Nyob rau hauv gynecology niaj hnub no, benign zes qe menyuam qog yog ib qho teeb meem ceev. Txhua xyoo tus kab mob tsuas yog "tau yau dua". Ob tug ntxhais hluas thiab cov poj niam laus raug cuam tshuam los ntawm nws. Kev kho tsis zoo tuaj yeem ua rau muaj kev puas tsuaj loj, suav nrog kev tuag.
zoo thiab malignant qog ntawm zes qe menyuam
Tus qog yog ib qho kev loj hlob ntawm cov kab mob pathologically deformed cellular cov ntaub so ntswg. Cov tom kawg yog tsim los ntawm cov ntsiab lus ntawm ntau lub hauv paus chiv keeb, ua ntau yam haujlwm. Cov qog yog ib txwm loj. Raws li rau cov poj niam cev xeeb tub, nyob rau hauv cov ntaub ntawv no, cov txheej txheem pathological thawj zaug pib tsim nyob rau hauv lub cev ntawm lawv tus kheej. Tom qab ntawd nws tuaj yeem txav mus rau cov tsev nyob sib ze, kov yeej txhua qhov chaw tshiab.
Muab cov kev hloov pauv tshwm sim hauv cov hlwb, tag nrho cov neoplasms hauv cheeb tsam noNws yog kev cai los faib ua ob pawg: malignant thiab benign qog ntawm zes qe menyuam. Qhov kev faib tawm no yog muaj cai. Thaum lub sij hawm cev xeeb tub, ib co benign formations hloov mus rau malignant sawv daws yuav. Txawm li cas los xij, lawv muaj ntau qhov sib txawv.
Cov qog nqaij hlav ntawm qhov xwm txheej tsis zoo yog tus cwj pwm los ntawm kev loj hlob sai thiab muaj peev xwm nkag mus rau tib neeg lub cev noj qab haus huv. Tag nrho cov no inevitably entails lub germination ntawm pathological ntsiab nyob rau hauv lub lymphatic hlab ntsha, ntxiv mus thoob plaws lub cev nrog rau cov ntshav khiav. Yog li ntawd, ntau yam metastases raug tsim. Histologically, malignant hlwb txawv nyob rau hauv lawv cov qauv los ntawm noj qab haus huv qhov chaw ntawm zes qe menyuam. Nyob rau hauv lawv cov tsos, lawv muaj ntau haiv neeg, vim hais tias lawv yog ib txwm nyob rau ntawm txawv theem ntawm kev loj hlob.
Kev tsim kho zoo yog txwv los ntawm cov ntaub so ntswg uas nyob ib sab los ntawm lub plhaub, tsis txhob dhau mus. Txawm li cas los xij, lawv txawv ntawm lawv lub peev xwm los nce qhov loj, uas qee zaum ua rau compression ntawm cov khoom nyob sib ze. Cov ntsiab lus zoo li no tsis ua kom cov ntaub so ntswg noj qab haus huv, tsis muaj kev xav rau metastasize. Tom qab kev phais tshem tawm, yuav luag ib txwm ua tiav. Kev mob ntshav qab zib yog qhov tsawg heev.
Txoj kev zoo ntawm cov txheej txheem zoo
Lub zes qe menyuam yog suav tias yog lub cev tseem ceeb tshaj plaws ntawm kev ua me nyuam. Lawv tsim cov tshuaj hormones poj niam txiv neej, qe loj. Ntawm qhov tod tes, lawv feem ntau ua raws li lub hom phiaj rau ntau yam txheej txheem pathological. Cysts thiab ntau yam neoplasms ntawm tag nrho cov kabmob ntawm lub cev xeeb tubfeem ntau xaiv cov zes qe menyuam. Lawv suav hais tias yog cov qauv yooj yim. Cov qog ntawm zes qe menyuam benign tsis tawm ntawm lub cev cuam tshuam, uas tso cai rau koj kom tshem tau tus kab mob raws sijhawm. Txoj kev tseem ceeb ntawm kev kho mob yog phais.
Ntawm lwm cov yam ntxwv ntawm cov qauv no, cov kws kho mob paub qhov txawv hauv qab no:
- Kev tsim ntawm txhua lub hnub nyoog.
- Kev txo qis hauv poj niam muaj peev xwm ua me nyuam.
- Tsis muaj tsos mob tshwj xeeb.
- High risk of malignancy - transformation to malignant qog.
Feem ntau, cov poj niam muaj hnub nyoog tshaj 30 xyoo raug cov txheej txheem pathological. Nws yog tus cwj pwm los ntawm kev kawm asymptomatic. Qhov no yog "silent cancer". Nws lub npe xav kom txhua tus poj niam ua tib zoo saib xyuas nws txoj kev noj qab haus huv thiab ua ntu zus los ntawm tus kws kho mob gynecologist.
Piv txwv li, mob mob ntawm lub appendages ib txwm ua rau mob hnyav. Qhov no ua rau tus poj niam mus rau tus kws kho mob, thaum nws txais tos ib tug kab mob txaus ntshai tshwm sim. Hauv lwm qhov xwm txheej, rub cov kev xav hauv plab plab yog qhov tsawg kawg nkaus. Yog li ntawd, cov txheej txheem mob qog noj ntshav tuaj yeem cuam tshuam nrog kev mob plab hnyuv lossis kab mob ntawm lub tsev menyuam. Raws li qhov tshwm sim, tus kab mob tseem tsis tau saib xyuas thiab nquag txhim kho.
ua rau ntawm pathology
Tus etiology ntawm benign zes qe menyuam hlav tsis paub. Cov kws kho mob tseem tham txog qhov teeb meem no, qhia txog ntau yam kev xav. Piv txwv li, cov kws kho mob tau tswj xyuas kom paub tag nrho cov pab pawg ntawm cov neeg ua phem. Lawv qhov cuam tshuam ncaj qha nce qhov muaj feem ntawm kev txhim kho pathologic altxheej txheem. Cov xwm txheej no suav nrog:
- hormonal ntshawv siab;
- ovulation txuas ntxiv;
- genetic predisposition;
- kev ua txhaum ntawm cov txheej txheem ntawm kev loj hlob ntawm follicles;
- noj progesterone;
- smoking.
Kev xeeb tub kuj tuaj yeem ua rau kev txhim kho ntawm cov txheej txheem zoo.
daim duab kho mob
Feem ntau, thaum ntxov, tsis muaj cov tsos mob tshwm sim ntawm cov qog nqaij hlav zes qe menyuam. Raws li kev kawm loj hlob, daim duab kho mob hloov. Feem ntau cov poj niam tuaj rau gynecologist nrog cov lus tsis txaus siab hauv qab no:
- Kev mob plab hauv plab, yam ntxwv ntawm ib sab.
- Kev tsis muaj menyuam.
- Kev ua phem rau poj niam lub voj voog.
- Nyob zoo qhov hnyav hauv plab plab.
- Dysuric disorders.
- Teeb meem nrog plab hnyuv, nce ntim ntawm lub plab vim flatulence.
Ob qhov kawg tshwm sim ntawm tus kab mob no tsis tshua muaj, tab sis tib lub sij hawm ib qho kev qhia ntxov ntawm cov qog me me. Cov poj niam lawv tus kheej thiab txawm tias kws kho mob xyaum tsis cuam tshuam qhov tseem ceeb rau nws.
Qee hom cystic formations, uas yog benign nyob rau hauv cov xwm, muaj peev xwm tsim cov tshuaj hormones. Yog li ntawd, tus kab mob no tuaj yeem nrog cov teeb meem kev noj qab haus huv hauv qab no:
- Nyob tsis muaj menses;
- clitoris o;
- txo qis mis;
- kev txhim kho pob txuv;
- txiv neej lub cev plaub hau ntau dhau;
- Cushing's syndrome.
Cov tsos mob zoo li no tuaj yeem tshwm sim ntawm txhua lub hnub nyoog, suav nrog thaum cev xeeb tub.
Cov tsos mob ntawm tus kab mob thaum lub pedicle ntawm cov qog yog twist
Ntau yam tsos mob tshwm sim los ntawm kev nyuaj ntawm cov qog nqaij hlav zes qe menyuam hauv cov poj niam. Nws feem ntau tshwm sim yog suav tias yog torsion ntawm pedicle ntawm neoplasm. Nws tuaj yeem tshwm sim hauv cov xwm txheej zoo thiab ciam teb. Cov qauv ntawm cov ceg phais muaj xws li cov hlab ntsha, hlab ntsha, cov hlab ntsha hauv plab, thaj chaw peritoneal thiab uterine ligament. Yog tias tus qog tsis noj zaub mov tsis zoo, cov tsos mob hauv qab no tshwm sim:
- mob unilateral nyob rau hauv lub plab mog, uas tej zaum yuav mus tas li;
- ntuav thiab xeev siab;
- bloating;
- npaum hws;
- daim tawv nqaij;
- nce lub cev kub.
Cov cim qhia ntawm kev ua txhaum cai tsis tas mus li. Nrog ib nrab torsion ntawm ob txhais ceg, lawv qhov hnyav yog ntau dua. Lawv tuaj yeem ploj ntawm lawv tus kheej thiab rov tshwm sim.
YKev faib tawm ntawm pathology
Nyob rau hauv niaj hnub gynecology, tag nrho cov neoplasms feem ntau yog muab faib ua pab pawg thiab subgroups. Muaj ntau qhov kev faib tawm ntawm cov qog nqaij hlav zes qe menyuam, txhua qhov yog raws li qee yam tsos mob. Piv txwv li, Lub Koom Haum Saib Xyuas Kev Noj Qab Haus Huv (World He alth Organization) qhia cov kev xaiv hauv qab no:
- Cov qog nqaij hlav epithelial:serous, mucinous, endometrioid, ntshiab cell, thiab lwm yam.
- Stromal neoplasms ntawm kev sib deev qaum: thecoma, fibroma, androblastoma.
- kab mob qog: dermoid cysts, zes qe menyuam struma.
- cov txheej txheem zoo li qog: ntau lub hlwv follicular, cov kab mob epithelial nyob sab nraud, endometriosis, stromal hyperplasia, hyperthecosis, thiab lwm yam.
Txawm li cas los xij, hauv kev xyaum, kev faib cov txheej txheem pathological rau hauv ob pawg feem ntau yog siv: cov qog zoo li tsim thiab sab nraud (epithelial) qog ntawm zes qe menyuam. Cov yam ntxwv tshwj xeeb ntawm txhua ntawm ob pawg yuav tau tham hauv qab no.
Tumor-like formations
qeb no ntawm cov qog nqaij hlav zes qe menyuam muaj xws li:
- Follicular cyst. Feem ntau kuaj pom hauv cov ntxhais hluas. Lub cyst tsim tsuas yog nyob rau hauv ib lub zes qe menyuam, yog yus muaj los ntawm siab zog thiab elasticity. Nws txoj kab uas hla tuaj yeem sib txawv ntawm 2.5 mus rau 10 cm Pathology yog tshwm sim los ntawm kev ua txhaum ntawm poj niam lub voj voog. Feem ntau nws txoj kev loj hlob yog nrog los ntawm kev ncua ntawm kev coj khaub ncaws, ua raws li los ntshav hnyav. Tom qab 3-6 lub voj voog, lub cyst ploj ntawm nws tus kheej. Nws tsis yooj yim rau malignancy, tab sis yuav tsum tau tswj. Thaum pom tau lawm, kev soj ntsuam txuas ntxiv raug pom zoo.
- Cyst of the corpus luteum. Qhov loj ntawm neoplasm tuaj yeem sib txawv ntawm 3-6.5 cm. Clinically, nws yog tshwm sim los ntawm kev ua txhaum ntawm kev coj khaub ncaws, scanty ntshav tawm ntawm qhov chaw mos, thiab engorgement ntawm cov qog mammary. Qee zaum corpus luteum cyst yog qee zaum yuam kev thaum cev xeeb tub. Ultrasound tuaj yeem siv los pomqauv. Lub xub ntiag ntawm ib leeg / ntau qhov sib faib, cov ntshav txhaws tsis suav nrog. Muaj peev xwm tawg ntawm kev kawm tom qab kev sib deev tom ntej.
- Serous cyst. Ua ntej soj ntsuam histological, pathology feem ntau yuam kev rau follicular cyst. Muaj cov lus qhia txog kev mob qog noj ntshav, tab sis lawv tsis tau muaj pov thawj hauv kev xyaum. Lub serous cyst tsim los ntawm cov seem ntawm cov kab mob hauv lub raum. Nws yog ib qho kev tsim ntawm lub xov tooj ntawm tes, qhov loj ntawm qhov tsis pub tshaj 10 cm. Feem ntau, cov qog tau kuaj pom tom qab torsion ntawm nws ob txhais ceg.
Kev kho cov neeg mob uas muaj cov qog nqaij hlav zes qe menyuam pib tsuas yog tom qab txiav txim qhov xwm txheej thiab hom kab mob.
YEpithelial neoplasms
Qhov no yog pawg loj tshaj plaws, suav txog li 70% ntawm tag nrho cov zes qe menyuam neoplasms. Cov qog tsim tawm los ntawm stroma thiab cov epithelium ntawm lub cev. Feem ntau lawv yog unilateral. Ntawm palpation, lawv tsis sib txawv ntawm qhov mob, tab sis yog tus cwj pwm los ntawm kev txav mus los thiab elasticity. Ob tog xwm txheej ntawm pathology yog suav tias yog ib qho kev tsis txaus ntseeg ntawm malignancy.
Cov qog nqaij hlav ciam teb tsim nyog tau txais kev saib xyuas tshwj xeeb. Cov no yog serous, mucous, sib xyaw thiab lwm hom kev tsim. Tom qab kev phais, qhov muaj peev xwm ntawm rov tshwm sim tsis raug txiav tawm. Raws li kev tshawb fawb, cov qog nqaij hlav ciam teb yog nyob rau hauv qeb ntawm cov qib qis pathologies. Lawv feem ntau kuaj tau rau cov hluaspoj niam nyob rau theem pib ntawm kev loj hlob.
Tshuaj ntsuam xyuas
Kev kuaj mob ntawm cov qog ntawm zes qe menyuam yog qhov teeb meem heev. Tshwj xeeb tshaj yog nyob rau theem pib, thaum tsis muaj qhov pom tseeb ntawm cov txheej txheem pathological. Ntau tus kws paub txog gynecologist tuaj yeem txheeb xyuas cov neoplasms los ntawm palpation. Txoj kev no yuav tsum tau siv thaum lub sijhawm tshuaj xyuas.
Yog xav tias muaj kab mob pathology, tus neeg mob tau muab tshuaj ultrasound ntawm lub plab mog. Transvaginal ultrasonography nrog xim Doppler yog suav tias yog qhov kev xaiv zoo tshaj plaws. Qhov no yog ib qho kev ntsuam xyuas uas tso cai rau koj los txiav txim seb tus qauv thiab qhov loj ntawm cov qog. Tsis tas li ntawd, kev kuaj ntshav yog muab los txiav txim cov cim CA-19 thiab CA-125. Nrog nws pab, qhov tshwm sim ntawm malignancy tau tshwm sim.
theem kawg ntawm kev kuaj mob yog kev kuaj mob histological, thaum tus kws kho mob coj mus kuaj cov qog nqaij hlav. Tom qab kawm cov khoom siv hauv chav kuaj, koj tuaj yeem hais meej txog qhov tsis zoo lossis qhov tsis zoo ntawm cov txheej txheem.
Txoj Kev Kho Mob
Kev kho mob tseem ceeb rau cov qog nqaij hlav zes qe menyuam yog kev phais. Txoj kev npaj kho mob thiab qhov ntsuas ntawm kev ua haujlwm raug xaiv ib tus zuj zus. Hauv qhov no, tus kws kho mob yuav tsum coj mus rau hauv tus account lub hnub nyoog ntawm tus neeg mob, nws lub siab xav tswj kev xeeb tub. Tsis yog lub luag haujlwm kawg hauv qhov teeb meem no yog ua los ntawm qhov xwm txheej ntawm neoplasm.
Hnub no, cov kws tshaj lij feem ntau nyiam kev phais laparoscopic. Ib tug benign zes qe menyuam hlav tseem tsis tau txiav txim. Nrog rau kev nrhiav kev pab kho mob raws sij hawm, nws muaj peev xwm tswj tau kev ua me nyuam. Txoj kev cuam tshuam no yog tus cwj pwm los ntawm qhov tsis tshua muaj kev pheej hmoo ntawm cov teeb meem, thiab lub sijhawm kho kom rov zoo tau nrawm heev.
Yog tias laparoscopy tsis tuaj yeem ua tau, oophorectomy tau qhia. Qhov kev ua haujlwm no suav nrog kev tshem tawm tag nrho ntawm zes qe menyuam nrog ib qho chaw neoplasm. Nws yog ib nqi sau cia hais tias resection ho nce qhov kev pheej hmoo ntawm infertility nyob rau hauv lub neej yav tom ntej. Yog li ntawd, kev kho mob ntawm benign zes qe menyuam qog nyob rau hauv txoj kev no yog nqa tawm nyob rau hauv heev mob. Nrog ob sab hauv cheeb tsam ntawm cov txheej txheem pathological, panhysterectomy yog ua - kev ua haujlwm uas lub tsev menyuam raug tshem tawm nrog cov khoom siv ntxiv.
Qee zaus neoplasms raug kuaj pom hauv cov poj niam cev xeeb tub. Hmoov zoo, cov kab mob no tsis tshua muaj thiab suav rau tsuas yog 0.4% ntawm cov neeg mob. Lub ntsiab lus qhia rau kev phais thaum cev xeeb tub yog benign zes qe menyuam qog loj dua 10 cm inch. Kev cuam tshuam kev phais tsuas yog ua nyob rau hauv 1st lossis 2nd trimester.
Muaj Teeb Meem
Thaum kuaj pom neoplasm, feem ntau, tus kws kho mob hais kom nws tshem tawm. Yog vim li cas rau qhov kev txiav txim siab no yog qhov muaj feem yuav muaj teeb meem. Cov poj niam yuav ntsib teeb meem dab tsi?
- Y Malignancy ntawm cov txheej txheem pathological. Qhov no yog qhov teeb meem txaus ntshai tshaj plaws ntawm benign zes qe menyuam qog. Lub sijhawm ua haujlwm ua rau muaj kev cia siabkom rov zoo tag nrho. Yog tias neoplasm tau kuaj pom hauv daim ntawv siab, thiab kev kho mob pib lig dhau lawm, qhov tshwm sim ntawm nws qhov kev hloov pauv mus rau qhov tsis zoo yog 30-50%. Hauv qhov no, cov qog muaj peev xwm loj hlob mus rau cov ntaub so ntswg thiab cov kabmob uas nyob sib ze. Cov ntsiab lus hloov pauv tuaj yeem kis thoob plaws lub cev, ua rau cov txheej txheem mob qog noj ntshav tsis tuaj yeem.
- Rupture of capsule. Qhov teeb meem no ib txwm nrog qhov mob hnyav, los ntshav thiab poob siab. Txaus sai sai cov ntsiab lus ntawm cov tshuaj ntsiav nkag mus rau hauv lub plab kab noj hniav. Yog li ntawd, aseptic peritonitis tshwm sim. Qhov teeb meem no yuav tsum tau muaj kev phais mob tam sim ntawd. Txwv tsis pub, qhov tshwm sim ntawm cov txheej txheem nplaum ntxiv, uas ua rau tus poj niam muaj peev xwm xeeb tub.
- Torsion ntawm pedicle ntawm qog. Qhov teeb meem ntawm cov qog ntawm zes qe menyuam benign ib txwm tshwm sim poob nthav. Feem ntau nws yog preceded los ntawm ib tug ntse zog ntawm lub cev los yog lub cev ua si. Lub torsion nws tus kheej ua rau muaj kev cuam tshuam ntawm trophism hauv cov qog. Pathology yog nrog los ntawm mob mob syndrome. Daim tawv nqaij ua daj ntseg, thiab lub plawv dhia sai sai. Torsion ntawm qog qia yuav tsum tau phais xwm txheej ceev. Txwv tsis pub, qhov tshwm sim ntawm necrosis ntawm kev tsim nce, kev loj hlob ntawm tus kab mob thib ob hauv lub cev.
Cov teeb meem uas tau teev tseg yog suav tias yog feem ntau.
Txoj Kev Tiv Thaiv
Qhov laj thawj tseem ceeb ntawm kev tsis saib xyuas ntawm pathology yog suav tias yog kev txhim kho latent. Nyob ntawmTxog niaj hnub no, kev ntsuas tshwj xeeb rau nws txoj kev tiv thaiv tsis tau tsim. Txawm li cas los xij, kev kuaj xyuas tsis tu ncua los ntawm tus kws kho mob gynecologist nrog kev kuaj mob ultrasound sib npaug tso cai tshawb pom raws sijhawm thiab kev tiv thaiv ntawm qhov ua tau ntawm cov qog nqaij hlav ntawm zes qe menyuam.
Cov lus pom zoo ntawm cov kws kho mob rau kev tiv thaiv tus kab mob kuj tseem nqis los saib xyuas cov tshuaj hormonal ib ntus. Qhov no siv tau rau txhua tus poj niam txiv neej ncaj ncees uas tau mus txog hnub yug me nyuam. Yog tias tsim nyog, koj yuav tsum sab laj nrog kws kho mob thiab ua raws li nws cov lus qhia kom normalize qhov nyiaj tshuav.
