Ngati mwamvapo za munthu yemwe ali ndi khansara ya chiberekero, ngati muli ndi zizindikiro zapakhosi, kapena ngati muli ndi mapepala osakanizika a Pap, mumakhala mukuganiza kuti khansa ya pachibelekero imapezeka bwanji. Tiyeni tiwone zomwe zizindikiro zikhoza kunena kuti khansa ilipo, njira zowunikira, ndi mayesero ena monga colposcopy ndi biopsy njira zomwe zimagwiritsidwa ntchito pa matendawa.
Khansara ya chiberekero imapezeka nthawi zambiri zizindikiro zilibe; Mwa kuyankhula kwina, munthu nthawi zambiri amadziwika bwino. Pamene akutsatila ndondomeko ya khansa ya khola la chiberekero, nthawi zambiri izi zimakhala choncho, ngakhale pali nthawi yomwe chizindikiro choyamba kuti chinachake cholakwika chingakhale zizindikiro.
Zizindikiro
Kusiyana ndi mitundu ina ya khansa, zizindikiro za khansa ya khola lachiberekero sizimawonekera mpaka khansara yakula kupita patsogolo. Chifukwa chakuti amayi ambiri sawona zizindikiro zomwe zimawawombera kuchipatala, Pap smear yowonongeka ndi yofunika kwambiri kuti ayambe kufufuza. Pamene zizindikiro zilipo zingakhale monga:
- Kutuluka kwa magazi kosazolowereka - Izi zimatha kukhala magazi omwe ndi olemera kapena opepuka kusiyana ndi ozolowereka, amapezeka pakati pa nthawi kapena kugonana, kapena amapezeka atatha kusamba
- Nthawi zambiri
- Kupweteka kwa majeremusi, makamaka pa kugonana
- Vaginal kumwa
Pap Smear
Pap smear imathandiza kwambiri kuti apeze khansa ya pachibelekero.
Ndi momwe amai ambiri amadziwira kuti amavutika ndi matenda a chiberekero kapena khansara ya chiberekero. Pap smear ndi mayeso osavuta omwe angawonetsere vuto lachiberekero asanabadwe ndi khansa.
Azimayi onse ayenera kukhala ndi mapepala a Pap nthawi zambiri pokhapokha ngati dokotala wawo wawachenjeza kuti sakusowa. Izi zingaphatikizepo amayi apamtima omwe amatha kumenyana ndi amayi omwe ali ndi vutoli.
Onetsetsani kuti musapewe zolakwa zapap zovuta kuti muthe mayesero anu ali olondola.
Kuyezetsa HPV
Kuyeza kwa HPV ndi mayeso ena ofunikira omwe angapangidwe panthawi imodzimodzimodzi ndi Pap smear kapena zotsatira zowonongeka. Ndikofunika kuzindikira kuti ngati muli ndi zaka zoposa 30, mukhoza kupempha kuti muyambe kuyesedwa ndi HPV.
Tengani nthawi yophunzira za papillomavirus yaumunthu (HPV). Ngakhale kuti pali matenda oposa 100, sikuti zonsezi zimachititsa khansa. Pafupifupi 70 peresenti ya khansa ya chiberekero imayambitsidwa ndi HPV 16 ndi HPV 18, ndipo 20 peresenti ya khansa ya pachibelekero ikugwirizana ndi matenda a HPV 31, 33, 34, 45, 52, ndi 58.
Pap Smears yosavomerezeka
Pali zovuta zambiri zomwe zingapezeke pa Pap smear, osati zonse zomwe zikutanthauza kuti muli pachiopsezo cha khansa ya pachibelekero. Ngati muli ndi mapepala osakanizika a Pap ndi zofunikira kwambiri kuti muzitsatira malangizo ochokera kwa dokotala wanu, kaya izo zikhale colposcopy, mtundu wina wa chiberekero cha chiberekero, kapena kuti pap smear yomwe imabwereza chaka chimodzi. Tengani kamphindi kuti muphunzire za mitundu yosiyanasiyana ya zotsatira zosavomerezeka za Pap smear ndi mawu akuti mankhwala omwe amagwiritsidwa ntchito pofotokoza izi.
Kupanga Colposcopy
Ngati mapulogalamu anu a Pap amasonyeza kuti vuto lachiberekero limakhala losawonongeka, ndiye kuti colposcopy ingakonzedwenso .
Chipangizo cha colposcopy chiri mu ofesi ya ofesi yomwe imalola dokotala kuona kachilombo koyambirira kwambiri ndi colposcope. Colposcope ndi chida chowunikira chomwe chimakweza chibelekero (ngati kukhala ndi Pap smear pansi pa microscope). Iyo imakhala kunja kunja kwa mkazi, panthawi ya kuyeza. Zithunzi zooneka kuchokera ku colposcope zingawonetsedwe pa kompyuta kapena pulogalamu ya pa TV. Simukuyenera kuyang'anitsitsa, koma zingakuthandizeni kumvetsa bwino mayeso.
Chiberekero cha Chiberekero ndi Chithandizo cha Endocervical
Pa colposcopy, dokotala akhoza kuchita chiopsezo cha chiberekero malinga ndi zomwe zimapezeka panthawi yoyezetsa magazi. Chidziwitso cha chiberekero chimaphatikizapo kuchotsa kachigawo kakang'ono ka mitsempha ya chiberekero kuti ifufuzidwe ndi microscope.
Kaŵirikaŵiri izi ndi chiwombankhanga, momwe dokotala amachotsera kachidutswa kakang'ono ka minofu ndi chipangizo chofanana ndi phokoso la pepala. Zimatenga mphindi zokha kuti dokotala apange zitsanzo zazing'ono ndipo zimangokhala zosavuta kwa kanthaŵi kochepa. Malingana ndi zomwe zapezeka pa colposcopy, m'madera ochepa a chiberekero akhoza kukhala opangidwa.
Pogwiritsa ntchito chiberekero cha khomo lachiberekero, mankhwala opatsirana pogonana (ECC) angapangidwenso. Pakati pa ECC, dokotala amagwiritsira ntchito burashi yaying'ono kuti achotse minofu kuchokera kumtsinje wamakono, malo ochepa pakati pa chiberekero ndi chiberekero. ECC ikhoza kukhala yopweteka kwambiri (monga zipsinjo zoyipa za kusamba), koma ululu umatha pamene ECC yatha.
Zotsatira za biopsy ndi ECC nthawi zambiri zimatenga masabata osachepera awiri kubwerera. Dokotala wanu akhoza kukukonzerani ulendo wina kuti mutenge zotsatirazo ndi inu kapena angakuitaneni kudzera foni kuti akudziwitse zotsatira.
Kusokoneza Kwake ndi LEEP
Pali nthawi yomwe chiwerengero chachikulu cha biopsy chiyenera kuchitidwa kuti apeze khansa ya chiberekero kapena kuchotsa minofu kuti isakhale khansara. Pazochitikazi, phokoso la cone likhoza kuchitidwa. Pakati pa phokoso la cones, minofu yofanana ndi khunyu imachotsedwa pansi pa anesthesia. Kachilombo ka kondomu kamagwiritsidwanso ntchito kuchotsa mitsempha yambiri yomwe imachokera pachibelekero.
Njira ina yothandizira kugwiritsira ntchito mankhwala osokoneza bongo, njira yothandizira opaleshoni yopangira opaleshoni (LEEP) ndi njira yomwe amachitira poyerekeza ndi anesthesia kuti athetse minofu pachibelekero. A LEEP amagwiritsa ntchito waya wothandizira magetsi pofuna kuchotsa zitsanzo. Njira imeneyi imagwiritsidwa ntchito kwambiri pofuna kuthana ndi apamwamba a kervical dysplasia , m'malo mozindikira khansara ya chiberekero.
Zotsatira za Chinthu Chake Chokhazikika kapena njira ya LEEP
Zotsatira za chiwerewere zikabwezeretsa, khansara ya chiberekero ikhoza kuwonetsedwa kunja. Ngati kansa ya chiberekero ikupangidwira, chotsatira ndicho kudziwa siteji ya khansa ya pachibelekero. Pali magawo asanu a khansara ya chiberekero ndipo aliyense amaimira momwe khansara yakula.
Pomwe siteji ya khansa ya chiberekero yatsimikizika, ndondomeko ya chithandizo ikhoza kukonzedwa. Kuchiza kungaphatikizepo opaleshoni yowonjezereka, mankhwala a chemotherapy , mankhwala a radiation , kapena mankhwala atsopano omwe alipo m'mayesero a zachipatala .
Zotsatira:
Kudela, E., Holubekova, V., Farkasova, A., ndi J. Danko. Kutsimikiza kwa Malignant Kukhoza Kachilombo ka Intraepithelial Neoplasia. Matenda Achilengedwe . 2016. 37 (2): 1521-5.
TSikouras, P., Zervoudis, S., Manav, B. et al. Khansara ya Chiberekero: Kuyeza, Kuzindikira ndi Kujambula. J BUON . 2016. 21 (2): 320-5.
Zorzi, M., Del Mistro, A., Farruggio, A. et al. Kugwiritsa Ntchito Pulogalamu Yopambana ya Kuopsa kwa Mankhwala a Papillomavirus DNA monga Phunziro Loyamba mu Pulogalamu ya Kuyezetsa Khansa ya Kachiberekero: Phunziro la Ogwirizanitsa Anthu. BJOG . 2013. 120 (10): 1260-7.