Hauv cov tshuaj niaj hnub no, feem ntau siv cov ntawv luv uas tsis meej meej rau ib tus neeg tsis muaj zib ntab. kev kawm. Ib qho ntawm cov ntawv luv luv no yog BPH. Nws yog dab tsi? Hais lus ntawm cov kws kho mob, qhov no yog benign prostatic hyperplasia. Tab sis nyob rau hauv cov neeg nws yog hu ua ntau yooj yim - prostate adenoma (ib tug variant ntawm "prostate adenoma" yog ua tau). Feem ntau, prostate adenoma tsis meej pem nrog cov kab mob xws li prostatitis. BPH yog ib qho benign tsim, thiab nws loj hlob tsis yog tsis muaj kev koom tes ntawm stromal tivthaiv ntawm prostate (nyob rau hauv lwm yam lus, glandular epithelium), thiab prostatitis yog tsis muaj dab tsi ntau tshaj li o ntawm lub caj pas prostate. Tsis txhob nkim lawv.
BPH. Nws yog dab tsi? Statistics
Raws li tau hais los saum no, BPH yog ib qho benign neoplasm. Nrog nws, me me nodules tsim nyob rau hauv lub prostate (lub npe luv ntawm tib prostate caj pas), uas, thaum lawv loj hlob, nyem lub urethra ntau thiab ntau.
Vim qhov no, ib tug txiv neej tsim kev tso zis. Tus kab mob no muaj kev loj hlob zoo, thiab qhov no yog qhov txawv ntawm BPH los ntawm kev mob qog noj ntshav.
BPH yog ib qho ntawm feem ntauCov kab mob hauv urology niaj hnub no. Raws li kev txheeb cais, nws tshwm sim hauv yuav luag 80 feem pua ntawm cov txiv neej hauv hnub nyoog laus. Hauv 20 feem pua ntawm cov neeg mob, tsis yog BPH, muaj atrophy ntawm lub caj pas lossis nws qhov loj.
kab mob BPH feem ntau tshwm sim hauv cov txiv neej tshaj 45.
Ntau tshaj li ib nrab ntawm cov txiv neej hnub nyoog 40 txog 50 mus rau tus kws kho mob tshwj xeeb uas muaj tus kab mob no, thiab tsuas yog qee zaus tus kab mob no kis tau tus hluas.
Ua rau BPH
Txog hnub tim, qhov tseeb ua rau kev loj hlob ntawm BPH ntawm prostate caj pas tsis tuaj yeem qhia tau, vim lawv tsuas yog tsis tau piav qhia tag nrho. Nws ntseeg hais tias tus kab mob no yog ib qho ntawm cov cim qhia ntawm menopause.
Tsuas yog yam txaus ntshai yog theem ntawm androgens hauv cov ntshav thiab tus neeg lub hnub nyoog.
Feem ntau, raws li ib tug txiv neej muaj hnub nyoog, qhov sib npaug ntawm cov tshuaj estrogens thiab androgens maj mam cuam tshuam, uas ua rau muaj kev ua txhaum ntawm kev tswj hwm kev loj hlob thiab kev ua haujlwm ntawm cov qog hlwb.
Nws paub tias tsis muaj kev sib txuas ntawm BPH ntawm prostate thiab ib tus neeg txoj kev sib deev, kev taw qhia, tus cwj pwm tsis zoo, kev sib deev thiab kab mob sib kis, thiab tsis muaj ib qho ntawm cov saum toj no cuam tshuam rau qhov pib ntawm tus kab mob.
Pathogenesis
BPH ntawm prostate feem ntau tshwm sim hauv nws qhov nruab nrab, tab sis qee zaum nws tuaj yeem ntes cov lobes sab nraud. Kev loj hlob ntawm benign hyperplasia nyob ntawm qhov loj hlob adenomatous (cov qog) ntawm cov qog paraurethral. Li nolub caj pas nws tus kheej cov ntaub so ntswg yog tsiv tawm sab nraud, thiab ib lub tshuaj ntsiav yog tsim nyob ib ncig ntawm lub loj hlob adenoma.
Hyperplastic (uas yog, cuam tshuam los ntawm cov qog) cov hlwb ntawm cov ntaub so ntswg prostate kuj zoo li loj hlob mus rau lub qhov quav thiab lub zais zis, thiab qhov no ua rau lub zais zis sab hauv hloov mus rau sab saud thiab ntev mus rau sab nraub qaum. urethra.
Muaj ntau hom hyperplasia raws li hom kev loj hlob:
- Subvesical daim ntawv ntawm BPH. Nws yog dab tsi? Nyob rau hauv tus kab mob no, cov qog loj hlob mus rau lub qhov quav.
- Intravesical daim ntawv ntawm BPH. Cov ntaub ntawv keeb kwm yog cim los ntawm kev loj hlob ntawm cov qog mus rau lub zais zis.
- Retrotrigonal daim ntawv ntawm BPH. Cov qog nyob rau hauv cov ntaub ntawv no yog nyob ncaj qha rau hauv daim duab peb sab ntawm tib neeg lub zais zis.
Ntau zaus, ntau hom BPH tuaj yeem pom hauv ib tus neeg tib lub sijhawm. Qhov no tshwm sim thaum lub qog loj hlob nyob rau hauv ob peb txoj kev ib zaug.
BPH tsos mob
Cov tsos mob ntawm tus kab mob no ncaj qha nyob ntawm qhov chaw ntawm cov qog, nws qhov kev loj hlob thiab qhov loj me, nrog rau qib ntawm lub zais zis tsis ua haujlwm.
BPH ntawm prostate tuaj yeem muab faib ua peb theem:
- Kev them nyiaj, lossis thawj theem. Daim ntawv no ntawm tus kab mob no tshwm sim los ntawm kev ncua sij hawm ntawm qhov pib tso zis (nquag ntuav kom npliag, tshwj xeeb tshaj yog thaum hmo ntuj, yog cov tsos mob sib txuam). Nrog BPH 1 degree, lub caj pas prostate nce hauv qhov loj, muaj qhov ntom ntom ntomsib xws. Nws cov ciam teb tau qhia meej meej, thiab feem ntau, palpation ntawm lub caj pas (thiab nws qhov nruab nrab sulcus) tsis mob. Nyob rau theem ntawm tus kab mob no, lub zais zis tseem nkim tag nrho, thiab tsis muaj cov zis seem. Qib 1 BPH tuaj yeem nyob ntawm ib mus rau peb xyoos.
- Subcompensated, lossis theem thib ob. Raws li cov qog loj hlob tuaj, nws compresses lub urethra ntau dua, thiab lub zais zis tsis tuaj yeem ua haujlwm li qub thiab khoob kiag li (nws cov phab ntsa tuab). Raws li qhov tshwm sim, nrog qib 2 BPH, cov zis seem tshwm sim, vim tias tus neeg mob xav tias lub zais zis tsis tiav. Vim yog nyem ntawm cov urethra, cov neeg mob tso zis me me, thiab tom qab ib pliag, cov zis pib tawm tsis tuaj yeem (vim qhov no yog lub zais zis ntau dhau). Qib 2 BPH qee zaum nrog cov tsos mob ntawm lub raum tsis ua haujlwm ntev (tsim tawm tsam nws keeb kwm yav dhau los).
- Decompensated, lossis theem peb. Lub zais zis zoo heev vim yog cov zis seem, cov urethra tseem nyem, thiab cov zis tso tawm los ntawm kev poob qis, qee zaum txawm tias muaj cov ntshav sib xyaw. Nyob rau theem no, BPH ua rau lub raum tsis ua haujlwm (lub raum tsis ua haujlwm). Kuj tseem muaj kev qaug zog, poob hnyav, tsis qab los noj mov, cem quav, anemia, qhov ncauj qhuav.
Kev kuaj kab mob
Lub hauv paus rau kev kuaj mob yog cov yam ntxwv tsis txaus siab ntawm cov txiv neej, rau qhov tshwj xeeb ntsuas rau kev ntsuas cov tsos mob ntawm prostate adenoma (raws liLus Askiv I-PSS). Hauv paus, kev kuaj mob ntawm BPH yog ua tom qab kev kuaj mob ntawm tus neeg mob, nrog rau cov kev tshawb fawb hauv qab no:
- Palpatory (ntiv tes) txoj kev ntsuas lub qhov quav rau kev kuaj lub caj pas prostate. Ua tsaug rau nws, cov kws kho mob muaj lub tswv yim txog qhov sib xws thiab qhov loj ntawm lub qog, muaj hwj txwv ntawm nws cov lobes, nrog rau qib ntawm qhov mob ntawm palpation.
- Kev tshawb fawb ntawm BPH. Nws yog dab tsi? Ua ntej ntawm tag nrho cov, qhov no yog ib tug paub txog kev kuaj zis. Lawv kuj tau kuaj ntshav biochemical, uas txiav txim siab qib PSA (sawv rau prostate tshwj xeeb antigen).
- Instrumental method. Feem ntau yog cystoscopy thiab ureteroscopy. Nrog lawv cov kev pab, koj tuaj yeem tshawb xyuas qhov patency ntawm cov urethra, qhov xwm txheej ntawm lobes ntawm lub caj pas thiab lub caj dab ntawm lub zais zis. Cov txheej txheem no tuaj yeem txiav txim siab qhov ntim ntawm cov zis seem.
- Ultrasound. Qhov no kuj yog ib yam ntawm cov cuab yeej cuab tam txoj kev uas tso cai rau koj mus saib qhov loj ntawm txhua lobe ntawm lub caj pas, nws tus mob (lub xub ntiag ntawm pob zeb, nodular formations). Ntxiv nrog rau cov pa ultrasound, TRUS (transrectal) kuj tseem siv.
- X-ray txoj kev tshawb fawb. Excretory urography (nrog qhov sib piv) thiab cov duab hluav taws xob (tsis muaj qhov sib txawv) tuaj yeem pab txiav txim siab qhov muaj teeb meem ntawm BPH uas tau kho. X-ray yog siv los nrhiav pob zeb hauv lub zais zis thiab ob lub raum.
kho BPH
Tam sim no, muaj ntau txoj hauv kev los kho tus kab mob, txhua qhov ua tau zoo ntawm ntau theemBPH. Kev kho mob ntawm tus kab mob no tuaj yeem muab faib ua peb ntu:
- kev kho mob
- Kev phais txoj kev kho mob
- Lwm yam kev kho tsis yog phais
Kev kho mob feem ntau yog muab rau thawj zaug ntawm BPH.
Nyob rau theem pib ntawm prostate BPH, kev kho mob yog tsom rau txo qis kev loj hlob ntawm cov ntaub so ntswg hyperplastic prostate, txhim kho cov ntshav ncig hauv cov nruab nrog cev, txo qhov mob ntawm prostate thiab zais zis, tshem tawm cov zis stasis, tshem tawm cem quav, thiab ua kom yooj yim. tso zis.
Ntxiv rau kev siv tshuaj, tus neeg mob tau pom zoo kom ua raws li kev ua neej nyob hauv mobile, tso cawv thiab ua rau muaj kev phom sij (rog dhau, ntsim, ntsim) zaub mov, haus luam yeeb.
Koj yuav tsum txo koj cov kua dej thaum tav su, tshwj xeeb tshaj yog ua ntej pw.
Nyob rau hauv lub xub ntiag ntawm chaw kho mob thiab kuaj cov tsos mob ntawm androgen deficiency, androgen hloov kho kuj tau sau.
Ntau zaus, ua ke nrog kev kho mob hyperplasia, nws cov teeb meem raug kho - cystitis, prostatitis lossis pyelonephritis.
Qee zaum (tawm tsam keeb kwm ntawm hypothermia lossis haus dej cawv), tus neeg mob tuaj yeem ua rau mob tso zis. Hauv qhov no, tus neeg mob yuav tsum tau mus pw hauv tsev kho mob sai thiab ua rau lub zais zis catheterization.
Cia peb saib xyuas txhua yam kev kho mob.
kev kho mob
Ob hom tshuaj feem ntau yog siv los kho BPH:
- Alpha-1 blockers (xws li tamsulosin, doxazosin, lossis terazosin). Lawv qhov kev txiav txim yog tsom rau kev so cov leeg du ntawm lub caj dab prostate thiab zais zis, uas ua rau kom yooj yim dua tso zis. Qhov kev txiav txim ntawm cov tshuaj no yuav ntev lossis luv.
- Inhibitors (blockers) 5-alpha reductase (permixon, dutasteride lossis finasteride). Cov tshuaj no tiv thaiv kev tsim ntawm dihydrotestosterone (cov tshuaj lom neeg ua haujlwm ntawm testosterone) hauv lub cev ntawm tus neeg mob, yog li txo cov qog prostate.
Kev phais txoj kev kho mob
Thiab tshwj xeeb yog mob hnyav, ib qho tshuaj kho mob tsis txaus, thiab, raws li txoj cai, ib tus yuav tsum tau mus rau kev cuam tshuam kev phais. Qhov no tuaj yeem yog kev txiav tawm ntawm cov ntaub so ntswg hyperplastic (adenomectomy) lossis tag nrho resection ntawm prostate caj pas (prostatectomy).
Muaj ob hom kev phais:
- Qhib kev ua haujlwm (transvesical adenomectomy). Nrog rau qhov kev cuam tshuam no, kev nkag mus rau cov ntaub so ntswg ntawm lub qog yog tau los ntawm phab ntsa ntawm lub zais zis. Hom no yog qhov mob siab tshaj plaws, thiab tsuas yog siv rau hauv cov xwm txheej siab heev. Qhib kev phais muab kev kho kom tiav rau BPH.
- Minimally invasive phais (nyob rau hauv uas tsis muaj kev cuam tshuam kev phais). Lawv tau ua los ntawm cov cuab yeej siv video endoscopic niaj hnub, tsis muaj qhov txiav. Nkag mus rau prostate los ntawm urethra.
Muaj lwm hom kev phais uas tsis tuaj yeem piv nrog cov saum toj no. Embolization ntawm cov hlab ntsha ntawm prostate yog ib qho kev ua haujlwm uas ua los ntawm cov kws phais endovascular (cov lus piav qhia saum toj no.ua los ntawm urologists) thiab muaj nyob rau hauv blockage ntawm cov hlab ntsha ntawm prostate nrog me me hais ntawm ib tug tshwj xeeb kho mob polymer (los ntawm lub femoral hlab ntsha). Tsis tas yuav mus pw hauv tsev kho mob, kev ua haujlwm yog ua raws li kev tshuaj loog hauv zos thiab tsis raug mob.
Tom qab txhua hom kev phais yuav muaj qhov pheej hmoo me me xws li tso zis, impotence lossis urethral nruj.
kev kho tsis ua haujlwm
Kev kho tsis ua haujlwm suav nrog cov hauv qab no:
- cryodestruction;
- transurethral koob ablation;
- siab siv tsom ultrasound kho;
- microwave prostate coagulation method lossis thermotherapy;
- ntxig ntawm prostatic stents hauv thaj tsam ntawm kev nqaim;
- balloon dilatation ntawm prostate.
Post-operative period
Alas, ntawm qee theem ntawm tus kab mob, kev phais tsuas yog tsim nyog. BPH yog ib yam kab mob hnyav, thiab txawm tias tom qab phais mob, koj yuav tsum ua raws li qee txoj cai txhawm rau txhawm rau txhawm rau txhawm rau tshem tawm cov kab mob thiab tsis ua rau rov tshwm sim. Peb yam tseem ceeb uas koj yuav tsum ua raws li tom qab kev phais yog kev noj zaub mov kom zoo, noj qab nyob zoo thiab mus ntsib kws kho mob tsis tu ncua.
Kev noj zaub mov tom qab yog qhov tseem ceeb heev rau tus neeg mob, vim nws tuaj yeem pab txhawb kom rov zoo sai. Kev noj zaub mov tom qab kev ua haujlwm tsis suav nrog cov khoom noj muaj roj, cov txuj lom, cov khoom qab ntsev thiab ntsim thiab, ntawm chav kawm, cawv. Nws raug nquahu kom noj cov zaub mov uas tsis muaj rog ntaufiber ntau.
Raws li kev ua haujlwm, yog tias koj txoj haujlwm tsis koom nrog kev tawm dag zog lub cev, ces koj tuaj yeem rov qab mus rau qhov chaw ua haujlwm ob peb lub lis piam tom qab ua haujlwm. Thaum ua haujlwm sedentary, nws raug nquahu kom ua qhov sov so txhua ib nrab teev. Kev ua neej nyob sedentary tuaj yeem ua rau stagnation ntawm cov ntshav hauv lub cev, uas tus kab mob tsuas yog zuj zus. Thawj ob peb hnub tom qab kev phais, tsis txhob xav txog kev nqa qhov hnyav!
Txhob haus luam yeeb yam tsawg kawg ntawm lub sijhawm tom qab phais (ob lub lis piam tom qab kev phais) yog tias koj tsis tuaj yeem txiav qhov kev quav yeeb quav tshuaj tag. Nicotine ua rau cov phab ntsa ntawm cov hlab ntsha puas, thiab qhov no cuam tshuam rau kev ncig ntawm prostate, uas ua rau muaj cov txheej txheem inflammatory.
Ntau tus neeg xav tias tom qab tshem BPH, koj yuav tsum tsis nco qab txog kev sib deev mus ib txhis. Qhov kev xav no yog qhov yuam kev, thiab kev ua haujlwm ntawm kev sib deev ntawm ib tug txiv neej tau rov qab ua tiav tom qab ib ntus. Txawm li cas los xij, nws tsim nyog rov pib kev sib deev tsis pub dhau 4 lub lis piam tom qab ua haujlwm.
Lwm cov lus qhia tsim nyog yuav tsum tau them rau: koj tsis tuaj yeem tsav tsheb mus txog ib hlis tom qab tshem tawm BPH.
Feem ntau, lub sijhawm tom qab phais yuav kav ntev li ib hlis, tom qab ntawd tus neeg mob tuaj yeem rov ua lub neej zoo li qub. Txawm li cas los xij, cov kws tshaj lij pom zoo kom ua lub neej noj qab haus huv los tiv thaiv tus kab mob rov qab los.
tso zis tom qab phais
Yuav luag tam sim tom qab kev ua haujlwm, cov zis tso zis yuav muaj zog dua, thiab lub zais zis yooj yim dua. Tom qab tshem tawm cov catheterQee lub sij hawm, qhov mob yuav tshwm sim thaum tso zis, yog vim li cas qhov no yog qhov tso zis los ntawm qhov chaw phais.
Cov kws kho mob tshwj xeeb tsis suav nrog qhov tshwm sim ntawm urinary incontinence lossis ceev ceev kom tso zis nyob rau lub sijhawm tom qab phais, cov xwm txheej no zoo li qub. Qhov ntau koj cov tsos mob thab koj thaum koj muaj mob, koj lub sijhawm rov qab yuav ntev dua. Sij hawm dhau mus, txhua yam teeb meem yuav ploj mus thiab koj yuav rov qab mus rau lub neej zoo li qub.
Qee lub sij hawm tom qab kev cuam tshuam, tej zaum yuav muaj cov ntshav txhaws hauv cov zis. Qhov tshwm sim no cuam tshuam nrog kev kho qhov txhab. Nws raug nquahu kom haus dej kom ntau li ntau tau kom yaug lub zais zis kom zoo. Tab sis nrog los ntshav hnyav, koj yuav tsum hu rau tus kws kho mob tam sim ntawd.
Huab cua
Kev tso zis ntev ntev (yog tias tsis kho BPH) tuaj yeem ua rau urolithiasis, uas cov pob zeb tsim hauv lub zais zis, thiab tom qab kis kab mob. Hauv qhov no, qhov teeb meem loj tshaj plaws uas tus neeg mob tuaj yeem xav tau yam tsis muaj kev kho mob zoo yog pyelonephritis. Tus kab mob no ua rau lub raum tsis ua haujlwm ntxiv.
Tsis tas li ntawd, prostate adenoma tuaj yeem ua rau muaj kev loj hlob tsis zoo - mob qog noj ntshav prostate.
Kev soj ntsuam nrog kev kho mob raws sijhawm thiab kho tau zoo heev.
tiv thaiv kab mob
Kev tiv thaiv zoo tshaj plaws ntawm BPH yog kev soj ntsuam tas li nrog cov kws kho mob tshwj xeeb thiab kho raws sijhawm ntawm prostatitis.
Nws kuj tsim nyog noj txoj cai (txocov khoom noj kib, qab ntsev, nrog rau ntsim, ntsim thiab haus luam yeeb), txwv tsis pub haus luam yeeb thiab dej cawv. Feem ntau, kev ua neej nyob noj qab haus huv txo qis kev pheej hmoo ntawm BPH.
Tam sim no koj paub tias BPH yog dab tsi. Cov cim qhia ntawm tus kab mob no, kev kho mob, lub sijhawm tom qab phais thiab kev tiv thaiv txawm tias tau piav qhia saum toj no.
Txawm li cas los xij, qhov kev paub no yuav pab tau rau koj. Noj qab nyob zoo!
