Ib tug poj niam txoj kev noj qab haus huv nyob ntawm ntau yam. Qhov tseem ceeb tshaj plaws hauv kev muaj peev xwm xeeb tub thiab yug me nyuam yog endometrium, uas muaj peev xwm hloov pauv thaum lub sij hawm poj niam cev xeeb tub. Tab sis muaj cov xwm txheej uas, nyob rau hauv kev cuam tshuam ntawm ntau yam, pathological tej yam kev mob tshwm sim nyob rau hauv lub endometrium, piv txwv li, nws heterogeneity. Qhov no txhais li cas thiab kev kho mob twg yog siv rau tus kab mob no, peb yuav txheeb xyuas hauv kab lus.
Kev txiav txim siab ntawm endometrium
Endometrium yog lub hauv ob sab ntawm lub tsev menyuam uas kab nws sab hauv. Nws yog nplua nuj nyob rau hauv ntau cov hlab ntsha. Lub thickness ntawm lub endometrium hloov thoob plaws hauv lub voj voog nyob rau hauv lub zog ntawm cov tshuaj hormonal. Nquag, nws muaj cov qauv sib xws, tib qhov ntom thiab kwv yees li tib lub thickness. Tam sim ntawd tom qab kev coj khaub ncaws, lub endometrium thickens nyob rau hauv kev npaj rau kev txuas ntawm lub qe fertilized. Yog tias qhov no tsis tshwm sim, cov txheej txheem ua haujlwm raug tsis lees paub thiab tawm hauv lub cev nrog cov ntshav, tom qab ntawdDab tsi yog qhov kho dua tshiab ntawm basal txheej.
Tab sis qee zaum muaj cov xwm txheej uas, thaum kuaj ultrasound, tus kws kho mob txiav txim siab tsis raws sij hawm heterogeneity ntawm endometrium. Nws txhais li cas? Tus mob no qhia txog kev ua tsis tiav hormonal lossis cov txheej txheem inflammatory loj.
Type
Tam sim no, cov kws tshaj lij paub qhov txawv ntawm ob hom endometrial heterogeneity, nyob ntawm seb qhov ua rau tus mob no thiab nws cuam tshuam rau tus poj niam lub cev. Wb mus saib ze dua:
- Ib txwm heterogeneity ntawm uterine mucosa, uas yog yam ntxwv ntawm qee theem ntawm kev coj khaub ncaws los yog theem ntawm cev xeeb tub. Nws yog ib tug variant ntawm tus qauv thiab tsis xav tau kev hloov kho. Heterogeneous endometrium nyob rau theem ob ntawm lub voj voog yuav qhia txog kev txhim kho ntawm qee yam kab mob. Xav tau kev kuaj mob ntxiv.
- Pathological heterogeneity ntawm endometrium. Nws tsis yog nyob ntawm kev coj khaub ncaws thiab muaj kev xeeb tub. Yuav tsum muaj kev tsim kho thaum ntxov ntawm qhov ua rau kev txhim kho thiab kev txiav txim siab ntawm kev kho kom zoo.
Qee lub sij hawm ib tug heterogeneous qauv ntawm endometrium ntawm ib tug congenital daim ntawv qhia.
Norms
Cia peb xav txog qhov ntsuas ib txwm muaj ntawm endometrium nyob ntawm theem ntawm kev coj khaub ncaws (saib rooj).
| Nkauj hnub | YEndometrial thickness, mm | YEchogenicity |
| 1–2 | 5–9, patchy | Rau |
| 3–4 | About 5 | Nyob zoo |
| 5–7 | mus txog 6 | txo qis |
| 8–10 | mus txog 10 | |
| 11–18 | 8–15 | Average |
| 19–23 | 12–16 | |
| 24–26 | 9–12 | |
| Menopause | About 6 |
Yog vim li cas
Endometrial heterogeneity tuaj yeem yog qhov tshwm sim ntawm ob qho tib si physiological txheej txheem tshwm sim hauv lub cev thiab cov txheej txheem pathological uas yuav tsum tau kho tam sim. Xav txog cov yam tseem ceeb tshaj plaws hauv kev loj hlob ntawm endometrial inhomogeneous thickness.
Lub cev ua rau lub cev muaj xws li:
- Tshuaj tshwj xeeb ntawm kev coj khaub ncaws.
- Kev xeeb tub. Hauv qhov no, kev saib xyuas kev noj qab haus huv yog qhov tsim nyog, vim tias tus mob no tuaj yeem qhia txog cov txheej txheem pathological uas ua rau muaj kev hem thawj ntawm cev xeeb tub.
- Menopause. Yuav tsum tau saib xyuas kev kho mob.
Pathological ua rau heterogeneous thickness ntawm endometrium ntawm lub tsev menyuam loj dua. Cov no suav nrog:
- Cov tshuaj hormones. Thaum cev xeeb tub, progesterone plays lub luag haujlwm tseem ceeb, nyob rau hauv kev cuam tshuam ntawm endometrium nce. Tom qab ntawd, txhawm rau tswj lub thickness ntawm lub tsev menyuam hauv ob sab phlu, estrogen pib ua, uas tiv thaiv kev loj hlob ntawm endometrium. Yog tias keeb kwm hormonal ua tsis tiav, muaj qhov tshwm sim ntau ntawm kev tsim cov kab mob txaus ntshai.
- Cov txheej txheem mob tshwm sim hauv cov appendages.
- Impaired ncig hauv tsev menyuam thiabLwm yam kabmob ntawm cov poj niam cev xeeb tub.
- Kev loj hlob ntawm lub cev xeeb tub.
- Adenomyosis, tus yam ntxwv los ntawm qhov tshwm sim ntawm cystic neoplasms ntawm ntau qhov ntau thiab tsawg hauv uterine kab noj hniav.
- Submucosal fibroids. Nyob rau hauv cov ntaub ntawv no, cov ntaub so ntswg loj hlob nyob ib ncig ntawm nws tus kheej, lub tsev menyuam nce. Heterogeneity ntawm endometrium raug kuaj pom hauv zos.
- Polyps, uas qhov kev loj hlob tsis sib xws ntawm cov mucous txheej ntawm lub tsev menyuam tshwm sim.
- Kev tsis zoo ntawm lub tsev menyuam kab noj hniav.
- Cov kab mob endometrial (xws li endometriosis, hypoplasia, lossis endometritis).
- Taumatic ntawm lub tsev menyuam.
- Abortions.
- noj tshuaj hormonal.
- Cov qog nqaij hlav hauv tsev menyuam.
- Malignant formations, uas, txawm li cas los xij, tsim muaj tsawg heev.
Symptomatics
Thawj theem ntawm tus mob uas endometrial heterogeneity txhim kho tsis pom cov cim qhia. Daim duab kho mob tuaj yeem ua rau qhov muag tsis pom. Raws li cov hauv paus ntsiab lus ntawm tus mob tshwm sim, cov tsos mob yuav hnyav dua. Xav txog cov paib feem ntau:
- Kev cuam tshuam ntawm kev coj khaub ncaws, nyob rau hauv uas ncua sij hawm ntev, mob lub sij hawm thiab lawv profusion yog ua tau.
- Kev tsis muaj menyuam.
- Kev cais cov muv ntawm qhov chaw mos.
- Nyob mes kas.
Yav tom ntej, qhov tshwm sim ntawm cov kab mob pathological yuav nyob ntawm qhov ua rau nws tshwm sim. Yog tias cov tsos mob saum toj no tshwm sim, nws raug pom zoosab laj nrog kws kho mob thiab kuaj qhov tsim nyog.
Diagnosis
Endometrial heterogeneity tsis tuaj yeem txiav txim siab los ntawm kev kuaj mob niaj hnub. Txoj kev kuaj mob tshaj plaws hauv qhov no yog kev kuaj mob ultrasound, thaum lub sijhawm tus kws kho mob tshwj xeeb tuaj yeem tsis tsuas yog ntsuas qhov mob ntawm endometrium, tab sis kuj txheeb xyuas cov neoplasms thiab lwm yam uas ua rau muaj kev hloov pauv hauv cov mucous ntawm lub tsev menyuam. Ntawm ultrasound, heterogeneous endometrium tuaj yeem kuaj pom tseeb li sai tau.
Ntxiv rau kev kuaj ultrasound, nws muaj peev xwm muab tshuaj tua kab mob, uas yog ob qho tib si kuaj mob thiab kev kho mob.
kuaj qhov ntsuas tseem ceeb heev, uas suav nrog:
- Urine tsom xam.
- Tau suav suav.
- Kev kuaj ntshav rau cov tshuaj hormones, uas ua rau qee hnub ntawm lub voj voog.
- Smears rau tus kab mob.
Kev kho mob
Nyob rau hauv kev kho mob ntawm heterogeneous endometrium, nws yog ib qho tseem ceeb heev kom tshem tawm cov kab mob hauv qab uas ua rau cov kab mob no.
- Yog tias qhov kev hloov pauv tau tshwm sim los ntawm cov txheej txheem inflammatory tshwm sim hauv lub cev ntawm tus poj niam, ces kev kho tshuaj tua kab mob tau raug sau tseg (piv txwv li, "Ceftriaxone").
- Nws tseem tuaj yeem sau tshuaj tsis yog tshuaj tiv thaiv kab mob steroidal (piv txwv li, Diclofenac).
- Lub luag haujlwm loj hauv kev kho cov endometrium ntawm cov qauv heterogeneous yog ua si los ntawm kev siv tshuaj hormonal uas tau sau tseg tsuas yog tom qab tau txais.tsim nyog kev tshuaj xyuas. Hauv qhov no, cov tshuaj xws li Yarina, progesterone (piv txwv li, Utrozhestan, Duphaston), nrog rau cov tshuaj estrogen (Estrogel) feem ntau siv.
Kev kho mob phais yog siv nyob rau hauv cov ntaub ntawv ntawm kev loj hlob ntawm endometrial loj, muaj teeb meem los yog tsis muaj tshwm sim los ntawm kev kho tshuaj.
ntsuas kev tiv thaiv
Txhawm rau tiv thaiv kev txhim kho ntawm endometrial heterogeneity, qee cov cai yuav tsum ua raws. Xav txog lawv kom ntxaws ntxiv:
- Ua ntej tshaj plaws, koj yuav tsum ua tib zoo saib xyuas koj txoj kev noj qab haus huv thiab tsis txhob tso tseg txoj kev npaj mus ntsib kws kho mob gynecologist, tshwj xeeb tshaj yog thaum cev xeeb tub.
- Txawm tias cov tsos mob me me yuav tsum mus tom tsev kho mob thiab kuaj xyuas ultrasound sai li sai tau.
- Saib xyuas cov qib ntawm cov tshuaj hormones hauv lub cev, kuaj ib ntus, tshwj xeeb tshaj yog rau cov poj niam thaum cev xeeb tub thiab thaum cev xeeb tub, vim tias cov tshuaj hormones hloov pauv hauv lub cev.
- Khawb kev huv si.
- Siv kev tiv thaiv kab mob.
- Ua raws txhua qhov lus pom zoo ntawm tus kws kho mob tuaj koom.
Muaj Teeb Meem
Thaum tsis muaj kev kho mob txaus thiab raws sijhawm, cov kab mob pathological uas ua rau muaj qhov sib txawv ntawm cov endometrium tuaj yeem ua rau muaj kev phom sij txaus ntshai. Cov no suav nrog:
- Kev tsis muaj menyuam.
- Nyob mes kas.
- Kev yug dua tshiab ntawm thaj chaw pathological hauvmalignant form.
- Bleeding.
- YEndometrial ruptures.
Yog hais tias tus qauv ntawm lub tsev menyuam endometrium yog heterogeneous, qhov tshwm sim tshwm sim nyob ntawm qhov ua rau ua rau muaj kev hloov hauv mucosa.
Huab cua thiab xaus
Nrog rau kev mus ntsib kws kho mob, nws tuaj yeem kuaj pom kev hloov pauv hauv endometrium thaum ntxov. Qhov no yuav tso cai rau kev tshawb pom raws sijhawm ntawm qhov ua rau provoked cov tsos ntawm mucosal heterogeneity, thiab pib kho. Nyob rau hauv cov ntaub ntawv no, qhov kev cia siab nyob rau hauv feem ntau yuav zoo. Txwv tsis pub, cov teeb meem loj tuaj yeem tshwm sim.
Nrog heterogeneity ntawm endometrium, kev kho tus kheej raug txwv. Kev kho mob tsuas yog sau los ntawm tus kws kho mob tom qab tsim qhov ua rau tus mob no thiab nruj me ntsis raws li tus kheej.
