Usenokuba wambona ugqirha wakho ngegazi elingavumelekanga lokuphuma kwintsholongwane
- Kunzima kunegazi eliqhelekileyo lokuphuma kwimihla
- Ukuhlamba phakathi kwamaxesha akho
- Ukuphuma kwamadoda
Ukuba unako, kunokwenzeka ukuba unikwe ukuxilongwa kwe-endometrial hyperplasia.
Sibanzi
I-endometrial hyperplasia yinto engaqhelekanga kwimbumba yesisu sakho okanye i- endometrium .
I-endometrium yakho yakha kwaye ihlawula inyanga nganye ngokuphendula kwiinguqu zakho eziqhelekileyo zokutshintsha kwe-hormonal.
Yona nxalenye ephambili yokuhamba kwamanyanga ngenyanga. Kuyinto eqhelekileyo ukuba umbane wakho wesibeletho uzule okanye ukhululeke ngexesha lesibini sokuqala
Kodwa, ukuba kukho ukungalingani kwi-hormone stimulation ye-endometrium into engaqhelekanga inokwenzeka. Olu tshintsho olungavumelekanga lugxininiswa ngokungaqhelekanga lwe-endometrium kwaye lubizwa ngokuba yi-endometrial hyperplasia.
Iimvumba zakho zivame ukuvelisa i-estrogen kunye neprogesterone ekuphenduleni ama-hormone akhuthazayo ukusuka kwingqondo. Olu tshintsho olulungelelanisiweyo nolulungele ixesha kunye nokulinganisela kwe-estrogen kunye neprogesterone yinto eyenza ixesha lakho lifike rhoqo, malunga neentsuku ezingama-28.
Indima yeHormone Ukungalingani
Ukungalingani kwe-hormonal ejongene ne-endometrial hyperplasia yintlaninge ye-estrogen kwi progesterone
I-Estrogen yi-hormone enoxanduva lokubangela ukunyusa okuqhelekileyo kwe-endometrium ngexesha lesibini sokuqala.
Xa kulungelelaniswa nexabiso elifanelekileyo leprogesterone yakho i-endometrium iyakhula kodwa ikhupha ngaphandle kokuvumela ukukhula okungavamile. Kodwa xa kukho isihlobo esingaphezulu kwe-estrogen, i-lining igqityiwe kwaye iqhubeka ikhula. Emva kwexesha elithintekayo liningini liqala ukuvelisa utshintsho olungavamile.
Izinto zobungozi
Imiqathango eyenza i-estrogen excess engabangela ukuba i-endometrial hyperplasia ibandakanye:
Ukunyanya
Amathambo enyama aguqula amanye ama-hormone kwi-estrogen. Oku kubangela i-estrogen eyongezelelekileyo evuselela umbane wesisu ngaphezu kwe-esrogen yesiqhelo eyenziwa ngamaqanda akho. Ukuba i-BMI yakho ingaphezu kwama-35 unomngcipheko omkhulu wokwanda kwe-endometrial hyperplasia xa kuthelekiswa nawe ngokulinganisa umzimba.
Ukugcoba
Kukho izizathu ezininzi zokuba ungenako ukuvusa. Ukuba awuyikuvusa i-ovary yakho ayiyi kunyusa umveliso wayo weprogesterone. Ukwanda kweprogesterone kuyimfuneko ukuba ubhedu lwebhola lwakho luchithe. Ngamanye amagama, awuyi kufumana ixesha lakho. Kwezinye iintlobo zentshukumo ezixhephayo, ukungahambi kakuhle kweprogesterone kuvumela isihlobo esingaphezu kwe-estrogen. Iziphumo ze-estrogen ezingenakulinganisela kwi-endometrium. Ekugqibeleni, uya kuba nohlobo oluthile lwegazi lomzimba olungaqhelekanga. Iipateni ezinokwakheka kwamanzi ezinjalo kunye nelo hlobo lokukhupha luquka ixesha eliqhelekileyo nelinzima okanye liphuma phakathi kwamaxesha akho. Izizathu eziqhelekileyo zolu hlobo lokungalingani kwe-hormonal ziquka:
IiHormone eziqhelekileyo
Ngokucacileyo ukuthatha indawo ye-estrojeni iyakwandisa amanqanaba e-estrogen ngokumalunga namazinga akho e-progesterone.
Kungenxa yoko ukuba usenayo isisu ufanele uthathe uhlobo lwe progestin (progesterone) ukukhusela i-endometrium yakho ukuba ingaphaya.
Olunye unyango lwe-hormonal olunokubangela ukwanda okungavamile kwe-endometrium nguTamoxifen . I-Tamoxifen yinyango ebizwa ngokuba yi-receptor modulator okanye iSERM. Iimfuno ze-SERM ziyizidakamizwa ezichaphazela iindawo zesifo se-estrogen zomzimba wakho ngeendlela ezahlukeneyo. I-Tamoxifen isoloko isetyenziselwa ukonyango lwe-cancer yebele ye-hormone ngoba ichasene nemiphumo ye-estrogen kwisisu sebele. Nangona kunjalo, i-Tamoxifen ivuselela i-estrogen receptors kwisigxina se-uterus ngoko yenza njenge-estrogen kwaye ingabangela i-endometrial hyperplasia.
Ukuba usebenzisa i-hormone yonyango okanye iTamoxifen uze uhlakulele ukuphuma kwamanzi omzimba kubaluleke kakhulu ukuba ubone ugqirha wakho kwaye uvavanywe.
I-Estrogen ivelisa izicubu ze-ovarian
IHormone ukuvelisa izicubu akuyona imbangela eqhelekileyo ye-endometrial hyperplasia. Nangona kunjalo, kukho ezinye iiswini ze-ovarian ezinobungozi ezivelisa i-estrogen.
Ukuxilongwa
Xa ubona ugqirha wakho ngezikhalazo zokuphuma kwintsholongwane engavumelekanga, kuya kwenzeka ukuba uya kuba ne-biopsy yecala lesisu sakho. Ugqirha wakho unokucetyisa ukuba i-biopsy ye-endometrial okanye iprogram yokuhlinzwa encinci ebizwa ngokuba yi-hysteroscopy ene-curettage okanye i-sampling ye-endometrium.
I-endometrial biopsy
Le yindlela eqhelekileyo ye-office-based gynecologic. Ngokuqhelekileyo, kulungeleke kakhulu.
Ngokwenziwa kwam, ndifumanisa ukuba ukulindela kunye nokuxhalaba ukuba nenkqubo yimbi kakhulu kunokuba yiyo-biopsy. Ukuba udinga ukuba ne-biopsy ye-endometrial, yinto efanelekileyo ukuthatha i-600 mg ye-ibuprofen kwaye ube ne-snack encinane malunga neyure ngaphambi kokuba inqubo. Unokufuna ukuzisa ipakethe encinci efudumele okanye ukupakisha kunye nawe ukunceda ukunciphisa i-cramping ngexesha nangemva kwenkqubo. Ugqirha wakho unokukunika enye ngexesha le-biopsy.
Ukumiselwa kwe-biopsy kufana ne-pap smear yesiqhelo. Emva kokuba i-speculum ifakwe ugqirha uya kuhlamba umlomo wakho wesibeleko kunye ne-antiseptic. Mhlawumbi ugqirha wakho uya kubeka i-gravix yakho kwindawo efanelekileyo ngenkqubela i-aspirator ifowuni. Uyakuthi ufumane ubunzima. Awuyi kuva nantoni na ebukhali kodwa uya kuba neenkampu. Ukuphazamiseka kunokuvela kwixesha elincinci leenkampu ukuya kwiinkcenkcesho ezinzulu ezifana neentlungu zokuqala zabasebenzi. Iindaba ezilungileyo yinkqubo ikhawuleza kwaye ihlala ingaphantsi komzuzu omnye. Ukuthatha ibuprofen phambi kwenkqubo kunye nokusebenzisa ipakthi elifudumeleyo ngexesha leenkqubo ngokuqinisekileyo, kunceda ukunciphisa intlungu.
Hysteroscopy
Ugqirha wakho unokubonisa ukuba ube nesampuli ye- hysteroscopy kunye ne-endometrial endaweni ye-biopsy ye-endometrial. Le yinto efanayo yenkqubo yokuhlinzwa kunye nakwezinye iintshukumo zobunzima, kwenziwa nakwiofisi esikhundleni segumbi lokusebenza. Inzuzo ye-hysteroscopy kukuba ivumela ugqirha wakho ukuba agcine ngokucacileyo umgca wesibeleko ukuqinisekisa ukuba zonke iindawo ze-endometrium zithatyathwa ngokufanelekileyo. Kukho iimeko ezithile apho ugqirha wakho angakuchaza le nkqubo inokungena embi kakhulu.
I-endometrial hyperplasia ayikwazi ukufumana uvavanyo lwegazi okanye i-ultrasound. Nangona kunjalo, kunokwenzeka ukuba ugqirha wakho unokuncoma iimvavanyo ezithile zegazi ukulawula ezinye izizathu zokuphuma kwegazi lomzimba. Kwakhona kunokwenzeka ukuba ugqirha wakho unokuyalela i-pelvic ultrasound yangaphakathi ekuncedeni ukuxilongwa kwesizathu sokuphuma kwamagciwane okungaqhelekanga.
I-endometrial hyperplasia inokufunyanwa kuphela emva kokuba i-endometrium yakho isampuliwe kwaye ihlolwe phantsi kwe-microscope ngumgulana wezilwanyana.
Iintlobo
Xa isifo sengqondo sibheka isampuli ye-endometrium yakho phantsi kwe-microscope bajonge ngokukodwa ukutshintshwa kwimiba emibini ye-endometrium yakho, izilonda kunye nezicubu ezisekelayo ezibizwa ngokuba yi-stroma. I-endometrial hyperplasia ifunyaniswa xa kukho iingqungquthela ezininzi ezinxulumene ne-stroma kunokuba ungayifumana kwi-endometrium eqhelekileyo okanye yebhayisikili. I-pathologist iya kuthi ikhona iiseli ezibonakalayo kwi-endometrium engabonakaliyo ekhokelela kwizigaba ezimbini ze-endometrial hyperplasia:
- Hyperplasia ngaphandle kwe-atypia
- Atypical hyperplasia
Kubalulekile ukuba ukhumbule ukuba i-endometrial hyperplasia ayikho umdlavuza we-endometrial kodwa ithathwa njengesimo esinqabileyo. Enyanisweni, kwezinye iimeko ze-hyperplasia ebalulekileyo ye-atypical, isifo somhlaza wesifo se-endometrial sisenokuba sele sikhona.
Unyango
Kubaluleke kakhulu ukuba zonke i-hyperplasia ye-endometrial zilandelwe okanye ziphathwe ngokuthe ngqo.
I-Endometrial hyperplasia ngaphandle kwe-atypia
Xa kungekho zisele ze-atypical zikhoyo, ithuba lokuphela kwe-endometrial hyperplasia ekugqibeleni liba ngumdlavuza we-endometrial. Ubungqina bubonisa ukuba kuphela ama-5% wabasetyhini abane-endometrial hyperplasia ngaphandle kwe-atypia baya kuvelisa umdlavuza we-endometrial. Kwakhona kunokwenzeka ukuba olu hlobo lwe-endometrial hyperplasia luya kulungisa ngokwalo.
Umgca wokuqala wonyango kukujonga izinto ezinobungozi eziguqukayo.
Ngokomzekelo, ukuba unobunzima kakhulu okanye ukhuluphele, ukulahlekelwa isisindo kuya kunceda ukunciphisa i-estrogen engaphezu kwee-fat cells. Oku kuya kuvumela ukuba umgca wesibeletho sakho uzinze kwakhona. Ngokufanayo, ukuba uthatha i-hormone unyango olutshintsho lwakho ugqirha unokufuna ukulungelelanisa umthamo wakho okanye uncoma ukuba uyeke ukuyisebenzisa.
Ugqirha wakho unokuncoma ukusebenzisa i-progestin yonyango ukulwa nomonakalo we-estrogen kwi-endometrium yakho. Izizathu zakho ugqirha unokubonisa ukunyanga ngeprogesterone ziquka:
- Ukuqwalaselwa kunye nokuguquka kwendlela yokuphila akuzange kusebenze
- Unesifo esingaqhelekanga sokuphuma kwamanzi
- Ufuna umphumo osheshayo
Iintlobo ezimbini zeprogesterone ezicetyiswa unyango lwe-endometrial hyperplasia ngaphandle kwe-atypia yi-progesterone yomlomo okanye i-progesterone ene-IUD. Ubungqina bumnandi bokusebenzisa i-levonorgestrel IUD ( iMirena ). Ukuba unamandla kakhulu nge-BMI> 35 kunokwenzeka ukuba unyango lwe-progesterone aluyi kusebenza kakuhle ngaphandle kokuba ulahlekelwe isisindo. Kufuneka uxoxe nodokotela wakho uluphi uhlobo lwonyango lwe-progesterone olungcono kuwe.
Ingaba ukhetha ukujonga okanye unyango nge progesterone kufuneka ulandelwe ngokuthe ngqo kunye neempendulo ze-endometrial sampling ukuqinisekisa ukuba i-endometrial hyperplasia ihambe kwaye ayibuyanga.
Iingcali zithi i- hysterectomy ayifanele ibe yinkqubo yokuqala yokwelashwa kwe-endometrial hyperplasia ngaphandle kwe-atypia ngenxa yokusebenza ngokubanzi kwonyango lwe-progesterone kunye nomngcipheko ophantsi wokuphucula umdlavuza we-endometrial. Nangona kunjalo, iingcali ziyavuma ukuba kukho iimeko ezithile apho i-hysterectomy ingaba yindlela efanelekileyo kakhulu yokonyango kwabasetyhini abenzileyo banabantwana. Ugqirha wakho unokuncoma i hysterectomy ukuba:
- Ngexesha lokulandelelana, uhlakulela i-hyperplasia ye-atypical
- I-hyperplasia ayiphucula emva kweenyanga ezili-12 zonyango lwe-progesterone
- Unokuphuma igazi elingavamile
- Uphuhlisa kwakhona i-endometrial hyperplasia emva kokuba uphathwe ngempumelelo
- Awufuni ukuhlaziya i-endometrial biopsies efunekayo ngonyango lwe-progesterone.
I-endometrial hyperplasia nge-atypia
Kukho umngcipheko omkhulu kakhulu wokuphucula umdlavuza we-endometrial ukuba unomdlavuza nge-atypia Ulawulo lugqithise kakhulu ngenxa yolo mngcipheko. Enyanisweni, iingcali zincoma i hysterectomy njengonyango wokuqala wonyango kwi-hyperplasia ye-atypical kubasetyhini abenzileyo banabantwana.
Ukuba ufunyanwe ukuba une hyperplasia ye-atypical kwaye usacwangcisa ukuzama ukukhulelwa uza kuphathwa ngeprogesterone, mhlawumbi kunye ne-levonorgestrel IUD.
Uza kuba neempendulo ze-endometrial rhoqo ukuqinisekisa ukuba i-hyperplasia ye-atypical iphathwe ngokwaneleyo. Ugqirha wakho uya kuphakamisa ukuba ubone ingcali yokuzala kwaye uzalise ukuzala kwakho ngokukhawuleza njengoko unakho. Kusenokwenzeka ukuba ugqirha wakho uya kuphakamisa ukuba ne-hysterectomy emva kokuba uyenze ubenabantwana ngenxa yobuhle obuphezulu bokuphindaphinda kwe-endemicrial hyperplasia.
Ngenxa yokuba ukuphuma kwegazi olungavamile kungumqondiso oqhelekileyo wokuba unayo i-endometrial hyperplasia, kubalulekile ukubona ugqirha wakho ukuxoxa ngalezi zinguqu ekuphumeni kwakho. Ugqirha wakho unako ukugqiba isigqibo sokuba ngaba uvavanyo olongezelelweyo kunye novavanyo luyimfuneko.
Imithombo:
I-Gallos, ID, kunye ne-al, 2016.BGSE / i-RCOG Isikhokelo esisisigxina: Ulawulo lwe-Endometrial Hyperplasia. [Online] London: BGSE / RCOG. Ifumaneka kwi-https: //www.rcog.org.uk/en/guidelines-research-services/guidelines/gtg67/