Mob ntshav tawm hauv plab tsis zoo

Txawv ntshav uterine tsis txaus (AUB) yog los ntshav los ntawm lub tsev menyuam uas ntev dua li ib txwm los yog tshwm sim thaum lub sijhawm tsis xwm yeem. Kev los ntshav yuav hnyav dua lossis sib zog dua li ib txwm muaj thiab tshwm sim ntau zaus lossis cia li ntwm.

AUB tuaj yeem tshwm sim:

• Xws li pom kev los ntshav lossis nruab nrab ntawm koj lub sijhawm
• Tom qab sib deev
• Rau hnub ntev dua li ib txwm
• Ntau dua li qub
• Tom qab lawm

Nws TSIS tshwm sim thaum cev xeeb tub. Los ntshav thaum cev xeeb tub muaj ntau cov laj thawj. Yog tias koj los ntshav thaum koj cev xeeb tub, nco ntsoov hu koj tus kws kho mob.

Txhua tus pojniam lub sijhawm (coj khaub ncaws) yog txawv.

• Qhov nruab nrab, tus poj niam lub sijhawm tshwm sim txhua 28 hnub.
• Feem ntau ntawm cov poj niam muaj voj voog ntawm 24 mus rau 34 hnub sib nrug. Feem ntau nws kav 4 rau 7 hnub.
• Cov ntxhais hluas yuav tau txais lawv lub sijhawm nyob qhov twg ntawm 21 txog 45 hnub lossis ntau dua.
• Cov poj niam hauv lawv lub hnub nyoog 40 xyoos tuaj yeem pib ua lawv lub sijhawm tsawg dua los yog ntu ntawm lawv lub sijhawm tsawg dua.

Rau feem ntau ntawm cov poj niam, poj niam qib theem poj niam hloov pauv txhua lub hli. Cov tshuaj hormones estrogen thiab progesterone raug tso tawm ua ib feem ntawm txheej txheem ntawm ov ov. Thaum poj niam tawm tsam lub qe, qe yuav tawm.

AUB tuaj yeem tshwm sim thaum lub zes qe menyuam tsis tso qe. Hloov cov qib qog hormone ua rau koj lub caij tom qab los yog ntxov dua. Koj lub sijhawm yuav hnyav dua li ib txwm.

AUB feem ntau muaj rau cov tub ntxhais hluas lossis cov poj niam premenopausal. Cov poj niam uas rog dhau hwv yuav muaj feem ntau AUB.

Hauv ntau tus poj niam, AUB tshwm sim los ntawm qog tsis txaus lawm. Nws tseem tuaj yeem tshwm sim vim cov hauv qab no:

• Thickening ntawm phab ntsa uterine lossis hauv ob sab phlu
• Uterine fibroids
• Uterine polyps
• Mob qog rau zes qe menyuam, tsev menyuam, ncauj tsev menyuam, lossis lub paum
• Kev los ntshav lossis teeb meem nrog ntshav txhaws
• Polycystic zes qe menyuam mob
• Kev hnyav hnyav
• Kev tswj tsis pub muaj menyuam siv, xws li tshuaj noj kom tsis muaj menyuam lossis khoom siv hauv lub cev (IUD)
• Kev rog dhau los sis rog tshaj (ntau tshaj 10 phaus lossis 4.5 phaus)
• Kev kis mob ntawm lub tsev menyuam lossis ncauj tsev menyuam

AUB yog qhov tsis paub. Los ntshav tej zaum yuav hnyav heev lossis pom, thiab tuaj yeem tshwm sim ntau lossis tsis tas li.

Cov tsos mob ntawm AUB tuaj yeem suav nrog:

• Los ntshav lossis los ntshav los ntawm qhov chaw mos ntawm ntu
• Cov sij hawm uas tshwm sim tsawg dua 28 hnub sib nrug (feem ntau) lossis ntau dua 35 hnub sib nrug
• Lub sij hawm hloov nruab nrab ntawm txhua lub hlis
• Muaj ntshav ntau heev (xws li ua cov txhaws loj heev, yuav tsum hloov pauv chaw tiv thaiv thaum hmo ntuj, so los ntawm daim ntaub huv lossis ntaub qhwv txhua txhua teev rau 2 rau 3 teev nyob rau hauv ib kab)
• Kev los ntshav uas kav mus ntev tshaj li ib hnub lossis ntau dua 7 hnub

Lwm cov tsos mob tshwm sim los ntawm cov kev hloov pauv hauv qib kev txawv txav yog:

• Kev loj hlob ntau dhau ntawm lub cev plaub hau hauv tus qauv txiv neej (hirsutism)
• Kub muag kub
• Mus ob peb vas hloov
• Kev sib deev thiab dryness ntawm lub paum

Tus poj niam yuav mloog zoo li nkees lossis ua rau lub cev yuag yog tias nws ua rau nws ntshav ntau dhau lub sijhawm. Nov yog cov tsos mob ntawm kev tiv thaiv ntshav liab.

Koj tus kws kho mob yuav txiav txim tawm lwm qhov teeb meem ua kom los ntshav tsis xwm yeem. Tej zaum koj yuav muaj txoj kev ntsuam xyuas hu ua pelvic thiab Pap / HPV kuaj. Lwm yam kev xeem uas yuav muaj xws li:

• Ua kom tiav cov ntshav suav (CBC)
• Cov ntshav txhaws profile
• Kev ntsuam xyuas lub siab ua haujlwm (LFT)
• Yoo cov ntshav cov ntshav
• Kev kuaj ntshav, rau FSH, LH, txiv neej hormone (androgen) theem, prolactin, thiab progesterone
• Cev xeeb tub ntsuam xyuas
• Kev ntsuas cov thyroid muaj nuj nqi

Koj tus kws khomob yuav qhia cov hauvqab no:

• Kab lis kev cai mus nrhiav kom kis tau tus mob
• Mus kuaj mus kuaj mob ua ntej, mob qog noj ntshav, lossis pab txiav txim siab txog kev kho tus kabmob
• Hysteroscopy, ua rau hauv koj tus kws khomob chaw haujlwm kom kuaj xyuas lub tsev menyuam hla lub paum
• Ultrasound los saib xyuas cov teeb meem hauv lub tsev me lossis lub plab mog

Kev kho mob yuav suav nrog ib lossis ntau yam ntawm cov hauv qab no:

• Kev siv tshuaj tiv thaiv kom tsis pub muaj tsawg
• Kev kho tshuaj hormones
• Kev siv tshuaj ntau cov tshuaj estrogen rau cov poj niam nrog los ntshav heev
• Intrauterine device (IUD) uas tso tawm cov tshuaj hormone progestin
• Cov tshuaj nonsteroidal anti-inflammatory (NSAIDs) tau noj ua ntej lub sijhawm pib
• Kev phais mob, yog tias qhov ua rau los ntshav yog polyp lossis fibroid

Koj tus kws kho mob yuav muab koj tso rau hauv cov hlau pab yog tias koj muaj ntshav khov.

Yog tias koj xav cev xeeb tub, koj yuav tau muab tshuaj los txhawb kev ov ov.

Cov poj niam muaj cov tsos mob hnyav uas tsis ua kom zoo dua los yog leej twg muaj mob qog nqaij hlav cancer lossis mob ua npaws yuav xav tau lwm cov txheej txheem xws li:

• Kev phais mob txhawm rau txhawm rau rhuav tshem lossis tshem cov roj ntsha ntawm lub tsev menyuam
• Hysterectomy los tshem tawm lub tsev menyuam

Kev kho tus kheej feem ntau txo cov tsos mob. Yuav tsis muaj kev kho mob yog tias koj tsis ua kom muaj ntshav khov vim tsis muaj ntshav. Ib txoj kev kho mob tsom rau qhov ua rau los ntshav feem ntau muaj kev tiv thaiv zoo. Vim li ntawd nws thiaj tseem ceeb kom nkag siab.

Teeb meem uas yuav tshwm sim:

• Ntxiv lawm tshob (cev tsis taus me nyuam)
• Kev mob ntshav siab vim cov ntshav ntau dhau sijhawm
• Muaj feem pheej hmoo mob cancer endometrial

Hu rau koj tus kws kho mob yog tias koj muaj ntshav tsis txaus hauv qhov chaw mos.

Anovulatory los ntshav; Kev mob ntshav hauv lub cev tsis zoo - hormonal; Polymenorrhea - dysfunctional uterine los ntshav

• Tej cev nqaij daim tawv (ntu txiav)

American College ntawm Obstetricians thiab Gynecologists lub website. ACOG pawg neeg tawm tswv yim tsis tau. 557: Kev tswj cov mob hnyav ua rau lub cev tsis muaj menyuam hauv cov pojniam uas tsis muaj menyuam yaus. Rov Pom Zoo 2017. www.acog.org/Clinical-Guidance-and-Publications/Commtees-Opinions/Commtees-on-Gynecologic-Practice/Management-of-Acute-Abnormal-Uterine-Bleeding-in-Nonpregnant-Reproductive-Aged-Women Cov. Nkag mus saib Lub Kaum Hli 27, 2018.

Bahamondes L, Ali M. Tsis ntev los no kev nce qib hauv kev tswj hwm thiab nkag siab kev coj khaub ncaws tsis txaus siab thaum coj khaub ncaws. F1000Prime Cov Neeg Sawv CevCov. Xyoo 2015; 7: 33. PMID: 25926984 www.ncbi.nlm.nih.gov/pubmed/25926984.

Ryntz T, Lobo RA. Kev lim ntshav hauv lub cev tsis zoo: etiology thiab tswj kev mob hnyav thiab mob ntev los ntshav. Hauv: Lobo RA, Gershenson DM, Lentz GM, Valea FA, eds. Saib Hluag Tshaj Lij HlawvCov. 7 tus ed. Philadelphia, PA: Elsevier; 2017: chap 26.

Schrager S. Txawv lub tsev menyuam los ntshav. Hauv: Kellerman RD, Bope ET, eds. Conn's Suab Kho Siab 2018Cov. Philadelphia, PA: Elsevier; 2018: 1073-1074.