Ubushushu obunokuqala xa umntwana eqala ukubonakalisa iimpawu zokuba ngumntwana ngaphambi kokuba athathwe njengesiqhelo. Amakhwenkwe, iimpawu zokubhinqa ngaphambi kweminyaka eyi-9 zivame ukucingwa ukuba ziqhelanisekile. Ukufumana amantombazana, iimpawu zokuba ngumntwana ngaphambi kweminyaka eyi-8 zithathwa njengengxaki. Nangona kunjalo, amanye amantombazana amantombazana afumana kuphela iimpawu zokuba ngumntwana wokukhula kwebele okanye ukuphuhlisa iinwele ze-pubic.
Ukukhula kobunwele be-pubic ngokukhawuleza kubonakala ngokuqhelekileyo kumantombazana amnyama abamnyama. Le miqondiso yodwa ayibhekthwanga njengobungqina bokusasazeka.
Kubalulekile ukuba uqaphele ukuba ubungqina bubonisa ukuba ubushushu buye kwenzeka kumncinci nangomncinci kwiminyaka. Kukho iingcamango ezininzi zokuba kutheni oku kwenzeka. Ukugqithisa kwangaphambili kunokunxulumaniswa nokuphucula ukutya okondle ebuntwaneni. Inokuthi idibaniswe kunye nokukhula kwexesha lokukhula komntwana. Ngakolunye uhlangothi, kukho ubungqina bokuba kunokunxulumana neenguqu kwimimandla. Iingcali zenzululwazi ziye zatsho kwizinto zonke ezivela kwingcinezelo ukuya kutshintsho olujikelezayo kumjikelezo weekhemikhali njengokuba kunokuba negalelo ekuhambeni inyaniso Inyaniso, akukho mntu uyazi.
Kubalulekile, nangona kunjalo, ukuqonda umahluko phakathi kobuntwaba obunobuncwane kunye nomkhwa wokuba ngumntwana wokuba unyaka wokuba usenokuba ngumntwana. Ukutshatyalaliswa kwangaphambili kubuntwabuntwana obunobutsha obusenzeka ngokukhawuleza kangangokuthi kunokubangela ukuba iingxaki zentlalo okanye zonyango zibhekiselele kumntu omncinci ojongene nalo.
Ngaba zikhona iingxaki ezinxulumene noBugqirha obusasazekayo?
Inani leemeko ezahlukeneyo lidibaniswe nobuntwaba obusasazekayo. Nangona kunjalo, ubungqina bezinye zeemeko zikhulu kunezinye. Kukho, umzekelo, ubungqina obuqinileyo bokuthi abantwana abafumana ubuntwaba obuqhelanisiweyo baya kuba nokukhula kancinci kodwa ke baphelise ngokuphakama kwabantu abade kunabalingane babo.
Isiqu esifutshane kakhulu yingxaki kubantwana abaqala ukuphuma ebusheni. Kuyenzeka kuba amathambo abo aqolileyo kwaye ayeke ukukhula ngokukhawuleza. Le yinye imeko enokuthi ithinteke ngokuqinisekileyo ngababhenki bentshukumo.
Ububungqina ngezinye iingxaki ezinxulumene nokunyuka kwangaphambili kunokuxuba. Ezinye iingcaphephe zibonisa ukuba ukutshatyalaliswa kwangaphambili kunokukhokelela ekuziphatheni okubi ngokwesini. Uphando lufumene, ngokungahambelani, ukuba ubushushu obunobuncwane bunxulumene neengxaki zokuziphatha kunye nezakhono zentlalo ezihluphekileyo. Kukho ububungqina bokuthi ukutshatyalaliswa kwangaphambili kunokukhokelela kwiingxaki zengqondo ezihlala zikhulile. Nangona kunjalo, ezinye zeemeko zentlalo kunye nempembelelo ezichaphazelekayo ezinokuxinzelelwa kobuncinci bokuqala, zingancitshiswa ngokuxhaswa kwabazali kunye nemfundo.
Kukho ubungqina bokuba ukuqala kokubaluleka kunokunxulumana nezinye iingozi zempilo emide. Kukho ukwanda kancinci kwesifo sikashukela, isifo senhliziyo, okanye isifo. Nangona kunjalo, le mingcipheko ididekile kukuba ukukhuluphala kunxulumene nokubanjwa kokuqala komntwana kunye nazo zonke iimeko zempilo ezintathu. Kukho nokuba nomngcipheko omncinci wesifo somhlaza kwibele kubasetyhini abancinci abanokuqala kwixesha elidlulileyo.
Yintoni Edala Ubunzima Bokuzalwa?
Inani lezinto ezahlukeneyo ziye zadibaniswa nobuntwaba obunobuncwane, nangona isizathu esicacileyo sisengummangaliso.
Ababhinci bokubhukuda basetyenziselwa ukunyanga oko kwaziwa ngokuba yiyona nto ebanzi yobushushu . Ubushushu obuphambili obuphambili buya kwenzeka xa ubuchopho buqala ukuthumela izibonakaliso zokuqalisa ukuqala.
Eminye imiba ehambelana nosuku oluphambili lwexesha lokusasa liquka:
- imfuza
- iingxaki zesondlo zangaphambili ezilandelwa ukukhuluphala
- kwingozi yengqondo kunye nenkqubo eyingozi yenkunkuma
Ngelishwa, amaninzi amaninzi okhuseleko olusenyongweni olusenyakatho luyi-idiopathic. Oko kuthetha ukuba oogqirha abayazi ukuba kutheni kwenzeka.
Kukho uluhlu lwesibini lobuntwaba obusasazekayo owaziwayo njengobunqunu obunobuncwane obunobuncwane okanye u- GnRH ozimeleyo . Ezi ziko zibangelwa yimveliso yehomoni engaqhelekanga eqala ngaphandle kwengqondo.
Yintoni Ababhinqileyo Abaqhawulayo? Bakuyeka Njani Ubuntshontsho Bokuqala?
Ababhinqileyo bebhedlele baziwa ngokuqhelekileyo njengeGnRH ezifanayo okanye i- GnRH agonists . Baphinde babhekiswe njengonyango lwe-GnRHa . Ezi zi yobisi ziphazamisa iimpawu ukuba ingqondo ibeka ukuxelela umzimba ukuba uqale ukuvelisa ama-hormone ahambelana nokuphelelwa kwintsapho kunye namantombazana. Ngaphambi kokuphelelwa ngumntwana, abantwana banomlinganiselo omncinane wehomoni ebizwa ngokuba yi-GnRH-gonadotropin ekhupha ihomoni. I-hormone ikhutshwa ngokungapheliyo kunye namaxabiso aphantsi. Xa uqala ukukhulelwa, umzimba uqala ukwenza i-GnRH ngakumbi kwaye ukhulula rhoqo. Ukunyangwa kwe-GnRHa kuguqula loo mqondiso kuze kufike oogqirha kunye nezigulane ukulungele ukuqala.
Ubushushu buvame ukuqala phakathi kweenyanga ezintandathu ukuya kunyaka emva kokuyeka unyango lwe-GnRHa. Iingcali zenzululwazi ziye zafumanisa ukuba abantu abatsha abafumana unyango lwe-GnRHa ukunyuka kwengqondo ngokugqithiseleyo bafikelela kwiindawo eziphakamileyo eziphezulu kunabo abangaphathwa. Oku kunjalo ngokwenene kulabo abafumana ukutshatyalaliswa kokuqala ngaphambi kokuqala kweminyaka emithandathu.
Uphando lubonisa ukuba abantu abatsha abafumana unyango banokufumana ukunciphisa uxinzelelo kunye nokunyaniseka kwiindlela iindlela zokutshatyalaliswa kwangaphambili kubenza ukuba bahluke kwiontanga zabo. Nangona kunjalo, uphando olongezelelweyo lufunekayo ngaphambi kokuba izazinzulu zifumane ukuqonda okwenyaniso kwimiphumo yengqondo yokunyanga kokuqala.
Zibini iifom ezenziweyo ezimfutshane kunye nexesha elide lokubaluleka kwabantu abasakhulayo. Iifom zexesha elide zingadlulela kwiminyaka emi-2 kungekho mfuneko yokuphinda unyango. Ezi zithatha iifom zentsholongwane okanye ixesha elide. Ukunyanga okuthe ngqo kubandakanya i-histrelin implant and depot leuprolide acetate injections.
Ngaba Abasakhulayo Bokukhusela Abakhuseleko?
Ababhinqileyo bebantwaba baye basebenzisa iminyaka engaphezu kwamashumi amathathu ukuba baphathe ubuntwaba. Ngokuqhelekileyo zibhekwa njengezikhuselekileyo zisebenzayo. Uphando lucebisa ukuba abantu abatsha abaye babesemagqabini abasaqalayo banomsebenzi wokuzala oqhelekileyo emva kokuba bayeke ukuwathabatha, nangona abafazi abaselula banokuba neengozi yokunyuka kwe- PCOS . Idatha iphinda ibonise ukuba abaluki bebhinqa abanomdla ongapheliyo kwixesha elide okanye emzimbeni. Nangona kunjalo, ezinye izazinzulu ziyakuthanda ukubona uphando ngemiphumo emibi yezo zonyango ngaphambi kokuba zivakalise ngokukhuselekileyo.
Ingqalelo, enye yengqwalasela ephambili yabantu abaselula kwi-GnRHa unyango kugcina ukulawulwa komzimba. Ezi ziyobisi zinganyaniswa nokufumana ubunzima kunye nokukhuluphala. Njengoko ukutyeba kunxulumene nokuphelelwa kwangoko, kubalulekile ukunyamekela ukutya nokuzilolonga kunye nezinye izinto ezinokukunceda umntu omncinci ukuba alondoloze isisindo esifanelekileyo. Nangona kunjalo, iindaba ezilungileyo kukuba uphando lubonisa ukuba kwixesha elide, unyango lwe-GnRHa ludibene nokufezekisa ubunzima obusempilweni, ubuncinci kumantombazana. Ngoko ke, akufanele kube yinto ebalulekileyo ekunqumeni ukuba ingaqalanga unyango.
Imithombo:
Fuqua JS. Unyango kunye neziphumo zokubuthwa kwangaphambili: ukuhlaziywa. J Clin Endocrinol Metab. 2013 Juni; 98 (6): 2198-207. i-doi: 10.1210 / jc.2013-1024.
Kim EY. Imiphumo emide yexesha elide le-gonadotropin-ukukhulula ama-hormone analogs kumantombazana aphakathi kobuntwaba obuphambili. Isikolo saseJorea J. 2015 Jan; 58 (1): 1-7. i-doi: 10.3345 / kjp.2015.58.1.1.
U-Pienkowski C, uTauber M. Gonadotropin-Ukukhupha iHormone Treatment Agonist kwi-Precocity yesondo. Endocr Dev. 2016; 29: 214-29. i-doi: 10.1159 / 000438893.
Thornton P, Silverman LA, Geffner ME, Neely EK, Gould E, Danoff TM. Ukuphononongwa kweziphumo emva kokupheliswa kwe-gonadotropin-ukukhupha i-hormone unyango lwe-agonist yamantombazana onobuncwane obusakhulayo. I-Pediatr Endocrinol u-Rev 2014 Mar; 11 (3): 306-17.
Yoo JH. Iimpembelelo zentsuku zokuqala zengxaki zempilo kunye nengqondo yengqondo kwiintombazana eziselula kunye nabasetyhini abadala. Isikolo saseJorea J. 2016 Sep; 59 (9): 355-361.