I-sclerokistoz ovary: yikuphi, izimbangela zokuqala, izimpawu, ukuxilongwa, ukwelashwa, imiphumela

Cishe amaphesenti amahlanu azo zonke izifo zesifo sofuba odokotela abaxilongwa "nge-sclerokystoz ovaries." Yilokho okukhona, akuwona wonke owesifazane ocabanga, abantu abaningi babona ukuthi ukuxilongwa okunjalo kuyisigwebo sokungakhulelwa. Ngempela, cishe ingxenye yesithathu yalabo abaye bathola lesi sifo, izingane zabo azikwazi ukuzenza. Kodwa bonke abanye banamathuba aphezulu okuthola futhi abelethe ingane enempilo.

I-osteoarthritis inegama elinye - i-Stein-Leventhal Syndrome, ngoba okokuqala kwachazwa ngamagciwane amabili aseMelika - u-Irving Stein noMichael Leventhal. Lokhu kwenzeka ngo-1935. Eminyakeni engamashumi ayisishiyagalombili eyalandela, i-pathogenesis yesifo iye yahlolwa ngokucophelela, izindlela zokwelapha kanye nokuxilonga zakhiwe, kodwa kuze kube manje ososayensi abazi zonke izizathu zalokho okwenzekayo.

Uma unikezwa ukuxilongwa okunjalo okudumazayo futhi ufuna ngempela ukuba nezingane, ungaphelelwa ithemba. Kulesi sihloko, sizozama ukukutshela into ebaluleke kakhulu mayelana ne-sclerokystosis yama-ovari kanye nezindlela ezivumela ukuba zibhekane nazo.

Yeka ukuthi ama-ovarie anempilo ahlelwe kanjani

Ukuze uqonde kangcono indlela i-ovarian sclerosis kanye nokukhulelwa okuhlobene ngayo, udinga ukwazi ukuthi lezi zitho zihlelwe kanjani nokuthi zisebenza kanjani uma zingenayo i-pathology. Ama-ovari yizitho zomzimba zobulili ezihlangene. Bangabelwa ngesimo sezikhwama zangempela ezigcwele izinto zobuchopho. Izindonga zama-ovari ezihlanganisa ubuningi bezicubu ezinamandla ezixhunyiwe, kukhona uhlaka lwezinto ezinama-cortical kuso. Inesakhiwo esiyinkimbinkimbi nokubaluleka. Kulolu ungqimba ukuthi ama-follicles akhiwa - izakhi ezithile ezakhiwe lapho amaqanda akha khona. I-follicles, ebizwa ngokuthi eyinhloko, ngokulingana nesigidi esisodwa kuya kwezigidi ezimbili ibekwa emzimbeni wezintombi ngamunye esiteji sesisu. Kuzo zonke izinsuku zokuphila, ukuqala ngesikhathi sokuvuthwa nokuphela kwesikhathi sokunqamuka kwesikhashana, kancane kancane kudliwa, futhi okusha akusekho ifomu. Ngakho-ke, ihora liyeza lapho isitolo sabo siphela.

Lokhu cishe akukaze kwenzeka kubantu besifazane abaneminyaka yobudala, ngakho ukuhluleka kwezintambo akukwazi ukubangela ukungasebenzi. Enye into ukuthi ekuvuthweni kwabo okuncane, ngezinye izikhathi ukwehluleka kwenzeka. Ngakho-ke yizona ezenza ukuthi ukukhulelwa okufunayo akukwenzeka. Ngaphezu kwalokho, ukuthuthukiswa okungalungile kwama-follicles ngamaphesenti angu-100 wamacala kuholela ezifweni ezithathelwanayo, ngaphandle kokwelashwa yimuphi abesifazane abasengozini enkulu ye-thrombosis, i-thrombophlebitis, isifo sikashukela, i-infarction, izilonda ezibulalayo ezigulini ezincelisayo.

I-cyst ye-ovari ivela kanjani futhi ihlobene kanjani nokukhulelwa

Lapho amantombazane evuthwa ngokocansi, inqubo yokuvuthwa kwezintambo eziyinhloko, ezize zilele manje, zifakwe emzimbeni wazo. Le nqubo iqhubeka njalo ngebhayisikili. Emjikelezweni ngamunye, cishe ama-follicles angu-15 "avuke". Bona, ngaphansi kwesenzo se-hormone FSH, esakhiwe yi-pituitary gland, iqala ukukhula, ikhuphuka ububanzi ukusuka kumamitha ayi-50 kuya kwangu-500. Ngalesi sikhathi, zakha umthamo wamanzi, kanti enkulu kunazo zonke zivela. Le follicle iba inkulu, ikhule ngamamitha angu-20, ihamba. Ngaphakathi, iqanda likhula ngokushesha. I-follicles esele evela eqenjini "elivusa" elilodwa lifa futhi lichithe. Uma konke kuhamba ngokuvumelana nemithetho, uhlelo lwe-endocrine lufakwe emzimbeni wesifazane. Ngenxa yalokho, ama-hormone e-estrogen, ama-progestins nama-androgens, anethonya lokuvuthwa okuqhubekayo kwe-follicle ephezulu, akhiqizwa. Ngaphansi kwethonya le-hormone luteinizing (i-luteotropin, i-lyutropin, i-LH elifingqiwe), liyaqhuma, iqanda liyishiya ibe yi-tublopian tube, futhi liphenduka umzimba ophuzi futhi ixazulule kancane kancane.

Uma ukuphuka kungenzeki, iqanda elingelapheki liphinde lizalwe, futhi esikhundleni se-follicle ibonakala ubukhulu be-cyst cherry ye-ovari. Labo "izinsipho" ezivusiwe, ezingenaso isikhathi sokufa, nazo ziphenduka ama-cysts, amancane kuphela ngobukhulu. I-cyst, eyakhiwe kusuka ku-follicle, ngezinye izikhathi ikhula ibe ngosayizi omkhulu (amamitha angu-40-60), kodwa ingase ingabonakali nganoma iyiphi indlela. Kwezinye izimo, iziguli zikhononda ngobuhlungu ema-ovari. Ngemuva kokuba owesifazane ejwayelekile ukukhiqiza ama-hormone, uhlakazeka kancane kancane. Uma i-ovulation yowesifazane ibuyiselwa, i- cylic follicular njengamanje ikhona ku-ovary ayiphazamisi ukuvela kokukhulelwa, kepha uma le cyst ikhula ibe ngamamitha angu-90, kufanele isuswe ngokuhlinzwa.

Izimbangela zesifo

Ososayensi bazi ngokuningiliziwe ukuthi i-sclerokystosis yama-ovari iyakhiwa kanjani. Izizathu zalesi simo azikafiki ngokucacile, zikhona izicabango kuphela. Njengoba ama-hormone edlala indima ebaluleke kakhulu ekuthuthukisweni okujwayelekile kwe-follicle nokukhululwa kwe-ovule kuwo, imbangela eyinhloko ye-ovarian sclerosis yizifo ze-hormonal, futhi ikakhulukazi, ukungasebenzi ngendlela yokwenziwa kwe-estrogens. Izimbangela ezilandelayo zezifo ze-hormonal zibizwa ngokuthi:

• Heredity;
• Ama-anomali esakhiweni sezakhi zofuzo;
• Ukuphazamiseka ohlelweni lwe-pituitary-ovarian;
• Ukuhlukunyezwa kwengqondo;
• Izinkinga ngemuva kokukhipha isisu;
• Izifo ezithathelwanayo nezigciwane;
• Izinkinga emva kokubeletha;
• Izinguquko emisebenzini ye-cortex yesikhangiso.

Izimpawu zomtholampilo

Ngeshwa, kungenzeka kuphela ekuqaleni kwesikhathi sokuvuthwa ukuthola intombazane ene-sclerocystosis yama-ovari. Izimpawu ngalesi sigaba ziphazamiseke futhi zibandakanya ukungalungi emjikelezweni wokuya esikhathini. Kodwa lesi senzakalo singaba nezinye izimbangela eziningi, hhayi ezihlobene nesifo se-ovarian, kuze kube nokudla okungenamsoco nokuphazamiseka kwemizwa. Ngeminyaka engamashumi amabili, kuya eminyakeni engamashumi amabili nanhlanu, amantombazane anezimpawu ezicacile ze-sclerokinosis yama-ovari. Okuyinhloko namanje ukuphulwa komjikelezo kanye nesimo sokuya esikhathini (ezingamaphesenti angu-96 eziguli). Ngokuvamile kukhona ukulibaziseka isikhathi eside kwenyanga (cishe izinyanga eziyisithupha noma ngaphezulu) noma inani elincane kakhulu lokuvimba (hypomenstrual syndrome). Isikhathi esiningi iziguli zikhononda ngesikhatsi kanye nesikhathi esiningi sokuya esikhathini.

Ezinye izimpawu ezivumela ukuthi i-sclerocystosis ecatshangelwayo yama-ovari yilezi:

• I-Hirsutism (cishe amaphesenti angama-90 eziguli ziba nezinwele ezungeze indawo ezungeze izingono, emuva, isisu, isifuba nangaphezulu kwe-lip);
• Ukuqapha ngokweqile (iziguli ezingama-70%);
• Ubuningi namaphimpi ebusweni (kwenzeka ezingekho ezingamaphesenti angu-40 amacala);
• Ezinye izinguquko ngokulingana komzimba;
• Ukuphazamiseka emsebenzini wesimiso sezinzwa;
• I-asthenic syndrome;
• Ukwandiswa kwe-Ovarian (okutholwe umjozi wezinzwa lapho kuhlolwa).

Ngaphezu kwalokho, abanye besifazane bangase babe nezimpawu ezivamile ezifweni eziningi: ubuhlungu esiswini esingaphansi, i-malaise, ukukhathala okungaqondakali okusheshayo.

Ucwaningo lwelabhu

Ngokusekelwe ezibonakalweni zangaphandle, i-ovarian sclerosis isolwe kuphela, futhi ukuhlolwa kokugcina kwenziwa ngemuva kokuhlolwa okwengeziwe. Lezi yizi:

• Ukuhlola igazi nge-testosterone (inani lifanele libe ngaphansi kwama-1.3 ng / ml, mahhala kwabesifazane abangaphansi kweminyaka engama-41 - ngaphakathi kuka-3.18 ng / ml, kuze kube yiminyaka engu-59 - okungaphezu kuka-2.6 ng / ml);
• Ukuhlaziywa kokutholakala kwe-glucose, okuqukethwe kwe-ushukela wegazi kanye ne-triglycerides;
• I-Colpositogram (indaba ithathwe esithweni sangasese, idatha yokuhlaziya ibonisa ukuthi kukhona noma yini i-ovulation, kanye ne-correspondence ye-colpositogram indices kuze kube sesikhathini sesiguli nesigaba sokujikeleza kwakhe kokuya esikhathini);
• Ukuqothula i-endometrium (ikuvumela ukuba uhlulele ukuphulwa kwemisebenzi kuma-ovari);
• Ukuqapha izinguquko ekushiseni okuyisisekelo;
• Izivivinyo zamahomoni athile wegciwane, i-pituitary gland, ama-ovari (LH, FSH, PGS, prolactin, cortisol, 17-hydroxyprogesterone);
• Ukunqunywa kwe-estrogen excretion.

Manje iziguli ngokwazo zingaqhuba ukuhlolwa okulula, okuvumela ukuba basolise ama-cystic ovarian formations. Lokhu kuzodinga i-microscope (ungathenga kuma-pharmacy). Ekuseni, lapho uvuka futhi ungadli noma uphuze noma yini, udinga ukubeka uphonsa wesikhala sakho egumbini lokubhubhisa futhi uvumele ukuthi umile. Ngesikhathi sokuvuthwa kwezinga, izinga le-estrogen likhuphuka njalo, eliphinde lishintshe ukwakheka komathe. Uma kune-ovulation, isampuli samathe emakrofroscope iyoba ngesimo samaqabunga amafern, futhi uma kungekho ukuvuthwa, ngendlela yamachashazi.

Ukuhlolwa kwekhwalithi

Njengomthetho, ukuthola ukuxilongwa okunembile nokucacile, iziguli zinqunywe ezinhlobonhlobo zokuhlolwa ngosizo lwemishini yezokwelapha.

Indlela elula kakhulu futhi engenabuhlungu kakhulu ukuhlolwa kwe-ultrasound ye-sclerokistoza yama-ovari. Le nqubo isifo sangasese (ngokusebenzisa isisu), i-transvaginal (indlela efundisa kakhulu kakhulu), i-transrectal (eyenziwa kuphela kumantombazane amancane nabesifazane asebekhulile).

Ngosizo lwe-ultrasound kunquma ubukhulu bama-ovari, isimo sabo, isakhiwo, inani lezintambo eziphakathi kwazo, ezilinganiselwa ku-8 mm, ubukhona noma ukungabikho kwe-follicle evamile, ukutholakala noma ukungabikho kwe-ovulation, ukutholakala kwama-cysts ku-ovary.

Olunye uhlobo lokuhlolwa yi-pelvetogram yegesi ebonisa ukwehluka okuvela esimeni sobukhulu bama-ovari nesisu.

Enye yezinkinga ezinzima kakhulu zokuxilongwa yi-laparoscopy. Kuqhutshwa esibhedlela ngaphansi kwe-anesthesia jikelele. I-algorithm injengendlela elandelayo: udokotela wesiguli ohlinzayo wenza i-perforation yodonga lwe-peritoneal futhi ujobe idivaysi ephazamisa i-carbon dioxide emzimbeni ukuze idale ivolumu e-peritoneum futhi ihlolisise kangcono izitho. Ngaphezu kwalokho, i-laparoscope ifakwe emzimbeni wesiguli, ekhombisa isimo sama-ovari esikrinini. I-laparoscopy iyindlela enembile kakhulu yokuxilongwa, kepha emva kwalokhu owesifazane udinga isikhathi sokuvuselela.

Izindlela zokwelapha zokwelashwa kwe-ovarian sclerocystosis

Ngemuva kokuxilongwa kokugcina, lo wesifazane unqunywe imithi ezikhathini eziningi. Umgomo wayo ukubuyisela umjikelezo ojwayelekile wokuya esikhathini bese uqala ukuvota. Kunokuba uphathe ama-ovaries ama-sclerokastoz, umjozi wezinkinga kanye nomtholampilo we-endocrinolog solves.

Uma isiguli sinomsoco, isigaba sokuqala sokwelashwa sinciphisa isisindo. Owesifazane unqunywe ukudla, ukuvivinya umzimba ngokomzimba.

Isigaba sesibili ukwanda kwombono we-insulin. Kubekwe "i-Metformin", okumele kuthathwe izinyanga ezingu-3-6.

Isigaba sesithathu yisisusa sokuvuthwa. Qala ukwelashwa ngemithi elula - Clomiphene. Inkambo yokuqala ihlanganisa ukuthatha isidakamizwa ebusuku ebusuku, kusukela ngosuku lwesihlanu lomjikelezo wezinsuku eziyisihlanu ezilandelanayo. Uma kungekho miphumela (ukuya esikhathini), i- "Clomifen" ithathwa phakathi nenyanga. Uma umphumela ungatholakali, umthamo ukwandiswa ube ngu-150 mg ngosuku.

Isigaba esilandelayo (ngokungabikho kwamandla ashukumisayo) yisimiso somuthi we-Menogon. Injected intramuscularly, futhi ekupheleni kwenkambo, imijovo ye "Horagon" yenziwa. "I-Menogon" ingashintshwa ngokuthi "Menodine" noma "Menopur".

Ngemva kokuqeda yonke inkambo, i-blood biochemistry yenziwa, futhi ngesisekelo semiphumela yokuhlaziya (uma i-hormone ye-LH inganele), khetha "i-Utrozhestan" noma i- "Dyufaston".

Ngokufanayo, odokotela bazama ukususa lo wesifazane ebucayi obukhulu, ngokuqondene nokuthi umiswe yini ngokuthi "Ovosiston" no "Metronidazole".

Ukwengeza okuphoqelekile kulolu hlelo kuyi-vitamin therapy.

I-osteoarthritis: ukwelashwa kokuhlinzwa

Uma kungakapheli izinyanga ezintathu emva kokulashwa kwezidakamizwa kungekho-ovulation, owesifazane kunqunywe ukuhlinzwa. Lenziwa ngezindlela eziningana. Yikuphi okumele ukwenze kuncike ekuboniseni isimo sama-ovari.

Esikhathini samanje, kukhona izinhlobo ezilandelayo zokusebenza:

• I-Cauterization ye-cysts ene-laser;
• Ukunciphisa (ukususwa ku-ovary kwesigaba sangaphakathi);
• Hlanganisa umthengisi (ukususwa kusuka ku-ovary kwesigaba esithintekile ngesimo somgqa);
• Ukuhlobisa izidakamizwa (udokotela ususa ungqimba omhlophe oguqulwayo ovary, ugwaza izintambo ezinesaliti kanye ne-sutures emaphethelweni abo);
• I-electrocautery (ukubhujiswa kwamaphuzu endaweni ye-ovary yendawo lapho ama-hormone amaningi akhiqizwa khona).
• Ukucwaninga (udokotela wabo ohlinzayo wenza ukujula kwe-1 cm ezindaweni lapho izintambo zibonisa khona ukuze zikhulule iqanda elivela kubo uma zivuthiwe).

Izibikezelo

Abesifazane abavumelana nanoma yiziphi izindlela ezinikezwa odokotela banesithakazelo embuzweni owodwa kuphela: kungenzeka yini ukuthi ukhulelwe nge-sclerocystosis yama-ovarie? Izibalo zibonisa ukuthi, ngaphandle kokwelashwa, ukungatholakali kutholakala ngamacala angu-90%. Ukwelashwa kwezidakamizwa I-Clomiphene ithuthukisa umsebenzi we-ovarian kwiziguli ezingu-90%, kodwa ukukhulelwa kwenzeka kuphela kuma-28% wabo. Yiqiniso, ngokweminye imibiko, imiphumela emihle ingafinyelela kuma-80%.

Ukuntuleka kwesidakamizwa "Klomifen" - kusebenza kuphela ekuqaleni kwalesi sifo noma ngemuva kokusebenza njengomsizi.

Ukwelashwa ngezidakamizwa ezinamandla, isibonelo, i- "Gonadotropin", ngokusho kwezibalo, kuholela ekuvuthweni okungenani okungama-28% weziguli, okuphezulu - ngo-97%. Kulesi simo, abesifazane abangu-7-65% bakhulelwe.

Uma i-ovarian sclerosis iphathwa ngokuhlinzwa, imiphumela emihle ibonakala ngokuphathelene nemvamisa efanayo njengokwelapha okulondolozayo. Ngokwezibalo, emva kokuhlinzwa kuma-ovarie, abesifazane abangu-70-80% bathola ithuba lokukhulelwa.

Ukubuyekeza

Kwabesifazane abaningi, kuyinhlekelele enkulu yokwenza ukuba ahlolwe ngokuthi "i-ovarian sclerocystosis." Ukuphawula kweziguli mayelana nokwelashwa kuhluke kakhulu. Omunye wasiza amaphilisi, othile-ukuhlinzwa, futhi othile akatholanga ukukhulelwa, naphezu kwanoma yiziphi izindlela ezenziwe.

Kukhona nengxenye encane yeziguli ezibika ukukhulelwa ngokujwayelekile ngaphandle kokwelapha, nakuba ukuxilongwa "kwe-ovarian sclerosis" akukhenqwanga. Imiphumela enjalo ephikisanayo ingenzeka ngenxa yezici eziqondene nomuntu ngamunye futhi akufanele ibhekwe njengendlela evamile.

Kodwa ngcono kwezempilo ngemuva kokwelashwa kubhaliwe ekubuyekezweni kwabesifazane abaningi. Iziguli ezimbalwa kuphela zibika ukuthi ukujwayela kwazo kokuya esikhathini sekuyisikhathi esifushane, emva kwalokho baphinde bathathe amalungiselelo ama-hormone.

Futhi ekugcineni, kunengxenye yezibuyekezo, lapho abesifazane bebheka ukubonakala kwemizwa ebuhlungu isikhathi eside emaqanda ama-ovari nase-peritoneum ngemuva kokwelashwa ngosizo lohlinzekwa.