Hyperplasia yog ib yam mob uas tshwm sim los ntawm kev nce ntawm cov hlwb hauv cov ntaub so ntswg lossis lub cev (tsis suav cov qog nqaij hlav). Qhov tshwm sim ntawm kev loj hlob ntawm tus kab mob no yog ib tug neoplasm los yog ib tug ceeb toom ntawm qhov loj ntawm lub cev.
Hyperplasia txhim kho tom qab muaj ntau yam cuam tshuam uas cuam tshuam rau kev tsim tawm ntawm cov hlwb. Yog li, antigenic irritants, oncogenic tshuaj, cov ntaub so ntswg loj hlob stimulants, los yog poob ntawm ib lub cev los yog ib feem ntawm cov ntaub so ntswg yog vim li cas yuav provoke kev loj hlob. Physiological hyperplasia yog kev loj hlob ntawm epithelium ntawm cov qog mammary thaum cev xeeb tub, qhov tshwm sim ntawm glandular hyperplasia ua ntej los yog thaum cev xeeb tub, thiab lwm yam tshwm sim zoo sib xws.
Raws li piv txwv ntawm hyperplasia nce hauv cov kab mob pathological, ib tus tuaj yeem hu ua qhov nce ntawm qhov ntim ntawm cov qauv hauv cov neeg mob uas muaj qee yam mob ntshav qab zib ntawm cov ntaub so ntswg myeloid. Tsis tas li ntawd, cov txheej txheem hyperplastic tuaj yeem tshwm sim hauv cov ntaub so ntswg lymphoreticular ntawm cov qog nqaij hlav, raws li kev tiv thaiv kab mob hauv tus po,kab mob sib kis.
Ntau yam duab
Hauv tshuaj, muaj ntau yam tseem ceeb:
- Physiological hyperplasia. Cov ntaub so ntswg proliferation tshwm sim, uas yog kev ua haujlwm lossis ib ntus. Piv txwv li, lub mis hyperplasia, thaum lactation lossis thaum cev xeeb tub.
- YPathological hyperplasia. Vim muaj ntau yam provokes, cov ntaub so ntswg proliferation tshwm sim.
Tsis tas li ntawd, tus kab mob no tuaj yeem yog focal, diffuse thiab polypous:
- Nyob rau hauv daim ntawv focal, muaj ib tug meej localization ntawm tus txheej txheem nyob rau hauv daim ntawv ntawm cais seem.
- Diffuse hyperplasia cuam tshuam rau saum npoo ntawm tag nrho txheej.
- Daim ntawv polyposis yog tus cwj pwm los ntawm kev loj hlob tsis sib xws ntawm cov khoom sib txuas. Hauv qhov no, hyperplasia tuaj yeem ua rau muaj kev loj hlob ntawm malignant formations thiab cysts.
Diffuse thyroid hyperplasia
Tus kab mob no tshwm sim nyob rau hauv rooj plaub ntawm cov tshuaj tiv thaiv ntawm cov thyroid caj pas kom tsis muaj iodine. Nyob rau tib lub sijhawm, lo lus "diffuse" txhais tau hais tias cov kab mob cuam tshuam rau tag nrho lub cev: nws qhov loj zuj zus vim qhov sib npaug ntawm cov qog hlwb txhawm rau txhawm rau tswj cov thyroid cov tshuaj hormones uas txhawb cov metabolism, nce oxygen uptake, thiab tswj cov qib zog..
Cov thyroid caj pas xav tau iodine los tswj nws cov haujlwm hormonal. Tsis muaj lossis tsis muaj iodine tau txais txiaj ntsig ua rau muaj kev loj hlob ntawm cov qog hlwb thiab tuaj yeem ua rau nws tsis ua haujlwm.
Hyperplasiaadrenal qog
Tus kab mob no tuaj yeem ua tau nodular lossis nthuav. Nws nrog cov ntaub so ntswg tsis hloov pauv hauv cov qog nqaij hlav pineal thiab Cushing's syndrome. Hauv cov neeg laus, daim ntawv no ntawm hyperplasia, tshwj xeeb tshaj yog sab laug, yog qhov nyuaj heev kom paub txog ultrasound thiab tseem yog qhov kev kawm los ntawm MRI thiab CT.
Qee zaus diffuse hyperplasia ntawm cov qog adrenal yog nrog los ntawm kev nce hauv cov kabmob nrog kev khaws cia ntawm cov qog nqaij hlav zoo li qub - hauv daim ntawv ntawm hypoechoic formations ncig los ntawm cov ntaub so ntswg rog. Nyob rau hauv cov ntaub ntawv ntawm nodular hyperplasia nyob rau hauv lub cheeb tsam ntawm lub "fat daim duab peb sab" ib tug yuav pom sib npaug, homogeneous hypoechoic formations. Lawv nyuaj heev kom paub qhov txawv ntawm adenoma los ntawm daim duab echographic.
YProstate caj pas - benign hyperplasia
Kwv yees li 85% ntawm cov txiv neej uas muaj hnub nyoog 50 xyoo yog cov kab mob no. Benign prostatic hyperplasia yog tus cwj pwm los ntawm kev tsim ntawm ntau qhov me me (los yog ib qho) ntawm prostate, uas, maj mam kis, pib ua rau lub siab ntawm cov zis, uas tom qab ntawd ua rau muaj teeb meem nrog zis.
Tus kab mob no tsis ua rau mob metastasis, qhov xwm txheej no txawv ntawm prostate cancer, yog li nws hu ua benign hyperplasia. Txawm li cas los xij, nws tsis muaj qhov laj thawj meej thiab feem ntau cuam tshuam nrog txiv neej menopause.
Y Uterine endometrium
Y Hyperplasia yog ib qho benign nce nyob rau hauv lub thickness thiab ntim ntawm sab hauv lub tsev menyuam. Tej zaum yuav tshwm sim hauvRaws li qhov tshwm sim ntawm kev loj hlob ntawm ob leeg glandular thiab lwm cov ntaub so ntswg. Tus kab mob no tuaj yeem ua rau muaj kev cuam tshuam ntawm kev ua haujlwm ntawm endometrium (teeb meem nrog kev xav, kev coj khaub ncaws tsis zoo).
Raws li ib txwm muaj, lub endometrium nyob rau hauv kev cuam tshuam ntawm estrogen loj hlob nyob rau hauv thawj lub sij hawm ntawm lub voj voog, nyob rau hauv tus ntawm progesterone nyob rau hauv lub thib ob lub sij hawm ntawm lub voj voog yog txwv. Nrog pathology, qhov kev loj hlob ntawm endometrium tshwm sim uncontrollably, nws muaj peev xwm mus ntes tag nrho cov puab plhaub thiab ib tug neeg qhov chaw (focal hyperplasia).
Ntau yam ntawm endometrial hyperplasia
Qhov tseem ceeb ntawm qee cov ntsiab lus hauv kev loj hlob endometrium sawv tawm:
- YGlandular hyperplasia. Cov qog endometrial overgrow.
- Polypous hyperplasia. Muaj ib qho kev loj hlob ntawm lub endometrium, uas muaj lub qog, glandular-fibrous, thiab fibrous cim. Hom hyperplasia no tsis tshua muaj tshwm sim, tab sis tuaj yeem ua lub hauv paus rau kev txhim kho cov kab mob gynecological.
- Adenomatous hyperplasia nrog atypical hlwb, precancerous. Hauv qhov no, kev hloov pauv mus rau hauv cov qog nqaij hlav ntawm hom hyperplasia tuaj yeem ncav cuag li 10%.
- YGlandular cystic hyperplasia. Glands thiab cysts loj hlob ib yam.
Kev tshwm sim
Hnub no, qhov laj thawj tseem ceeb ntawm tus kab mob no yog qhov ntau dhau ntawm lub cev ntawm cov tshuaj estrogen nrog cov txheeb ze tsis muaj progesterone. Ua li ntawdtej zaum yuav ua rau:
- Hnub nyoog hloov pauv nrog hormonal tsis txaus thiab hormonal surges.
- Poj niam rog.
- polycystic ovary syndrome.
- Menopause.
- noj tshuaj uas muaj tshuaj estrogen yam tsis noj progesterone.
Ntau zaus, endometrial hyperplasia (kev tshuaj xyuas ntawm cov kws tshaj lij paub meej tias qhov no) tshwm sim hauv cov poj niam ua ntej poj niam cev xeeb tub thiab cov ntxhais hluas nulliparous.
Cov kab mob sib txuas uas ua rau muaj qhov tshwm sim ntawm hyperplasia yog teeb meem nrog cov qog adrenal thiab ob lub mis, kab mob thyroid, ob hom ntshav qab zib mellitus, thiab kub siab. Yam xws li:tuaj yeem ua rau muaj kev loj hlob ntawm hyperplasia
- Hloov rau cov kab mob ntawm qhov chaw mos.
- adenomynosis.
- YUterine fibroids.
- Kev rho menyuam tawm thiab kho.
- Cov txheej txheem mob ntawm qhov chaw mos.
Ua rau kev loj hlob thiab hom glandular endometrial hyperplasia
Qhov laj thawj tseem ceeb ntawm glandular hyperplasia:
- Anovulation.
- Ntau tshaj.
- Kev muaj cov kab mob follicular.
- Mopa.
Kuj txaus ntshai yog follicle persistence syndrome, glycemia thiab granulosa cell hlav.
Tsis muaj kev kho mob thiab kev kuaj mob lig ntawm tus kab mob no yog qhov ua rau muaj kev phom sij txaus ntshai xws li kev loj hlob ntawm cov qog nqaij hlav endometrial. Yeej, muaj kev pheej hmoo yog cov menyuam ntxhais raug kev txom nyem los ntawm atypical ademonatous hyperplasia, thiab cov poj niam nyob rau lub sijhawm tom qab menopause. Nws yog focal thiab diffusehyperplasia yog ib hom kab mob precancerous.
Lwm cov ntaub ntawv ntawm endometrial hyperplasia yog suav tias yog cov glandular epithelium, cystic enlarged glands, thiab glandular cystic hyperplasia.
Symptoms
Feem ntau, glandular hyperplasia tshwm sim yam tsis muaj cov tsos mob tshwm sim. Nyob rau hauv cov ntaub ntawv no, dysfunctional uterine los ntshav tshwm sim los ntawm ib tug ua txhaum ntawm lub cev ntas voj voog (mob khaub thuas qeeb) yog suav hais tias yog ib qho tshwm sim. Cov ntshav no tuaj yeem ua tau ob qho tib si profuse thiab ntev, thiab cov ntshav poob tuaj yeem ua rau ntau lossis nruab nrab. Raws li qhov tshwm sim, cov tsos mob anemic tshwm sim: poob qab los noj mov, qaug zog, tsis muaj zog.
Nruab nrab ntawm lub sijhawm, koj tuaj yeem pom qhov pom. Heev feem ntau, infertility tshwm sim nyob rau hauv cov poj niam vim anovulation. Qhov ntawd yog, nws yog infertility uas yog vim li cas mus rau tus kws kho mob, tom qab kuaj mob no. Cov tsos mob kuj muaj xws li mob hauv plab plab.
Glandular hyperplasia tuaj yeem kuaj tau los ntawm kev kuaj mob curettage, uas tau ua ua ntej kev coj khaub ncaws. Feem ntau, ultrasound thiab hysteroscopy yog siv los kuaj mob.
Hyperplasia focal
Focal hyperplasia (kev tshuaj xyuas ntawm cov kws tshaj lij qhia qhov no) tuaj yeem ua rau mob qog noj ntshav thiab tsis muaj menyuam. Ib chav kawm me me lossis asymptomatic tso cai rau koj kuaj pom tus kab mob no tsuas yog thaum kuaj ultrasound lossis thaum kuaj gynecological.
Lub zos hyperplasia feem ntau tshwm sim tom qab muaj kev cuam tshuam hormonal, tom qab muaj kab mob somatic thiab rho menyuam, lossis tawm tsam keeb kwm ntawm glandular hyperplasia.
Focal hyperplasia ntawm uterine epithelium raug kuaj pom raws li cov tsos mob hauv qab no:
- los ntshav tom qab kev coj khaub ncaws nres;
- acyclic lossis cyclic menstrual irregularities.
Kev kho tus kab mob no yog ua los ntawm ob txoj hauv kev:
- Txoj kev kho mob - nrog kev pab ntawm cov tshuaj tshwj xeeb, suav nrog cov tshuaj hormonal.
- Kev phais lossis kev ua haujlwm - los ntawm kev khawb lub uterine kab noj hniav.
Kev kuaj mob ntawm endometrial hyperplasia
Lub hauv paus rau kev kuaj mob ntawm tus kab mob no yog kev kuaj los ntawm gynecologist, instrumental and laboratory studies.
Cov kev kuaj mob tseem ceeb suav nrog:
- Ultrasound ntawm appendages thiab uterus nrog kev sojntsuam qhov chaw mos.
- Hysteroscopy nrog sampling rau kev kuaj histological.
- Diagnostic curettage of the uterine kab noj hniav.
- Yog tias nws tsim nyog los qhia meej txog hom hyperplasia, ua rau aspiration biopsy.
Ib qhov kev sim tseem ceeb tshaj plaws yog qhov kev txiav txim siab ntawm cov ntshav qab zib cov tshuaj hormones thiab cov thyroid caj pas, nrog rau cov qog adrenal.
Nws yog ib qho tseem ceeb kom nco ntsoov tias txhua hom hyperplasia xav tau kev kuaj mob kom raug thiabqhia qhov tseeb uas ua rau cov ntaub so ntswg nce.
Kev kho mob
Yog tias hyperplasia tau kuaj pom, kev kho mob tau ua tam sim ntawd. Txoj kev raug xaiv raws li qhov tshwm sim ntawm tus kab mob thiab hnub nyoog ntawm tus neeg mob.
Txoj kev ua tau zoo tshaj plaws yog kev kuaj mob curettage lossis hysteroscopic tshem tawm cov txheej txheem endometrial diffuse.
Yog tias txoj kev kho mob muaj ntau theem, tom qab ntawd, ua ntej ntawm tag nrho, muaj xwm txheej ceev lossis kev npaj tshem tawm. Thawj qhov kev xaiv yog siv rau ntshav ntshav lossis los ntshav.
Thaum cov txiaj ntsig histology muaj, tus kws tshaj lij tuaj yeem sau cov kev kho mob hauv qab no:
- Gonadotropin antagonist tshuaj yog muab rau thaum muaj hnub nyoog tshaj 35.
- Intrauterine ntaus ntawv "Mirena" nrog gestagens.
- Nyob rau lub sijhawm thib ob ntawm lub voj voog, kev npaj tshuaj progestin raug sau tseg ("Dufaston", "Utrozhestan").
- Yuav kom tsis txhob phais los ntshav ntawm cov ntxhais thaum tseem hluas, nws raug tso cai siv cov tshuaj tiv thaiv qhov ncauj hauv koob loj loj.
- Kev siv tshuaj tiv thaiv qhov ncauj sib xyaw ("Regulon", "Yarina", "Janine") tau sau tseg rau 6 lub hlis nrog cov tshuaj ib txwm muaj.
Cov tshuaj tau hais los saum toj no tsim cov txiaj ntsig zoo ib yam li kev noj ntshav, tab sis nws rov qab los.
Tom qab kev kho mob rau lwm lub hlis, kev tswj hwm tau ua tiav, yog tias muaj qhov rov ua dua ntawm daim ntawv adenomatous ntawm hyperplasia, ces kev tshem tawm ntawm lub tsev menyuam yog qhia. Hauv qab lwm yamCov ntaub ntawv rov tshwm sim thiab tsis muaj txiaj ntsig ntawm lwm txoj kev kho mob, kev puas tsuaj ntawm endometrium (ablation) yog ua.
Kev Ntsuas thiab Teebmeem
Qhov teeb meem txaus ntshai tshaj plaws ntawm endometrial hyperplasia yog nws hloov mus ua mob qog noj ntshav hauv tsev menyuam. Txawm li cas los xij, los ntshav thiab rov qab los nrog kev txhim kho ntawm kev xeeb tub thiab ntshav qab zib tsis txaus ntshai.
Feem ntau, qhov kev cia siab yog qhov zoo: vim yog kev phais thiab noj tshuaj rau 6-12 lub hlis, nws muaj peev xwm kho tau tus kab mob no.
Kev Tiv Thaiv
Cov kev ntsuas tseem ceeb tshaj plaws rau kev tiv thaiv endometrial hyperplasia yog kev tiv thaiv cov xwm txheej ntxhov siab, kev tawm tsam tawm tsam qhov hnyav dhau thiab kho tam sim ntawm kev coj khaub ncaws tsis zoo. Tsis tas li ntawd, kev kuaj gynecological raws sij hawm ntawm cov poj niam tseem ceeb heev.
Qee zaum rau cov ntxhais hluas, tus kws kho mob tshwj xeeb yuav pom zoo cov tshuaj hormonal rau kev tiv thaiv, uas pab txo qis kev pheej hmoo ntawm endometrial hyperplasia thiab mob qog noj ntshav. Ib tug poj niam yuav tsum paub hais tias yog hais tias lub tsev menyuam los ntshav tshwm sim, koj yuav tsum tam sim ntawd hu rau tus kws kho mob tshwj xeeb. Nco ntsoov tias mus ntsib kws kho mob raws sij hawm yuav pab kom tsis txhob muaj teeb meem feem ntau yav tom ntej.
