Fibroids yog cov qog uas loj hlob hauv cov leeg nqaij ntawm lub tsev menyuam. Uterine fibroids feem ntau tshwm sim, tab sis feem ntau ntawm lawv ua rau tsis muaj tsos mob. Fibroids feem ntau yog benign (tsis mob qog noj ntshav). Yog fibroids ua rau mob, tsis xis nyob, lub cev ntas nyuaj, lossis lwm yam teeb meem, lawv yuav tsum tau kho. Kev siv tshuaj tuaj yeem siv los txo cov fibroids thiab/lossis txo cov tsos mob ntsig txog fibroid. Tsis tas li, ntau txoj hauv kev phais-xws li los ntawm kev kis tus mob mus rau kev phais loj-tuaj yeem siv rau kev tshem tawm fibroid.
Cov kauj ruam
Txoj Kev 1 ntawm 3: Kho Fibroids nrog Tshuaj
Kauj Ruam 1. Noj cov tshuaj tiv thaiv kab mob thiab/lossis cov tshuaj tiv thaiv kab mob
Cov tshuaj tiv thaiv menyuam yaus thiab lwm tus neeg sawv cev tuaj yeem siv los tswj kev coj khaub ncaws thiab txo ntshav. Cov tshuaj hormonal no feem ntau tau sau tseg kom txo cov tsos mob ntawm cov qog nqaij hlav hauv tsev. Kev tiv thaiv qhov ncauj kuj yuav tiv thaiv tau cev xeeb tub.
- Yog tias cov tshuaj tsis txhim kho ntshav tom qab 3-4 lub hlis, tham nrog koj tus kws kho mob.
- Cov poj niam laus dua 35 xyoo uas haus luam yeeb yuav tsum tsis txhob siv cov tshuaj tiv thaiv qhov ncauj.
- Cov tshuaj tiv thaiv qhov ncauj thiab cov tshuaj tiv thaiv kab mob yuav tsis muaj qhov cuam tshuam rau qhov loj ntawm cov fibroids.
- Cov kev mob tshwm sim tuaj yeem suav nrog: pom ntawm lub sijhawm, xeev siab, mob taub hau, mob lub mis, txo qis kev sib deev, nce hnyav, hloov pauv lub siab, thiab/lossis ncua sijhawm.
Kauj Ruam 2. Muaj cov cuab yeej siv tshuaj tiv thaiv kab mob hauv lub cev
Ib qho progestin tso cov cuab yeej tso rau hauv lub cev (IUD) yog cov cuab yeej me me tso rau hauv koj lub tsev menyuam. Cov cuab yeej no tiv thaiv lub sijhawm hnyav (lossis qee zaum ua rau ncua sijhawm), uas txo qis cov tsos mob fibroid. Ib qho IUD tseem tiv thaiv kev xeeb tub.
- Hom IUD no tuaj yeem nyob hauv koj lub cev txog li 5 xyoos.
- IUDs tsuas yog kho cov tsos mob ntawm fibroids, tsis thim lossis txo lawv.
- Cov kev mob tshwm sim tuaj yeem suav nrog: hnyav ntuav ntshav thaum thawj 2-3 lub lis piam tom qab tso ntshav tawm, ua rau mob nraub qaum, mob taub hau, poob siab/ntxhov siab, kiv taub hau me ntsis, xeev siab, ntuav, tsam plab, thiab/lossis mob lub mis.
Kauj Ruam 3. Siv cov tshuaj tranexamic los kho cov tsos mob
Tranexamic acid (tseem hu ua Lysteda) yog cov tshuaj tsis muaj tshuaj uas siv los ua kom yooj yim rau qhov tsis xis nyob ntawm lub cev hnyav. Cov tshuaj no tuaj yeem pab txo qee qhov tsos mob ntawm cov qog nqaij hlav hauv tsev.
- Cov tshuaj no feem ntau yog siv 3 zaug hauv ib hnub txog li 5 hnub hauv koj lub hlis. Koj tsis tuaj yeem nqa nws ntau dua 5 hnub.
- Cov kev mob tshwm sim tuaj yeem suav nrog: xeev siab, ntuav, raws plab, lossis kiv taub hau.
Kauj Ruam 4. Noj cov tshuaj GnRH agonist
Cov tshuaj GnRH agonist (tseem hu ua Lupron) ua rau koj lub cev mus rau lub xeev ib ntus lawm. Qhov no ncua koj cov kev coj khaub ncaws, thiab ua rau cov fibroids nqaim. Tom qab koj tsum tsis noj cov tshuaj no, fibroids tuaj yeem rov qab los.
- Qee zaum qhov no yog siv los txo cov fibroids ua ntej kev phais tshem tawm.
- Cov kev mob tshwm sim tuaj yeem suav nrog kub nyhiab, nyuaj siab, tsaug zog, txo qis kev sib deev, thiab mob sib koom.
- Feem ntau cov tshuaj no yuav tsum siv ntev dua 6 lub hlis.
- Koj yuav tsum tsis txhob noj cov tshuaj no yog tias muaj caij nyoog uas koj yuav xeeb tub.
- Tom qab koj tsis noj tshuaj GnRH agonist, nws tuaj yeem siv sijhawm 2-8 lub lis piam rau koj lub cev ntas rov los.
Txoj Kev 2 ntawm 3: Tshem Fibroids phais
Kauj Ruam 1. Nkag mus rau cov hlab ntshav hauv lub tsev menyuam yog tias koj xav tau tus txheej txheem kho mob sab nrauv
Qhov txheej txheem tsawg tshaj plaws no cuam tshuam nrog kev txhaj tshuaj me me (cov neeg ua haujlwm embolic) rau hauv cov hlab ntsha uas muab ntshav rau lub tsev menyuam. Qhov no txiav tawm cov ntshav ntws mus rau lub tsev menyuam fibroids, ua rau lawv nqaim thiab tuag tawm. Uterine artery embolization (UAE) tuaj yeem siv tau zoo hauv kev kho mob fibroids.
- UAE tau ua los ntawm kws kho hluav taws xob, hauv chav kho hluav taws xob ntau dua li chav ua haujlwm.
- Tom qab tus txheej txheem, koj yuav tsum pw hauv txaj li 6 teev. Qhov no feem ntau tsis xav tau pw hmo ntuj hauv tsev kho mob.
- Cov teeb meem tuaj yeem tshwm sim yog tias cov ntshav xa mus rau koj lub zes qe menyuam lossis lwm yam kabmob ua rau muaj kev cuam tshuam, txawm hais tias qhov no tsis tshua muaj.
- Xaiv cov txheej txheem no yog tias koj tsis cia siab tias yuav xeeb tub yav tom ntej.
Kauj Ruam 2. Muaj myomectomy yog tias koj tab tom xeeb tub
Myomectomy yog txheej txheem muaj txiaj ntsig zoo tshaj plaws rau kev tshem tawm cov fibroids, tshwj xeeb hauv cov poj niam uas vam tias yuav xeeb tub. Txawm li cas los xij, ntau tus poj niam hluas zoo li yuav rov muaj fibroids hauv lawv lub neej. Cov poj niam uas tab tom cev xeeb tub tsis zoo li yuav pom fibroids rov qab los. Muaj 3 txoj hauv kev los ua myomectomy, thiab cov no sib txawv raws li kev cuam tshuam. Qhov loj thiab qhov chaw ntawm koj cov fibroids yuav pab txiav txim seb txoj kev twg yog qhov zoo rau koj.
- Hysteroscopic myomectomy - Rau cov txheej txheem no, koj tus kws phais mob tshem tawm cov fibroids siv cov cuab yeej tso los ntawm koj lub paum. Qhov no tuaj yeem ua tiav rau submucosal fibroids (fibroids sab hauv lub tsev menyuam). Nov yog txheej txheem kho mob sab nrauv thiab tuaj yeem ua tiav hauv ob peb teev. Cov poj niam feem ntau yuav xav tau 1-4 hnub nyob hauv tsev kom rov zoo.
- Laparoscopic myomectomy - Cov txheej txheem no siv cov cuab yeej tso los ntawm qhov txhab me me hauv koj lub plab kom tshem cov fibroids. Cov poj niam feem ntau yuav nyob 1 hmo hauv tsev kho mob, tom qab ntawd 2-4 lub lis piam rov qab los tsev.
- Abdominal myomectomy - Rau cov txheej txheem no, kev phais me me tau ua los ntawm daim tawv nqaij ntawm koj lub plab qis. Fibroids raug tshem tawm los ntawm qhov qhib no. Cov leeg nqaij ntawm lub tsev menyuam tau xaws rov qab ua ke nrog ob peb txheej txheej ntawm xaws. Cov poj niam feem ntau yuav nyob tau 2 hmo hauv tsev kho mob, tom qab ntawd 4-6 lub lis piam rov qab los tsev.
Kauj Ruam 3. Siv myolysis yog tias koj xav rov zoo sai
Myolysis yog txheej txheem laparoscopic uas siv rab koob tso rau hauv cov fibroids thiab hluav taws xob tam sim no lossis khov tau siv los rhuav tshem cov fibroids thiab ua rau cov hlab ntsha nqaim.
- Nyob ntawm qhov chaw ntawm koj cov fibroids, cov txheej txheem no yuav siv lub laparoscope (uas yuav tsum tau phais me me) lossis hysteroscope (uas tso rau hauv koj lub paum).
- Hysteroscopic myolysis tuaj yeem ua tiav hauv ob peb teev. Laparoscopic myolysis yuav xav kom pw hauv tsev kho mob ib hmos.
- Cov poj niam feem ntau yuav xav tau 1-4 hnub kom rov zoo nyob hauv tsev.
- Xaiv cov txheej txheem no yog tias koj tsis muaj phiaj xwm tam sim kom cev xeeb tub. Koj lub tsev menyuam yuav xav tau sijhawm kom rov zoo, tab sis koj tuaj yeem muaj peev xwm xeeb tub yav tom ntej.
Kauj Ruam 4. Tau txais endometrial ablation yog tias koj tsis npaj yuav cev xeeb tub
Cov txheej txheem no cuam tshuam nrog kev tso cov cuab yeej tshwj xeeb rau hauv koj lub tsev menyuam. Qhov ntsuas no siv cua sov thiab/lossis hluav taws xob txhawm rau txhawm rau rhuav koj lub tsev menyuam. Cov txheej txheem no yuav txo qis lossis tas mus li koj cov kev coj khaub ncaws.
- Cov txheej txheem no tuaj yeem ua tiav nrog cua sov, dej kub, microwave lub zog, lossis hluav taws xob tam sim no.
- Endometrial ablation txo qis koj lub peev xwm kom muaj menyuam thiab ua rau muaj feem yuav muaj teeb meem yog tias koj yuav tsum xeeb tub.
- Endometrial ablation tsis pom zoo rau cov poj niam uas tseem cia siab tias yuav xeeb tub.
- Qhov no suav tias yog txheej txheem kho mob sab nrauv thiab tuaj yeem ua tiav hauv ob peb teev. Cov poj niam feem ntau yuav xav tau so 1-4 hnub hauv tsev kom rov zoo.
Kauj Ruam 5. Muaj menyuam hauv plab yog tias koj nyob ze rau lub cev ntas lawm
Hysterectomy yog txheej txheem phais loj uas cuam tshuam nrog kev tshem tawm ntawm lub tsev menyuam. Hysterectomy yog tib txoj hauv kev mus tas li thiab kho tag nrho cov uterine fibroids. Qhov kev phais no yuav koom nrog 1-3 hnub nyob hauv tsev kho mob, nrog rau 4-6 lub lis piam ntawm lub sijhawm rov zoo nyob hauv tsev. Qhov chaw ntawm koj cov fibroids, lwm yam teeb meem ntawm kev tsim menyuam yaus uas koj yuav muaj, thiab ze li cas koj thiaj li yuav cev xeeb tub yuav pab koj thiab koj tus kws kho mob txiav txim seb hom kev hlais menyuam puas haum rau koj. Cov no suav nrog:
- Subtotal hysterectomy (ib nrab hysterectomy) - Hauv cov txheej txheem no, tsuas yog sab saud ntawm lub tsev menyuam raug tshem tawm. Qhov no yog qhov zoo tshaj yog tias koj tseem yog txoj hauv kev ntev los ntawm lub cev ntas.
- Tag nrho hysterectomy - Hauv txoj kev no, tag nrho lub tsev menyuam thiab lub ncauj tsev menyuam raug tshem tawm. Hauv qee kis, lub zes qe menyuam thiab cov hlab ntaws raug tshem tawm, ib yam.
- Radical hysterectomy - Cov txheej txheem no suav nrog tshem tawm ntawm lub tsev menyuam, cov ntaub so ntswg ntawm ob sab ntawm lub ncauj tsev menyuam, thiab sab saud ntawm qhov chaw mos.
Txoj Kev 3 ntawm 3: Txheeb Xyuas Fibroids Uterine
Kauj Ruam 1. Paub txog cov tsos mob ntawm fibroids
Rau ntau tus poj niam, fibroids yuav tsis ua rau muaj tsos mob. Fibroids feem ntau pom thaum lub sijhawm kuaj mob plab. Hmoov tsis zoo, hauv cov poj niam uas tau ntsib cov tsos mob fibroid, cov no tuaj yeem mob heev. Cov tsos mob ntawm uterine fibroids suav nrog:
- Los ntshav hnyav thiab lub sijhawm mob
- Hnov ua kom puv lossis siab nyob hauv thaj chaw hauv plab
- O ntawm lub plab
- Nquag tso zis
- Mob thaum sib deev
- Mob hauv qab nraub qaum
- Teeb meem thaum cev xeeb tub
- Teeb meem kev ua me nyuam, suav nrog ntxiv lawm tshob (uas yog qhov tsawg heev)
Kauj Ruam 2. Teem caij nrog koj tus kws kho mob
Yog tias koj tab tom ntsib qee yam lossis tag nrho cov tsos mob no, koj yuav tsum sab laj nrog kws kho mob. Mus ntsib koj tus kws kho mob tas li lossis mus ntsib kws kho mob poj niam. Ua ntej koj mus ntsib:
- Sau cov npe ntawm koj cov tsos mob. Suav nrog txhua yam uas cuam tshuam koj, txawm tias koj tsis paub tseeb tias nws cuam tshuam nrog.
- Sau cov npe tshuaj thiab tshuaj ntxiv uas koj noj. Sau koj cov tshuaj.
- Siv qee yam los sau rau. Tej zaum koj yuav xav sau cov ntaub ntawv tseem ceeb thaum koj mus ntsib.
- Yog ua tau, thov kom phooj ywg lossis tus neeg hauv tsev neeg nrog koj mus.
Kauj Ruam 3. Ua qee qhov kev xeem
Txhawm rau kuaj mob fibroids uterine, koj tus kws kho mob yuav tsum tau ua qee qhov kev sim. Feem ntau cov fibroids loj tuaj yeem kuaj pom nrog kuaj lub plab, thaum qee qhov kev kuaj ntshav (xws li suav cov ntshav tag) tuaj yeem pab txiav tawm lwm yam mob. Ultrasound thiab MRI qee zaum ua, tab sis tsis tas li. Hysterosonography (uterine sonogram) thiab hysteroscopy (uterine Scope) yog qhov zoo nkauj heev, tab sis yuav siv los kuaj mob fibroids uas me me lossis nyuaj rau hnov thaum lub sijhawm kuaj ib txwm muaj.
Kauj Ruam 4. Nug cov lus nug kom nkag siab txog koj tus mob thiab kev kho mob
Yog tias koj tau kuaj pom tias muaj fibroids ntawm lub tsev menyuam, nco ntsoov tias koj nkag siab zoo tias yuav muaj dab tsi tshwm sim nrog koj lub cev. Tham nrog koj tus kws kho mob kom koj nkag siab koj cov kev xaiv rau kev kho mob. Koj yuav nug:
- "Kuv muaj pes tsawg fibroids?"
- "Kuv cov fibroids loj npaum li cas?"
- "Kuv cov fibroids nyob qhov twg?" (Lawv tuaj yeem yog sab nrauv, sab hauv sab hauv, lossis hauv phab ntsa ntawm lub tsev menyuam.)
- "Koj puas xav tias kuv cov fibroids yuav txuas ntxiv mus?" thiab "Kuv yuav paub li cas yog tias lawv loj dua?"
- "Cov teeb meem kev noj qab haus huv twg tuaj yeem ua rau kuv cov fibroids?"
- "Kuv puas yuav tsum tau kuaj tas li txhawm rau saib xyuas kuv cov fibroids?" thiab yog tias muaj, "Cov kev xeem twg?"
- "Kuv txoj kev kho mob yog dab tsi?"
- "Koj txoj kev npaj khomob pom zoo yog dab tsi?"
