Tej zaum, peb txhua tus muaj kev tsis xis nyob, ciam teb ntawm kev ntshai, thaum hnov qhov kev kuaj mob qog nqaij hlav. Thoob plaws ntiaj teb, cov kws tshawb fawb tau tawm tsam los txiav txim siab seb nws tuaj ntawm qhov twg thiab yuav kho li cas nrog 100% lav, tab sis alas, txog tam sim no cov txiaj ntsig tau poob siab. Kev kuaj mob ntawm "adenomatous polyp" tsis zoo li tsis meej pem, thiab ob peb tus neeg tsis yog kws kho mob tuaj yeem piav qhia nws yog dab tsi. Meanwhile, tus kab mob no suav hais tias yog ib tug mob precancerous, yog li ntawd nws yog heev txaus ntshai. Cov uas pom tias muaj nws yuav tsum tau ua tam sim ntawd kom cawm lawv txoj kev noj qab haus huv thiab tej zaum lawv txoj sia.
yam ntxwv ntawm polyps
Ntawm nws cov tub ntxhais, polyps hauv tib neeg lub cev yog thaj tsam ntawm cov mucous membrane uas tau loj hlob rau qee yam. Ntawd yog, lawv tuaj yeem tshwm sim hauv txhua lub cev uas npog nrog mucous. Raws li kev txheeb xyuas kev kho mob, ib qho adenomatous polyp, txwv tsis pub hu ua adenoma, ua rau muaj teeb meem ntau thiab yog cov qog nqaij hlav. Lub ntsiab txhais ntawm "benign" txhais tau tias nyob rau hauv ib qho chawlub cev dheev pib faib cov hlwb tsis tuaj yeem tswj tau, tab sis tam sim no lawv tag nrho lossis ib nrab khaws cov haujlwm ntawm lub cev los yog cov ntaub so ntswg thiab tsis muab metastases. Nws yog qhov tseem ceeb feature uas muab sij hawm los kho lawv tag nrho. Yog li ntawd, ib qho adenomatous polyp tseem tsis tau muaj kab lus. Txawm li cas los xij, yam tsis muaj kev nqis tes ua, feem ntau cov qog nqaij hlav benign ua malignant. Yog li, polyps, qhov loj ntawm cov uas tau mus txog tsuas yog 1 cm, muaj nrog ib tug siab probability invasive mob hlwb hlwb, uas yog, cov uas twb metastasizing. Muaj tseeb tiag, qhov loj me me ntawm kev loj hlob tsis muab 100% lav kev nyab xeeb, txij li thaum muaj cov mob qog noj ntshav tsim los ntawm ib lub tsev ntawm polyp.
Kev faib tawm
Cov mucous daim nyias nyias ntawm tib neeg muaj ntau txheej thiab, nyob ntawm seb lub cev uas lawv npog, muaj epithelium ntawm cov qauv sib txawv. Adenoma loj hlob ntawm cov mucous daim nyias nyias, lub epithelium uas yog sawv cev los ntawm ib tug glandular qauv, uas yog, nws muaj xws li ntau lub qog. Raws li qhov no, polyps tuaj yeem tshwm sim hauv plab, hauv lub gallbladder, hauv cov hnyuv, hauv cov kabmob ntawm cov kab mob genitourinary.
Dhau li ntawm qhov chaw, muaj ntau yam ntawm lawv cov kev faib tawm:
1. Raws li hom ntawm lub hauv paus: ntawm ob txhais ceg (stem) los yog ntawm lub platform dav (zaum). Nws ntseeg tau tias tsis muaj adenomatous polyp pib metastases sai dua. Daim duab saum toj no qhia tau hais tias qhov loj sessile polyp zoo li ntawm phab ntsa plab hnyuv.
2. Loj: me me, nruab nrab, loj. Ntev npaum li adenomas tsawg dua 1 cm, lawv yog qhov tsawg tshaj plaws uas yuav ua rau mob qog noj ntshav. Hloov pauv, ntawm adenomas loj dua 1 cm, kwv yees li 13% muajmob qog noj ntshav, thiab ntau dua 2 cm qhov tshwm sim ntawm degeneration mus rau mob qog noj ntshav yog 51%.
3. Cov tsos mob: spherical, oval, nceb-puab, ntom, mos.
4. Los ntawm localization: ib leeg, zes, ntau. Cov tom kawg no rov yug los ua mob qog noj ntshav ntau dua 2 zaug.
Morphological nta
Adenomatous polyp ntawm txoj hnyuv, plab, tag nrho cov plab hnyuv siab raum tau teeb tsa sib txawv, uas cuam tshuam rau qhov tshwm sim ntawm kev rov zoo. Lawv yog:
1. qog. Lawv muaj ntau cov qog thiab cov ntaub so ntswg uas nplua nuj nyob hauv cov hlab ntsha. Lawv tau muab faib ua benign, nrog rau cov tsos mob ntawm atypia (cov cell poob lawv cov duab, lawv cov nuclei thicken) thiab nrog malingation (atypical hlwb thiab qog ua rau hauv cov leeg nqaij thiab submucosal txheej ntawm epidermis, uas yog, qhov tseeb, lawv tab tom npaj rau metastasis.).
2. Villous. Cov polyps no yog velvety nyob rau hauv tsos, zoo ib yam li lub taub hau ntawm cauliflower, thiab feem ntau muaj ib tug ntxhib nto. Qhov tshwm sim ntawm malinga lawv muaj tshaj 60%.
3. Glandular-villous.
4. Hyperplastic. me me, mos, khaws cov qauv ntawm cov mucosa.
5. Cov menyuam yaus. Tsis txhob malingate, muaj cystic qog thiab ntom stroma.
6. Fibrous. Hauv stroma, lawv muaj ntau cov hlab ntsha loj, uas yog vim li cas lawv zoo li inflammatory infiltration.
7. False.
Yog vim li cas thiaj pom
Vim li cas polyps pib loj hlob, tseem tsis tau muaj cov lus teb tseeb. Qee cov kws tshawb fawb ntseeg tias lawv tshwm sim hauv cov neeg laus, lwm tusrefute. Cov ntaub ntawv pov thawj hais tias hauv cov menyuam yaus lub sijhawm kuaj pom adenomas yog 28%, hauv cov neeg muaj hnub nyoog qis dua 30 xyoo - 30%, thiab cov neeg laus dua 70 xyoo - tsuas yog 12.8%. Qhov siab tshaj plaws ntawm kev kuaj pom adenoma tshwm sim thaum muaj hnub nyoog 40-50 xyoo.
Qhov ntawd yog, ib qho adenomatous polyp ntawm lub qhov quav lossis lwm lub cev tuaj yeem tshwm sim hauv ib tus neeg ntawm txhua lub hnub nyoog, txawm tias nyob rau hauv cov menyuam mos (muaj ib qho kev paub txog kev kuaj tus kab mob hauv tus menyuam hnub nyoog 2 hli hauv lub plab). Tej zaum cov kws tshawb fawb muaj xws li:
- pathologies hauv embryonic kev loj hlob;
- heredity (cov me nyuam uas nws niam nws txiv tau ntsib adenoma kuj muaj li 2 npaug ntau dua);
- inflammatory txheej txheem nyob rau hauv lub plab zom mov (gastritis, colitis, dysentery, teeb meem nrog defecation thiab lwm yam);
- malnutrition;
- ua txhaum ntawm kev rov tsim dua ntawm cov mucous ntawm lub plab thiab cov hnyuv tom qab kis.
Adenomatous polyp ntawm plab
Lub cev no yog thawj qhov chaw hauv cov ntsiab lus ntawm predisposition rau cov tsos ntawm adenomas. Raws li ib qho ntawm cov kev faib tawm raws li cov yam ntxwv morphological, cov nram qab no hom kab mob plab tau kuaj pom:
- tubular;
- papillary;
- sib xyaw (papillotubular).
Lawv faib tsis sib npaug hauv plab. Yog li, nyob rau hauv nws sab sauv peb ntawm 2241 kuaj cov neeg mob, polyps tau pom nyob rau hauv 2.1%, nyob rau hauv nruab nrab peb cov ntaub ntawv no mus txog 17%, thiab nyob rau hauv lub thib peb sab muaj 66.8% ntawm pathologies.
Kev loj hlob ntawm cov qog nqaij hlav hauv plab tshwm sim raws li qhov yooj yimtswvyim: ib txwm epithelium - tsim ntawm ib tug polyp - nws txoj kev loj hlob mus rau carcinoma - mob cancer. Ntau zaus, qhov xwm txheej zoo li no tshwm sim hauv ob xyoos, qhov siab tshaj plaws ntawm peb, tab sis muaj qee kis thaum tib neeg nyob nrog polyposis txog 20 xyoo.
Qhov ua rau adenomas hauv plab yog qhov tshwm sim - heredity, kev loj hlob pathologies ntawm embryonic theem, inflammatory kab mob, feem ntau gastritis, qua ntxi zaub mov, cawv, kab mob gastrointestinal mob. Tsis tas li, raws li cov kws tshawb fawb, ntau yam kab mob neuropsychiatric pab txhawb kev loj hlob ntawm cov mucous hauv plab.
Symptoms
Tsis muaj ib daim duab kho mob qhia tias muaj adenomatous polyp tau loj hlob hauv plab. Cov tsos mob ntawm txhua tus neeg mob yog ib txwm muaj. Ntawm qhov ntau tshaj plaws, peb tuaj yeem paub qhov txawv:
- mob mob (txog 88.6%);
- xav tias lub plab twb puv lawm, txawm tias tom qab noj zaub mov tsawg;
- poob qab los;
- kub;
- xeev siab;
- nce salivation;
- flatulence;
- mob siab;
- qhov ncauj tsis zoo.
Mob feem ntau tshwm sim tom qab noj mov thiab kav ob peb teev, tom qab ntawd txo qis.
Ntxiv nrog rau cov tsos mob ntawm polyps, cov neeg mob muaj cov cim qhia tias muaj teeb meem hauv lub cev. Cov no yog qaug zog, qaug zog, qee zaum ua npaws, insomnia, mob taub hau, ua rau muaj kev nyuaj siab.
Muaj cov paib plab ntxiv uas qhia tias polyposis, tshwj xeeb tshaj yog tias nws yog keeb kwm. Cov no yog cov pob ntawm daim tawv nqaij (nyob ib ncig ntawm daim di ncauj, qhov ntswg, lub puab tsaig,hauv siab, xib teg, nraub qaum, plab, caj dab) nyob rau hauv daim ntawv ntawm freckles, uas tsis hloov lawv cov tsos nyob rau hauv tej huab cua thiab nyob rau hauv txhua lub caij.
Diagnosis
Adenomatous polyp nyob rau hauv ib lub cev yuav luag tsis tuaj yeem kuaj pom yam tsis muaj kev kuaj mob kho vajtse. Rau plab nws suav nrog:
- Ultrasound;
- x-ray nrog cov kua tuab ntawm barium (zoo li ntawm 4.6% ntawm cov neeg mob);
- gastroscopy;
- fibrogastroscopy;
- biopsy;
- Gastrolaparoscopy.
Tsis muaj qhov tseem ceeb yog qhov kev sim kuaj ntshav plab, ntshav thiab tshuaj tiv thaiv rau cov ntshav occult hauv cov ntsiab lus ntawm lub plab.
Cov txiaj ntsig siab tshaj plaws tau txais los ntawm kev xeem los ntawm ntau txoj hauv kev ib zaug.
Adenomatous colon polyp
Tus kab mob no nyob rau hauv qhov chaw thib ob "muaj koob muaj npe" tom qab gastric polyposis. Raws li kev txheeb cais, polyps hauv txoj hnyuv tau sau nrog cov zaus hauv qab no:
- poj niam - 46%;
- txiv neej – 53%.
Kev vam khom ntawm kev loj hlob ntawm tus kabmob raws hnub nyoog yog raws li hauv qab no:
- cov neeg mob hnub nyoog 41 txog 60 xyoo - 56%;
- los ntawm 31 txog 40 xyoo - 23%;
- hnub nyoog 14 txog 30 xyoo - 10%.
Qhov degeneration ntawm polyps mus rau hauv cov qog malignant muaj qee qhov kev vam khom rau lawv tus lej. Yog li, yog tias muaj 5 lossis ntau dua ntawm cov qauv no hauv lub qhov quav, lawv loj hlob mus rau mob qog noj ntshav hauv 100% ntawm cov neeg mob.
Polyps kuj tseem faib tsis sib npaug hauv txoj hnyuv. Yog li, 13% ntawm tag nrho cov xwm txheej tau sau tseg hauv qhov nce mus, 13.5% hauv txoj hnyuv loj, thiabsigmoid ib feem thiab lub qhov quav - 73.5%. Cov ua rau polyps nyob rau hauv cov hnyuv yog hais txog tib yam li thaum lawv tshwm sim nyob rau hauv lub plab, tab sis cov kws kho mob muab qhov tseem ceeb rau inflammatory kab mob. Yog li, ntawm 455 tus neeg mob kuaj mob uas muaj polyps, 30% raug kev txom nyem los ntawm cov kab mob ntev (colitis, proctosigmoiditis thiab lwm yam), thiab 16.4% muaj kab mob dysentery. Lub luag hauj lwm tseem ceeb belongs rau irrational khoom noj khoom haus. Vim li no, colitis pom muaj ntau dua 50% ntawm cov neeg mob.
Cov tsos mob thiab kev kuaj mob ntawm polyps hauv cov hnyuv
Tsis muaj cov cim qhia tshwj xeeb rau txoj hnyuv polyposis. Feem ntau, ntev ntev, cov neeg mob tsis hnov cov tsos mob ntawm txhua qhov adenomatous polyp tau pib loj hlob hauv lawv. Cov tsos mob feem ntau ntawm tus kab mob:
- ntshav quav (89%);
- nrog rau kev loj hlob ntawm tus kab mob, los ntshav yog ua tau thaum lub sij hawm los yog tom qab defecation;
- raws plab lossis cem quav (55.2%);
- mob hauv lub peritoneum;
- kub thiab / lossis khaus hauv qhov quav (txog 65%);
- anemia (7%);
- xeev siab;
- mob siab;
- mob taub hau;
- kub;
- flatulence;
- mob hauv qhov quav, tawm mus rau sab nraub qaum thiab sacrum.
Kev kuaj mob suav nrog palpation, ultrasound, radiography, sigmoidoscopy, hu rau beta radiometry, colonoscopy, fibrocolonoscopy, kuaj kuaj.
polyps hauv lub gallbladder
Adenomatous polyp ntawm lub gallbladder yog ib yam kab mob tsis tshua muaj tshwm sim tsawg dua 1% ntawm txhua tus neeg mob polyposis. Los ntawmRaws li kev txheeb cais, feem ntau tus kab mob cuam tshuam rau tib neeg tom qab 45 xyoo. Lub gallbladder yog ib qho me me, hauv cov neeg laus nws tsuas yog ntev txog 14 cm thiab dav txog li 5 cm. Nyob rau hauv cov qauv, nws zoo li lub hnab nrog nyias phab ntsa, lub cev dav, lub caj dab tapering thiab ib qho nqaim heev, los ntawm cov kua tsib lub hauv paus chiv keeb. Qhov teeb meem loj tshaj plaws yog qhov chaw ntawm polyps nyob rau hauv lub caj dab los yog duct. Nyob rau tib lub sijhawm, kev tawm ntawm cov kua tsib mus rau hauv cov hnyuv raug thaiv, thiab hauv cov neeg mob, yellowness ntawm daim tawv nqaij thiab qhov muag dawb tshwm. Ntxiv nrog rau cov tsos mob no, muaj lwm cov cim qhia tias polyp tuaj yeem loj hlob hauv lub gall:
- mob mob;
- raum colic;
- xeev siab (tshwj xeeb thaum sawv ntxov);
- iab hauv qhov ncauj;
- plab zom mov.
Qhov ua rau tus kab mob tuaj yeem yog o ntawm lub gallbladder thiab nws cov mucosa, cov metabolism tsis zoo, khoom noj khoom haus tsis zoo, kev xeeb tub.
Kev kuaj mob yog nqa tawm siv ultrasound, ultrasound. Kev kho mob feem ntau yog phais, suav nrog kev tshem tawm ntawm lub gallbladder. Tsuas yog qee zaum, tus kws kho mob yuav muab tshuaj es tsis txhob phais - "Ursosana" lossis "Ursofalk".
Kev kho mob
Nyob ntawm qhov chaw, qhov loj me thiab lwm yam ntxwv, tus kws kho mob tau sau cov kev kho mob ntawm adenomatous polyp. Yog tias pom nyob rau hauv lub plab, tsuas yog kev kho mob phais nkaus xwb, vim tias tsis muaj tshuaj yuav ua rau polyp loj hlob tuaj. Cov ntsiav tshuaj tsuas yog luv luv txhim kho tag nrho cov duab, tab sis tsis txo qis kev pheej hmoo ntawm neoplasm degeneration mus rau mob qog noj ntshav. Thaum kuaj pomib leeg polyp raug tshem tawm nkaus xwb, thiab yog tias pom muaj ntau qhov kev loj hlob, kev phais plab.
Lwm txoj kev kho mob yog polypectomy siv lub endoscope. Nws yog qhia rau qia polyps los ntawm 0.5 cm loj thiab muaj nyob rau hauv lawv tshem tawm nrog ib tug hlau voj. Qee qhov xwm txheej, nws tau ua raws li tus neeg mob sab nraud. Yuav tsum muaj biopsy tom qab ua haujlwm no. Tib txoj kev ntawm kev kho mob ntawm polyps nyob rau hauv cov hnyuv thiab cov hnyuv. Hauv qhov quav, yog tias pom adenoma nyob deb li ntawm 10 cm ntawm lub qhov quav, nws yuav raug muab tshem tawm hauv zos tshuaj loog.
Kev loj hlob me me raug tshem tawm los ntawm electrocoagulation.
Ntawm cov kev kho mob niaj hnub no, raws li kev qhia, kev tshem tawm ntawm polyps nrog lub laser, hluav taws xob impulses lossis xov tooj cua tsis muaj peev xwm muab tau.
Txawm li cas los xij, tom qab kis tau tus mob, tus neeg mob tau noj zaub mov nruj.
Nws ntseeg tias benign polyps hauv txoj hnyuv tuaj yeem kho nrog celandine enemas, uas yuav tsum tau ua 25-30 ib chav kawm. Cov tshuaj yog npaj raws li nram no: twist 50 grams ntawm ntsuab nplooj thiab stems nyob rau hauv ib tug nqaij grinder, ncuav 300 ml ntawm boiling dej, tos kom txog thaum nws txias, lim. 2 teev ua ntej kho enema, ntxuav lub enema. Tus neeg mob yuav tsum khaws cov tshuaj celandine hauv nws tus kheej txog li 1.5 teev, thiab cov menyuam yaus - txog li 30 feeb. Cov txheej txheem tau ua txhua hnub.
Ib qho tseem ceeb: rau ntau tus neeg mob, txoj kev no tsis tau ua pov thawj rau nws tus kheej, thiab lawv yuav tsum tau mus phais kom tshem tawm cov polyps uas tau tsim los ua cov qog nqaij hlav.
