Dab tsi yog fibroids - ntau tus poj niam txaus siab, tshwj xeeb tshaj yog cov neeg uas muaj kev pheej hmoo rau qhov tshwm sim ntawm tus kab mob no. Qhov no yog ib qho benign neoplasm uas nyob ncaj qha rau hauv lub tsev menyuam nws tus kheej los yog ntawm caj dab ntawm lub cev. Txawm hais tias muaj ntau tus kab mob, cov kws tshawb fawb tseem tsis tau tsim kom muaj qhov tseeb ntawm qhov tshwm sim.
Qhov loj ntawm neoplasm tuaj yeem sib txawv heev, thiab nws tuaj yeem ua ib leeg lossis ntau yam. Fibroids feem ntau tsim rau cov poj niam hnub nyoog 35-45 xyoo. Txawm li cas los xij, nws kuj tshwm sim hauv cov neeg mob hluas. Nws yog ib qho tseem ceeb kom nkag siab qhov tseeb tias fibroid yog dab tsi thiab nws tshwm sim nws tus kheej li cas kom kho tau raws sijhawm.
Ntxhais kab mob
Y Uterine fibroids yog ib qho qog nqaij hlav zoo uas tshwm sim hauv lub tsev me nyuam los yog ntawm nws lub tsev me nyuam. Nws qhov ntev tuaj yeem tsis tseem ceeb, thiab tuaj yeem ncav cuag ob peb centimeters. Hom kab mob feem ntau yog ntau cov qog.
Nws feem ntau cuam tshuam rau cov poj niam ntawm kev yug me nyuamhnub nyoog. Myoma yog ib qho neoplasm uas muaj cov kab mob loj ntawm lub tsev menyuam, tsim cov pob txha ntom ntom ntom ntom ntom ntom ntom ntom ntom ntom nrog cov hlab ntsha. Ib qho tshwj xeeb ntawm cov qog yog tias nws txoj kev loj hlob thiab kev loj hlob feem ntau nyob ntawm qib ntawm cov tshuaj hormones poj niam txiv neej.
Nws yog ib qho tseem ceeb tsis yog kom nkag siab tias fibroid yog dab tsi, tab sis kuj muaj qhov tshwm sim uas nws muaj. Qhov tseem ceeb tshaj plaws yog qhov loj ntawm cov qog thiab nws qhov chaw. Thaum nws nce mus txog qhov loj me, nws tuaj yeem ua rau mob, ua poj niam cev xeeb tub, thiab teeb meem thaum cev xeeb tub.
Kev faib tawm
fibroids yog dab tsi, thiab hom qog no yog dab tsi, tus kws kho mob tuaj yeem qhia rau koj raws nraim. Muaj ntau qhov sib txawv ntawm cov qog no, nyob ntawm qhov chaw, cellular muaj pes tsawg leeg. Muaj ntau hom xws li:
- subserous;
- submucosal;
- kev sib deev;
Subserous yog tus yam ntxwv ntawm qhov tseeb tias neoplasm nyob rau sab nraud ntawm lub tsev menyuam, ze ntawm lub plab hnyuv. Intramuscular - nyob ncaj qha rau hauv cov leeg nqaij fibers. Submucosal - kev loj hlob ntawm cov qog nyob rau hauv lub tsev menyuam, uas yog nyob rau hauv nws cov mucosa, dhau mus rau hauv lub lumen. Stem fibroids tsis yog ib pawg tshwj xeeb, tab sis tsuas yog ib hom kab mob uterine uas tshwm sim nrog subserous lossis submucosal hom. Qhov txawv nyob ntawm nws qhov dav lossis nqaim qia.
Intramural fibroids yog qhov ntau tshaj. Qhov no yog ib qho zoo heev pathology rau cov poj niam hnub nyoog 40 xyoo. Hom qog no yog tsim los ntawm cov ntaub so ntswgcov leeg nqaij txheej, uas ua rau muaj qhov loj ntawm tag nrho lub cev. Qhov no tsis tuaj yeem tab sis cuam tshuam rau cov kab mob nyob ze, vim tias neoplasm cuam tshuam rau lawv thiab cuam tshuam nrog cov ntshav ib txwm muaj. Lub ntsiab tseem ceeb ntawm cov dej ntws yog ua txhaum ntawm kev coj khaub ncaws, muaj qhov mob thiab lub siab xav.
Multinodular fibroids muaj ob peb lub pob thiab ua rau lub tsev menyuam loj. Raws li nws loj hlob, qhov no neoplasm tuaj yeem pom pom, raws li lub plab loj hlob sai. Ntawm cov cim tseem ceeb, nws yog ib qho tsim nyog los qhia txog qhov ntev thiab los ntshav hnyav, qhov kev xav ntawm hnyav, mob, tsis muaj zog.
Kev tshwm sim
Kev loj hlob ntawm fibroids tshwm sim tawm tsam keeb kwm yav dhau los ntawm ntau yam hormonal ntshawv siab, yog li qhov no suav hais tias yog qhov ua rau tus kabmob tseem ceeb. Feem ntau, cov qog nqaij hlav hauv cov poj niam hluas thiab ua tiav zoo thaum lub cev xeeb tub tshwm sim, txij li lub sijhawm no cov tshuaj estrogen pib txo qis. Tsis tas li ntawd, muaj ntau yam tseem ceeb ntxiv, tshwj xeeb, xws li:
- genetic predisposition;
- kab mob gynecological;
- kev nyuaj siab;
- frequent rho menyuam;
- kev rog thiab kev ua neej nyob tsis muaj zog;
- kev sib deev tsis muaj orgasm.
Qhov no yog qog nqaij hlav nyob hauv cov tshuaj hormones, yog li nws tsuas yog tsim thaum muaj menyuam yaus. Nws txoj kev loj hlob yog qhib nrog kev nce qib ntawm cov tshuaj hormones lub luag haujlwm rau kev noj zaub mov ntawm lub cev. Kev xeeb menyuam thiab kev rho menyuam kuj tseem cuam tshuam rau lub tsev menyuam. Txawm tias cov poj niam uas tau yug me nyuam ib zaug txo qis kev pheej hmoo ntawm tus mob no.kab mob.
Qhov laj thawj tseem ceeb ntawm kev txhim kho ntau yam kab mob yog khoom noj khoom haus. Cov kab mob metabolic, qhov tsis tu ncua ntawm cov rog ua kom zoo thiab rog rog ua rau nce qib estrogen.
Cov tsos mob tseem ceeb
Rau lub sijhawm ntev, tsis muaj cov tsos mob ntawm uterine fibroids tshwm, thiab nws feem ntau pom muaj kev sib tsoo thaum kuaj los ntawm gynecologist. Qee lub sij hawm muaj cov tsos mob, tab sis kom txog rau thaum lub sij hawm lawv muaj me ntsis qhov muag plooj, uas pom tau tias yog tus qauv. Feem ntau, cov cim qhia tau tshwm sim nrog cov qog ntawm hom submucosal lossis nyob rau hauv lub xub ntiag ntawm cov nodes loj, tsis hais lawv qhov chaw nyob.
Ntawm cov tsos mob tseem ceeb ntawm uterine fibroids yog:
- ntev thiab hnyav;
- ntshav;
- mob plab plab;
- kev ua haujlwm pelvic;
- kev muaj menyuam;
- miscarriage.
Cov tsos mob tseem ceeb tshaj plaws yog lub caij nyoog ntev thiab hnyav heev, tab sis lub sij hawm ntawm lub voj voog tsis cuam tshuam. Qhov no tuaj yeem ua rau kev loj hlob ntawm anemia. Tsis tas li ntawd, tej zaum yuav los ntshav nyob nruab nrab ntawm lub voj voog.
Ntawm cov cim qhia ntawm uterine fibroids, mob hauv plab plab thiab hauv thaj tsam lumbar tuaj yeem paub qhov txawv. Lawv muaj ib tug whining cim. Mob hnyav tuaj yeem tshwm sim thaum lub pedicle ntawm fibroid node twisted, uas ua rau muaj kev cuam tshuam loj heev. Thaum cov neoplasm nce mus txog qhov loj me, nws pib ua rau sab hauvkab mob hauv nruab nrog cev, thiab tus poj niam pib txhawj xeeb txog kev tso zis ntau zaus, cem quav ntev lossis tso zis tsis txaus.
Ib qho ntawm cov cim qhia ntawm uterine fibroids yog infertility lossis nchuav menyuam. Cov qog tiv thaiv kev txav mus los ntawm cov phev los ntawm cov hlab ntsha fallopian. Nyob rau hauv cov ntaub ntawv no, lub localization ntawm neoplasm plays lub luag hauj lwm tseem ceeb. Ib tug poj niam tuaj yeem xeeb tub nrog fibroids thiab yug me nyuam noj qab nyob zoo, tab sis qhov no yuav tsum tau saib xyuas kev kho mob tas li.
Diagnostics
Ua ntej sau tshuaj kho rau uterine fibroids, koj yuav tsum ua qhov kev ntsuam xyuas tsim nyog los txiav txim seb nws hom, qhov loj me thiab qhov chaw nyob. Thaum kuaj pom, thawj tus poj niam raug coj mus rau kev tshuaj ntsuam. Txoj kev kuaj mob yog ua raws li cov kev tshawb fawb xws li:
- kuaj gynecological;
- ultrasound;
- hysteroscopy;
- laparoscopy.
Thaum kuaj gynecological, koj tuaj yeem pom tias lub tsev menyuam loj me me. Ultrasound diagnostics tso cai rau koj los soj ntsuam qhov loj ntawm fibroids, tus naj npawb, qhov loj, qhov chaw ntawm cov nodes thiab txiav txim seb tus qauv ntawm lub tsev menyuam.
Hysteroscopy pab txhawm rau kuaj pom muaj cov qog, thiab kom tau txais cov ntaub ntawv raug ntau dua, yuav tsum muaj kev kuaj ntshav biopsy los ntsuas nws cov kab mob histological thiab cytological. Diagnostic laparoscopy yuav pab tsis tau tsuas yog kom paub tseeb tseeb, tab sis kuj soj ntsuam cov degree ntawm kev puas tsuaj thiab tsis saib xyuas ntawm tus kab mob. Ntxiv rau, yog tias tsim nyog, koj tuaj yeem tshem tawm cov nodes tam sim ntawd.
Txoj Kev Kho Mob
Muaj 3 txoj hauv kev tseem ceeb ntawm kev kho cov uterine fibroids, tshwj xeeb:
- drug;
- tsis yog tshuaj;
- surgical.
Tsis muaj lwm txoj kev kho mob tau tsim, tom qab ntawd nws yuav ua tau kom sai thiab zoo tshem cov qog uas twb muaj lawm. Kev kho mob raug xaiv nruj me ntsis rau tus kheej. Tus kws kho mob xaiv txoj kev ua tau zoo tshaj plaws nyob ntawm seb hom qog, nws txoj kev loj hlob, nrog rau muaj ntau yam kab mob.
Qee zaum, cov tshuaj siv tau rau cov fibroids. Ib txoj hauv kev zoo sib xws yog xaiv thaum tus kab mob pib tsis muaj tsos mob hnyav. Nws lub hom phiaj tseem ceeb yog kom tsis txhob muaj kev loj hlob ntawm neoplasm thiab nws tag nrho ploj mus. Progestogens, ua ke cov tshuaj tiv thaiv qhov ncauj, antigonadotropins tuaj yeem raug sau tseg. Kev xaiv cov tshuaj tshwj xeeb tsuas yog ua los ntawm tus kws kho mob uas tsim nyog. Tsis tas li ntawd, nws txiav txim siab npaum li cas thiab lub sijhawm kho.
Yog tias kev siv cov tshuaj tsis tau txais txiaj ntsig, ces tus kws kho mob tuaj yeem muab tshuaj rau kev phais. Kev tshem tawm ntawm uterine fibroids yuav tsum tau nyob rau hauv cov xwm txheej xws li:
- mob qog nqaij hlav loj;
- nws loj hlob sai heev;
- tso siab rau cov kabmob uas nyob ib sab;
- ntshav tshwm sim hnyav.
Yog tias lub pob nyob hauv qab lub plhaub sab nraud ntawm lub cev, tom qab ntawd laparoscopy ntawm fibroid tau ua. Thaum lub qog nyobhysteroscope yog siv nyob rau hauv lub mucosa. Nyob rau hauv cov ntaub ntawv ntawm ib tug txawv localization, ib tug sawb txoj hauj lwm yog muab. Tom qab tshem tawm ntawm uterine fibroids, lub sij hawm yuav mob me ntsis thiab tsis mob.
Nrog cov qog nqaij hlav zoo, kev kho tsis yog tshuaj muaj peev xwm ua tau, tshwj xeeb, tshuaj ntsuab, kho lub cev, balneotherapy thiab kev kho mob spa. Txoj kev kho ntau tshaj plaws yog embolization. Thaum lub sijhawm ua haujlwm no, cov hlab ntsha hauv tsev menyuam uas pub cov neoplasm yog txhaws. Cov ntshav muab rau cov qog raug cuam tshuam thiab nws txoj kev loj hlob nres thiab tuag.
Kev kho tsis yog phais
Thaum tus poj niam mus txog lub hnub nyoog ntawm poj niam cev xeeb tub, yog tias cov qog me me thiab maj mam loj hlob, kev kho mob ntawm fibroids tau tso cai, uas tau txais kev tshuaj xyuas zoo heev. Ntau tus neeg mob hais tias nrog kev kho mob nyuaj, cov txiaj ntsig tau zoo tuaj yeem ua tiav thiab cov neoplasm tuaj yeem raug tshem tawm yam tsis muaj kev phais. Kev kho yog raws li kev siv tshuaj xws li:
- tshuaj tiv thaiv qhov ncauj;
- hormone antagonists;
- antiprogestogen;
- antigonadotropins;
- gestagens.
Ntawm cov tshuaj tiv thaiv qhov ncauj, nws yog ib qho tsim nyog yuav tsum tau hais txog xws li Novinet, Ovidon, Mercilon. Cov kev kho mob zoo li no tuaj yeem tiv taus qhov mob hauv plab hauv plab thiab los ntshav, tab sis lawv tsis cuam tshuam rau kev txo qis ntawm cov fibroids, tsuas yog ua rau txo qis hauv cov nodes los ntawm ob peb centimeters.
Hommon antagonists yog tsim los siv mus ntev. Lawv pab me ntsis txo cov qog loj, thiab tseem tau muab tshuaj ua ntej ua haujlwm, kom cov ntshav poob qis dua. Ntawm cov tshuaj no, nws yog ib qho tsim nyog los qhia txog "Diferelin", "Zolodex", "Decapeptyl"
Ntawm cov tshuaj tiv thaiv kab mob, Mifepristone yuav tsum tau muab cais tawm, uas pab tshem tawm cov tsos mob uas twb muaj lawm thiab txo qhov loj ntawm cov nodes. Qee qhov xwm txheej, FUS-ablation yog ua, vim qhov no yog txoj kev niaj hnub tshaj plaws raws li ultrasound raug rau fibroids. Kev tsom xam meej ntawm cov kab teeb tso cai rau koj kho cov neoplasm sai sai.
Surgery
Nws tsis yog ib txwm ua tau los kho cov tsis phais uterine fibroids. Kev ua haujlwm tau pom nyob rau hauv rooj plaub xws li:
- qog loj tshaj 12 cm;
- nrawm nrawm;
- uterine los ntshav;
- txoj kev tuag;
- tsim ntawm submucosal node.
Raws li hom neoplasm, qhov chaw thiab qhov loj ntawm cov qog, tus kws kho mob xaiv ib txoj kev kho mob. Ntawm cov hom kev phais tseem ceeb kom tshem tawm cov uterine fibroids, cov hauv qab no yuav tsum paub qhov txawv:
- laparoscopy;
- hysterectomy;
- hysteroscopy;
- qhib phais.
Txhua hom kev phais mob tau muab faib ua radical thiab kev khaws cia hauv lub cev. Txhua qhov kev ua haujlwm tau ua nws muaj nws qhov zoo thiab qhov tsis zoo. Txoj kev tshaj plaws yog kev tshem tawm tag nrho ntawm lub tsev menyuam. Xws li kev cuam tshuam tuaj yeem ua tau qhib thiablaparoscopically. Nrog rau tag nrho cov txiaj ntsig ntawm kev ua haujlwm: cov fibroid raug tshem tawm tag nrho, thiab tsis muaj kev rov qab los, cov kws kho mob tseem hais txog ntau qhov tsis zoo, xws li:
- muaj teeb meem tshwm sim;
- tshuaj loog xav tau;
- ntev rov qab.
Kev cuam tshuam li no yog qhov tsis xav tau rau cov neeg mob uas tsis muaj menyuam thiab leej twg npaj yuav xeeb tub yav tom ntej. Myomectomy yog ib qho haujlwm khaws cia hauv lub cev, muaj nyob rau hauv kev tshem tawm cov nodes nkaus xwb. Nws muaj ntau qhov zoo, txij li lub sijhawm rov qab siv sijhawm 2-3 lub lis piam. Tsis tas li ntawd, nyob rau hauv lub neej yav tom ntej nws yog heev muaj peev xwm mus npaj ib tug cev xeeb tub. Tom qab ntawd, tsis muaj qhov txuas ntxiv ntawm uterine fibroids. Kev ua haujlwm feem ntau ua tiav, tab sis ntau yog nyob ntawm qhov kev paub ntawm tus kws phais, qhov loj, qhov chaw thiab tus naj npawb ntawm cov nodes.
Tsis tas li ntawd, hysteroscopic myomectomy tuaj yeem raug sau tseg, uas yog ua nrog submucosal qhov chaw ntawm neoplasm uas loj hlob mus rau hauv lub lumen ntawm lub tsev menyuam. Kev phais yog ua los ntawm kev siv lub hysteroscope tso rau hauv lub uterine kab noj hniav los ntawm qhov chaw mos.
Lwm hom kev phais mob yog qhov embolization ntawm cov hlab ntsha ntawm lub tsev menyuam ntawm fibroids. Kev ua haujlwm yog cuam tshuam cov ntshav ntws mus txog thaum nws nres kiag li. Raws li qhov tshwm sim, muaj qhov txo qis hauv cov nodes, lawv hloov nrog cov ntaub so ntswg sib txuas lossis ua tiav ploj mus.
Kev kho mob nrog pej xeem tshuaj
Heev feem ntau, pej xeem txoj kev siv los kho uterine fibroids, lawv tsim nyog tshuaj xyuas zoo heev, vim tias lawv pab ua kom qeeb ntawm cov qog. Txawm li cas los xij, nws tsim nyog nco ntsoov tias lawv tsuas yog siv tau rau cov neoplasms me me nrog kev loj hlob qeeb. Tsis tas li ntawd, koj yuav tsum sab laj nrog koj tus kws kho mob ua ntej txog kev nyab xeeb ntawm kev siv tshuaj.
Kev kho mob, kev siv ntau yam cawv tinctures ntawm hemlock, mistletoe, cinquefoil yog qhia. Cov nroj tsuag no muaj tshuaj lom heev, uas yog vim li cas nws thiaj li yuav tsum tau siv cov extracts npaj rau lawv lub hauv paus kom zoo zoo, hauv cov kev kawm luv luv, nrog kev saib xyuas tshwj xeeb.
Propolis pab tiv thaiv cov pob txha zoo, vim nws txhawb kev tiv thaiv kab mob thiab muaj cov tshuaj tiv thaiv kab mob. Nws yog siv nyob rau hauv daim ntawv ntawm ntau yam extracts thiab tinctures, nrog rau cov tshuaj pleev thiab suppositories.
Knotweed, horsetail thiab lungwort yog siv rau kev kho mob, vim tias cov tshuaj ntsuab no muaj peev xwm tswj kev tsim cov ntaub so ntswg. Lawv tiv thaiv kev tsim ntawm nti thiab adhesions.
Muaj Teeb Meem
Ntau yam teeb meem tuaj yeem tshwm sim nrog fibroids, feem ntau yog:
- tsis muaj hluav taws xob tsis ua haujlwm;
- necrosis;
- twisted ceg ntawm kev kawm;
- hnyav los ntshav.
Hauv qee kis, tej zaum yuav muaj teeb meem xws li uterine eversion, uas tshwm sim nrog cov kab mob submucosal. Qee lub sij hawm tej zaum yuav muaj qhov degeneration ntawm fibroids rau hauv cov qog malignant.
Myoma thaum nqa me nyuam
Kev tswj cev xeeb tub nrog fibroids tsim qee yam teeb meem rau cov kws kho mob thiab cov neeg mob. Tsis muaj contraindications rau kev tswj cev xeeb tub yog qhov tsis txaus ntseeg ntawm malignant degeneration ntawm cov qog, kev loj hlob sai ntawm cov nodes, lawv lub ncauj tsev menyuam-isthmus localization, infringement, necrosis.
Txawm li cas los xij, txawm tias tag nrho cov contraindications tsis tuaj yeem tshwm sim, kev nchuav menyuam tuaj yeem ua tau, qhov xav tau rau kev phais mob phais nrog kev tshem tawm tom qab ntawm node.
Myoma yog ib qho benign neoplasm, tab sis nyob rau hauv txhua rooj plaub, yuav tsum tau kho raws sij hawm los tiv thaiv kev loj hlob ntawm cov teeb meem txaus ntshai.
