Iwe ungangodaro wakaona chiremba wako nokuda kwekusaurapa kweutachiona kubuda ropa zvakadai se
- Inorema kukunda kubuda kwepanguva yekubuda kumwedzi
- Kushambadzira pakati pemakore ako
- Post-menopausal kubuda ropa
Kana iwe uine, zvinoita kuti iwe wakapiwa kuongororwa kwe endometrial hyperplasia.
Overview
Endometrial hyperplasia isingaenzaniswi yechipfuva chechibereko chako kana endometrium .
Your endometrium ndiyo inovaka uye inoita mwedzi woga woga pakupindura maitiro ako ega ega ecyclic hormonal change.
Ndicho chikamu chikuru chekuenda kwako kwemwedzi kwemazuva. Izvo zvakajairika kuti ruvara rwechibereko chako ruwedzere kana kuti ruwedzere mukati mehafu yekutanga yekuenda kwako kumwedzi
Asi, kana pane kusaenzana kwehutemoni inokurudzira ye endometrium kusakanganisika kunogona kuitika. Iyi shanduko isingawanzogadziriswa isinganzwisisiki kukura kwe endometrium uye inonzi endometrial hyperplasia.
Mazai ako anowanzobereka isrogen uye progesterone mukupindura mahomoni anokonzera kubva muuropi. Iyi shanduko yakarongeka uye yakagadziriswa uye yakaenzana ye estrogen uye progesterone ndiyo inoita kuti nguva yako iuye nguva dzose, inenge mazuva makumi mana nerimwe.
Basa reHormone Kusarura
Kusawirirana kwehomoni kunokonzera endometrial hyperplasia isiri yakanyanya ye estrogen ku progesterone
Estrogen ndiyo hormone iyo inokonzera kukonzera kukwanisika kwekupedzisira kwe endometrium mukati mehafu yekutanga yekuenda kwako kumwedzi.
Kana uchienzanisa nehuwandu hwakakwana hweprogesterone yako endometrium inovaka asi zvino inopedza kwete kubvumira kukura kwechimwe kudarika. Asi kana pane chiyero chakawandisa chestrogen chigadziko chiri kupfuura chinokurudzirwa uye chinoramba chichiita. Penguva yakareba iyo iyo yakanyoroveswa midzi inotanga kukura kuchinja kusina kuitika.
Risk Factors
Mamiriro ezvinhu anoita kuti isrogen yakawandisa inogona kutungamirira kune endometrial hyperplasia inosanganisira:
Kuwedzera muviri
Mafuta anocheka anotendeuka mamwe mahomoni kune esrogen. Izvi zvinoguma kune esrogen yakawedzera iyo inokurudzira kubatana kwechiberekero kuwedzera kune yakakwana cyclic estrogen inogadzirwa nemaavo ako. Kana yako BMI inopfuura 35 iwe unowedzera dambudziko rekuwedzera endometrial hyperplasia kana uchienzanisa newe pane muviri wakakwana.
Anovulation
Ikoko kunogona kuva nezvikonzero zvakasiyana siyana nei iwe usingaiti. Kana iwe usingaiti kuti ovary yako iwedzere kuwedzera kubudiswa kwayo kweprogesterone. Iko kukura kweprogesterone kunofanirwa kuti chigadziko chechibereko chako chibudiswe. Mune mamwe mazwi, haungatori nguva yako. Mune dzimwe mhando dzehupenyu hunopisa, kushayikwa uku kwepumpeter muprogesterone kunobvumira kuti hama yakawandisa isrogen. Ichi chisina kukodzera isrogen chinoguma nekunyanya kusina kukwana kwe endometrium. Pakupedzisira, uchava nemhando yehutachiona hwehutachiona hunopa ropa. Zviratidzo zvekubuda ropa zvine rudzi urwu rwekuzodza zvinosanganisira nguva dzisina kukwana uye inorema kana kubuda ropa pakati penguva yako. Zvinokonzera zvinokonzerwa nemhando iyi yekusagadzikana kwehomoni zvinosanganisira:
Exogenous Hormones
Zviri pachena kuti kutora isrogen kushandiswa kuchawedzera maitiro ako esrogen maererano nehuwandu hweprogesterone yako.
Ndicho chikonzero kana iwe uchiri nechibereki iwe unotora humwe huwandu hweprogesin (progesterone) kudzivirira kuti endometrium yako isati yapfuura.
Imwe mishonga inokonzerwa nehomoni inogona kukonzera kuwedzera kusingagumi kwe endometrium ndiTamoxifen . Tamoxifen mishonga inonzi "selective" estrogen receptor modulator kana SERM. SERMs imishonga inobata maitiro eestrogen senhengo dzomuviri wako nenzira dzakasiyana. Tamoxifen inowanzoshandiswa mukurapa makondomu anokonzerwa nehommone-yekare nokuti inopesana nemigumisiro yewesrogen muhunhu. Zvisinei, Tamoxifen inokurudzira maestrogen eestrogen muchibato chechibereko kuitira kuti iite seestrogen uye inogona kukonzera endometrial hyperplasia.
Kana uri kushandisa hormone replacement therapy kana Tamoxifen uye iwe unokura uine muviri usina kuchena uine ropa rinokosha zvikuru kuti uone chiremba wako uye kuongororwa.
Estrogen inobvisa zvipembenene zvemaawa
Hormone inobereka zvipembenene haisi iyo inowanzokonzera ye endometrial hyperplasia. Zvisinei, kune dzimwe nguva zvipembenene zvinotapira mahara zvinokonzera kuwedzerwa isrogen.
Kuziva
Apo iwe ukaona chiremba wako nemakunyuro eusterin ropa risingakanganisiki iwe unogona kunge iwe uchanzwa bhiopsy yechipfuva chechibereko chako. Chiremba wako anogona kukurudzira kana hofisi ye-endometrial biopsy kana chirongwa chiduku chekuvhiya chinonzi hysteroscopy nechirwere kana sampling ye endometrium.
Endometrial biopsy
Iyi inowanzozivikanwa nehofisi-based gynecologic procedure. Kazhinji, zvakanyatsorambidzwa.
Mune tsika yangu, ndinoona kuti kutarisira uye kuzvidya mwoyo kwekuita iyo nzira yakanyanya kuipa kudarika iyo chaiyo inonzi biopsy. Kana iwe uchida kuva ne-endometrial biopsy, iyo pfungwa yakanaka kutora 600 mg yeIbuprofen uye uine zviduku zvishoma pamusoro peawa imwe isati yasvika. Iwe unogona kuda kuuya nekambani yemhepo inotonhora kana chikwata chako kuti ubatsirewo kuderedza kudzvinyirira munguva uye shure kwekuita. Chiremba wako angakwanisa kukupa imwe panguva panguva yebiopsy.
Iko yakagadzirirwa iyo biopsy yakafanana neyomuitiro wep smear. Mushure mekunge speculum inogadzirirwa chiremba wako achachenesa kubva pamuviri wako nemushonga unonyorovesa. Zvichida chiremba wako achazoisa gorosi kuti ubate chibereko chako muchigarire apo mudiki muduku aspirator akaiswa. Iwe unogona kunge uchinzwa kusagadzikana. Iwe haunganzwi chinhu chakaoma asi iwe uchange uine humwe hupombwe. Kuvhiringidzika kunogona kubva pane zvinyoro zvishoma zvinoputika kusvika kune zvakanyanyisa zvakafanana nekurwadziwa kwepakutanga. Nhau dzakanaka ndiyo nzira inokurumidza uye inowanzopedza pasi pemaminitsi mana. Kutora ibuprofen isati yasvika uye kushandisa shanduro inotonhora panguva yakarongeka chaizvo, inobatsira kuderedza marwadzo.
Hysteroscopy
Chiremba wako angaratidza kuti iwe ugove nechirwere chekunyengedzera uye sempometrial sampling panzvimbo yepopometric biopsy. Iri ndiro zuva rimwe chete rokuvhiya uye mune mamwe maitiro edzimai, rinoitwawo muhofisi pane nzvimbo yekushandisa. Kubatsirwa kwehutorioscopy ndeyekuti inobvumira chiremba wako kuti atarise zvakananga chidimbu chechibereko chinoita kuti zvikamu zvose zve endometrium zvive zvakakwana sampuli. Ikoko kunogona kuva nemamwe mamiriro ezvinhu apo chiremba wako angaratidza kuti izvi zvinowanzovhiringidza.
Endometrial hyperplasia haigoni kuongororwa nedzivo rekuongorora ropa kana ultrasound. Zvisinei, zvinogoneka kuti chiremba wako anogona kukurudzira dzimwe kuongorora ropa kuti atonge zvimwe zvinokonzera kusachena kwechiropa uterine. Zvinogona zvakare kuti chiremba wako anogona kuraira peclinal pelvic ultrasound kuti ibatsire pakuongorora kwechikonzero chekusava nekuropa kwako kwechiropa.
Endometrial hyperplasia inongogona kuongororwa mushure mekunge endometrium yako yakashandiswa uye ichiongororwa pasi pe microscope nehutachiona.
Aina
Apo muongorori anotarisa muenzaniso we endometrium yako pasi pe microscope vanotarisa zvakananga kuchinjwa mune zvikamu zviviri zvekupedzisira kwako, glands uye mhuka inotsigira inonzi stroma. Endometrial hyperplasia inoratidzwa apo pane majozi akawanda anowedzera kune stroma kupfuura iwe waungawana mune zvakakosha kupararira kana bhasikoro endometrium. Muongorori wezvirwere achazobva ataura pamusoro pekunge kune maasypical anoonekwa masero mune endometrium iyi isinganzwisisiki iyo inotungamirira kune zvikamu zviviri zve endometrial hyperplasia:
- Hyperplasia pasina atypia
- Atypical hyperplasia
Zvakakosha kuyeuka kuti endometrial hyperplasia haisi chirwere chemapetometrial asi inofungidzirwa sechinhu chisingatauriki. Ichokwadi, mune dzimwe mamiriro ekukosha eyypical hyperplasia, chikwata chekutanga chemapirisa chemapetometri inogona kunge yavapo.
Mishonga
Zvakakosha kuti zvose endometrial hyperplasia zvinyatsotevedzwa kana kurapwa.
Endometrial hyperplasia pasina atypia
Kana pasina masero emasikirini aripo, mukana wekupedzisira wemakemikari hyperplasia pakupedzisira kuva kenza yemapemetrase haigoneki. Icho humwe hunoratidza kuti chete 5% yevakadzi vane endometrial hyperplasia vasina atypia vachakura nekenza yemakemikari. Zvinogonawo kuti rudzi urwu rwemapetometrial hyperplasia ruchazvigadzirisa pacharo pane nguva.
Mutsara wokutanga wemishonga ndeyekutsvaga njodzi dzinoshandiswa.
Semuenzaniso, kana iwe uri kunyanya kuwandisa kana kuora, kuora muviri kunobatsira kuderedza kuwedzera kwestrogen yakagadzirwa nemafuta masero. Izvi zvinobvumira kubatana kwechibereko chako kuti chigadzirise zvakare. Saizvozvowo, kana uri kutora hormone replacement therapy chiremba wako angave achida kugadzirisa dose yako kana kukurudzira kuti urege kuishandisa.
Chiremba wako anogona kukurudzira kushandisa progestin marapirwo ekudzivirira kuwedzera kwehutano hweweserogen yakawandisa pane endometrium yako. Zvikonzero zviremba wako angaratidza kuti anokubata neprogesterone zvinosanganisira:
- Kucherechedza uye mararamiro ehupenyu hazvina kushanda
- Iwe unenge uine uwandine husingawanisi kubuda ropa
- Iwe unoda chibereko chinokurumidza
Mhando mbiri dze progesterone dzakagadzirirwa kurapwa kwe endometrial hyperplasia pasina atypia inotaura progesterone kana progesterone-ine IUD. Icho uchapupu hunoshandisa kushandisa levonorgestrel IUD ( Mirena ). Kana iwe wakanyanyisa neBMI> 35 zvinowanzoita kuti mushonga weprogesterone usashanda zvakanaka kunze kwekuti iwe unoremawo. Iwe unofanirwa kukurukura nachiremba wako rudzi rwepi yeprogesterone kurapa yakakunakira iwe.
Kunyangwe iwe wakasarudza kuongorora kana kurapa neprogesterone iwe uchafanirwa kuteverwa pedyo nepakati pemapurogiramu endometrial kuti uve nechokwadi chokuti endometrial hyperplasia yaenda uye haidzoki.
Nyanzvi dzinotaura kuti hysterectomy haifaniri kupiwa semutambo wokutanga mushonga wekugadzirisa endometrial hyperplasia pasina atypia nekuda kwehuwandu hwehutano hweprogesterone kurapwa uye pangozi yakaderera yekudzidzira kenza yemapendometri. Zvisinei, nyanzvi dzinobvumirana kuti kune mamwe mamiriro ezvinhu umo hysterectomy inogona kuva yakakodzera kurapwa chisarudzo kune vakadzi vanoitwa vane vana. Chiremba wako anogona kukurudzira hysterectomy kana:
- Panguva yekutevera, unokura atypical hyperplasia
- Iyo hyperplasia haina kuvandudza mushure memwedzi 12 yeprogesterone yekurapa
- Iwe uri kuita ropa rinoshamisa risingaiti
- Iwe unowedzera endometrial hyperplasia zvakare mushure mokunge wapora kurapwa zvakanaka
- Iwe hausi kuda kudzokorora zvinonzi biometric endometrial inodiwa neprogesterone.
Endometrial hyperplasia ne atypia
Pane njodzi yakawanda zvikuru yekuve nekenza yemapendometri kana iwe uine hyperplasia neatypia Kutungamirirwa kwakanyanya kurwisana nekuda kwechiitiko ichi chakawedzerwa. Ichokwadi, iyo nyanzvi dzinokurudzira hysterectomy seyokutanga kurapwa kwemaatypical hyperplasia kuvakadzi vanoitwa vane vana.
Kana iwe wakamboonekwa kuti une atypical hyperplasia uye uchiri kuronga kuedza kuve nepamuviri iwe unogona kutarisirwa neprogesterone, zvichida ne levonorgestrel IUD.
Iwe uchange uine nguva yakawanda yekugadzirisa shanduro yekugadzirira kuti uone kuti iyo yenyuchi inonzi hyperplasia yakarapwa zvakakwana. Chiremba wako angangokuratidza kuti unoona nyanzvi yekubereka uye kupedzisa kubereka kwako nekukurumidza sezvaungagona. Zvichida kuti chiremba wako acharatidza kuva ne hysterectomy mushure mekunge maitwa kuva nevana nekuda kwekanhu hukuru hwekudzoka kweeatypical endometrial hyperplasia.
Nemhaka yokuti uterine ropa rinowanzova chiratidzo chinonyanya kukosha kuti iwe unogona kuva ne-endometrial hyperplasia, zvinokosha kuona chiremba wako achikurukurirana kuchinja uku mukubuda ropa kwako. Chiremba wako anogona kusarudza kana kuwedzerwa kuongororwa uye kuongororwa kunokosha.
Sources:
Gallos, ID., Et al, 2016.BGSE / RCOG Joint Guideline: Kutungamirirwa kweEndometrial Hyperplasia. [Online] London: BGSE / RCOG. Inowanika pa https://www.rcog.org.uk/en/guidelines-research-services/guidelines/gtg67/