Kusintha Chilankhulo cha Zotsatira Zakuyesedwa
Zingakhale zowopsya kuti mutenge zotsatira za Pap wanu zochokera kwa dokotala wanu. "Zachizolowezi" n'zosavuta kumvetsa. Komabe, ngati muli ndi mapiritsi ovuta a Pap, zingakhale zovuta kudziwa ngati zotsatira ziri zonse zomwe mukufunikira kuti mudandaule nazo. Chotsatirachi kwa zotsatira zapasariti za Pap zidzakuthandizani kumvetsa zomwe dokotala akuyesera kukuuzani. Mukamamvetsa zambiri, zidzakhala zosavuta kupanga chisankho chodziwitsa za chisamaliro chotsata.
Zachibadwa
Chotsatira cha pap smear choyenera chimatanthauza kuti maselo onse mu chitsanzocho amayang'ana momwe ayenera. Kuwonjezera kwotsatira sikusonyezedwe. Muyenera kupitiliza kuyesedwa malinga ndi malangizo omwe alipo.
ASCUS
ASCUS imayimira ma Atypical Squamous Maselo Osaneneka Ofunika . Mwa kuyankhula kwina, pali maselo a squamous omwe samawoneka abwino. Komabe, maselo amenewo si achilendo mokwanira kuti azionedwa ngati dysplasia .
ASCUS ndi zotsatira zofala kwambiri zap smear ya Pap . Kaŵirikaŵiri palibe chodandaula nacho. Ngakhale ASCUS ikhoza kuyambitsa matenda a HPV, matenda a ASCUS angakhalenso chifukwa chokwiyitsa kugonana kapena njira zoipa za Pap smear. Kufufuza kwa ASCUS nthawi zambiri kudzathetsa mosalakwitsa panthawi yopanda chithandizo kapena mankhwala.
Kutsata kwa ASCUS nthawi zambiri kumabwereza pap smear pa miyezi isanu ndi umodzi. Ngati izi ndi zachilendo, ndiye kuti palibe zotsatira zowonjezera. Panthawi imeneyi, wodwalayo akhoza kubwerera ku ndondomeko yoyenera yowonetsera.
Mwinanso, odwala omwe ali ndi ASCUS akhoza kuyesedwa kwa HPV. Ndiye, aliyense yemwe ali ndi vuto la mtundu woopsa kwambiri akhoza kutumizidwa kuti apite patsogolo, monga colposcopy kapena LEEP . Malangizo othandizira amasiyana ndi msinkhu komanso kukhala ndi mimba, koma ASCUS samafuna kuti anthu azitsatira kapena azitsatira.
SIL
SIL ndi zotsatira zina zofala za Pap smear. Chizindikirochi chikuimira squamous intraepithelial lesion. Zilonda zam'mimba zotchedwa intraepithelial ndi maselo ochuluka omwe asinthidwa m'njira yomwe imasonyeza kuti pamapeto pake akhoza kukhala ndi khansa. Izi, komabe, sizikutanthauza kuti adzakhala khansara. Ngakhale popanda chithandizo, matenda ambiri a SIL adzathetsa okha.
Zojambula zam'mimba zotchedwa scandous intraepithelial zikhoza kugawidwa mu mitundu iwiri: kalasi yapamwamba ndi kalasi yochepa. Zogwirizanitsa izi ndi CIN 1 ndi CIN 2 kapena 3 matenda, motsatira.
LSIL / CIN 1: Zilonda zapakati za squamous intraepithelial (LSIL) nthawi zambiri zimakhala chizindikiro kuti mkazi watenga kachilombo ka HIV. Izi zimatanthauzanso kuti dokotala wowerenga Pap smear kapena biopsy ali ndi zizindikiro zomwe zimawoneka ngati asanatengere kansa.
Matenda a LSIL safala. Nthawi zambiri amadzipangira okha popanda mankhwala. Amayi achichepere kwambiri amatsata mapepala a Pap smear m'miyezi isanu kapena iwiri. Kwa achikulire, amayi okalamba, malangizo a American College of Obstetrics ndi Gynecology (ACOG) amasonyeza colposcopy kuti adziwe kuchuluka kwa kuwonongeka. SABO amalimbikitsa mankhwala. Kwa amayi apamtima amathawa, kutsatila kungakhale kobwerezabwereza Pap smear, kuyesa HPV , kapena colposcopy.
Chifukwa chakuti LSIL nthawi zambiri imachiritsa palokha, madokotala ambiri amalimbikitsa njira yotsatila yotsatila m'malo mochiza. Ndipotu, malangizo a ACOG amanena kuti CIN 1 / LSIL sayenera kuchitidwa kupatula ngati yapitirira zaka ziwiri, ikupita ku CIN 2 kapena CIN 3, kapena zinthu zina zamankhwala zikukhudzidwa. Komabe, mankhwala ochiritsira, amathabe. Nthawi zina pamene anthu amva mawu akuti "maselo asanakhalepo khansa" amalingalira kuti angakhale otetezeka kusiyana ndi chisoni, ngakhale pamene chithandizochi chingakhale ndi zotsatira zoyipa.
HSIL / CIN 2-3: Maphunziro apamwamba kwambiri omwe amatha kukhala khansara ya chiberekero kuposa LSIL.
Komabe, ambiri mwa zilondazi akudzipatulira okha. Carcinoma in situ, kapena CIS, ndiyo njira yoopsa kwambiri ya HSIL ndi yomwe ingatheke kupita ku khansa. CIS ingathenso kupezedwa ngati CIN 3.
Malangizo akunena kuti mkazi aliyense amene amapezeka ndi HSIL ndi Pap smear ayenera kutsatiridwa ndi colposcopy. Panthawi ya colposcopy ndondomeko , zilonda zingayambe kugwiritsidwa ntchito, kapena zikhoza kuchitidwa ndi LEEP , conization , cryzingrapy , kapena laser therapy. Kwa zilonda zazing'ono, nthenda yamoto ingagwiritsidwe ntchito ngati mankhwala.
ASC-H
Zolemba zovuta kwambirizi zikuyimira kuti "matenda osokonezeka, sangathe kupatula HSIL." Izi zikutanthawuza kuti madokotala akuvutika kuti apeze matenda. Mukhoza kukhala ndi HSIL, simungathe. Madokotala sangakhoze kunena popanda kuyesedwa kwina. Kutsatiridwa ndi colposcopy kumalimbikitsidwa.
AGC
Maselo otchuka a AGC amasonyeza kusintha kwa chiberekero chomwe sichipezeka mu squamous epithelium . M'malomwake, maselo osadziwika amatha kuona mu chitsanzo. Zotsatira izi zimasonyeza kuti pangakhale khansara kumtunda kwa chiberekero kapena chiberekero.
Kutsata kwa AGC kungaphatikizepo colposcopy, kuyezetsa HPV, ndi zitsanzo za chiberekero cha chiberekero (endocervix) ndi chiberekero (endometrium). Kusankha zotsatila kumadalira mitundu yeniyeni ya maselo osadziwika omwe amawoneka mu smear. Kuchiza kwa AGC, ngati kuli kotheka, kuli kovuta kwambiri kusiyana ndi chithandizo cha maselo osokoneza bongo.
Khansa
Ngati mwapezeka kuti muli ndi khansara ya chiberekero , zikutanthauza kuti kuwonongeka kwa chiberekero sikungowonjezereka. Mwinamwake mudzatumizidwira kwa oncologist kuti mupitirize kutsata ndi chithandizo. Kuchuluka kwa mankhwala kudzasiyana ndi kukula kwa khansara yanu.
Zotsatira:
> Komiti ya ACOG ya Ma Practic Bulletins - Gynecology. ACOG Practice Bulletin ayi. 109: Kuwonetsetsa kwa kervical cytology. Choletsa Gynecol. 2009 Dec; 114 (6): 1409-20. lembani: 10.1097 / AOG.0b013e3181c6f8a4.
> Corbelli J, Borrero S, Bonnema R, McNamara M, Kraemer K, Rubio D, Karpov I, McNeil M. Kusiyana pakati pa madokotala oyang'anira chisamaliro chachipatala ku 2009 ACOG zowonetsera kansalu ya khansa ya chiberekero. J Womens Health (Larchmt). 2014 May; 23 (5): 397-403. lembani: 10.1089 / jwh.2013.4475.
> Munk AC, Kruse AJ, Van Diermen B, Janssen EA, Skaland I, Gudlaugsson E, Nilsen ST, Baak JP. Cervical intraepithelial neoplasia grade 3 zilonda akhoza regress. APMIS. 2007 Dec; 115 (12): 1409-14. lembani: 10.1111 / j.1600-0463.2007.00769.x.