Ma polyps m'chiberekero ndi mapangidwe a endometrium omwe amapezeka azaka 9. Nthawi zambiri amapezeka asanakwane msinkhu mzaka 40 - 50. Polyp amatanthauza zotupa zoyipa, koma ngati simukuyesetsa kuchitira izi, motsimikiza zikhoza kukhala zoipa. Mpata woipa choterowo ndi 1 - 2%.
Mapuloteni ndi osakwatira pamunsi kapena pa pedicel, ndipo ambiri (polyposis).
Mawere a chiberekero amapezeka mwa amayi pafupifupi 10% a milandu. Zina mwa matenda odwala matendawa ndi 25% a milandu, zomwe zimasonyeza kufalikira kwa vutoli.
Zambiri m'mimba ndizo zimayambitsa
Powerenga matendawa, anapeza kuti ziwalo za chiberekero, zomwe zimayambitsa vutoli ndizosiyana, dzuka kumbuyo:
• kusokonezeka kwa mahomoni;
• chitetezo chochepa;
• kupanikizika komanso kupitiliza kwamanjenje kwa nthawi yayitali;
• zosintha zomwe zimadza chifukwa cha msinkhu wa mayi.
Kuwonjezera apo, pamakhalabe misa zifukwa zoopsya zomwe zimapangitsa chitukuko cha mazira m'chiberekero:
1. Matenda a ziwalo zoberekera mwa akazi (zotupa zotulutsa mazira, ma fibroids, endometriosis).
2. Kuwonongeka kwa khomo pachibelekeropo komwe kumabwera chifukwa cha mayeso am'mimba, chifukwa cha matenda otupa (endocervicitis), panthawi yobereka kapena kuchotsa mimba.
3. Matenda opatsirana pogonana (matenda opatsirana pogonana), komanso chifukwa cha kuphwanya kwa microflora ya abambo. Zowopsa kwambiri ndizo: ureaplasmosis, herpes, toxoplasmosis, mycoplasmosis, candidiasis.
4. Kutengera kwa chibadwa.
5. Kusagwira ntchito.
6. Chithandizo cha nthawi yayitali ndi Temoxifen - mankhwala omwe amagwiritsidwa ntchito pamaso pa zotupa kuti aletse zolandilira zomwe sizimva mahomoni. Zotsatira zake, mwa odwala ena, ma cell endothelial amayamba kukula mwamphamvu ndipo ma polyps amapanga.
Kuchulukitsa kwapakati: Pamene mimba imapangidwira kuzungulira iyo, kuwonjezeka kwachangu kwa maselo a epithelial kumayambira.
Gulu loopsya limaphatikizapo amayi omwe:
• kunenepa kwambiri;
• matenda a hypertonic;
• matenda a endocrine.
Kapangidwe ka polyps mu chiberekero
Chifukwa cha kulephera kwa mahomoni, kugwira ntchito kwakanthawi kwa thumba losunga mazira kumatha kusokonezeka, chifukwa chake gawo lalikulu la estrogen limalowa m'magazi.
Kawirikawiri, kupanga kwake kumachitika pakatha masabata awiri kumapeto kwa msambo. Ali ndi matenda a mahomoni, amalowa mwazi mosalekeza. Pogwiritsa ntchito mphamvu zake, pali kuwonjezeka kwakukulu kwa endometrium.
Pa nthawi ya msambo, endometrium sichitha kwathunthu; gawo lina limakhalabe m'chiberekero. Njirayi imapitilira magawo angapo ndipo imatsogolera pakupanga mapangidwe pamalo a kudzikundikira kwa endometrial.
M'tsogolomu, pali kumera kwa mitsempha ya mitsempha ndi zida za minofu yothandizira - mapulogalamu amapangidwa.
Mitundu ya mapuloteni m'mimba
Mapuloteni, malingana ndi maselo omwe amapangidwa ndi zigawo zawo, amasiyanitsa:
1. Zilonda zam'mimba - zopangidwa adakali aang'ono, zofanana ndi zotupa zamadzimadzi.
2. Ma polyps owoneka bwino - wandiweyani, chifukwa amapangidwa ndi minyewa yolumikizana, amakula atakwanitsa zaka 40, asanakwane kapena asamba.
3. Glandular - fibrous, yopangidwa motsatana, kuchokera kumaselo am'magazi ndi minofu yolumikizana.
4. Polyps - adenomas: ma atypical cell amapezeka m'mapangidwe awo, chifukwa chake khansa imatha.
5. Mapuloteni amadzimadzi amapangidwa kuchokera ku tinthu tating'onoting'ono tomwe timasungidwa pambuyo pobereka.
Miyeso ya tizilombo ta chiberekero imasiyanasiyana kuchoka pa millimeters pang'ono kufika ku 3,0 masentimita. Kawirikawiri, mapuloteni amapezeka mpaka masentimita 1,0.
Zambiri m'mimba zimakhala zizindikiro zoyamba
Mawere a m'mimba amatha kukhala osakanikirana. Zikatero, iwo amapeza kufufuza kwa matenda ena, kapena pofotokozera zomwe zimayambitsa kusabereka.
Pamene mazira ena amapezeka mu chiberekero, zizindikiro zoyamba zimawonetseredwa:
• zosiyanasiyana kuphwanya msambo;
• Kutuluka magazi m'chiberekero pakati pa msambo;
• kutuluka magazi pakusamba;
• kupweteka ndi kusapeza nthawi yogonana, ndipo pambuyo pake - kuwona.
Ndiponso, mapuloteni amatha kupezeka ngati kutukuka kumachitika kapena kupwetekedwa kumapezeka. Izi zikutsogolera, kuwonjezera pa pamwambapa, kuwonetseredwa kwa kutsatira zizindikiro za kuchipatala:
• kukoka zowawa zomwe zimachitika osati kokha panthawi yogonana, komanso nthawi yochepa kusamba kusanachitike;
• kupezeka kwa magazi pakumwa, osagwirizana ndi msambo.
Zambiri m'mimba zimakhala zizindikiro
Pamene mapuloteni amakula mu chiberekero, zizindikiro zawo zimakhala zowonjezereka:
• kuchepa kwa magazi m'thupi;
• kupitiriza kuphwanya msambo;
• kupita padera;
• fetal hypoxia;
• kusabereka;
• Khansa ya m'chiberekero, yomwe ndi ngozi yayikulu ya tizilombo tating'onoting'ono.
Kuzindikiritsa mapuloteni m'mimba
Chiberekero cha chiberekero ndi njira yofikirira, yophunzitsira komanso yopweteka kwambiri. Pamene ndondomekoyi ikuchitidwa ndi sensa yapakhungu, zotsatira zabwino kwambiri zimapezeka.
Kuti mudziwe mwatsatanetsatane, zowonjezereka zimagwiritsidwa ntchito: zipangizo (tizilombo tating'ono ndi chipinda) zimalowetsedwa mu chiberekero cha uterine. Zosakaniza ngati zili zofunikira, kutenga zinthu zakuthupi. Komanso kudzera mu zipangizo mu uterine, mukhoza kulowa wothandizira ndi kupanga X-ray.
Chithandizo cha polyps mu chiberekero
Kuchiza kwa chiberekero mu chiberekero ndiko kungopanga opaleshoni yokha. Pamene pulopeni imodzi imapezeka, imadulidwa. Mu polyposis, chigawo chapamwamba cha uterine mucosa chimachotsedwa.
Zisonyezo za mankhwala opaleshoni ndizo:
• kusowa mphamvu kuchokera kuchipatala;
• azaka zoposa 40;
• kukula kwa mapangidwe ndikoposa 1,0 cm;
• ngati maselo atypical amapezeka pakuwunika kwa histological.
Pakalipano, chithandizo cha polyps mu chiberekero chimagwiritsidwa ntchito ndi njira zosakanikirana ndi laparoscopic.
Njira yotchedwa Hysteroscopic imaonedwa kuti ndi yopweteketsa kwambiri, imapangidwa pansi pa nthendayi pang'ono ndipo imatha pafupifupi maminiti a 20.
Nthawi yoyenera kwambiri yopanga mankhwalawa ndi 2 - 3 patatha masiku osamba: chiberekero cha mucosa ndi chochepa thupi panthawiyi, polyp imatsimikiza mosavuta, chifukwa ikakwera pamwamba pake, mutha kuchotsa mwachangu. Njirayi ili ndi ubwino wambiri:
• chitetezo;
• kupweteka;
• kusakhala ndi zochekacheka, motero, magawo ogwira ntchito;
• kamera ya hysteroscope imakupatsani mwayi wopeza tizilomboto ting'onoting'ono ndikuwachotsa.
Laparoscopy imagwiridwa motsogozedwa ndi laparoscope kudzera pa kutseguka (0,5 - 1,5 cm) pamimba yotsika. Njira yake ndi yothandiza kwambiri pakhungu. Ngati maselo atypical apezeka mu polyp, yomwe ikuwonetsa chiopsezo chachikulu chotupa, chiberekero chimachotsedwa pogwiritsa ntchito njirayi.
Ubwino wa laparoscopy ndi:
• kupweteka pambuyo pa opaleshoni ndikosowa;
• palibe zovuta;
• kupezeka kwa zipsera;
• kuchira msanga kwa thupi.
Chithandizo cha polyps mu chiberekero
Chithandizo cha ma pops mu chiberekero nthawi zina chikuchitika popanda opaleshoni. Izi ndizotheka nthawi zina:
• mwa amayi omwe sanabadwe, popeza kuti opaleshoni imabweretsa mavuto pakubereka;
• mwa odwala achichepere (milandu imafotokozedwa pomwe tizilombo tina tomwe timapezeka mwa atsikana achichepere)
• ngati pali polyp imodzi yaying'ono, kumwa mankhwala ena kumatha kuichepetsa ndikukwaniritsidwa kwathunthu.
Popeza kuti mapuloteni amapangidwa mu chiberekero cha uterine chifukwa cha mankhwala apamwamba a estrogen, mankhwala ophera mahomoni amalembedwa kuti athe kuchepetsa kuchuluka kwa estrogens ndikuthandizira kuwonjezeka kwa progesterone. Amathetsa chiwalo cha etiological (estrogens), zomwe zimapangitsa kuti mcherewo usachepe kwambiri, umadumphira ndipo umachoka pachiberekero pa nthawi ya kusamba.
Kukonzekera kwa chithandizo cha polyps kumasankhidwa kuganizira zaka:
• mpaka zaka 35 - estrogen - njira zolerera za gestagenic (Regulon, Janine, Yarina);
• patatha zaka 35 - gestagens (Dyufaston, Utrozhestan, Norkolut);
• patatha zaka 40 komanso kuyamba kusamba - gonadotropin yotulutsa omwe amatsutsana ndi mahomoni (Zoladex, Dipherelin) - amateteza motsutsana ndi zotsatira za ma estrogen omwe amachititsa kusintha kwa chiberekero;
• mankhwala a antibacterial amapatsidwa msinkhu uliwonse - ndi ofunikira panthawi yomwe mapangidwe amtundu wa polyps adachitika chifukwa chotupa m'chiberekero (Zitrolide, Monomycin, etc.).
Mankhwala onse amalembedwa ndi azimayi mu gawo lina la kayendetsedwe kake komanso molingana ndi dongosolo lapadera.
Kupewa ma polyps mu chiberekero
Kupewa ma polyps mu chiberekero kumagwirizanitsidwa ndi kutayika kwa mazira ochuluka omwe amachititsa ochuluka ma estrogens. Choncho, njira zothandizira ndizo:
• kupita pafupipafupi kwa azachipatala kuti asatenge matendawa ndikusankha njira zolerera;
• zolimbitsa thupi, kulimbana ndi hypodynamia kupatula kuchepa kwamagazi m'chiuno;
• kusafuna chiwerewere;
• osadya nyama yomwe ili ndi mahomoni;
• pewani kutentha thupi mwadzidzidzi.
Nthawi zonse zimakhala zofunikira kuti muzisamalira thupi lanu mosavuta komanso kuchepetsa kufunsa nthawi ndi katswiri kuti mupewe mavuto ovuta.