Atypical endometrial hyperplasia

Endometrial hyperplasia - yog ib qho txawv txav kev loj hlob ntawm lub puab (mucosal) hauv ob sab phlu ntawm lub tsev me nyuam, qhov chaw uas nws yuav ntau npaum li cas thicker dua li ib txwm. Nyob rau hauv dav dav, lub sij hawm "hyperplasia" txhais tau tias ib qho kev nce rau hauv lub xov tooj ntawm hlwb los yog ntaub so ntswg ntawm lub cev, uas ua nyob rau hauv ib tug ntim ntawm lub cev nce. Raws li kev kho mob statistics, endometrial hyperplasia yuav raug rau 20% ntawm cov poj niam thiab 5-10% ntawm lawv yog hloov mus rau hauv ua cancer kab mob.

Muaj ob peb hom hyperplasia yog:

• glandular hyperplasia;
• cystic hyperplasia;
• adenomatosis, piv txwv li atypical endometrial hyperplasia;
• lobular hyperplasia ntawm lub endometrium.

Tau ua ntawm tus kab mob no yog hu ua hormonal ntshawv siab, gynecological mob, polycystic ntawm zes qe menyuam syndrome (PCOS), rho menyuam, uterine fibroids, diagnostic curettage, adenomyosis, ekstragenital'nye txog kab mob (thyroid adrenal kab mob, mob ntshav qab zib, rog, mob ntshav siab).

Cov tsos mob ntawm endometrial hyperplasia yuav ua raws li coj khaub irregularities (nws lengthening los yog shortening, hnyav ntshav poob); cia li uterine los ntshav thaum lub sij hawm ua poj niam los yog nyob rau hauv nruab nrab ntawm lub voj voog, ntev mus txog ob peb lub lis piam; ntxiv lawm tshob.

Atypical endometrial hyperplasia Nws yog ib lub loj tshaj plaws tus kab mob ntawm tag nrho cov saum toj no hais hom. Cov kev hem thawj ntawm nws transformation mus rau hauv cancer, yog tias tsis kho, los ntawm 20% mus rau 80% thiab feem ntau feem ntau pom nyob rau hauv kev txiav ntawm lub sij hawm (los ntawm lub hnub nyoog) coj khaub muaj nuj nqi. Nyob rau hauv atypical endometrial hyperplasia thickness yog 3 cm.

tsawg (Lobular) hyperplasia ntawm lub endometrium - yog polyps germinating ib tug neeg zov me nyuam. Raws li cov qauv ntawm cov polyps yog fibrous, glandular thiab adenomatous. Nyob ntawm seb qhov loj ntawm lub polyp, endometrial thickness yuav ua tau 6 cm.

Underdeveloped puab txheej ntawm lub tsev me nyuam - hypoplastic endometrium - yog tsis yog ib tug kab mob. Tej endometrium cai nyob tsis muaj zog cawv ntawm zes qe menyuam cov tshuaj hormones thiab tsis yuav tsum tau kev kho mob - tsuas saib.

Nyob rau hauv tus neeg mob qhov twg lub atypical endometrial hyperplasia recurs thiab muaj ib tug yuav muaj nws txoj kev hloov mus rau ib tug cancer rau daim ntawv siv phais - overgrown txheej yog muab tshem tawm endometrium. Tus txheej txheem yog ib co tseeb, ceev ceev thiab lig kev ruaj ntseg, ua tsaug rau niaj hnub siv tshuab.

Lwm yam txoj kev kho cov kab mob no yog nyuab los ntawm kev tshem tawm ntawm polyps - polypectomy, thiab tshem tawm ntawm lub tsev me nyuam nrog adnexa - hysterectomy. Hysterectomy yog feem ntau yog siv nyob rau hauv mob loj heev nyuab txoj kev loj hlob atypia, nrhiav, nrog polyps, myomas.

Yuav kom ib tug loj raws li tej yam ntawm kev phais nyob ntawm yuav ua li cas zoo preoperative lawm txoj kev kho, yuav txo tau qhov ntim ntawm focal hyperplastic endometrium. kuj kheev siv ua ke nrog txoj kev kho uas combines ob peb hom kev kawm, piv txwv li, kev phais kho mob nrog hormonal txoj kev kho.

Atypical endometrial hyperplasia thiaj paub hais tias:

• transvaginal ultrasound;
• ehogisterosalpingografiey (Echo GHA);
• hysteroscopy (GHA);
• ib tug me ntawm lub endometrium;

Rau kev tiv thaiv ntawm tus kab mob yog tsim nyog los:

• dua ib zaug los yog ob zaug ib xyoos ib tug tiv thaiv kev gynecological xeem (txawm yog hais tias muaj yog tsis muaj kev tsis txaus siab);
• kev kho mob los ntawm ntau yam concomitant extragenital cov kab mob (mob ntshav qab zib, rog, kub siab, thiab lwm tus neeg.);
• mob thiab tom ntej kev kho mob ntawm qhov chaw mos kab mob (uterine fibroids, adenomyosis li al.);
• tau tshem ntawm tshaj ceeb thawj.

Periodic xeem los ntawm cov kws tshwj xeeb cia lub sij hawm kom paub tias ib tug txaus ntshai tus kab mob thiab thaum lub sij hawm yuav ua rau kom tus muaj feem rau ib tug tag nrho thiab hais rov qab.