Cervical dysplasia - ua rau, tsos mob, kho thiab qib 1, 2 thiab 3 ntawm ncauj tsev menyuam dysplasia

Cov txheej txheem:

Cervical dysplasia - ua rau, tsos mob, kho thiab qib 1, 2 thiab 3 ntawm ncauj tsev menyuam dysplasia
Cervical dysplasia - ua rau, tsos mob, kho thiab qib 1, 2 thiab 3 ntawm ncauj tsev menyuam dysplasia
Anonim

cervical dysplasia yog dab tsi?

Cervical dysplasia (cervical dysplasia) yog ib yam mob ntawm cov epithelium uas npog lub ncauj tsev menyuam, uas yog tus cwj pwm los ntawm kev hloov pauv ntawm cov txheej txheem thiab cov qauv ntawm cov hlwb uas tsim nws. Nyob rau tib lub sijhawm, hauv qab daus daim nyias nyias thiab cov khaubncaws sab nraud povtseg sab saud tsis koom nrog hauv cov txheej txheem. Dysplasia yog hais txog cov kab mob uas, nyob rau hauv qee qhov xwm txheej, tuaj yeem ua rau kev loj hlob ntawm qog nqaij hlav ntawm lub ncauj tsev menyuam.

Cervical dysplasia yog ib qho kev phom sij heev thiab feem ntau cov kab mob precancerous uas hloov cov qauv ntawm cov mucous membrane ntawm lub ncauj tsev menyuam thiab qhov chaw mos. Dysplasia tuaj yeem muaj qhov sib txawv, tab sis nws yeej ib txwm nrog los ntawm kev ua txhaum ntawm cov qauv cellular ntawm lub epithelium. Nws cuam tshuam tsis tsuas yog cov khaubncaws sab nraud povtseg, tab sis tuaj yeem nkag mus tob dua.

Feem ntau cervical dysplasia hu ua erosion, tab sis lo lus no tsis qhia tag nrho cov ntsiab lus ntawm qhov tshwm sim. Qhov sib txawv tseem ceeb ntawm ob txoj kev no yog tias kev yaig tshwm sim vim kev puas tsuaj rau cov ntaub so ntswg, thiab dysplasia yog tus cwj pwm los ntawm kev ua txhaum ntawm cellular qauv ntawm cov ntaub so ntswg.

Nyob ntawm qhov tob ntawm qhov txhab ntawm lub ncauj tsev menyuam ntawm lub ncauj tsev menyuam, faib:

ncauj tsev menyuam dysplasia
ncauj tsev menyuam dysplasia
  • tsis muaj zog qhia (mob) daim ntawv ntawm dysplasia (txog li ib feem peb ntawm cov tuab ntawm cov txheej ntawm squamous epithelium raug cuam tshuam; cov hlwb ntawm cov txheej nruab nrab yuav o);
  • qhia tawm nruab nrab (nruab nrab) daim ntawv ntawm dysplasia (cuam tshuam los ntawm ib feem peb mus rau ob feem peb ntawm cov tuab; polarity ntawm qhov chaw ntawm lub epithelium cuam tshuam);
  • nthuav tawm (mob) daim ntawv ntawm dysplasia (tag nrho cov txheej txheem ntawm epithelium raug cuam tshuam).

Txhua xyoo ib ncig ntawm 40 lab tus poj niam thoob ntiaj teb tau kuaj pom lossis kuaj pom tus mob ncauj tsev menyuam thawj zaug. Tus kab mob no suav txog kwv yees li 15-18% ntawm cov neeg mob uas tau txheeb pom pathologies ntawm lub ncauj tsev menyuam. Nws yog ib qho tseem ceeb rau cov poj niam hauv lub hnub nyoog yug me nyuam ntawm 34-35 xyoo. Qhov nruab nrab ntawm kev hloov pauv ntawm cov ntaub ntawv hnyav ntawm ncauj tsev menyuam dysplasia mus rau mob qog noj ntshav yog kwv yees li 10-30% raws li ntau yam kev tshawb fawb.

Cov neeg mob feem ntau, tsis nkag siab qhov tseem ceeb ntawm cov txheej txheem pathological, ua rau lub ncauj tsev menyuam tsis meej pem nrog kev yaig lossis mob qog noj ntshav. Ob nqe lus tsis raug. Txhawm rau kom nkag siab qhov txawv yog dab tsi, koj yuav tsum tig mus rau lub cev.

Dysplasia los ntawm tus kws kho mob qhov kev xav

Dysplasia los ntawm tus kws kho mob qhov kev xav
Dysplasia los ntawm tus kws kho mob qhov kev xav

Lub ncauj tsev menyuam yog thaj tsam ntawm qhov chaw mos thiab lub tsev menyuam nws tus kheej. Nws muaj 3 hom ntaub:

  • epithelial;
  • muscular;
  • kev sib tw.

Ib yam ntawm nws cov epithelium yog tias nws yog heterogeneous hauv nws cov qauv. Lub ncauj tsev menyuam yog lub rooj sib tham ntawm 2 hom integumentary epithelium: cylindrical, cov hlwb uas nyob hauv ib txheej, muaj cov duab plaub thiab kab ntawm lub tsev menyuam kab noj hniav thiab cov kwj dej ntawm ncauj tsev menyuam, thiab stratified squamous, yam ntxwv ntawm qhov chaw mos thiab sawv cev. los ntawm ob peb kab ntawm flattened hlwb. Ob qho tib si epithelium yog nyob rau ntawm nyias hauv qab daim nyias nyias, muaj cov collagen fibers thiab ua si lub luag hauj lwm ntawm lub hauv paus ruaj khov thiab limiter.

Nws yog qhov tseeb vim yog cov qauv ntawm lub ncauj tsev menyuam uas muaj ntau yam txheej txheem pathological feem ntau tshwm sim hauv cheeb tsam no cuam tshuam nrog kev hloov pauv ntawm cov yam ntxwv ntawm tes.

Qhov tseem ceeb tshaj plaws yog:

  • Erosion yog qhov hloov chaw ntawm lub cylindrical epithelium mus rau qhov chaw mos. Cov qauv, kev ua haujlwm, cov yam ntxwv ntawm kev loj hlob ntawm tes tsis raug ua txhaum cai. Vim qhov sib txawv ntawm cov kab mob hauv lub ncauj tsev menyuam thiab hauv qhov chaw mos, cylindrical cells raug puas tsuaj los ntawm ib puag ncig acidic, cov khoom pov tseg ntawm cov microflora ntawm tus poj niam qhov chaw mos, kev raug mob thaum muaj kev sib deev, tsim cov qhov txhab tsis zoo - yaig. Thaum lub sij hawm kuaj gynecological ntawm lub rooj zaum, nws zoo li ib thaj ntawm cov nplua nuj liab ntawm cov xim liab liab.
  • Cervical Cancer yog txheej txheem ntawm kev hloov cov qauv, kev ua haujlwm ntawm cov hlwb epithelial, uas tau txais lub peev xwm loj hlob tsis muaj kev txwv. Yog hais tias lub overgrown hlwb tsis tau dhau mus rau hauv qab daus daim nyias nyias, ces lawv hais txog "mob cancer nyob rau hauv situ" (CIS carcinoma nyob rau hauv situ), nws yog thawj theem nyob rau hauv kev loj hlob ntawm malignant neoplasms ntawm tej yam hauv nruab nrog cev. Yog hais tias cov qog nqaij hlav cancer tau loj hlob los ntawm lub hauv paus hauv qab, ces los ntawm kev kho mob ntawm qhov pom, peb tab tom tham txog kev mob qog noj ntshav (qhov no yog mob qog noj ntshav hauv tus neeg mob lub siab).
  • Dysplasia yog ib qho kev hloov pauv ntawm cov qauv ntawm cov stratified squamous epithelium uas npog lub ncauj tsev menyuam, thaum cov hlwb uas muaj "hnyav" zoo li ntawm lub nucleus tshwm sim hauv nws, ntau lub nucleated, tsis xwm yeem hauv cov duab, anatomical faib rau hauv cov khaubncaws sab nraud povtseg poob. Txawm li cas los xij, cov hlwb hloov pauv tsis muaj peev xwm loj hlob tsis tu ncua thiab tsis nkag mus rau hauv qab ntawm daim nyias nyias. Lub cylindrical epithelium nyob rau hauv qhov chaw hloov pauv ntawm lub ncauj tsev menyuam tseem tsis hloov pauv.

Cov tshuaj niaj hnub tsis tau siv lo lus "dysplasia" rau lub sijhawm ntev, tsis yog nws, ob qho tib si hauv kev kuaj mob thiab hauv cov ntaub ntawv tshawb fawb, koj tuaj yeem pom cov ntsiab lus hauv qab no: cervical intraepithelial neoplasia (CIN, lossis CIN), uas txhais tau hais tias tsim cov cellular tshiab uas tsis yog yam ntxwv ntawm cov ntaub so ntswg cervical epithelium.

Ua rau ncauj tsev menyuam dysplasia

Ua rau cervical dysplasia
Ua rau cervical dysplasia

Cov tsos mob ntawm ncauj tsev menyuam dysplasia, zoo li lwm yam kab mob precancerous, tsis tshwm sim los ntawm ib qho ntawm ib qho. Nws yog ib txwm ua ke ntawm ntau yam provoking Cheebtsam.

Lub ntsiab yog vim li cas rau kev tsim ntawm foci ntawm dysplasia yog:

  • kis nrog qee yam ntawm tib neeg papillomavirus (HPV);
  • tshuaj tiv thaiv kab mob hormonal rau kev siv mus ntev (txij li 5 xyoos);
  • pib pib ntawm kev sib deev (14-15 xyoos);
  • coob tus neeg sib deev;
  • tus cwj pwm phem (smoking).

Tsis tas li, lawv lub luag haujlwm hauv kev txhim kho cov txheej txheem dysplastic tuaj yeem muaj:

  • noj zaub mov tsis muaj vitamin C, A;
  • kev tiv thaiv tsis zoo;
  • caj ces predisposition rau ib qho mob qog noj ntshav;
  • kab mob sib deev;
  • kev kawm qis, lub neej, kev coj cwj pwm tsis zoo;
  • ntau tus yug.

Qhov kev tshawb pom ntawm lub luag haujlwm tseem ceeb ntawm tus kab mob HPV hauv kev txhim kho dysplasia thiab qog nqaij hlav qog nqaij hlav yog qhov ua tiav hauv kev txhim kho txoj hauv kev zoo los tawm tsam mob qog noj ntshav ntawm poj niam cev xeeb tub.

Viral factor

Cervical dysplasia feem ntau tshwm sim los ntawm tib neeg papillomavirus (HPV). Tus kab mob no feem ntau yog asymptomatic, txij thaum pib ntawm dysplasia mus rau qhov pib mob qog noj ntshav, feem ntau nws yuav siv li 10 xyoo.

Kev kis tus kab mob tib neeg papillomavirus tuaj yeem tshwm sim hauv txhua tus, tab sis cov poj niam uas muaj kev sib deev thiab muaj ntau tus neeg koom nrog kev sib deev muaj kev pheej hmoo. Kev tsis saib xyuas kev tiv thaiv kab mob thiab kev kho mob tsis zoo ntawm cov kab mob ntawm cov kab mob hauv lub cev xeeb tub kuj ua rau muaj feem kis tau tus kab mob HPV. Kev raug mob rau lub ncauj tsev menyuam kuj tuaj yeem tshwm sim vim kev rho menyuam lossis yug me nyuam.

Muaj ntau hom kab mob HPV, txhua tus tuaj yeem ua rau muaj qhov mob tshwm sim. Piv txwv li: kab mob sib kis ntawm caj npab thiab txhais ceg, kab mob hauv qhov chaw mos; dysplasia thiab mob qog noj ntshav.

Raws li qib ntawm oncological "kev phom sij", txhua hom HPV tuaj yeem muab faib ua 3 pawg:

  • Non-oncogenic thiab tsis tshua muaj kev pheej hmoo muaj nyob rau hauv cov pob qij txha thiab qhov chaw mos, cov no yog hom 1, 2, 3, 5, 6, 11, 42, 43, 44.
  • Tsawg tus kab mob oncogenic. Cov kab mob uas muaj cov kab mob oncogenic heev muaj nyob rau hauv 90% ntawm tag nrho cov mob dysplasia thiab malignant neoplasms ntawm lub ncauj tsev menyuam. 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68 hom.
  • High oncogenic txaus ntshai. Tshwj xeeb yog nruj heev ntawm lawv yog 16 thiab 18, uas muaj ntau dua li lwm tus thiab ua rau muaj kev mob qog noj ntshav hauv tsev menyuam hauv ib nrab ntawm cov neeg mob.

HPV ua li cas hloov cellular?

HPV
HPV

Nyob hauv lub cev noj qab haus huv, txhua lub cell puas raug puas tsuaj tam sim ntawd los ntawm lub cev tiv thaiv kab mob thiab cov tshuaj tiv thaiv kab mob hauv lub cev uas tsis tso cai rau nws nkag mus rau hauv cov txheej txheem ntawm kev faib tawm thiab tsim cov hlwb zoo sib xws. Tsis tas li ntawd, tus naj npawb ntawm kev faib tawm ntawm txhua hom cell yog nruj me ntsis txwv los ntawm txoj haujlwm genetic program. Qhov no txiav txim siab cov txheej txheem kev laus hauv lub cev, nrog rau txhua qhov kev ntshaw ib tus neeg tsis tuaj yeem nyob mus ib txhis.

Thaum tus kab mob HPV, uas muaj kev ua haujlwm oncogenic siab, nkag mus rau hauv lub cev, nws nqa los ntawm cov ntshav mus rau qhov chaw mos thiab nkag mus rau hauv cov hlwb ntawm lub ncauj tsev menyuam squamous epithelium. Cov kab mob kis tau tsim cov protein tshwj xeeb uas thaiv "kev ruaj ntseg" ntawm cov cell epithelial thiab puas DNA. Raws li qhov tshwm sim, cov hlwb atypical raug tsim uas tsis tuag, tsis raug tshem tawm los ntawm lub cev tiv thaiv kab mob, lawv muaj peev xwm faib thiab rov tsim cov qauv "tsis txawv txav" rau lawv tus kheej. Yog li, muaj kev hloov pauv ntawm cov txheej txheem ntawm cov txheej txheem ntawm cov epithelium ntawm lub ncauj tsev menyuam, uas nyob rau hauv kev tsom xam txhais tau tias yog cervical intraepithelial neoplasia (CIN, los yog CIN). Txawm li cas los xij, hauv dysplasia, tsis zoo li mob qog noj ntshav, cov hlwb atypical tsis muaj cov cuab yeej ntawm kev loj hlob tsis muaj kev txwv.

siv tshuaj tiv thaiv

Cov txiaj ntsig ntawm kev siv ntev ntev ntawm kev siv tshuaj tiv thaiv kab mob hauv qhov ncauj (COCs) ntawm qhov tshwm sim ntawm cov txheej txheem dysplastic hauv lub ncauj tsev menyuam tau raug kawm zoo.

Muaj 2 qhov cuam tshuam sib cais (COCs) hauv qhov no:

  • indirect;
  • ncig.

Qhov cuam tshuam tsis ncaj yog cov poj niam uas niaj hnub noj COCs, feem ntau cov tub ntxhais hluas hnub nyoog 20-40 xyoo, muaj kev sib deev, feem ntau hloov cov neeg sib deev, lawv raug mob venereal ntau dua li lwm tus hauv cov pejxeem, lawv haus luam yeeb. Kev sib xyaw ua ke ntawm cov xwm txheej no ua rau muaj kev pheej hmoo ntawm kev tsim cov txheej txheem dysplastic hauv lub ncauj tsev menyuam.

Lub tshuab ntawm cov txiaj ntsig ncaj qha tsis nkag siab tag nrho, txawm li cas los xij, raws li cov ntaub ntawv txheeb cais, nws tau txiav txim siab tias kev siv COCs mus ntev (5 xyoos lossis ntau dua) ua rau muaj kev pheej hmoo ntawm kev tsim cov ncauj tsev menyuam los ntawm yuav luag 2 zaug..

Cov poj niam uas siv cov tshuaj progestin (cov tshuaj tiv thaiv kev yug menyuam rau cov poj niam cev xeeb tub) rau kev tiv thaiv tsis poob rau hauv cov kev pheej hmoo, vim tias hom kev tiv thaiv kab mob no tsis cuam tshuam rau lub ncauj tsev menyuam epithelium. Tib yam siv rau cov poj niam cev xeeb tub lossis zes qe menyuam tshem tawm cov poj niam uas tau txais kev kho tshuaj hormone hloov, qhov kev pheej hmoo ntawm kev tsim cov txheej txheem dysplastic hauv lawv tsis nce.

Lwm yam yog vim li cas

Qhov ua rau ntawm ncauj tsev menyuam dysplasia tuaj yeem yog ob qho tib si kev ua neej tsis zoo thiab tus cwj pwm tsis zoo (tshwj xeeb yog haus luam yeeb), vim txo qis kev tiv thaiv thiab hypoxia ua rau muaj qhov tshwm sim ntawm microtrauma ntawm lub ncauj tsev menyuam epithelium.

Lwm yam, xws li kev sib deev thaum ntxov, ntau tus neeg koom nrog kev sib deev, kev sib raug zoo tsis zoo - tag nrho cov ntawm lawv muaj feem cuam tshuam ncaj qha rau kev kis tus kab mob no ntawm cov poj niam uas muaj ntau hom HPV.

Tsis muaj cov vitamins A thiab C, kev tiv thaiv kab mob hauv lub cev, caj ces predisposition ua rau muaj kev ua txhaum ntawm lub cev tiv thaiv kab mob thiab ua tsis tiav hauv qhov kev pab cuam rau kev puas tsuaj ntawm cov cellular cov ntsiab lus, uas tseem txhawb kev tsim cov txheej txheem dysplastic.

Feem ntau, kev txhim kho ntawm ncauj tsev menyuam dysplasia tuaj yeem piav qhia siv txoj kev xav ntawm "cov nyom", uas tau npaj rau xyoo 1995 los ntawm tus xibfwb ntawm University of California, tus kws kho menyuam yaus Michael Policar (Michael Policar). Nyob rau hauv nws lub tswv yim, lub ncauj tsev menyuam epithelium yog cov av uas "cov noob" ntawm cellular hloov nyob rau hauv daim ntawv ntawm HPV lub caij nplooj zeeg, txawm li cas los, nyob rau hauv thiaj li yuav germinate, "dej, teeb, tshav kub" yog xav tau, lub luag hauj lwm ntawm uas yog ua si. los ntawm lwm yam hauv kev txhim kho cov txheej txheem dysplastic - haus luam yeeb, txo kev tiv thaiv, beriberi, caj ces predisposition. Yog tsis muaj lawv, txawm tias muaj HPV, kev loj hlob ntawm ncauj tsev menyuam dysplasia tsis tshwm sim.

Tam sim no, nws tseem tsis tau lees paub qhov kev tshawb xav no hauv chaw kho mob thiab kuaj. Txawm li cas los xij, kev sib xyaw ntawm HPV nrog rau lwm yam kev pheej hmoo ntawm cov poj niam feem ntau txhawb qhov kev xav ntawm kev tshawb fawb no.

Cov tsos mob ntawm ncauj tsev menyuam dysplasia

Cov tsos mob ntawm cervical dysplasia
Cov tsos mob ntawm cervical dysplasia

Nyob rau hauv thawj daim ntawv, tus kab mob no feem ntau asymptomatic. Tus kab mob no tshwm sim nws tus kheej nkaus xwb nyob rau hauv cov kev mob siab heev: ib tug poj niam muaj mob nyob rau hauv lub plab mog, tej zaum yuav muaj me me los ntawm qhov chaw mos. Txhawm rau zam qhov no thiab pib kho raws sijhawm, nws yog ib qho tsim nyog yuav tsum tau kuaj xyuas gynecological tsis tu ncua, uas suav nrog kev ntsuas ntsuas, kuaj thiab kev tshawb fawb soj ntsuam.

Cov tsos mob ntawm dysplasia tsuas yog kuaj tau yog tias cov tsos mob nrog rau lwm yam kab mob. Raws li gynecologists, feem ntau, nyob rau hauv lub xub ntiag ntawm cervical dysplasia, muaj erosion ntawm lub ncauj tsev menyuam. Yog li, tus kws kho mob muaj peev xwm yuav xa tus neeg mob mus rau PAP tsom xam (SMEAR) yog tias nws tau yaig.

Cov tsos mob ntawm dysplasia tuaj yeem yog:

  • plentiful leucorrhoea yam tsis muaj ntxhiab tsw ntxhiab, milky dawb;
  • txoj ntshav tawm hauv qhov chaw mos tom qab kev sib raug zoo;
  • mob thaum sib deev.

Ib zaug ntxiv, cov tsos mob no tsis yog tshwj xeeb rau lub ncauj tsev menyuam dysplasia, siv tsis tau rau kev kuaj mob, tab sis tsuas yog ceeb toom rau tus poj niam tias nws tus poj niam noj qab haus huv xav tau kev kuaj xyuas kom zoo.

Degrees of dysplasia

Nyob ntawm seb qhov ncauj tsev menyuam tau cuam tshuam li cas, muaj 3 degrees ntawm ncauj tsev menyuam dysplasia:

  • 1 degree (tsis muaj zog);
  • 2 degree (nruab nrab);
  • 3 degree hnyav.

Yog tias peb xav txog ib ntu ntawm lub epithelium nyob rau hauv daim ntawv ntawm ib daim duab plaub, sab qis ntawm uas yog lub hauv paus daim nyias nyias, thiab sab sauv yog kab kab ntawm cov hlwb, ces txawv degrees ntawm dysplasia yuav zoo li no..

Cervical Dysplasia Qib 1 (Mild)

Hauv cov ntaub ntawv kho mob (cov txiaj ntsig kuaj lossis tso tawm), nws raug xaiv raws li hauv qab no: CIN I (cervical intraepithelial neoplasia I). Nws tau muab tso rau yog tias tsuas yog qis dua 1/3 ntawm cov txheej txheem epithelial uas nyob ib sab rau hauv qab daus daim nyias nyias tau hloov pauv pathological.

Cervical Dysplasia Qib 2 (Moderate)

Kev kuaj mob raws li CIN II (cervical intraepithelial neoplasia II). Nws yog tsim los thaum cov txheej txheem pathological kis mus rau 2/3 ntawm qhov tob ntawm lub epithelium, thaum lub sab sauv 1/3 tseem tsis cuam tshuam.

Cervical Dysplasia Qib 3 (Severe)

Denoted as CIN III (cervical intraepithelial neoplasia III). Nws yog hom mob hnyav tshaj plaws ntawm ncauj tsev menyuam dysplasia, thaum cov qauv ntawm txhua txheej ntawm lub epithelium cuam tshuam. Qhov kev kawm no yog ib txoj kab zoo ntawm dysplasia per se thiab thawj theem ntawm mob qog noj ntshav ("cancer in situ", lossis carcinoma in situ). Txawm li cas los xij, lub hauv paus membrane tsis nyob twj ywm. Txhua qhov sib txawv tsuas yog nyob rau hauv kev ua haujlwm ntawm cov hlwb, uas tau txais lub peev xwm los faib ua ntu zus. Kev kuaj mob histological tuaj yeem pab tsim kom muaj qhov hnyav ntawm cov txheej txheem pathological.

Qhov tshwm sim ntawm cervical dysplasia

Qhov tshwm sim ntawm cervical dysplasia
Qhov tshwm sim ntawm cervical dysplasia

Dab tsi tuaj yeem hem tus poj niam uas muaj lub ncauj tsev menyuam ncaj qha nyob ntawm nws qib:

1 degree

Cervical dysplasia ntawm qib 1 hauv 57% ntawm cov neeg mob daws nws tus kheej tom qab tshem tawm tus kab mob ntawm tus poj niam lub cev. Hauv ib tus neeg noj qab haus huv, hauv 9 kis ntawm 10, tus kab mob no tsis tuaj yeem kuaj pom hauv cov ntshav tom qab rau lub hlis lossis ib xyoos txij li lub sijhawm nws nkag mus rau hauv lub cev. Muaj kev ywj pheej ntawm kev puas tsuaj ntawm cov kab mob los ntawm lub cev tiv thaiv kab mob.

Hauv 32% ntawm cov neeg mob, muaj cov kab mob ntev ntev uas tsis muaj kev vam meej, txawm tias qhov phem lossis qhov zoo dua. Hauv 11% ntawm cov neeg mob, muaj kev hloov pauv ntawm 1 degree mus rau qhov thib ob.

2 degree

Cervical dysplasia ntawm 2nd degree hauv 43% ntawm cov neeg mob kuj ploj mus ntawm nws tus kheej tom qab tso tawm ntawm lub cev los ntawm HPV. Hauv 35%, nws cov chav kawm ruaj khov mus ntev tau pom. Yog li, 70% ntawm cov poj niam rov zoo nyob rau hauv 2 xyoos ntawm kev kuaj mob.

Hauv 22% ntawm cov poj niam mob, qib 2 dysplasia nce mus rau qib 3.

3 degree

Raws li kev tshawb fawb tau ua los ntawm ntau pawg ntawm cov poj niam, qhov tshwm sim ntawm kev tig 3 degrees ntawm ncauj tsev menyuam dysplasia rau hauv mob qog noj ntshav yog 10-30%. Yog vim li cas rau qhov kev tawg ntawm cov txiaj ntsig no yog qhov muaj ntau tus neeg muaj feem cuam tshuam rau ntau pawg ntawm cov poj niam (los ntawm hnub nyoog, txoj kev siv tshuaj tiv thaiv kab mob, tus cwj pwm phem, kev ua neej, tus lej ntawm kev sib deev).

Cervical dysplasia thiab cev xeeb tub

Cervical dysplasia thiab cev xeeb tub
Cervical dysplasia thiab cev xeeb tub

Cervical dysplasia tsis yog ib qho contraindication rau cev xeeb tub hauv cov poj niam uas tau kuaj pom thawj zaug thaum cev xeeb tub. Lub xub ntiag ntawm cov txheej txheem pathological no tsis cuam tshuam rau kev loj hlob ntawm tus menyuam hauv plab, tsis cuam tshuam kev ua haujlwm ntawm placenta. Nyob rau tib lub sijhawm, cev xeeb tub nws tus kheej tsis nyob rau hauv ib txoj kev cuam tshuam rau ncauj tsev menyuam dysplasia, tsis ua rau nws txoj kev kawm thiab tsis ua rau muaj kev hloov pauv mus rau qhov hnyav dua.

Tsis tas li ntawd, nyob rau hauv kev cuam tshuam ntawm cov tshuaj hormones hloov pauv hauv cov poj niam cev xeeb tub, kev hloov pauv ntawm lub cev tuaj yeem txhim kho ntawm lub ncauj tsev menyuam uas tuaj yeem ua yuam kev rau lub ncauj tsev menyuam dysplasia. Peb tab tom tham txog ectrapion (pseudo-erosion), nyob rau hauv uas lub hlwb cov yam ntxwv ntawm lub ncauj tsev menyuam kwj dej tau hloov mus rau qhov chaw mos. Ntawm kev kuaj xyuas, tus mob no raug txheeb xyuas tias yog liab corolla ntawm lub ncauj tsev menyuam.

Yog li ntawd, yog tias tus poj niam tau kuaj 1-3 xyoos ua ntej cev xeeb tub thiab muaj qhov tsis zoo ntawm kev tshuaj ntsuam cytological, ces tsis muaj kev tswj thib ob.

Yog hais tias tus poj niam cev xeeb tub tsis tau raug kuaj los ntawm HPV carriage lossis rau cov hlwb atypical, tom qab ntawd thaum muaj kev hloov pauv thawj zaug ntawm lub ncauj tsev menyuam, kev smear raug coj mus rau Papanicolaou txoj kev tshawb fawb (smear-test) txhua lub sijhawm.

Txoj kev tawm tsam ntxiv nyob ntawm qhov tshwm sim. Yog tias nws tsis zoo, ces tsis muaj kev nqis tes ua ntxiv thiab kev tswj hwm tau muab 12 lub hlis tom qab xa khoom. Yog tias qhov kev kuaj pom tau zoo thiab pom muaj qhov me me ntawm dysplasia, tom qab ntawd kuaj colposcopy thiab tswj tau ua 12 lub hlis tom qab yug me nyuam.

Rau qhov nruab nrab ntawm lub ncauj tsev menyuam dysplasia, colposcopy thiab rov kuaj xyuas tom qab yug menyuam.

Yog xav tias qib 3 dysplasia yog qhov xav tias, ib qho kev kuaj mob qog nqaij hlav - noj ib daim ntawm cov ntaub so ntswg hloov pauv rau kev tshuaj xyuas. Yog tias qhov mob dysplasia hnyav heev, yuav tsum tau ua colposcopy txhua 3 lub hlis mus txog rau thaum yug thiab thawj 1.5 lub hlis txij li lub sijhawm yug menyuam.

Thaum kuaj pom mob qog noj ntshav, kev tswj xyuas ntxiv ntawm tus neeg mob tau pom zoo nrog tus kws kho mob oncologist thiab nyob ntawm qhov xwm txheej tshwj xeeb.

Kev kuaj mob ntawm ncauj tsev menyuam dysplasia

Kev kuaj mob ntawm ncauj tsev menyuam dysplasia
Kev kuaj mob ntawm ncauj tsev menyuam dysplasia

Vim tias dysplasia tuaj yeem hloov mus ua mob qog noj ntshav raws li ntau yam mob, qhov tseem ceeb tshaj plaws hauv kev tiv thaiv cov teeb meem yog nws qhov kev kuaj mob ntxov. Txhua tus poj niam uas muaj hnub nyoog 21 xyoos uas muaj kev sib deev yuav tsum tau mus ntsib kws kho mob gynecologist ib xyoos ib zaug rau kev kuaj thiab kuaj cytological ib zaug txhua 3 xyoos.

Cov hauv qab no yog siv los kuaj tus kab mob no:

  • tshuaj ntsuam;
  • cytological smear (Papanicolaou, lossis smear-test);
  • colposcopy;
  • tissue sampling (targeted biopsy).

Thaum saib hauv daim iav, thaj chaw ntawm dysplasia zoo li qhov chaw tsis zoo (plaques) ntawm cov xim dawb. Thaum ua tiav qhov kev xeem Schiller - staining lub ncauj tsev menyuam epithelium nrog Lugol cov tshuaj - txiav txim siab tsis sib xws. Cov cheeb tsam ntawm dysplasia tseem sib zog dua li cov ntaub so ntswg noj qab haus huv.

Kev kuaj mob cytological tuaj yeem txiav txim siab qhov muaj ntawm ncauj tsev menyuam dysplasia nrog qhov tseeb ntawm 60-90%. Qhov rhiab heev ntawm txoj kev nce raws li qib ntawm dysplasia nce.

Colposcopy yog ib qho cuab yeej siv tshuaj ntsuam xyuas qhov chaw mos ntawm lub ncauj tsev menyuam nrog lub cuab yeej tshwj xeeb - colposcope. Ntawm kev kuaj xyuas, cov hlab ntsha tsis raug nyob hauv thaj tsam ntawm dysplasia, mosaicism, thiab xim daj ntseg ntawm cov hloov pauv epithelium yuav pom. Thaum kho lub ncauj tsev menyuam nrog cov tshuaj acetic acid, cov chaw hloov pauv yuav dawb.

Nws yuav tsum nco ntsoov tias tsis muaj ib txoj hauv kev no tuaj yeem sib txawv dysplasia hnyav los ntawm mob qog noj ntshav. Qhov no tsuas yog ua tau nrog kev pab los ntawm kev kuaj histological ntawm ib daim ntawm epithelium. Txoj kev uas qhov no ua tiav yog hu ua lub hom phiaj biopsy nrog curettage ntawm lub ncauj tsev menyuam kwj dej. Cov ntaub so ntswg tau txais los ntawm cov txheej txheem yog ua tib zoo kawm. Txoj kev no yog 100% tseeb.

Kev kho mob ntawm ncauj tsev menyuam dysplasia

Kev kho mob ntawm ncauj tsev menyuam dysplasia
Kev kho mob ntawm ncauj tsev menyuam dysplasia

Ua ntej kho lub ncauj tsev menyuam dysplasia, tus kws kho mob kuaj pom thiab tshem tawm nws qhov ua rau (hormonal disorders, kab mob lossis o). Qhov no yuav tsum txwv tsis pub txoj kev loj hlob ntawm dysplasia nyob rau hauv cov ntaub ntawv undeveloped thiab ua rau cov ntaub so ntswg caws pliav. Hauv cov xwm txheej sib txawv, cov neeg mob tau pom zoo rau kev kho mob phais.

Ib txoj hauv kev kho dysplasia yog ib qho hluav taws xob, uas yog siv los tshem tawm cov ntaub so ntswg. Kev kho mob tom qab kev ua haujlwm zoo li no yuav siv sijhawm peb lub hlis, tab sis tuaj yeem ua pob caws pliav thiab los ntshav, uas ua rau muaj kev pheej hmoo ntawm kev xeeb menyuam tsis zoo.

Cervical dysplasia kuj kho nrog laser phais. Nyob ntawm qhov tsis saib xyuas ntawm cov txheej txheem pathological, kev kho mob tuaj yeem siv li ob lub hlis, tab sis qhov kev kho no muaj kev nyab xeeb thiab yuav luag tsis muaj qhov tshwm sim.

Lwm txoj kev kho mob phais ntawm dysplasia yog cryotherapy. Cov ntaub so ntswg cuam tshuam yog khov nrog kua nitrogen. Tsis tas li ntawd, kuj tseem muaj cov txheej txheem tshuaj kho mob, uas muaj nyob rau hauv kev siv tshuaj tshwj xeeb uas ua kom cov nqaij mos rau lub foci ntawm dysplasia. Tom qab ob peb hnub, lawv poob rau hauv daim ntawv nyias nyias.

Kev kho mob tactics cuam tshuam los ntawm qhov hnyav ntawm cov txheej txheem pathological:

1 degree

Vim muaj cov ntaub ntawv tshawb fawb tau lees paub tias feem ntau ntawm lub ncauj tsev menyuam dysplasia ntawm qib 1 yuav ploj mus ntawm nws tus kheej tom qab 1-2 xyoos, yog tias lub cev tau tso tawm los ntawm HPV, cov kws kho mob niaj hnub tsis pom zoo siv kev kho mob ntawm theem no.

Kev kho mob muaj raws li hauv qab no:

  • Kev soj ntsuam zoo txog li 2 xyoos txij li lub sijhawm kuaj pom;
  • Cytology thiab colposcopy txhua xyoo;
  • kho cov kab mob ntawm kev ua me nyuam (vaginitis, venereal infections);
  • tawm tsam tus cwj pwm phem (tso haus luam yeeb);
  • xaiv lwm txoj hauv kev tiv thaiv kab mob;
  • kho cov teeb meem ntawm endocrine system.

Vim tias tsis muaj tshuaj tiv thaiv kab mob rau kev kho mob HPV tseem tsis tau tsim, kev noj zaub mov kom raug thiab kev txhawb nqa vitamin muaj txiaj ntsig zoo rau lub cev hauv kev tawm tsam tus kab mob. Nws raug nquahu kom noj multivitamin complexes uas muaj cov vitamins E, B12, B6, A, C, folic acid, selenium.

Yog tias thaum lub sijhawm kuaj xyuas, ua tiav 2 xyoos tom qab kuaj pom, tsis muaj kev nyiam rau qib 1 dysplasia kom txo qis, lossis, hloov pauv, muaj cov cim qhia ntawm nws txoj kev hloov mus rau qib 2, tom qab ntawd txoj kev nruj dua. kev kho mob yuav tsum tau.

Cov cheeb tsam me me ntawm qib 1 cervical dysplasia tau ua tiav nrog cov tshuaj coagulation tshuaj xws li Solcogin, Vagotid.

2 thiab 3 degree

Kev phais yog siv los kho qib 2 thiab 3 ntawm ncauj tsev menyuam dysplasia:

  • Moxibustion
  • Cryodestruction
  • Laser kho mob
  • xov tooj cua kho mob
  • Electroconization (excision)
  • Photodynamic kho mob

Kev phais yuav tsum tau ua tam sim tom qab qhov kawg ntawm kev coj khaub ncaws, qhov no tiv thaiv kev txhim kho ntawm endometriosis thiab txhim kho txoj kev kho. Ua ntej tus txheej txheem, nws yuav tsum tau smears rau cytological kuaj, colposcopy thiab biopsy.

  1. Moxibustion:

    • Lub hauv paus ntsiab lus ntawm cauterization yog raws li qhov tseeb tias cov kab mob hloov pauv pathological raug puas tsuaj los ntawm kev cuam tshuam ntawm cov hluav taws xob qis tam sim no. Cov txheej txheem yog ua los ntawm ib tug tshwj xeeb apparatus nrog electrodes nyob rau hauv daim ntawv ntawm ib lub voj.
    • Qhov zoo ntawm txoj kev yog nws tus nqi qis, muaj cov cuab yeej siv, kev yooj yim ntawm kev siv.
    • Qhov tsis zoo ntawm cov txheej txheem: tsis muaj peev xwm tswj tau qhov tob ntawm qhov raug, qhov caws pliav ntxhib tom qab kho, muaj kev pheej hmoo siab ntawm cov teeb meem hauv daim ntawv ntawm endometriosis.
  2. Cryodestruction:

    • Nrog rau txoj kev no, kev tshem tawm cov hloov pauv ntawm cov hlwb epithelial yog ua los ntawm tam sim ntawd khov lawv nrog kua nitrogen. Qhov kub ntawm cov kua nitrogen yog -196 C%, cov dej uas muaj nyob rau hauv lub epithelial hlwb instantly hloov mus rau hauv dej khov, yog li cov ntaub so ntswg hloov pauv.
    • Qhov kom zoo dua ntawm txoj kev yog tias nws tsis tawm ntawm qhov caws pliav tom qab, yog li nws tuaj yeem pom zoo rau cov poj niam nulliparous yog tias nws tsis tuaj yeem siv ntau txoj hauv kev.
    • Qhov tsis zoo suav nrog ntau qhov tso tawm kom pom tseeb tom qab kev ua kom khov, uas tuaj yeem cuam tshuam tus poj niam mus txog 1 lub hlis, yuav tsum tsis txhob muaj kev sib deev mus txog 2 lub hlis txij li lub sijhawm kho mob, tsis muaj peev xwm tswj tau qhov zoo. qhov tob ntawm kev ua haujlwm.
  3. Laser kho:

    • Txoj kev no yog ua raws li "evaporation" ntawm cov ntaub so ntswg cuam tshuam raws li kev ua haujlwm ntawm lub zog laser.
    • Qhov zoo: tsis tawm ntawm qhov caws pliav, cov cuab yeej siv niaj hnub tso cai rau koj los tswj qhov tob ntawm kev nkag mus ntawm lub laser beam, uas tso cai rau koj tshem tawm tag nrho cov kab mob pathological.
    • Qhov tsis zoo: kub hnyiab ntawm qhov chaw noj qab haus huv ntawm lub ncauj tsev menyuam tuaj yeem tshwm sim, yuav tsum tau siv tshuaj loog rau lub sijhawm luv, vim tias qhov ua tau zoo yog nyob ntawm tus neeg mob tsis tuaj yeem.
  4. Kev kho xov tooj cua yoj: Hais txog cov txheej txheem tshiab, nws yog raws li kev tshem tawm ntawm kev ua kom pom tseeb ntawm dysplasia nyob rau hauv kev cuam tshuam ntawm cov nthwv dej ntau zaus. Ua rau ntawm lub cuab yeej Surgitron.

    Qhov zoo ntawm txoj kev yog:

    • raug mob me;
    • muaj peev xwm tswj tau qhov tob ntawm qhov cuam tshuam;
    • painless;
    • sijhawm luv luv;
    • tsis muaj qhov caws pliav tom qab lub sijhawm kho;
    • qis feem pua ntawm qhov rov tshwm sim ntawm dysplasia;
    • muaj peev xwm siv tau rau cov poj niam tsis muaj menyuam.

    Qhov tsis zoo: ib txoj hauv kev kim heev uas tsuas muaj nyob hauv tsev kho mob ntiag tug xwb.

  5. Excision (conization): tshem tawm cov cheeb tsam ntawm dysplasia nrog scalpel lossis Surgitron apparatus. Vim muaj kev raug mob siab thiab muaj ntau yam teeb meem tom qab cov txheej txheem, nws tsis yog siv rau cov poj niam uas muaj hnub nyoog me nyuam. Tam sim no, es tsis txhob conization nrog ib tug scalpel, conization nrog ib tug laser beam yog siv. Nrog rau kev ua haujlwm zoo li no, qhov tshwm sim los ntshav ob qho tib si thaum lub sijhawm ua haujlwm thiab lub sijhawm rov ua haujlwm raug txo qis, uas cuam tshuam nrog cov nyhuv cauterizing ntawm laser.

    Nyeem ntxiv: Electroconization ntawm lub ncauj tsev menyuam rau dysplasia

  6. Photodynamic therapy: yog ib txoj hauv kev tshiab tshaj plaws ntawm kev kho mob qog noj ntshav. Nws cov ntsiab lus raug txo qis rau kev xaiv tsub zuj zuj ntawm photosensitizer los ntawm cov qog tom qab txhaj tshuaj lossis hauv zos tswj hwm. Tom qab ntawd, cov qog nqaij hlav cancer yog irradiated nrog lub teeb ci (laser lossis tsis-laser). Raws li qhov tshwm sim, cov tshuaj tiv thaiv tshwm sim hauv cov ntaub so ntswg cuam tshuam nrog kev tso tawm ntawm singlet oxygen. Qhov no ua rau kev tuag ntawm cov qog nqaij hlav cancer.

    Nyeem Ntxiv: Cervical Photodynamic Therapy

Nrog rau txhua txoj kev kho mob hauv lub sijhawm tom qab phais, nws yuav tsum tau ua raws li qee qhov kev tswj hwm hauv thawj lub hlis:

  • Kev sib deev kev sib haum xeeb;
  • Tsis txhob nqa qhov hnyav;
  • Tsis txhob tawm dag zog;
  • Tsis txhob mus ncig lub pas dej, sauna, puam;
  • Tsis txhob da dej lossis mus rau solarium, tshwj xeeb tshaj yog cov poj niam uas muaj tus kab mob HPV;
  • Tsis txhob da dej, tsuas yog tso da dej xwb;
  • Tsis txhob txhaj rau hauv qhov chaw mos yam tshuaj, tshuaj, tsuas yog kws kho mob tau sau tseg;
  • Nco ntsoov ua qhov kev soj ntsuam gynecological tom qab kev coj khaub ncaws tom ntej tom qab kev kho mob.

Ntau tus poj niam, ntshai tsis hnov qhov kuaj pom, tso tawm mus ntsib kws kho mob, tab sis qhov no yog kev ntshai cuav. Cervical dysplasia yog kho tau zoo kawg nkaus yog ua tiav raws sijhawm thiab nrog txoj hauv kev zoo.

Tshuaj

Tshuaj
Tshuaj

Yog tias qhov kev kuaj mob ntawm ncauj tsev menyuam dysplasia tau ua nyob rau theem pib, ces kev tshem tawm tus kabmob feem ntau ua tiav. Kev noj tshuaj yog muab los ua ib qho kev pabcuam kho mob, thiab kev phais yog suav tias yog txoj hauv kev tseem ceeb ntawm kev kho mob. Thaum nws siv, cov chaw pathological raug tshem tawm. Txawm li cas los xij, kev kho tshuaj tseem xav tau. Ua ntej ntawm tag nrho cov, nws yog ib qhov tsim nyog yuav tsum tau neutralize HPV, uas feem ntau ua rau kev loj hlob ntawm dysplasia. Kev xaiv cov tshuaj yuav tsum yog nyob ntawm tus kheej tus yam ntxwv ntawm tus kab mob, thiab tseem yuav tsum ua raws li lub hnub nyoog ntawm tus neeg mob thiab nws lub siab xav kom muaj menyuam nyob rau yav tom ntej.

Lub hom phiaj ntawm txoj kev kho yog raws li hauv qab no:

  • Tshuaj mob o (anti-inflammatory).
  • Restore ua haujlwm ntawm cov ntaub so ntswg epithelial (cov tshuaj hormonal raug sau tseg).
  • Txhob lub cev tiv thaiv (immunomodulators).
  • Restore microflora ntawm qhov chaw mos.

Yog li, nyob rau theem ntawm kev kho tshuaj, immunomodulators, vitamin-mineral complexes (vitamin A, C, E, folic acid) raug tshuaj.

Tshuaj kho mob ncauj tsev menyuam dysplasia

Tshuaj txhawb kev tiv thaiv
  1. Prodigiosan
  2. Isoprinosine Y
  3. Interferon-alpha 2
  1. Txoj kev tiv thaiv kab mob dav dav
  2. Tiv thaiv kab mob thiab kab mob
  3. Ua kom muaj cov kab mob tiv thaiv kab mob uas tiv thaiv kab mob zoo
Vitamins thiab minerals
  1. Vitamin A Y
  2. Vitamin E thiab Vitamin C
  3. Selenium Y
  1. Tsis pub cov ntaub so ntswg epithelial tawg
  2. Normalizes cell division processes
  3. Vitamin E yog qhov muaj zog tshaj plaws antioxidant, thiab vitamin C ntxiv dag zog rau lub cev tiv thaiv
  4. Txhawb kev rov tsim dua tshiab ntawm endocervix hlwb tom qab cauterization thiab lwm yam cuam tshuam.

Cov kws kho mob sim ncua kev phais kom ntev li ntev tau. Txawm li cas los xij, nws tsis yog ib txwm ua tau los tiv thaiv lub ncauj tsev menyuam dysplasia nrog kev pab ntawm cov tshuaj. Yog li ntawd, nyob rau hauv 65-70% ntawm cov neeg mob, koj tseem yuav tau mus rau kev pab los ntawm ib tug kws phais. Nyob rau yav tom ntej, kev kho tshuaj kho tau raug sau tseg.

Tshuaj tua kab mob thiab tshuaj tua kab mob tsuas yog muab thaum dysplasia hnyav heev. Feem ntau, kev kho tshuaj rau cov txheej txheem neoplastic tsis zoo.

Pom zoo: