Mob qog noj ntshav Prostate: cov tsos mob, kev kho mob, ua rau thiab theem

Cov txheej txheem:

Mob qog noj ntshav Prostate: cov tsos mob, kev kho mob, ua rau thiab theem
Mob qog noj ntshav Prostate: cov tsos mob, kev kho mob, ua rau thiab theem

Video: Mob qog noj ntshav Prostate: cov tsos mob, kev kho mob, ua rau thiab theem

Video: Mob qog noj ntshav Prostate: cov tsos mob, kev kho mob, ua rau thiab theem
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Raws li kev txheeb cais, mob qog noj ntshav prostate tau kuaj pom hauv 14% ntawm cov neeg mob. Feem ntau, pathology raug kuaj pom hauv cov txiv neej tom qab 50 xyoo. Nws kuj yog qhov ua rau tuag ntawm cov neeg sawv cev ntawm kev sib deev muaj zog ntawm cov laus thaum ntxov hauv 73% ntawm cov neeg mob. Cov txheeb cais tu siab no ua rau peb xav txog kev saib xyuas kev noj qab haus huv thiab kev ua haujlwm ntawm lub caj pas prostate. Cov tsos mob thiab kev kho mob qog noj ntshav yuav tau tham hauv tsab xov xwm hnub no.

Kev piav qhia tus kab mob

Y Lub prostate yog ib lub qog endocrine uas yog ib feem ntawm kev ua me nyuam. Nws ua haujlwm ntau yam: kev tsim cov kua dej seminal, kev koom tes hauv ejaculation. Lub caj pas yog nyob rau saum lub zais zis thiab tom ntej no mus rau txoj hnyuv loj, qhwv ib ncig ntawm lub urethra. Outwardly thiab loj, nws zoo li lub walnut.

Prostate cancer yog ib hom kab mob oncological loj. malignant qognyiam faib cov metastases rau lwm lub cev. Kev loj hlob ntawm cov txheej txheem pathological yog qeeb heev thiab imperceptible. Cov tsos mob ntawm microscopic cov tsos mob ntawm neoplasm, qhov pib ntawm ib qho tseem ceeb theem yuav siv sij hawm li ntawm 10 mus rau 15 xyoo. Cov neeg mob tig mus rau tus kws kho mob nrog kev tsis txaus siab thaum nws nce mus txog qhov loj me thiab pib metastasize.

mob qog noj ntshav prostate
mob qog noj ntshav prostate

Qhov laj thawj tseem ceeb

Cov xwm txheej mob qog noj ntshav prostate sib txawv raws thaj chaw. Piv txwv li, nyob rau sab hnub tuaj thiab South Asia nws qis dua thaum piv nrog cov cheeb tsam nyob sab Europe. Cov kws kho mob tseem tsis tuaj yeem txiav txim siab qhov tseeb ntawm kev txhim kho pathology. Txawm li cas los xij, kev tshawb fawb paub cov kev pheej hmoo tseem ceeb:

  1. Hnub nyoog. Hauv cov txiv neej uas muaj hnub nyoog qis dua 40 xyoo, qhov kev pheej hmoo ntawm kev tsim cov qog nqaij hlav yog tsawg. Nws nce tom qab hnub nyoog 60 xyoo. Thaum lub hnub nyoog no, oncopathology raug kuaj pom hauv txhua yim tus neeg sawv cev ntawm kev sib deev muaj zog.
  2. Heredity. Yog tias cov neeg txheeb ze tau kuaj pom tias muaj mob qog noj ntshav prostate, qhov ua rau lawv muaj mob ntau zaus. Tib lub sijhawm, nws thawj cov tsos mob tau kuaj pom ua ntej hnub nyoog 60.
  3. Kev ua neej. Cov cwj pwm phem (kev haus luam yeeb, haus cawv) tuaj yeem ua rau cov txheej txheem degeneration ntawm cov qog uas twb muaj lawm rau hauv cov txheej txheem malignant.
  4. Khoom noj. Cov nqaij liab, cov zaub mov muaj roj ntau hauv tsiaj, thiab tsis muaj fiber ntau hauv cov zaub mov tuaj yeem ua rau mob qog noj ntshav.
  5. Hormonal keeb kwm yav dhau. Muaj pov thawj ncaj qha ntawm kev sib txuas ntawm txiv neejKev sib deev cov tshuaj hormones nrog qhov tshwm sim ntawm malignant nodules nyob rau hauv cov qog nqaij hlav ntawm prostate.
  6. kab mob. Peb tab tom tham txog prostatitis, ntshav qab zib, rog.

Yog tias ib tug txiv neej poob rau hauv ib lossis ob peb pab pawg txaus ntshai ib zaug, nws yuav tsum ua tib zoo saib xyuas nws tus kheej noj qab haus huv. Kev kuaj pom tus kab mob raws sij hawm tso cai rau koj pib kho sai sai thiab kov yeej tus kab mob.

daim duab kho mob

Thaum pib, nws nyuaj heev rau kev kuaj mob qog noj ntshav prostate. Cov tsos mob ntawm tus kab mob yog tsis tuaj kawm ntawv los yog muaj ib tug latent chav kawm. Nws thawj qhov tshwm sim tau pom thaum lub neoplasm hla ciam teb ntawm cov urethra. Txawm li cas los xij, cov neeg mob tuaj yeem yws txog:

  • tso zis tsis sib haum;
  • ntau hmo thiab nruab hnub tso quav;
  • xav kom tso zis nrog mob hnyav;
  • xav tias lub zais zis tsis tiav;
  • tsis xis nyob hauv thaj tsam lumbar;
  • ntshav tso zis los yog phev.

Nrog kev nce ntxiv ntawm qhov loj ntawm neoplasm, qhov kev siv ntawm cov tsos mob tau teev tseg nce ntxiv. Thaum metastases pib nkag mus rau hauv lub cev nyob ze, cov duab kho mob hloov me ntsis. Qhov tshwm sim ntawm o nyob rau hauv ob txhais ceg qhia qhov swb ntawm malignant hlwb ntawm cov qog nqaij hlav hauv pliaj. Kev ua txhaum ntawm cov txheej txheem defecation nyob rau hauv daim ntawv ntawm cem quav qhia txog kev nkag mus ntawm metastases rau hauv qhov quav. Metastasis tuaj yeem tshwm sim hauv lub plab thiab cov plab hnyuv siab raum. Hauv qhov no, hais txog kev koom tes hauv cov txheej txheem pathological ntawm lub ntswshais tias hnoos hnyav, thiab daim siab - jaundice.

Cov tsos mob ntawm tus mob prostate
Cov tsos mob ntawm tus mob prostate

Degrees thiab theem ntawm kev txhim kho kab mob

Muaj qee qhov sib txawv ntawm ob lub ntsiab lus ntawm "theem" thiab "qib" ntawm mob qog noj ntshav. Nyob rau hauv rooj plaub tom kawg, nws yog kev cai coj cov txiaj ntsig ntawm kev tshawb fawb ntawm cov cell loj ntawm lub qog ntawm cov qib histological thiab cytological ua lub hauv paus rau kev faib tawm.

Muaj 5 qib ntawm kev mob qog noj ntshav prostate:

  • pib. Nws yog tus cwj pwm los ntawm kev hloov pauv morphological qeeb ntawm cov ntsiab lus ntawm tes.
  • Second. Hloov cov hlwb twb txawv txawv ntawm cov neeg noj qab nyob zoo. Nyob rau tib lub sijhawm, lawv cov tsub zuj zuj hauv ib cheeb tsam raug kuaj pom, thiab cov kab mob pathological tau tsim.
  • Thib peb. Cells nrog txawv morphology yog cais. Yog tias tsis kho, cov qog pib loj tuaj sai sai.
  • Plaub. Cov ntsiab lus feem ntau nyuaj rau kev sib txawv.
  • Thib tsib. Lub cell loj tsis txawv, yog atypical kiag li.

Thaum xav tias mob qog noj ntshav prostate, theem ntawm tus kab mob kuj tseem ceeb rau kev txiav txim siab. Muaj plaub tag nrho:

  1. Kev hloov pauv tsuas yog kuaj pom ntawm qib microscopic tom qab kuaj pom ntawm lub cev. Ultrasound thiab palpation tsis pub kuaj tus kab mob.
  2. Nyob rau theem ob, cov kab mob tuaj yeem kuaj pom los ntawm ultrasound. Cov node tseem txwv rau cov tshuaj ntsiav, thiab qhov loj ntawm neoplasm tsis mus dhau ntawm lub cev.
  3. theem thib peb yog txiav txim siab los ntawm kev tawm ntawm cov qog tawm sab nraud. Muaj feem ntau ntawm kev tshawb pom ntawm metastases hauv lub zais zis thiab qhov quav.
  4. theem kawg yog piv rau qib 4 mob qog noj ntshav prostate. Metastases tseem nquag kis thoob plaws lub cev. Tus txiv neej hnov mob tas li thaum tso zis thiab yws tias qaug zog.

Rau txoj kev kho kom zoo, tus kws kho mob yuav tsum txiav txim siab kom raug qib thiab theem ntawm kev loj hlob ntawm tus kab mob. Txoj hauv kev no tseem tso cai rau kwv yees nws cov chav kawm ntxiv.

kuaj mob qog noj ntshav
kuaj mob qog noj ntshav

Txoj kev kuaj mob

Thaum qhov kev xav tsis thoob me ntsis ntawm prostate tsis ua haujlwm, tus txiv neej yuav tsum sab laj nrog kws kho mob. Kev kuaj tus qauv pib nrog lub qhov quav palpation thiab kuaj xyuas tus neeg mob keeb kwm. Nrog rau qhov loj me ntawm lub cev, ib qho kev tshuaj xyuas ntxiv yog muab - ntsuas qhov concentration ntawm prostate specific antigen (PSA) hauv cov ntshav. Nws ua raws li hom kab mob qog noj ntshav. Kev kuaj ntshav yog txoj kev kuaj mob tshaj plaws. Tsis tas li ntawd, ultrasound thiab MRI ntawm prostate yog sau.

Tsuas yog ib qho biopsy tuaj yeem lees paub qhov kev kuaj zaum kawg. Cov txheej txheem no suav nrog kev siv rab koob tshwj xeeb uas tau muab tso rau hauv qhov quav. Nrog kev pab ntawm nws, tus kws kho mob siv cov ntaub so ntswg los ntawm neoplasm rau kev tshawb fawb ntxiv hauv chav kuaj. Txoj kev kuaj no muaj kev phiv - qhov tsos ntawm cov ntshav impurities hauv cov phev thiab zis. Feem ntau, cov teeb meem no yuav tsum dhau ob peb hnub. Txawm li cas los xij, qhov yuav tshwm sim ntawm qhov mob ntawm qhov chaw biopsy yog qhov siab heev.

pes test
pes test

kev xaiv kho mob

Kev xaiv kev kho mob qog noj ntshav prostate yog nyob ntawm tus kws kho mob. Hauv qhov no, tus kws kho mob yuav tsum coj mus rau hauv tus account ntau yam: lub hnub nyoog ntawm tus neeg mob, qib ntawm kev loj hlob ntawm pathology, muaj metastases, thiab lwm yam.

Tib algorithm tsis muaj nyob. Feem ntau, kev phais tshem tawm ntawm neoplasm yog pom zoo yog tias tsis muaj contraindications rau kev phais. Cov no muaj xws li hnub nyoog laus, muaj teeb meem concomitant ntawm ib feem ntawm lub hauv nruab nrab paj hlwb thiab vascular system. Txwv tsis pub, qhov kev cuam tshuam yuav ua rau muaj kev phom sij ntau dua rau tus neeg mob dua li txo nws qhov mob. Nyob rau theem 1-2 oncology, radical kho txoj kev tsis tas yuav tsum tau. Nyob rau hauv cov ntaub ntawv no, tshuaj kho mob yog dispensed nrog. Cov ntsiab lus ntxiv txog txhua txoj kev kho mob qog noj ntshav prostate yuav piav qhia hauv qab no.

Surgery

Cov txheej txheem tshem tawm cov neoplasm tuaj yeem ua tau ob txoj hauv kev: phais plab lossis laparoscopy.

Thawj zaug, tus kws kho mob ua ib qho kev phais me me hauv plab plab, cais cov qog los ntawm lub zais zis thiab excised. Nyob rau tib lub sijhawm, cov hlab ntsha lub luag haujlwm rau erection yog khaws cia. Tom qab ntawd, los ntawm kev siv catheter, lub urethral stump txuas nrog lub zais zis, uas tau muab tshem tawm tom qab 2 lub lis piam. Cov txheej txheem zoo li no feem ntau nrog cov teeb meem hauv daim ntawv ntawm cov zis incontinence, impotence.

Cov kws kho mob niaj hnub no nyiam txoj kev laparoscopic los tshem tawm cov qog nqaij hlav prostate. Kev ua haujlwm yog tus cwj pwm los ntawm kev raug mob tsawg thiab lub sijhawm rov qab sai. Thaum lub sij hawm tus txheej txheem, ob pebpunctures nyob rau hauv lub plab kab noj hniav, los ntawm cov cuab yeej rau kev phais manipulations yog ces muab tso rau. Txawm li cas los xij, nws tsuas yog ua tau thaum tsis muaj metastases.

Kev kho mob qog noj ntshav prostate
Kev kho mob qog noj ntshav prostate

Tshuaj siv tshuaj

Cov txiv neej laus uas muaj contraindications rau kev phais yog muab tshuaj kho nrog kev siv tshuaj hormonal. Txoj kev no ua rau lub neej ntev ntawm tus neeg mob nrog cov ntaub ntawv mob qog noj ntshav nrog metastases. Nws lub hom phiaj tseem ceeb yog txo qis qib siab ntawm androgens artificially.

Kev kho tshuaj hormone suav nrog cov tshuaj hauv qab no:

  1. Cov tshuaj uas thaiv kev tsim cov testosterone ("Triptorelin", "Goselerin"). Lawv raug qhia ib zaug txhua 30 hnub, tab sis qee zaus tsawg dua.
  2. Antiandrogens uas nres qhov kev txiav txim ntawm testosterone ntawm prostate ("Flutamide", "Nilutamide"). Thawj 4 lub hlis ntawm kev kho mob, cov nyiaj no raug sau ib txhij nrog agonists. Lawv siv feem ntau tso cai rau koj kom txuag libido thiab erectile muaj nuj nqi.
  3. Estrogens. Kev siv tshuaj los ntawm cov pab pawg no yog cov yam ntxwv ntawm kev ua haujlwm siab, tab sis kuj tuaj yeem ua rau muaj kev phiv. Peb tab tom tham txog myocardial infarction, cuam tshuam ntawm lub plab zom mov, thromboembolism.

Cov tshuaj niaj hnub tsis xav tias nws tsim nyog siv cov tshuaj hormones kho thaum ntxov ntawm kev mob qog noj ntshav, vim qhov no nws cov txiaj ntsig zoo sib npaug rau xoom.

hormonal kev kho mob rau prostate cancer
hormonal kev kho mob rau prostate cancer

Tshuaj khomob

Nyob rau theem siab ntawm mob qog noj ntshav prostateCov qog nqaij hlav nrog metastases tau kho nrog tshuaj kho mob. Nws txoj kev pab kuj yog siv rau qhov tsis txaus ntseeg ntawm cov qog rau cov tshuaj hormonal, rov ua dua tom qab phais. Kev kho mob suav nrog kev siv tshuaj nrog cov tshuaj lom hauv cov khoom xyaw, uas thaiv kev loj hlob ntawm cov qog nqaij hlav cancer. Ib zaug hauv lub cev, lawv cov khoom tau nqa mus thoob plaws lub cev nrog rau cov hlab ntsha thiab pom cov metastases nyob deb tshaj plaws.

Txawm li cas los xij, lawv kuj muaj kev cuam tshuam rau lub cev ib txwm muaj. Cov kws tshawb fawb tseem tsis tau muaj peev xwm los tsim cov tshuaj universal nrog cov nyhuv xaiv. Yog li ntawd, cov neeg mob tom qab ib chav kawm ntawm chemotherapy feem ntau tsim cov tsos mob ntawm intoxication (zaub mov, xeev siab nrog ntuav, anemia, plaub hau poob). Nws yog nqa tawm nyob rau hauv lub voj voog ntawm 3 mus rau 6 lub hlis, tom qab lub sij hawm muab rau lub cev kom rov zoo.

Radiotherapy

Radiation los yog xov tooj cua yog siv los txo tus nqi ntawm kev faib cov khoom phem. Txawm li cas los xij, txoj kev kho tom kawg tsis yog kev lees paub ntawm tus neeg mob txoj kev rov zoo. Yog li ntawd, nws yog siv ua ke nrog tshuaj hormonal.

Lwm txoj hauv kev ntawm kev puas tsuaj ntawm cov kab mob pathological nyob rau hauv thawj theem ntawm prostate cancer yog brachytherapy. Nws yog ua raws li kev taw qhia ntawm radioactive iodine rau hauv lub cev. Tag nrho cov txheej txheem yog nqa tawm raws li kev tswj ntawm lub tshuab ultrasound. Vim muaj qhov raug mob hauv cheeb tsam, theem ntawm cov hluav taws xob nce tsuas yog nyob rau hauv qhov txhab, thiab cov ntaub so ntswg noj qab haus huv tseem tsis zoo. Cov txheej txheem yog ua raws li tus neeg mob sab nraud thiab siv sijhawm tsis pub dhau ib teev.

Kev ntsuas kom rov zoo

Raws li kev txheeb caiscov kev tshawb fawb, txhua txhua xya tus neeg sawv cev ntawm kev sib deev muaj zog tom qab 50 xyoo muaj mob qog noj ntshav prostate. Cov tsos mob ntawm tus kab mob no nyob ntawm nws theem. Nyob rau hauv thawj theem, yog tias tus neeg mob ua raws li tag nrho cov kws kho mob cov lus pom zoo, qhov kev muaj sia nyob tsib xyoos yog 100%. Nyob rau theem ob, daim duab no qis dua me ntsis - 85%. Nyob rau hauv cov ntaub ntawv ntawm cov qog loj hlob sab nraum lub cev, tsuas yog txhua tus neeg mob thib ob tuaj yeem cia siab rau qhov txiaj ntsig zoo. Nrog rau cov kab mob metastases thiab cov kab mob hnyav heev, cov neeg mob nyob tsis pub dhau peb xyoos.

prognosis kom rov zoo
prognosis kom rov zoo

Txoj Kev Tiv Thaiv

Thaum cov tsos mob ntawm tus mob qog nqaij hlav prostate tshwm sim, kev kho mob yuav tsum pib tam sim ntawd. Tsuas yog nyob rau hauv rooj plaub no peb tuaj yeem cia siab rau qhov txiaj ntsig zoo. Yuav tiv thaiv kev loj hlob ntawm tus kab mob li cas?

Tsis muaj kev tiv thaiv tshwj xeeb. Txawm li cas los xij, kev pheej hmoo ntawm kev mob yuav txo qis yog tias ib tus neeg:

  • saib xyuas koj cov zaub mov;
  • zam kev raug tshuaj lom;
  • noj qab nyob zoo;
  • muaj kev sib deev tsis tu ncua.

Nws tseem ceeb heev uas yuav tsum tau kuaj tag nrho nrog tus kws kho mob urologist ib ntus.

Pom zoo: