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რამდენად საშიშია ჰემანგიომა და რამდენად ექვემდებარება მკურნალობას | ჯანმრთელობა | vidal.ge

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რამდენად საშიშია ჰემანგიომა და რამდენად ექვემდებარება მკურნალობას

თარიღი: 29 მაისი, 2022

რა არის ჰემანგიომა?

რა და რა სახის არსებობს ის?

შესაძლებელია თუ არა მისი მკურნალობა და როგორია პრევენცია?

ამ თემაზე ჩაჩავას კლინიკის ონკოლოგი, მედიცინის მეცნიერებათა დოქტორი, ლევან ჩოლოყაშვილი გვესაუბრება:
ჰემანგიომა სისხლძარღვოვანი კეთილთვისებიანი სიმსივნეა, რომელსაც არაფერი საერთო არ აქვს ჰემანგიოსარკომასთან (სისხლძარღვოვან-შემაერთებელქსოვილოვანი ავთვისებიანი სიმსივნე) და მისგან არსებითად განსხვავდება, როგორც კლინიკური ნიშნებით, ასევე ჰისტომორფოლოგიური სურათითაც. გვხვდება სხვადასხვა ფორმის, როგორც ეგზოფიტურად მზარდი (ზედაპირიდან ამობურცული), ასევე ენდოფიტური (ქსოვილის სისქეში გავრცელებული). სტრუქტურის მიხედვით გვხვდება: კაპილარული, კავერნოზული, დატოტვილი, შერეული, ტელეანგიოექტაზიები და ჰიპერტროფიული ფორმები.

შესაძლებელია თუ არა პრევენცია ორსულობის პერიოდში, რომ ბავშვს არ აღმოაჩნდეს ჰემანგიომა?
ჰემანგიომის განვითარებას რიგ შემთხვევაში საფუძვლად უდევს გენეტიკური წინასწარგანწყობა. პრევენცია, რომ ბავშვს არ აღმოაჩნდეს ჰემანგიომა, პრაქტიკულად შეუძლებელია.

მითია თუ რეალობა რომ, ორსულობის პერიოდში დედის გაციებამ შესაძლოა გამოიწვიოს ჰემანგიომა?
არავითარი მეცნიერულად დასაბუთებული კორელაცია არ არსებობს დედის გაციებასა და ნაყოფში ჰემანგიომის განვითარებას შორის.

შეიძლება, რომ ჰემანგიომა შეძენილი იყოს და ის მოზარდობის პერიოდში განვითარდეს?
დიახ, შეიძლება. ჰემანგიომა განვითარებისა და სტრუქტურის მიხედვით სახვადასხვა ფორმის არსებობს. თანდაყოლილი ფორმებია: კაპილარული, კავერნოზული. შეძენილ ჰემანგიომებს შორის უფრო გავრცელებულია: ვარსკვლავისებური ტელეანგიოექტაზიები, დატოტვილი და შერეული ფორმები.

ვიზუალური დათვალიერების გარდა, რა კვლევები ტარდება დიაგნოზის დასასმელად?
ჰემანგიომები გვხვდება როგორც კანის ზედაპირზე, დაახლოებით 70% და მათგან უმეტესი თავ-კისრის არეშია (ამ დროს ხდება დათვალიერება კროსპოლარული ნათების მქონე დერმატოსკოპით), ასევე შინაგან ორგანოებშიც. მაგალითად, ღვიძლში საკმაოდ გავრცელებულია და ყველა ტიპის კლინიკური კვლევისას - ულტრასონოგრაფიაზე, რენტგენზე, კარგად გამოხატული, გლუვი კონტურები აქვს.

იკურნება თუ არა ჰემანგიომა?
ჰემანგიომა იკურნება ისევე სრულად, როგორც ყველა კეთილთვისებიანი წარმონაქმნი.

რა სახის მკურნალობა ტარდება?
მკურნალობის მეთოდი დამოკიდებულია იმაზე, თუ როგორი მორფოლოგიური აგებულების არის და სად ლოკალიზდება. ამის მიხედვით ვიყენებთ სკლეროთერაპიას, რადიოსიხშირულ აბლაციას, თერმულ დესტრუქციას როგორც დაბალი, ასევე მაღალი ტემპერატურული რეჟიმით, ენდოვასკულარულ ოკლუზიას.

შესაძლოა თუ არა, რომ ასაკის მატებასთან ერთად ჰემანგიომა გართულდეს?
როგორც ზემოთ აღვნიშნე, ჰემანგიომას შესაძლოა სხვადასხვა ლოკალიზაცია ჰქონდეს. ასევე ხშირია, როცა ჰემანგიომა ახლოს არის რომელიმე მსხვილ ნერვთან და მისი კომპრესიის შედეგად იწვევს ძლიერ ტკივილს და დისკომფორტს, ამ შემთხვევაშიც სასწრაფო სამედიცინო ჩარევაა საჭირო.

რა რჩევას მიცსემდით პაციენტებს, რომელთაც ეს პრობლემა აწუხებთ?
გარდა ჩვილი ბავშვებისა, რომლებსაც შეიძლება ზოგიერთი სახის ჰემანგიომა თავისით გაუქრეთ, ზრდასთან ერთად, ექიმის გადაწყვეტილებით შეიძლება დავაკვირდეთ 2 წლის ასაკამდე. დანარჩენ შემთხვევაში უმჯობესი იქნება გეგმიური მოცილება. ეს გამორიცხავს უნებლიე ტრავმებით გამოწვეულ ძლიერ სისხლდენებს, როდესაც სასწრაფო წესით ხდება ხოლმე საჭირო აღნიშნული წარმონაქმნების მოცილება.