Polycystic ovary syndrome yog ib qho teeb meem uas ntau tus poj niam ntsib. Kev tsim thiab kev loj hlob ntawm ntau lub cysts feem ntau yog txuam nrog cov tshuaj hormonal. Yog tsis kho, tus kab mob ua rau infertility. Yog vim li cas nws thiaj tsim nyog kawm ntxiv txog qhov no pathology.
Vim li cas thiaj li mob polycystic zes qe menyuam tshwm sim? Yuav ua li cas kho xws li ib tug pathology? Cov tsos mob dab tsi yuav tsum tsis txhob ignored? Puas muaj peev xwm xeeb tub nrog tus kab mob no? Cov lus teb rau cov lus nug no txaus siab rau ntau tus poj niam.
kab mob yog dab tsi?
Cov ntaub ntawv dab tsi txog kab mob ICD muaj? Puas yog polycystic zes qe menyuam syndrome txaus ntshai? Cov tsos mob dab tsi nrog? Cov ntaub ntawv no tau nrhiav los ntawm ntau tus neeg mob.
Yog li, polycystic zes qe menyuam syndrome (ICD-10 muab cov kab mob pathology E28.2) yog ib yam kab mob uas muaj ntau lub hlwv me me hauv cov ntaub so ntswg ntawm zes qe menyuam. Raws li txoj cai, tus kab mob yog txuam nrog hormon alteeb meem.
Dab tsi yog qhov txheej txheem ntawm kev loj hlob ntawm polycystic zes qe menyuam syndrome? Lub pathogenesis ntawm tus kab mob yog to taub zoo. Kev tso zis ntau ntxiv ntawm estrogen, androgens thiab insulin ua rau muaj kev cuam tshuam ntawm kev loj hlob thiab kev loj hlob ntawm cov qe. Cov qauv cystic pib tsim los ntawm cov follicles tsis paub qab hau.
Tus niam tsev lawv tus kheej yog me me, nrog lub plhaub tuab tuab thiab ua kua txheem sab hauv. Feem ntau, cysts tshwm sim hauv ob lub zes qe menyuam. Lub xub ntiag ntawm cov qauv no hauv kwv yees li 25% ntawm cov neeg mob ua rau muaj menyuam tsis taus.
Nyob ntawm keeb kwm, ob hom kab mob sib txawv.
- Primary polycystic ovary syndrome yog tshwm sim los ntawm congenital anomalies. Daim ntawv no kuj tuaj yeem tshwm sim hauv cov ntxhais thaum lub sijhawm ua haujlwm ntawm kev coj khaub ncaws.
- Daim ntawv thib ob ntawm tus kab mob no tshwm sim hauv cov neeg laus thiab feem ntau cuam tshuam nrog kev kis kab mob ntawm cov qog endocrine los yog yav dhau los cov kab mob inflammatory ntawm lub cev xeeb tub.
Polycystic ovary syndrome: ua rau
Hmoov tsis zoo, qhov no yog ib qho pathology ntau heev. Vim li cas polycystic ovary syndrome tshwm sim hauv cov poj niam? Qhov tseeb, cov laj thawj yuav txawv.
- Feem ntau tus kab mob tsim tawm tsam keeb kwm ntawm pathologies ntawm hypothalamic-pituitary system. Qhov tseeb yog tias follicle-stimulating thiab luteinizing cov tshuaj hormones yog synthesized nyob rau hauv lub pituitary caj pas, uas yog lub luag hauj lwm rau kev loj hlob thiab kev loj hlob ntawm follicles, cov txheej txheem ntawm ovulation. Tawm tsam keeb kwm yav dhau los ntawm kev nce qib ntawm cov tshuaj hormones, hyperproduction ntawm androgens nyob rau hauv cov ntaub so ntswg ntawm zes qe menyuam, uas ua rau cov tsos thiab kev loj hlob ntawm lub zes qe menyuam.cyst.
- polycystic zes qe menyuam syndrome tuaj yeem cuam tshuam nrog cell tsis kam rau insulin. Kev nce qib ntawm insulin cuam tshuam rau tag nrho cov kab mob endocrine. Hauv particular, tus nqi ntawm cov tshuaj androgens synthesized thiab luteinizing hormone nce. Xws li kev hloov pauv ua rau kev loj hlob ntawm cov follicles. Txawm li cas los xij, tsis muaj ib qho ntawm cov qauv no paub tab - kev laus ntxov ntxov ntawm cov hauv paus hniav teeb tsa, ua rau muaj ntau yam cysts.
- Cov xwm txheej tseem ceeb kuj suav nrog ntau dhau ntawm cov txiv neej cov tshuaj hormones, uas tseem cuam tshuam kev loj hlob thiab kev loj hlob ntawm cov qe hauv zes qe menyuam.
- Muaj caj ces. Txog niaj hnub no, tsis muaj cov ntaub ntawv uas yuav lees paub qhov kev sib kis ntawm tus kab mob. Txawm li cas los xij, cov poj niam uas tau muaj cov neeg mob zoo sib xws hauv lawv tsev neeg muaj kev pheej hmoo.
- Nws tsim nyog sau cia tias qee yam tshuaj kuj suav tias yog qhov muaj feem pheej hmoo. Nws kuj tau raug pov thawj tias tawm tsam keeb kwm ntawm kev rog rog, polycystic zes qe menyuam syndrome tshwm sim hauv daim ntawv hnyav dua. Los ntawm txoj kev, raws li kev txheeb cais, kwv yees li 40% ntawm cov neeg mob hnyav dhau.
- Cov xwm txheej txaus ntshai kuj suav nrog kev ntxhov siab, kev hloov pauv huab cua, kev kis kab mob yav dhau los (yog tias tus neeg mob muaj qhov yuav tsum tau ua ua ntej rau kev txhim kho pathology).
Polycystic ovary syndrome cov tsos mob
Qee lub sij hawm cov kab mob tshwm sim yam tsis muaj qhov tshwm sim ntawm cov cim tshwj xeeb - hauv qee cov neeg mob, tus kab mob tau kuaj pom los ntawm kev sib tsoo. Tab sis nyob rau hauv feem ntau, ib tug xov tooj ntawm kev ua txhaum cai tshwm sim uas qhia tau hais tias muajpolycystic zes qe menyuam syndrome. Cov tsos mob txawv ntawm poj niam mus rau poj niam.
- Pathology feem ntau cuam tshuam rau kev coj khaub ncaws. Nws dhau los ua tsis xwm yeem - ncua sij hawm ntev ntawm kev coj khaub ncaws tuaj yeem ua tau, mus txog rau qhov tsis tuaj yeem ua tiav (amenorrhea). Muaj kev ua txhaum cai, thiab qee zaum ploj ntawm ovulation. Qee lub sij hawm ncua sij hawm ntev ntawm kev coj khaub ncaws yog hloov los ntawm cov uterine los ntshav.
- Vim cov txheej txheem ntawm kev loj hlob ntawm lub qe raug cuam tshuam thiab ovulation tsis tuaj, cov poj niam tsim muaj menyuam.
- nce qib androgen ua rau kom muaj sebum ntau lawm. Cov neeg mob raug kev txom nyem los ntawm seborrhea, nce greasiness ntawm cov plaub hau. Cov tawv nqaij yog npog nrog pob txuv thiab blackheads. Cov kab mob zoo li no nyob mus ib txhis thiab siv tsis tau los kho cov tsos mob.
- Ib yam ntxwv ntawm tus kab mob polycystic yog rog rog. Tus neeg mob lub cev hnyav nce nce siab los ntawm 10-15 kg yam tsis muaj laj thawj (tus poj niam tseem noj li niaj zaus). Qee lub sij hawm cov roj deposits faib sib npaug thoob plaws hauv lub cev. Tab sis vim qhov nce hauv qib androgen, txiv neej-hom rog tuaj yeem ua tau. Cov rog ntau dhau hauv lub duav thiab plab.
- Kev rog dhau, tsis muaj cov metabolism hauv carbohydrates thiab lipids qee zaum ua rau muaj kev loj hlob ntawm hom 2 mob ntshav qab zib.
- Kev loj hlob ntawm cov plaub hau ntawm lub cev yog ua tau: nce qib ntawm cov txiv neej cov tshuaj hormones ua rau txiv neej cov plaub hau loj hlob - "antennae" tshwm saum daim di ncauj, cov plaub hau loj hlob yog pom ntawm lub hauv siab, plab, sab hauv. ntohips.
- Ntau tus poj niam yws yws ntawm qhov mob ntev hauv plab plab. Mob yog me ntsis pronounced, rub hauv xwm. Qee zaum qhov mob kis mus rau thaj tsam plab thiab sab nraub qaum.
Qhov muaj qhov ua txhaum cai no tsis tuaj yeem tsis quav ntsej. Yog tias tsis kho, pathology ua rau muaj teeb meem.
Muaj Teeb Meem
Tus mob polycystic zes qe menyuam tuaj yeem txaus ntshai li cas? Kev tshuaj xyuas ntawm cov kws tshaj lij qhia tau hais tias nrog kev kuaj mob ntxov thiab kev kho kom raug, tus kab mob tuaj yeem daws tau. Txawm li cas los xij, qee zaum, tus kab mob ua rau muaj kev txhim kho ntawm qee yam teeb meem.
- Pathology yog nrog los ntawm cov tshuaj hormonal, vim tias tus neeg mob tsis ovulate. Qhov no, dhau los, ua rau muaj menyuam tsis taus.
- Kev mob ntev ntev, tsis kho yuav ua rau pom cov qog nqaij hlav hauv cov ntaub so ntswg lossis ncauj tsev menyuam.
- PCOS, ua ke nrog ntshav qab zib thiab rog rog, tseem xav tias yuav ua rau muaj kev pheej hmoo ntawm kev mob qog noj ntshav mis.
- Hormonal cuam tshuam ua rau cuam tshuam cov roj metabolism hauv ib txwm. Qhov hnyav dhau, ua ke nrog cov kab mob metabolic, ua rau muaj kev cuam tshuam ntawm lub plawv thiab cov hlab ntsha. Tias yog vim li cas cov npe ntawm cov teeb meem suav nrog atherosclerosis, mob stroke, myocardial infarction.
ntsuas ntsuas
Yuav ua li cas yog tias koj xav tias polycystic zes qe menyuam syndrome? Cov tsos mob tau piav saum toj no yog qhov laj thawj zoo mus ntsib kws kho mob. Tsis txhob kho tus kheej lossis sim txiav txim qhov teeb meem ntawm koj tus kheej, vim qhov no tuaj yeem ua rau muaj kev phom sij.
Yuav ua li cas txheeb xyuas tus mob polycystic zes qe menyuam? Kev kuaj mob hauv qhov no suav nrog ntau cov txheej txheem.
- Ua ntej, koj yuav tsum tau xeem anamnesis thiab kuaj dav dav. Tus kws kho mob saib xyuas cov yam ntxwv ntawm lub cev, tshuaj xyuas cov tawv nqaij thiab cov mucous daim nyias nyias, sau cov xwm txheej ntawm cov plaub hau kev loj hlob, sau tag nrho cov tsos mob uas yuav qhia tau tias muaj teeb meem hormonal.
- Ua raws li kev kuaj gynecological thiab palpation ntawm lub plab. Yog li tus kws kho mob yuav pom qhov tawv tawv lossis loj ntawm zes qe menyuam.
- Ultrasound ntawm lub plab hnyuv siab raum yog qhov yuav tsum tau ua. Thaum lub sijhawm txheej txheem, koj tuaj yeem pom qhov nce ntawm zes qe menyuam, paub meej tias muaj cov cysts.
- Doppler ultrasound pab ntsuas qhov xwm txheej ntawm cov ntshav ntws hauv zes qe menyuam.
- Tus neeg mob kuj pub ntshav rau kev tshuaj xyuas. Nws yog ib qho tsim nyog los txiav txim siab qib ntawm estrogen, progesterone, androgens, cortisol, insulin, pituitary hormones.
- Cov ntshav tseem raug kuaj xyuas seb muaj lipids thiab qib lipids - qhov no ua rau nws tuaj yeem kuaj pom cov metabolism tsis ua haujlwm.
- Kev ntsuas qhov sib nqus resonance tso cai rau tus kws kho mob kom tau txais cov duab tseeb ntawm zes qe menyuam, txiav txim siab qhov loj, qhov chaw thiab tus lej ntawm cov hlwv.
Raws li cov txiaj ntsig, tus kws kho mob tuaj yeem kuaj pom tus mob polycystic zes qe menyuam. Kev kho mob nyob rau hauv cov ntaub ntawv no yuav nyob ntawm daim ntawv thiab theem ntawm kev loj hlob ntawm tus kab mob, lub xub ntiag ntawm concomitant pathologies.
kev kho mob
Hmoov tsis zoo, nws tsis tuaj yeem tshem tawm tag nrho cov kab mob xws li polycystic ovary syndrome. Kev kho mob nyob rau hauv rooj plaub no yog tsom rau kev rov ua kom lub voj voog ib txwm muaj, txhawb cov txheej txheem ovulation (yog tias tus neeg mob xav cev xeeb tub), txo cov kev tshwm sim sab nraud ntawm tus kab mob (dawb tawv nqaij, plaub hau), normalizing carbohydrate thiab rog metabolism.
- Yog tias muaj kev ua txhaum ntawm cov metabolism hauv carbohydrate, cov neeg mob tau muab cov tshuaj hypoglycemic, piv txwv li, Metformin. Tshuaj pab normalize ntshav qabzib.
- Yog tias tus neeg mob sim cev xeeb tub, ces qhov kev xav ntawm ovulation yog qhov tsim nyog. Rau lub hom phiaj no, raws li txoj cai, cov tshuaj "Clomiphene" yog siv, uas ua kom lub qe tso tawm ntawm zes qe menyuam. Raws li txoj cai, cov tshuaj yog pib rau hnub 5-10 txij thaum pib ntawm kev coj khaub ncaws. Raws li kev txheeb cais, xws li kev kho mob hauv 60% ntawm cov neeg mob xaus nrog ovulation. Hauv kwv yees li 35% ntawm cov neeg mob, nws xaus nrog fertilization.
- Cov tshuaj hormonal contraceptives yog siv los kho cov kev coj khaub ncaws ib txwm muaj.
- Qee zaum cov tshuaj "Veroshpiron" suav nrog hauv kev kho mob. Qhov no yog ib qho potassium-sparing diuretic, uas kuj txo cov theem ntawm androgens hauv tus poj niam lub cev, thaiv lawv cov teebmeem. Txoj kev kho no kav ntev li rau lub hlis thiab pab tshem tawm cov plaub hau tsis zoo, ua kom cov qog sebaceous zoo li qub.
noj kom raug
Kev nce siab hauv lub cev hnyav yog ib qho ntawm cov tsos mob ntawm tus mobpolycystic zes qe menyuam. Cov lus pom zoo kho mob kuj tseem siv tau rau kev noj zaub mov. Thaum kho, nws yog ib qho tseem ceeb heev kom normalize metabolism thiab tswj lub cev qhov hnyav nyob rau hauv ib txwm txwv.
- Cov neeg mob tau qhia kom haus tsis pub ntau tshaj 1200-1800 kcal ib hnub.
- Khoom noj yuav tsum yog feem. Cov poj niam yuav tsum noj ntau zaus (tsawg kawg 5-6 zaug hauv ib hnub), tab sis hauv me me.
- Nco ntsoov suav cov zaub tshiab thiab txiv hmab txiv ntoo hauv koj cov zaub mov. Lawv muaj cov vitamins thiab fiber ntau, tab sis kuj muaj calories tsawg.
- Nws yog ib qho tseem ceeb los muab lub cev nrog cov proteins. Cov zaub mov raug pom zoo kom suav nrog tsev cheese, nqaij ntshiv, ntses, nqaij nruab deg.
- Tus tsiaj cov rog yuav tsum txwv. Cov kev cai niaj hnub yuav tsum tsis pub tshaj 80 g. Koj tuaj yeem hloov cov khoom no nrog cov roj zaub, uas muaj txiaj ntsig zoo dua.
- Nws tsim nyog txwv tsis pub lossis muab cov piam thaj, ncuav qab zib, zib ntab, jam, qab zib, hauv ib lo lus, los ntawm txhua yam uas muaj cov piam thaj ntau.
- Cov kws tshaj lij kuj pom zoo kom muab cov zaub mov hauv kaus poom, cov txuj lom, cov txuj lom, kua ntses, cov khoom noj qab zib, cov nqaij haus luam yeeb.
- 1-2 zaug hauv ib lub lis piam koj yuav tsum tau siv sijhawm yoo mov. Piv txwv li, koj tuaj yeem noj txhua hnub tsuas yog txiv apples, tsev cheese, kefir. Yuav luag txhua yam kev noj zaub mov mono yuav ua.
- Nws raug nquahu kom tso cawv, vim ethanol tsis zoo cuam tshuam rau kev ua haujlwm ntawm tag nrho cov kabmob.
Physiotherapy
Nws tsim nyog hais tias kev noj tshuaj tsis yog ib qho uas yuav tsum tau muaj rau tus kab mob no,zoo li polycystic zes qe menyuam syndrome. Cov kws kho mob cov lus pom zoo kuj siv tau rau tus neeg mob txoj kev ua neej.
Tau kawg, ib feem tseem ceeb ntawm kev kho mob yog kev noj zaub mov kom raug. Tsis tas li ntawd, kev tawm dag zog lub cev kuj raug pom zoo. Peb tab tom tham txog kev ua tau zoo, txawm tias nws ua luam dej, Pilates lossis taug kev ntev. Qhov tseeb yog tias subcutaneous rog deposits yog ib qho ntxiv ntawm androgens. Kev poob phaus yuav tsis tsuas yog muaj txiaj ntsig zoo ntawm daim duab thiab kev noj qab haus huv, tab sis kuj tseem yuav pab ua kom cov qib hormonal normalizes.
Ua tau zoo yog galvanophoresis siv lidase. Cov txheej txheem no tso cai rau koj mus qhib lub enzymatic system ntawm zes qe menyuam. Nws kuj txhim kho lub cev ua haujlwm. Kev kho mob, raws li txoj cai, muaj kaum tsib txheej txheem txhua hnub.
Nws yuav tsum nkag siab tias kev kho rau tus kab mob no yuav tsum muaj kev qhia dav. Tsis txhob suav rau kev kho sai thiab ua tiav.
Surgery
Feem ntau, kev kho mob, ua ke nrog kev kho lub cev thiab kev noj zaub mov kom zoo, txaus los ua kom cov kab mob endocrine ua haujlwm zoo li qub. Txawm li cas los xij, qee zaum kev phais yog tsim nyog. Kev phais feem ntau yog siv los kho infertility. Feem ntau, laparoscopy yog ua. Cov cuab yeej tshwj xeeb tau muab tso rau hauv los ntawm kev txiav me me. Muaj ob txoj hauv kev los ua haujlwm.
- Ntxhais zes qe menyuam resection cuam tshuam nrog kev tshem tawm ntawm zes qe menyuam cov ntaub so ntswg uas cov tshuaj hormones androgen synthesized.
- Ovarian electrocauterization muaj qhov kev puas tsuajcov qauv ntawm zes qe menyuam, uas yog lub luag haujlwm rau kev sib txuas ntawm "txiv neej" cov tshuaj hormones. Qhov no yog txoj kev raug mob tsawg dua uas tso cai rau koj kom txuag tau cov ntaub so ntswg noj qab haus huv ntau tshaj plaws.
Nws yog ib qho tsim nyog sau cia tias thaum lub sijhawm phais laparoscopic, tus kws kho mob muaj lub sijhawm los tshem tawm cov neeg kho tshuab ua rau tsis muaj menyuam, piv txwv li, txiav cov adhesions ntawm phab ntsa lossis tshem tawm cov kev cuam tshuam ntawm cov hlab ntsha. Kev ua haujlwm yog ua raws li kev siv tshuaj loog thiab pom tias muaj kev nyab xeeb.
Nyob rau yav tom ntej, kev saib xyuas kev noj qab haus huv tau ua tiav. Feem ntau ob lub lis piam tom qab kev ua haujlwm, thawj ovulation tshwm sim. Txawm li cas los xij, qee zaum nws yuav siv sij hawm 6-12 lub hlis los kho qhov kev coj khaub ncaws ib txwm muaj. Yog tias nyob rau hauv 2-3 lub voj voog ovulation tseem tsis tuaj, ces tus neeg mob tau muab tshuaj rau tib yam Clomiphene.
Nws yog ib qho tsim nyog sau cia tias txawm tias tom qab ua tiav fertilization thiab yug me nyuam, qhov kev pheej hmoo ntawm kev rov qab los yog siab heev. Raws li kev txheeb cais, feem ntau cov kab mob polycystic tau qhib rau 5 xyoos tom qab kev kho mob. Tias yog vim li cas tus neeg mob yuav tsum tau sau npe nrog kws kho mob, kuaj xyuas thiab kuaj ob zaug hauv ib xyoos. Qhov kuaj pom qhov rov qab sai dua, nws yooj yim dua los nres nws cov tsos mob thiab tiv thaiv kev txhim kho ntawm cov teeb meem tshwm sim.
Kev ntsuas kev tiv thaiv thiab kev kwv yees
Nws tsim nyog sau cia tias nws tsis tuaj yeem tshem tawm cov kab mob no kom tiav. Txawm li cas los xij, kev kho mob pib thaum ntxov pub rau cov poj niam kom tsis txhob muaj qhov tshwm sim tsis zoo xws li kev xeeb tub (lawv yuav tsis muaj qhov xaus nrog polycystic syndrome).zes qe menyuam). IVF, noj cov tshuaj hormones, ovulation stimulation - tag nrho cov no pab ib tug poj niam los ua ib tug niam.
Hmoov tsis zoo, tsis muaj kev tiv thaiv tshwj xeeb. Cov poj niam raug qhia kom saib xyuas lub xeev ntawm kev noj qab haus huv thiab kev tsis tu ncua ntawm lub voj voog, thiab yog tias muaj cov tsos mob txaus ntshai, mus ntsib kws kho mob tam sim ntawd. Nco ntsoov tias txhua txhua rau lub hlis koj yuav tsum tau mus kuaj xyuas gynecological. Nws tseem yog ib qho tseem ceeb kom ua raws li kev noj haus, ua kom haum, kho mob thiab kis kab mob hauv lub sijhawm.
Ib tug ntxhais thaum nws laus laus yuav tsum tau piav qhia tias yuav ua li cas rau nws lub cev. Txij li cov hlwv feem ntau pib tsim thaum lub sij hawm kev coj khaub ncaws, cov ntxhais kuj raug qhia kom kuaj xyuas kev tiv thaiv thiab kuaj ib ntus.
