Sklerokistoz zes qe menyuam: nws yog dab tsi, ua rau, cov tsos mob, mob, kev kho mob, txim

Kwv yees li tsib feem pua ntawm txhua tus neeg mob gynecological kab mob, cov kws kho mob thiaj paub hais tias "ntawm zes qe menyuam sklerokistoz". Yuav ua li cas nws yog, yog nws tus kheej tsis yog txhua tug poj niam, thiaj li muaj ntau perceive ib tug mob ntxiv lawm tshob raws li ib tug kab lus. Nyob rau hauv qhov tseeb, hais txog ib feem peb ntawm cov neeg uas muaj sab no pathology, lawv cov me nyuam muaj peev xwm tsis muaj. Tab sis rau lwm tus neeg muaj siab muaj feem yuav rov qab thiab ib tug me nyuam noj qab nyob zoo tus me nyuam.

Sklerokistoz zes qe menyuam muaj lwm lub npe - Stein-Leventhal syndrome, vim hais tias nws twb xub piav los ntawm ob American gynecologist - Irving Stein thiab Maykl Levental. Qhov no tshwm sim nyob rau hauv 1935. Nyob yim caum xyoo tom qab twb kom huv si kawm pathogenesis ntawm tus kab mob, tsim txoj kev kho mob thiab tus mob, tab sis, thaum tam sim no zaum tsis paub tag nrho cov yog vim li cas rau nws tshwm sim.

Yog hais tias koj muab tso rau ib tug disappointing mob thiab koj yeej xav kom muaj cov me nyuam, tsis txhob tag kev cia siab. Nyob rau hauv no tsab xov xwm peb yuav sim qhia txhua yam tseem ceeb hais txog ntawm zes qe menyuam sklerokistoz thiab txoj kev los daws nrog nws.

Yuav ua li cas yog kev noj qab nyob zes qe menyuam

Yuav kom to taub zoo dua yuav ua li cas hais txog sklerokistoz zes qe menyuam thiab cev xeeb tub, koj yuav tsum paub yuav ua li cas los mus tsim cov lub cev thiab yuav ua li cas lawv ua hauj lwm, Yog hais tias muaj yog tsis muaj tus kab mob nyob rau hauv lawv. Lub zes qe menyuam yog cov poj niam me nyuam hauv nruab nrog cev ua khub. Lawv yuav tsum tau sawv cev nyob rau hauv daim ntawv ntawm cov thawj lub hnab uas muaj cov hlwb muaj teeb meem. Zes qe menyuam phab ntsa yog hlua nrog ib tug txheej ntawm tuab connective cov ntaub so ntswg nyob rau hauv nws yog ib tug txheej ntawm cov cortex. Nws muaj ib tug complex qauv thiab tseem ceeb heev. Nws yog nyob rau hauv no txheej yog tsim hauv paus - cov yam ntxwv hais nyob rau hauv uas lub tsim oocyte. Hauv paus yog hu ua cov thawj, nyob rau hauv ib tug npaum li ntawm txog ib mus rau ob lab pw nyob rau hauv lub cev ntawm txhua fetus ntxhais lwm kauj ruam. Thoob plaws hauv lub neej, los ntawm lub kom loj hlob lub sij hawm thiab qhov xaus lub sij hawm ntawm lub lawm, lawv maj mam noj thiab sawv daws yuav tshiab tsis tau tsim. Yog li ntawd, lub teev los, thaum lawv Tshuag sau.

Qhov no yuav luag yeej tsis tshwm sim nyob rau hauv cov poj niam uas nyuam muaj hnub nyoog, yog li qhov ua rau ntawm ntxiv lawm tshob yuav tsis tau cov tsis muaj hauv paus. Ib qho ntxiv uas yog tias nyob rau hauv lawv cov gradual maturation tej yam mus tsis ncaj ncees lawm. Yog li ntawd lawv yog cov yuav liam rau lub fact tias cov kev kawm uas cev xeeb tub tsis tshwm sim. Ntxiv mus, qhov txawv txav kev loj hlob ntawm hauv paus nyob rau hauv ib puas feem pua ntawm cov neeg mob ua rau yus gynecological kab mob, uas tsis kho nyob rau hauv cov poj niam tsub kom kev pheej hmoo ntawm thrombosis, thrombophlebitis, mob ntshav qab zib, plawv nres, malignant qog nyob rau hauv lub mammary qog.

Raws li ntawm zes qe menyuam cyst tshwm thiab yuav ua li cas hais txog cev xeeb tub

Thaum hluas nkauj ua kev plees kev paub tab nyob rau hauv lawv lub cev muaj nyob rau hauv lub chaw ua hauj lwm cov txheej txheem ntawm maturation ntawm thawj cov hauv paus uas hitherto zoo li tsaug zog lawm. Qhov no txoj kev ib txwm yuav siv sij hawm qhov chaw nyob rau hauv tas mus li. Nyob rau hauv txhua lub voj voog ntawm "tsaug zog" mus txog 15 hauv paus. Lawv nyob rau hauv qhov kev txiav txim ntawm FSH lawm uas ua los ntawm lub pituitary caj pas, pib nyob rau hauv txoj kev loj hlob, ua nyob rau hauv txoj kab uas hla los ntawm 50 mus rau 500 microns. Thaum lub sij hawm no lub sij hawm, lub follicular kua yog tsim nyob rau ntawd, thiab qhov loj tshaj plaws ntawm lawv tshwm sim kab noj hniav. Qhov no follicle yuav tseem ceeb, tsub kom mus rau 20 millimeters, bulges. Hauv nws yog sai tsim qe. Tus so ntawm lub follicle los ntawm cov pab pawg neeg ntawm "paub" ib tug tom qab lwm yam tuag thiab yaj. Yog hais tias tag nrho cov mus raws li cov kev cai nyob rau hauv tus poj niam lub cev muaj nyob rau hauv lub chaw ua hauj lwm ntawm lub endocrine system. Cov ua los ntawm cov tshuaj hormones estrogen, progestins, thiab androgens, uas feem xyuam rau txoj rau qhov ntxiv maturation ntawm lub hom follicle. Nyob rau hauv tus ntawm luteinizing hormone (lyuteotropina, lutropin, abbreviated li LH), nws yog tawg, nws yoojyim los ntawm lub qe mus rau hauv txoj hlab qe raj, thiab nws puv mus rau hauv lub corpus luteum thiab maj resorbed.

Yog hais tias tus so tsis tshwm sim, lub qe yog tsis tau tso tawm yog reborn, thiab qhov chaw ntawm lub follicle tshwm lws suav-sized ntawm zes qe menyuam cyst. Lawv cov hauv lub "paub" hauv paus uas tseem tsis tau muaj sij hawm los tuag, thiab tig mus rau hauv cov hlwv, tsuas me me. Cyst, tsim los ntawm ib tug follicle, tej zaum hlob mus rau ib tug loj (40-60 hli), tab sis tsis tau lawv tus kheej tso rau. Tsuas yog nyob rau hauv ib tug ob peb tus neeg mob, cov neeg mob tsis txaus siab ntawm qhov mob nyob rau hauv lub zes qe menyuam. Thaum ib tug poj niam muaj qub zus tau tej cov tshuaj hormones, nws maj mam yaj. Yog hais tias ib tug poj niam tau rov qab los ovulation, nyob rau hauv lub sij hawm ntawm zes qe menyuam follicular cyst ntawm cev xeeb tub tsis cuam tshuam, tab sis yog hais tias tus cyst tau zus mus rau lub luaj li cas ntawm 90 millimeters, nws yuav tsum tau surgically tshem tawm.

Cov ua rau tus kab mob

Zaum paub nyob rau hauv kom meej yuav ua li cas cov duab sklerokistoz zes qe menyuam. Yog vim li cas rau qhov no tshwm sim yog tsis zoo tsim, muaj tsuas yog kev xav. Raws li nyob rau hauv lub qub kev loj hlob ntawm lub follicle thiab ovum tso zis therefrom cov tshuaj hormones ua si ib tug tseem ceeb luag hauj lwm, lub ntsiab ua rau ntawm sklerokistoz xam tau tias yog zes qe menyuam hormonal ntshawv siab, thiab nyob rau hauv particular ib tug tsis ua hauj lwm nyob rau hauv lub mechanism ntawm cov tshuaj no synthesis. Xa mus rau cov nram qab no ua rau hormonal tsis txaus:

• caj;
• kev txawv txav nyob rau hauv noob qauv;
• teeb nyob rau hauv lub pituitary-ntawm zes qe menyuam system;
• kev poob plig;
• teeb meem tom qab rho menyuam;
• kab thiab gynecological kab mob;
• mob tom qab muab yug;
• hloov lub zog ntawm cov adrenal cortex.

soj ntsuam cov tsos mob

Tu siab, tsuas yog thaum pib ntawm lub kom loj hlob lub sij hawm mus nrhiav tau tus hluas nkauj sklerokistoz zes qe menyuam. Cov tsos mob thaum lub sij hawm rau theem no lubricated thiab tsuas yog muaj nyob rau hauv lub cev ntas. Tab sis qhov no tshwm sim muaj peev xwm ua tau ntau lwm yam yog vim li cas tsis muaj feem xyuam rau tus kab mob ntawm lub zes qe menyuam, cia rau cov neeg pluag noj haus thiab paj ntshawv siab. Rau nees nkaum, mus rau ib tug tshaj plaws ntawm nees nkaum-tsib xyoo cov ntxhais tshwm sim ntau kev cov tsos mob ntawm zes qe menyuam sklerokistoz. Lub ntsiab yog tseem muaj ib tug ua txhaum ntawm cycling thiab qhov xwm ntawm poj niam (96 feem pua ntawm cov neeg mob). Feem ntau cov kev ntev qeeb txhua hli (txog ib nrab los yog ntau tshaj) los yog ib yam nkaus thiab me me ntawm precipitates (hypomenstrual syndrome). Ntau tsawg yuav tsis txaus siab txog qhov ntev ntawm tus neeg mob thiab xauv npo txhua hli.

Lwm yam tsos mob Muab ntawm zes qe menyuam sklerokistoz nram qab no:

• hirsutism (nyob rau hauv kwv yees li 90 feem pua ntawm cov neeg mob cai hairiness cheeb tsam ib ncig ntawm lub txiv mis, rov qab, plab mog, thiab lub puab tsaig saum toj no lub di ncauj);
• nyhav dhau heev lawm (70 feem pua ntawm cov neeg mob);
• mas thiab pob txuv ntawm lub ntsej muag (tshwm sim nyob rau hauv tsis muaj ntau tshaj li 40 feem pua ntawm cov neeg mob);
• ib co kev hloov nyob rau hauv lub cev proportions;
• malfunction ntawm poob siab system;
• asthenic syndrome;
• ntawm zes qe menyuam o (kuaj thaum lub sij hawm soj ntsuam gynecologist).

Nyob rau hauv tas li ntawd, ib co poj niam tej zaum yuav muaj cov tsos mob uas yog tshwm sim rau ntau cov kab mob: lub mob nyob rau hauv lub qis lub plab, tsis xis nyob, inexplicable qaug zog.

laboratory kev tshawb fawb

Nyob rau lub hauv paus ntawm lwm yam tshwm sim ntawm zes qe menyuam sklerokistoz pawg xav tias tsam, thiab qhov kawg mob yog ua tom qab ntxiv xeem. Cov no yog cov:

• tsom xam rau cov ntshav testosterone (tag nrho cov yuav tsum tau nyob rau hauv ntau ntawm 1.3 ng / mL, free poj niam rau 41 xyoo - nyob rau 3.18 ng / ml, thiab mus txog rau 59 xyoo - tsis muaj ntau tshaj li 2.6 ng / ml);
• tsom xam ntawm lub nyhav ntawm zib nyob rau hauv cov ntshav qab zib, thiab triglycerides;
• kolpotsitogramma (cov ntaub ntawv uas coj los ntawm qhov chaw mos los tshuaj ntsuam cov ntaub ntawv qhia tau tias, yog tsis muaj los yog ovulation, raws li zoo raws li txoj kev indices kolpotsitogrammy hnub nyoog ntawm tus neeg mob thiab lub sij hawm ntawm nws cev ntas);
• scraping ntawm lub endometrium (muab ib tug hais txog ntawm kev ua txhaum ntawm lub zes qe menyuam);
• tswj basal kub hloov;
• Ib txhia ntsuam rau cov thyroid hormones, pituitary, zes qe menyuam (LH, FSH, PSSG, prolactin, cortisol, 17-hydroxyprogesterone);
• kev txiav txim ntawm cov tshuaj no feem.

Tam sim no tus neeg mob yuav nws tus kheej nqa tawm ib tug yooj yim kev kuaj nyaj ntawm zes qe menyuam hlwv. Qhov no yuav tsum tau ib tug tshuab kuaj kab mob (muaj nyob rau ntawm cov chaw muag tshuaj). Nyob rau hauv thaum sawv ntxov, cia li sawv thiab tseem tsis muaj dab tsi twb tau noj mov thiab haus, koj yuav tsum muab tso rau ib tug nco ntawm nws cov qaub ncaug rau ib daim ntawm cov iav kuaj thiab muab nws mus rau qhuav. Thaum lub sij hawm ovulation yeej ib txwm tsub kom cov theem ntawm cov tshuaj no, uas nyob rau hauv lem alters nyob tus yeees ntawm cov qaub ncaug. Yog hais tias ovulation yog, ib tug qaub ncaug qauv nyob rau hauv lub tshuab kuaj kab mob yuav nyob rau hauv daim ntawv ntawm cov fern nplooj, thiab yog hais tias muaj yog tsis muaj ovulation, - nyob rau hauv daim ntawv ntawm cov ntsiab lus.

kho vajtse diagnostics

Raws li txoj cai, yog thiab tseem mob ntawm cov neeg mob muab lub complex soj ntsuam ntawm kev kho mob kiag li lawm.

Qhov tseem maj mam thiab kiag li tsis mob yog cov ultrasound mob ntawm zes qe menyuam sklerokistoz. Tus txheej txheem yog transabdominal (los ntawm lub plab mog), transvaginal (mas tuav txoj kev), transrectal ultrasound (ua tsuas yog nyob rau cov me ntxhais thiab cov neeg laus cov poj niam).

Siv ultrasound txiav txim ntawm zes qe menyuam loj, me, zoo, qauv, tus naj npawb ntawm cov hauv paus nyob rau hauv lawv, uas nws txoj kab uas hla - 8 hli, cov muaj los yog tsis tuaj kawm ntawv ntawm lub hom follicle, lub muaj los yog tsis tuaj kawm ntawv ntawm ovulation, lub xub ntiag ntawm cov hlwv nyob rau hauv lub zes qe menyuam.

Lwm hom daim ntawv ntsuam xyuas - gas pelveogramma uas qhia kev txawv txav me me ntawm lub zes qe menyuam thiab lub tsev me nyuam.

Ib tug ntawm cov feem ntau nyuaj hom mob yog laparoscopy. Nws yog ua nyob rau hauv ib tug lub tsev kho mob nyob rau hauv kev tshuaj loog. Lub algorithm ntawm cov hauv qab no: tus neeg mob tus kws phais neeg ua tej ntawm lub peritoneum phab ntsa thiab nkag mus rau rau hauv lub apparatus, lub tshuab cov pa roj carbon dioxide roj nyob rau hauv thiaj li yuav ua tau ib lub ntim nyob rau hauv lub peritoneum thiab zoo tshawb kabmob. Ntxiv mus, tus neeg mob lub cev yog tswvcuab laparoscope, uas qhia tau hais tias nyob rau hauv lub screen rau hauv lub xeev ntawm lub zes qe menyuam. Laparoscopy - lub feem ntau muaj tseeb txoj kev mob, tab sis tom qab tus poj niam xav tau kev ncaj ncees lub sij hawm.

Conservative kev kho mob ntawm zes qe menyuam sklerokistoz

Tom qab ib tug tseem mob nyob rau hauv feem ntau ib tug poj niam yog raug tsa los ua ntej cov tshuaj kho. Nws lub hom phiaj - los ib txwm cev ntas thiab ovulation mus rov pib dua. Lub sklerokistoz kho ntawm zes qe menyuam gynecologist txiav txim siab ua ke nrog rau cov endocrinologist.

Nyob rau hauv lub xub ntiag ntawm rog, tus neeg mob thawj kauj ruam nyob rau hauv kev kho mob yog los nqa tsis tau. Poj niam muab noj cov zaub mov, ib ce muaj zog ua tau.

Qhov thib ob theem - ua lub xaav ntawm insulin. Taw "Metformin" uas koj yuav tsum coj 3-6 lub hlis.

Qhov thib peb theem - stimulation ntawm ovulation. Pib kev kho mob nrog rau cov nyuaj tshuaj - "clomiphene". Thawj zaug thaum kawg yog yuav tau txais rau lub ntuj nyob rau hauv ib koob tshuaj 50 mg, pib los ntawm 5 hnub ntawm lub voj voog rau 5 hnub sib law liag. Yog hais tias muaj yog tsis muaj tshwm sim (ua poj niam), "Clomiphene" coj ib lub hlis. Yog hais tias thiab thaum twg no cov nyhuv yog tsis tau, lub koob tshuaj twb tau nce mus 150 mg ib hnub twg.

Cov theem tom ntej (nyob rau hauv qhov qhaj ntawv los ntawm zoo puab) - sij hawm ntawm cov tshuaj "menogon". Nws yog tsim los siv intramuscularly, thiab tom qab ua hauv chav kawm tshuaj "Horagona". "Menogon" yuav hloov "Menodinom" los yog "Menopur".

Tom qab ua kom tiav tag nrho cov hoob kawm, ua ntshav Science News for KIDS, thiab xaiv "Utrozhestan" los yog "Djufaston" raws li tus tsom xam ntawm cov kev tshwm sim (yog hais tias tsis txaus ntawm cov hormone LH).

Nyob rau hauv parallel, cov kws kho mob sim tshem tawm ib tug poj niam muaj hirsutism, nyob rau hauv kev twb kev txuas nrog cov uas nws yog tshuaj, "Ovosiston" thiab "Metronidazole".

Yuav Tsum Tsis tas li ntawd mus rau lub Hoob no yog ib tug vitamin.

Sklerokistoz zes qe menyuam: cov kev kho mob ntawm kev phais hom kev kawm

Yog hais tias tsis pub dhau peb lub hlis tom qab cov tshuaj txoj kev kho yog tsis ovulation tshwm sim, tus poj niam yog tus kws kho phais. Nws yog nqa tawm los ntawm ob peb txoj kev. Uas yog ib tug mus siv nyob rau hauv lub yeej ntawm zes qe menyuam raws li txoj cai.

Thaum lub tam sim no theem, cov nram qab no ua hauj lwm:

• moxibustion hlwv siv ib laser;
• demedulyatsiya (zes qe menyuam tshem tawm nyob rau hauv nws nruab nrab ib feem);
• npoo resection (tshem tawm ntawm ib tug zes qe menyuam seem ntawm lub cov feem nyob rau hauv daim ntawv ntawm ib tug npoo);
• decortication (tus kws kho mob tshem tawm hloov tunica txheej ntawm zes qe menyuam hauv paus thiab lub koob pierces lub npoo sutured);
• galvanocautery (point kev puas tsuaj ntawm lub zes qe menyuam nyob rau hauv nws daim teb, uas ua heev npaum li cas lawm).
• notches (lawv tus kws phais neeg ua ib tug tob ntawm 1 cm nyob rau hauv qhov chaw nyob qhov twg ci hauv paus thiaj li hais tias lawv yuav tso thaum lub sij hawm maturation ntawm lub qe nws tus kheej).

forecasts

Cov poj niam uas pom zoo rau tej tswv yim txoj kev rau cov kws kho mob, xav nyob rau hauv ib lo lus nug: yog nws tau los ua cev xeeb tub thaum sklerokistoz zes qe menyuam? Txheeb cais qhia tau tias tsis muaj kev kho mob, ntxiv lawm tshob yog kuaj nyob rau hauv 90% ntawm cov neeg. Tshuaj kho "clomiphene" pab txoj kev ntawm zes qe menyuam muaj nuj nqi nyob rau hauv 90% ntawm cov neeg mob, tab sis lub cev xeeb tub tshwm sim thaum tsuas yog 28% ntawm lawv. Txawm li cas los, raws li ib txhia zoo tau tej zaum yuav raws li high school raws li 80%.

Tsis muaj "Clomiphene" khoom - nws tsuas zoo thaum pib ntawm tus kab mob los yog tom qab kev phais raws li ib tug adjuvant.

Kev kho mob los ntawm ntau haib tshuaj, xws li "gonadotropins", raws li statistics, yam tsawg kawg ua rau ovulation nyob rau hauv 28% ntawm cov neeg mob, lub siab tshaj plaws - 97%. Yog li cev xeeb tub los ntawm 7 mus rau 65% ntawm cov poj niam.

Yog hais tias ntawm zes qe menyuam sklerokistoz kho surgically, coj zoo thiaj tau cai uas hais txog cov tib zaus raws li hais tias ntawm lub conservative kev kho mob. Raws li statistics, tom qab phais rau lub zes qe menyuam ib lub caij tau cev xeeb tub tau 70-80% ntawm cov poj niam.

Xyuas

Rau ntau cov poj niam, kom lawv khaum staging mob "ntawm zes qe menyuam sklerokistoz". Xyuas ntawm cov neeg mob nyob rau hauv kev kho mob yog sib txawv heev. Ib tug neeg pab ntsiav tshuaj rau ib tug neeg - lub lag luam, thiab ib tug neeg uas cev xeeb tub tsis tau tshwm sim, tsis muaj teeb meem dab tsi txoj kev yog npaum li cas.

Muaj kuj yog ib feem me me ntawm cov neeg mob qhia pib ntawm lawv cev xeeb tub tsis muaj kev kho mob, txawm hais tias tus mob ntawm "sklerokistoz zes qe menyuam," tsis yog cia. Cov contradictory tau tej zaum yuav yog vim muaj cov neeg tus yam ntxwv ntawm txhua tus neeg thiab yuav tsum tsis txhob coj raws li cov cai.

Tab sis cov kev txhim kho ntawm kev noj qab nyob tom qab kev kho mob, lawv sau nyob rau hauv ib tug saib xyuas, feem ntau ntawm cov poj niam. Tsuas yog ib tug ob peb cov neeg mob tau qhia hais tias lawv tau normalized txhua hli uas rau ib tug luv luv lub sij hawm, tom qab uas lawv tau dua yuav tsum tau coj cov tshuaj hormones.

Thiab thaum kawg, muaj yog ib feem ntawm kev txheeb xyuas nyob rau hauv uas cov poj niam raug kev txom nyem los ntawm cov tsos ntawm lawv ntev-lub sij hawm kev mob nyob rau hauv lub cheeb tsam ntawm lub zes qe menyuam thiab cov peritoneum tom qab kev kho mob nrog kev phais.