
• phais;
• tawg txoj kev kho;
• txias kev kho mob;
• tshuaj kho;
• corticosteroids.

Muaj ib tug ntawm lawv nws muaj nws qhov zoo thiab qhov tsis zoo. Uas txoj kev los siv, nyob rau hauv txhua rooj plaub yuav tsum tau txiav txim siab los ntawm tus kws kho mob. Ntxuav hypertrophic thiab keloid nti txawm ntau, uas yog feem ntau paub hais tias raws li dermatofibroma thiab txawm infiltrating cancer, tsuas yuav tsum tau nyob rau hauv tshwj xeeb tsev kho mob.

phais kev pab

Hypertrophic thiab keloid nti tsis tshua muab tshem tawm surgically, vim hais tias tom qab xws li kev kho yog yuav luag ib txwm ib tug relapse. Piv txwv li, yog hais tias peb tham txog keloids, defect rov qab yuav siv sij hawm qhov chaw nyob rau hauv 80-90% ntawm tag nrho cov qhia tus neeg mob thiab yog manifested nyob rau hauv lub tsim ntawm caws pliav nqaij yog tseem loj tshaj nws yog ua ntej qhov kev tshem tawm. Nyob rau hauv cov ntaub ntawv ntawm hypertrophic cirrhosis yam tab kaum tus nqi yog me ntsis qis. Phais kho yog zoo tshaj plaws nqa lub nti yog tsis ntau nrog ntse hau. Thaum lub sij hawm lawv lub lag luam, tus kws phais excised, txiav npoo piv tsis inseam hais tias me ntsis hnov li cas. Qhov no lub lag luam yog ua nyob rau hauv lub zos tshuaj loog. Pw tsev kho mob yog tsis yuav tsum tau.

Yog hais tias tus qauv ntawm kev phais tshem tawm uas nws kim heev cirrhosis, xws li keloids, ua patchwork tawv yas (hloov).

compression

Hypertrophic nti nyob rau hauv no txoj kev yog suab tseeb, tab sis nyob rau hauv cov ntaub ntawv ntawm keloid nws muab fee tau. Cov qauv no yog thov mus rau qhov chaw lub caws pliav ceev ntaub qhwv, uas tus neeg mob ris, tsis tshem, los ntawm 3 lub hlis mus rau ib xyoos. Tej zaum nws yuav kom ib tug ntaub qhwv txhua txhua 12 teev. Vim lub siab hlab ntsha nyob rau hauv lub caws pliav tsis nws lub hwj chim. Nyob rau tib lub sij hawm compressed thiab cov npoo ntawm caws pliav nqaij, uas tiv thaiv nws ntxiv escalation.

tawg txoj kev kho

Qhov no yog cov zoo tshaj plaws thiab yog siv nyob ib ncig ntawm lub ntiaj teb no. Kev tshem tawm ntawm hypertrophic nti, keloids, thiab lwm yam formations ntawm daim tawv nqaij yog ua los ntawm thiaj li hu Bucky rays (X-rays los ntawm txoj kev high-precision beta tiav). Raws li ib tug tshwm sim, zom los yog tso tseg lawv txoj kev loj hlob fibroblasts, collagen synthesis yog haujlwm. Tej zaum yuav siv rays ntawm txawv intensities.

Nyob rau hauv txhua rooj plaub, 90% ntawm lawv nqus cov sab sauv khaubncaws sab nraud povtseg ntawm daim tawv nqaij, thiab ib tug 10% lub caij nplooj zeeg nyob rau hauv lub dermis. Feem ntau cov qauv no yog siv nyob rau hauv ua ke nrog kev phais tshem tawm ntawm lub caws pliav. Recurrences tom qab txoj kev kho xws sau npe nyob rau hauv 50% ntawm cov neeg. Nyob rau hauv view ntawm cov yam ntxwv ntawm tus X-ray raug txoj kev yog siv los mus tshem nti rau hauv lub taub hau, caj dab thiab hauv siab. Contraindications:

• Oncology;
• mob ntshav qab zib;
• lub plawv thiab leeg tshav kab mob;
• exacerbation ntawm ntau yam kab mob.

cryotherapy

Qhov no yog ib qho ntawm tus tov thiab zoo txoj kev. Keloids tsis muaj relapse ntawm txias kiag li ploj nyob rau hauv 51% ntawm cov neeg. Thiab nyob rau hauv 76% ntawm cov neeg raug muab tshem tawm hypertrophic nti. Kev kho mob yuav tsum tau complex (cryotherapy thiab lwm hom kev kawm - kev siv ntawm ointments, silicone), ces nws yuav ua rau kev txiav txim zoo rau kev cia siab rau lub luag tiav (90%) ntawm cov disappearance ntawm nti, tsis muaj teeb meem thiab rov. Cov kev muaj subjecting lub caws pliav kua nitrogen (kub ntawm txog -196 ° C). Nws thov ib tug tshwj xeeb applicator ncoo. Raws li ib tug tshwm sim, hlwb tsim dej khov muaju, cytoplasm thiab organelles tuag. Yog li ntawd lov fibroblasts, collagen synthesis yog haujlwm. Raug nitrogen kav ib tug tshaj plaws ntawm 30 vib nas this, tiam sis feem ntau txaus, thiab 5 vib nas this. Rau siab tshem tawm cov caws pliav, nws yog txaus ob peb txheej txheem. tsis zoo:

• txoj kev mob;
• tau txoj kev ua ib hlwv ntawm qhov chaw ntawm lub caws pliav;
• hyperpigmentation tom qab kev kho mob.

silicone kev kho mob

Tam sim no cov kws tuam txhab uas muag tau tsim ib gel muaj pob zeb ntais, thiab tshwj xeeb silicone phaj. Hauv paus ntsiab lus ntawm cov lag luam ntawm kwv yees li tib yam tshuaj - lawv pab kom maximize tso zis thiab softening ntawm nti lub cev, overlapping kev nkag tau ntawm oxygen mus rau txo nws fibers thiab collagen synthesis.

Qhov no txoj kev tshem tawm atrophic thiab hypertrophic nti. nws tsis yog haum rau cov kev kho mob ntawm keloids. Cov phiaj yog ua nrog ntau daim thiab ntau thiab tsawg. Nyob rau hauv ib tes lawv muaj ib tug nplaum txheej los muab nyiaj pab ntau tshaj adhesion mus rau lub tuab caws pliav. Lawv cov qauv yog xws li hais tias cov huab cua rau ntawm daim tawv nqaij lawv dhau, ua li watertight. Qhov zoo ntawm tus qauv muaj xws li nyob rau hauv qhov yooj yim ntawm kev siv, kuj tsis tshua muaj nqi, tsis mob thiab tsis muaj teeb meem, ua xua, phiv. Tsis zoo: cov txheej txheem ntev (ob peb lub hlis) thiab tsawg cuam tshuam.

corticosteroids

Muaj coob tus neeg nug, yuav ua li cas kom tshem tawm cov hypertrophic caws pliav sai sai thiab nrog ib tug hnov li cov nyhuv. Depot kev txhaj tshuaj (nrog ib tug ntev ntev ntawm kev txiav txim) corticosteroids ua cov kev xav hauv cov neeg mob uas tau zoo yog tiav nyob rau hauv cov kev kho mob ntawm keloids. Niaj hnub no siv corticosteroids "Kenalog" thiab "Diprosan". Lawv mechanism ntawm qhov kev txiav txim yog kwv yees li tib yam thiab muaj nyob rau hauv txo tus naj npawb ntawm cov ntshav dawb thiab cytokine inhibiting kev loj hlob tau necrosis thiab loj hlob, fibroblast braking lag luam, kev tshem tawm ntawm kev tsis haum tshuaj, ib tug txo nyob rau hauv collagen theem. Tus txheej txheem yog ua 1 lub sij hawm nyob rau hauv 10-14 hnub. Sab los:

• hypopigmentation;
• ntshav-los ntawm mesh ntawm cov hlab ntsha nyob rau hauv daim tawv nqaij;
• cov tsos ntawm steroid pob txuv;
• thinning ntawm daim tawv nqaij;
• zuag qhia tag nrho tsis zoo rau lub cev.

Yuav kom txo tau tshwm sim los ntawm corticosteroids prick ua ke nrog lidocaine (1: 5), saline, pentoxifylline. Ib qho zoo heev tshwm sim muab txoj kev ua no nyob rau hauv nrog cryotherapy.

laser txoj kev kho

Sib Tsoo hypertrophic caws pliav los yog keloid laser muab nyiaj pab ntau tshaj cov nyhuv. Lub essence ntawm cov txheej txheem yog meej heev thiab ncaj heev tshem tawm ntawm lub qaum txheej ntawm daim tawv nqaij thiab caws pliav nqaij. Cov tawv nqaij tshiab, lub kho cheeb tsam tsim ib tug tshiab elastin thiab collagen txo caws pliav convexity, nws yog yuav luag piv nrog cov surrounding npog. Tom qab ua ntawv thov rau cov qauv no hypertrophic nti kiag li ploj nyob rau hauv 80-95%, thiab keloid - nyob rau hauv 60-70% ntawm cov neeg. Teeb meem tom qab rau txoj kev:

• o;
• yaug kais dej;
• nce daim tawv nqaij rhiab heev rau tshav ntuj;
• erythema;
• Hyperpigmentation (sau tsis kho);
• pob txuv;
• cyst tsim.

Laser raug yog amblyatsionnoe (ntxaum) thiab neamblyatsionnoe (ntau maj mam). Nyob rau hauv lub thib ob cov ntaub ntawv ntawm cov teeb meem, feem ntau tsawg, tiam sis ntev ntev ntawm kev kho mob.

tshuaj kho

Muaj txheej thiab kev kho mob los ntawm txoj kev saib xyuas tshuaj nyob rau hauv lub cev ntawm lub caws pliav. Cov kev txhaj tshuaj siv formulations raws li hyaluronidase (ib qho enzyme uas hypertrophic nti ua tsawg o, cov mos mos, flattened lawv nyem). Cov no muaj xws "Lidaza", "Alidaza", "Longidaza", "Vilidaza" thiab lwm tus neeg. Tshuaj yuav tsum tau ua txhua txhua hnub los yog txhua txhua 2 hnub rau 1-2 lub lis piam. tsis zoo:

• khov ntawm cov enzyme;
• phiv tshuaj;
• allergenicity.

Rau cov tshuaj pleev kev kho mob ntawm tshuaj pleev, muab tshuaj pleev, tshuaj tsuag. Lub tsev muag tshuaj muaj ntau ntau yam ntawm cov tshuaj, tshem tawm nti. Cov feem nrov "Kontraktubeks", "Dermatiks", "Kelo-Côte", "Kelobibraza". Qhov zoo ntawm tus qauv yog nws lightness, tau ntawm kev kho mob nyob rau hauv tsev, hauv lub qhaj ntawv ntawm cov kev phiv. Tsis zoo - nyob rau hauv uas tsis muaj hauj lwm zoo.

Tiv thaiv keloids kev pab me ntsis thiab tshuaj pleev, thiab tshuaj, thiab kev kho mob tsuas yog complex.

Yuav ua li cas kom tsis txhob muaj cov tsos ntawm ntxhib nti

Yog hais tias lub qhov txhab yog loj heev, qhov caws pliav, ib txoj kev los sis lwm, yuav nyob twj ywm. Tab sis tej zaum nws yog tau mus sim kom txo tau nws cov tsos. Yog li ntawd, hypertrophic caws pliav tom qab tias kev tshem tawm yog yuav luag yeej tsis tsim yog hais tias tus txheej txheem ua cryotherapy, electrocautery, laser-pab. Noj cov tias muab tshem tawm los ntawm kev phais, qhov caws pliav yeej ib txwm nyob. Thiab thaum twg koj tshem tawm nws tus kheej, nyob rau hauv tsev, nws yuav pib lub inflammatory txheej txheem, uas yuav ntxiv exacerbate qhov teeb meem no.

Rau tej kev raug mob ntawm daim tawv nqaij, lub qhov txhab kho zoo dua thiab sai dua, koj yuav tsum ua raws li tej kev cai:

• Tsis txhob cia av los cov raug mob daim tawv nqaij hmoo;
• tsis txhob sib haum xeeb thiab tshoov neeg lub qhov txhab nto (e.g., khaub ncaws);
• Nyob rau hauv tsis muaj cov ntaub ntawv tsis dua tawm lub kiav txhab tsim;
• npog lub qhov txhab los ntawm ncaj qha tshav ntuj;
• siv ib tug tshwj xeeb qab zib rau pab sai zoo thiab txo cov kev pheej hmoo ntawm cirrhosis (ib tug ntawm qhov zoo tshaj plaws cov xws tshuaj yog "Kontraktubeks").