Ama-polyps esibelethweni amafomu avela ku-endometrium avela eminyakeni eyi-9. Okuvame ukutholakala ngaphambi kokunqamuka kokuya esikhathini eminyakeni engama-40 - 50. I-polyp ibhekisela kuma-neoplasms anobungozi, kepha uma ungathathi zinyathelo zokuyelapha, ngokuqinisekile izimo, angase abe yingozi. Amathuba okushisa okunjalo yi-1 - 2%.
Ama-polyps angashadile ngesisekelo esibanzi noma ku-pedicel, futhi amaningi (polyposis).
Ama-polyps esibelethweni atholakala kwabesifazane cishe ku-10% wamacala. Phakathi kwezifo ze-gynecological ziyi-25% yamacala, okukhombisa ukusabalalisa okubanzi kwenkinga.
Ama-Polyps esibelethweni yizimbangela
Lapho ufunda lesi sifo kutholakala ukuthi ama-polyps esibelethweni, izimbangela zaso kulowo nalowo cala zihlukile, vuka ngemuva:
• ukuphazamiseka kwamahomoni;
• ukunciphisa ukuzivikela komzimba;
• ukucindezeleka kanye nokusebenza ngokweqile kwemizwa;
• Izinguquko ezidalwa yiminyaka yowesifazane.
Ngaphezu kwalokho, kusekhona isisindo izici ezingozini ezenza ukuthuthukiswa kwe-polyps esibelethweni:
1. Izifo zezitho zobulili kwabesifazane (ama-ovarian cysts, fibroids, endometriosis).
2. Ukulimala komshini wesibeletho okuvela ekuhlolweni kwezinsimbi zabesifazane, ngenxa yezifo ezivuthayo (i-endocervicitis), ngesikhathi sokubeletha noma sokukhipha isisu.
3. Izifo ezithathelwana ngocansi (ama-STI), kanye nangemuva kokwephulwa kwe-microflora yesitho sangasese sowesifazane. Okuyingozi kunazo zonke yilezi: ureaplasmosis, herpes, toxoplasmosis, mycoplasmosis, candidiasis.
4. Izakhi zofuzo.
5. Ukungasebenzi komzimba.
6. Ukwelashwa kwesikhathi eside ngeTemoxifen - umuthi osetshenziswa lapho kunezimila ukuze uvimbele ama-receptors azwela ama-hormone. Ngenxa yalokhu, kwezinye iziguli, amaseli endothelial aqala ukukhula ngamandla futhi ama-polyps akha.
Ukwanda kwe-Vascular: lapho i-vasculature ikhiwa nxazonke, ukuphindaphinda okusebenzayo kwamaseli e-epithelial kuqala.
Iqembu lezinhlekelele libandakanya abesifazane abane:
• ukukhuluphala ngokweqile;
• isifo se-hypertonic;
• i-endocrine pathology.
Inqubo ye-polyps esibelethweni
Ngenxa yokuhluleka kwe-hormone, ukusebenza okuvamile kwama-ovari kungaphazamiseka, ngakho-ke inani elikhulu lama-estrogens angena egazini.
Ngokuvamile, ukukhiqizwa kwalo kwenzeka ngaphakathi kwamasonto amabili kokuya esikhathini. Ngenkinga ye-hormone, ungena egazini ngokuqhubekayo. Ngaphansi kwethonya layo, kukhona ukwanda okwandisiwe kwe-endometrium.
Phakathi nenkathi ye-endometrium yanyangazonke ayiqedi ngokuphelele, enye ingxenye yayo ihlala esibelethweni. Le nqubo yenziwa phakathi kwemijikelezo eminingana futhi iholela ekwakhiweni kokubunjwa kweqoqo le-endometrial esakhiweni sokuxubana.
Esikhathini esizayo, kukhona ukuhluma kwemithambo yegazi kanye namafayili amathishu axhumeneyo - i-polyp ekwakhiwa.
Izinhlobo zama-polyps esibelethweni
Ama-Polyps, kuye ngokuthi amangqamuzana abakhiwe kuwo kanye nezinhlaka zawo, ahlukanise:
1. Ama-polyps weglandular - akhiwa esemncane, afana nama-cyst fluid.
2. Ama-polyps amancanyana - aminyene, ngoba asuselwa kuzicubu ezixhuma, akhula ngemuva kweminyaka engama-40, ngaphambi kokunqamuka kokuya esikhathini nasesikhathini sokunqamuka kokuya esikhathini.
3.I-glandular - fibrous, eyakhiwe, ngokulandelana, evela kumaseli wezindlala nezicubu ezihlangene.
4. Ama-polyps - adenomas: amaseli we-atypical atholakala esakhiweni sawo, ngakho-ke, ukuthuthukiswa komdlavuza kungenzeka.
5. Ama-polyp polacental akhiwa ngezinhlayiya ze-placenta ezigcinwe ngemuva kokubeletha.
Ukulinganisa kwama-polyps esibelethweni kuyahlukahluka kumamitha ambalwa kuya ku-3,0 cm. Ngokuvamile, ama-polyps avela ku-1,0 cm.
Ama-Polyps esibelethweni yizona zimpawu zokuqala
I-polyps esibelethweni ingaba yinto engavamile. Ezimweni ezinjalo, zitholakala ekuhlolweni kwesinye isifo, noma lapho kucacisa izimbangela zokungabikho.
Uma izinambuzane ezithile zifinyelelwa esibelethweni, izimpawu zokuqala zibonakala:
• ukungajwayelekile kokuya esikhathini;
• ukuphuma kwesibeletho phakathi kwezikhathi;
• ukopha ngesikhathi sokunqamuka kokuya esikhathini;
• ubuhlungu nokungahambi kahle ngesikhathi socansi, futhi ngemuva kwaso - ukukhipha ukuphuma.
Futhi, i-polyp ingatholakala uma ukuvuvukala kuvela noma kuphazamiseka kwenzeka. Lokhu kuholela, ngaphezu kokungenhla, ekubonisweni kwe kulandela izimpawu zomtholampilo:
• ukudonsa izinhlungu ezenzeka hhayi kuphela ngesikhathi sokuya ocansini, kepha futhi nangaphambi nje kokuqala kokuya esikhathini;
• ubukhona begazi ekucucuzeni, okungahambisani nokuya esikhathini.
Ama-Polyps esibelethweni yizibonakaliso
Njengoba ama-polyps ekhula esibelethweni, izibonakaliso zabo ziba ngaphezulu:
• i-anemia iyakhula;
• ukwephula okuqhubekayo komjikelezo wokuya esikhathini;
• ukuphuphuma kwesisu;
• i-hypoxia yesisu;
• ukungabi nenzalo;
• umdlavuza wesibeletho, okuyingozi enkulu yama-polyps.
Ukuxilongwa kwama-polyps esibelethweni
Isibeletho se-ultrasound yisindlela esitholakalayo kakhulu, efundisa futhi engenabuhlungu yokuxilongwa. Lapho inqubo yenziwa ngunzwa we-intravaginal, imiphumela enembile kakhulu iyatholakala.
Ukuze uthole ucwaningo oluningiliziwe, i-hysteroscopy yenziwa: i-apparatus (ithubhu elincanyana nekamelo) lifakwe emgodini we-uterine. I-hysteroscopic uma kudingeka, ukuthatha impahla ye-biopsy. Futhi ngokusebenzisa ama-apparatus emgodini we-uterine, ungangena i-agent ehlukile bese wenza i-X-ray.
Ukwelashwa kwama-polyps esibelethweni
Ukwelashwa kwama-polyps esibelethweni kuhlinzekwa kuphela. Uma i-polyp eyodwa ifunyanwa, inqunywe. Ku-polyposis, ungqimba olungaphezulu lwe-uterine mucosa lukhishwa.
Izinkomba zokwelapha ukwelashwa yizo:
• ukungabi nomphumela ekwelashweni kwehomoni;
• uneminyaka engaphezu kwengu-40;
• ubukhulu bokwakheka bungaphezu kuka-1,0 cm;
• uma kutholakala amaseli we-atypical ngesikhathi sokuhlolwa kwe-histological.
Okwamanje, ukwelashwa kwama-polyps esibelethweni kwenziwa ngezindlela ze-hysteroscopic ne-laparoscopic.
Indlela ye-hysteroscopic ibhekwa njengendlela ephansi yokuthungatha, eyenziwa ngaphansi kwe-anesthesia encane futhi ihlala emaminithini we-20.
Isikhathi esingcono kakhulu ukukhohlisa - izinsuku 2 ngemva kokuya esikhathini - 3: endometrium ngalesi sikhathi inamakhasi ambalwa, le polyp kungaba azimisele kalula, okungukuthi, ukuba esikhulu phezu kwaso, ungayisusa ngokushesha ... Indlela inezinzuzo ezimbalwa:
• ukuphepha;
• ukungenabuhlungu;
• ukungabikho kokuqhekeka futhi, ngokufanele, imikhakha yokusebenza;
• ikhamera ye-hysteroscope ikuvumela ukuthi uthole ama-polyps amancane futhi uwasuse.
I-laparoscopy yenziwa ngaphansi kokulawula i-laparoscope ngokusebenzisa umgodi (0,5 - 1,5 cm) esiswini esingaphansi. Le ndlela iphumelela kakhulu lapho kutholakala ukwakheka okubi. Uma kwenzeka ukutholakala kwamangqamuzana angavamile ku-polyp, ebonisa ukuthi ingozi enkulu ye-tumor, isisu sisusiwe ngokusebenzisa le ndlela.
Inzuzo ye-laparoscopy yilezi:
• ubuhlungu be-postoperative abuvamile;
• azikho neze izinkinga;
• ukungabi khona kwezibazi;
• ukululama okusheshayo komzimba.
Ukwelashwa kwama-polyps esibelethweni
Ukwelashwa kwama-polyps esibelethweni ezimweni ezithile kwenziwa ngaphandle kokuhlinzwa. Lokhu kungenzeka kwezinye izimo:
• kwabesifazane abangazalanga, ngoba ukuhlinzwa kuholela ezinkingeni zokukhulelwa;
• ezigulini ezisencane (amacala achazwa lapho kutholakala ama-polyps emantombazaneni asakhula)
• uma kune-polyp eyodwa encane, ukuthatha imishanguzo ethile kungakunciphisa futhi kufinyelele ekunyamalaleni okuphelele.
Njengoba kunikezwe ukuthi i-polyp yenziwa emgodini we-uterine ngaphansi kwethonya eliphezulu eliphezulu le-estrogen, izidakamizwa ze-hormone zenziwa ukuthi zinciphise inani lama-estrogens futhi zenze ukwandisa izinga le-progesterone. Ziqeda isici se-etiological (i-estrogens), okuholela ekunciphiseni okuphawulekayo kwipolitiki, itshaya futhi ishiya isibeletho ngesikhathi sokuya esikhathini.
Ukulungiselela ukwelashwa kwama-polyps kuqokwa ngokucabangela iminyaka:
• kuze kube yiminyaka engama-35 ubudala - i-estrogen - izindlela zokuvimbela inzalo ze-gestagenic (Regulon, Zhanin, Yarina);
• ngemuva kweminyaka engama-35 - i-gestagens (iDyufaston, i-Utrozhestan, iNorkolut);
• ngemuva kweminyaka engama-40 nokuqala kokunqamuka kokuya esikhathini - i-gonadotropin ekhipha abaphikisana namahomoni (iZoladex, iDipherelin) - bayazivikela emiphumeleni yama-estrogens abangela ushintsho esibelethweni;
• imishanguzo elwa namagciwane ibekiwe kunoma yisiphi isikhathi - iyadingeka ezimweni lapho ukwakheka kwama-polyps kwenzeke mayelana nenqubo yokuvuvukala esibelethweni (iZitrolide, Monomycin, njll.).
Zonke izidakamizwa zinqunywe umjozi wezifo zesifo sangasese esigabeni esithile somjikelezo futhi ngokusho kwesimiso esikhethekile.
Ukuvimbela ama-polyps esibelethweni
Ukuvimbela ama-polyps esibelethweni kuhlotshaniswa nokukhubazeka kwama-ovari okukhiqiza inani elikhulu le-estrogens. Ngakho-ke, izinyathelo zokuvimbela zihlanganisa:
• ukuvakashela udokotela wezifo zabesifazane njalonjalo ukukhipha ukugula kanye nokukhetha okulungile kwemithi yokuvimbela inzalo;
• umsebenzi osebenzayo, ukulwa ne-hypodynamia akufaki ukuma kwegazi okhalweni oluncane;
• ukukhiphela ngaphandle ucansi lokuziphatha okuxekethile;
• ungadli imikhiqizo yenyama equkethe ama-hormone;
• gwema i-hypothermia engazelelwe.
Kuhlale kudingekile ukuphatha ngokucophelela umzimba wakho kanye nokuhluleka okuncane ukubonisana nesikhathi nomchwepheshe ukuze ugweme izinkinga ezingathandeki.