Nyob hauv lub neej, ib tug poj niam yuav tsum tau nrog cov kab mob ntawm lub cev xeeb tub. Ib tug ntawm lawv yog tsim ib cyst ntawm zes qe menyuam. Kev loj hlob ntawm cov kab mob no feem ntau cuam tshuam rau cov poj niam uas muaj hnub nyoog me nyuam. Lub cyst yog benign nyob rau hauv cov xwm thiab, feem ntau, yog kho tau zoo heev. Tab sis thaum tsis muaj kev kho mob lossis nyob rau hauv kev cuam tshuam ntawm lwm tus neeg sab nrauv, xws li teeb meem xws li cyst torsion tuaj yeem tsim. Yuav ua li cas qhov no pathology manifests nws tus kheej thiab dab tsi yuav tshwm sim, peb yuav soj ntsuam nyob rau hauv no tsab xov xwm.
Definition
Ib lub zes qe menyuam yog ib qho benign tsim, uas yog ib lub hnab uas muaj kua hauv. Cov ceg ntawm lub cyst muaj cov hlab ntsha uas pub nws, lymphatic hlab ntsha thiab paj hlwb. Kev kawm zoo li nce ntxiv vim qhov sib sau ntawm cov zais cia. Hauv qhov no, kev loj hlob ntawm zes qe menyuam nws tus kheej kuj tau pom. Nyob rau hauv nws tus kheej txoj kevNyob rau hauv qhov xwm txheej, lub cyst yog heev mobile, uas yuav ua rau nws torsion. Qhov no ua rau cov ntshav tsis txaus, uas yog fraught nrog kev txhim kho ntawm cov txheej txheem inflammatory. Nws tuaj yeem kis mus rau hauv lub plab kab noj hniav, ua rau peritonitis. Lub cyst kuj tseem tuaj yeem tawg, ua rau los ntshav. Nrog rau cov kab mob no, kev kuaj mob raws sij hawm tseem ceeb heev, vim tias qhov tshwm sim ntawm torsion ua rau muaj kev phom sij rau tus poj niam lub neej.
Nyob torsion
Hauv cov tshuaj, torsion ntawm lub cyst qia yog qhov ua tsis tiav thiab ua tiav. Xav txog lub xeev cov ntaub ntawv kom ntxaws ntxiv:
- Tsis tiav (tsawg dua 360 °). Hauv qhov no, tsuas yog cov hlab ntsha me me thiab cov hlab ntsha raug nyem. Cov hlab ntsha txuas ntxiv ua haujlwm, yog li cov ntshav muab rau lub cyst tsis nres kiag li. Cov mob no yog qhov txaus ntshai vim tias cov cim qhia tsis muaj zog - qhov no ua rau kev kuaj mob lig ntawm pathology. Lub sij hawm ntawm qhov tshwm sim ntawm qhov mob rhiab heev hloov nrog lawv cov subence. Nyob rau hauv palpation, ib tug ntom, nruj neoplasm yog palpated. Thaum sim tshem nws, tus poj niam hnov qhov mob hnyav heev.
- Pull (ntau dua 360 °). Nrog rau hom torsion no, cov hlab ntsha kuj tseem koom nrog hauv cov txheej txheem squeezing, uas tag nrho cov ntshav muab rau lub cyst. Yog tsis muaj kev pab raws sij hawm, tej yam kev hem thawj yuav tshwm sim. Nrog rau tag nrho torsion ntawm ob txhais ceg ntawm zes qe menyuam cyst, cov tsos mob yog heev pronounced. Qhov no tso cai rau koj los txheeb xyuas qhov tseeb ntawm pathology.
ua rau ntawm pathology
Qhov ua rau ntawm zes qe menyuam torsion muaj ntau heev. Xav txog qhov feem ntau ntawm lawv:
- Sudden txav uas tense xovxwm.
- Nyhav lifting.
- zais zis. Kev tshem tawm tsis tu ncua tuaj yeem ua rau muaj ntau yam pathological. Cyst torsion yog ib qho ntawm lawv.
- Cov leeg mob plab tsis muaj zog.
- Kev cev xeeb tub thiab yug menyuam.
- khaw cia.
- Txhua tus yam ntxwv ntawm tus qauv ntawm lub cyst. Piv txwv li, ib ceg ntev.
- Kev mob plab hnyuv.
- Kev sib raug zoo.
- Npaj ntshav siab hauv neoplasm.
- Kev poob phaus. Vim yog tshem tawm cov rog ntau dhau, lub cev tau hloov pauv me ntsis, uas tuaj yeem ua rau muaj kev sib tw.
Symptomatics
Cov tsos mob ntawm zes qe menyuam cyst torsion nyob rau hauv cov poj niam nyob ntawm nws hom thiab tus nqi ntawm kev loj hlob. Cov cim ntawm kev ua tiav thiab ib nrab torsion zoo sib xws, qhov sib txawv tsuas yog qib ntawm lawv qhov hnyav. Cov tsos mob hauv qab no ntawm pathology tau sau tseg:
- mob siab los ntawm lub zes qe menyuam cuam tshuam, uas tawm mus rau perineum thiab sab nraub qaum.
- Kev mob plab hnyuv.
- Npaj roj ntau lawm.
- nce hauv lub cev kub, qhia txog kev txhim kho ntawm cov txheej txheem inflammatory.
- qaug zog thiab kiv taub hau.
- ntxub tawm hws.
- Ntxhais tawv nqaij.
- Ncua tso zis, tshwj xeeb tshaj yog thaum torsion tau tsim ze ntawm lub zais zis.
- Qub qhov ncauj.
- Ntaus thiab ntuav.
- Tshuaj tsis haum plab. NtawmPalpation poj niam hnov mob.
- Ua pa ntau ntxiv thiab lub plawv dhia.
- Xav tau qee qhov kev mob tshwm sim los tom qab tus poj niam xav tias "fetal position"
Nws yog ib qho tseem ceeb kom paub tias thaum lub sij hawm kev loj hlob ntawm necrosis nrog ua tiav torsion ntawm zes qe menyuam cyst, cov tsos mob yuav rov qab. Qhov no yog ib qho mob txaus ntshai, vim tias tsis muaj kev kho mob tam sim ntawd, peritonitis tuaj yeem tshwm sim, uas tuaj yeem ua rau tuag taus.
Diagnosis
Kev kuaj mob ntawm zes qe menyuam cyst torsion suav nrog cov txheej txheem kuaj mob uas yuav ntsuas cov qib ntawm cov kab mob pathological thiab tsis suav nrog lwm cov xwm txheej txaus ntshai uas muaj cov tsos mob zoo sib xws (piv txwv li, cev xeeb tub, plab hnyuv, mob plab hnyuv). Cov kev ntsuam xyuas hauv qab no yuav tsum tau ua kom paub meej qhov kev kuaj mob:
- Kev kuaj mob, uas suav nrog palpation ntawm lub plab txhawm rau txiav txim siab qhov mob thiab nruj ntawm cov leeg plab. Kev kuaj gynecological kuj tau ua. Ib qho tseem ceeb ntawm kev kuaj mob yog qhov kev nug ntawm tus neeg mob. Cov ntaub ntawv hauv qab no tuaj yeem pab ua qhov kev kuaj mob - lub sijhawm pib ntawm cov tsos mob, lawv lub sijhawm thiab kev siv zog.
- Ua tiav cov ntshav txhawm rau txiav txim siab erythrocyte sedimentation rate (ESR) thiab cov qe ntshav dawb suav.
- Ua tiav urinalysis.
- Histological xeem.
- Ultrasound. Nws yog txoj kev kuaj mob zoo tshaj plaws, uas ntsuas qhov loj ntawm lub cyst, qib ntawm torsion, cov qauv ntawm cov neoplasm thiab nws cov kev cuam tshuam rau cov kabmob uas nyob sib ze. Nws raug nquahu kom ua cov txheej txheem no sai li sai tau thaum cov tsos mob ntawm zes qe menyuam torsion tshwm sim. Daim duab ultrasound tau nthuav tawm hauv qab no.
- Laparoscopy. Cov txheej txheem no yog ua los ntawm kev siv cov cuab yeej tshwj xeeb - laparoscope. Cov txheej txheem yog siv tsis tau tsuas yog rau kev kuaj mob, tab sis kuj rau kev kho mob. Nyob rau tib lub sij hawm, peb incisions yog ua nyob rau hauv lub plab kab noj hniav los ntawm qhov uas cov cuab yeej muab tso rau. Tsis tas li ntawd, lub laparoscope tau nruab nrog lub koob yees duab uas qhia cov duab ntawm lub monitor nyob ze.
Kev pab ib zaug
Thaum cov tsos mob ntawm zes qe menyuam torsion tshwm sim, hu rau lub tsheb thauj neeg mob sai li sai tau. Ib tug poj niam yuav tsum tau pw ntawm nws sab hauv "fetal position" kom txo tau qhov mob. Ua pa yuav tsum ceev, tab sis tsis tob. Kev siv tshuaj tsis raug pom zoo, vim tias lawv tuaj yeem ua rau qhov muag tsis pom daim duab kho mob thiab provoke rupture ntawm lub cyst. Txias yuav tsum tau siv rau hauv plab plab yog tias los ntshav.
Kev kho mob
Ovarian cyst torsion tsis kho kom zoo. Tus kab mob yuav tsum tau kev phais mob sai. Qhov kev ua haujlwm ua ntej ua ntej, qhov tsis tshua muaj kev loj hlob ntawm cov teeb meem.
Tam sim no, txoj kev phais ntawm kev kho mob pathology yog ua raws li hauv qab no:
- Laparotomy. Hom kev phais no yog siv rau qhov mob hnyav tshaj plaws (piv txwv li, thaum ntau tshaj 6 teev tau dhau los txij li lub sijhawm torsion). Cov txheej txheem yog ua raws li kev tshuaj loog. Thaumphais, tus kws phais ua ib qho incision nyob rau hauv lub plab kab noj hniav, tom qab uas nws tshem tawm cov cyst nrog rau lub appendage. Thaum lub cyst ruptures, cauterization ntawm cov hlab ntsha yog ua.
- Laparoscopy. Nws raug sau tseg yog tias tsis pub dhau ob teev dhau los tom qab torsion thiab peritonitis tsis tau kuaj pom. Txoj kev phais no zoo heev thiab tsis muaj lub sijhawm rov qab los ntev. Tom qab tshem tawm cov cyst, lub zes qe menyuam tau khaws cia thiab tom qab ib ntus pib ua haujlwm li qub. Lub sijhawm rov ua haujlwm rau kev phais mob ua los ntawm txoj kev no yog 3-4 hnub. Tam sim no, muaj ntau txoj kev kho mob uas siv lub laparoscope, uas yog siv yog tias lub cyst yog benign thiab kev ua haujlwm ntawm zes qe menyuam tsis ua haujlwm. Thaum lub sijhawm ua haujlwm, lub cev tsis sib xws yog untwisted thiab cov ntshav ntws rov qab los. Tom qab ntawd, lub cyst raug tshem tawm. Yog tias cov ntshav ntws tsis rov qab los, lub zes qe menyuam raug tshem tawm tag nrho.
Tom qab ua haujlwm, txhawm rau tshem tawm txoj kev txhim kho ntawm cov txheej txheem inflammatory, cov tshuaj tua kab mob tau muab tshuaj thiab kev kho yog nqa tawm txhawm rau txhawm rau kis tus kabmob.
Muaj Teeb Meem
Ib lub zes qe menyuam yog ib qho tsim kev phom sij heev, vim nws qhov torsion tuaj yeem ua rau muaj kev phom sij rau lub neej. Xav txog qhov tshwm sim loj tshaj plaws:
- Cyst rupture tom qab peritonitis.
- Tsim cov adhesion los ntawm cov ntaub so ntswg sib txuas. Qhov no yog kev tiv thaiv ntawm lub cev, uas tsis yog tsom rau kev tiv thaiv kev sib tw ntxiv. ATRaws li qhov tshwm sim ntawm stagnation ntawm cov ntshav venous, fibrin yog tsim rau ntawm lub cyst, uas tsim cov adhesions nrog cov kabmob uas nyob sib ze. Tab sis lawv tuaj yeem cuam tshuam nrog lawv cov kev ua haujlwm ib txwm muaj thiab tsis tuaj yeem lav tag nrho kev tiv thaiv kev sib tw ntxiv.
- Bleeding.
- Kev ua txhaum ntawm kev ncaj ncees ntawm zes qe menyuam.
- Kev hloov pauv ntawm cov txheej txheem inflammatory mus rau lub tsev menyuam, uas tej zaum yuav yog ib qho qhia rau nws tshem tawm.
- Kev tsis muaj menyuam.
Kev Tiv Thaiv
Qhov kev tiv thaiv tseem ceeb rau cyst torsion yog nws kho raws sijhawm. Yog tias, tom qab kuaj mob, neoplasm tsis ploj hauv ob mus rau peb lub hlis, nws yuav tsum siv cov tshuaj hormonal rau nws cov resorption. Qee zaum, tus kws kho mob txiav txim siab txog txoj kev phais tshem tawm.
Tsis tas li, kev tiv thaiv ntawm torsion ntawm neoplasm yog cov lus pom zoo hauv qab no:
- Txoj kev tawm dag zog lub cev ntau dhau thiab txav lub cev tam sim ntawd.
- Saib xyuas koj cov zaub mov thiab kev ua haujlwm ntawm plab hnyuv, tsis txhob cem quav.
- Ua tib zoo saib xyuas koj txoj kev noj qab haus huv thiab mus ntsib kws kho mob tsis tu ncua.
- Sijhawm dhau mus kuaj qhov tsim nyog, suav nrog ultrasound. Nws yuav pab txheeb xyuas qhov kev loj hlob ntawm cov kab mob pathological nyob rau theem pib.
- Yog tias muaj cov tsos mob ntawm zes qe menyuam torsion, hu rau lub tsheb thauj neeg mob sai li sai tau.
Huab cua
Nrog rau kev kuaj mob ntxov ntawm pathology thiab kev kho mob raws sij hawm, qhov kev mob tshwm sim feem ntau yog qhov zoo. Qee lub sij hawm nws muaj peev xwm txuag tau lub zes qe menyuam thiab ua kom tiav nws cov haujlwm. Tab sis vim lub fact tias nyob rau hauv thaum ntxov ua sawv ntawm txoj kev loj hlob ntawm pathology, cov tsos mob yuav ua rau qhov muag plooj, torsion yog kuaj tau nyob rau hauv ib tug ntau dua theem thiab cov kev pheej hmoo ntawm kev txuag lub cev yog txo.
Zoo kawg
Ovarian cyst torsion yog ib qho kev phom sij uas yuav tsum tau muaj kev phais sai. Nws muaj kev loj hlob sai, thiab nyob rau hauv rooj plaub ntawm kev ncua, nws tuaj yeem hem lub neej ntawm tus poj niam. Koj yuav tsum ua tib zoo saib xyuas koj txoj kev noj qab haus huv thiab tsis txhob tso tseg qhov kev npaj mus ntsib kws kho mob.
