Sklerokistoz mazira: icho chiri, zimayambitsa, zizindikiro, matenda, mankhwala, zotsatira

Pafupifupi peresenti asanu a milandu onse a matenda matenda, madokotala anandipeza "yamchiberekero sklerokistoz". Kodi ali, sindiye mkazi aliyense, choncho ambiri ndazindikira kuti akudwala matenda osabereka monga m'sentensi. Ndipotu, pafupifupi hafu ya anthu amene apeza kudwala imeneyi, ana awo alibe. Koma ena ali ndi mwayi mkulu kuchira n'kubereka mwana wathanzi.

Sklerokistoz mazira ali dzina lina - Stein-Leventhal syndrome, chifukwa anafotokozedwa koyamba American gynecologist awiri - Irving Stein ndi Maykl Levental. Izi zinachitika mu 1935. Pa makumi asanu ndi atatu kenako mwatsatanetsatane anaphunzira pathogenesis matendawa, anayamba njira ya mankhwala ndi matenda, koma mpaka pano asayansi sankadziwa zifukwa zonse pakuwonekera kwake.

Ngati kuyika matenda zokhumudwitsa ndi mukufunadi ndi ana, musataye mtima. M'nkhani ino tidzayesetsa kuuza zonse zofunika za sklerokistoz yamchiberekero ndi njira zothetsera izo.

Kodi mazira wathanzi

Kumvetsetsa momwe ikukhudzana mazira sklerokistoz ndi mimba, muyenera kudziwa m'mene kumanga matupi awa ndi momwe iwo ntchito ngati palibe matenda mwa iwo. Thumba losunga mazira ndi wamkazi Ziwalo zoberekera wophatikizidwa. Iwo akhoza akuimira mu mawonekedwe a matumba choyambirira wodzazidwa ndi nkhani ubongo. N'kuwasanganiza khoma wodzaza ndi wosanjikiza wandiweyani connective minofu pa izo ndi wosanjikiza kotekisi lapansi. Iye ali ndi dongosolo komanso zofunika. Ndi mu wosanjikiza izi anapanga follicles - mndandanda structural zinthu zimene osauka oocyte. Follicles amatchedwa chachikulu, mu kuchuluka za munthu miliyoni anaika mu thupi la aliyense wosabadwa atsikana chinthu china. Pa moyo, kuchokera nthawi kukhwima ndi nthawi mathero a kusintha, iwo pang'onopang'ono kudyedwa ndi atsopano kuti si anapanga. Choncho, ikudza nthawi, pamene katundu wawo nkutha.

Izi pafupifupi konse kumachitika mwa akazi a msinkhu wobereka, kotero chifukwa cha osabereka sangakhale kupanda follicles. Chinthu china ndi chakuti mu kusasitsa awo pang'onopang'ono nthawi zina zinthu sizikuwayendera. Choncho iwo ndiwo amachititsa chakuti mimba anakhumba zimachokeradi. Komanso, chitukuko nthenda ya follicles mu zana pa zana a milandu kumayambitsa matenda matenda, amene sanalandire chithandizo mu akazi kumaonjezera ngozi ya thrombosis, thrombophlebitis, matenda a shuga, matenda a mtima, zotupa zilonda mu zopangitsa za mammary.

Monga yamchiberekero chotupa zikuoneka ndi mmene zikutikhuzira mimba

Pamene atsikana kukhala okhwima pogonana mu thupi lawo m'gulu ndondomeko ntchito ya kusasitsa wa follicles chachikulu chimene ndigwira monga kugona. Zimenezi nthawi zonse zimachitika m'zinthu. Aliyense mkombero wa "maso 'pafupifupi 15 follicles. Iwo pansi zochita za FSH timadzi opangidwa ndi pituitary England, ali ndinayamba kakulidwe wowonjezera awiri kuchokera microns 50 500. Nthawi imeneyi, madzimadzi follicular aumbike mmenemo, ndi dziko lalikulu kwambiri iwo amaoneka patsekeke. follicle Ichi chimakhala lalikulu, kumawonjezera kwa 20 millimeters, bulges. Mkati mofulumira osauka dzira. Otsala a follicle ku gulu la "kudzutsidwa" mmodzi kufa zina ndi kupasuka. Ngati zonse zimapita malinga ndi malamulo a thupi wamkazi zili m'gulu la ntchito za dongosolo endocrine. The chifukwa amapangidwa ndi mahomoni ndi esitirojeni, progestins, ndi androgens, amene kusonkhezera pa kusasitsa winanso wa follicle lalikulu. Mothandizidwa luteinizing timadzi (lyuteotropina, lutropin, chidule monga LH), ndi wosweka, amachoka ku dzira mu mazira chubu, ndipo iye nkuzinyoza mu corpus luteum ndi pang'onopang'ono resorbed.

Ngati yopuma zimachokeradi, dzira si anamasulidwa ndi wobadwanso, ndi malo a follicle pamaoneka chitumbuwa-kakulidwe yamchiberekero chotupa. Anthu a "kudzutsidwa" follicles kuti sitinakhale nayo nthawi yoti afe, ndipo kuwasandutsa cysts, kokha ang'onoang'ono. Chotupa, anapanga kuchokera follicle, nthawi zina limakula ndi lalikulu kwambiri (40-60 mm), koma simungathe okha chionetsero. Only mu Nthawi zina odwala amadandaula kuwawa mu thumba losunga mazira ndi. Kamodzi mkazi ali ndi kupanga yachibadwa mahomoni, pang'onopang'ono amasungunula. Ngati mkazi wabwezeretsa ovulation, kupezeka pa nthawi ya yamchiberekero follicular chotupa mimba sikusokoneza, koma ngati chotupa nkulu kukula 90 millimeters, ziyenera opaleshoni yochotsa.

Zimayambitsa matenda

Asayansi kudziwa tsatanetsatane wa mmene chithunzi sklerokistoz mazira. Chifukwa zodabwitsazi si kukhazikika bwino, pali mfundo zokha. Monga mu chitukuko wabwinobwino wa follicle ndi linagwira linanena bungwe therefrom mahomoni kumathandiza yovuta, chinthu chachikulu chomwe sklerokistoz ankaona matenda m'thupi yamchiberekero, makamaka kulephera limagwirira timafunika kaphatikizidwe. Otchulidwa zimayambitsa zotsatirazi vutoli m'thupi:

• chibadwa;
• kuvutika mu dongosolo jini;
• chisokonezo mu dongosolo pituitary-yamchiberekero;
• zoopsa;
• zosokonezeka pambuyo mimba;
• opatsirana ndi matenda matenda;
• mavuto pambuyo pobereka;
• kusintha ntchito za kotekisi adrenal.

zizindikiro matenda

Mwatsoka, chiyambi chabe nthawi kukhwima kupeza mtsikana sklerokistoz mazira. Zizindikiro pa gawo ili afewetsedwa ndi makamaka MUKACHULUKIDWE kuzungulira kusamba. Koma zodabwitsazi angakhale zifukwa zina zambiri osati zokhudzana ndi matenda a mazira, pansi kudya ndi mitsempha matenda osauka. Pakuti makumi awiri, kuti munthu pazipita zaka twente-faifi atsikana kuoneka zizindikiro zenizeni kwambiri kwa sklerokistoz yamchiberekero. Waukulu akadali ndi kuphwanya kupalasa njinga ndi chikhalidwe cha kusamba (peresenti 96 odwala). Ambiri akukumana kuchedwa yaitali mwezi (pafupifupi theka kapena zambiri) kapena zochepa kwambiri precipitates (hypomenstrual syndrome). Zambiri zokayikitsa akudandaula za kutalika kwa wodwalayo komanso kuzikhala pamwezi.

Zizindikiro zina likunena za sklerokistoz yamchiberekero zotsatirazi:

• hirsutism (pafupifupi 90 peresenti ya odwala anati hairiness malo ozungulira nipple, kumbuyo, pamimba, ndi chibwano pamwamba mlomo wa);
• onenepa (70 peresenti ya odwala);
• mpala ndi ziphuphu zakumaso pa nkhope (amapezeka zosaposa 40 peresenti milandu);
• kusintha kufanana thupi;
• wonongeka ya ubongo;
• asthenic syndrome;
• yamchiberekero kukulitsa (wapezeka pa gynecologist anayendera).

Komanso amayi ena akhoza kuona zizindikiro zomwe zimachitikira matenda ambiri: ululu mu m'munsi pamimba, malaise, zosamvetsetseka kutopa.

kafukufuku zasayansi

Pamaziko a zizindikiro kunja sklerokistoz yamchiberekero chabe amaganiziridwa, ndi matenda yomaliza anapangidwa pambuyo mayeso zina. Awa:

• kusanthula pa testosterone magazi (okwana ayenera kukhala mu osiyanasiyana 1.3 ng / mL, akazi ufulu chaka 41 - mkati 3,18 ng / ml, ndi zaka 59 - zosaposa 2.6 ng / ml);
• Kupenda chiwopsezo cha shuga mu shuga magazi, ndipo triglycerides;
• kolpotsitogramma (zakuthupi anatengedwa kuchokera kumaliseche amasonyeza zofufuza deta, palibe kapena ovulation, komanso zofanana akalozera kolpotsitogrammy m'badwo wa wodwalayo ndi gawo la mkombero kusamba kwake);
• kuchipala kwa endometrium (apereka umboni wa kuyan'anila za mazira a);
• kulamulira kusintha woyambira kutentha;
• Ena kusanthula pa mahomoni chithokomiro, pituitary, mazira (LH, FSH, PSSG, prolactin, tochepa, 17 hydroxyprogesterone);
• mtima wa esitirojeni excretion.

Tsopano wodwala paokha achite mayeso ophweka kuganiza pa cysts yamchiberekero. Izi zimafuna maikulosikopu (likupezeka pa pharmacies). M'mawa, monga anadzuka ndipo palibenso wakhala kudya ndi kumwa, muyenera kuika dontho la malovu pa chidutswa cha zasayansi galasi ndi kuupereka kwa ziume. Pa ovulation nthawi kumawonjezera mlingo timafunika, womwe kumasintha zikuchokera malovu. Ngati ovulation ndiwo, malovu chitsanzo maso idzakhala mu mawonekedwe a masamba fern, ndipo ngati palibe ovulation, - mu mawonekedwe a mfundo.

diagnostics hardware

Monga ulamuliro, cholondola ndi okhazikika matenda a odwala kutumikiridwa zovuta kuyendera kudzera zipangizo zachipatala.

The njira kwambiri wofatsa ndipo sabweretsa chisoni mwamtheradi ndi ultrasound matenda a sklerokistoz yamchiberekero. zimatenga transabdominal (kudzera pamimba), transvaginal (njira kwambiri nkhani), transrectal ultrasound (anachita okha pa atsikana kwambiri ndi akazi okalamba).

Kugwiritsa ultrasound kudziwa yamchiberekero kukula, mawonekedwe, kapangidwe, chiwerengero cha follicles mu yawo awiri - 8 mm, kukhalapo kapena kusapezeka kwa follicle lalikulu, kukhalapo kapena kusapezeka kwa ovulation, pamaso pa cysts mu n'kuwasanganiza lapansi.

mtundu wina wa kafukufuku - mpweya pelveogramma kusonyeza nthenda kukula kwa thumba losunga mazira ndi chiberekero.

Za mtundu wina ovuta kwambiri matenda ndi laparoscopy. Iwo anachita mu chipatala pogonekedwa ndi mankhwala ambiri. The aligorivimu zotsatirazi: wodwala dokotala akupanga puncture a linga peritoneum ndipo amalowa zida, ndi kuwomba mpweya woipa mpweya kuti alenge buku mu peritoneum ndi bwino kufufuza ziwalo. Komanso, thupi mtima umayamba laparoscope, lomwe limasonyeza pa zenera boma la thumba losunga mazira ndi. Laparoscopy - njira yolondola kwambiri matenda, koma pambuyo mkazi amafunika nthawi konzanso.

chithandizo ndiwofatsa wa sklerokistoz yamchiberekero

Patapita matenda okhazikika nthawi zambiri mkazi Amasankhidwa mankhwala mankhwala oyamba. cholinga chake - kubwezeretsa yachibadwa msambo ndi ovulation kuyambiranso. The sklerokistoz kuchitira yamchiberekero gynecologist wasankha pamodzi ndi m'thupi yemwenso ndi.

Mu kukhalapo kwa kunenepa, wodwalayo sitepe yoyamba mankhwala ndi kulemera imfa. Mkazi Kwalamulidwa zakudya, chitani zotheka.

Gawo lachiwiri - kuwonjezera maganizo a insulin. Yoikika "Metformin" kuti muyenera miyezi 3-6.

Gawo lachitatu - kukondoweza kwa ovulation. Yambani chithandizo ndi mankhwala losavuta - "clomiphene". Njira koyamba kulandira usiku mlingo wa 50 mg, kuyambira tsiku 5 cha mkombero kwa masiku 5 zotsatizana. Ngati palibe chifukwa (kusamba), "Clomiphene" kutenga mwezi umodzi. Ngati ndi pamene zotsatira izi simudalandira, mlingo anali ziwonjezeke kwa 150 mg pa tsiku.

Siteji yotsatira (pakalibe mphamvu zabwino) - Kusankha mankhwala "menogon". Iwo kutumikiridwa intramuscularly, ndipo akamaliza njira jakisoni "Horagona". "Menogon" akhoza m'malo "Menodinom" kapena "Menopur".

Atamaliza njira yonse, kuchita umagwirira magazi, ndipo uzipereke "Utrozhestan" kapena "Djufaston" zochokera kusanthula zotsatira (ngati sikokwanira wa timadzi LH).

Mu yomweyi, madokotala kuti muchotse mkazi ali hirsutism, mogwirizana ndi chimene Kwalamulidwa, "Ovosiston" ndi "Metronidazole".

Kuvomerezedwa Kuwonjezera Inde ndi vitamini.

Sklerokistoz mazira: mankhwalawa njira opaleshoni

miyezi Ngati mwa atatu pambuyo mankhwala si ovulation zikachitika, mkazi Kwalamulidwa opaleshoni. Iwo ikuchitika ndi njira zingapo. Ndi mmodzi uti ntchito zimadalira chosonyeza udindo yamchiberekero.

Pa gawo lino, ntchito zotsatirazi:

• moxibustion cysts ntchito laser;
• demedulyatsiya (n'kuwasanganiza kuchotsa mbali yapakati);
• mphero resection (kuchotsa mbali n'kuwasanganiza a mbali akhudzidwa mu mawonekedwe a mphero);
• decortication (dokotala amachotsa kusandulika tunica wosanjikiza yamchiberekero follicles ndi singano napyoza m'mbali sutured);
• galvanocautery (mfundo chiwonongeko cha n'kuwasanganiza m'munda wake, umene umabala timadzi kwambiri).
• notches (dokotala awo amapanga akuya 1 masentimita m'madera kudzawala follicles n'cholinga choti amasule pa kusasitsa wa dzira yokha).

Zoneneratu

Akazi amene amagwirizana pa njira iliyonse akufuna kuti madokotala, chidwi funso limodzi: zimatheka kutenga mimba pamene thumba losunga mazira sklerokistoz? Kafukufuku amasonyeza kuti popanda mankhwala, osabereka amawapeza 90% ya milandu. Mankhwala mankhwala "clomiphene" bwino ntchito yamchiberekero 90% odwala, koma mimba kumachitika pamene% 28 okha a iwo. Komabe, malinga ndi zina zabwino akhoza kukhala mkulu 80%.

Kupanda "Clomiphene" mankhwala - yekha ogwira pa chiyambi cha matenda kapena pambuyo pa opaleshoni monga adjuvant ndi.

Chithandizo cha mankhwala amphamvu kwambiri, monga "gonadotropins", malingana ndi kuwerengera, osachepera kumabweretsa ovulation 28% odwala, pazipita - 97%. Choncho pakati pa 7 ndi 65% ya Amayi.

Ngati yamchiberekero sklerokistoz ankachitira opaleshoni, zotsatira zabwino anaona ndi za kuchuluka mofanana ndi mankhwala ndiwofatsa. Malinga ndi kafukufuku, pambuyo opaleshoni thumba losunga mazira ndi mwayi kutenga mimba kupeza 70-80% ya akazi.

Reviews

Kwa amayi ambiri, azikwera tsokali staging matenda "yamchiberekero sklerokistoz". Reviews odwala mankhwala ndi osiyana kwambiri. Wina anathandiza mapiritsi munthu - opareshoni, ndipo munthu mimba sichinachitikepo, ziribe kanthu zomwe njira atengedwa.

Palinso gawo laling'ono la odwala malipoti isanayambike mimba zawo popanda chithandizo chilichonse, ngakhale matenda a "sklerokistoz n'kuwasanganiza" sanali anajambula. Zotsatira zotsutsana mwina chifukwa cha makhalidwe munthu wa munthu aliyense ndi sayenera kumwedwa monga mwakale.

Koma kusintha thanzi mankhwala, iwo kulemba ndemanga, akazi ambiri. Only ndi odwala ochepa onena kuti iwo dekhetsa mwezi patsogolo kwa nthawi yochepa, kenako iwo kachiwiri chofunika kutenga mahomoni.

Ndipo potsiriza, pali gawo la ndemanga imene akazi amadwala maonekedwe kupweteka yaitali m'dera la thumba losunga mazira ndi peritoneum mankhwala ndi opaleshoni.