I-Hyperplasia yiyiphi? I-hyperplasia ehlabayo ye-endometrium. I-endometrial focal hyperplasia

I-Hyperplasia yisimo esibonakala ukwanda kwenani lamaseli ezicubu noma isitho (ngaphandle kwalezi zicubu zesisu). Umphumela wokuthuthukiswa kwalesi sifo i-neoplasm noma ukwanda okwenziwe ngobukhulu besitho.

Ithuthukisa i-hyperplasia ngemuva kwemithonya ehlukahlukene ethinta ukukhiqizwa kwamaseli akhuthazayo. Ngakho-ke, izinto ezihlasela i-antigenic, izinto ze-oncogenic, izishukela zokukhula kwezicubu noma ukulahlekelwa kwesigungu noma isisindo somzimba nganoma yisiphi isizathu kungasusa ukuthuthukiswa. I-hyperplasia engokwemvelo ukukhula kwe-epithelium yezinhlayiya ze-mammary ngesikhathi sokukhulelwa, ukubonakaliswa kwe-hyperplasia embi ngaphambili noma ngesikhathi sokuya esikhathini nokunye ukubonakaliswa okufanayo.

Njengesibonelo se-hyperplasia, ukuqhubekela phambili ezimweni zokugula, umuntu angabiza ukwanda komthamo wezinto ezakhiwe ezigulini ezinezinhlobo ezithile ze-anemia yezicubu ze-myeloid. Ngaphezu kwalokho, izinqubo ezingenasisindo zingase zenzeke emithanjeni ye-lymphatic tissue lymph nodes, njengempendulo yegciwane lengculaza kulesi siphepho, esimweni sezifo ezithathelwanayo.

Izinhlobo ezihlukahlukene

Ezokwelapha, kunezinhlobo eziningana eziyinhloko:

1. Hyperplasia yemvelo. Kukhona ukwanda kwezicubu, ezisebenza noma zesikhashana. Isibonelo, i-mammary gland hyperplasia, ngesikhathi sokudla noma ngesikhathi sokukhulelwa.
2. I-hyperplasia engokwemvelo. Ngenxa yezizathu eziningana ezivusa amadlingozi, izicubu zanda.

Ngaphezu kwalokho, lesi sifo singaba sigxile, sisakaze futhi sibe nesisindo esikhulu:

1. Ngesimo esibucayi, ukucaciswa kwendawo okucacile kwenqubo kubonakala ngendlela yezigaba ezihlukene.
2. Uma i-hyperplasia ehlukanayo isithinta ubuso bawo wonke ungqimba.
3. Ngefomu le-polpous, ukukhula okungalingani kwezici zokuxhuma kuyisici. Kulesi simo, i-hyperplasia ingashukumisa ukuthuthukiswa kwezinhlelo ezingekho emthethweni kanye nama-cysts.

I-hyperplasia ye-thyroid ehlukile

Lesi sifo senzeke esimweni sokusabela okunomsoco we-gland yegciwane ngokuntuleka kwe-iodine. Igama elithi "ukusabalalisa" lisho ukuthi lesi sifo sithinta isilwane sonke: usayizi wawo ukwanda ngenxa yokuphindaphinda kwamangqamuzana amgundane ukuze kugcinwe ukuvinjelwa kwe-hormone yegciwane, okugqugquzela ukuqubuka kwamakhemikhali e-oxygen okugcina izinga lamandla.

I-gland yegciwane idinga i-iodine ukugcina umsebenzi wayo we-hormonal. Ukuntuleka noma ukungabikho kwe-iodine okufakwayo kukhuthaza ukukhula kwamangqamuzana e-gland futhi okulandelayo kungaholela ekusebenziseni kwawo ukungasebenzi.

I-Hyperplasia yezingqungquthela eziyingozi

Lesi sifo singaba nodular noma siphumelele. Ihambisana nezicubu ezingenakwenzeka ze-grenal adrenal uma kwenzeka isisu somzimba we-pineal no-Cushing's syndrome. Kubantu abadala, lolu hlobo lwe-hyperplasia, ikakhulukazi kwesokunxele, lukhuni kakhulu ukuqaphela nge-ultrasound futhi luhlala luyinto yokutadisha yi-MRI no-CT.

Ngezinye izikhathi ukusabalalisa i-hyperplasia yezingqungquthela ezihamba phambili kuhambisana nokwanda kwezitho zokulondolozwa kohlobo olujwayelekile lwezinhlayiya - ngendlela yokwakhiwa kwe-hypoechoic, ezungezwe izicubu ezinamafutha. Endabeni ye-nodular hyperplasia, esifundeni "soxantathu olunamafutha" umuntu angabona ama-hypoechoic ahlanganisiwe, ahlukene. Kunzima kakhulu ukuhlukanisa kusuka ku-adenoma esithombeni se-echographic.

I-Prostate - i-hyperplasia enobungozi

Abantu abangaba ngu-85% abaneminyaka engaphezu kwengu-50 ubudala bayathinteka yilesi sifo. I-Benign prostatic hyperplasia ibonakala ngokubunjwa kwe-prostate yama-nodules amancane (noma owodwa), okuyinto, ngokusakazeka kancane, eqala ukucindezela ku-urethra, okubangela ukuthi kube nzima ukuvuthwa.

Lesi sifo asibangeli i-metastasis, lesi sici sihlukanisa umdlavuza wakhe wesifo sofuba, ngakho-ke sabizwa ngokuthi i-hyperplasia enesibindi. Kodwa-ke, ayikho isizathu esicacile sokuthi kwenzeke futhi, njengomthetho, ihlotshaniswa nesisindo sokunqamuka kwamadoda.

I-Endometrium yesibeletho

I-Hyperplasia iyanda inhlanhla ebunzini kanye nomthamo we-lining yangaphakathi yesibeletho. Kungenzeka ngenxa yokuphindaphinda kokubili kwamangqamuzana nezinye izicubu zomzimba. Lesi sifo singabangela ukwephula umsebenzi osebenzayo we-endometrium (izinkinga zokukhulelwe, ukwephulwa kokuya esikhathini).

Ngaphansi kwezimo ezivamile, i-endometrium ngaphansi kwesenzo se-estrogen ikhula esikhathini sokuqala somjikelezo, ngaphansi kwethonya le-progesterone esikhathini sokujikeleza sesibili kuvinjelwe. E-pathology, ukukhula kwe-endometrium kwenzeka ngokungalawuleki, kukwazi ukuthatha kokubili i-membrane yangaphakathi kanye nezingxenye zomuntu ngamunye (ukugxila kwe-hyperplasia).

Izinhlobo ze-endometrial hyperplasia

Ngokuyinhloko yezinye izakhi ku-endometrium ekhulayo, kukhona:

1. I-hyperplasia embi. Izigulane ze-Endometrial zikhula ngokweqile.
2. I-hyperplasia yama-polpous. Kukhona ukwanda okugxile kwe-endometrium, ene-glandular, glandular fibrous, ne-fibrous character. Lolu hlobo lwe-hyperplasia aluvamile ukuba lubi, kepha lungasetshenziswa njengesisekelo sokuthuthukiswa kwezifo zesifo somzimba.
3. I-hyperplasia ene-adenomatous ngokutholakala kwamaseli atypical, precancerous. Kulesi simo, ukuguqulwa kwesifo somdlavuza waloluhlobo lwe-hyperplasia kungafinyelela cishe ngo-10%.
4. I-cystic-glandular hyperplasia. Ama-glands nama-cysts akhula ngendlela efanayo.

Izimbangela

Kuze kube manje, imbangela eyinhloko yalesi sifo kungaphezu kokuntuleka kwesihlobo se-progesterone yesimo se-estrogen. Lesi simo singaholela ku:

1. Ubudala besikhathi esihamba phambili nokuphulwa komzimba wama-hormonal kanye nokuqhuma kwama-hormone.
2. Ukukhuluphala kwesifazane.
3. I-Polycystic i-ovary syndrome.
4. Isikhathi sokuya esikhathini.
5. Ukuthatha imithi equkethe i-estrogen ngaphandle kokuthatha i-progesterone.

Ngokuvamile, i-endometrial hyperplasia (ukubuyekezwa kochwepheshe kuqinisekisa lokhu) kubonakala kwabesifazane ngaphambi kokumisa esikhathini nasemantombazaneni amancane.

Izifo ezihambisanayo, okwandisa ukubonakaliswa kwe-hyperplasia, ziyinkinga nge-adrenal and breast, izifo ze-thyroid, isifo sikashukela sezinhlobo zombili, kanye ne-hypertension. Ukuthuthukiswa kwe-hyperplasia kungaholela nasezimpikweni ezifana nalezi:

1. Ubungcwele ngezifo zofuzo.
2. Adenominosis.
3. I-fibroids ye-uterine.
4. Ukukhipha isisu nokukhishwa.
5. Izinqubo zokuvuvukala zezocansi.

Izimbangela zentuthuko kanye nezinhlobo ze-hyperplasia e-glandular ye-endometrium

Izimbangela eziyinhloko ze-hyperplasia glandular:

1. Anovulation.
2. Ukuqhathanisa ngokweqile.
3. Ukuba khona kwama-cysts follicular.
4. Ukunqamuka kwesikhathi.

Futhi, ingozi i-syndrome ye-follicle ukuphikelela, i-glycemia kanye nezicubu zamaseli we-granulosa.

Ukuntula ukwelashwa nokuthola ukuthi lesi sifo asihloliswanga ngokungazelelwe kubangelwa imiphumela enobungozi njengokwakhiwa komdlavuza we-endometrial. Iningi lamasosha kukhona amantombazane aphethwe yi-hyperplasia e-atypical adenomatous, kanye nabesifazane esikhathini esilandelayo se-menopausal. Yigxile futhi ihlukanise i-hyperplasia - lezi yizimo eziqaphile zalesi sifo.

Ezinye izinhlobo ze-endometrial hyperplasia yizona zanda kakhulu ze-epithelium e-glandular, izigulane ezikhulunywe nge-cystic, kanye ne-hyperplasia yama-cystic.

Izimpawu

Ezimweni eziningi, i-hyperplasia ekhukhulayo ivela ngaphandle kwempawu zomtholampilo. Ngesikhathi esifanayo, ukuphuma kwamagciwane okungasebenzi okubangelwa ukungahambisani nokuya esikhathini (kubambezeleka kokuya esikhathini) kubhekwa njengokubonakaliswa okuvamile. Lezi zimfucumfucu zingaba yilapho iqhubekile, futhi ihlala isikhathi eside, futhi ilahlekelwa igazi - iningi noma ilinganiselwe. Ngenxa yalokho, izimpawu ze-anemic zihlakulela: ukulahlekelwa isifiso, ukukhathala, ubuthakathaka.

Phakathi kokuya esikhathini, ungabona ukubona indawo. Ngokuvamile abesifazane abathintekayo ukugcoba kwenzeka ukungasebenzi. Okokuthi, ukungabi nalutho yisona isizathu sokuya kudokotela, obese ehlola lesi sifo. Phakathi kwezimpawu, ungabuye ubuke ubuhlungu esiswini esingaphansi.

Ukuxilongwa kwe-hyperplasia engokwemvelo kungenziwa nge- diagnostic scraping, eyenziwa ngokushesha ngaphambi kokuya esikhathini. Ngokuvamile ukuxilongwa, i-ultrasound ne-hysteroscopy isetshenziswa.

Hyperplasia of focal

I-Focal hyperplasia (ukubuyekezwa kochwepheshe kuphakamisa lokhu) kungasongela umdlavuza nokungabi namandla. Ukuhlunga okungekho emthethweni noma ukuvuza okungavumelekile kuvumela ukubona lesi sifo kuphela phakathi nokuhlolwa kwe-ultrasound noma ukuhlolwa komzimba.

I-Focal hyperplasia ivame ukuvela ngemva kokugula kwe-hormonal, ngemuva kokudluliswa kwezifo ezibangelwa isifo somzimba kanye nokukhipha izisu noma ngokumelene nesizinda sohlobo oluthile lwe-hyperplasia.

I-focal hyperplasia ye-epithelium yesibeletho itholakale ngesisekelo sezimpawu ezilandelayo:

• Ukukhishwa kwamanzi ngemva kokuyeka ukuya esikhathini;
• Izimpikiswano ze-Acyclic noma ze-cyclic zomjikelezo wokuya esikhathini.

Ukwelashwa kwalesi sifo kwenziwa ngezindlela ezimbili eziyinhloko:

1. Indlela yezidakamizwa - ngosizo lwezidakamizwa ezikhethekile, kubandakanya i-hormonal.
2. Indlela yokuhlinza noma yokuhlinza - ngokushaya isikhumba sembele.

Ukuxilongwa kwe-endometrial hyperplasia

Isizathu sokuthola lesi sifo siwukuhlolwa ngudokotela-gynecologist, ukuqhuba izifundo ze-instrument and laboratory.

Izindlela eziyinhloko zokuxilongwa yizi:

1. I-Ultrasound ye-appendages nesibindi ngesinzwa sangasese.
2. I-Hysteroscopy enezici ezibonakalayo zokuhlolwa kwe-histological.
3. Ukuqothula ukuxilonga kwesigumbi se-uterine.
4. Uma kudingekile ukucacisa uhlobo lwe-hyperplasia, i- biopsy yokufisa isenziwa .

Omunye wezifundo ezibaluleke kakhulu ze-laboratory ukuzimisela kwi-serum yegazi yezinga lama-hormone ocansi kanye ne-gland yegciwane, kanye nezinhlayiya ze-adrenal.

Kubalulekile ukukhumbula ukuthi noma yiluphi uhlobo lwe-hyperplasia kudingeka luhlolwe ngokunembile futhi lubone imbangela yangempela eyenza ukwanda kwezicubu.

Ukwelapha

Uma i-hyperplasia ifunyanwa, ukwelashwa kwenziwa ngokushesha. Indlela ikhethwe ngokusekelwe ekubonakalweni kwesifo kanye nobudala besiguli.

Indlela ephumelela kunazo zonke ukuguqulwa kokuxilongwa noma ukususwa kwe-hysteroscopic kwinqubo evelele ye-endometrium.

Uma inqubo yokwelapha isesimweni esikhulu, ke okokuqala, ukuphulukiswa okuphuthumayo noma okujwayelekile kuyasebenza. Ikhetho lokuqala lisetshenziselwa i-anemia noma ukuphuma kwamanzi.

Ngokushesha nje lapho imiphumela ye-histology itholakala, lochwepheshe ungachaza izindlela ezilandelayo zokwelapha:

1. Lapho uneminyaka engaphezu kwengu-35, abaphikisanayo be-gonadotropin baqokwe.
2. Idivayisi ye-intrauterine "i-Mirena" ene-gestagens.
3. Ngenkathi yesibili yomjikelezo, ama-gestagenic amalungiselelo anqunywe (uDufaston, Utrozhestan).
4. Ngenhloso yokumisa okungavunyelwe ukuphuma kwamantombazane emantombazaneni esemncane, ukuvimbela ukubeletha ngomlomo kuvunyelwe emazingeni amancane kakhulu.
5. Ukuhlanganiswa kokubeletha komlomo ("Regulon", "Yarina", "Zhanin") kunqunywe izinyanga ezingu-6 ngehlelo lokudliwa kwendabuko.

Lezi zidakamizwa okukhulunywe ngenhla zenza umphumela ofana ne-climacterium, kodwa iyabuyiselwa.

Ngemuva kokuphulukiswa, ukulawulwa kwenziwa okwesiqingatha sonyaka; uma kukhona ukuphindaphinda kwesimo esibucayi se-hyperplasia, ukususwa kwesibeletho kuboniswa . Ngenye amafomu ajwayelekile kanye nokungasebenzi kwezinye izindlela zokwelashwa, i-endometrium ichithelwa ngokugcwele (ablation).

Isibikezelo kanye nezinkinga

Ingxube eyingozi kunazo zonke ye-endometrial hyperplasia ukuguqulwa kwe-endometrium ibe ngumdlavuza wesibeletho. Kodwa-ke, akuyona ingozi encane ephuma futhi ephinde ibuyele ekuthuthukiseni ukungabi nabantwana kanye nokuphelelwa yisifo semfuyo.

Ezimweni eziningi, lesi sifo siyakwamukela: ngenxa yokungenelela kokuhlinzwa kanye nezidakamizwa zokuqala ezinyangeni ezingu-6-12, lesi sifo singaphiliswa ngokuphelele.

Ukuvimbela

Izinyathelo ezibaluleke kakhulu zokuvimbela i-endometrial hyperplasia yizo zokuvimbela izimo ezicindezelayo, umzabalazo osebenzayo ngokumelene nesisindo esiningi futhi ukwelashwa okusheshayo kwezimpikiswano zomjikelezo wenyanga. Ngaphezu kwalokho, ukuhlolisiswa kwabesifazane ngokweqile kwabesifazane kubaluleke kakhulu.

Ngesinye isikhathi amantombazane amancane anganconywa ngemithi yokuvimbela i-hormone, efaka isandla ekunciphiseni ingozi ye-hyperplasia kanye nomdlavuza we-endometrial. Noma yikuphi owesifazane kufanele aqaphele ukuthi uma kukhona ukuphuma kwegazi kudingekile ukuba uthintane nochwepheshe ngokushesha. Khumbula ukuthi ukufinyelela okufika ngesikhathi kudokotela kuzosiza esikhathini esizayo ukugwema izinkinga eziningi.