Postovariectomy Syndrome yog ib qho nyuaj ntawm cov tsos mob uas muaj kev cuam tshuam nrog endocrine, vegetative-vascular system. Nws yog tsim vim ua tiav kev phais castration nyob rau hauv cov ntxhais ntawm cov me nyuam muaj hnub nyoog. Nws yog ib qho tsim nyog tau txais kev sab laj nrog tus kws kho mob gynecologist thiab tus kws kho mob endocrinologist txhawm rau txheeb xyuas qhov teeb meem.
Signs
Lub tsev kho mob ntawm post-castration syndrome hauv cov poj niam yog cov tsos mob hauv qab no:
- Tides.
- Tachycardia.
- Sweating.
- Arrhythmia.
- Hypertensive crises.
- Kev hloov pauv ntawm cov txheej txheem metabolic.
- Kev puas siab puas ntsws (tearfulness, nquag irritability, hostile-suppressed xeev, hloov mus rau sab phem ntawm pw tsaug zog thiab attentiveness).
- Urogenital paib.
Kev kuaj mob tom qab castration syndrome yog raws li kev kuaj mob gynecological tiav, kev tshawb fawb txog qib tshuaj hormones.
Kev piav qhia
Post-castration dysgenitalism yog tus cwj pwm los ntawm kev ua haujlwm txhua hli vim yog tshem tawm ntawm zes qe menyuam lossis lub tsev menyuam nrog zes qe menyuam. Lwm cov tsos mob tom qab castration hauv gynecology hu ua "postovariectomy dysgenitalism" thiab "kev phais (ua rau) menopause." Qhov zaus ntawm kev tsim yog kwv yees li 60-75%; Hauv 3% ntawm cov neeg mob, postovariectomy dysgenitalism daws nrog cov tsos mob hnyav ua rau muaj kev tsis taus. Cov theem ntawm kev mob tshwm sim tom qab castration yog heev cuam tshuam los ntawm lub hnub nyoog ntawm tus ntxhais thaum lub sij hawm tus txheej txheem, multifunctional dynamism ntawm cov qog adrenal thiab lwm yam mob.
Kev tshwm sim muaj txhua txoj hauv kev tuaj yeem tshwm sim tam sim tom qab tshem tawm ntawm zes qe menyuam, thiab tom qab 2 - 3 lub hlis. Cov hnub nyoog qis dua, qhov tsawg dua qhov syndrome no tshwm sim. Feem ntau, nyob rau hauv ntau tus neeg mob, qhov tshwm sim ntawm tus mob no tshwm sim rau lub hlis, tab sis nyob rau hauv ib lub quarter ntawm cov neeg mob nws muaj peev xwm mus txog rau 3 xyoo.
Qhov tshwm sim ntawm PCS tuaj yeem piav qhia los ntawm kev txo qis ntawm cov tshuaj estrogens thiab nres hauv kev ua haujlwm ntawm cov qog nqaij hlav ntawm qhov chaw mos. Txawm li cas los xij, nws yuav tsum tau hais tias tsis yog txhua tus ntxhais uas muaj cov tshuaj estrogen tsawg thiab qib siab ntawm gonadotropins yuav raug kev txom nyem los ntawm PCS. Thaum nws tshwm sim, siab hypothalamic-pituitary dynamism tseem ceeb. Xws li cov txheej txheem no thiab lwm cov tshuaj hormones tropic (ACTH, TSH). Twb tau tom qab qhov nce hauv lub cev muaj zog hypothalamic-pituitary tshwm sim, cov haujlwm ntawm cov thyroid caj pas, cov qog adrenal - peripheral endocrine qog raug cuam tshuam, thiab lawv, dhau los, muaj zog li sai tau hauv kev txhim kho kev hloov pauv thiab homeostasis.
Qhov no feem ntau piav qhia txog cov tsos mob ntawm PCS thiab yog vim li cas nws thiaj li tsim tsis tau sai tom qab castration, tab sistom qab ib lub sij hawm, tom qab uas cov kev hloov kho theem nrab yog tsim. Vim li no, ntau tus ntseeg tias hauv cov poj niam laus, PCS tau tsim ua ntej ntau dua li cov ntxhais hluas, thiab qhov no cuam tshuam nrog cov hnub nyoog ntsig txog kev ua haujlwm ntawm cov chaw hypothalamic. Txawm hais tias koj them sai sai rau qhov mob ntawm tus kab mob no, tom qab ntawd hauv cov ntxhais hluas nws nyuaj thiab teeb meem ntau dua li cov laus. Txawm li cas los xij, nyob rau hauv cov ntaub ntawv txaus ntshai, nws tau nthuav tawm nyob rau hauv cov ntxhais uas yav dhau los raug kev puas tsuaj los ntawm kev puas siab puas ntsws, kev kis kab mob ntev, kev qaug rau lub cev.
Symptoms
Daim duab kho mob ntawm post-castration syndrome muaj xws li cov hauv qab no pathologies:
- About 71% - vegetovascular pathologies ("kub flashes", arrhythmia, hyperhidrosis, mob plawv, tachycardia).
- 13% - metabolic thiab endocrine pathologies (teeb meem nrog hnyav dhau, hyperglycemia).
- 16% - kev puas siab puas ntsws sib txawv (kev pw tsaug zog tsis zoo, kua muag, ntxhov siab, ntxhov siab, xeev siab, tsis meej pem).
Tag nrho cov tsos mob ntawm post-castration syndrome tuaj yeem muab faib ua ntxov (tso 1-3 hnub tom qab castration) thiab lig (tshem 1-3 xyoos tom qab).
Muaj ntxov (tso tshwm sim 1-3 hnub tom qab kev ua haujlwm tshem tawm zes qe menyuam) thiab lig (tsim tom qab 1-3 xyoos) cov tsos mob tshwm sim tom qab castration syndrome. Rau cov cim thaum ntxovbelong to:
- kev puas siab puas ntsws - kev nyuaj siab, kev xav tsis thoob, kev xav ntxhov siab, ntshai qhov chaw kaw, kev xav tua tus kheej;
- vegetoneurotic pathologies (pathologies hauv kev tswj hwm lub paj hlwb thiab kev cuam tshuam ntawm tag nrho cov kab mob) - kub taub hau, ua daus no, xav tias nkag mus, txaus ntshai rau huab cua kub;
- pw tsaug zog - qaug zog, asomnia, lub teeb tsaug zog nrog nquag sawv, npau suav tsis txaus;
- mob plawv - palpitations, plawv dhia tsis xwm yeem, mob, nce ntshav siab.
Cov tsos mob thaum ntxov yuav tshwm sim sai heev nyob rau lub sijhawm ntawm lub hlis raws li tus ntxhais lub cev hloov kho kom tsis txhob zes qe menyuam ntawm cov tshuaj hormones poj niam txiv neej, thiab cov qog adrenal coj los ua haujlwm ntawm kev tsim cov tshuaj estrogen, tau kawg, ntawm qhov me me.. (cov qog endocrine nyob rau hauv lub raum cheeb tsam).
Tom ntej
Cov cim qhia lig ntawm post-castration syndrome yog:
- nce hauv cov roj cholesterol, qhov tshwm sim ntawm qhov ua rau rog rog.
- Kev txhim kho ntawm atherosclerosis (txhim cov roj plaques hauv cov phab ntsa ntawm cov hlab ntsha, ua rau cov ntshav txav mus los ntawm lawv).
- Ntshav tuab, ua rau muaj kev pheej hmoo ntawm kev tsim cov ntshav txhaws (cov ntshav txhaws uas tuaj yeem nkag mus rau hauv cov hlab ntsha thiab thaiv cov ntshav ntws los ntawm lawv).
- Kev pheej hmoo ntawm myocardial infarction.
- Nyob hauv siab.
- tso zis ntau zaus, enuresis (tsis yeem tso zis thaum lub cev muaj zog lossisluag).
- Sensing dryness thiab overthrow ntawm qhov chaw mos thiab qhov chaw mos, tsis xis nyob thiab mob thaum muaj kev sib deev.
- Osteoporosis yog qhov txo qis ntawm calcium hauv cov pob txha, vim tias lawv cov fragility nce, thiab kev pheej hmoo ntawm pob txha nce.
- Txo kev nyiam (kev ntshaw kev sib deev).
- Txoj kev mob siab, nco, paub cov ntaub ntawv.
- Txoj kev ua neej zoo thiab kev sib raug zoo.
Cov cim qhia ntxov ntawm post-castration syndrome tshwm sim ob peb hnub tom qab tus txheej txheem. Cov paib lig qhia lawv tus kheej tom qab qee lub sijhawm, rau lawv qhov tsim nws yuav siv sijhawm tsawg kawg rau lub hlis tom qab kev phais.
Shapes
Raws li qib ntawm qhov mob hnyav ntawm cov tsos mob, cov hauv qab no hom ntawm cov kab mob tom qab castration syndrome yog txawv:
- easy;
- medium;
- hnyav.
Yog vim li cas
Tag nrho oophorectomy (kev tshem tawm ob sab ntawm lub zes qe menyuam) yog suav tias yog qhov tsim ntawm tus kab mob, tsawg dua - kev tshem tawm ib sab. Tsis tas li ntawd, cov xwm txheej zoo li no tuaj yeem tshwm sim los ntawm kev siv lub sijhawm ntev ntawm lub plab hauv plab thaum lub sijhawm kho radial (hauv kev kho cov kab mob malignant), tsis tshua muaj thaum noj tshuaj tiv thaiv kab mob. Nrog subtotal oophorectomy, poj niam txiv neej cov tshuaj hormones (estrogen thiab progesterone) sai sai nres nkag mus rau hauv lub cev, uas tau secreted los ntawm zes qe menyuam nyob rau hauv raws li txoj cai ua ntej tus txheej txheem.
Qhov tseeb, kev tso tseg tam sim ntawm cov tshuaj hormones no ua rau cov tsos mob ntau duamanifested tshaj li thaum lub sij hawm cev xeeb tub (hnub nyoog-txog rau attenuation ntawm zes qe menyuam muaj nuj nqi thiab thaum kawg ntawm kev coj khaub ncaws), tej zaum ib tug txo nyob rau hauv kev tso tawm ntawm cov tshuaj hormones kev sib deev tshwm sim nyob rau lub sij hawm, thiab lub cev muaj sij hawm los hloov.
Diagnosis
PKD kuaj pom raws li:
- Kev tsis txaus siab ntawm tus ntxhais (kev noj qab haus huv, kev hloov pauv hauv lub siab, kub kub, hnov qhov kub thiab txias, hyperhidrosis, plawv tsis ua haujlwm) thiab kev tshuaj xyuas txog keeb kwm kev kho mob (qhov pib ntawm cov tsos mob tom qab kev tshem tawm ntawm zes qe menyuam).
- Kev tshuaj xyuas cov kab mob ntev (kev mob yav dhau los, kev ua haujlwm, kev raug mob, thiab lwm yam).
- Kev tshuaj xyuas kev coj khaub ncaws (lub sijhawm pib ntawm thawj coj khaub ncaws, kev ua haujlwm thiab lub sijhawm ntawm lub hli dhau los, hnub kawg ntawm kev coj khaub ncaws, thiab lwm yam);
- Kev tshuaj xyuas keeb kwm ntawm obstetric thiab gynecological: tus naj npawb ntawm cev xeeb tub thiab yug menyuam, kev mob yav dhau los thiab cov txheej txheem gynecological.
- Cov ntaub ntawv ntawm kev kuaj xyuas gynecological (tus kws kho mob tuaj yeem kuaj pom cov cim tshwj xeeb - txo qis hauv suab nrov, kev hloov pauv hauv cov khoom noj khoom haus thiab dryness ntawm cov mucous daim nyias nyias ntawm qhov chaw mos ntawm cov menyuam ntxhais).
- Pelvic ultrasound cov ntaub ntawv - koj tuaj yeem kuaj pom qhov tsis muaj zes qe menyuam (yog tias ib qho zes qe menyuam ploj lawm, lub xeev thib ob raug kuaj), txhawm rau ntsuas lub xeev ntawm endometrium.
- Cov ntaub ntawv kuaj ntshav - tsim kom muaj qhov siab ntawm qib ntawm cov tshuaj hormones hauv cov ntshav (qhov txo qis ntawm cov tshuaj hormones poj niam txiv neej estrogen thiab progesterone yuav raug saib xyuas nrog kev nce qib ntawm cov tshuaj hormones pituitary - cov qog hlwb,tswj kev ua haujlwm hormonal ntawm tag nrho cov qog ntawm lub cev), txiav txim siab cov ntsiab lus ntawm cov roj (cholesterol) hauv biochemical kuaj ntshav, kuaj pom cov ntshav txhaws (tsim cov ntshav txhaws) hauv coagulogram (ib qho kev kuaj ntshav tshwj xeeb uas qhia tau tias muaj kev hloov pauv hauv cov ntshav txhaws).
- Electrocardiography cov ntaub ntawv - ua rau nws muaj peev xwm nthuav tawm cov kab mob hauv lub siab ua haujlwm.
- Cov ntaub ntawv ntawm cov pob txha radiography thiab densitometry (kev txiav txim siab ntawm cov pob txha ntom) - ua kom nws tuaj yeem txheeb xyuas cov tsos mob ntawm cov pob txha pob txha (siab fragility ntawm cov pob txha vim qhov txo qis ntawm cov calcium hauv lawv).
- Cov txiaj ntsig ntawm kev soj ntsuam kev puas siab puas ntsws thiab kev sim - txhawm rau nthuav tawm qhov hloov pauv ntawm lub hlwb ntawm tus ntxhais.
- Tej zaum, lwm qhov kev sab laj nrog tus kws kho mob gynecologist-endocrinologist, kws kho mob hlwb, kws kho mob hlwb, kws kho hlwb.
Kev kho mob
Qhov hnyav ntawm cov kab mob no yog txiav txim siab los ntawm lub sijhawm ntawm kev pib kho thiab tiv thaiv kab mob, qhov ntim ntawm cov txheej txheem, hnub nyoog ntawm tus neeg mob, thiab keeb kwm yav dhau los. Kev kho mob ua ntej yuav tsum pib nrog kev npaj psychotherapeutic. Tus ntxhais yuav tsum tau piav qhia txog qhov tseem ceeb ntawm cov txheej txheem thiab qhov tshwm sim tom qab kev phais, vim hais tias poj niam tag nrho - kev coj khaub ncaws thiab kev sib deev ua haujlwm yuav ploj mus.
Non-drug therapy
Kev kho tsis yog tshuaj (theem I):
- kev tawm dag zog thaum sawv ntxov;
- massage;
- kho lub cev kab lis kev cai;
- khoom noj kom raug;
- music raucalm lub paj hlwb;
- cov txheej txheem physiotherapy (electroanalgesia, galvanization ntawm lub hlwb, dab tshos nrog novocaine, kev tawm dag zog);
- kev kho spa - da dej radon, hydrobalneotherapy, hydrotherapy.
Tshuaj
Tshuaj tsis-hormonal kho yog tias lub tsev menyuam raug tshem tawm (theem II):
- Vitamins A, E - lawv yuav pab txhim kho lub xeev ntawm lub hlwb thiab tseem tuaj yeem pab cov cim pib.
- Neuroleptic tshuaj yog cov khoom ntawm phenothiazine series - Triftazin, Meterazin, Frenolon. Lawv lub hwj chim tshwm sim nyob rau theem ntawm lub hlwb, nyob rau hauv lub subcortical textures, ntau ntseeg hais tias lawv muaj ib tug pathogenic nyhuv. Ua ntej, cov tshuaj me me yog siv, thiab tom qab 2 lub lis piam, cov txiaj ntsig tau soj ntsuam. Txo cov koob tshuaj raws sijhawm.
- Tranquilizers - Elenium, Sibazon.
Nyob zoo Hormones
Hormonotherapy (theem III). Hormone therapy hem:
- yuav tsim cov txheej txheem hyperplastic hauv lub tsev menyuam;
- tshuaj estrogen-progestin - lawv tsuas yog siv thaum tus ntxhais tseem muaj hnub nyoog yug me nyuam, tej zaum yuav muaj contraindications - thromboembolic pathologies, ntshav qab zib mellitus.
Kev kho tshuaj hormone yuav tshem tawm qhov ua rau kua muag ntawm cov poj niam. Tom qab tag nrho, nws tshwm sim tawm tsam keeb kwm yav dhau ntawm kev hloov pauv hauv hormonal.
Nws tuaj yeem hloov kho cov tshuaj hormones nyob rau hauv qhov xwm txheej uas tus poj niam raug kho rau PCD muaj hnub nyoog tshaj 45 xyoo thiab tsis muaj contraindications rau estrogen-histogenictshuaj. Twb tau tom qab tuaj txog ntawm lub caij nyoog poj niam cev xeeb tub (feem ntau tom qab 50 xyoo), ntau tus ntxhais tsuas yog tsis xav ua kom lub cev ntev.
Ob-, peb-theem tshuaj ("Divina", "Klimen", "Femoston", "Trisequens", thiab lwm yam) yog siv nyob rau hauv ib tug repetitive txiav txim ntawm contraception nyob rau hauv cov neeg mob uas muaj ib tug khaws cia uterus.
Kev kho cov tshuaj hormone hloov pauv tsis tau sau tseg, thiab nws feem ntau yog contraindicated, txawm tias muaj qog ntawm lub tsev menyuam lossis cov qog mammary, kab mob siab, thrombophlebitis tau kuaj pom.
