IHemangioma yekhanda nentamo

I-hemangiomas yizimila ezinobungozi ezakhiwe ukwakheka okungavamile kwemithambo yegazi esikhumbeni noma ezithweni zangaphakathi. Lokhu kukhula okuvamile kuvame ukuvela ezinsaneni nasezinganeni ezincane. Zivela njengezigaxa ezibomvu noma ezinsomi futhi zingakhula noma kuphi emzimbeni, ikakhulukazi ekhanda, ebusweni, esifubeni nangemuva.

Iningi lama-hemangiomas lilandela izigaba zokukhula ezihlukene:

• Ukukhula okusheshayo kokuqala ezinyangeni zokuqala ezingu-2-3
• Ukukhula okunensayo ezinyangeni ezi-3-4 ezilandelayo
• Isikhathi sokuzinzisa
• Ukuncipha kancane kancane nokufiphala, kuqala cishe unyaka owodwa

Izinhlobo ze-hemangiomas

Odokotela bahlukanisa i-hemangioma ngezigaba eziningana ezihlukene ngokusekelwe endaweni nokujula kwayo emzimbeni. Ukuhlukaniswa okuvame kakhulu yilokhu:

• I-Superficial Hemangiomas: I-Superficial hemangioma ikhula ebusweni besikhumba, ibonakala njengamaqhubu abomvu ngokugqamile, anokwakheka okungalingani. Lezi zivame ukubizwa ngokuthi "izimpawu zokuzalwa ze-strawberry" ngenxa yokubukeka kwazo okuhlukile. 
• I-Deep Hemangiomas: I-hemangioma ejulile ikhula ngaphansi kwesikhumba, idale ukuvuvukala okunombala oluhlaza okwesibhakabhaka noma onsomi endaweni ebushelelezi.
• I-hemangioma ehlanganisiwe noma ehlanganisiwe: Lawa ma-hemangioma abonisa izici zakho kokubili okuhlukile okukha phezulu nokujulile.

Okunye ukuhlukaniswa okubalulekile kuhlanganisa:

• I-Infantile Hemangiomas (IHs): Lezi zivela phakathi namasonto okuqala ayisishiyagalombili okuphila futhi zingena esigabeni sokukhula ngokushesha izinyanga ezingu-6-12
• I-Congenital Hemangioma (CHs): Yethula ekuzalweni njengezilonda ezikhule ngokugcwele
• I-Congenital Hemangiomas (RICH) Ebandakanya Ngokushesha: Lezi zivela ekuzalweni njengama-plaque abomvu-nsomi futhi zinyamalale ngokuphelele ezinyangeni eziyi-12-18
• I-Congenital Hemangiomas (NICH) engahlanganisi: Kwethulwa ngesikhathi sokuzalwa njengama-plaque apinki noma ansomi akhula ngokulinganayo nengane

Okunye ukuhlukaniswa okubalulekile kuhlanganisa:

• I-Capillary Hemangioma: Lezi zihlanganisa imithambo yegazi emincane, ebambene ngokuqinile ehlanganiswe izicubu ezincane ezixhumeneyo. 
• I-Cavernous Hemangiomas: I-Cavernous-type hemangiomas ihlanganisa imithambo yegazi emikhulu, enwetshiwe enezikhala ezigcwele igazi phakathi kwayo.

Zingenzeka Kuphi?

Ukusatshalaliswa kwe-anatomical kwe-hemangiomas kulandela iphethini ehlukile:

• Isifunda sekhanda nentamo
• Izindawo ze-trunk
• Ukudlondlobala
• Ngaphakathi kwesifunda sobuso:
  • Izindebe zibalelwa ku-55.2% wamacala
  • Izihlathi zakha u-37.9%

Lokhu kukhula kungabonakala ngaphandle nangaphakathi, nge-51.7% yeziguli ezithola ukubandakanyeka okuhlanganisiwe kwangaphakathi nokwengeziwe komlomo.

• Izehlakalo ze-Intraoral: I-buccal mucosa iyindawo eyinhloko, ethinta i-37.9% yamacala, ilandelwa yi-labial mucosa ku-25.9%. 
• I-Cavernous hemangiomas ivame ukukhula eduze kwendawo yamehlo, ivela kumajwabu amehlo, ebusweni beso, noma ngaphakathi kwesokhethi yamehlo.
• Ngaphandle kwezindawo ezibonakalayo, ama-hemangioma angakheka ezicutshini ezijulile nasezithweni. Isibindi simi njengendawo yangaphakathi ephawulekayo yalokhu kwakheka kwemithambo. Ukukhula kwangaphakathi okunjalo kungase kungabonakali izimpawu ezingaphezulu kodwa kungabangela ukuphazamiseka kokusebenza.

Iziguli zingase zibe nokulahlekelwa ukubona, ukungezwa kahle, noma ukukhubazeka kobuso, ikakhulukazi ezinokukhubazeka okukhulu, okudlula indawo.

Iyini i-Age Group?

Nakuba i-hemangioma ingakhula kunoma ibuphi ubudala, lokhu kukhula kwemithambo kuthinta kakhulu izingane. Ucwaningo luveza ukuthi cishe u-10% wezingane zizalwa zine-hemangioma. 

Kusukela ebuntwaneni, i-hemangiomas ithinta amaqembu eminyaka ehlukene ngokuhlukile. Abantu abadala abaneminyaka ephakathi bakha ingxenye enkulu yamacala. Ukuvama kuyahlukahluka kubo bonke abakaki beminyaka yobudala, iziguli ezineminyaka engu-20-29 zibonisa izinga eliphansi lokuvela ku-1.78%.

Ukusabalala kuyanda ngokuya ngeminyaka, kufinyelela inani eliphakeme kakhulu kubantu abadala, lapho cishe ama-75% abantu abaneminyaka engama-75 nangaphezulu eba nama-cherry hemangiomas.

Ezinganeni eziningi, inqubo yokuncipha iqedwa phakathi kweminyaka engu-3.5 kuya kwengu-4. 

Izingozi Zezingozi

Okulandelayo ezinye izici ezivamile zobungozi ze-hemangioma yekhanda nentamo:

• Ubulili budlala indima ebalulekile, abesifazane babonisa ukuthambekela okuphezulu ngesilinganiso sokufika ku-5:1 uma kuqhathaniswa nabesilisa.
• Isizinda sobuhlanga sinomthelela kakhulu kumazinga okwenzeka, ikakhulukazi ezithinta izinsana zaseCaucasia. 
• Izimo ezihlobene nokuzalwa zimi njengezici eziyingozi kakhulu, ezihlanganisa:
  • Ukuzalwa ngaphambi kwesikhathi
  • Isisindo sokuzalwa esiphansi
  • Ukuzalwa okuningi
  • I-hypoxia yokubeletha
  • Isampula ye-post-chorionic villus
• Izimo zempilo kamama ngesikhathi ekhulelwe zithinta ngokuphawulekayo ukukhula kwe-hemangioma.  
• Umlando womndeni uvela njengenye into ebalulekile, lapho izingane zakini zabantu abathintekile zikhombisa ingozi ephindwe kabili. 

Izinketho Zokwelapha I-Hemangioma Ekhanda Nentamo

Izinketho zokwelashwa eziyinhloko zihlanganisa:

• Ukwelashwa Kwezidakamizwa: 
  • Ipropranolol imelela njengokwelashwa komugqa wokuqala, esikhundleni se-corticosteroids yendabuko. Iziguli eziningi zibonisa impendulo phakathi nesonto lokuqala i-propranolol. 
  • Oral itraconazole iveza enye inketho, ithola ukuncipha kwama-88.97% kumthamo we-hemangioma emasontweni ayisishiyagalombili.
• Ukwelashwa nge-Laser: I-Pulsed dye laser (PDL) iyindlela esetshenziswa kakhulu, enikeza ukusebenza kahle nokuphepha okuphezulu. Isistimu ye-laser ye-KTP, esebenza ngamandla aphansi okukhipha (2 kuya ku-5 W), iphatha ngempumelelo i-hemangiomas ejulile ngenkathi yehlisa izinga lokubola ukusuka ku-20% ukuya ku-2%.
• Ukungenelela Ngokuhlinzwa: Nakuba kungaseyona inketho yokuqala, ukuhlinzwa kuhlala kubalulekile ezimweni ezithile, ikakhulukazi lezo ezihilela ijwabu leso noma i-hemangioma yesikhumba esikhulu. Ukungenelela kokuhlinzwa kusenesikhathi kuvame ukuveza imiphumela engcono, ikakhulukazi izilonda ebusweni.
• I-Sclerotherapy: Le ndlela, ehlanganiswe nemithi yomlomo, ibonisa imiphumela ethembisayo. Indlela ekabili esebenzisa umjovo we-sodium tetradecyl sulphate eceleni kokwelashwa ngomlomo kunciphisa ubude besikhathi sokwelashwa.

Isiphetho

I-hemangioma yekhanda nentamo imelela ukukhula kwemithambo eyinkimbinkimbi edinga ukunakekelwa ngokucophelela nokuphathwa kwezokwelapha. Nakuba lezi zimila eziyingozi zithinta abantu bayo yonke iminyaka, izinsana zisengozini enkulu, ikakhulukazi izingane ezizalwa ngaphambi kwesikhathi nalezo ezinesisindo esiphansi.

Odokotela manje banezinketho eziningi zokwelapha ezisebenzayo abazisebenzisayo. Ukuqonda izici eziyingozi kusiza odokotela benze izinqumo ezingcono zokuxilonga nezokwelashwa. Amacala amaningi ezingane azixazulula ngokwemvelo ngokuhamba kwesikhathi, nakuba ezinye iziguli zingase zigcine izibazi ezincane. Izimo zabantu abadala, ikakhulukazi lezo ezithinta izicubu ezijulile, zingadinga ukugadwa okuqhubekayo kwezokwelapha. Odokotela bangakwazi ukuphatha lokhu ngempumelelo ukukhula kwemithambo ngokuxilongwa okufanele kanye nokungenelela okufika ngesikhathi, ukuqinisekisa imiphumela engcono yesiguli.

Imibuzo Evame Ukubuzwa

1. Ingabe i-hemangioma iyinkinga enkulu?

Iningi lama-hemangioma alinabungozi futhi alibi bucayi, kodwa amanye angadinga ukunakekelwa kwezempilo.

2. Kufanele ngikhathazeke nini nge-hemangioma?

Ukhathazeke uma kuphazamisa ukubona, ukuphefumula, noma ukudla noma uma kubonisa ukukhula okusheshayo noma izilonda.

3. Indlela yokumisa i-hemangioma ekukhuleni?

Izinketho zokwelapha zihlanganisa i-beta-blockers, i-corticosteroids, noma i-laser therapy, njengoba udokotela ebeka.

4. I-hemangioma iyeka ukukhula ineminyaka emingaki?

Ngokuvamile, i-hemangiomas iyayeka ukukhula futhi iqala ukuncipha (i-involute) ngezinyanga eziyi-12-18 ubudala.

5. Iyini imbangela ye-hemangioma?

Isizathu esiqondile asikaziwa, kodwa kukholakala ukuthi sihlobene nezicubu ze-placenta ngesikhathi ukukhulelwa.

6. Iyini imiphumela emibi ye-hemangioma?

Imiphumela engemihle engaba khona ihlanganisa isilonda, ukopha, izibazi, noma izinkinga uma ziseduze nezitho ezibalulekile.

CARE Medical Team