Ukunyaniseka kwangaphambili
Ukutshatyalaliswa kwangaphambi kokuqala kubonwa njengenyaniso xa kudibaniswa neqondo eliphezulu kakhulu lamahomoni amabini aveliswa yi-pituitary: i-follicle stimulating (FSH) kunye ne-hormone ye-luteinizing (LH), ebizwa ngokuba yi-gonadotropins. Ezi hormone zikhuthaza izilonda zesini (iimvavanyo kunye namaqanda). I-FSH ne-LH ibalulekile ekuphuculweni ngokwesondo ngokuqhelekileyo. Ukuba ziveliswa ngokugqithiseleyo, ubuntwaba bufike ngaphambi kwangoko kwaye luqhubele phambili ngokukhawuleza. Ukunyaniseka kwangaphambi kokuqala, ngakumbi kumadoda amancinci, kunokunxulumana neenguqu ezinokwenziwa kwengqondo, umzekelo, ngenxa yokukhathazeka kokuzalwa komzimba njenge-hydrocephalus (i-hydrocephalus), kunye nokunciphisa umsebenzi we-thyroid gland.
Ubuntwaba obusakhulayo
Ngokuphathelele ukunyuka kwengqungquthela ukuthetha xa kungabandakanywa nokugqitha kwe-FSH kunye ne-LH, kodwa kukho iimeko ezikhokelela ukwandisa kwinqanaba le-hormone yesondo (testosterone kubafana kunye ne-estrogens kumantombazana). Ubuqhetseba obungakabikho ngaphambi kokuqala kokuzalwa kungaphantsi kweyona nyaniso, kwaye izimbangela zayo zingaba zicubu ze-ovari, ii-testes kunye ne-adrenals, kunye ne-oral steroids. Ukuze unqobe ubunzima obunxulumene nezinguqu kwiimeko zesimo sengqondo nokuziphatha ngenxa yobusana obusanda kuzalwa, umntwana kunye nentlungu yakhe kufuneka iluleko lweengqondo kunye nenkxaso. Olu tshintsho lunikela ngakumbi inkxalabo yobusana ngaphambi kokuba kuqhele. Ukuqwashisa abantwana abancinci kuncinci kunabantwana abadala, kukulungele ukunqoba iingxaki ezinxulumene nokukhula komzimba kunye nempembelelo yamahomoni.
• Ukucetyiswa ngabanye kudla ngokubaluleka kubantwana abancinci abaneengxaki zokuqalisa ukukhulelwa.
Iimpazamo ezixilongwa
Ukuxilongwa okungahambiyo kokuqala komntwana kungenziwa kwiimeko ezilandelayo:
- Ukuphuhliswa kwangaphambili kweentloko zeemfesane
Kwamanye amantombazana, izilonda ezincinci zingakhula ngobunzima kwiinyanga ezintandathu ukuya kwiminyaka emibini. Inkqubo inokubambisana kunye okanye ngokubanzi. Kule meko, ayikho inwele ye-pubic kunye nokunyuka kokukhula. Le meko ayilona uphawu lwesifo kwaye ayifuni unyango.
- Ukuxilongwa ngokukhawuleza kokuqala komntwana
Kwimantombazana engaphantsi kweminyaka yobubhozo kunye namakhwenkwe angaphantsi kweminyaka engama-9, ukukhula kwe-pubic kungenzeka ngokungabikho kwempawu zesini zesibini. Ngokuqhelekileyo le nto ibonakaliswa kubantwana baseAsia, eAfrika naseCaribbean. Umbuso onjalo unxulumene nokukhawuleza kwangoko kwezinga lokukhula. Unyango aluyadingeki, nangona kunjalo, ukuba izinto ezinjalo zibonwa kumntwana oneminyaka engaphantsi kweminyaka emithandathu ubudala, le nto inokuba yimbangela yokukhathazeka. Ukutshatyalaliswa kwintsasa emakhwenkwe kuncinci ngokuqhelekileyo kunamantombazana, kwaye idla ngokudibanisa nesifo esibi, njengesifo se-tumor. Ukuba le nkwenkwe inezibonakaliso zokuqala komntwana, ngokukodwa ihamba kunye nokunyuka kwamanye ama-testic, isizathu siqhelekileyo kwinqanaba le-hormone ye-pituitary (FSH neLH) egazini. Nangona kunjalo, ukuba ngethuba lokutshatyalaliswa kwentombazana inokukhuliswa kwetekisi enye, omnye unokugxeka isigxina sakhe. Ukuba le nkwenkwe inayo yonke imbonakalo yangaphandle yobushushu, kodwa inamathole amancinci (prepubertal) aphucula ngaphezu kwezinye iindawo zomzimba, oku kunokuthetha ukuba imbangela yokubuthwa kwangaphambi komntwana kuyingozi.
Ulawulo lwezigulane
Isinyathelo sokuqala kunyango lwezigulane ezineminyaka engama-18 ubudala ekuqaliseni ukuqala kokuzalwa, kukuchongwa kwesizathu salo. Kwinqanaba lokuqala, kuyimfuneko ukukhuphela isisu seengqondo. Xa kuboniswe isizathu, amanyathelo acwangciselwe ukupheliswa kwawo ngokufanelekileyo.
Ukukhula kwesikhumba
Ukuvuthwa kwezesondo, kokuqhelekileyo kunye nokukhawuleza, kuhambelana nokuphuhliswa kwamathambo. Emva kokuxhuma ekukhuleni ngexesha lokunyusa, amathambo omzimba wexesha elide aphelile. Ukutshatyalaliswa kwangaphambi kokuqala kuhlanganiswa nesigxina esifutshane, njengoko ukukhula kwamathambo kula bantwana kubambezela, kwaye kuphelile kwiminyaka yobudala kunokuba bephilile. Ukukhula okuncinci kunokuba nempembelelo enamandla yengqondo kumntwana, ngoko, ekufikeni komntwana osemva, inxalenye ebalulekileyo yonyango iyancipha izinga lokubunjwa kwethambo. Isizathu sokutshatyalaliswa kwangaphambi kwentsapho kumantombazana akunqabile. Ngokuqhelekileyo kukho ukubonakaliswa kwangaphambili kweempawu zobushushu obuqhelekileyo. Kule meko, ubuntwaba buya kuqhubeka ngendlela efana neyokuba iqala ngexesha elifanelekileyo kumgangatho oqhelekileyo. Olu hlobo lokutshatyalaliswa kwangaphambi kokubeleka lunokuba lulifa kunye necala elilodwa xa ukukhubazeka okufanayo kwakungabonakali kwimbali yosapho.
Isifo esilindele
Ukukrokra intombazana yesiphina isifo kuyimfuneko xa kwenzeka ukuba ukukhula komzimba okwenziwe ngokwesini kungahambelani nesikimu esiqhelekileyo; Ngokomzekelo, xa kunye kunye nokukhula kweengcambu ze-mammary kwi-pubis, kubonakala kuphela iimbumba zodwa okanye ukuphuhliswa kwabalinganiswa bezesondo zesibini kwenzeka ngokukhawuleza kunoko. Esinye sezi zifo sisifo se-Albright-McCun, esichazwa ngumonakalo kwesikhumba, amathambo kunye neengcina ze-endocrine, kunye nokuya esikhathini. Kwakhona, ubukho nawuphi na isifo esifanelekileyo kufuneka sikrokrwe ukuba kukho iimpawu zomonakalo wengqondo.
Uviwo
Xa useneminyaka engama-10 engama-10 ubudala ekufikeni kwentombazana, ithuba lokuba nesifo esifihliweyo singahlolwa ngokusebenzisa i-ultrasound yamalungu epilvic. Kule meko, i-uterus nama-ovari zihlolwe ngokubanzi. Ukuba ubuntwabuntwana obusenyongweni buyinto ehlukileyo kwimiqathango, kwaye kungekhona ngenxa yesifo, ukuhlolwa kwe-ultrasound kuya kuqinisekisa utshintsho olulindelekileyo kwizitho zangaphakathi ezenzeka ngexesha lokusasa. Ngokukodwa, i-ultrasound iya kubonisa ukwanda kwimbumba kunye ne-cysts ezininzi kuma-ovari. Ukungabikho kwezi ziimpawu kufuneka kuqaphele ugqirha wezingane. Nangona kunjalo, kwiimeko ezininzi, akukho mfuneko - kwaye akukho mfuneko yoviwo olongezelelweyo.