Sklerokistoz ovaries: ihe ọ bụ, na-akpata, ihe mgbaàmà, nchoputa, ọgwụgwọ, pụta

Odika percent ise N'ọnọdụ nile nke gynecological ọrịa, ndị dọkịta chọpụtara na "ovarian sklerokistoz". Gịnị ka ọ bụ, bụ onwe ya bụghị nwaanyị ọ bụla, ọtụtụ aghọta a nchoputa nke infertility dị ka a ikpe. N'ezie, ihe a atọ nke ndị na-chọpụtara nke a daa ọrịa, ụmụ ha nwere ike na-enweghị. Ma ndị ọzọ nwere elu Ohere na-agbake na-amụ a ike nwa.

Sklerokistoz ovaries nwere aha ọzọ - Stein-Leventhal syndrome, n'ihi na ya na nke mbụ kọwara abụọ American ọkachamara n'ọrịa ụmụ nwanyị - africa igbo gospel music Stein na Maykl Levental. Nke a mere na 1935. N'ime afọ na iri asatọ mgbe e mesịrị e juputara amụ pathogenesis nke ọrịa, mepụtara ụzọ nke ọgwụgwọ na nchoputa, ma ruo ugbu a ndị ọkà mmụta sayensị amaghị ihe mere ya na omume.

Ọ bụrụ na ị na-etinye a na-akụda nchoputa na ị chọrọ n'ezie ka ụmụ, enwela obi nkoropụ. N'isiokwu a, anyị ga-agbalị ịgwa ihe niile dị mkpa banyere ovarian sklerokistoz na ụzọ nke-anagide ya.

Olee otú ike ovaries

Iji mma ịghọta otú ịkọ sklerokistoz ovaries na afọ ime, mkpa ka ị mara otú rụọ ndị a ozu na otú ha na-arụ ọrụ, ma ọ bụrụ na e nweghị ọrịa ha. The ovaries bụ nwaanyị omumu akụkụ paired. Ha nwere ike na-anọchi anya na ụdị mbụ akpa jupụtara ụbụrụ okwu. Ovary mgbidi gburugburu na a oyi akwa nke oké connective anụ ahụ na ọ bụ a oyi akwa nke cortex. O nwere a mgbagwoju Ọdịdị na mkpa. Ọ bụ na nke a oyi akwa na-guzobere follicles - kpọmkwem bughi ọcha na nke na-emepe emepe oocyte. Follicles na-akpọ isi, ke ichekwa banyere onye nde abụọ tọrọ ke idem nke ọ bụla nwa ebu n'afọ ụmụ agbọghọ ọzọ. Ná ndụ, site na ntozu okè oge na-agwụcha oge nke menopause, ha na-eji nwayọọ nwayọọ iwesa na ndị ọhụrụ na-kpụrụ. Ya mere, oge awa na-abịa, mgbe ha ngwaahịa na-agba si.

Nke a fọrọ nke nta mgbe pụtara na ndị inyom nke ịmụ nwa afọ, ya mere, ihe na-akpata infertility nwere ike ịbụ enweghị follicles. Ihe ọzọ bụ na ha nwayọọ nwayọọ maturation mgbe ụfọdụ ihe ọjọọ. Ya mere, ha na-ata ụta maka eziokwu na chọrọ ime anaghị eme. Ọzọkwa, ọrịa ntutu ịdapụsị mmepe nke follicles na otu narị percent nke ikpe na-eduga ná gynecological ọrịa, nke ekpe untreated nwanyi enwekwu ihe ize ndụ nke thrombosis, thrombophlebitis, ọrịa shuga, nkụchi obi, ịza aza etuto ahụ na mammary glands.

Ka ovarian ahu otutu na-egosi na otú ọ na-akọ na ime

Mgbe ụmụ agbọghọ na-enwe mmekọahụ tozuru okè na ha ahụ gụnyere ọrụ usoro nke maturation nke isi follicles nke mb ka na-ehi ụra. Nke a usoro mgbe niile na-ewe ebe cycles. Na nke ọ bụla okirikiri nke "edidemede" banyere 15 follicles. Ha na-n'okpuru edinam nke FSH hormone emepụta site na pituitary gland, na-malitere na ibu, na-amụba n'obosara site 50 ruo 500 microns. N'oge a, ndị follicular ọmụmụ a kpụrụ nime ya, na kasị ukwuu n'ime ha na-egosi oghere. Nke a follicle na-aghọ isi, enwekwu 20 millimeters, fụliri elu. Inside na ọ na-ngwa ngwa na-emepe emepe egg. The ike nke follicle si ìgwè nke "edemede" otu mgbe ndị ọzọ na-anwụ na igbari. Ọ bụrụ na niile na-aga dị ka iwu si na nwaanyị ahụ a gụnyere na-arụ ọrụ nke endocrine usoro. N'ihi emepụta site na homonụ estrogen, progestins, na androgens, nke na-emetụta na n'ihu maturation nke ọchịchị kasị follicle. N'okpuru nduzi nke luteinizing hormone (lyuteotropina, lutropin, abbreviated dị ka LH), ya gbajiri, ya doo si egg n'ime fallopian tube, ọ na-amama n'ime corpus luteum na-eji nwayọọ nwayọọ resorbed.

Ọ bụrụ na ezumike adịghị ime, akwa na-adịghị tọhapụrụ bụ ejikere ịlọ ụwa, na ebe nke follicle egosi cherry-sized ovarian ahu otutu. Ndị nke "edemede" follicles na-adịghị nwere oge na-anwụ anwụ, na-atụgharị n'ime cysts, naanị nta. Ahu otutu, kpụrụ si a follicle, mgbe ụfọdụ, na-etolite ka a bukwanu size (40-60 mm), ma nwere ike ọ bụghị onwe ha ngosi. Naanị na a ole na ole mgbe, ọrịa mkpesa nke mgbu na ovaries. Ozugbo a nwaanyị nwere nkịtị mmepụta nke homonụ, o ji nwayọọ nwayọọ dissolves. Ọ bụrụ na a nwaanyị eweghachiwo ovulation, dị na oge nke ovarian follicular ahu otutu nke afọ ime anaghị egbochi, ma ọ bụrụ na ahu otutu toro na size nke 90 millimeters, ọ ga-surgically wepụrụ.

Na-akpata ọrịa

Ọkà mmụta sayensị maara n'ụzọ zuru ezu otú ndị image sklerokistoz ovaries. Ihe mere ihe a onu na-adịghị mma ike, na e nwere nanị echiche. Dị ka na nkịtị mmepe nke follicle na ovum mmepụta na ya homonụ na-egwu a dị oké egwu ọrụ, isi na-akpata sklerokistoz atụle ovarian mmiri ọgwụ ọrịa, na karịsịa a odida na usoro nke estrogen njikọ. Kwuru na ndị na-esonụ na-akpata nke mmiri ọgwụ ahaghị nhata:

• si n'aka ruo n'aka;
• abnormalities na site n'usoro Ọdịdị;
• na-enwe nsogbu ndị pituitary-ovarian usoro;
• trauma;
• nsogbu mgbe ete ime;
• na-efe efe na gynecological ọrịa;
• nsogbu mgbe ha mụsịrị nwa;
• ịgbanwe ọrụ nke adrenal cortex.

adakarị mgbaàmà

N'ụzọ dị mwute, ọ bụ nanị mmalite nke ntozu okè oge na-achọpụta girl sklerokistoz ovaries. Mgbaàmà n'oge a na-adọ lubricated na tumadi iso na ịhụ nsọ okirikiri. Ma nke a onu nwere ike ịbụ na ọtụtụ ihe ndị ọzọ metụtara ọrịa nke ovaries, ruo ogbenye oriri na-edozi na akwara ọrịa. N'ihi na iri abụọ, ka a kacha nke iri abụọ na ise afọ ụmụ agbọghọ apụta ọzọ ụfọdụ mgbaàmà nke ovarian sklerokistoz. The isi bụ ka a mebiri nke ịgba ígwè na odidi nke ịhụ nsọ (pasent 96 nke ọrịa). Ọtụtụ na-enwe ogologo na-egbu oge kwa ọnwa (ihe dị ka ọkara ma ọ bụ karịa) ma ọ bụ nnọọ obere ego nke precipitates (hypomenstrual syndrome). Ukwuu na-erughị yiri ka mkpesa banyere ogologo nke ndidi na hiri nne kwa ọnwa.

Mgbaàmà ndị ọzọ na-egosi nke ovarian sklerokistoz na-esonụ:

• hirsutism (na ihe dị ka pasent 90 nke ọrịa hụrụ hairiness ebe gburugburu ọnụ ara, azụ, afo, na agba n'elu egbugbere ọnụ);
• ibu ibu (70 percent nke ọrịa);
• nkwọcha na otutu na ihu (pụtara na ọ dịghị ihe karịrị pasent 40 nke ikpe);
• mgbanwe ụfọdụ na aru n'ike-n'ike;
• malfunction nke ụjọ usoro;
• asthenic syndrome;
• ovarian nditat (ahụrụ n'oge nnyocha ọkachamara n'ọrịa ụmụ nwanyị).

Ke adianade do, ụfọdụ ụmụ nwaanyị nwere ike mgbaàmà ndị a na-enwekarị ọtụtụ ọrịa: mgbu ke ala afo, malaise, na-apụghị ịkọwa ike ọgwụgwụ.

laabu research

Na ndabere nke mpụga ịrịba ama nke ovarian sklerokistoz naanị-enyo enyo, na ikpeazụ nchoputa a mere mgbe n'ihu ule. Ndị a bụ:

• analysis na ọbara testosterone (ngụkọta kwesịrị ịbụ na nso nke 1.3 and / ml, free inyom 41 afọ - n'ime 3,18 and / ml, na ruo afọ 59 - ọ dịghị ihe karịrị 2.6 and / ml);
• analysis nke susceptibility nke glucose dị n'ọbara sugar, na triglycerides;
• kolpotsitogramma (ihe e si ikpu nnwale data show, ọ dịghị ma ọ bụ ovulation, nakwa dị ka abịa indices kolpotsitogrammy afọ nke ọrịa ahụ na-adọ nke oge ịhụ nsọ ya okirikiri);
• scraping nke endometrium (enye ihe na-egosi nke imebi nke ovaries);
• ịchịkwa basal okpomọkụ mgbanwe;
• Ụfọdụ nyochara on thyroid homonụ, pituitary, ovaries (LH, FSH, PSSG, prolactin, cortisol, 17-hydroxyprogesterone);
• mkpebi siri ike nke estrogen excretion.

Ugbu a onye ọrịa nwere ike onwe mepụta a dị mfe ule chee na ovarian cysts. Nke a ga-achọ a mikroskopu (dị na pharmacies). Na ụtụtụ, dị nnọọ teta ma ka na-enweghị ihe a na-eri, na-aṅụ, ị mkpa ka a dobe ya asu a mpempe iko laabu na-enye ya nkụ. N'oge ovulation mgbe enwekwu larịị nke estrogen, nke n'aka nke gbanwere mejupụtara nke asu. Ọ bụrụ na ovulation bụ, a asu sample na mikroskopu ga-abụ n'ụdị nke fern epupụta, na ọ bụrụ na e nweghị ovulation, - n'ụdị ihe.

hardware nchọpụta nsogbu

Dị ka a na-achị, ezi na definitive nchoputa nke ọrịa ndinọ mgbagwoju nnyocha site ngwaọrụ ahụike.

The kasị nwayọọ na nnọọ mwute na-adịghị na usoro bụ ultrasound nchoputa nke ovarian sklerokistoz. The usoro transabdominal (site na afo), transvaginal (ukwuu ọmụma usoro), transrectal ultrasound (rụrụ naanị na nnọọ ụmụ agbọghọ na ndị agadi inyom).

Iji ultrasound chọpụta ovarian size, udi, Ọdịdị, ọnụ ọgụgụ nke follicles na ha, onye n'obosara - 8 mm, ọnụnọ ọ bụ enweghị ọchịchị kasị follicle, ọnụnọ ọ bụ enweghị ovulation, ọnụnọ nke cysts na ovary.

Ọzọ ụdị nnyocha e mere - gas pelveogramma egosi ndiiche size nke ovaries na akpanwa.

Otu n'ime ihe ndị kasị sie ike iche nke nchoputa bụ laparoscopy. Ọ na-rụrụ na a ọgwụ n'okpuru general ná Nkụnwụ. The algọridim nke na-esonụ: ndidi dọkịta na-awa na-eme ka a mgbapu nke peritoneum mgbidi na-abatakwa n'ime ngwa, ịfụ carbon dioxide gas iji ike na olu na peritoneum na mma inyocha akụkụ. Ọzọkwa, onye ọrịa ahụ na ẹkenam laparoscope, nke na-egosi na ihuenyo ala nke ovaries. Laparoscopy - kasị ezi usoro nke nchoputa, ma mgbe nwanyị kwesịrị na ghara ịgbanwe oge.

Conservative ọgwụgwọ nke ovarian sklerokistoz

Mgbe a definitive nchoputa ọtụtụ mgbe a nwaanyị na-họpụtara mbụ aṅụ ọgwụ. Nzube ya - iji weghachi nkịtị ịhụ nsọ okirikiri na ovulation ka ịmalitegharịa. The sklerokistoz emeso ovarian ọkachamara n'ọrịa ụmụ nwanyị kpebie ọnụ na endocrinologist.

Na ọnụnọ nke ibu oké ibu, onye ọrịa nzọụkwụ mbụ ọgwụgwọ bụ felata. Woman kenyere nri, na-egosipụta na-apụtakarị.

Agba nke abụọ - na-amụba nghọta nke insulin. Kara Aka "Metformin" na gị mkpa iji 3-6 ọnwa.

The atọ na-adọ - mmetuta nke ovulation. Malite ọgwụgwọ na mfe ọgwụ - "clomiphene". The mbụ N'ezie bụ na-enweta maka n'abalị na a dose nke 50 mg, malite na 5th ụbọchị nke okirikiri maka 5 consecutive ụbọchị. Ọ bụrụ na e nweghị N'ihi (ịhụ nsọ), "Clomiphene" na-a ọnwa. Ọ bụrụ na mgbe a mmetụta na-adịghị nwetara, ndị dose ama ọkọri 150 mg kwa ụbọchị.

The ọzọ ogbo (na-anọghị nke oma Ọnọdụ) - oge akara aka nke ọgwụ ọjọọ "menogon". Ọ na-ndinọ intramuscularly, na mgbe na-emecha N'ezie injections "Horagona". "Menogon" nwere ike dochie anya "Menodinom" ma ọ bụ "Menopur".

Mgbe-emecha ụzọ dum, na-eme na ọbara onwu, na ihe "Utrozhestan" ma ọ bụ "Djufaston" dabeere na analysis of pụta (ma ọ bụrụ na adịghị ezu nke hormone LH).

Ke ukem, ndị dọkịta na-agbalị iji wepụ a nwaanyị nwere hirsutism, na njikọ na nke ọ na-kenyere, "Ovosiston" na "Metronidazole".

Amanyere bụ iwu mgbakwunye na N'ezie bụ a vitamin.

Sklerokistoz ovaries: ọgwụgwọ nke ịwa ahụ usoro

Ọ bụrụ na n'ime ọnwa atọ mgbe usoro ọgwụ na-adịghị ovulation emee, nwaanyị a na-kenyere n'ịwa ahụ. Ọ na-rụrụ site na ọtụtụ ụzọ. Nke onye na-eji na-adabere na-egosi ovarian ọnọdụ.

N'oge ugbu ogbo, ndị na-esonụ arụmọrụ:

• moxibustion cysts eji a laser;
• demedulyatsiya (ovary mwepụ ya n'etiti akụkụ);
• nkpirikpi resection (mwepụ nke ihe ovary ngalaba nke emetụtara akụkụ n'ụdị a nkpirikpi);
• decortication (dibịa ewepu gbanwee tunica oyi akwa ovarian follicles na agịga amapu n'ọnụ sutured);
• galvanocautery (mgbe mbibi nke ndị na ovary ya ubi, nke na-amịpụta ukwuu hormone).
• notches (ha dọkịta na-awa na-eme ka a omimi nke 1 cm n'ebe na-enwu follicles ka ha nwee ike hapụ n'oge maturation nke egg onwe ya).

amụma

Women onye na-ekweta na ihe ọ bụla chọrọ ụzọ maka ndị dọkịta, ndị nwere mmasị na otu ajụjụ: na-na-ekwe omume na-atụrụ ime mgbe sklerokistoz ovaries? Statistics na-egosi na enweghị ọgwụgwọ, infertility na-chọpụtara na 90% nke ikpe. Drug ọgwụ "clomiphene" mma ovarian ọrụ 90% nke ọrịa, ma na ime emee mgbe naanị 28% nke ha. Otú ọ dị, dị ka ụfọdụ ezi ihe nwere ike dị elu dị ka 80%.

Enweghị "Clomiphene" ngwaahịa - ya nanị irè na mmalite nke ọrịa ma ọ bụ na-esonụ ịwa ahụ dị ka ihe adjuvant.

Ọgwụgwọ nke ọzọ dị ike ọgwụ ọjọọ eme ihe, dị ka "gonadotropins", dị ka ọnụ ọgụgụ, ọ dịkarịa ala na-eduga ná ovulation na 28% nke ndị ọrịa, na kacha - 97%. N'ihi ya ime 7 na 65% nke ndị inyom.

Ọ bụrụ na ovarian sklerokistoz emeso surgically, na ezi ihe chọpụtara banyere otu ugboro dị ka na nke mgbanwe ọgwụ. Dị ka ọnụ ọgụgụ, mgbe ịwa ahụ na ovaries a ohere ga-atụrụ ime na-70-80% nke ndị inyom.

Nyocha

N'ihi na ọtụtụ ndị inyom, na-ha ọjọ staging nchoputa "ovarian sklerokistoz". Nyocha nke ọrịa na ọgwụgwọ dị nnọọ iche. Onye nyeere Erere onye - ọrụ, na onye afọ ime ya emebeghị, n'agbanyeghị ihe na ụzọ na-e.

E nwekwara a obere akụkụ nke ọrịa akuko mmalite nke ha ime enweghị usoro ọgwụgwọ ọ bụla, ọ bụ ezie na nchoputa nke "sklerokistoz ovary" e filmed. Ndị a na-emegiderịta pụta nwere ike ịbụ n'ihi na onye e ji mara onye ọ bụla na-ekwesịghị iwere dị ka na-emekarị.

Ma mma nke ahụ ike mgbe omume, ha na-ede na a nyochaa, na ọtụtụ ndị inyom na. Naanị a ọrịa ole na ole kọrọ na ha normalized kwa ọnwa na-aga n'ihu n'ihi na a obere oge, mgbe nke na ha na-ọzọ chọrọ na-homonụ.

Ndien ke akpatre, e nwere a akụkụ nke reviews na nke ụmụ nwanyị na-ata ahụhụ site n'ile ha ogologo oge mgbu na ebe nke ovaries na peritoneum mgbe omume na ịwa ahụ.