Uterine fibroids

Uterine fibroids yog cov hlav uas hlav hauv tus poj niam lub tsev menyuam (lub tsev menyuam). Cov kev loj hlob no feem ntau tsis mob qog nqaij hlav (tsis zoo).

Uterine fibroids muaj ntau. Coob npaum li ib ntawm tsib tus pojniam yuav mob caj dab thaum lawv yug menyuam xyoo. Ib nrab ntawm tag nrho cov poj niam muaj fibroids thaum muaj hnub nyoog 50 xyoos.

Fibroids tsis tshua muaj tshwm sim rau cov poj niam hnub nyoog qis dua 20. Lawv muaj feem ntau hauv cov neeg Asmeskas Dub ntau dua Neeg Dawb, Neeg Hispanic, lossis cov poj niam Asian.

Tsis muaj leej twg paub tseeb tias dab tsi ua rau mob fibroids. Lawv xav tias yuav tshwm sim los ntawm:

• Cov tshuaj hormones hauv lub cev
• Cov noob (yuav khiav hauv tsev neeg)

Fibroids tuaj yeem ua rau me me uas koj xav tau lub tshuab tsom kom pom lawv. Lawv tuaj yeem loj hlob ntau. Lawv yuav puv tag nrho lub tsev menyuam thiab yuav hnyav ob peb phaus lossis phaus. Txawm hais tias nws muaj peev xwm ua tau tsuas yog ib qho fibroid los tsim kho, feem ntau muaj ntau dua ib leeg.

Fibroids tuaj yeem loj hlob:

• Hauv cov leeg phab ntsa ntawm lub tsev menyuam (myometrial)
• Cia li nyob hauv qab ntawm txheej tsev menyuam (submucosal)
• Tsuas yog sab hauv qab ntawm lub tsev menyuam (sab hauv)
• Ntawm tus ntoo ntev ntawm lub ncauj tsev menyuam lossis sab hauv lub tsev menyuam (pedunculated)

Cov tsos mob tshwm sim ntawm uterine fibroids yog:

• Los ntshav ntawm ntu
• Los ntshav hnyav hauv koj lub sijhawm, qee zaum mob ntshav txhaws
• Cov sij hawm uas yuav kav ntev dua li ib txwm
• Xav tau tso zis ntau zaus
• Pelvic cramping los yog mob nrog ntu
• Zoo nkaus li muaj qhov puv lossis siab nyob hauv koj lub plab qis dua
• Mob lub sij hawm sib deev

Feem ntau, koj tuaj yeem muaj cov hlab ntsha thiab tsis muaj tsos mob dab tsi. Koj tus neeg saib xyuas kev noj qab haus huv yuav pom thaum kuaj mob lossis kuaj lwm yam. Fibroids feem ntau ntsws me me thiab ua rau tsis muaj cov tsos mob ntawm cov poj niam uas tau mus lawm. Kev tshawb nrhiav tsis ntev los no tseem pom tau tias qee qhov cov fibroids me me poob rau hauv cov poj niam premenopausal.

Koj tus kws khomob yuav kuaj kuaj plab mos. Qhov no tuaj yeem qhia tau tias koj muaj kev hloov pauv ntawm lub cev hauv koj lub tsev menyuam.

Fibroids tsis yog qhov yooj yim rau kev kuaj mob. Kev rog tuaj yeem ua cov pob qij txha tawv txhawm rau txhawm rau tshawb tau. Koj tuaj yeem xav tau cov kev sim no kom pom cov fibroids:

• Ultrasound siv suab tsis zoo los tsim cov duab ntawm lub tsev menyuam.
• MRI siv cov hlau nplaum muaj zog thiab xov tooj cua kom tsim tau duab.
• Saline infusion sonogram (hysterosonography) - Saline yog txhaj rau hauv lub tsev menyuam kom pom kev pom lub tsev me me siv ultrasound.
• Hysteroscopy siv lub raj ntev ntev thiab nyias nyias ntxig nkag rau hauv qhov chaw mos thiab mus rau hauv lub tsev menyuam los tshawb xyuas sab hauv lub tsev menyuam.
• Endometrial me me tawm ib qho me me tawm ntawm lub tsev menyuam los kuaj mob qog nqaij hlav yog tias koj los ntshav txawv txawv.

Hom kev kho mob koj muaj nyob ntawm:

• Koj lub hnub nyoog
• Koj txoj kev noj qab haus huv txhua yam
• Koj cov tsos mob
• Hom fibroids
• Yog koj xeeb tub
• Yog tias koj xav tau menyuam yaus yav tom ntej

Kev kho rau cov tsos mob ntawm cov nqaij (fibroids) yuav muaj:

• Intrauterine devices (IUDs) uas tso tawm cov tshuaj hormones los pab txo qis los ntshav thiab mob.
• Tranexamic acid txhawm rau txo cov roj ntshav kom txaus.
• Cov khoom siv hlau pab tiv thaiv lossis kho kom tsis txhob muaj ntshav txhaus vim ntev heev.
• Cov tshuaj tiv thaiv kab mob, xws li ibuprofen lossis naproxen, rau cramps lossis mob.
• Kev tos ntsoov tos - Koj tuaj yeem ua raws li pelvic kev kuaj mob los yog cov tshuab hluav taws xob txhawm rau kuaj cov fibroid's kev loj hlob.

Kho mob los yog kev kho mob hormonal uas tuaj yeem pab ntsws me xws li:

• Tshuaj tswj kom tsis txhob muaj menyuam muaj peev xwm pab tswj tau lub sijhawm hnyav.
• Ib hom IUD uas tso cov tshuaj hormone progestin tsawg kawg rau hauv tsev menyuam txhua hnub.
• Cov tshuaj hormones pab txo qis fibroids los ntawm kev nres ovulation. Feem ntau, qhov kev kho no tsuas yog siv rau lub sijhawm luv los ntsws fibroids ua ntej kev phais mob. Lawv kuj tseem siv tau ntev dua thaum siv me me ntawm estrogen hormone ntxiv rov qab los txo cov kev phiv.

Kev phais mob thiab cov txheej txheem siv los kho fibroids muaj xws li:

• Hysteroscopy - Qhov txheej txheem no tuaj yeem tshem tawm cov fibroids zuj zus hauv lub tsev menyuam.
• Endometrial ablation - Cov txheej txheem no qee zaum siv los kho mob hnyav los ntshav txuam nrog fibroids. Nws ua haujlwm zoo tshaj plaws thaum cov leeg (fibroids) yog qhov me me. Nws ib txwm tso tseg tsis coj khaub ncaws tag.
• Uterine artery embolization - Qhov txheej txheem no txwv tsis pub cov ntshav mus rau ntawm lub raum, ua rau nws ntsws thiab tuag. Qhov no yog qhov kev xaiv zoo yog tias koj xav kom zam kev phais mob thiab tsis npaj yuav muaj menyuam.
• Myomectomy - Qhov kev phais no tshem tawm cov fibroids los ntawm lub tsev menyuam. Qhov no kuj tseem yog qhov kev xaiv zoo yog tias koj xav tau me nyuam. Nws yuav tsis tiv thaiv cov fibroids tshiab kom loj hlob.
• Hysterectomy - Qhov kev phais no tshem tawm lub tsev me nyuam kom tag. Nws yog ib txoj hauv kev yog tias koj tsis xav tau menyuam yaus, tshuaj tsis ua haujlwm, thiab koj tsis tuaj yeem muaj lwm yam txheej txheem.

Cov kev kho mob tshiab, xws li siv cov tsom rau ultrasound, raug soj ntsuam hauv kev tshawb fawb soj ntsuam.

Yog tias koj muaj fibroids yam tsis muaj tsos mob, koj yuav tsis tas mus kho.

Yog tias koj muaj fibroids, lawv yuav loj tuaj yog tias koj cev xeeb tub. Qhov no yog vim qhov ntshav nce ntxiv thiab cov qib tshuaj estrogen siab dua. Cov fibroids feem ntau rov qab los rau lawv qhov qub loj tom qab koj tus me nyuam yug.

Lwm yam mob ntawm cov leeg xws li:

• Kev mob hnyav lossis los ntshav ntau uas xav tau kev phais mob ceev.
• Kev sib tw ntawm cov leeg (fibroid) - Qhov no tuaj yeem ua rau cov hlab ntshav sim uas pub cov nqaij hlav. Koj yuav tsum tau phais yog tias qhov no tshwm sim.
• Plawv (tsis muaj ntshav liab txaus) los ntshav ntau.
• Cov mob txeeb zig - Yog tias cov hlab ntsha tso rau ntawm lub zais zis, nws tuaj yeem nyuaj rau koj lub zais zis kom tas.
• Ntxiv lawm tshob, muaj tsawg.

Yog tias koj cev xeeb tub, nws muaj qhov phom sij me me uas yuav ua rau cov leeg (fibroids) tuaj yeem ua rau muaj teeb meem:

• Koj tuaj yeem xa koj tus menyuam tau ntxov vim tias tsis muaj chaw txaus hauv koj lub tsev menyuam.
• Yog tias cov hlab ntsha ua rau thaiv tus menyuam yug lossis tso tus menyuam nyob rau qhov chaw txaus ntshai, koj yuav tsum tau muaj kev phais plab (C-section).
• Koj tuaj yeem yuav los ntshav hnyav tom qab yug menyuam tas.

Hu rau koj tus kws khomob yog koj muaj:

• Los ntshav hnyav, nce hauv plab, lossis los ntshav ntawm ntu
• Tag nrho lossis hnyav dua nyob hauv koj lub plab qis dua

Leiomyoma; Fibromyoma; Myoma; Cov Pob Khoom; Txoj hlab ntaws hauv plab - fibroids; Vaginal los ntshav - nqaij ntuag ntshav nrog

• Hysterectomy - plab - tso tawm
• Hysterectomy - laparoscopic - kev tso tawm
• Hysterectomy - chaw mos - tso tawm
• Uterine artery embolization - kev tshem tawm

• Pelvic laparoscopy
• Poj niam deev aub
• Cov hlav qog hlav
• Uterus

Dolan MS, Toj C, Valea FA. Cov txhab txhab ua haujlwm rau lub ntsej muag: lub chaw mos, lub paum, lub ncauj tsev menyuam, lub tsev menyuam, oviduct, zes qe menyuam, ultrasound duab ntawm pelvic lug. Hauv: Lobo RA, Gershenson DM, Lentz GM, Valea FA, eds. Saib Hluag Tshaj Lij HlawvCov. 7 tus ed. Philadelphia, PA: Elsevier; 2017: chap 18.

Moravek MB, Bulun SE. Uterine fibroids. Hauv: Jameson JL, De Groot LJ, de Kretser DM, li al, eds. Endocrinology: Cov Neeg Loj thiab PediatricCov. 7 tus ed. Philadelphia, PA: Elsevier Saunders; 2016: cha 131.

Spies JB. Tam sim no lub luag haujlwm ntawm uterine artery embolization nyob rau hauv kev tswj hwm ntawm uterine fibroids. Clin Obstet GynecolCov. 2016; 59 (1): 93-102. PMID: 26630074 pubmed.ncbi.nlm.nih.gov/26630074/.

Stewart EA. Cov chaw kho mob xyaum. Uterine fibroids. N Engl J MedCov. Xyoo 2015; 372 (17): 1646-1655. PMID: 25901428 pubmed.ncbi.nlm.nih.gov/25901428/.

Verpalen IM, Anneveldt KJ, Nijholt IM, li al.Sib nqus resonance-siab siv teem ultrasound (MR-HIFU) txoj kev kho cov tsos mob uterine fibroids nrog rau kev kho tsis raws kev cai: kev tshuaj xyuas hauv nruab thiab ntsuas. Eur J RadiolCov. 2019; 120: 108700. doi: 10.1016 / j.ejrad.2019.108700. PMID: 31634683 pubmed.ncbi.nlm.nih.gov/31634683/.