Ovarian cyst yog ib yam mob tshwm sim rau cov poj niam uas muaj hnub nyoog me nyuam. Tsawg zaus, xws li pathology raug kuaj pom hauv cov neeg mob laus dua tsib caug xyoo. Lub cyst yog ib qho tsim tsis zoo, tab sis qee zaum nws tuaj yeem degenerate rau hauv daim ntawv malignant. Yog li ntawd, thaum kuaj pom tus kab mob, kev ua haujlwm kom tshem tawm cov cyst ntawm zes qe menyuam yog pom zoo rau feem ntau.
cyst yog dab tsi
Ib lub cyst yog ib qho kev tsim kho zoo nyob rau hauv cov qauv ntawm zes qe menyuam uas zoo li lub vial uas muaj cov ntsiab lus ua kua. Raws li cov kua dej accumulates, qhov loj ntawm lub zes qe menyuam kuj nce. Raws li txoj cai, nws tshwm sim nrog kev cuam tshuam hormonal hauv lub cev, cov txheej txheem inflammatory thiab kis kab mob.
Dab tsi ntawm kev ua haujlwm thiab tsis ua haujlwm ntawm zes qe menyuam.
Nyob zoo cysts
Nyob hauv norooj plaub, cov tsos ntawm formations yog txuam nrog ib tug tej theem ntawm lub voj voog thiab nyob ntawm seb qhov ua hauj lwm ntawm lub zes qe menyuam nws tus kheej. Pawg no suav nrog:
- Follicular cyst. Hom no tshwm sim thaum ovulation tsis tau tshwm sim, thaum lub follicle tseem ceeb tsis tau tawg. Nws txoj kev loj hlob txuas ntxiv nrog rau kev sib sau ntawm cov kua dej secretory. Nws tuaj yeem tsim ob sab hauv lub zes qe menyuam thiab ntawm nws daim nyias nyias.
- Cyst of the corpus luteum. Nws yog tsim thaum, nyob rau hauv lub thib ob theem ntawm lub voj voog, lub caj pas ib ntus tsis regress, tab sis txuas ntxiv nws txoj kev loj hlob.
Qhov tseem ceeb ntawm cov hlwv ua haujlwm yog lawv lub peev xwm yaj ntawm lawv tus kheej tom qab ib ntus. Yog tias qhov no tsis tshwm sim, ces kev kho tshuaj nrog kev siv tshuaj hormonal feem ntau pab.
Ntxhais kab mob tsis ua haujlwm
Cov kev tsim tsis ua haujlwm yog cov uas nws txoj kev loj hlob tsis cuam tshuam nrog tus poj niam lub cev ntaj ntsug. Cov no suav nrog:
- YEndometrioid cyst. Qhov no yog ib qho mob hnyav uas tshwm sim thaum cov khoom ntawm endometrium nkag mus rau hauv zes qe menyuam thiab txuas rau nws. Maj mam, ib qho me me capsule yog tsim, uas muaj cov ntshav coj khaub ncaws. Yog tias tsis kho, nrog rau txhua lub voj voog, cov tshuaj ntsiav loj tuaj, ntau thiab ntau ntxiv nrog cov ntshav coj khaub ncaws tshiab.
- Dermoid. Ib daim ntawv tsis tshua muaj heev. Nws xav tias nws tsim tshwm sim thaum lub sij hawm fetal kev loj hlob, vim hais tias nws tsis muaj cov ntsiab lus ua kua, tab sis nrog cov ntaub so ntswg (cov plaub hau, rog, thiab lwm yam).
- YParaovarian cyst.
Tsis ua haujlwmcysts tsis kho nrog tshuaj. Lawv tsis yaj ntawm lawv tus kheej. Yog li ntawd, thaum lawv raug kuaj pom, muaj kev ua haujlwm kom tshem tawm cov zes qe menyuam.
Symptoms
Thaum muaj cyst tshwm sim, tus poj niam tsis pom cov tsos mob tshwj xeeb, tshwj xeeb tshaj yog tias qhov tsim me me. Cov cim qhia tsuas yog mob thaum cev xeeb tub thiab ovulation. Tsis tas li ntawd cuam tshuam yog rub qhov mob thiab lub voj voog tsis zoo. Cov tsos mob tau tshaj tawm nrog kev nce qib hauv kev kawm, uas tuaj yeem ua rau muaj qhov tshwm sim loj.
Cov tsos mob thiab kev kho mob ntawm zes qe menyuam hlwv muaj kev cuam tshuam zoo, txij li kev kuaj pom tseeb ntawm tus kab mob tuaj yeem qhia txog kev txhim kho cov kab mob txaus ntshai uas yuav tsum tau kho tam sim. Cov tsos mob no suav nrog:
- plab o;
- mob ntswj mob hauv plab plab;
- qee zaum muaj qhov nce hauv lub cev;
- mob thaum sib deev;
- nro ntawm phab ntsa plab anterior;
- mob tso zis.
Diagnosis
Txij li thaum nyob rau theem pib ntawm kev loj hlob ntawm lub cyst thiab nrog nws qhov me me, cov tsos mob me me, ib tug poj niam feem ntau paub txog qhov muaj kev kawm ntawv heev los ntawm kev sib tsoo ntawm gynecologist lub sij hawm. Yuav pib nrog, tus kws kho mob ua ib qho kev ntsuam xyuas gynecological, uas ntsuas qhov xwm txheej ntawm cov poj niam lub cev, lawv muaj peev xwm nce. Tom ntej no, kuaj cov tshuaj hormones, kuaj ultrasound, kuaj doppler, uas yuav tso cai rau koj los xyuas cov ntshav ntws hauv lub cyst nws tus kheej kom tsis suav nrog.xwm txheej phem. Tab sis qhov tseeb tshaj plaws thiab qhov tseeb yog kev kuaj mob uas siv laparoscopy.
Indications rau kev phais
Kev ua haujlwm kom tshem tawm lub zes qe menyuam yog raug sau rau hauv cov xwm txheej hauv qab no:
- Thaum nws loj hlob ntxiv.
- Yog tias lub cyst tsis rov qab nyob rau hauv ntau lub voj voog.
- Yog tias qhov tsim tau raug kuaj pom thaum lub cev tsis muaj zog.
- Yog koj muaj PCOS.
- Thaum xav tias qhov xwm txheej phem. Hauv qhov no, kev kho mob raug sau ua ke nrog tus kws kho mob oncologist tom qab kuaj pom tseeb.
- Yog muaj teeb meem - rupture, torsion of the leg, suppuration.
- Rau qhov mob loj heev.
Kev tshem tawm
Yuav ua li cas tshem cov cyst yuav siv los ntawm tus kws kho mob nyob ntawm tus yam ntxwv ntawm tus poj niam thiab qhov xwm txheej ntawm tus kab mob. Tam sim no, peb hom kev phais yog siv - laparoscopy, laparotomy thiab laser tshem tawm.
Laparoscopic zes qe menyuam tshem tawm yog txoj kev nrov tshaj plaws. Qhov no yog vim qhov tseeb tias lub sijhawm kho kom rov zoo sai dua, qhov kev pheej hmoo ntawm cov teeb meem thiab qhov mob raug txo.
Laparotomy yog kev ua haujlwm hauv plab kom tshem tawm lub zes qe menyuam. Hom kev phais no yog siv rau lub cyst loj, kev loj hlob ntawm cov txheej txheem purulent lossis malignant.
Tseem muaj ntau hom kev phais, nyob ntawm seb qhov kev cuam tshuam ntawm kev phais:
- Ycystectomy. Hauv qhov no, cov ntaub so ntswg noj qab haus huvovary tseem tsis hloov. Qhov no yog txoj kev tshem tawm maj mam tshaj plaws;
- oophorectomy. Lub zes qe menyuam raug tshem tawm nrog rau lub cyst;
- resection - ib feem ntawm lub zes qe menyuam raug tshem tawm nrog rau kev tsim cystic;
- hysterectomy - thaum lub cyst raug tshem tawm, lub zes qe menyuam, uterus thiab txoj hlab qe menyuam raug cuam tshuam. Txoj kev no yog siv rau hauv cov txheej txheem malignant.
Npaj rau kev phais
Ua ntej npaj tshem tawm cov cyst, koj yuav tsum xeem dhau tag nrho cov kev ntsuam xyuas los ntawm tus kws kho mob:
- ntshav kuaj - dav dav, hormonal, biochemical, clotting thiab Rh factor;
- urinalysis;
- ECG;
- fluorography;
- ultrasound.
Ob peb hnub ua ntej kev ua haujlwm, kev noj zaub mov tshwj xeeb raug sau tseg, tsis suav nrog kev siv cov khoom noj uas tuaj yeem ua rau muaj roj ntau ntxiv (cov dej qab zib, legumes, zaub qhwv, zaub mov rog thiab kib). Tso cai cereals, pasta, lean nqaij.
Tsis txhob noj lossis haus rau hnub phais. Yog tias qhov txheej txheem tshem tawm cyst raug teem rau tag kis, koj yuav tsum hla noj hmo.
Nws raug pom zoo kom noj cov tshuaj enema thiab noj tshuaj kom txo qis kev tsim cov pa hauv cov hnyuv.
Ntawm ntawm laparoscopy
Cov txheej txheem laparoscopy yog txoj kev yooj yim tshaj plaws thiab tsis mob feem ntau ntawm kev tshem tawm lub cyst, uas txo qhov kev pheej hmoo ntawm kev tawg. Cov txheej txheem yog ua los ntawm kev siv lub laparoscope - ib lub cuab yeej nruab nrog lub koob yees duab uas qhia cov duab ntawm lub vijtsam nyob rau hauv daim ntawv loj, uas tso cai rau kev ua haujlwm zoo heev. CovIb hom kev phais mob yog siv los kho cov poj niam ntawm lub hnub nyoog yug me nyuam, txij li thaum lub sijhawm ua haujlwm, cov ntaub so ntswg ntawm zes qe menyuam thiab cov kabmob nyob ze tau khaws cia ntau tshaj plaws.
Ntau tus neeg txaus siab rau lo lus nug: yuav siv sijhawm ntev npaum li cas thiaj tshem tau lub zes qe menyuam? Cov txheej txheem yog ua raws li kev siv tshuaj loog thiab siv sijhawm li 15 feeb mus rau ib teev, nyob ntawm seb tus kab mob thiab tus neeg mob li cas.
Laparoscopy tau ua nyob rau ntau theem:
- Ib roj yog txhaj rau hauv tus neeg mob lub plab kab noj hniav uas siv cov cuab yeej tshwj xeeb, uas cais cov kabmob rau cov khoom siv kom meej dua.
- Lub plab thiab perineum raug kho nrog tshuaj tua kab mob, tom qab ntawd peb qhov kev sib tsoo yog tsim rau hauv lub plab kab noj hniav rau cov hlab ntsha tshwj xeeb, qhov twg lub koob yees duab thiab cov cuab yeej siv rau kev ua haujlwm tau muab tso rau.
- Nrog kev pab ntawm cov cuab yeej no, kev tsim tawm raug tshem tawm. Yog hais tias tus kws phais tau pom ib lub cyst loj, ces thawj zaug nws yog punctured, ces cov ntsiab lus yog aspirated, tom qab ntawd lub plhaub nws tus kheej raug tshem tawm.
- Tom qab cov txheej txheem tiav lawm, cov pa roj carbon dioxide raug tshem tawm ntawm lub cev, thiab cov ntaub so ntswg thiab kev hnav khaub ncaws tom qab raug siv rau qhov chaw sib tsoo.
- Qee zaum yuav tsum muaj lub raj xa dej rau lub sijhawm.
Cov tshuaj tiv thaiv kab mob thiab tshuaj tua kab mob tau raug sau tseg thaum lub sijhawm rov ua haujlwm. Cov stitches raug tshem tawm tom qab li peb hnub. Kev rov zoo tag nrho ntawm lub cev tshwm sim hauv peb lub lis piam. Kev coj khaub ncaws tom qab laparoscopy ntawm lub zes qe menyuam cyst tsis hloov pauv, txij li cov txheej txheem tau sau tseg rau hnub 7-8 ntawm lub voj voog, thiab thaum pib ntawm tus poj niam tom ntej.twb muab tag nrho lawm. Cia li nco ntsoov tias hnub ua haujlwm yuav yog thawj hnub ntawm kev coj khaub ncaws tshiab.
Nrog rau lub sijhawm tshem tawm ntawm lub zes qe menyuam, kev tshuaj xyuas feem ntau yog qhov zoo.
Contraindications rau laparoscopy
Txawm hais tias qhov tseeb tias laparoscopic tshem tawm ntawm zes qe menyuam yog sai thiab yuav luag tsis muaj teeb meem, muaj ntau yam contraindications rau nws siv.
- muaj cov kab mob sib kis lossis cov txheej txheem inflammatory hauv lub cev;
- hemophilia;
- raum lossis siab tsis ua haujlwm;
- cyst loj heev;
- muaj adhesions lossis hernias;
- kab mob plawv;
- txheej txheem phem.
Cov teeb meem thiab qhov tshwm sim ntawm laparoscopy
Qhov muaj teeb meem tom qab qhov txheej txheem tau pom nyob rau hauv tsawg kawg ntawm cov poj niam, thiab lawv feem ntau cuam tshuam nrog xeev siab, ntuav ntuav, kis kab mob thaum lub sijhawm ua haujlwm. Yog tias pom los ntshav, ces qhov ua rau feem ntau yog teeb meem nrog ntshav txhaws. Yog li ntawd, koj yuav tsum xeem tag nrho cov kev xeem tsim nyog ua ntej pib txheej txheem.
Laparotomy
Txawm hais tias qhov kev ua haujlwm hauv plab yog qhov txaus ntshai heev thiab muaj lub sijhawm rov ua haujlwm ntev, lawv tseem siv tau ntau zaus. Txoj kev no nyob rau hauv kev tshem tawm ntawm zes qe menyuam cyst yog siv nyob rau hauv cov ntaub ntawv ntawm ib tug loj heev tsim, muaj adhesions, purulent txheej txheem, torsion thiab malignant qog. Qhov kev tshem tawm yuav siv qhov chaw los ntawm ib tug ncaj loj incision nyob rau hauv lub plab mog nyob rau hauv lub general anesthesia. Cov lus pom zoo hauv kev npajCov txheej txheem yog tib yam li laparoscopy.
Cov kauj ruam ntawm kev ua haujlwm:
- Lub plab yog kho nrog tshuaj tua kab mob.
- Ib qho phais hauv plab.
- Tom ntej no, tus kws phais tshem tawm cov tsim thiab kuaj cov kabmob thiab cov ntaub so ntswg nyob ze rau lwm cov txheej txheem pathological.
- Tom qab tag nrho cov txheej txheem phais, qhov kev txiav yog sutured.
Lub sijhawm kho dua tshiab hauv qhov xwm txheej no ntev dua thiab mob hnyav dua. Nrog rau txoj kev no ntawm kev tshem tawm ntawm zes qe menyuam cyst, qhov tshwm sim tuaj yeem yog cov hauv qab no: adhesions, o, kab mob, kev puas tsuaj rau qee yam kabmob. Kev rov zoo tag nrho ntawm lub cev tshwm sim hauv 1-1.5 lub hlis.
Nyob rau hauv thawj thiab thib ob txoj kev kho mob, cov ntaub so ntswg tshem tawm raug xa mus rau kev kuaj histological.
Contraindications rau laparotomy:
- kab mob chronic;
- hemophilia;
- mob ntshav qab zib mellitus;
- nquag ntshav siab.
Tej yam tshwm sim muaj xws li qhov txhab mob, los ntshav, ntshav txhaws.
Laser cyst tshem tawm
Laser tshem tawm yog ib txoj hauv kev zoo heev. Cov ntaub so ntswg noj qab nyob zoo yog xyaum tsis cuam tshuam. Cov txheej txheem yog ua raws li tshuaj loog hauv zos.
Kev ua haujlwm nce qib:
- Tom qab cov tshuaj loog tau siv lawm, ib qho me me ntawm daim tawv nqaij, rau ib rab koob tshwj xeeb, uas tau muab tso rau hauv cov kab noj hniav.
- Ib lub teeb laser yog siv los ntawm rab koob no, uas yajcyst thiab ntsaws cov ntaub so ntswg puas.
- Tom qab ntawd, siv tib rab koob, cov ntaub so ntswg tshem tawm siv lub tshuab nqus tsev.
Contraindications rau cov txheej txheem no suav nrog ntshav qab zib mellitus, txheej txheem oncological, kab mob ntawm lub paj hlwb.
Rehab
Tom qab tshem tawm ntawm zes qe menyuam cyst, lub sijhawm postoperative yog tsom rau kev rov ua haujlwm ntawm tus poj niam thiab kev ua haujlwm ntawm lub cev. Kev saib xyuas ntau kuj tau them rau qhov tsis suav nrog kev rov tshwm sim ntawm tus kab mob. Cov theem ntawm kev rov zoo:
- Hormone intake: hluavtaws progestins, antigonadotropins.
- Special diet.
- Nkag mus rau ascorbic acid hauv nruab nrab ntawm lub voj voog.
- Phonophoresis.
- Magnitolaser therapy.
- Tsis muaj kev tawm dag zog.
Zoo kawg
Vim qhov tseeb tias lub zes qe menyuam, cov tsos mob thiab kev kho mob uas peb tau piav qhia saum toj no, tuaj yeem tshwm sim yam tsis muaj tsos mob, teem caij mus ntsib kws kho mob gynecologist tseem ceeb heev. Kev loj hlob ntawm tus kab mob tuaj yeem kuaj pom thaum ntxov, uas yuav pab tau zoo heev rau kev kho mob.
