Mwinamwake mwamuwona dokotala wanu chifukwa cha magazi osadziwika monga
- Olemera kuposa momwe amadziwira kumaliseche
- Kutaya magazi pakati pa nthawi yanu
- Kutuluka kwa magazi kumbuyo
Ngati muli nawo, n'zotheka kuti mwapatsidwa matenda a endometrial hyperplasia.
Mwachidule
Endometrial hyperplasia ndi chinthu chosazindikiritsa cha chiberekero cha chiberekero chanu kapena endometrium .
Endometrium yanu ndi yomwe imamangirira mwezi uliwonse poyang'ana kusintha kwanu kosasintha.
Ndicho chigawo chachikulu cha kutha kwa mwezi kwa mwezi. Ndi zachilendo kuti chiberekero cha chiberekero chanu chikhale chowopsa kapena chochulukirapo pa theka loyamba la kusamba.
Koma, ngati pali kusayenerera kwa mphamvu ya hormonal ya endometrium chinthu chosadziwika chitha kuchitika. Kusintha kwakukulu kumeneku ndikutambasula kwa endometrium ndipo kumatchedwa endometrial hyperplasia.
Mazira anu ambiri amabala estrogen ndi progesterone potengera mahomoni opangitsa ubongo. Kusintha kwadongosolo komanso koyenera nthawi zonse komanso estrogen ndi progesterone ndizo zomwe zimapangitsa kuti nthawi yanu ibwere nthawi zonse, pafupifupi masiku 28.
Udindo wa kutayika kwa homoni
Kusiyanitsa kwa mahomoni komwe kumayambitsa endometrial hyperplasia ndi kuchuluka kwa estrogen kwa progesterone
Estrogen ndiyo hormone yomwe imayambitsa kuphulika kwa endometrium pa theka loyamba la kusamba.
Poyerekeza ndi kuchuluka kwa progesterone, endometrium yanu imamangirira koma kenako imatulutsa kukula kosayembekezereka. Koma pamene pali chiwerengero chokwanira cha estrogen chipinda chimatha ndipo chimapitirizabe kuchepa. Pakapita nthawi, chida chocheperako chimayamba kukula.
Zowopsa
Zomwe zimachititsa kuti estrogen yoposa zomwe zingayambitse endometrial hyperplasia zikuphatikizapo:
Kunenepa kwambiri
Minofu yamafuta imatembenuza mahomoni ena ku estrogen. Izi zimapangitsa mavitrojeni ena omwe amachititsa kuti chiberekerocho chikhale chophatikizapo mavitamini omwe amapezeka ndi mazira ochuluka. Ngati BMI yanu ili ndi zaka zoposa 35 muli ndi chiopsezo chowonjezereka chokhala ndi endometrial hyperplasia poyerekeza ndi inu pa kulemera kwa thupi.
Kudzodza
Pakhoza kukhala zifukwa zingapo zomwe simungapangitse. Ngati simugwiritsa ntchito ovary yanu simudzawonjezera progesterone. Kuwonjezeka kwa progesterone ndikofunikira kuti chiberekero cha chiberekero chanu chithe. Mwa kulankhula kwina, simungapeze nthawi yanu. Mu mitundu ina yowonjezera, kuperewera kwa puloteniku kumapangitsa kuti wachibale woposa maselo a estrogen apitirire. Izi sizilombo zopanda thanzi zimayambitsa matenda aakulu a endometrium. Potsirizira pake, mudzakhala ndi mtundu wina wa magazi omwe simudziwa. Mchitidwe wamagazi woterewu ndi kudzoza kotereku kumaphatikizapo nthawi zosawerengeka komanso zolemetsa kapena zamagazi pakati pa nthawi. Zomwe zimayambitsa vutoli ndizo:
Zozizwitsa za Hormone
Mwachidziwikire kutenga malo a estrojeni kudzawonjezera ma level estrojeni okhudzana ndi ma progesterone anu.
Ndicho chifukwa chake ngati muli ndi chiberekero muyenera kutenga mawonekedwe a progesin (progesterone) kuti muteteze kuti endometrium isadetsedwe.
Mankhwala ena omwe amachititsa kuti thupi la endometrium likhale losazolowereka ndi Tamoxifen . Tamoxifen ndi mankhwala omwe amatchedwa estrogen receptor modulator kapena SERM. Masamu ndi mankhwala omwe amakhudza mbali zotetezeka za estrogen za thupi lanu m'njira zosiyanasiyana. Kawirikawiri Tamoxifen imagwiritsidwa ntchito pochiza khansa yoyamwitsa ya mahomoni chifukwa imatsutsa zotsatira za estrogen m'matumbo. Komabe, Tamoxifen imalimbikitsa maselo a estrogen mu chiberekero cha chiberekero kotero zimakhala ngati estrogen ndipo zimayambitsa endometrial hyperplasia.
Ngati mukugwiritsa ntchito mankhwala otchedwa hormone substitution therapy kapena Tamoxifen ndipo mumakhala ndi magazi osadziwika omwe ndi ofunikira kwambiri kuti muwone dokotala wanu ndikuyesedwa.
Estrogen imatulutsa zilonda zam'mimba
Mahomoni otulutsa mitsempha sizodziwika kwambiri chifukwa cha endometrial hyperplasia. Komabe, pali zina zambiri zotupa zowonongeka zomwe zimapangitsa otero kwambiri.
Kudziwa
Mukawona dokotala wanu ndi zodandaula za magazi osadziwika bwino, mumakhala ndi chidziwitso cha chiberekero cha chiberekero chanu. Dokotala wanu angakulangize ofesi yotchedwa endometrial biopsy kapena njira yochizira yaing'ono yotchedwa hysteroscopy ndi chithandizo kapena sampuli za endometrium.
Endometrial biopsy
Imeneyi ndi njira yodziwika bwino ya maofesi. Kawirikawiri, ndi bwino kulekerera.
Muzochita zanga, ndikuwona kuti kuyembekezera ndi kuda nkhawa kuti zikhale zovuta kwambiri kuposa zochitika zenizeni. Ngati mukufuna kukhala ndi biometsy endometrial, ndibwino kutenga 600 mg ya ibuprofen ndikukhala ndi chotupitsa pang'ono pafupi ndi ola lisanafike. Mungafune kubweretsa phukusi laching'ono kapena patch kuti muthandizenso kuchepetsa kupundula panthawi ndi pambuyo pake. Dokotala wanu akhoza kukupatsani inu nthawi imodzi ya biopsy.
Zokonzedwa kuti zikhale zofanana ndi zofanana ndi mapepala a pap. Pambuyo pa speculum adayikidwa dokotala wanu amachotsa kachilombo ka HIV ndi kachilombo ka HIV. Mwinanso dokotala wanu adzaika kachilombo koyambitsa matenda anu pachiberekero pamene chipangizo chochepa cha aspirator chimaikidwa. Mwinamwake mukukumana ndi mavuto. Simungamve kanthu kalikonse koma mutakhala ndi zina. Kupwetekako kumatha kuchoka ku zochepa zochepa zomwe zimapweteka kwambiri ngati zowawa zoyambirira za ululu. Uthenga wabwino ndizochitika mwamsanga ndipo kawirikawiri zimakhala zosachepera mphindi imodzi. Kutenga ibuprofen musanayambe ndondomekoyi ndi kugwiritsa ntchito paketi yotentha panthawiyi, kumathandiza kuchepetsa ululu.
Hysteroscopy
Dokotala wanu angakuuzeni kuti mukhale ndi sampulini yochulukirapo komanso endometrial m'malo mwa biometric endometrial. Ili ndilo tsiku lomwelo opaleshoni komanso njira zina zowonetsera akazi, zimagwiritsidwanso ntchito muofesi mmalo mwa chipinda chochitira opaleshoni. Phindu la hysteroscopy ndiloti limalola dokotala wanu kuti ayang'ane mosamalitsa chiberekero cha chiberekero kutsimikizira kuti madera onse a endometrium ali osankhidwa mokwanira. Pakhoza kukhala zochitika zina zomwe dokotala wanu angakuwonetseni njirayi yowonjezera.
Endometrial hyperplasia sangathe kupezedwa ndi mayeso a magazi kapena ultrasound. Komabe, n'zotheka kuti dokotala wanu angalimbikitse mayeso ena a magazi kuti athetse zifukwa zina za magazi osadziwika bwino. N'kuthekanso kuti dokotala wanu akhoza kulamula kuti pulojekiti yotchedwa ultraviculus ikhale yopanda mphamvu kuti imvetsetse chifukwa chake mumayambitsa magazi oopsa.
Endometrial hyperplasia ikhoza kupezeka kokha pambuyo pa endometrium yanu itayesedwa ndi kuyesedwa pansi pa microscope ndi katswiri wa matenda.
Mitundu
Pamene wodwalayo akuyang'ana zitsanzo za endometrium pansi pa microscope amayang'ana mwachindunji kusintha kwa magawo awiri a endometrium yanu, glands ndi minofu yothandizira yotchedwa stroma. Endometrial hyperplasia imapezeka pamene pali zilonda zochuluka zokhudzana ndi stroma kuposa momwe mungazipeze muyezo wochulukitsa kapena wamakilomita endometrium. Katswiriyu amatha kufotokozera ngati pali maselo owonetsetsa aumphawi m'maganizo otere a endometrium omwe amalembedwa mosavuta kwambiri omwe amatsogolera ku magawo awiri a endometrial hyperplasia:
- Hyperplasia popanda atypia
- Atypical hyperplasia
Ndikofunika kukumbukira kuti endometrial hyperplasia si khansa ya m'magazi koma imaonedwa ngati yangwiro. Ndipotu, nthawi zina matenda oopsa a hyperplasia, atha kukhala ndi matenda a kansa ya m'magazi.
Kuchiza
Ndikofunika kuti zonse zotchedwa endometrial hyperplasia zizitsatiridwa mosamala.
Endometrial hyperplasia popanda atypia
Ngati palibe maselo aumulungu omwe alipo, mwayi wa endometrial hyperplasia potsiriza kukhala khansa ya m'magazi sizingatheke. Umboni umasonyeza kuti azimayi okha 5% omwe ali ndi endometrial hyperplasia popanda atypia adzakhala ndi khansa ya endometrial. N'kuthekanso kuti mtundu uwu wa endometrial hyperplasia udzathetsa nokha pa nthawi.
Mzere woyamba wa mankhwala ndi kufufuza zoopsa zomwe zingasinthidwe.
Mwachitsanzo, ngati muli olemera kwambiri kapena olemera kwambiri, kuchepa thupi kumathandiza kuchepetsa mavitrojeni owonjezereka opangidwa ndi maselo olemera. Izi zidzalola kuti chiberekero cha chiberekero chanu chikhazikike. Mofananamo, ngati mukugwiritsa ntchito mankhwala opatsirana am'madzi, adokotala angafunikire kusintha mlingo wanu kapena akulimbikitseni kuti musiye kugwiritsa ntchito.
Dokotala wanu angalimbikitse kugwiritsa ntchito mankhwala a progesin kuti asamangodzipweteka kwambiri ndi estrogen yochuluka pa endometrium yanu. Zifukwa zomwe dokotala angakupangire kuti akupatseni progesterone ndi awa:
- Kuwonetsetsa ndi kusintha kwa moyo sikukugwira ntchito
- Mukukhala ndi magazi osadziwika
- Mukufuna zotsatira zofulumira kwambiri
Mitundu iwiri ya progesterone yomwe imapereka chithandizo cha mankhwala a endometrial hyperplasia popanda atypia ndi progesterone wamlomo kapena zokhudzana ndi progesterone. Umboni umathandiza kugwiritsa ntchito levonorgestrel IUD ( Mirena ). Ngati muli olemera kwambiri ndi BMI> 35 ndizotheka kuti chithandizo cha progesterone sichingagwire ntchito pokhapokha ngati mutataya thupi. Muyenera kukambirana ndi adokotala mtundu wina wa mankhwala a progesterone omwe ndi abwino kwa inu.
Kaya mwasankha kuwona kapena kuchiza ndi progesterone muyenera kutsatiridwa mosamalitsa ndi zitsanzo zamakono za endometrial kuti mutsimikizire kuti endometrial hyperplasia yapita ndipo siibweranso.
Akatswiri akuti hysterectomy sayenera kuperekedwa monga njira yoyamba yopatsira mankhwala a endometrial hyperplasia popanda atypia chifukwa cha mphamvu ya mankhwala a progesterone komanso chiopsezo chachikulu chokhala ndi kansa ya m'magazi. Komabe, akatswiri amavomereza kuti pali zochitika zina zomwe hysterectomy ikhoza kukhala njira yabwino kwambiri ya chithandizo kwa akazi omwe ali ndi ana. Dokotala wanu angakulangize hysterectomy ngati:
- Pambuyo pake, mumakhala ndi hyperplasia yamakono
- Hyperplasia sichikuyenda pambuyo pa miyezi 12 ya mankhwala a progesterone
- Mukukhala ndi magazi ambiri osadziwika
- Mumayambitsa endometrial hyperplasia kachiwiri mutachiritsidwa bwino
- Simukufuna kubwereza zomwe zimaphatikizidwa ndi mankhwala a progesterone.
Endometrial hyperplasia ndi atypia
Pali chiopsezo chachikulu kwambiri chokhala ndi kansa ya m'magazi ngati muli ndi hyperplasia ndi atypia Utsogoleriwo ndi woopsa kwambiri chifukwa cha chiopsezo chowonjezeka. Ndipotu, akatswiri amalimbikitsa hysterectomy ngati mankhwala oyamba a atypical hyperplasia mwa amayi amene ali ndi ana.
Ngati mwapezeka kuti muli ndi hyperplasia ya atypical ndipo mukukonzekera kuyesa kutenga mimba mumatha kuchiritsidwa ndi progesterone, makamaka ndi levonorgestrel IUD.
Mudzakhala ndi sampuli zamakono kuti mutsimikizire kuti hyperplasia yamachilendo imachiritsidwa mokwanira. Dokotala wanu angakuwonetseni kuti muwone katswiri wa chonde ndi kumaliza kubereka kwanu mwamsanga momwe mungathere. N'kutheka kuti dokotala wanu anganene kuti ali ndi hysterectomy musanafike pokhala ndi ana chifukwa cha kuchuluka kwa chiwonongeko chotchedwa endometrial hyperplasia.
Chifukwa chakuti magazi osadziwika bwino ndi chizindikiro chofala kwambiri kuti mutha kukhala ndi endometrial hyperplasia, ndikofunika kuti dokotala wanu akambirane kusintha kumeneku mwazi. Dokotala wanu amatha kusankha ngati kuyesedwa ndi kuyesedwa kofunikira n'kofunika.
Zotsatira:
Gallos, ID., Et al, 2016.BGSE / RCOG Lotsogolere Yonse: Kulamulira kwa Endometrial Hyperplasia. [Online] London: BGSE / RCOG. Ipezeka pa https://www.rcog.org.uk/en/guidelines-research-services/guidelines/gtg67/