Sklerokistoz amaqanda: oko kukuthi, oonobangela, iimpawu, uxilongo, unyango, iziphumo

Malunga nama-amahlanu ekhulwini kuzo zonke iimeko zezifo yamanina, oogqirha kwafunyaniswa ukuba "sklerokistoz ovarian". Ntoni na, ngokwaso asinguye wonke umfazi, abaninzi kangaka ndiyaqonda ukuba une ukungachumi njenge zivakalisi. Enyanisweni, malunga yesithathu kwabo baye bafumanisa le ngezifo, abantwana babo ukuba. Kodwa ke abanye amathuba aphezulu ukubuyisa uze uzale nosana esempilweni.

Sklerokistoz amaqanda inomnye igama - Stein-Leventhal syndrome, kuba echazwe kuqala ezimbini ugqirha American - Irving Stein kunye Maykl Levental. Oku kwenzeka ngo-1935. Kwiminyaka engaphezu kwama asibhozo kamva wahlolwa ngokucokisekileyo Pathogenesis esi sifo, liphuhlise iindlela zonyango kunye sifo, kodwa kude kube ngoku izazinzulu babengazi zonke izizathu ukwenzeka kwayo.

Ukuba ufake sifo kwezinye kwaye ngokwenene ufuna ukuba nabantwana, ungaphelelwa lithemba. Kweli nqaku siza kuzama ukuxelela yonke ebalulekileyo malunga sklerokistoz ovarian kunye neendlela zokuhlangabezana nayo.

Njani zamaqanda enempilo

Ukuze siqonde ngcono ukuba babalise indlela amaqanda sklerokistoz nokukhulelwa, kufuneka akwazi ukwakha indlela ezi mizimba kwaye zisebenza njani, ukuba akukho sifo kuzo. Zamaqanda amalungu ababhinqileyo okuzala nesithandwa sakhe. Baya angamelwa ngohlobo weengxowa original ezaliswe umcimbi ebuchotsheni. udonga yamaqanda igcwele ngomaleko izihlunu ashinyeneyo nokuqina kulo ngumaleko le uthinte. Yena isakhiwo kwaye ebalulekileyo. Kungenxa kule nwebu akhiwa zoboya - izinto ezithile kumaziko apho kweqanda asakhasayo. Zoboya zibizwa eziziiprayimari, xa isixa malunga enye ukuya kwizigidi ezibini ulalisiwe ke umzimba amantombazana nganye olungekazalwa elinye inyathelo. Kubo bonke ubomi, ukususela ixesha lokuvuthwa kunye nexesha nesiphelo koku-, baya ngokuthe ngcembe osetyenzisiweyo kwaye ezintsha hayi ndakubumba. Ngoko ke, ukuba kuza ilixa, xa imfuyo yabo sishiywe.

Oku phantse alikho namakhosikazi aselekhulile yokuzala, ngoko ke unobangela ukungachumi ayikwazi kuba ukungabikho zoboya. Enye into kukuba xa nokwanda lwabo ngokuthe ngcembe maxa wambi izinto zingahambi kakuhle. Ngoko ke ityala ngenxa yokuba ukukhulelwa oyifunayo lungenzeki. Ngaphezu koko, uphuhliso okungaqhelekanga of zoboya engamakhulu elinye ekhulwini amatyala kukhokelela isifo yamanina, ezishiye lunganyangwa kwabasetyhini kwandisa umngcipheko thrombosis, thrombophlebitis, isifo seswekile, isifo sentliziyo, nangezilonda amabi, kwi amadlala mammary.

Njengoko cyst ovarian ubonakala nendlela esinceda ngayo lokukhulelwa

Xa amantombazana ebudodeni ngokwesini emzimbeni lwabo luquka kwinkqubo emsebenzini ekukhuleni zoboya zaseprayimari leyo kude ngathi ukulala. Le nkqubo kusoloko lwenzeka kwimijikelo. Kumjikelo ngamnye of "siphaphile" ukuze malunga 15 zoboya. Bona phantsi inyathelo FSH hormone yi ingqondo yebhinqa, zizakuqalwa phezulu ukukhula, ukwandisa ubukhulu ukusuka microns-50 ukuya 500. Ngeli xesha, i ulwelo follicular ukhandwa kuyo, yaye likhulu zivele kwisisu. Le follicle kuba sinamandla, kwandisa ukuya iimillimitha-20, bulges. Ngaphakathi kuyo okhula ngokukhawuleza iqanda. Amanye amalungu follicle ukusuka iqela 'ayivukanga "elinye emva kwelinye zibhubha ucombulule. Ukuba konke kuhambe ngokwemithetho kumzimba imazi ifakiwe umsebenzi kwinkqubo yonyango. Isiphumo yenziweyo iihomoni estrogen, progestins, kunye androgens, apho ifuthe kwi nokuvuthwa ngakumbi follicle lubalaseleyo. Phantsi impembelelo luteinizing ihomoni (lyuteotropina, lutropin, olufinyeziweyo njengoko LH), lotshitsha, isishiya ukusuka iqanda ukuya ityhubhu Imibhobho, yaye iba kungena luteum corpus kunye ngcembe resorbed.

Ukuba break lungenzeki, iqanda ongakhululwanga azalwe, kwaye nendawo follicle kubonakala cherry-ubungakanani cyst ovarian. Abo zoboya 'ayivukanga "ezingakhange ixesha lokuba afe, babuya ibe cysts, ezincinane kuphela. Cyst, lithatyathwe follicle, maxa wambi ikhula a ngomli- (40-60 mm), kodwa akakwazi ngokwabo mboniso. Kuphela nje iimeko ezimbalwa, izigulane ezikhala iintlungu zamaqanda. umfazi once uye imveliso okuqhelekileyo emzimbeni, oko kancinane iyachithakala. Ukuba ibhinqa liye ebuyiselweyo ovulation, zifumaneke ngexesha ovarian cyst follicular zokukhulelwa akuyiphazamisi, kodwa ukuba cyst lakhula ukuya ubungakanani iimillimitha 90, kufuneka lisuswe.

Ezibangela isifo

Iinzululwazi bayazi ngokweenkcukacha indlela umfanekiso sklerokistoz zamaqanda. Izizathu zale meko akukho kuqiniseka kakuhle, kukho okucingelwayo kuphela. Njengoko kuphuhliso yesiqhelo follicle kunye iqanda output zoko emzimbeni zidlala indima ebaluleke kakhulu, oyena nobangela sklerokistoz ingqalelo ukuphazamiseka ovarian hormone ingakumbi ukwahluleka indlela estrogen yokuqaphela. Wabhekisela oonobangela zilandelayo ukungalingani hormone:

• ufuzo;
• na ukungaqheleki kubume zofuzo;
• yokuphazamiseka kwinkqubo yebhinqa-ovarian;
• ukuphatheka;
• iingxaki emva isisu;
• Izifo ezosulelayo kunye yamanina;
• iingxaki emva kokubeleka;
• ukutshintsha imisebenzi uthinte adrenal.

iimpawu clinical

Ngelishwa, kuphela ekuqaleni kwethuba ukuvuthwa ukuze bafumane amaqanda intombazana sklerokistoz. Iimpawu ngexesha lesi sigaba lubricated kwaye ikakhulu zibandakanya kumjikelo sexesheni. Kodwa lo mba unokuba ezinye izizathu ezininzi ezinxulumene isifo zamaqanda, wehla kwisondlo nemithambo kakuhle ukuphazamiseka. Ukuze amabini, ukuya kuma kwiminyaka engamashumi amabini anesihlanu amantombazana kuvela iimpawu ezininzi ethile sklerokistoz ovarian. Eyona isekhona kukwaphula ibhayisikile kunye nohlobo sexesheni (96 ekhulwini izigulane). Uninzi abafumana ukulibaziseka elide ngenyanga (malunga nesiqingatha okanye nangaphezulu) okanye imali encinci kakhulu ehlele (hypomenstrual syndrome). Kakhulu amathuba ukukhalaza ubude kumguli wenyanga echumayo.

Ezinye iimpawu emqondweni of sklerokistoz ovarian zilandelayo:

• hirsutism (ngo-90 ekhulwini izigulane baphawula indawo hairiness jikelele ingono, emva, isisu, nasesilevini ngaphezu umlebe);
• amavila (70 ekhulwini abantu);
• nenkqayi nezici ebusweni (kwenzeka ezingaphezulu kwama-40 ekhulwini kwamatyala);
• ezinye utshintsho zobukhulu komzimba;
• ukungasebenzi-luvo;
• syndrome asthenic;
• yesinye ovarian (zafunyanwa ngexesha ugqirha nokuhlola).

Ukongezelela, abanye abafazi zinokuba iimpawu ziqhelekilyo izifo ezininzi: intlungu esiswini asezantsi, umkhuhlane, ukudinwa ukuyichaza.

uphando laboratory

Ngokusekelwe iimpawu yangaphandle sklerokistoz ovarian kukrokrelwa nje, kwaye uxilongo lokugqibela wenziwa emva kokuba iimviwo ngakumbi. Zizo ezi:

• uhlalutyo on testosterone igazi (ewonke kufuneka sibe uluhlu 1.3 ng / ml, abafazi ukhululekile kunyaka 41 - kwisithuba 3.18 ng / ml, kwaye ukuya kutsho kwiminyaka 59 - hayi ngaphezulu kwe 2.6 ng / ml);
• uhlalutyo susceptibility glucose kwi iswekile egazini, kunye triglycerides;
• kolpotsitogramma (izinto othatyathwe kwilungu lobufazi kulingwa data show, akukho okanye ovulation, ngokunjalo adibanayo indices kolpotsitogrammy ubudala kumguli isigaba komjikelo kokuba sexesheni kwakhe);
• kokuphalwa endometrium (inika isalathiso ukunyhashwa zamaqanda);
• ukulawula utshintsho lobushushu Uhlobo Lokuqala;
• Ezinye ihlaziya phezu hormone, yebhinqa, amaqanda (LH, FSH, PSSG, prolactin, cortisol, 17-hydroxyprogesterone);
• nokuzimisela zinomgutyulo estrogen.

Ngoku ke sigulane asikwazi ngokuzimeleyo ukwenza uvavanyo elula barhanela kwi cysts ovarian. Oku kuya kufuna ngemicroscope (iyafumaneka ekhemesti). Ngentsasa elandelayo, nje wavuka yaye akukho nto sele esidla esela, kufuneka ubeke nethontsi amathe akhe phezu kwiphetshana elebhu iglasi kwaye ukuba yome. Ngexesha ovulation usoloko kwandisa inqanaba estrogen, nto leyo iguqula nokwakheka amathe. Ukuba ovulation kukuthi, isampuli amathe neemicroscope kuya kuba ngohlobo amagqabi omfisi, kwaye ukuba akukho ovulation, - ngohlobo amanqaku.

uxilongo hardware

Njengomgaqo, ukuxilongwa kunye bokuphela izigulane ezilawulwa lokuhlolwa ezintsonkothileyo nge izixhobo zonyango.

Eyona ndlela kakhulu nobubele kwaye yalula gca yona uxilongo ultrasound sklerokistoz ovarian. Inkqubo le transabdominal (ngokusebenzisa esiswini), transvaginal (indlela kakhulu ulwazi), ultrasound transrectal (lwenziwa kuphela xa amantombazana aselula kakhulu kwaye abafazi abadala).

Ukusebenzisa ultrasound ukuqinisekisa ubungakanani ovarian, imilo, isakhiwo, inani zoboya kuzo, ogama ubukhulu - 8 mm, ubukho okanye kungekho follicle elibalaseleyo, ubukho okanye ukungabikho ovulation, ubukho cysts isizalo.

Olunye uhlobo survey - pelveogramma igesi ebonisa ubungakanani okuthile zamaqanda kunye esibelekweni.

Enye yeentlobo zinzima uphethwe laparoscopy. Oku kwenziwa esibhedlele phantsi Ukubulawa jikelele. I algorithm kwezi zilandelayo: ugqirha nomonde yenza okuhlatywa kodonga peritoneum kwaye Asikokungena apparatus, i kuvuthela carbon igesi dioxide ukwenzela ukudala ivolyum kwi peritoneum uze uphonononge ngcono amalungu. Ngaphezu koko, umzimba isigulane kuqaliswa laparoscope, nto leyo ebonisa kwikhusi imeko zamaqanda. Laparoscopy - indlela echanekileyo loxilongo, kodwa emva kokuba umfazi kufuneka ixesha kwimeko yesiqhelo.

unyango Conservative of sklerokistoz ovarian

Emva isifo esichazayo kwiimeko ezininzi umfazi ubekwa unyango ngamachiza kuqala. injongo yawo - ukubuyisela umjikelo oluqhelekileyo exesheni kunye ovulation ukuze uqhube. Le sklerokistoz ngayo ugqirha ovarian ugqiba kunye endocrinologist.

Phambi ukutyeba, inyathelo nomonde yokuqala unyango kukuba umzimba. Mfazi emiselweyo ukutya, ukusebenzisa kwenzeke.

Inqanaba lesibini - ukwandisa kwimbono insulin. Abamiselweyo "Metformin" ukuba kufuneka uthathe iinyanga 3-6.

Isigaba sesithathu - ukukhuthazwa ovulation. Qala unyango kunye namayeza zilula - "clomiphene". Ikhosi yokuqala eya kuzamkelela ebusuku xa umthamo we-50 mg, ukususela ngomhla wesi-5 zomjikelo iintsuku ezi-5 zilandelelana. Ukuba akukho japan (esexesheni), "Clomiphene" thatha inyanga. Ukuba xa oku sele enaningenzelwanga, ithamo landiswa ukuya 150 mg ngosuku.

Inqanaba elilandelayo (kungekho nemiba positive) - Ukuqeshwa iziyobisi "menogon". Oku kulawulwa intramuscularly, yaye emva kokugqiba izitofu ikhosi "Horagona". "Menogon" buyisela "Menodinom" okanye "Menopur".

Emva kokugqiba le khosi lonke, esenza chemistry igazi, abeke "Utrozhestan" okanye "Djufaston" ngokusekelwe kuhlalutyo lweziphumo (ukuba ngokwaneleyo na LH hormone).

Ngokuhambelana, oogqirha bazama ukususa umfazi hirsutism, ngokunxulumene kuso emiselweyo, "Ovosiston" yaye "Metronidazole".

Ngaphezu olugunyazisiweyo kule khosi vitamin.

Sklerokistoz amaqanda: unyango ubuchule zoqhaqho

iinyanga Ukuba phakathi ezintathu emva konyango ichiza hayi ovulation kwenzeka, umfazi emiselweyo uqhaqho. It ikhutshwa phandle ngeendlela ezininzi. Yeyiphi enye ukusetyenziswa kuxhomekeke engatshintshiyo ovarian.

Ngelo langoku nqanaba, imisebenzi zilandelayo:

• cysts moxibustion usebenzisa laser;
• demedulyatsiya (ukususwa esizalweni inxalenye yayo ephakathi);
• nesinqumka resection (ukususwa icandelo yamaqanda inxalenye nachaphazelekayo ngohlobo esime);
• decortication (ugqirha ususa similise tunica layer zoboya ovarian kunye inaliti lihlaba kungqameko sutured);
• galvanocautery (point ukutshatyalaliswa esizalweni lentsimi yayo, oveza hormone kakhulu).
• zingakhona (ugqirha wabo yenza ubunzulu 1 cm kwiindawo apho zoboya ukhanye ukuze bakwazi ndinikhululele ngexesha nokuvuthwa beqanda ngokwalo).

uqikelelo

Abasetyhini kuvunyelwane naziphi na iindlela ekucetywa ukuba oogqirha, abanomdla umbuzo omnye: ke kunokwenzeka ukuba ukhulelwe ngoxa zamaqanda sklerokistoz? Iinkcukacha-manani zibonisa ukuba ngaphandle unyango, ukungachumi banesifo ngo-90% yamatyala. therapy "clomiphene" Drug kuphucula umsebenzi ovarian ngo-90% yezigulane, kodwa kwenzeka ukuba ukukhulelwa gama%-28 kuphela kubo. Noko ke, ngokutsho kwezinye iziphumo emihle kuma-80%.

Ukungabikho "Clomiphene" imveliso - kuphumelela kuphela ekuqaleni sifo okanye uqhaqho ilandelayo nje adjuvant.

Unyango iziyobisi enamandla kakhulu, ezifana "gonadotropins" Ngokwezibalo, ubuncinane kukhokelela ovulation ngo-28% yezigulane, ubuninzi - 97%. Ngaloo abakhululwe-7 ukuya kuma-65% yabasetyhini.

Ukuba sklerokistoz ovarian baphathwa intsumpa, iziphumo ezintle yabonakala malunga nezihlandlo efanayo naleyo nothomalaliso endala. Ngokutsho manani, emva utyando kwi zamaqanda ithuba ukukhulelwa ukufumana 70-80% yabafazi.

reviews

Kuba abafazi abaninzi, bawafumane ilishwa zokusingatha diagnosis "sklerokistoz Ovarian". Izimvo izigulane kunyango zahlukile kakhulu. Umntu wamnceda ipilisi umntu - ukusebenza, kwaye umntu ukukhulelwa lwenzeke, akukho nto iindlela zithathwe nto.

Kukho kwakhona inxenye encinane izigulane ingxelo kuqala yokukhulelwa kwabo ngaphandle naluphi unyango, nangona lokufunyaniswa "maqanda sklerokistoz" ayizange iyaqhutywa. Ezi ziphumo iphikisana inokuba ngenxa iimpawu ngamnye zomntu ngamnye yaye akumele ithathwe njenge eqhelekileyo.

Kodwa kuphuculo lwempilo emva konyango, ukuba abhale ncomo, inkoliso yamabhinqa. iziguli ezimbalwa kuphela ingxelo ukuba nganye ngenyanga phambili ixesha elifutshane, emva kokuba kuye kwafunwa ukuba ukuthatha iihomoni.

Kwaye ekugqibeleni, kukho inxalenye ncomo apho abafazi ubunzima kwathabathela embonakalweni intlungu yabo ixesha elide kwingingqi zamaqanda kunye peritoneum emva konyango nge uqhaqho.