Kurapwa

Nekuti vazhinji uterine fibroids hazvikonzeri zviratidzo (zvinonzi "asymptomatic"), vanachiremba vanowanzopa "kuchenjerera kutarisa" kwekukura kwefibroid. Kazhinji, fibroid isingakonzere zviratidzo haidi kurapwa.

Kana kurapwa kuchidiwa, sarudzo yekusarudza imwe pane imwe inoenderana nezvinhu zvakasiyana-siyana: kuoma kwezviratidzo, chido chekuva nevana kana kuti kwete, zera, zvido zvemunhu, nezvimwewo chete.hysterectomy, ndiko kuti, kubviswa kwechibereko, kunopa mhinduro chaiyo.

Mazano ekubvisa zviratidzo

• Kushandisa compresses inodziya (kana ice) kunzvimbo dzinorwadza kunogona kubatsira kubvisa marwadzo. marwadzo.
• Over-the-counter mishonga inobatsira kubvisa marwadzo emudumbu uye musana. Iyi mishonga inosanganisira acetaminophen kana paracetamol (kusanganisira Tylenol®,) uye ibuprofen (yakadai seAdvil® kana Motrin®).
• To counter the Constipation, iwe unofanirwa kudya zvishanu kusvika gumi zvemichero nemiriwo pazuva, pamwe chete nehuwandu hwakanaka hwekudya fiber. Izvi zvinowanikwa muzvigadzirwa zvezviyo zvezviyo (chingwa chakazara zviyo uye pasta, mupunga webrown, mupunga wesango, bran muffin, nezvimwewo).

  NB Kuti uenderane nekudya kwakapfuma mufiber, zvakakosha kunwa yakawanda kudzivirira kuvhara nzira yekugaya.

• kana Constipation rinoramba, tinogona kuedza misa laxative (kana ballast), yakavakirwa psyllium semuenzaniso, iyo inoshanda zvinyoro. Stimulation laxatives inogumbura zvakanyanya uye kazhinji haina kukurudzirwa. Kuti uwane mamwe matipi, ona peji redu reConstipation. Aya matipi haafanire kushanda kana uchitambura kubva kune yakakura fibroid, sezvo kuvimbiswa kwakabatana nekutsikirira kwegumbo rekudya, uye kwete nekudya kwakashata kana kufamba kwakashata.
• Kana zva'kazhinji kuda kuita weti, inwa nguva dzose mukati mezuva asi kudzivisa kunwa pashure pa18 pm kuitira kuti usazofanira kumuka kazhinji kazhinji usiku.

Pharmaceuticals

Iyo mishonga inoshanda pane mutemo wekuenda kumwedzi kuderedza zviratidzo (kunyanya kubuda ropa kumwedzi), asi hazvideredze saizi yefibroid.

Kune matatu mhinduro kune vakadzi vane inonetsa fibroids:

- iyo IUD (Mirena®). Inogona chete kuiswa muchibereko nemamiriro ezvinhu ekuti fibroid haisi submucosal (formal contraindication) uye fibroids haisi yakakura zvikuru. IUD iyi zvishoma nezvishoma inoburitsa progestin zvinoita kuti ropa riderere. Inofanira kutsiviwa makore mashanu oga oga.

- tranexamic acid (Exacyl®) inogona kurongerwa kwenguva yekubuda ropa.

- mefenamic acid (Ponstyl®), mushonga unopesana nekuputika unogona kurongerwa panguva yekubuda ropa.

Kana iyo fibroid yakakura kwazvo kana kubuda ropa kwakanyanya, mamwe mahormone anogona kurongerwa kuderedza ukuru hwefibroid isati yavhiyiwa. Kuwedzerwa kwesimbi kunogona kurongerwa kuvakadzi vanotambura nekubuda ropa kwakanyanya, kuitira kubhadhara kurasikirwa kwesimbi mumuviri wavo.

Pre-kuvhiya kurapwa kweuterine fibroids.

- Gn-RH analogues (gonadorelin kana gonadoliberin). Gn-RH (Lupron®, Zoladex®, Synarel®, Decapeptyl®) ihomoni inoderedza mazinga eesrogen kusvika pamwero wakafanana neyemukadzi mushure mekuenda kumwedzi. Naizvozvo, kurapwa uku kunogona kuderedza saizi yefibroids ne30% kusvika 90%. Mushonga uyu unokonzeresa kuenda kumwedzi kwenguva pfupi uye unoperekedzwa nezviratidzo, sekupenya kwekupisa uye kushomeka kwemapfupa. Migumisiro yaro yakawanda, iyo inogadzirisa kushandiswa kwayo kwenguva refu. Gn-RH saka inonyorerwa munguva pfupi (pasi pemwedzi mitanhatu) uchimirira kuvhiyiwa. Dzimwe nguva chiremba anowedzera tibolone (Livial®) kune Gn-RH analogues.

- Danazol (Danatrol®, Cyclomen®). Mushonga uyu unotadzisa kugadzirwa kweesrogen nemaovary, izvo zvinowanzokonzera kukanganisa kuenda kumwedzi. Inogona kubatsira kuderedza kubuda ropa, asi mhedzisiro yaro inorwadza: kuwedzera uremu, kupisa kupenya, kuwedzera cholesterol mazinga, mburwa, kukura kwebvudzi zvakanyanya ... Inoshanda kwemwedzi mitatu, kuderedza zviratidzo zvefibroids, asi hapana chidzidzo chisina kuongorora. kushanda kwenguva yakareba. Inoratidzika kunge ine mamwe maside mhedzisiro uye kushoma kushanda pane GnRH analogues. Naizvozvo haichakurudzirwi

sejari

Kuvhiya kunonyanya kuratidzwa pakubuda ropa kusingadzoreki, kushaya mbereko, kurwadziwa kwakanyanya mudumbu kana kurwadza kwemusana.

La myomectomy ndiko kubvisa fibroid. Inobvumira mukadzi anoda kuita vana. Iwe unofanirwa kuziva kuti myomectomy haisi nguva dzose mhinduro chaiyo. Mu15% yezviitiko, mamwe mafibroids anoonekwa uye mu10% yezviitiko, tichapindira zvakare nekuvhiyiwa.6.

Kana fibroids iri diki uye submucosal, myomectomy inogona kuitwa nehysteroscopy. Hysteroscopy inoitwa pachishandiswa chiridzwa chine rambi diki nekamera yevhidhiyo iyo chiremba anovhiya anopinza muchibereko nemubeche nemuromo wechibereko. Mapikicha anoratidzwa pachiratidziro anobva atungamira chiremba wekuvhiya. Imwe nzira, laparoscopy, inobvumira mudziyo wekuvhiya kuti uiswe kuburikidza nekachekwa kadiki kanoitwa muzasi medumbu. Mumamiriro ezvinhu apo fibroid isingasviki kune nzira idzi, chiremba anovhiya anoita laparotomy, kuvhura kwekare kwemadziro emimba.

THEembolisationfibroids inzira ye endosurgical inoomesa fibroids isina kuabvisa. Chiremba (an interventional radiologist) anoisa catheter mutsinga inodiridza chibereko kuitira kubaya ma microparticles ekugadzira ane mhedzisiro yekuvharisa arteri inopa fibroid. Iyo fibroid, iyo isingachagamuchiri oksijeni uye chikafu, zvishoma nezvishoma inorasikirwa ne50% yehuwandu hwayo.

Pamusoro pekuchengetedza chibereko, nzira iyi haina kurwadza kupfuura myomectomy. Kupora kwemazuva manomwe kusvika gumi kunokwana. Kana tichienzanisa, hysterectomy inoda mavhiki matanhatu ekupora. Maererano neongororo yakabudiswa muna 2010, uterine artery embolization (UAE) inopa migumisiro inofananidzwa nemakore mashanu kana ichienzaniswa neyo hysterectomy, zvichiita kuti chibereko chichengetedzwe. Nekudaro, nzira iyi haigone kushandiswa kune ese mafibroids. Semuenzaniso, hazvikurudzirwe kurapa submucosal fibroids.

Nzira inonzi uterine artery ligation inogonawo kuitwa nelaparoscopy. Inoumbwa nekuisa zvimedu patsinga. Asi zvinoita sezvisingashande pane embolization nekufamba kwenguva.

- Kubviswa kwe endometrium (iyo mutsara wechibereko) inogona, mune dzimwe nguva, yakakodzera kuvakadzi vasingadi vamwe vana kuitira kuderedza kubuda kukuru. Apo endometrium inobviswa nekuvhiyiwa, kubuda ropa kumwedzi mumatambudziko akawanda kunoenda, asi hazvichakwanisi kuva nepamuviri. Kuvhiya uku kunonyanya kuitwa kana paine kubuda ropa kwakanyanya uye akawanda madiki, madiki submucosal fibroids.

Dzimwe nzira dzichangoburwa dziri kuwanda uye dzinowanzo kuwanikwa:

Thermachoice® (bharumu rinopinzwa muchibereko robva razadzwa nemvura inopisa kusvika 87 ° kwemaminetsi akati wandei), Novasure® (kuparadzwa kwefibroid neradiofrequency neelectrode yakaunzwa muchibereko), Hydrothermablabor® (saline serum uye kupisa kusvika 90 ° yakaunzwa muuterine mhango pasi pekutonga kwekamera), thermablate® (bharumu yakafukidzwa nemvura pa173 ° inounzwa muuterine mhango).

Dzimwe nzira dzemyolysis (kuparadzwa kwemyoma kana fibroma zvichiri mumunda wekutsvakurudza): myolysis ne microwave, cryomyolysis (kuparadzwa kwefibroid nechando), myolysis ne ultrasound.

- Hysterectomy, kana kubviswa kwechibereko, inochengeterwa zviitiko zvinorema apo maitiro ekare asingakwanisi, uye kune vakadzi vasingachadi kuita vana. Inogona kuva chikamu (kuchengetedza cervix) kana kukwana. Iyo hysterectomy inogona kuitwa mudumbu, kuburikidza nekuchekwa kunoitwa mudumbu rezasi, kana kumukadzi, pasina kuvhurwa kwedumbu kuri kuitwa, kana nelaparoscopy kana saizi yefibroid ichibvumira. Iyi ndiyo mhinduro ye "radical" kurwisa fibroids, sezvo hapagone kudzokororwa mushure mekubviswa kwechibereko.