Reactive hloov nyob rau hauv lub epithelium yog txaus ntshai rau poj niam txoj kev noj qab haus huv. Thiab tib lub sijhawm, lawv tsis tshua pom lawv tus kheej hauv txhua txoj kev. Cov chav kawm Asymptomatic nyob rau lub sijhawm nyuaj rau kev kuaj mob. Yog li ntawd, nws raug pom zoo kom txhua tus poj niam mus rau qhov chaw ua haujlwm gynecological tsawg kawg ib xyoos ib zaug los kuaj cytological ntawm microflora.
Vim li cas cov kev hloov no tshwm sim txhua? Dab tsi yog qhov yuav tsum tau ua ua ntej thiab yog vim li cas? Puas muaj cov tsos mob? Qhov no thiab ntau lwm yam yuav tau tham tam sim no.
Normal indicators
Ua ntej koj yuav tsum tham txog lawv. Lub tsev menyuam muaj peb txheej - sab hauv mucosa (tseem hu ua endometrium), cov leeg thiab integumentary.
Nquag, qhov chaw ntawm nws lub ncauj tsev menyuam yog xim liab thiab du. Qhov no yog vim ib txheej txheej ntawm basal epithelium. Nquag, qhov ntsuas ntsuas Schiller (kev ntsuas ntsuas) hloov xim av.
Thaum lub sijhawm soj ntsuam cytological, ib qho nyiaj ntawmleukocytes, nrog rau squamous epithelial cells.
Leukocytes ib txwm muaj cov nuclei thiab cov cytoplasm ntshiab. Tsis muaj cov tsos mob ntawm phagocytosis. Swabs tej zaum yuav muaj cov hlwb nrog hloov cytoplasm thiab mucus.
Pathogenesis
Cov kev hloov pauv hauv epithelium tshwm sim vim yog kis los ntawm tus poj niam uas muaj tus kab mob. Qhov no tshwm sim, raws li txoj cai, vim tsis muaj kev tiv thaiv kev sib deev nrog tus khub tsis tau lees paub.
Kwv yees li 50% ntawm tag nrho cov kab mob yog los ntawm cov kab mob. Cov kab mob ntawm qhov chaw mos provokes ib tug zoo xws li cov txheej txheem uas tshwm sim nyob rau hauv lub ncauj tsev menyuam.
Ntxim qab kawg, qee zaum txawm tias cov kab mob uas ua rau lub ntuj microflora ntawm qhov chaw mos yog cov kab mob sib kis. Tab sis qhov no tsuas yog tshwm sim thaum lub cev tsis muaj zog.
Kev kuaj thawj zaug, txhawm rau txheeb xyuas cov kev hloov pauv hauv epithelium, qhia qhov mob. Kev tsom xam rau cytology qhia cov ntsiab lus ntawm ntau cov leukocytes nrog cov nuclei puas, eosinophilic thiab lymphoid ntsiab. Yog hais tias peb tham txog cov microflora, ces nrog reactive hloov nyob rau hauv lub epithelium, nws yuav sib tov.
Yog tias kuaj pom qhov mob nyob rau lub sijhawm, nws tuaj yeem ua tiav nrog kev pab kho cov kab mob txaus. Kev kho yog ua tiav nrog kev kho cov microflora - rau qhov no, prebiotics yog siv.
Kev faib tawm
Tom qab kev soj ntsuam cytological, xws li reactivesquamous pauv:
- Exudative. Ib tug poj niam tau rhuav tshem neutrophil leukocytes. Cov smear muaj cov seem ntawm cov cell thiab nuclei. Ciaj sia nyob, tag nrho, hauv lub xeev ntawm phagocytosis.
- Kev kho. Lub npe ntawm hom kev hloov pauv no tau muab los ntawm kev kho qhov tshwm sim ntawm qhov tsis zoo ntawm cov txheej txheej thiab tom qab epithelialization. Raws li qhov tshwm sim ntawm kev tsom xam, cov hlwb ntawm qhov loj tuaj yog pom. Nws yog vim lawv cov ntaub so ntswg loj hlob, uas replenishes cov cheeb tsam cuam tshuam. Lub nuclei loj dua, tab sis tsis txhob poob lawv cov contours meej. Chromatin tsub zuj zuj yog tsis pom. Los ntawm txoj kev, nws muaj ib tug mos-grained qauv.
- Degenerative. Manifested los ntawm wrinkling ntawm cell nucleus. Kuj tseem muaj kev ua txhaum ntawm cov qauv ntawm cov ntaub so ntswg nuclear thiab chromatin. Kev loj hlob ntawm cov epithelium qhia tau hais tias muaj cov txheej txheem mob ntev.
Hais txog cov kev hloov pauv hauv squamous epithelium, nws yuav tsum tau muab sau tseg tias kev tshuaj xyuas cytological kuj feem ntau qhia txog kev sib xyaw ua ke ntawm kev hloov pauv. Feem ntau, cov tshuaj kho tau ua ke nrog cov degenerative thiab proliferative sawv daws yuav.
Nyob rau hauv cov xwm txheej zoo li no, kuaj pom cov cell multinucleated nrog cov nuclei loj. Daim duab cytological zoo li dysplasia lossis mob qog noj ntshav. Yog hais tias peb tham txog inflammatory atypia, ces nws yog txawv los ntawm ib tug uniform faib ntawm chromatin. Cov pob muaj fuzzy contours.
Kev loj hlob
Nov yog lub npe ntawm kev hloov pauv hauv cov qog nqaij hlav hauv lub cev. Nws manifest nws tus kheej li cas? Qhov nce ntawm cov cellular glandular Cheebtsam nyob rau hauv lub ncauj tsev menyuam kwj dej. nwsTsis yog tus kab mob ywj pheej, tab sis kev hloov pauv ntawm cytological.
Yog li, kev loj hlob nruab nrab qhia tias pseudo-erosion. Thaum lub sij hawm kuaj xyuas, nws muaj peev xwm txheeb xyuas cov cim qhia ntawm tus kab mob nyob rau hauv qhov chaw mos ntu, qhov twg lawv tsis nyob rau hauv tus qauv. Raws li ib feem ntawm kev kuaj mob, kev kuaj pom, smear cytology thiab colposcopy tau ua.
Yog tias ib tug poj niam mob o nrog kev loj hlob, nws yuav hnov mob hauv qhov chaw mos thiab tsis xis nyob. Thaum cov tshuaj hormones tsis txaus yog qhov ua rau, los ntshav ntawm lub sijhawm, amenorrhea thiab lwm yam tsos mob kuj tshwm sim.
Qhov ua rau tsis yog ib txwm raug mob lossis kis kab mob. Txawm hais tias tus poj niam noj qab haus huv tuaj yeem loj hlob yog tias nws siv OCs thiab feem ntau tsis quav ntsej txog kev tswj hwm tshuaj.
Kev kho mob los ntawm kws kho mob yog ib txwm tsom rau kev tshem tawm qhov ua rau tus kab mob. Yog hais tias, piv txwv li, nws tshwm sim vim muaj kab mob, ces cov tshuaj tua kab mob yuav siv tau.
Kev poob qis
Yog li, "kev hloov pauv hloov pauv hauv lub epithelium" txhais li cas - nws yog qhov tseeb. Tam sim no koj yuav tsum delve rau hauv txoj kev kawm ntawm lub ncauj lus no thiab xav txog tej yam kab mob.
Cervical erosion yog ib qho kev puas tsuaj uas ua rau lub npe hu ua squamous epithelium nyob ib ncig ntawm lub cev sab nraud.
Tau kawg, qhov ua rau yog mob. Erosion tshwm sim nyob rau hauv feem ntau ntawm cov poj niam uas muaj cervicitis thiab endocervicitis. Txawm hais tias tseem muaj ib qho version raws li qhov laj thawj yog qhov hloov pauvqib ntawm cov tshuaj steroid poj niam txiv neej. Muaj qee qhov tseeb hauv qhov no, txij li kev soj ntsuam soj ntsuam tau pab txheeb xyuas cov tsos mob ntawm kev yaig thaum cev xeeb tub. Hauv lub sijhawm tom qab yug menyuam, lawv dhau mus, raws li keeb kwm hormonal stabilizes.
Erosion yog tus yam ntxwv los ntawm kev rov tshwm sim, ntev, tsis tu ncua. Cov kab mob no tsis tuaj yeem hloov kho rau kev kho mob. Tab sis hmoov tsis, qhov kev kuaj mob yog qhov nyuaj, vim tias tsis muaj cov yam ntxwv tsis txaus siab ntawm cov poj niam. Tsis tas li ntawd, tus kab mob no, uas yog tshwm sim los ntawm reactive hloov nyob rau hauv epithelial hlwb, kuj asymptomatic.
Koj tuaj yeem kuaj pom kab mob thaum kuaj pom lub ncauj tsev menyuam, nrog rau los ntawm colposcopy.
Kev kho erosion
Lub hauv paus ntawm kev kho mob txhawm rau txhawm rau tshem tawm tus kab mob no yog lub tswv yim txhawm rau txhawm rau rhuav tshem cov hlwb ntawm lub cylindrical epithelium. Lub hom phiaj yog tsis lees txais lawv thiab rov qab kho cov epithelium squamous ntxiv.
Muaj ntau ntau txoj hauv kev los pab ua kom tiav:
- Diathermocoagulation. Thaum lub sij hawm tus txheej txheem, cov ntaub so ntswg hloov pauv yog cauterized nrog ib tug alternating high-frequency hluav taws xob tam sim no. Nws provokes cov ntaub so ntswg cua sov, vim qhov xav tau tshwm sim. Cov txheej txheem no yog contraindicated nyob rau hauv cov neeg mob nulliparous, raws li caws pliav raws li qhov tshwm sim, thiab lawv tiv thaiv qhov qhib ntawm lub ncauj tsev menyuam thaum lub sij hawm tus me nyuam. Tsis tas li ntawd, txoj kev yog traumatic. Kev kho mob yuav kav li ntawm 1.5-3 lub hlis. Feem ntau qhov tshwm sim yog endometriosis, yog li nws yog qhov tsim nyog los ua cov txheej txheem hauv theem ob ntawm kev coj khaub ncaws.
- Laser vaporization. Qhov no yog "cauterization"laser yaig. Qhov zoo tshaj plaws, nws yuav tsum tau nqa tawm rau hnub 5-7 ntawm lub voj voog. Kev huv ntawm lub ncauj tsev menyuam thiab qhov chaw mos yog prescribed. Tag nrho cov txheej txheem yog tsis mob thiab tsis tawm nti. Kev rov tsim dua tshiab tau pom tom qab ib hlis.
- xov tooj cua kho mob. Nyob rau hauv cov txheej txheem no, high zaus electromagnetic oscillations ua rau lub pathological tsom. Lawv tsis tuaj yeem hnov lub cev. Cov txheej txheem yuav siv sij hawm tsawg tshaj li ib feeb, thiab tsis tas yuav siv tshuaj loog lossis kev kho mob tom qab phais.
- Cryodestruction. Nws txhais tau hais tias khov ntawm cov ntaub so ntswg yaig nrog kua nitrogen lossis nws cov oxide. Cov txheej txheem tsis yog fraught nrog mob, ntshav, lossis nti. Thaum thawj hnub, tus neeg mob yuav muaj cov kua dej ntau dhau thiab o. Tab sis nws yuav dhau mus sai. Nws yuav siv sij hawm ib mus rau ib thiab ib hlis ib nrab los kho.
Nws yuav tsum tau muab sau tseg tias ib qho ntawm cov txheej txheem saum toj no tsuas yog tom qab kuaj xyuas cov kev hloov pauv hauv cov hlwb epithelial.
Nws yog ib qho tseem ceeb uas yuav tsum tau ua txhua yam txheej txheem - los ntawm kev tsom mus rau biopsy mus rau colposcopy, txhawm rau tshem tawm cov txheej txheem oncological. Yog tias tus kws kho mob pom tias qhov kev cia siab ntawm malignant degeneration, ces tus neeg mob yuav tau txais kev pab cuam phais.
Leukoplakia
Txuas ntxiv los tham txog cov kev hloov pauv hauv lub ncauj tsev menyuam, yuav tsum tau ua tib zoo saib xyuas tus kab mob no.
yog dab tsi? Leukoplakia yog ib tug pathological hloov nyob rau hauv lub exocervix, uas yog yus muaj los ntawm proliferation thiab keratinization ntawm lub multilayer.epithelium.
Qhov ua rau tuaj yeem raug mob, tshuaj lom neeg lossis kis kab mob, nrog rau kev cuam tshuam ntawm endogenous yam (tsis muaj zog tiv thaiv kab mob thiab kev tswj hwm hormonal). Kuj tseem ua lub luag haujlwm ua txhaum cai ntawm kev sib raug zoo ntawm lub tsev menyuam, zes qe menyuam, pituitary caj pas thiab hypothalamus. Vim nws yog fraught nrog anovulation, hyperextrogenia thiab progesterone deficiency.
Predisposing yam yog promiscuity thiab kab mob raug kev txom nyem los ntawm ib tug poj niam. Squamous hlwb nrog cov kev hloov pauv tau pom nyob rau hauv cov neeg mob uas raug kev txom nyem los ntawm ib qho ntawm cov hauv qab no:
- Adnexitis.
- YEndometritis.
- Oligomenorrhea lossis amenorrhea.
- Chlamydia.
- YUreaplasmosis.
- YMycoplasmosis.
- Cervicitis.
- Colpitis.
- Ectopia.
Herpes
Feem ntau tus kab mob no yog asymptomatic, tab sis qee zaum nrog kev sib chwv tawm thiab leucorrhoea. Cov hauv paus ntsiab lus ntawm kev kuaj mob yog tib yam li hauv rooj plaub ntawm kev yaig. Tsis tas li ntawd, scrapings thiab biopsy raug kuaj, uas yog coj mus kuaj histological ntawm cov khoom.
Kev kho mob ntawm qhov kev hloov pauv no hauv epithelium ntawm lub ncauj tsev menyuam yog txhawm rau tshem tawm cov kab mob tom qab, nrog rau kev tshem tawm tag nrho ntawm foci qhov twg pathology tau tshwm sim nws tus kheej. Raws li tus kws kho mob cov lus qhia, tshuaj tua kab mob, tshuaj tua kab mob thiab tshuaj tiv thaiv kab mob yog nqa tawm. Lawv feem ntau siv rau ib qho ntawm cov txheej txheem qhia thaum yaig (lawv tau tham saum toj no).
Erythroplakia
Kawm cov xeev uas muajsquamous epithelial hlwb nrog reactive hloov, nws yog tsim nyog los tham txog tus kab mob no. Erythroplakia yog ib yam kab mob uas ua rau muaj kab mob ua ntej uas cov mucosa ntawm exocervix atrophies.
Kuj asymptomatic. Qee zaum mucous tawm thiab los ntshav yog pom. Qhov ua rau tshwm sim zoo ib yam li cov xwm txheej dhau los, tab sis lub nra hnyav tseem tuaj yeem tshwm sim. Cov kws tshawb fawb tseem tsis tau muaj peev xwm ua pov thawj qhov kev sib txuas ntawm erythroplakia nrog chromosomal thiab noob aberrations. Txawm li cas los xij, raws li kev txheeb cais, qhov tshwm sim ntawm kev mob tshwm sim ntau dua ntawm cov ntxhais hauv nws tsev neeg nws tau tshwm sim rau cov poj niam.
Los ntawm txoj kev, lwm qhov ua rau mob nrog kev hloov pauv hauv lub epithelium tuaj yeem raug mob. Kev tawg ntawm lub ncauj tsev menyuam feem ntau tshwm sim thaum yug menyuam, hysteroscopy, rho menyuam thiab kho.
Thaum erythroplakia cuam tshuam tag nrho cov txheej txheem rov ua dua tshiab, nrog rau kev loj hlob thiab kev tsis lees paub ntxiv ntawm exocervix hlwb. Qhov no ua rau muaj kev tsis sib haum xeeb ntawm cov hlwb ntawm ob peb txheej ntawm daim nyias nyias ib zaug. Sij hawm dhau mus, cov mucous ntawm qhov chaw mos ua nyias nyias.
Tus kab mob no asymptomatic, tsuas yog mob hnyav, mob hnyav heev nrog los ntshav.
Yog tias cov hlwb squamous nrog cov kev hloov pauv tau pom, thiab nws tau pom tias qhov no ua rau erythroplakia, kev kho phais raug kho. Conservative therapy yog tsis muaj nuj nqis. Txawm hais tias muaj kev cuam tshuam me me lossis kev cuam tshuam ntawm ncauj tsev menyuam.
Cervical dysplasia
Nrog rau tus kab mob no, ib lub cytogram nrog cov kev hloov pauv hauv cov epithelium qhia txog kev tsimatypical hlwb nyob rau hauv cov chaw uas ib txheej yog mated nrog lub multilayer.
Txhim kho peb theem. Nyob rau theem kawg, muaj cov columnar epithelium nrog cov kev hloov pauv ntawm qhov xwm txheej loj uas nws thiaj li ua rau mob qog noj ntshav.
Tus mob no tshwm sim thawj zaug vim tus kab mob herpes lossis HPV. Cov laj thawj muaj xws li:
- mob hnyav, mob mus ntev.
- Kev haus luam yeeb los yog kev haus luam yeeb.
- Immunodeficiency.
- Hormonal imbalances vim cev xeeb tub, menopause lossis hormonal tsim txom.
- Cervical raug mob.
- Thaum Ntxov Sib Tham thiab Kev Yug Me Nyuam Thaum Hnub Nyoog Me Nyuam Yaus.
Thaum tham txog kev hloov pauv hauv cov hlwb ntawm columnar epithelium thiab lwm yam ntawm cov ncauj lus hauv kev sib tham, nws yuav tsum raug sau tseg tias dysplasia tsis muaj daim duab kho mob ywj pheej. Nws nce mus zais hauv kwv yees li 10% ntawm cov poj niam. Tab sis feem ntau cov kab mob microbial koom nrog, txhua yam uas yuav luag ib txwm ua rau nws tus kheej xav. Feem ntau, cov no yog kab mob gonorrhea, warts, chlamydia.
Raws li ib feem ntawm kev kuaj mob, kuaj lub ncauj tsev menyuam, kuaj cytological ntawm Pap smear, colposcopy, kev tshawb fawb biopsy, thiab tseem ua haujlwm rau immunological PCR cov txheej txheem tau ua.
Yuav ua li cas txog kev kho mob? Nrog rau qhov mob loj heev, kev siv cov interferons thiab lawv cov inducers, nrog rau immunomodulators, tau qhia. Hauv qhov xwm txheej hnyav, kev cuam tshuam kev phais yog qhia - txawm tias thaj chaw dysplasia lossis tag nrho lub ncauj tsev menyuam raug tshem tawm.
Cervical polyps
Ntau tau hais saum toj no txog kev hloov pauv hauv squamous thiab columnar epithelium. Muaj lwm yam mob pathological - nws yog tus cwj pwm los ntawm kev tsim cov polyps hauv lub ncauj tsev menyuam.
Cov no yog cov qog zoo li cov qog uas tuaj ntawm columnar epithelium. Lawv loj hlob mus rau qhov sib txawv.
Cov kab mob no feem ntau ntsib los ntawm cov poj niam hnub nyoog 40 xyoo. Nws yog feem ntau lees paub tias qhov ua rau muaj hnub nyoog hloov pauv, hormonal ntshawv siab, teeb meem tiv thaiv kab mob, kev ntxhov siab. Mechanical trauma, diagnostic curettage, thiab chronic endocercivites yog suav hais tias yog yam muaj tshwm sim.
Kwv yees li ntawm 75% ntawm cov neeg mob, polyps tau ua ke nrog kev yaig, fibroids, zes qe menyuam, atrophic colpitis, pseudo-erosion. Tseem muaj kev pheej hmoo yog cov poj niam uas muaj candidiasis, herpes, mycoplasmosis, ureaplasmosis, trichomoniasis, HPV, thiab lwm yam.
Asymptomatic. Polyps pom pom. Kev kuaj mob yog ua los ntawm kev siv colposcopy, cervical biopsy, ultrasound.
Txhua polyp yog qhov qhia txog kev tshem tawm. Tom qab cov txheej txheem no, scraping yog nqa tawm kom cov ceg tsis nyob hauv. Lub txaj polyp kuj tau kho nrog lub xov tooj cua lossis txoj kev cryogenic. Yog tias kuaj pom cov cim echographic, hysteroscopy yog qhia. Ces curettage ntawm uterine kab noj hniav kuj ua.
Cia li papilloma papilloma
Nov neoplasm no txaus ntshai heev, vim nws muaj peev xwm heevprovoke kev loj hlob ntawm mob qog noj ntshav. Txhua yam pib nrog kev nkag mus ntawm HPV rau hauv lub cev. Tus kab mob kis mus rau lub hlwb ntawm cov mucosa thiab daim tawv nqaij, ua rau cov ntaub so ntswg loj hlob.
Cov laj thawj muaj xws li:
- Kev quav cawv.
- Kev cev xeeb tub.
- Kev noj cytostatics.
- Smoking.
- tsis muaj cov vitamins.
- Thaum pib ntawm kev sib deev.
- YAtopic dermatitis.
- Kev tshem tawm papilloma.
- cuam tshuam microflora hauv qhov chaw mos thiab hauv cov hnyuv.
- Local manifestations of disease.
Cov tsos mob yuav tsis tshwm sim rau lub sijhawm ntev. Papilloma tuaj yeem kuaj pom thaum kuaj, thaum ntsuas ntsuas saum toj no.
Cov tsos mob tshwm sim tsuas yog thaum cov neoplasm tau mus txog qhov loj. Tus poj niam pib hnov qhov kub hnyiab hauv qhov chaw mos, nws cov qog inguinal nce, thiab cov hnoos qeev pib tawm ntawm qhov chaw mos.
Tom qab nrhiav pom papilloma, nws yog qhov tsim nyog los pib kho tshuaj. Cov kws kho mob feem ntau sau ntawv Gardasil. Nws yog ib qho tseem ceeb uas yuav tau muab nws nrog kev noj tshuaj uas ua rau kom lub cev tiv thaiv. Raws li txoj cai, nws raug pom zoo kom siv cov txhais tau tias:
- Immunomodulators - "Interferon" lossis "Genferon"
- YCytostatics - 5-fluorouracil, Bleomycin thiab Podophyllin.
- Antiviral - Panavir thiab Isoprinosine.
Cov tshuaj tua kab mob kuj tuaj yeem raug sau tseg, kev noj haus uas ua rau kev puas tsuaj ntawm kev loj hlob. Tab sis nyob rau hauv cov xwm txheej hnyav, tau kawg, kev phais yog muab.kev kho mob.
Kev Tiv Thaiv
Txhua tus ntxhais raug pom zoo kom kuaj gynecological tsawg kawg ib xyoos ib zaug. Raws li cov lus hais saum toj no, nws tuaj yeem nkag siab tias ntau yam mob hnyav tuaj yeem ua rau asymptomatic, thiab thaum lawv ua rau lawv tus kheej hnov, nws yuav lig dhau rau kev kho kom zoo.
Kev kho mob kuj yog ib txwm muab rau ntawm tus kheej. Lub hauv paus chiv keeb ntawm tus mob, hnub nyoog ntawm tus neeg mob, txawm tias nws tab tom npaj cev xeeb tub thiab, ntawm chav kawm, hom pathology raug coj mus rau hauv tus account.
Tab sis qhov tseem ceeb tshaj plaws yog kev lav phib xaub rau kev xaiv cov neeg sib deev. Tej zaum yuav tsis muaj ib tug txiv neej mus tas li, tab sis nws yog ib qho tsim nyog los tiv thaiv koj tus kheej. Vim nws yog STDs uas ua rau muaj kev hloov pauv.
Thiab koj kuj yuav tsum tau tswj hwm koj txoj kev tiv thaiv, tsis tu ncua ntxiv dag zog rau nws. Vim tias kev tiv thaiv tsis muaj zog ntawm lub cev muab cov xwm txheej zoo tshaj plaws rau kev txhim kho tus kabmob.
Thiab tau kawg, nws yuav tsum ua tib zoo xaiv cov tshuaj tiv thaiv qhov ncauj. Lawv xaiv yog tswj los ntawm kws kho mob. Kev xaiv cov tshuaj tsis raug tuaj yeem ua rau muaj qhov tshwm sim loj. Qhov cuam tshuam hormonal keeb kwm yav dhau yog ib qho laj thawj rau kev hloov pauv.
