I-Myoma iyi-neoplasm enobungozi ehlala ngaphakathi kwesibeletho. Lesi sifo asinikezi izimpawu isikhathi eside, ngakho sitholakala esiteji sekwephuzile, lapho i-myoma ngokwayo inomthamo omkhulu. Ukuze uthole ukwelashwa, inani elingaphansi kwe-myoma ye-uterine elibalulekile kubalulekile, ubukhulu - ngokusebenza lezi ziyimingcele ebalulekile.
Ukuxilongwa kwe-uterine fibroids
I-Myoma i-neoplasm eyakhiwe kusuka kumaseli ayisisindo e-smooth. Ubukhulu bayo bungaba ngamamitha ambalwa kuya ku-30 cm noma ngaphezulu. Kodwa-ke, kakade i-myoma encane ingatholakala nge-ultrasound. Ukuxilongwa kwe-ultrasound ye-uterine fibroids yisisekelo sabo bonke izinyathelo zokuxilonga. Ukusebenzisa lobu buchwepheshe kungenzeka ukusetha ubukhulu besakhiwo, inamba yabo, kodwa futhi nokwaziswa okuqondile kwezakhiwo ze-pathological.
Okubalulekile ekuxilongweni kwe-fibroids kuhlolwa kwe-bimanual. Ngosizo lwaso, i-myoma enkulu ye-uterine ingatholakala, usayizi wokusebenza unqunywa nge-ultrasound. Udokotela, ezwa ukwakheka ngodonga lwangaphakathi lwesisu, angenza ucabange mayelana nesimo, ubukhulu kanye nendawo yesikhumba. Ukuze uthole ulwazi oluthe xaxa ngevolumu yemfundo, isakhiwo salo, inombolo ye-foci, izifundo ezengeziwe zenziwa:
- I-X-ray: I-X-ray yezitho zomzimba;
- endoscopic: i- hysteroscopy , i-cervicoscopy, i- colposcopy .
I-Myoma yesibindi sesisu
Ubukhulu be-uterine fibroids buyingxenye ebalulekile yokuxilonga. Le parameter ithathwa ngokuqondile lapho ikhetha indlela yokwelapha. Ngosayizi omncane we-tumor, ukwelashwa okulondolozayo kungenziwa. Kuhilela ukusetshenziswa kwezidakamizwa ze-hormonal ezinciphisa ukukhula kwesisu. Ukwandiswa kokuhlushwa kwe-hormone yesondo kubangela ukukhula okwandayo kwama-node amanga. Ngenxa yalokho, ubukhulu besitho sobulili buyanda. Ngokuphathelene nalokhu, ivolumu yomsindo iboniswa emasontweni okukhulelwa (ubukhulu besibeletho buqhathaniswa nalokho kokubeletha).
Kuye ngobukhulu be-neoplasm, ama-node ama-myomatous angahlukaniswa:
- okuncane;
- isilinganiso;
- ezinkulu.
Ubukhulu be-fibroids kumamitha
Ubukhulu be-fibroids ye-uterine ngo-mm bungasungulwa ngesikhathi se-ultrasound. Udokotela uhlola ngokucophelela isigxobo sesifuba esincane, ikakhulukazi isibeletho. Phakathi nenqubo, asifundeli kuphela ubukhulu bemfundo, kodwa futhi sihlolisise isakhiwo salo, inani lezinombolo ezitholakalayo. Kubalulekile ukucacisa uhlobo lwesisu. Inani elibalulekile lokuxilonga ubukhulu be-myoma.
Ekuphetheni, udokotela ubonisa ulwazi olulandelayo:
- i-fibroids encane - ukuxilongwa kwenziwa uma ubukhulu be-tumor engadluli ku-20 mm;
- isilinganiso - lesi siphetho senziwa uma ububanzi be-tumor buyi-20-60 mm;
- Ivolumu emikhulu idlula u-60 mm.
Ubukhulu be-uterine fibroids emasontweni
Ngezici ezijwayelekile zesisu, odokotela bavame ukulinganisa ubukhulu be-fibroids emasontweni uma behlola lesi sifo. Isibonelo, uma owesifazane ehlonishwa ukuthi unamaviki angu-11 e-uterine, lokhu kusho ukuthi ivolumu yesibindi yanda ubukhulu besitho socansi emavikini angu-11 okukhulelwa. Ngakho-ke, nge-myome elinganisa u-3-4 cm ububanzi, isiphetho siboniswa esiphethweni: i-neoplasm (i-myoma) ingamaviki angu-6-7.
Odokotela bachaza ubukhulu be-uterine fibroids emavikini kanje:
- i-myoma encane - ubukhulu besitho socansi asidluli amasonto amane ayi-obstetric;
- isilinganiso - kutholakala ukuthi uma isibeletho sifana namaviki angu-10-11;
- elikhulu - lilingana namaviki angu-12-16 wokubeletha.
Ngakanani usayizi we-uterine fibroids owenza lo msebenzi?
Uma i-myoma ye-uterine itholakele, ubukhulu bokusebenza yi-parameter odokotela abaphatha ngayo, ngaphezu kwesakhiwo sokwakheka. Kubalulekile ukuqapha isisu ku-dynamics. Abesifazane abanesifo esifanayo ngezikhathi ezithile bahlolwa, i-ultrasound. Uma kune-tumor ekhula ngokushesha, ukungenelela kokuhlinzwa kuyimpoqo. Uma ukuhlinzwa kungenziwanga, i-tumor ithatha yonke isikhala samahhala esikhwameni esincane. Kukhona ukwephulwa komsebenzi we-excretory.
Lapho kutholakala ukuthi i-hysteromyoma ubukhulu bokusebenza ngamamitha ayizinyanga abayifaki noma bayifake. Isiboniso sokungenelela okudingekayo ukuhlinzekwa okudingekayo ukukhula kwe-fibroids - ukubunjwa kwanda ngamamitha angu-20 nangaphezulu phakathi nonyaka. Ngaphezu kwalokho, lawo ma-fibroid angenawo usayizi omkhulu asebenza, kodwa kukhona umlenze omncane. Ngokuqondile kule ndawo kukhona ingozi enkulu yokuhlukunyezwa, okuholela ekushintsheni kwezicubu ezibhubhisa, i-necrosis. Ezinye izinkomba zokususwa kwe-fibroids zingabandakanya:
- ukungabi nabantwana kokubili ;
- ukukhulelwa okuvamile;
- ubuhlungu obukhulu obuhlungu (ubuhlungu obuqhubekayo esiswini, ku-rectum, isambiso).
I-myoma esheshayo yesisu - ubukhulu bokusebenza
I-myoma ehlukumezayo ibhekisela ekubunjweni okungenangqondo. Iyakuthinta ingxenye yangaphandle yelungu, ikhula ngokuya kwesigxobo se-pelvis encane. Ngefomu, kufana nefindo elinesisekelo esikhulu noma unyawo oluncane. I-hysteromyoma ehlukumezayo yobukhulu obukhulu ingaphansi kokususwa okugunyazayo. Ngesikhathi esifanayo, umbuzo wokwenza ukwelapha ukwelashwa kuphakama lapho ukwakheka ububanzi kufinyelela ku-80 mm.
I-myoma ene-uterine enomzimba - ubukhulu bokusebenza
Ubukhulu be hysteromyoma ekusetshenzisweni kwaloluhlobo lwesakhiwo akufani nalokho okushiwo ngenhla (8 sm nokuningi). Ubungqayizivele be-myoma enengqondo yi-submucosal localization ye-node ngokwayo. Kulesi simo, izintambo ze-fibrosis ze-muscular layer of the uterus zikhona ekwakheni. Ukukhula kwe-tumor kuqondiswa ngaphakathi kwesitho socansi. Ukwelapha okuhlinzekwa kwalolu hlobo lwe-neoplasm kungenziwa ngokusebenzisa amasu alandelayo:
- i-myoectomy - ukususwa kwama-nodes;
- Ukwakhiwa kwe-arterial uterine ukuphulwa komsoco we-tumor, ngenxa yalokho ukuthuthukiswa kwayo okuqhubekayo kwenzeka.
I-myoma yama-uterine amaningi
Njengoba sibhekene nobukhulu lapho kususwa khona i-uterine fibroids, kufanele kuqashelwe ukuthi ngenxa yokwenziwa okuhlukahlukene, odokotela abazinaki imiqulu yezinombolo ezithile. Lapho ukhetha indlela yokusebenza, ukutholakala kwendawo ye-myomas kanye nesiguli sesiguli kuyacatshangelwa. Uma lona wesifazane ehlela ukuba nezingane, misela i-myoectomy nokulondoloza isitho sobulili. Ukuhlinzwa kwenziwa nge-laparoscopy. Ukubuyiselwa komzimba emva kokuhlinzwa ngale ndlela kuyashesha, ngakho-ke ngemva konyaka ukungabi khona kwezinkinga kuvunyelwe ukuhlela ukukhulelwa.
I-myoma ye-uterine isusiwe kanjani?
Ukususwa kwe-fibroids ye-uterine ngendlela ye-classical yi-myoectomy. Yenziwa ngaphansi kwe-anesthesia jikelele noma ngokusetshenziswa kwe-anesthesia ye-epidural. Ngaphambi kokuba i-myoma yebele isuswe, ukulinganisa kokusebenza okunikeziwe kubhekwe ngaphambi kokuhlinzwa. Kungenziwa ngenye yezindlela ezilandelayo:
- Vula ukusebenza kwegundane - ukucubungula okulinganiselwe kwenziwa 2-3 cm ngaphezu kokushicilelwa kokushicilela. Khona-ke kancane kancane uvula ukufinyelela i-jumbo bese uyifisa. Isetshenziselwa ubukhulu obukhulu bokubunjwa.
- I-laparoscopy - ebusweni besisu, kunezimbobo eziningana ezenziwa ngazo izinsimbi ezikhethekile kanye nemishini yevidiyo.
- I-myomectomy ye-hysteroscopic - isetshenziselwa i-myomas e-submucous. Ukufinyelela kungena ngesifazane, usebenzisa i-resectoscope. Ukusebenzisa le nsimbi, eyenza isisu nge-high-frequency wamanje, i-myoma ibhujisiwe, futhi izingcezu zayo zihlanzwa bese zihlanzwa ngaphandle kwe-uterine cavity.
Ukwelashwa kwe-fibroids ye-uterine yobukhulu obukhulu ngaphandle kokuhlinzwa
Lapho i-myoma encane ye-uterine itholakele, odokotela bazama ukuyiphatha ngemithi. Ukwelashwa kwama-fibroids amakhulu ngaphandle kokusebenzisa ukungenelela kokuhlinzwa akuvumelekile. I-tumor izoqhubeka ikhula, ngakho-ke umsebenzi wezinye izitho nezinhlelo kungaphazamiseka ngokushesha. Ukuphathwa kwezidakamizwa kungenzeka uma kutholakala ukuthi i-myoma yomlomo wesibeletho, ubukhulu obuvunyelwe bubekwe ku-3 cm. Ezimweni eziningi, izidakamizwa ze-hormone zinomphumela wesikhashana nje kuphela, futhi ukuphela kokuphela kwesisu akupheli.