Leiomyoma ntawm lub cev ntawm lub tsev menyuam yog ib qho kev loj hlob ntawm cov leeg nqaij ntawm cov phab ntsa ntawm lub cev, uas ua rau mob oncology. Cov qog nws tus kheej muaj cov qauv benign, tab sis tiv thaiv keeb kwm yav dhau los ntawm kev tsis saib xyuas kev kho mob, nws kuj tuaj yeem ua malignant. Hauv cov tshuaj, qhov no pathology tseem hu ua fibromyoma lossis uterine myoma. Tus kab mob no tuaj yeem tshwm sim hauv ib ntawm plaub tus poj niam uas muaj hnub nyoog ntawm peb caug thiab plaub caug. Tus kab mob no suav hais tias yog tshuaj hormone-dependant, tuaj yeem ua mus rau nws tus kheej. Tab sis feem ntau, pathology yuav tsum tau kho kom tsim nyog.
Cia peb mus saib seb nws yog dab tsi thiab yuav ua li cas kho uterine leiomyoma.
Ntawm ntawm pathology thiab qauv ntawm lub tsev menyuam
Yuav kom tau txais lub tswv yim ntawm cov qog no, koj yuav tsum kawm cov qauv ntawm cov poj niam cev xeeb tub. Lub tsev menyuam yog ib lub cev hollow uas muaj peev xwm nqa tau tus menyuam thiab thawb nws tawm thaum yug menyuam. Qhov no complex mechanism ntawm kev ua hauj lwm tshwm sim vim lub myometrium - lub puab txheej ntawm lub cev. Xws li ib tug muaj zog thav duab yog tsim los ntawm cov leeg nqaij fibers ntawm ntau hom nyob rau hauv ua ke nrog connective cov ntaub so ntswg.
Nws yog dab tsi - uterine leiomyoma, koj tuaj yeem pom hauv daim duab.
Sab nraud, lub myometrium yog npog nrog cov serous membrane, uas zoo li cov kab noj hniav hauv plab. Cov txheej sab hauv yog hu ua endometrium, uas muaj txheej txheej ntawm epithelium. Nyob rau hauv ib lub sij hawm ntawm lub voj voog, txheej txheej no tau hloov kho, tom qab ntawd kev coj khaub ncaws tshwm sim. Cov txheej txheem zoo li no yog tswj los ntawm poj niam cov tshuaj hormones, uas yog tsim nyob rau hauv zes qe menyuam.
Tus kab mob no tshwm sim los ntawm qhov tshwm sim ntawm myomatous node. Yog tias muaj ntau qhov tshwm sim, qhov no yog ntau yam uterine leiomyoma. Cov kev loj hlob zoo li no txawv ntawm qhov loj, qauv thiab hom. Cov ntaub ntawv nodular feem ntau tsis tshwm sim rau lawv tus kheej nyob rau hauv ib txoj kev, thiab cov poj niam tsis paub txog tus kab mob rau xyoo yog tias lawv tsis mus ntsib gynecologist tsis tu ncua.
Cov qog tsis muaj cov tsos mob tshwj xeeb thaum ntxov. Daim duab kho mob yog nyob rau hauv ntau txoj kev zoo ib yam li ntau yam kab mob gynecological. Hauv qhov no, txoj kev ntseeg siab tshaj plaws ntawm kev kuaj mob yog ultrasound thiab hysteroscopy. Cov kws kho mob tsis tas yuav tshuaj kho uterine leiomyoma rau cov neeg mob. Feem ntau, thaum tus poj niam mus dhau lawm, cov qog, tig mus, khov thiab rov ua dua. Yog li, nws yuav tsum tau saib xyuas tsis tu ncua.
Qhov noTus kab mob yog nyob ntawm cov tshuaj hormones. Hauv qhov no, nws yooj yim cuam tshuam los ntawm cov tshuaj hormonal. Cov fibroids me me nyob rau hauv kev cuam tshuam ntawm cov tshuaj tuaj yeem ploj mus lossis nres hauv lawv txoj kev loj hlob. Kev ua haujlwm tshem tawm tau raug sau tseg rau hauv cov xwm txheej uas muaj kev pheej hmoo ntawm qhov teeb meem loj, thiab tus poj niam, dhau los, hnov mob hnyav nrog rau kev ua haujlwm tsis zoo ntawm cov kabmob nyob ze. Tab sis txawm tias tom qab phais mob, tus kab mob no tuaj yeem rov qab los. Qhov no feem ntau tshwm sim vim yog kev kho mob tsis raug los tshem tawm cov qog nqaij hlav.
Types of uterine leiomyoma
Tam sim no xav txog kev faib tawm. Nyob ntawm qhov chaw ntawm qhov tshwm sim ntawm myomatous node, cov qog no muaj ntau lub npe hauv cov tshuaj.
- Intramural leiomyoma ntawm lub cev ntawm lub tsev menyuam muaj ntau dua li lwm hom. Nws yog tsim nyob rau hauv lub puab cheeb tsam ntawm cov leeg nqaij txheej. Nws tsim yog tob txaus. Cov tsos mob tshwm sim los ntawm qhov mob ntawm lub plab hauv plab, lub voj voog tsis xwm yeem, thiab ntxiv rau, ua txhaum txoj haujlwm ntawm cov khoom nruab nrog cev.
- Thaum submucosal leiomyoma tshwm sim, cov ntaub so ntswg loj hlob nyob rau hauv ob sab ntawm lub tsev menyuam. Feem ntau, cov qog no tuaj yeem loj hlob hauv lub cev, thiab tsis tuaj yeem xeeb menyuam ib txwm muaj.
- Subserous leiomyoma yog tsim nyob rau hauv lub serosa, uas yog pom tseeb los ntawm lub npe. Nws tuaj yeem nyob rau sab nraud thiab feem ntau loj hlob nyob rau hauv kev coj ntawm lub plab kab noj hniav. Hom no yog tus cwj pwm los ntawm qhov tsis muaj cov tsos mob. Qhov tsuas yog qhov uas cov poj niam pom tsuas yog qhov tsis xis nyob me ntsis hauv plab plab.
- Ntau yam leiomyomas yog tsim los ntawm ntau lub pob uas sib txawv hauv ntim, qhov chaw txuas thiab cov ntaub so ntswg muaj pes tsawg leeg.
- Daim ntawv tsis qhia txog uterine leiomyoma yog hais txog ib daim ntawv zais ntawm cov qog uas tsis tuaj yeem lees paub los ntawm kev kuaj mob. Qhov no tuaj yeem tshwm sim tsis tshua muaj vim qhov me me ntawm cov qog los yog vim nws txoj kev loj hlob qeeb. Gynecologists tsuas tuaj yeem kwv yees txog qhov muaj teeb meem. Cov poj niam yuav tsum tau saib xyuas los ntawm kws kho mob tas li kom tsis txhob nco qhov pib ntawm tus kab mob.
Uterine nodular leiomyoma raug kuaj pom hauv ntau tus neeg mob. Qhov no yog ib hom kab mob gynecological ntau. Nws tshwm sim hauv 30% ntawm cov poj niam ntawm lub hnub nyoog yug me nyuam lig thiab cov neeg mob thaum cev xeeb tub. Raws li rau qhov kev tshwm sim ntawm tus kab mob no, muaj kev tsis ntseeg. Yog tias qhov teeb meem raug kuaj pom raws sijhawm, kev tshuaj xyuas dav dav tau ua tiav thiab kho kho, ces tus kab mob tuaj yeem kho tau sai. Tab sis muaj kev pheej hmoo siab rov tshwm sim, yog li nws yog ib qho tseem ceeb kom mus ntsib kws kho mob gynecologist tsis tu ncua.
Thaum daim ntawv ntawm nodular leiomyoma nce siab, qhov tsim tuaj yeem ua rau malignant, nrog rau qhov no, txawm tias tuag tau.
Leiomyomatosis thiab theem ntawm nws cov maturation
Txhua yam leiomyomatosis tsim hauv myometrium thiab dhau los ntawm qee theem ntawm kev loj hlob:
- Thaum xub thawj, cov leeg pob txha yog tsim, uas loj hlob los ntawm cov leeg nqaij thiab cov fibers nyob ib ncig ntawm cov hlab ntsha me. Nyob rau theem no, kev kho mob tshwm simploj lawm vim uterine leiomyoma me.
- Cia li los siav. Lub sijhawm no, myoma yog nquag loj hlob thiab tsim ib lub pob ntawm cov leeg nqaij, uas thickens dhau sijhawm. Cov ntaub so ntswg uas nyob ib sab pib sib sau ua ke nyob ib ncig ntawm nws, uas tsim ib qho tshwj xeeb capsule. Cov txheej txheem no tseem hu ua qog loj hlob. Thaum kuaj pom, fibroids yog qhov yooj yim los kuaj pom, thiab tus neeg mob twb pom cov tsos mob tshwm sim.
- kauj ruam tom ntej yog kev laus ntawm leiomyoma. Xav tias cov ntaub so ntswg degenerate vim cov txheej txheem pathological, cov node tsis loj hlob.
Nyob rau hauv txhua rooj plaub, oncology tuaj yeem coj txawv txawv. Koj yuav tsum tsis txhob cia siab tias yuav muaj cov tsos mob zoo ib yam rau txhua tus poj niam uas muaj tus kab mob no.
Leiomyoma thiab nws cov laj thawj
Cov qog gynecological kuaj tau ncaj qha nyob ntawm tus poj niam cov tshuaj hormones. Nyob rau hauv lub xub ntiag ntawm ib tug loj npaum li cas ntawm estrogens, hlwb pathologically faib, thiab thaum lub sij hawm cev xeeb tub, cov txheej txheem no freezes. Qhov tseeb ua rau leiomyoma tseem tsis to taub tag nrho, tab sis muaj cov hauv qab no provoking yam:
- Lub hauv paus tseem ceeb yog kev raug mob hlwb nrog rau vascular pathologies thiab kev puas siab puas ntsws. Pituitary thiab hypothalamic cov tshuaj hormones tswj kev ua haujlwm ntawm zes qe menyuam. Lub zes qe menyuam, nyob rau hauv lem, yog lub luag hauj lwm rau cov txheej txheem ntawm maturation ntawm follicles thiab ovulation. Yog li, txhua yam kev cuam tshuam hauv kev ua haujlwm ntawm lub hlwb tuaj yeem ua rau lub cev tsis ua haujlwm ntawm cov menyuam yaus.
- Qhov zoo tshaj plaws yog kis kab mob thiab mob ntawm zes qe menyuammob ntev, suav nrog polycystic. Tawm tsam keeb kwm yav dhau los no, qhov tsis txaus ntawm cov tshuaj hormones tshwm sim, uas ua rau kev kuaj mob ntawm leiomyomatosis. Hauv kev xyaum kho mob, qhov tseem ceeb tshaj plaws yog qhov feem ntau.
- Nrog rau qhov ua rau lub tsev menyuam, txhua yam kev raug mob rau lub cev xeeb tub tuaj yeem ua rau cov tsos mob ntawm neoplasms. Txawm tias tawm tsam keeb kwm ntawm kev ua haujlwm zoo ntawm zes qe menyuam, tsev menyuam tsis tuaj yeem pom cov tshuaj hormones vim kev puas tsuaj rau cov receptors. Kev yug me nyuam nyuaj, nrog rau kev rho menyuam thiab kev phais, tuaj yeem ua rau muaj kev raug mob zoo sib xws.
- Cov yam ntxwv cuam tshuam yog cov teeb meem hauv endocrine system, thyroid kab mob thiab lwm yam. Tag nrho cov no ua rau kev loj hlob ntawm myomatous node.
Thaum tus poj niam paub ua ntej txog nws qhov kev xav txog yam tsawg kawg yog ib qho ntawm cov xwm txheej no, nws raug nquahu kom mus ntsib kws kho mob gynecologist thiab ua tib zoo saib xyuas nws txoj kev noj qab haus huv.
Cov tsos mob ntawm uterine leiomyoma yog dab tsi?
Symptoms of disease
Daim duab kho mob ntawm tus kab mob no ncaj qha nyob ntawm kev loj hlob ntawm cov qog, thiab ntxiv rau, ntawm tus naj npawb ntawm cov nodes, lawv qhov chaw nyob thiab kev loj hlob ntawm pathology. Me me interstitial leeg nodes tsis txaus ntshai rau lub cev. Tab sis submucosal leiomyoma ntawm lub tsev menyuam, txawm tias muaj me me, tuaj yeem tshwm sim nws tus kheej nrog cov tsos mob hauv qab no:
- Muaj kev coj khaub ncaws tsis xwm yeem. Menses tuaj yeem ua tsis xwm yeem, hnyav, thiab ntev dua. Thaum ntxov, xws li tshwm sim raug tshem tawm los ntawm cov tshuaj, yog li ntawd cov neeg mob tsis tam sim ntawdnrog kws kho mob. Tab sis maj mam, ntshav poob ua qhov tseem ceeb, ua rau tsis xis nyob nrog mob. Qhov no ua rau muaj ntshav tsis txaus, thiab tom qab ntawd koj tsis tuaj yeem ua yam tsis muaj kev pab los ntawm kws kho mob.
- Mob Syndrome tuaj yeem tshwm sim vim qhov mob hnyav ntawm myometrium. Loj fibroleiomyomas tsis cia lub epithelium exfoliate, mob tshwm sim. Mob hnyav tuaj yeem tshwm sim nrog subserous myoma. Ncaj nraim nrog daim ntawv intramural, cov kev xav tau rub thiab mob. Nyob rau hauv cov ntaub ntawv uas necrosis tshwm sim nyob rau hauv cov ntaub so ntswg ntawm lub tsev menyuam, ib tug ntse mob yuav hnov.
- Kev ua txhaum ntawm kev ua haujlwm ntawm lub cev nyob sib ze. Leiomyomatosis tuaj yeem ua rau muaj kev cuam tshuam hauv kev ua haujlwm ntawm cov hnyuv thiab zais zis. Tawm tsam keeb kwm yav dhau los no, tus poj niam yuav hnov ntau zaus mus rau chav dej. Los yog, ntawm qhov tsis sib xws, tej zaum yuav muaj teeb meem nrog lub plab zom mov lossis cov txheej txheem tso zis.
- Qhov tshwm sim ntawm qhov tsis ua haujlwm ntawm lub cev xeeb tub. Tawm tsam keeb kwm ntawm leiomyoma thiab cov kab mob sib kis, nrog rau kev tsis txaus ntawm cov tshuaj hormones hauv cov poj niam, kev xeeb tub tshwm sim, thiab ntxiv rau, ovulation cuam tshuam. Yog vim li cas rau qhov no yog qhov tsis muaj hmoo qhov chaw ntawm myomatous node nyob rau hauv cov kab noj hniav ntawm lub cev, uas tiv thaiv qhov txuas ntawm lub qe. Leiomyoma thaum cev xeeb tub qee zaum muaj qhov tsis zoo rau hauv daim ntawv ntawm kev txiav ntxov ntxov thiab nchuav menyuam. Tab sis raws li kev txheeb cais, cov xwm txheej no muaj tsawg heev.
Kev kuaj kab mob
Thaum thawj zaug nrog tus kws kho mob gynecologist, lub tsev menyuam tau tshuaj xyuas thiab sau cov lus tsis txaus siab ntawm tus neeg mob. Raws li ib feem ntawm kev kawm ob txhais tes, qhov deformation ntawm lub cev thiab nws qhov loj yog txiav txim siab. Nws yog qhov loj ntawm lub tsev menyuamtseem ceeb heev. Tus kws tshaj lij xaiv ib hnub tshwj xeeb ntawm lub voj voog, thiab lub xyoo, ntawm lub sijhawm tshwj xeeb no, kev ntsuam xyuas tau ua. Yog hais tias lub tsev menyuam tsis tau loj hlob nyob rau hauv ib xyoos, ces cov kws kho mob tham txog qhov qeeb ntawm tus kab mob.
Ua tsaug rau kev siv cov speculum, nws tuaj yeem kuaj pom cov kab mob submucosal loj hlob nyob rau hauv kev coj ntawm lub ncauj tsev menyuam. Txhawm rau kom tau txais txiaj ntsig zoo dua, siv txoj kev colposcopy. Ultrasound yog suav hais tias yog txoj hauv kev txhim khu kev qha tshaj plaws los kuaj mob oncology, nrog kev pab los ntawm nws tsim:
- Tag nrho cov fibroids nrog rau lawv cov yam ntxwv.
- qauv, lub sijhawm thiab hom leiomyoma.
- YPathology ntawm endometrium.
- Qhov kev ua haujlwm ntawm zes qe menyuam.
Ntxiv rau ultrasound, hysteroscopy yog ua, thiab ib tug swab yog coj mus rau flora nrog rau ib tug biopsy rau oncocytology.
kho mob Leiomyoma
Kev kuaj mob leiomyoma li cas, peb twb tau kawm lawm. Tom ntej no, peb yuav pom tias kev kho mob ntawm tus kab mob no tshwm sim li cas. Hauv kev kho mob, cov qog no feem ntau yog kho los ntawm txoj kev khaws cia. Feem ntau, nws ploj ntawm nws tus kheej los yog rov ua dua thaum lub sij hawm cev xeeb tub. Hauv qhov no, cov kws kho mob tsis maj nrawm los ua kev phais tshem tawm ntawm uterine leiomyoma. Kev xaiv ntawm kev kho kom haum ncaj qha nyob ntawm qhov tshwm sim ntawm kev kuaj mob thiab kev noj qab haus huv ntawm tus neeg mob. Cov xwm txheej rau kev kho nrog cov txheej txheem ib txwm muaj yog cov hauv qab no:
- qog loj txog li peb centimeters nrog rau me ntsis hauv lub tsev menyuam.
- Asymptomatic course of disease.
- Cov poj niam npaj kev xeeb tub yav tom ntej.
- Kev muaj cov intramural lossis subserous fibroids.
Surgery rau leiomyoma
Cov kws kho mob cuam tshuam kev phais muab rau cov neeg mob hauv cov xwm txheej hauv qab no:
- Kev muaj tus kab mob siab, thaum submucosal uterine leiomyoma loj heev.
- Kev pom ntawm submucosal nodes.
- Ntawm qhov torsion ntawm ob txhais ceg ntawm cov nodes nrog rau necrosis ntawm phab ntsa ntawm lub tsev menyuam.
- Kev txhim kho ntawm subserous fibroids nrog cov tsos mob hnyav heev.
- Nrhiav leiomyoma ntawm lub ncauj tsev menyuam.
- Kev muaj cov txheej txheem hyperplastic.
- Tsis muaj txiaj ntsig ntawm kev kho mob.
Cov txheej txheem phais niaj hnub no ua rau nws tuaj yeem khaws cov kab mob hauv lub cev thaum phais rau lub tsev menyuam leiomyoma, tshem tawm cov neoplasm nkaus xwb. Cov haujlwm no suav nrog myomectomy, FUS-ablation nrog rau kev tshem tawm ib feem ntawm lub tsev menyuam los ntawm defundation. Kev tshem tawm tag nrho ntawm lub cev yog ua nrog kev pab ntawm hysterectomy. Kev ua haujlwm txhawm rau tshem tawm cov qog tsis tas yuav ua rau nws ploj mus tas li. Qee zaum fibroids tuaj yeem loj hlob rov qab.
Dab tsi yog siv los kho tus mob uterine leiomyoma?
siv tshuaj kho mob
Qhov tseem ceeb hauv kev kho tus kab mob no yog kom muaj peev xwm txwv tsis pub qhov tshwm sim ntawm nws. Yog li ntawd, ntau zaus, kev kho tshuaj hormone yog muab los ntawm cov kws kho mob tshwj xeeb txhawm rau txo qis cov tshuaj estrogen thiab normalize lawv tus lej. Rau qhov no, cov hauv qab notshuaj:
- Analogues of GnRH.
- YAntiprogestogens.
- YProgesterone analogues.
- Cov tshuaj tiv thaiv qhov ncauj sib xyaw.
Txhua cov tshuaj txawv ntawm lawv tus kheej contraindications rau kev siv. Piv txwv li, ib txhia ntawm lawv tsis tuaj yeem noj yog tias tus poj niam muaj keeb kwm ntawm hemorrhagic syndrome. Raws li ib feem ntawm lawv cov kev siv, koj yuav tsum xub nyeem cov lus qhia thiab sib tham txog kev tswj hwm nrog tus kws kho mob. Kev kho mob nrog tshuaj hormonal yog ib txwm xav tau rau lub sijhawm ntev. Ua ke nrog qhov no, cov neeg mob tau muab tshuaj kho nrog pej xeem tshuaj, thiab ntxiv rau, nws raug nquahu kom siv cov tshuaj sedative, antianemic thiab vitamin npaj.
Lub sijhawm kho yog li rau lub hlis lossis ntau dua. Lub sijhawm no, nws yog ib qho tsim nyog los tswj cov txheej txheem pathological nrog kev pab los ntawm kev kuaj ultrasound txhua peb lub hlis. Yog tias tsim nyog, tus kws kho mob yuav hloov cov tshuaj los yog hloov cov tshuaj. Lwm txoj kev siv tshuaj xws li hirudotherapy, homeopathy, muv khoom, thiab lwm yam tuaj yeem siv los ua kev npaj pab.
Tab sis yuav tsum nco ntsoov tias leiomyoma yog ib yam kab mob uas muaj nws cov teeb meem thiab txaus ntshai rau lub cev. Koj tsis tuaj yeem kho tus kheej, nws yog ib qho tsim nyog los sab laj nrog tus kws kho mob tshwj xeeb. Muaj cov mob degeneration ntawm cov qog no mus rau hauv qog noj ntshav, xws li kev hloov pauv hu ua uterine leiomyosarcoma. Yog li ntawd, nyob rau hauv tsis muaj xwm txheej yuav tsum tau qhov nokab mob ntawm nws tus kheej.
Kev tshuaj xyuas ntawm uterine leiomyoma
Cov poj niam sau txog tus kab mob no tias nws yog ib qho kev tsis zoo siab heev. Ntau tus neeg yuav tsum tau phais kom tshem tawm leiomyomas. Feem ntau, cov poj niam sau hais tias nrog kev tshem tawm ntawm cov qog, tag nrho cov teeb meem cuam tshuam nrog qhov tsis zoo ntawm qhov kev kho mob tshwm sim ntawm tus kab mob no ploj mus.
Tab sis qhov tsis zoo ntawm kev phais yog qhov tsis muaj peev xwm yug menyuam. Tsis tas li ntawd, cov neeg uas yuav tsum tau mus rau hysterectomy qhia tias tom qab kev ua haujlwm lawv tsim adhesions, cem quav thiab teeb meem hauv thaj chaw sib raug zoo. Cov poj niam sau ntawv tias tom qab phais hysterectomy, lawv tsim caries, muaj teeb meem nrog pob txha, kub flashes thiab kiv taub hau tshwm.
Yog li, raws li kev tshuaj xyuas, peb tuaj yeem hais tias kev phais mob qog noj ntshav ntawm keeb kwm ntawm leiomyoma ua rau muaj ntau yam tsis zoo. Thiab ntawm qhov zoo ntawm cov poj niam, lawv lub npe tsuas yog tshem tawm ntawm kev coj khaub ncaws thiab tiv thaiv qhov ua tau degeneration ntawm leiomyoma mus rau hauv ib qho malignant neoplasm. Cov poj niam kuj sau tias hysterectomy, txawm tias tag nrho cov kev tsis zoo thiab qhov tshwm sim, yog nyob deb ntawm cov kev daws teeb meem zoo tshaj plaws xws li uterine leiomyoma.
Nws yog dab tsi thiab yuav kho li cas pathology tam sim no meej.
