Zimayambitsa zowonjezera kutentha kwa khansara
Ngati mwauzidwa kuti muli ndi mapepala osakanizika a Pap , chiyambi chanu choyamba chingakhale mantha kapena kuopa kwambiri. Ndizochita mwachibadwa.
Koma kodi "zachilendo" kwenikweni amatanthawuza chiyani pa nkhani ya Pap smear, ndipo iwe uyenera kuchita chiyani ngati uli nawo?
Kumvetsetsa Pap Smears Osasintha
Pap Smear yosavuta kumangotanthauza kuti kufufuza kwa maselo akutengedwa kuchokera pachibelekero chako sikunali monga momwe walangizi a labata akanayembekezera.
Pakhoza kukhala zifukwa zambiri za izi, kuyendetsa masewerawa kuchokera ku chifuwa chofewa mpaka khansa ya pachibelekero.
Pamapeto pake, zonsezi zimatiuza kuti kachilombo ka HIV kamasowa kupitilira. Nthawi zina, mungathe kupitiliza kuyeza ndi kupopera; panthawi ina, mukhoza kupemphedwa kuti mubwerere kuti mukapume pap smear m'zaka zitatu.
Mapuloteni osavuta a pap ndizofala kwambiri. Malingana ndi Centers for Disease Control and Prevention (CDC), amayi pafupifupi mamiliyoni atatu amalandira zotsatira zapadera za Pap chaka chilichonse. Mwa awa, pafupi 12,000 (kapena pafupifupi 250) adzapita ku khansara ya chiberekero.
Mavuto Osakanikirana ndi Kukula kwa Khansa
Zizolowezi zamtundu wina zimatchedwa dysplasia. Mndandanda weniweni wa maselo a dysplastic ndi awa:
- ASCUS (maselo ochititsa chidwi omwe sali ofunika kwenikweni)
- LGSIL (kutsika kochepa kwambiri m'mimba mwachisawawa)
- HGSIL (kuthamanga kwapamwamba kwambiri m'kati mwa intraepithelial lesion)
- AGC (maselo osakanikirana a pamapu a Pap)
Makina opangira maselo osasintha samasintha kapena amachititsa mavuto. Mwa iwo omwe amasintha, ena adzakhala mosamalitsa , kutanthauza kuti pali mwayi iwo adzakhala khansa.
Ena mwa maselowa amapita patsogolo pamatenda otchedwa carcinoma in situ momwe maselo amakhala khansara koma amangokhala pa zomwe zimatchedwa membrane (gawo limene limasiyanitsa minofu ya chiberekero kuchokera kumagazi ofunika kwambiri).
Ndipokha pamene imafalikira patali pamtunda kuti kachilombo ka HIV kamakhala ngati khansa ya pachibelekero.
ASCUS Pap Smears
ASCUS (maselo oopsa omwe sali ofunika kwenikweni) ndi mtundu wamba wonyansa, wowerengera pafupifupi 75 peresenti ya kuwerengedwa kosadziwika.
Maselo a squamous amathandiza kupanga minofu ya kunja ya chiberekero chotchedwa intraepithelial layer. ASCUS imangotanthauza kuti maselo asintha koma sakunena za chisanadze khansa. Kusintha kumeneku kungayambitsidwe ndi matenda a abambo kapena, nthawi zambiri, matenda opatsirana pogonana otchedwa papillomavirus (HPV).
SIL Pap Smears
SIL (matenda osokoneza bongo) amatanthauza kusintha kosasintha kwa maselo osokonezeka omwe apanga zilonda. SIL sichidziŵika kuti ndi chonchi kapena khansa. Zimangokhala zopanda pake pamtengo, mawonekedwe, ndi maonekedwe ake, motere:
- LGSIL (maselo otsika kwambiri a intraepithelial) amakhala osafewa mwachibadwa, kawirikawiri chifukwa cha matenda a HPV. Ambiri mwa matendawa amachoka popanda mankhwala.
- HSIL (maselo apamwamba otchedwa intraepithelial cells) amatanthauza kusintha komwe kungagwirizane ndi chitukuko cha maselo osakanikirana.
AGC Pap Smears
AGC (maselo am'thupi omwe amatha kupweteka kwambiri) ndi mtundu wina wa selo umene umaphimba mkamwa wamkati wa chiberekero komanso chiberekero.
Chotsatira cha AGC chimatanthauza kuti kusintha kwa maselowa kumadzetsa nkhaŵa za kukhalapo kwazodziwika kapena khansa.
Chimachitika Ngati Muli ndi Pap Smear Yodabwitsa
Dokotala wanu angapangire mayesero enanso ngati zotsatira zapap smear zosavomerezeka zalandiridwa. Izi zidzadalira makamaka pa kafukufuku wamatayi, umoyo wanu wamakono, ndi chithandizo cha dokotala wanu.
Njira zowonjezeka zingakhale monga:
- Kuwonetsetsa mwatsatanetsatane ndi kachitidwe kawiri kawiri ka Pap smear kufufuza
- Kuyezetsa HPV (kuphatikizapo reflex HPV kuyesa yomwe imagwiritsa ntchito maselo ku Pap smear)
- colposcopy ndi biopsy ya minofu iliyonse yodabwitsa
- sampuli yamakono (njira yomwe chimbudzi cha kholachi chikugwiritsidwa ntchito pogwiritsa ntchito chipangizo chopangidwa ndi supuni chotchedwa curette)
- sitiroli ya endometrial (kuchotsedwa kwa chitsanzo cha minofu pachiberekero ngati dokotala akuganiza kuti maselo osadziwika ali pachiberekero)
- Chithandizo chosasangalatsa ( cones biopsy ) kuchotsa chotupa kapena kukula
Malangizo othandizira amasiyana ndi zaka, dysplasia classification, ndi HIV ya amayi:
Zaka 21-24 | Zaka 25-29 | Zoposa 30, HPV-hasi | Zoposa 30, HPV-positive | |
ASCUS | Bweretsani Pap mu miyezi 12 (okondedwa) Reflex HPV (yovomerezeka) | Reflex HPV (yosankhidwa) Bwerezani Pap mu miyezi 12 (yovomerezeka) | Bwerezerani kuyezetsa Pap ndi HPV m'zaka zitatu | Colposcopy |
LSIL | Bweretsani Pap mu miyezi 12 | Colposcopy | Bweretsani Pap mu miyezi 12 (okondedwa) Colposcopy (yovomerezeka) | Colposcopy |
ASC-H | Colposcopy | Colposcopy | Colposcopy | Colposcopy |
HSIL | Colposcopy | Kusasamala kapena colposcopy | Kusasamala kapena colposcopy | Kusasamala kapena colposcopy |
AGC | Zimadalira magulu akuluakulu a AGC | Zimadalira magulu akuluakulu a AGC | Zimadalira magulu akuluakulu a AGC | Zimadalira magulu akuluakulu a AGC |
> Chitsime:
> American College of Obstetrics ndi Gynecology (ACOG). "Zotsatira Zowononga Kachilombo ka Khansa Yachilendo." Washington, DC; zasinthidwa mwezi wa 2016; FAQ 187.