Cov tsos mob ntawm uterine fibroids yog dab tsi thiab yuav kho li cas

2024 Tus sau: Malcolm Clapton | [email protected]. Kawg hloov kho: 2023-12-17 03:58

Lub neej hacker nrhiav seb yog vim li cas cov qog ua thiab yuav kho li cas.

Dab tsi yog uterine fibroids

Myoma Uterine fibroids (fibroma, leiomyoma) yog ib qho mob qog nqaij hlav ntawm cov leeg ntawm lub tsev menyuam, lossis myometrium, uas tshwm sim rau cov poj niam uas muaj hnub nyoog me nyuam. Tus kab mob no tshwm sim heev. Kev tshawb fawb ntawm uterine fibroids: ib chav kawm rau kev khaws cia hauv nruab nrog cev qhia tau tias thaum muaj hnub nyoog 35-49 xyoo, 70% ntawm cov neeg mob muaj nodules. Tab sis tsis yog txhua tus paub txog qhov teeb meem, thiab yog tias lawv paub, lawv ntshai heev.

Kev phom sij yuav tsum tsis txhob ua kom dhau. Myoma tsis degenerate rau hauv mob qog noj ntshav thiab tsis tuaj yeem metastasize, thiab me me neoplasm tsis muaj tsos mob. Tab sis tawm hauv tus kab mob tsis tuaj yeem saib xyuas kuj tsis tsim nyog. Qee lub sij hawm cov node nquag loj hlob thiab ua rau muaj ntau yam teeb meem.

Dab tsi yog uterine fibroid

Ib lub tsev menyuam ib txwm loj dua li lub qe qaib, thiab thaum fibroids tshwm, nws loj. Nyob rau hauv cov nqaij txheej, Uterine fibroids yuav muaj ib los sis ntau tuab nodules xws li nyob rau hauv txoj kab uas hla los ntawm ib tug me me hlaws mus rau ib tug loj Kua. Nyob rau hauv cov ntaub ntawv siab heev, cov qog ntim nce mus txog qhov loj me me ntawm cov txiv hmab txiv ntoo. Tab sis gynecologists feem ntau ntsuas tsis yog fibroid nws tus kheej, tab sis tag nrho qhov loj ntawm lub tsev menyuam loj. Tom qab ntawd nws muab piv nrog lub ntim ntawm lub cev los ntawm lub lis piam, niaj hnub mus rau kev tswj cov neeg mob uas muaj uterine fibroids ntawm cev xeeb tub. Hauv kev kuaj mob, lawv yuav sau, piv txwv li: uterine fibroids sib raug rau rau lub lis piam.

Nyob ntawm seb qhov chaw fibroid ntawm cov fibroid hlob zoo li cas rau phab ntsa uterine, muaj peb hom:

• Submucous - cov node nyob rau hauv lub puab mucous txheej. Qee lub sij hawm nws protrudes muaj zog mus rau hauv lub uterine kab noj hniav los yog dai rau ntawm ib tug nyias qia, nyob rau hauv uas cov hlab ntsha nyob rau hauv lub pub.
• Interstitial - lub qog nyob rau hauv lub thickness ntawm cov leeg, ncab thiab thawb lawv sib nrug.
• Subserous - myoma cov ntaub ntawv nyob rau sab nraud ntawm lub tsev menyuam, nyob rau hauv lub serous membrane. Qee lub sij hawm lub pob caus kuj stretches thiab tsim ib ceg.

Hom qog muaj feem cuam tshuam rau cov tsos mob thiab xaiv kev kho mob.

Yog vim li cas uterine fibroids tshwm

Qhov tseeb ua rau tus kab mob no tseem tsis tau tsim. Raws li txoj kev xav tseem ceeb ntawm uterine fibroids: chav kawm rau kev khaws cia ntawm lub cev, lub pob pib loj hlob vim kev puas tsuaj rau ib leeg leeg. Nws txoj kev faib yog txhawb los ntawm poj niam txiv neej cov tshuaj hormones estrogens, uas nyob rau tib lub sij hawm ua rau kom proliferation ntawm connective cov ntaub so ntswg nyob rau hauv lub tsom xam. Yog li ntawd, cov fibers alternate, intertwine, zoo li threads nyob rau hauv ib lub pob. Qhov no tsim ib ntom, yuav luag puag ncig knot. Yog hais tias muaj ob peb li pathological hlwb, ntau tshaj ib tug fibroid yuav tshwm nyob rau hauv phab ntsa ntawm lub tsev menyuam.

Cov kws tshawb fawb tau txheeb xyuas cov xwm txheej uas tuaj yeem ua rau muaj kev puas tsuaj rau myometrium. Feem ntau cov no yog:

• Thaum ntxov ntawm menses Uterine Fibroids. Nws ntseeg tau tias nws tsis zoo rau lub cev yog tias thawj qhov kev coj khaub ncaws tshwm sim ua ntej Lub Koom Haum Hnub Nyoog ntawm Menarche Nrog Ntau Cov Fibroids nyob rau hauv ib pawg ntawm cov poj niam uas tau txais kev soj ntsuam Standardized Ultrasound rau 11 xyoo. Feem ntau, cov ntxhais no muaj cov tshuaj estrogen ntau dua, uas tuaj yeem txhawb kev loj hlob ntawm fibroids.
• Thawj cev xeeb tub lig los yog tsis txaus siab ntawm uterine fibroids: ib chav kawm rau kev txuag lub cev kom muaj menyuam. Cov kws kho mob hais tias qhov kev tsis lees paub ntawm cov mucous membrane thaum lub caij ua poj niam ua rau muaj kev cuam tshuam ib ntus ntawm cov ntshav ntws hauv microvessels ntawm lub tsev menyuam. Nyob rau tib lub sijhawm, nws cov ntaub so ntswg raug kev txom nyem los ntawm qhov tsis muaj oxygen thiab qee lub hlwb tuaj yeem raug puas tsuaj.
• Abortions Uterine fibroids: ib chav kawm rau kev khaws lub cev. Thaum lub sijhawm cev xeeb tub, cov phab ntsa ntawm lub tsev menyuam raug mob, thiab cov kev hloov hormonal tom qab tuaj yeem pab txhawb qog nqaij hlav.
• Kev mob ntev ntawm lub tsev menyuam fibroids: ib chav kawm rau kev khaws cia ntawm lub tsev menyuam. Hauv qhov no, cov tshuaj lom neeg raug tso tawm thiab cov tshuaj tiv thaiv kab mob tshwm sim, uas ua rau cov hlwb ntawm myometrium.

Kev loj hlob ntawm fibroids tuaj yeem txhawb nqa tsis yog los ntawm estrogens, tab sis kuj los ntawm progesterone. Yog li ntawd, nyob rau hauv ib co poj niam, ib tug inconspicuous qog loj hlob nyob rau hauv loj thaum lub sij hawm cev xeeb tub, thaum no cov tshuaj hormones loj.

Qhov kev pheej hmoo ntawm kev tsim nodule nce Uterine fibroids nrog kev rog, vitamin D tsis txaus, tsis muaj zaub thiab txiv hmab txiv ntoo hauv kev noj haus, nrog rau kev haus cawv ntau, nrog rau npias.

Dab tsi yog cov tsos mob ntawm uterine fibroids

Ntau tus poj niam tsis paub tias lawv muaj fibroids vim tias cov qog me me tsis muaj tsos mob. Tab sis qhov loj ntawm cov node ua, ntau cov tsos mob ntawm Uterine Fibroids kab mob tshwm. Nws tuaj yeem yog:

• profuse thiab mob khaub thuas;
• los ntshav ntawm lub sijhawm;
• mob, rub qhov mob hauv plab plab, tawg mus rau sab nraub qaum;
• mob Cov nyhuv ntawm myoma uteri thiab myomectomy ntawm kev ua haujlwm ntawm kev sib deev thaum sib deev;
• tso zis ntau ntxiv los yog cem quav;
• nce qhov loj ntawm lub plab.

Vim li cas uterine fibroids txaus ntshai

Cov kws tshawb fawb Uterine fibroids lees paub tias fibroids tsis tig mus ua mob qog noj ntshav. Tab sis kev hloov pauv hormonal uas tshwm sim hauv lub cev tuaj yeem ua rau Uterine Fibroids tsim cov qog nqaij hlav hauv lub tsev menyuam.

Tsis tas li ntawd, vim muaj cov qog loj thiab muaj kev coj khaub ncaws ntau, tus poj niam poob ntshav ntau, nws tsim cov ntshav ntshav Uterine fibroids. Yog cov qog loj heev, nws nias rau ntawm lub zais zis. Nws tsis tuaj yeem npliag tag nrho, tus poj niam mus rau chav dej ntau zaus lossis hnov mob.

Qee lub sij hawm cov ntshav ntws cuam tshuam hauv cov leeg ntawm Uterine fibroids, vim tsis muaj oxygen, cov hlwb tuag. Qhov no yog nrog los ntawm mob hnyav, mob plab. Tib cov tsos mob yuav tshwm sim yog tias ib qho fibroid ntawm ib txhais ceg nyias twists nyob ib ncig ntawm nws axis thiab cov ntshav tsis ntws mus rau cov qog.

Cov me me fibroids feem ntau tsis cuam tshuam nrog kev xeeb tub. Tab sis nyob rau hauv kev cuam tshuam ntawm hormonal hloov tom qab conception, lub pob yuav pib loj hlob Uterine Fibroids sai, deform lub uterine kab noj hniav thiab ua rau kom muaj kev pheej hmoo ntawm nchuav menyuam. Vim lub qog, Uterine fibroids ntawm lub placenta yuav exfoliate los yog kev loj hlob ntawm tus me nyuam hauv plab yuav qeeb.

Tab sis qee zaus, cov kws kho mob xav txog poj niam infertility fibroids ua rau poj niam infertility. Cov nodes tuaj yeem thaiv lub lumen ntawm lub raj mis, yog li cov phev yuav tsis nkag mus rau lub qe lossis cov qog yuav tiv thaiv lub embryo los ntawm kev txuas mus rau cov mucous membrane.

Yuav kuaj mob uterine fibroids li cas?

Qee zaum, ntawm kev kuaj xyuas, tus kws kho mob gynecologist yuav pom tias muaj qhov loj ntawm lub tsev menyuam lossis kev hloov pauv ntawm nws cov duab thiab qhia tias muaj fibroid. Yuav kom paub meej qhov kev kuaj mob, Uterine Fibroids yuav raug kuaj:

• Ultrasound ntawm lub plab me me. Fibroids tuaj yeem tshawb pom tau yooj yim siv ultrasound, tus kws kho mob tuaj yeem txiav txim siab tus naj npawb ntawm cov nodes, lawv qhov loj thiab qhov chaw.
• Sonohysterography. Lub tsev menyuam tau ntim nrog kua thiab ua tiav ultrasound. Nyob rau hauv cov ntaub ntawv no, cov duab yog ntau contrasting thiab zoo.
• MRI. Txoj kev tshawb no tso cai rau koj mus nrhiav cov nodes me me, qhov loj ntawm qhov tsis pub tshaj ob peb millimeters.
• CT. Nws yog siv tsawg dua thiab ua haujlwm kom tau txais cov duab tseeb ntawm qhov chaw ntawm fibroid hauv lub plab mog.
• Hysteroscopy. Lub raj hloov tau nrog lub koob yees duab yees duab tau muab tso rau hauv lub tsev menyuam kab noj hniav hauv qab tshuaj loog txhawm rau tshuaj xyuas tag nrho cov phab ntsa. Txoj kev yog siv rau cov qog subserous. Qee lub sij hawm thaum kuaj xyuas, cov nodes ntawm lub pedicle tuaj yeem raug tshem tawm tam sim ntawd.
• Hysterosalpingography. Cov kua dej tshwj xeeb yog txhaj rau hauv lub tsev menyuam, uas muab cov duab sib piv ntawm X-ray. Cov txheej txheem yuav pab saib seb lub uterine kab noj hniav yog deformed thiab seb cov hlab yog passable.
• Laparoscopy. Ib lub raj nrog lub koob yees duab yees duab yog ntxig los ntawm ib qho me me hauv lub plab, uas yuav pab kom pom lub tsev menyuam los ntawm sab nraud. Txoj kev kuaj mob yog siv rau cov nodes subserous.

Yuav kho uterine fibroids li cas?

Yog hais tias, thaum lub sij hawm soj ntsuam, gynecologist pom ib tug me me fibroid, tab sis nws tsis tshwm sim nws tus kheej nyob rau hauv txhua txoj kev, nws yuav tsum pom zoo kom tus poj niam ua ultrasound ntawm lub plab mog ib xyoos ib zaug. Qhov no yuav pab tswj cov qog loj hlob. Hauv cov neeg mob tom qab 45-50 xyoo, cov qog me me no yuav ploj mus.

Yog hais tias ib tug poj niam muaj cov tsos mob ntawm fibroids los yog muaj teeb meem vim lub qog, tus kws kho mob yuav xaiv ib txoj kev kho mob.

Cov tshuaj kho mob

Cov kws tshawb fawb tseem tsis tau tsim cov tshuaj uas yuav pab tshem tawm cov fibroids. Tshuaj Uterine fibroids: ib chav kawm ntawm kev khaws cia hauv nruab nrog cev yog siv los nres qhov kev loj hlob ntawm cov qog, me ntsis txo nws qhov loj me lossis tshem tawm cov tsos mob tsis zoo. Feem ntau, gynecologists sau cov tshuaj hauv qab no:

• Combined contraceptives nyob rau hauv cov neeg mob nrog uterine myoma, qhov ncauj contraceptives. Lawv xav tau los tswj kev coj khaub ncaws los ntshav, ua kom qeeb ntawm kev loj hlob ntawm cov leeg tsis muaj ntau tshaj 2 centimeters nyob rau hauv txoj kab uas hla. Tab sis hauv qee tus poj niam, cov tshuaj no, ntawm qhov tsis sib xws, tuaj yeem txhawb kev nce hauv fibroids.
• Agonists Gonadotropic tso cov tshuaj hormone agonists hauv kev kho mob ntawm uterine fibroids ntawm gonadoliberin tso cov tshuaj hormones. Lawv inhibit zus tau tej cov tshuaj hormones pituitary, uas ib txwm ua rau lub zes qe menyuam muaj nuj nqi thiab estrogen synthesis. Yog li ntawd, tus poj niam tsim tshuaj menopause, thiab fibroid ua me me. Tab sis 6-12 lub hlis tom qab kev kho mob, cov nodes yuav pib loj hlob dua. Vim muaj cov tsos mob ntawm cov tsos mob tsis zoo ntawm lub cev tsis muaj zog, xws li kev kho mob tsis tshua siv thiab tsuas yog npaj rau kev phais.
• Antigestagens Uterine fibroids. Kev kho tsis yog phais. Cov tshuaj no thaiv cov progesterone receptors, inhibit fibroids loj hlob, thiab ua rau fibroids ntsws. Cov tshuaj nyob rau hauv pab pawg no tsis muaj kev phiv los ntawm kev ua cev tsis muaj zog, yog li cov poj niam tuaj yeem zam kev kho mob yooj yim dua.

Rau qee tus neeg mob, tus kws kho mob yuav pom zoo kom siv cov tshuaj hormonal intrauterine los tswj kev loj hlob ntawm cov leeg.

Tshem tawm yam tsis muaj kev phais

Fibroids tuaj yeem kho nrog cov txheej txheem minimally invasive. Yog hais tias qhov loj ntawm cov qog yog me me, nws nyob rau hauv lub thickness ntawm cov ntaub so ntswg, thiab tsis nyob rau ntawm lub pedicle, nws yuav puas lawm yam tsis muaj kev phais.

Thawj txoj kev ntawm Focused ultrasound phais yog tsom ultrasound ablation (FUS-ablation). Cov txheej txheem tsis mob, koj tsis tas yuav mus rau hauv tsev kho mob rau nws. Ib tug qog muaj nyob rau hauv ib tug poj niam nrog kev pab los ntawm ultrasound, thiab tom qab ntawd lub pob yog rhuab nrog ib tug tshwj xeeb ultrasound nrog lub zog siab. Nyob rau tib lub sijhawm, cov ntaub so ntswg ib puag ncig tsis raug puas ntsoog, qhov teeb meem ntawm kev xaiv cov kev kho mob tactics nyob rau hauv cov neeg mob uas muaj uterine fibroids npaj cev xeeb tub (cov ntaub ntawv tshuaj xyuas), myoma cells tuag, thiab tom qab ntawd yaj tag nrho hauv ib xyoos.

Txoj kev thib ob yog Uterine Artery Embolization ntawm uterine artery (UAE). Cov txheej txheem yog ua los ntawm tus kws phais mob vascular. Nws ntxig ib lub raj nyias los ntawm cov hlab ntsha femoral uas ncav cuag lub tsev menyuam. Tom qab ntawd cov tshuaj yog txhaj rau hauv lub catheter no, nws mus ncaj qha mus rau lub nkoj noj cov fibroids, thiab glues nws. Cov ntshav muab rau cov qog nres, nws tuag thiab daws tsis pub dhau 3-12 lub hlis.

Kev ua haujlwm

Yog hais tias cov qog loj los yog nyob rau ntawm lub pedicle, cov kev teev saum toj no tsis tuaj yeem siv. Yog li ntawd, tus gynecologist yuav coj mus rau hauv tus account tus poj niam lub hnub nyoog, nws lub siab xav kom muaj menyuam, hom fibroids thiab yuav muab ib qho ntawm cov kev kho mob phais.

Myomectomy Ib qho uterine fibroid yog ib qho kev ua haujlwm los tshem tawm cov node. Nyob rau tib lub sijhawm, tus neeg mob khaws lub tsev menyuam, tom qab rov qab los, tus poj niam yuav xeeb tub. Manipulation yog ua nyob rau hauv ntau txoj kev:

• Hysteroscopic - yog tias myoma yog submucous. Nyob rau hauv cov tshuaj loog, ib tug hysteroscope muab tso rau ntawm qhov chaw mos thiab cov qog raug tshem tawm.
• Laparoscopically - yog hais tias lub pob nyob rau hauv lub serous membrane. Cov punctures me me yog ua rau ntawm lub plab thiab cov myoma raug txiav tawm los ntawm cov hlab hlau.
• Laparotomically - thaum lub sij hawm ua hauj lwm, ib qho kev phais yog ua nyob rau hauv lub plab mog, ces nyob rau hauv lub tsev menyuam thiab cov node raug tshem tawm.

Qee lub sij hawm fibroids raug tshem tawm tsis yog nrog scalpel, tab sis siv xov tooj cua zaus Uterine Fibroids txoj kev. Qhov no yog ib hom nthwv dej uas ib txhij txiav cov ntaub so ntswg thiab kaw nws, yog li muaj teeb meem tsawg dua tom qab kev phais.

Txawm li cas los xij, tom qab kev phais mob, qee zaum cov pob me me nrog txoj kab uas hla ntawm 1-2 millimeters nyob hauv phab ntsa ntawm lub tsev menyuam, uas tsis tuaj yeem pom. Tom qab ib pliag, lawv tuaj yeem pib nquag loj hlob.

Yog tias cov qog loj loj, nias rau ntawm lub zais zis lossis qhov quav thiab cuam tshuam nrog kev mus rau hauv chav dej, lossis tus poj niam feem ntau muaj los ntshav, tus kws kho mob gynecologist yuav hais kom uterine myoma tshem tawm lub tsev menyuam. Tab sis lub zes qe menyuam yuav khaws cia kom cov qib hormonal tsis raug kev txom nyem.

Puas muaj peev xwm tiv thaiv uterine fibroids

Cov kws tshawb fawb tsis paub Uterine Fibroids txoj kev uas yuav tiv thaiv qhov tsos ntawm fibroids. Tab sis yog tias koj ua raws li cov cai yooj yim, koj tuaj yeem txo qhov kev pheej hmoo ntawm kev tsim qog:

• Ua kom lub cev hnyav.
• Noj kom zoo kom koj muaj txiv hmab txiv ntoo, zaub thiab khoom noj siv mis txaus hauv koj cov zaub mov.
• Tsis txhob rho menyuam tshwj tsis yog muaj kev kho mob qhia.
• Kho o ntawm lub tsev menyuam thiab appendages hauv lub sijhawm.
• Txo koj cov cawv kom tsawg.
• Yog tias koj tsis xav xeeb tub, noj Uterine fibroids qhov ncauj tshuaj tiv thaiv kab mob tom qab sab laj nrog koj tus kws kho mob.