Uterine fibroids (fibroma, fibromyoma, leiomyoma) - ib qho kev tsim kho zoo uas tsim los ntawm uterine myometrium (cov leeg nqaij). Ib qho pathology ntau heev, 10-27% ntawm cov poj niam tig mus rau gynecologist rau nws. Nws raug suav hais tias yog cov qog ua haujlwm ntawm cov tshuaj hormones. Nws tshwm sim feem ntau hauv cov hnub nyoog me nyuam, nrog rau qhov tshwm sim siab tshaj plaws ntawm 35-40 xyoo. Nws tsis tsuas yog cuam tshuam rau kev noj qab haus huv ntawm tus neeg mob, tab sis feem ntau cuam tshuam rau kev ua me nyuam nws tus kheej. Niaj hnub no, pathology feem ntau pom thaum muaj hnub nyoog yau, ua rau muaj menyuam tsis taus.
Qhov loj ntawm uterine fibroids yog kwv yees nyob rau hauv lub lis piam raws li nws sib haum mus rau kev loj hlob ntawm lub tsev menyuam thaum cev xeeb tub. Ib nrab ntawm cov neeg mob tau txais kev phais mob rau myoma yog qhov zoo tshaj plaws. Yav dhau los, kev kho mob ntawm uterine fibroids raug txo kom tiav kev tshem tawm ntawm lub cev. Niaj hnub no, kev saib xyuas myomectomy tau ua ntau zaus, uas ua rau kev ua me nyuam muaj peev xwm khaws cia tag nrho.
Ua rau fibroids
Qhov ua rau neoplasms muaj xws li hauv qab no:
- kev hloov pauv;
- qhov tsis zoo ntawm myometrial anlage hauv embryogenesis;
- ntau tus rho menyuam;
- mob khaub thuas (MC);
- kho lub tsev menyuam rau kev kuaj mob;
- niam yug raug mob;
- qee endocrinopathies (mob ntshav qab zib, rog), thyroid hypofunction;
- tsis muaj menyuam yaus hnub nyoog qis dua 30;
- early menarche;
- kev sib deev tsis sib haum xeeb;
- hypodynamia.
Txawm li cas los xij, hormonal imbalances tseem yog qhov laj thawj tseem ceeb thiab ua rau.
Type of fibroids
Fibroids tuaj yeem muaj nyob hauv ib qho kev tsim los yog ntau yam, loj hlob hauv daim ntawv ntawm lub pob lossis muaj lub hauv paus chiv keeb, muaj ceg tawv lossis lub hauv paus dav, nyob rau hauv lub tsev menyuam lossis lub tsev menyuam, yooj yim, proliferating, presarcoma.
Raws li qhov chaw ntawm fibroids tuaj yeem yog:
- Interstitial lossis intramural - nyob hauv nruab nrab ntawm myometrium.
- Subserous fibroid - hlob nyob rau hauv sab sauv ntawm lub tsev menyuam thiab feem ntau yog coj mus rau lub plab kab noj hniav.
- Submucosal - thaj chaw nyob rau hauv lub mucosa, thiab nws txoj kev loj hlob yog coj mus rau lub uterine kab noj hniav.
- Intraligamentary uterine fibroids - qhov chaw hauv cheeb tsam no tsis tshua muaj, cov qog loj hlob sab nraud ntawm lub cev ntawm lub tsev menyuam, nkag mus ntawm qhov tshwj xeeb anatomical formations - ligaments.
Kev nyuaj siab
Fibroma tsis yog qhov tsis zoo li nws zoo li, txawm tiasrau nws txoj kev zoo. Nws yuav luag ib txwm ua rau muaj teeb meem:
- nchuav menyuam, fetal malnutrition thiab hypoxia;
- kev muaj menyuam;
- tom qab yug me nyuam, txo qis hauv lub tsev menyuam, los ntshav raws li qhov no;
- mob ntshav qab zib vim los ntshav ntau hauv lub tsev menyuam;
- rebirth into a sarcoma;
- nrog rau lub cev thiab cov fibroids loj, txhais ceg yuav twist;
- malnutrition;
- kev nce qib hauv kev kawm;
- Yendometrial hyperplasia;
- kev txhim kho ntawm hydronephrosis lossis pyelonephritis.
Yuav ua li cas thaum fibroids tshwm
Kev kho mob ntawm fibroids nyob ntawm qhov loj ntawm lub pob, lub hnub nyoog ntawm tus poj niam thiab nws lub siab xav kom muaj cov xeeb ntxwv yav tom ntej. Yog tias cov qog me me, tsis zoo li loj hlob, tus poj niam yuav tsis yug, nws yuav tsim nyog los kho HRT - kev kho tshuaj hormone hloov. Kev npaj tshuaj hormonal, nrog rau lawv cov kev xaiv kom raug, tuaj yeem tsis tsuas yog qeeb, tab sis kuj txwv txoj kev loj hlob ntawm kev kawm. Cov chav kawm feem ntau raug muab faib ua ob peb ua ke.
Yog li, cov lus qhia rau kev kho tshuaj hormone:
- Fibroids yuav tsum tsis pub tshaj 12 lub lis piam;
- intramural thiab subserous fibroids;
- tsis mob lossis los ntshav;
- tsis tuaj yeem ua haujlwm vim yog contraindications.
kev kho mob phais
Kev kho phais nrog kev tshem tawm cov fibroids yog ua nrog nws qhov loj me lossis teeb meem.
Nws yog dab tsi hauv gynecology - myomectomy ntawm uterine fibroids? Qhov no yog kev txiav tawm ntawm myomatous neoplasms los ntawm kab noj hniav. Niaj hnub no, kev saib xyuas myomectomy yog siv, uas yog suav tias yog kev ua haujlwm ntawm lub cev.
Cov nodes fibroid raug tshem tawm nrog nws, tab sis lub tsev menyuam tsis yog. Qhov no muaj tseeb nyob rau hauv rooj plaub ntawm kev npaj cev xeeb tub thiab tswj kev coj khaub ncaws.
Tom qab myomectomy, txhua tus poj niam thib ob tuaj yeem suav hais tias cev xeeb tub. Yog li ntawd, kev tshuaj xyuas ntawm kev saib xyuas myomectomy yog ib txwm zoo. Raws li qee cov lus ceeb toom, kev kho dua tshiab ntawm cov poj niam zoo li no tau nce mus txog 69%.
Kev vam meej ntawm myomectomy rau hnub ntawm lub voj voog
Kev ua haujlwm feem ntau ua txij hnub 6 txog rau hnub 18 ntawm lub voj voog. Txawm li cas los xij, thaum tsis muaj menyuam, nws tsis muaj teeb meem hnub twg ntawm MC ua myomectomy.
Lwm yam thaum nws los txog rau tus poj niam cev xeeb tub: lub sijhawm zoo tshaj plaws yog 14-19 lub lis piam ntawm cev xeeb tub. Los ntawm lub sij hawm no, lub placenta twb ua hauj lwm tag nrho, lub cev yog pw, thiab nyob rau hauv cov ntshav peripheral ntawm expectant niam, progesterone doubles. Vim li cas progesterone tseem ceeb? Nws nce thiab tswj cov kev ua haujlwm ntawm obturator ntawm lub tsev menyuam thiab txo qhov kev pheej hmoo ntawm kev yug ntxov ntxov. Cov yam ntxwv no tiv thaiv.
Contraindications rau kev phais
Contraindications suav nrog:
- Precancerous lossis twb mob qog noj ntshav hauv lub ncauj tsev menyuam lossis endometrium.
- Nkauj ntseeg malignancy.
- Kev kuaj mob fibroids thiab adenomyosis tib lub sijhawm.
- Pathology ntawm kev ua pa thiab lub plawv.
- Fibroids loj dua 15-20 cm, txawm tias tom qab ua ntej HRT.
- Ntau cov fibroids nrog rau ntawm 5-6 cm.
txheeb ze contraindications
Lawv tuaj yeem yogkho mob kom raug:
- mob ntshav qab zib mellitus nrog hnyav hyperglycemia.
- Kev rog.
- Cov txheej txheem kis-purulent ntawm lub tsev menyuam thiab appendages.
- Severe iron deficiency anemia.
Cov lus qhia hauv cov poj niam tsis cev xeeb tub
Nws raug nquahu kom ua kev phais rau cov neeg mob uas muaj hnub nyoog yug menyuam thiab tsis muaj menyuam, nrog rau:
- kev loj hlob ntawm lub pob hauv lub tsev menyuam;
- muaj ob txhais ceg hauv fibroids;
- acyclic los ntshav lossis lub sijhawm ntev thiab hnyav ua rau ntshav ntshav;
- kev muaj menyuam;
- thaum qhov loj ntawm cov fibroid ntau tshaj 12 lub lis piam, txawm tias tsis muaj kev tsis txaus siab, vim nws tseem ua txhaum cov kab mob nyob ze;
- cim ntawm compression ntawm cov kabmob uas nyob ib sab;
- atypical qhov chaw ntawm node - nws tuaj yeem loj hlob hauv caj dab lossis isthmus, hauv ligaments ntawm lub tsev menyuam;
- Ymyoma necrosis;
- kev loj hlob ntawm fibroids ob npaug hauv 1 xyoos.
Thaum muaj ntau yam fibroids, nws raug nquahu kom ua UAE ua ntej. Qhov no ua rau kev tshem tawm cov nodes me me, thiab cov loj yuav txo qis thiab ua kom pom tseeb thaum lub sijhawm ua haujlwm.
Cov lus qhia tseem ceeb rau myomectomy thaum cev xeeb tub
Kev phais thaum cev xeeb tub yog qhia hauv cov xwm txheej hauv qab no:
- Fibroids necrosis vim pedicle torsion.
- Txhob ntawm lub cev vim kev loj hlob neoplasm.
kev npaj ua ntej
Nws tsis txawv ntawm lwm hom kev ua haujlwm. Cov txheej txheem kev kawm ncaj ncees suav nrog:
- kuaj ntshav thiabtso zis;
- x-ray;
- ECG;
- ultrasound;
- vaginal swab;
- kuaj qhov quav.
Qhov zoo thiab qhov tsis zoo ntawm kev saib xyuas myomectomy
txiaj ntsig:
- cov qog tshem tawm ib zaug thiab lub tsev menyuam tau khaws cia;
- txheej txheem kev ua haujlwm yog paub zoo rau feem ntau cov kws kho mob gynecologists.
Cons:
- qhov tshwm sim ntawm kev rov qab los - raws li kev txheeb cais, qhov no tau pom hauv 70% ntawm cov neeg mob;
- kev muaj teeb meem.
- tom qab nkag mus rau laparotomic yuav muaj qhov caws pliav ntawm lub tsev menyuam, uas yuav tsum tau phais phais rau kev yug menyuam yav tom ntej;
- kev nyuaj nyuaj hauv ntau lub fibroids.
Price for surgery
Lawv sib txawv me ntsis, tab sis qhov nruab nrab ntawm cov txheej txheem raug nqi ntawm 25 thiab 120 txhiab rubles. Kev ua haujlwm EMA kim tshaj plaws yog los ntawm 100 txog 200 txhiab rubles.
Tus nqi yog nyob ntawm qhov kev cuam tshuam thiab hom kev nkag. Nws suav nrog cov nqi ntawm cov khoom siv, tshuaj, hnav khaub ncaws. Hauv ntau lub tsev kho mob, ob qho tib si nyob hauv tsev kho mob thiab noj mov ntxiv ntawm no.
Cov hom tseem ceeb yog:
- myomectomy;
- embolization;
- radical hysterectomy.
Myomectomy
Nws tau ua ntau txoj hauv kev:
- abdominal (laparotomic myomectomy);
- hysteroscopic;
- laparoscopic.
Cov ntsiab lus tseem ceeb yog tsim kom muaj kev puv puv(muaj nplua nuj) caws pliav ntawm lub tsev menyuam thiab, yog tias ua tau, qhov siab tshaj plaws ntawm kev tiv thaiv adhesions, kev xaiv ntawm qhov chaw zoo tshaj plaws ntawm lub tsev menyuam, qhov tseeb exfoliation ntawm myoma node tom qab qhib nws cov tshuaj ntsiav. Nws yog ib qho tseem ceeb kom tsis txhob los ntshav yam tsis tau siv cov diathermocoagulation (zoo - los ntawm kev nyem cov ntaub so ntswg ntawm cov hlab ntsha).
Yog tias qhov kev txiav ua rau hauv lub tsev menyuam, nws cov sutures yog siv rau hauv 3 kab rau stitching, siv Vicryl threads. Lawv zoo kawg nkaus uas lawv tsis raug lees paub thiab daws lawv tus kheej ntev.
Lawv sim txiav cov tshuaj ntsiav raws nws tus ncej sab sauv, kom tsis txhob ua rau cov hlab ntsha loj. Tsis tas li ntawd, qhov kev txiav no yuav tso cai rau koj kom tshem tawm lwm cov nodes ib txhij yog tias lawv muaj.
Txhawm rau txo qis qhov adhesions, thaum kawg ntawm kev phais, qhov chaw pelvic yog kom qhuav, thiab cov tshuaj tiv thaiv adhesion tau nkag rau hauv nws. Nyob rau tib lub sijhawm, tsawg kawg ib liter ntawm cov tshuaj no yuav siv tau ib qho kev ua haujlwm.
Myomectomy thaum cev xeeb tub
Cov txheej txheem ntawm kev ua haujlwm tsis txawv, lub peculiarities yog noj mus rau hauv tus account lub xub ntiag ntawm fetus nyob rau hauv lub tsev menyuam. Qhov no yog vim tsis tsuas yog lub xub ntiag ntawm tus me nyuam hauv plab, tab sis kuj rau lub tsev menyuam loj thiab nws cov ntshav txaus. Yog li ntawd, txoj hauj lwm dhau los ua kom tsis txhob los ntshav, raug mob rau lub embryo thiab sepsis tom qab phais.
Kev nkag mus yog los ntawm qhov nruab nrab qhov txiav ntawm phab ntsa hauv plab, tom qab ntawd tus kws phais tshem tawm lub tsev menyuam nrog tus menyuam hauv plab rau hauv qhov txhab thiab tuav nws. Qhov no txo qhov kev pheej hmoo ntawm cov ntshav poob loj. Nyob rau hauv lub cev xeeb tub, tsuas yog cov nodes tseem ceeb yog husked, uas tiv thaiv lub fetus los ntawm loj hlob thiab nyem.lwm lub cev.
Kev tshuaj xyuas ntawm plab myomectomy thaum cev xeeb tub qhia txog kev ua tiav ntawm txoj kev siv, ua raws li kev xeeb tub. Kev xa tawm tom qab myomectomy nrog tib lub cev xeeb tub tsuas yog ua los ntawm kev phais.
Abdominal myomectomy
Txoj kev tseem hu ua laparotomy - qhov no yog kev ua haujlwm hauv plab. Niaj hnub no nws tsis tshua siv. Tsuas yog nyob rau hauv cov ntaub ntawv ntawm ib tug loj heev deformed lub tsev menyuam vim muaj ntau lub nodes los yog lawv loj loj.
Ib qhov me me yog ua nyob rau hauv qhov chaw suprapubic ntawm lub plab, thiab cov neoplasm yog ua tib zoo exfoliated los ntawm uterine kab noj hniav. General tshuaj loog. Lub sijhawm postoperative nyob rau hauv cov ntaub ntawv no yog qhov nyuaj tshaj plaws thiab ntev - 2-3 lub lis piam. Ntxiv rau manipulations - hauv kev tswj cov chav kawm ntawm kev ua haujlwm ncaj qha los ntawm tus kws phais. Cov neeg mob hauv lawv cov kev tshuaj xyuas ntawm lub plab ua haujlwm ntawm myomectomy tham txog qhov tshwm sim ntawm cev xeeb tub 6-18 lub hlis tom qab kev cuam tshuam.
Laparoscopic myomectomy
Laparoscopic myomectomy tso cai rau tag nrho cov kev tsim nyog yuav tsum tau ua los ntawm me me 3-4 punctures nyob rau hauv anterior plab phab ntsa, tom qab uas xyaum tsis muaj nti. Me me nti nyob rau hauv daim ntawv ntawm cov dots tseem nyob ntawm qhov chaw ntawm qhov incisions. Kev nce qib ntawm kev ua haujlwm yog saib xyuas los ntawm kev saib xyuas.
Muaj qhov zoo meej ntawm laparotomy. Lub sijhawm postoperative yog luv dua nrog laparotomy - tsuas yog 2 lub lis piam. Tsis tas li ntawd, laparoscopy xyaum tsis ua rau muaj teeb meem xws li kab mob, los ntshav, thiab lwm yam, vim tias tsis muaj qhov txiav ntawm lub tsev menyuam, tsis muaj caws pliav, muaj lub caij nyoog zoo rau yug menyuam.feem ntau.
Laparoscopic myomectomy tshuaj xyuas feem ntau yog qhov zoo. Tus neeg mob tuaj yeem tawm hauv tsev sai li 2-3 hnub tom qab kev cuam tshuam endoscopic.
txwv rau laparoscopy:
- myoma nodule loj dua 9 lub lis piam;
- knot nyuaj mus txog qhov chaw;
- yuav tsum tsis muaj lus hais;
- rog rog qib 2;
- ntau tus fibroids.
Hysteroscopic myomectomy
Qhov no yog kev tshem tawm ntawm myomatous nodes los ntawm lub tsev me nyuam kab noj hniav los ntawm nws lub tsev me nyuam thiab qhov chaw mos, xws li transvaginally, tsis muaj incisions. Lwm lub npe yog transcervical tshem tawm.
Cervical dilation yog ua tiav nrog hysteroscope. Lawm, txoj kev no muaj feem xyuam rau cov nodes me me thiab lawv qhov chaw submucosal. Tsis muaj qhov caws pliav ntawm lub tsev menyuam thiab daim tawv nqaij, uas yog qhov tseem ceeb rau cov poj niam npaj cev xeeb tub thiab yug menyuam.
Hysteroscopic myomectomy lossis hysteroresectoscopy yog ua los ntawm tus neeg mob sab nraud, feem ntau nyob rau hauv cov tshuaj loog hauv zos. Ua mechanically lossis electrosurgically.
Indications:
- submucosal nodes ntawm ceg tsawg dua 10 cm;
- submucosal fibroids raug rau UAE ua ntej.
Cov txheej txheem muaj kev tshuaj xyuas zoo. Ntau tus poj niam nyiam hysteroscopic myomectomy vim nws qhov ua tau zoo thiab lub sijhawm me me - tsuas yog 15-20 feeb xwb. Lwm qhov ntxiv yog tias ob peb teev tus neeg mob mus tsev.
Tsim nyog tau hysteroscopicmyomectomy tshuaj xyuas ntawm txoj kev npaj zoo kuj vim tias muaj teeb meem nrog txoj kev no yog qhov tsawg kawg nkaus, kev xeeb tub tuaj yeem npaj tau nyob rau thawj rau lub hlis thiab cia siab rau nws txoj kev kawm tiav.
FUS ablation ntawm uterine fibroids
Ib txoj hauv kev tshiab los kho uterine fibroids. Nws lub ntsiab lus yog nyob rau hauv qhov tseeb hais tias cov fibroid hlwb raug rau tsom ultrasonic tsis. Li no lub npe FUS - tsom ultrasound. Nws yog ua los ntawm kev tswj ntawm MRI, tsis muaj tshuaj loog. Nrog kev pab los ntawm xws li ablation, qhov luaj li cas ntawm neoplasm yuav txo tau yam tsis muaj kev phais. Contraindications: lub siab xav ntawm tus poj niam los xeeb tub yav tom ntej, ntau tshaj 5 myoma nodes nyob rau hauv lub tsev menyuam.
Kev tshuaj xyuas txog kev ua haujlwm ntawm myomectomy hauv txoj kev no yog qhov zoo. Txawm hais tias tus txheej txheem nws tus kheej tuaj yeem siv sijhawm li 6 teev.
Yuav Hysterectomy
Tag nrho kev tshem tawm ntawm tsev menyuam yog qhov chaw kawg. Nws yog tshuaj rau cov fibroids loj, ntau yam, nrog rau cov teeb meem loj. Kev tshem tawm ntawm lub tsev menyuam tuaj yeem ua tau los ntawm ib qho ntawm cov khoom siv saum toj no - laparotomy, laparoscopy, hysteroscopy.
Tshem tawm lub tsev me nyuam, cov appendages tseem sim txuag nws. Rau dab tsi? Kev ua me nyuam yuav tsis ua hauj lwm, tab sis kev tsim cov tshuaj estrogen yuav txuas ntxiv mus, thiab kev phais lawm yuav tsis tshwm sim.
Txoj haujlwm no muaj nws qhov zoo:
- tshem tawm ntawm qhov tuaj yeem los ntshav ntawm ntau yam;
- tsis muaj kev pheej hmoo ntawm fibroid rov ua dua;
- tsis muaj mob qog noj ntshav;
- tsis txhob siv kev tiv thaiv.
Uterine embolizationarteries (UAE)
Uterine artery embolization yog qhov ua haujlwm tsawg kawg nkaus uas txiav tawm cov ntshav mus rau fibroids. Nws cov ntsiab lus yog tias lub catheter tau ntxig los ntawm kev sib tsoo ntawm cov hlab ntsha femoral, los ntawm cov sclerosing tshwj xeeb tshuaj raug txhaj rau hauv cov hlab ntsha uas pub cov qog.
Vim li ntawd, cov hlab ntsha tau txhaws thiab cov ntshav ntws tsis tshwm sim hauv lawv. Myoma cells nres tau txais zaub mov thiab maj mam tuag. Cov ntaub so ntswg loj hlob hauv lawv qhov chaw. Yav tom ntej, nws yuav daws tau.
yam tseem ceeb
Hysteroscopic phais yog txheej txheem sab nraud. Laparoscopy tso cai rau tus neeg mob tawm hauv 1-3 hnub. Nrog laparotomy, tus neeg mob nyob hauv chav haujlwm li 7-10 hnub.
Mob tom qab myomectomy, lossis zoo dua, tsis xis nyob hauv plab plab tshwm sim thawj 3-4 hnub nyob rau hauv daim ntawv ntawm rub qhov mob hauv plab tom qab phais. Lawv tau yooj yim nres los ntawm cov pa analgesics. Tom qab phais hysteroscopic, lawv tsis tas yuav tsum tau.
Tom qab myomectomy, pom pom tshwm sim thaum thawj hnub. Qee zaum lawv tuaj yeem kav ntev txog ib hlis tom qab myomectomy. Thawj 2 hnub lawv muaj ntau ntau. Maj mam ua tsawg, pob tshab thiab nres. Txwv tsis pub, nws yuav qhia qhov teeb meem.
Lub voj voog kev coj khaub ncaws feem ntau rov qab los tsis muaj teeb meem, nyob rau hauv txoj kev uas hnub ua haujlwm suav tias yog thawj hnub ntawm lub voj voog dhau los. Nrog myomectomy, kev coj khaub ncaws rov qab sai heev: kev xeeb tub tsis raug cais tawm hauv thawj lub hlis tom qab ua haujlwm.
Tab sis qhov no yog qhov tsis xav tau, yog li cov kws kho mobNws raug pom zoo kom siv cov tshuaj tiv thaiv kab mob hauv thawj 4-5 lub hlis. Cov hlua khi raug tshem tawm rau hnub 7-10.
Rehabilitation period
Tom qab myomectomy, kev rov qab los yog txiav txim siab los ntawm qhov raug xaiv ntawm kev kho mob, qhov ntim ntawm kev ua haujlwm, muaj teeb meem, lub hnub nyoog ntawm tus poj niam, thiab comorbidities.
Tshuaj uas pab tiv thaiv kab mob ntshav qab zib, tshuaj tiv thaiv kab mob thiab tshuaj uas txhim kho cov ntshav microcirculation hauv cov ntaub so ntswg tau sau tseg. Tsis tas li ntawd, nws raug nquahu kom hnav cov ris tsho elastic compression rau qis qis kom tiv thaiv thrombosis, uas yuav tshwm sim thaum lub sijhawm rov ua haujlwm.
Txhua yam no ua ke yuav tsis yog tsuas yog kho cov myometrium thiab endometrium xwb, tab sis kuj tseem pab tsim cov caws pliav puv ntawm lub tsev menyuam, uas yog qhov tseem ceeb heev rau cov poj niam uas muaj hnub nyoog yug me nyuam.
Txhawm rau tiv thaiv kev kis kab mob thib ob ntawm qhov caws pliav thiab qhov txhab, tus kws kho mob yuav tsum muab tshuaj tua kab mob nrog cov tshuaj tua kab mob dav dav.
Laparoscopic myomectomy tshuaj xyuas feem ntau yog qhov zoo. Nrog txoj kev cuam tshuam no, tus poj niam tau sawv thiab taug kev hnub tom ntej.
Nrog laparotomic myomectomy, qhov no ua tau rau 4-5 hnub. Tab sis nyob rau hauv txhua rooj plaub, nws yuav tsum tau: nyob rau hauv 3 lub hlis tom qab qhov kev cuam tshuam, koj yuav tsum tsis txhob hnyav lub cev, hnav ib daim ntaub qhwv postoperative thiab sim tiv thaiv cem quav.
Kev kho mob tom qab phais
Tom qab myomectomy, kev kho mob ib txwm txuas ntxiv nrog cov tshuaj hormones (HRT). Nws kav ntau lub hlis thiab suav nrog kev siv cov tshuaj hormones xws li Buserelin,"Mifepristone" thiab lwm yam.
Lub sijhawm rov kho dua tom qab myomectomy rau 5-7 hnub, thiab tom qab ntawd tom qab 2 lub hlis thiab rau lub hlis, ultrasound raug pom zoo. Nws yuav pab ntsuam xyuas qhov mob ntawm qhov caws pliav ntawm lub tsev menyuam thiab muaj qhov rov ua dua tshiab. Nws yuav tsum nco ntsoov tias kom txog rau thaum qhov kev txiav txim siab tau muab rau tag nrho cov caws pliav, cev xeeb tub tsis suav nrog.
Rau cov poj niam uas nyiam tos-thiab-pom cov tswv yim thaum lawv muaj fibroids, vam tias thaum cev xeeb tub tshwm sim, cov fibroids yuav daws lawv tus kheej (qhov kev xav no muaj ntau heev), nws tsim nyog xav tias kev ua siab ntev hauv qhov teeb meem no txaus ntshai..
Myoma yeej ib txwm muaj kev pheej hmoo, thiab tsis muaj leej twg tuaj yeem kwv yees nws tus cwj pwm. Qhov kev tawm tsam no feem ntau ua rau tom qab xav tau tshem tawm lub tsev menyuam. Yog tias koj yuav yug menyuam thiab muaj menyuam, myomectomy yuav tsum tau ua tsis pub dhau 3 xyoos tom qab kuaj pom.
Yuav muaj teeb meem tom qab myomectomy
Cov teeb meem hauv qab no tuaj yeem ua tau:
- Ntsuag. Txhawm rau txo nws txoj kev pheej hmoo, kev kho tshuaj hormonal, UAE, kev kaw ib ntus ntawm qee cov hlab ntsha thaum lub sijhawm phais yog siv ua ntej kev phais.
- Kev coj khaub ncaws tsis xwm yeem. Kev ua haujlwm yog ib qho kev ntxhov siab rau lub cev, thiab hormonal tsis ua haujlwm yog ib qho kev teb ntawm lub cev. Tab sis thaum tsis muaj teeb meem, kev coj khaub ncaws rov qab los tom qab ib hlis, qhov siab tshaj plaws - tom qab 3. Txwv tsis pub, qhov ua rau yuav tsum tau qhia meej nrog kws kho mob.
- Kev kis kab mob - txhawm rau zam kom tsis txhob kis mob, tom qab phais tas yuav tsum tau saib xyuas kom zoo, tsis txhob cia cov kab mob me me ntawm nws.
- Kev sib txawv ntawm cov seams. Yog vim li cas tej zaum yuav tsis raugnws txoj cai los yog kev saib xyuas tsis raug. Txhawm rau pab nyob rau hauv xws li mob, lub qhov txhab yog nquag ntxuav nrog tshuaj tua kab mob thiab kho nrog tshuaj tua kab mob. Hauv qhov xwm txheej hnyav, yuav tsum tau ua haujlwm thib ob.
- Adhesion yog ib qho tshwm sim ntau zaus tom qab ua haujlwm plab. Nws manifests nws tus kheej raws li ib tug rub mob nyob rau hauv lub plab mog thiab nyob rau hauv nws lateral seem. Nrog cov lus tshaj tawm adhesions nyob rau hauv cov hlab ntsha fallopian, kev xeeb tub ectopic yuav tshwm sim nrog ntxiv lawm tshob. Tom qab ntawd IVF tau tshwm sim.
- Fibroids rov tshwm sim. Kev txheeb cais thiab tshuaj xyuas ntawm myomectomy ntawm uterine fibroids qhia tias kev ua haujlwm tsis yog panacea. Nrog rau ib leeg, kev rov tshwm sim tuaj yeem tshwm sim hauv txhua tus neeg mob thib tsib, nrog ntau lub pob - hauv txhua thib ob. Lawv tuaj yeem tshwm sim tom qab 5-10 xyoo. Cov kws kho mob thiaj li qhia kom tsis txhob ncua kev xeeb tub rau xyoo, tab sis npaj kom cev xeeb tub 6-12 lub hlis tom qab ua haujlwm.
Kev txwv tom qab myomectomy tom tsev
Cov cai hauv qab no yuav tsum tau ua tom qab ua haujlwm:
- No sex for 1.5 months.
- Tsis txhob nqa qhov hnyav, qhov hnyav - tsis tshaj 3kg.
- Tsis muaj kev cob qhia lossis ua haujlwm lub cev.
- Kev ua si nawv, mus ntsib solarium, saunas, da dej, pas dej da dej rau 2 lub hlis tsis pom zoo.
- Thaum ua poj niam (tshwj xeeb tshaj yog tom qab hysteroscopic myomectomy), tsis txhob siv tampons.
Cov ntsiab lus tseem ceeb tom qab phais
Cov haujlwm hauv qab no raug pom zoo:
- Txhawb nqa ntaub qhwv yuav tsum tau nyob hauv ib hlis.
- Kev noj zaub mov tsis qab thiab khoom noj fermenting.
- Hnav nkaus xwbntuj linen.
- Da dej xwb, tsis da dej.
- Siv cov khoom siv tu cev.
Thaum twg kuv tuaj yeem npaj thiab yug me nyuam tom qab myomectomy?
Koj tuaj yeem npaj cev xeeb tub thiab yug me nyuam tom qab txhua hom kev phais mob myomectomy tsis ntxov tshaj li 4 lub hlis, thiab tseem zoo dua hauv rau lub hlis. Lub sijhawm no txaus rau qhov caws pliav ntawm lub tsev menyuam kom kho tau ntau yam uas tus poj niam yuav nqa tau tus menyuam mus txog qhov kawg yam tsis muaj teeb meem thiab yug me nyuam.
Tseem ceeb kom paub
Kev xeeb tub thaum ntxov uas tsis muaj qhov caws pliav tuaj yeem ua rau muaj teeb meem loj heev thaum yug menyuam, mus txog rau lub tsev menyuam rupture nrog los ntshav loj. Nws tsis tsim nyog suav rau. Lub cev xeeb tub tom qab myomectomy tuaj yeem ua tau tsuas yog tom qab tsim cov caws pliav nplua nuj ntawm lub tsev menyuam, uas yuav raug qhia ntawm ultrasound lossis vim yog kev tshem tawm ntawm fibroids los ntawm txoj kev transvaginal.
Nyob rau lwm qhov xwm txheej, ib qho kev phais mob yog qhia raws li kev npaj. Cov poj niam tawm tswv yim sib txawv txog myomectomy. Cov kws kho mob feem ntau pom zoo kom ua haujlwm ua haujlwm kom tshem tawm qhov kev pheej hmoo. Cov tactics zoo li no yog kev ncaj ncees, vim yeej muaj kev pheej hmoo.
Kev tiv thaiv ntawm uterine fibroids
Rau lub hom phiaj ntawm kev tiv thaiv, yuav tsum tau ua cov kev ntsuas hauv qab no:
- Nyob mus ntsib kws gynecologist ob zaug hauv ib xyoos.
- Ultrasound ntawm lub plab pelvic ib xyoos ib zaug.
- Kev sib deev lub neej.
- Tsis suav rho menyuam tawm los ntawm txhua txoj kev muaj.
- Siv cov tshuaj hormone hloov kho.
- kho mob gymnastics.
- Nco ntsoovluj.
- Y Prophylactic kom tau txais cov vitamin-mineral complexes nrog cov tshuaj antioxidant (vitamin A, E, C, hlau, zinc, iodine, selenium).
Reviews
Feem ntau, txawm tias 2 lub hlis tom qab myomectomy, raws li kev tshuaj xyuas, cov poj niam pib ua lub neej ib txwm muaj. Ua tsaug rau kev ua haujlwm, ntau tus neeg tswj kom cev xeeb tub thiab muaj kev nyab xeeb xeeb menyuam. Kev phais niaj hnub no muab lub sijhawm rau tus poj niam kom yug nws tus kheej, tshem cov fibroids yam tsis muaj caws pliav.
Nyob zoo los ntawm cov kws kho mob tshwj xeeb los ntawm Road Clinical Hospital. N. A. Semashko. Raws li kev txheeb xyuas, myomectomy, hysteroscopy thiab laparoscopy tau ua hauv lub tsev kho mob no yuav luag tsis ua rau muaj teeb meem tom qab phais. Tsis tas li ntawd, kev kho kom rov zoo li no sai dua thiab yooj yim dua.
Cov lus pom zoo ntawm kev saib xyuas myomectomy tseem tshuav los ntawm cov poj niam uas, vim yog kev loj hlob ntawm tus kab mob, tau ntsib kev xeeb tub thib ob. Lawv nco ntsoov tias tom qab kev txiav tawm ntawm cov kab mob pathological, lawv tau txais lub sijhawm los npaj cev xeeb tub thiab yug lawv tus kheej, txawm tias muaj qhov caws pliav ntawm lub tsev menyuam uas tseem nyob tom qab "qhib" ua haujlwm. Qhov no yuav tsum tau muab tso nrog, feem ntau yam tsis muaj kev cuam tshuam, kev tshem tawm cov fibroids tsis tau.
Lub tsev haujlwm loj tshaj plaws uas cov poj niam tig mus rau kev kho mob myomectomy yog National Medical Research Center muaj npe tom qab V. A. Almazov hauv St. Petersburg thiab lub tsev kho mob muaj npe tom qab N. A. Semashko - lub tsev kho mob hauv Moscow rau cov neeg ua haujlwm railway thiab lawv tsev neeg.
Myomectomy tshuaj xyuas hauvQhov chaw ntawm Almazov feem ntau tsis yog li rosy. Muaj ntau qhov tsis txaus siab rau qhov chaw no. Kev tshuaj xyuas tsis zoo ntawm myomectomy ntawm Almazov Kev Tshawb Fawb Lub Tsev Haujlwm, pom tau tias yog cov neeg mob uas tau ntsib teeb meem. Hais txog lub tsev kho mob Semashko, muaj tsawg dua kev tshuaj xyuas tsis zoo txog myomectomy.
