Uterine fibroids yog ib qho tshuaj hormone-dependent benign tsim uas tshwm rau ntawm cov leeg nqaij ntawm lub tsev menyuam hauv cov menyuam ntxhais hnub nyoog me nyuam.
Myoma yog suav tias yog hom qog nqaij hlav tshaj plaws ntawm cov poj niam cev xeeb tub. Cov qog ntawm lub tsev menyuam muaj ntau heev, tshwj xeeb tshaj yog cov poj niam hnub nyoog 30-45 xyoo. Puas yog uterine fibroids txaus ntshai? Qhov no yuav tham hauv qab no.
Nws yog ib puag ncig kev loj hlob hu ua fibroids.
Uterine fibroids kuaj pom. Yuav ua li cas? Ntau tus neeg txaus siab rau lo lus nug no. Hom uterine fibroids thiab lawv qhov chaw nyob yuav tau tham hauv kab lus no. Tus kab mob no yog dab tsi?
Kev faib tawm
Uterine fibroids yog benign o ntawm cov leeg nqaij thiab cov nqaij sib txuas. Qhov loj ntawm cov qog tuaj yeem sib txawv ntawm ob peb millimeters mus rau ib nrab ib 'meter' inch. Fibroids hnyav tshaj cuaj kilograms tau sau npe hauv kev kho mob.
Nyob rau hauv uterine fibroids, cov ntxhais uas tsis yog tshwj xeeb thiab kws kho mob (kom yooj yim rau tus neeg mob nkag siab txog tus kab mob) txhais tau tias ntau yam benign neoplasms ntawm lub tsev menyuam. Cov qog tuaj yeem cuam tshuam rau cov ntaub so ntswg sib txawvlub cev no. Nyob ntawm qhov chaw ntawm qhov chaw, cov neoplasm raug cais raws li hauv qab no:
- Leiomyoma yog tsim nyob rau hauv cov leeg nqaij ntawm lub tsev menyuam.
- Fibroma - tsim los ntawm cov ntaub so ntswg sib txuas, yog qhov tsawg heev.
- Rhabdomyoma is a benign neoplasm tsim los ntawm cov leeg nqaij striated.
- Angiomyoma yog ib qho neoplasm ntawm cov leeg nqaij nrog lub network zoo ntawm cov hlab ntsha.
Raws li localization, muaj xws li kev faib tawm ntawm uterine fibroids:
- Intramuscular lossis intermuscular qog tshwm hauv nruab nrab cov leeg nqaij.
- Subperitoneal lossis subserous qog loj hlob hauv qab serosa, sab nraud ntawm lub cev.
- Submucosal lossis submucosal qog nyob hauv lub tsev menyuam, hauv qab cov mucous.
Kev faib tawm ntawm uterine fibroids los ntawm tus lej ntawm neoplasms:
- Ib leeg qog yog ib thaj chaw myomatous. Qhov loj ntawm cov node, raws li txoj cai, nws txawv ntawm ob peb millimeters mus txog 8-10 centimeters, tsis tshua muaj ntau.
- Ntau lossis ntau lub uterine fibroids, muaj ob lossis ntau dua myomatous neoplasms, qee qhov muaj qhov txawv txav "pob hauv ib lub pob".
Yog vim li cas
Dab tsi yog tus provocateur ntawm cov tsos mob ntawm pathology? Qhov laj thawj tseem ceeb ntawm uterine fibroids yog ib qho teeb meem ntawm kev ua haujlwm hormonal ntawm zes qe menyuam, uas tsim cov tshuaj estrogen ntau dhau. Nws tau lees paubQhov tseeb tias kev siv cov tshuaj tiv thaiv hormonal nrog rau feem tseem ceeb ntawm cov tshuaj estrogen ua rau muaj kev nce ntxiv hauv uterine fibroids, thiab, qhov kawg, qhov kawg ntawm kev tsim cov tshuaj estrogen hauv postmenopause ua rau nws regression thiab ploj. Tab sis lub sijhawm ntawm qhov tshwm sim ntawm uterine fibroids hauv cov ntxhais uas muaj keeb kwm hormonal ib txwm paub.
Lwm yam ua rau uterine fibroids yog kev phais ntawm cev xeeb tub, cev xeeb tub thiab yug me nyuam, adenomyosis (endometriosis) ntawm lub tsev menyuam, inflammatory kab mob ntawm cov hlab ntsha thiab zes qe menyuam, cysts zes qe menyuam, tsis muaj cev xeeb tub thiab yug menyuam hauv ib tug ntxhais dhau. Peb caug xyoo, rog rog, caj ces, tiv thaiv kab mob thiab endocrine pathologies, mus ntev insolation.
Symptoms
Feem ntau cov neeg mob fibroids tsis pom cov cim. Tus kab mob no tau kuaj pom tsis tau txog thaum kuaj gynecological lossis ultrasound. Cov tsos mob ncaj qha nyob ntawm theem ntawm uterine fibroids. Ib yam li mob qog noj ntshav, nyob rau theem pib, tus poj niam yuav tsis hnov cov tsos mob. Tab sis nrog kev loj hlob ntawm tus kab mob, lawv tau tshwm sim hnyav heev.
Cov cim qhia ntawm uterine fibroids yuav tshwm sim:
- Nyuaj thiab ntev. Cov tsos mob tshwm sim ntau dua yog qhov ntev thiab muaj zog los ntshav thaum cev xeeb tub. Nws yog vim qhov nce hauv fibroids ze rau ntawm lub tsev menyuam kab noj hniav. Lub sijhawm ib hlis yuav ntev dua li ib txwm.
- mob lub hli. Los ntshav loj thiab txhaws tuaj yeem ua rau mob hnyav thiab mob thaum cev xeeb tub. Qhov tseem ceeb fibroidstuaj yeem ua rau muaj ntshav siab thiab mob hauv plab lossis sab nraub qaum, lawv pib thaum nruab nrab ntawm kev coj khaub ncaws thiab zoo ib yam li cov kab mob ib txwm muaj nyob rau hauv rooj plaub no.
- tso zis tsis yooj yim. Ib qho fibroid loj tuaj yeem nias rau ntawm lub zais zis thiab tso zis, ua kom cov zis tso zis sai, tshwj xeeb tshaj yog thaum hmo ntuj, yog tias tus ntxhais nyob hauv txoj hauj lwm supine. Fibroids tuaj yeem ua rau lub siab ntawm cov ureters, uas tuaj yeem cuam tshuam los yog thaiv cov zis ntawm cov zis.
- Kev cem quav. Lub siab ntawm fibroids ntawm lub qhov quav tuaj yeem ua rau cem quav.
- Mob thaum sib deev.
- Kev loj hlob ntawm lub tsev menyuam thiab plab. Qhov o loj heev tuaj yeem ua rau lub plab loj tuaj thiab ua rau muaj kev xav hnyav lossis siab.
kuaj gynecological thiab keeb kwm noj
Tus kws kho mob tuaj yeem txheeb xyuas qee hom fibroids thaum lub sijhawm kuaj gynecological. Thaum lub sijhawm teem tseg, cov lus nug yuav raug nug txog lub neej zoo ntawm tus neeg mob, txog lub sijhawm thiab qhov tshwm sim ntawm kev coj khaub ncaws.
YUltrasound
Ultrasound yog suav tias yog ib qho kev kuaj pom zoo los kuaj pom uterine fibroids. Kev kuaj suab tuaj yeem ua tau ob qho tib si transabdominally thiab transvaginally. Nrog tus cwj pwm ntawm transabdominal ultrasound, lub tshuab ultrasound txav mus rau hauv lub plab mog. Nrog transvaginal ultrasound, cov cuab yeej tso rau hauv qhov chaw mos.
YHysterosonography
Nrog rau ultrasound, hysterosonography tuaj yeem ua tau. Thaum lub sijhawm kuaj, ultrasound yog siv nrog rau lub cevib yam khoom uas tau nkag mus rau hauv kab noj hniav ntawm lub cev txhawm rau txhim kho qhov pom ntawm lub cev. Xws li kev ntsuam xyuas muab cov duab tseeb ntau dua ntawm cov kab noj hniav, suav nrog patency ntawm cov hlab ntsha fallopian thiab muaj cov kab mob pathologies.
Hysteroscopy
Hysteroscopy ntawm uterine fibroids yog suav tias yog ib qho haujlwm uas siv los txiav txim seb muaj cov fibroids, polyps lossis lwm yam los ntshav. Nws kuj tseem siv rau hauv cov txheej txheem ntawm kev phais kom tshem tawm cov fibroids. Thaum lub sijhawm ua haujlwm, lub raj loj elastic yog siv, uas yog hu ua hysteroscope. Nws tau nkag mus rau hauv qhov chaw mos los ntawm lub ncauj tsev menyuam thiab mus txog lub cev nws tus kheej. Ua tsaug rau qhov no, tus kws tshaj lij muaj lub sijhawm los tshuaj xyuas cov kab noj hniav kom ntxaws. Hysteroscopy yog suav hais tias yog kev ua haujlwm tsis muaj kev cuam tshuam thiab tsis tas yuav muaj kev phais, tab sis qee tus ntxhais hauv lawv cov kev tshuaj xyuas qhia txog qhov mob hnyav thaum lub sijhawm ua haujlwm, vim li no siv tshuaj loog hauv zos lossis dav dav.
Laparoscopy
Nyob hauv qee qhov sib txawv, cov txheej txheem laparoscopic tau ua raws li kev kuaj mob. Los ntawm ib lub qhov me me hauv lub peritoneum, tus kws kho mob tuaj yeem kuaj xyuas cov kab noj hniav hauv lub tsev menyuam, thiab tseem kuaj xyuas sab nraud, xws li zes qe menyuam, cov hlab ntsha, thiab cov plab hnyuv siab raum. Kev soj ntsuam yog ua los ntawm kev siv ultrasound lossis lub koob yees duab yees duab.
Biopsy
Nyob rau qee kis, yuav tsum muaj kev kuaj mob endometrial txhawm rau txhawm rau tsim kom muaj cov hlwb tsis zoo nyob rau hauv ob sab ntawm lub tsev menyuam. Cov qog nqaij hlav cancer tuaj yeem qhia qhov muaj nyoboncology.
Kev kho mob
Ib tug poj niam lub hnub nyoog thiab qhov hnyav ntawm cov tsos mob yog lub hauv paus tseem ceeb ntawm kev xaiv ib txoj hauv kev kho cov uterine fibroids (cov cim qhia ntawm tus kab mob tau tham saum toj no). Ntau tus poj niam txiav txim siab tsis kho tus kab mob kom txog thaum lub cev tsis muaj zog. Cov qog loj hlob qeeb, thiab nws txoj kev loj hlob nres tom qab lub cev tsis muaj zog. Txawm li cas los xij, yog tias neoplasm ua rau mob, los ntshav, lossis nce sai, kev kho mob yog qhov tseem ceeb. Fibroids therapy npog ntau yam tshuaj thiab kev xaiv phais.
Kev kho mob tam sim no, muaj peb hom kev kho mob.
Tshaj tawm tswv yim
Qhov no tsis tas yuav kho, tshwj xeeb tshaj yog tias tus poj niam nyob ze rau lub cev tsis muaj zog lossis cov qog tsis qhib. Kev kuaj gynecological ib ntus thiab ultrasound yuav pab txiav txim seb tus kab mob puas kis tau lossis tsis.
kev kho mob
Kev kho mob suav nrog cov tshuaj hauv qab no rau uterine fibroids:
- Anti-inflammatory and painkillers.
- Cov tshuaj tiv thaiv Hormonal. Kev siv cov tshuaj tiv thaiv qhov ncauj tsis tu ncua tuaj yeem rov ua kom lub cev tsis muaj zog thiab txo qis los ntshav. Cov tshuaj siv los tswj lub cev hnyav los ntshav cuam tshuam nrog fibroids, tab sis hmoov tsis lawv tsis txo cov fibroid o. Tsis ntev los no, cov tshuaj tshiab ntawm kev noj tshuaj tiv thaiv qhov ncauj tsis tu ncua tau tshwm sim uas tuaj yeem txo cov ntshav. Lawv suppress estrogen los yog progesterone los yog ob qho tib sicov ntaub ntawv tshuaj hormones ib txhij.
- khoom siv hauv lub cev.
kev kho mob phais
Yuav ua li cas tshem tawm uterine fibroids? Txoj kev phais muaj ntau txoj hauv kev ntawm kev phais mob. Qhov no suav nrog endometrial myomectomy (tshem tawm ntawm endometrium), embolization ntawm uterine fibroids, thiab hysterectomy (tshem tawm ntawm lub cev).
Cov poj niam yuav tsum tau tham txog txhua yam kev ua haujlwm nrog tus kws kho mob tus kheej. Kev txiav txim siab txog ib txoj kev phais tshwj xeeb yog nyob ntawm qhov chaw, qhov loj me, thiab tus naj npawb ntawm fibroids. Qee qhov kev phais muaj qhov cuam tshuam loj rau koj txoj hauv kev xeeb tub thiab tsuas yog pom zoo rau cov poj niam uas muaj hnub nyoog tshaj li lawv muaj menyuam lossis cov uas tsis npaj siab yuav xeeb tub. Hauv qab no yog txoj hauv kev los tshem tawm uterine fibroids.
Myomectomy
Myomectomy - Qhov kev phais phais no yog tsom rau kev tshem tawm ntawm cov fibroids nkaus xwb. Lub tsev menyuam tsis cuam tshuam, raws li qhov tshwm sim ntawm qhov uas nws hloov tawm los khaws cov kev ua me nyuam ntawm tus ntxhais. Cov txheej txheem no tuaj yeem kho qhov mob uterine los ntshav pib los ntawm fibroids. Yog tias cov fibroids ntau thiab loj, lawv tuaj yeem ua rau poob ntshav ntau.
Txhawm rau ua myomectomy, tus kws phais muaj peev xwm siv txoj kev phais "qhib" ib txwm (laparotomy) lossis tsawg dua kev cuam tshuam (hysteroscopy thiab laparoscopy).
Laparotomy yog ua los ntawm kev txiav ntawm phab ntsa plab. Nws yog siv rau subserous fibroids, uas suav hais tias loj heev,ntau. Kev rov qab los tom qab ib qho kev mob plab myomectomy tuaj yeem ua tau tom qab ib mus rau ob lub hlis. Kev phais qhib tuaj yeem ua rau caws pliav thiab ntshav ntau. Qhov kev hem thawj ntawm kev rov tshwm sim ntawm myomatous nodes tshiab kuj tseem ua tau.
Hysteroscopic myomectomy yuav raug qhia rau submucosal lossis submucosal fibroids nyob hauv lub tsev menyuam. Thaum lub sijhawm ua haujlwm, fibroids raug tshem tawm siv lub cuab yeej hu ua hysteroscopic resectoscope, uas tau muab tso rau hauv qhov chaw ntawm lub tsev menyuam los ntawm qhov chaw mos thiab ncauj tsev menyuam, tom qab uas tus kws kho mob siv cov khoom siv hluav taws xob los tshem cov qog.
YUterine artery embolization
Uterine artery embolization (UAE), uas yog hu ua uterine fibroid embolization, yog ib txoj hauv kev tshiab ntawm kev kho cov kab mob. Embolization ntawm uterine fibroids deprives lawv ntawm lawv cov ntshav, yuam cov qog kom ntsws. UAE yog suav tias yog qhov tsawg tshaj plaws invasive thiab technically non-surgical therapy. Cov txheej txheem tsis yooj yim rau tus neeg mob li hysterectomy thiab myomectomy, thiab sawv tawm rau nws lub sij hawm rov qab luv dua li lwm cov kev phais. Thaum lub sijhawm ua haujlwm, tus neeg mob tseem nco qab, txawm tias muaj tshuaj loog. Lub sijhawm ntawm cov txheej txheem yog li ib teev, tsawg zaus - ib thiab ib nrab.
Kev kho mob nrog pej xeem tshuaj
Thaum muaj mob, nws yog ib qho tseem ceeb uas yuav tau hu rau tus kws kho mob tshwj xeeb hauv lub sijhawm. Nrog uterine fibroids, nws yog ib qho tseem ceeb heev uas yuav tsum tau ua kom muaj kev ntsuam xyuas lub cev, kuaj xyuas kom raug, thiab tsim ib qho kev kho mob rau tus kheej. Yuav ua li cas thaumuterine myoma, qhov kev faib tawm uas tau hais los saum toj no?
Tseem tshuaj tsis muaj cov khoom tsim nyog los siv tag nrho cov kev tshwj xeeb rau kev kho mob hnyav. Ntxiv mus, "cov tshuaj hauv tsev" tuaj yeem tsim kev puas tsuaj, pab txhawb kev loj hlob ntawm cov qog. Thaum lub sij hawm tsim ntawm neoplasm, lub cev xav tias kev ntxhov siab: kev tiv thaiv kab mob phem zuj zus tuaj, muaj teeb meem nrog kev tshem tawm cov hnyuv thiab zais zis. Tus kab mob yuav tsum tau kho nrog cov pov thawj thiab siv tau zoo ntawm cov tshuaj ib txwm siv.
Txawm li cas los xij, nws paub tias cov tshuaj ntsuab tuaj yeem siv tau, vim tias ntau cov nroj tsuag muaj cov ntsiab lus zoo ib yam li cov tshuaj hormones lossis tshuaj tiv thaiv kab mob. Tab sis lawv txoj kev siv ywj pheej tuaj yeem ua rau muaj kev cuam tshuam tsis zoo rau lub xeev kev noj qab haus huv, ua rau muaj teeb meem sai lossis nce hauv cov qog. Yog li ntawd, ua ntej koj pib kho nrog tshuaj ntsuab, koj yuav tsum sab laj nrog ib tus kws kho mob tshwj xeeb. Kev ua tau zoo ntawm kev kho mob nrog pej xeem cov tshuaj tau raug pov thawj scientific, tab sis nws yog ib qho tsim nyog los muab cov kev kho mob no nrog cov lus pom zoo thiab cov tshuaj ntawm ib tus kws kho mob uas tau lees paub.
