Okuqukethwe
Zifundele wena bese utshela umngane wakho! Ungazivikela kanjani kumdlavuza we-ovari futhi welashwa kanjani?
Ngo-2020, kwabhaliswa amacala angaphezu kwezinkulungwane eziyi-13 zomdlavuza we-ovarian eRussia. Kunzima ukuyivimbela, kanye nokuyibona ezigabeni zokuqala: azikho izimpawu ezithile.
Kanye nodokotela wezifo zabesifazane we-"CM-Clinic" u-Ivan Valerievich Komar, sithole ukuthi ubani osengozini, indlela yokunciphisa amathuba okuba nomdlavuza wesibeletho kanye nendlela yokwelapha uma kwenzeka.
Uyini umdlavuza wesibeletho
Wonke amangqamuzana asemzimbeni womuntu anesikhathi sokuphila. Ngenkathi ingqamuzana likhula, liphila futhi lisebenza, ligcwala udoti futhi liqongelela izinguquko. Uma seziningi kakhulu, ingqamuzana liyafa. Kodwa ngezinye izikhathi okuthile kuyaphuka, futhi esikhundleni sokufa, ingqamuzana elingenampilo liyaqhubeka lihlukana. Uma emaningi kakhulu kulawa maseli, kanti amanye amangqamuzana omzimba angenaso isikhathi sokuwabhubhisa, umdlavuza uyavela.
Umdlavuza we-ovary uvela kuma-ovari, izindlala zokuzala zesifazane ezikhiqiza amaqanda futhi ziwumthombo oyinhloko wamahomoni wesifazane. Uhlobo lwesimila luncike engqamuzaneni esiqhamuke kulo. Isibonelo, izimila ze-epithelial ziqala kumangqamuzana e-epithelial we-fallopian tube. Amaphesenti angu-80 azo zonke izimila zesibeletho zinjalo nje. Kodwa akuwona wonke ama-neoplasms ayingozi.
Yiziphi izimpawu zomdlavuza wesibeletho
Isigaba sesi-XNUMX somdlavuza we-ovarian akuvamile ukuba sibe nezimpawu. Futhi ngisho nasezigabeni zakamuva, lezi zimpawu azicacisi.
Ngokuvamile, izimpawu ziyizi:
ubuhlungu, ukuqunjelwa, umuzwa wobunzima esiswini;
ukungakhululeki nobuhlungu esifundeni se-pelvic;
ukopha kwesitho sangasese sowesifazane noma ukuphuma okungavamile ngemva kokuya esikhathini;
ukusutha ngokushesha noma ukulahlekelwa ukudla;
ukushintsha imikhuba yasendlini yangasese: ukuchama njalo, ukuqunjelwa.
Uma kuvela noma yiziphi zalezi zimpawu futhi zingasuki emasontweni amabili, udinga ukubonana nodokotela. Ngokunokwenzeka, lokhu akuwona umdlavuza, kodwa enye into, kodwa ngaphandle kokubonisana nodokotela wezifo zabesifazane, awukwazi ukuthola noma ukukwelapha.
Iningi lomdlavuza ekuqaleni alibonakali, njengoba kunjalo ngomdlavuza wesibeletho. Kodwa-ke, uma isiguli, isibonelo, sine-cyst engase ibe buhlungu, lokhu kuzophoqa isiguli ukuba sifune usizo lwezokwelapha futhi sithole izinguquko. Kodwa ezimweni eziningi, azikho izimpawu. Futhi uma zivela, khona-ke isimila kungenzeka ukuthi sesivele sikhulu ngobukhulu noma sibandakanya ezinye izitho. Ngakho-ke, iseluleko esiyinhloko akufanele ulinde izimpawu futhi uvakashele njalo i-gynecologist.
Ingxenye eyodwa kwezintathu kuphela yamacala omdlavuza wesibeletho atholwa esigabeni sokuqala noma sesibili, lapho isimila silinganiselwe kuma-ovari. Lokhu ngokuvamile kunikeza ukubikezela okuhle mayelana nokwelashwa. Ingxenye yamacala itholwa esigabeni sesithathu, lapho kuvela ama-metastase emgodini wesisu. Futhi ama-20% asele, isiguli ngasinye sesihlanu esiphethwe umdlavuza wesibeletho, sitholwa esigabeni sesine, lapho ama-metastase esakazeka kuwo wonke umzimba.
Ubani osengozini
Akunakwenzeka ukubikezela ukuthi ubani ozothola umdlavuza nokuthi ubani ongeke. Kodwa-ke, kunezici eziyingozi ezandisa leli thuba.
Ubudala: Umdlavuza we-Ovarian uvame ukwenzeka phakathi kweminyaka engama-50-60.
Izinguquko ezizuzwe njengefa kuzakhi zofuzo ze-BRCA1 ne-BRCA2 nazo ezandisa ingozi yomdlavuza webele. Phakathi kwabesifazane abanokuguqulwa kwe-BRCA1 lapho sebeneminyaka engu-80, bazoba nomdlavuza wesibeletho, futhi nge-BRCA2 - 11-17%.
Umdlavuza wesibeletho noma webele ezihlotsheni eziseduze.
I-Hormone replacement therapy (HRT) ngemva kokuya esikhathini. HRT , ebuyela kuleveli yangaphambilini lapho kuphela umthamo womuthi.
Ukuqala kokuya esikhathini kanye nokuqala sekwephuzile kokuya esikhathini.
Ukuzalwa kokuqala ngemva kweminyaka engu-35 noma ukungabi khona kwezingane kule minyaka.
Ukukhuluphala ngokweqile nakho kuyisici esiyingozi. Izifo eziningi ze-oncological zabesifazane zincike ku-estrogen, okungukuthi, zibangelwa umsebenzi we-estrogens, ama-hormone ocansi wesifazane. Akhiqizwa ama-ovari, ngokwengxenye yizindlala ze-adrenal kanye nezicubu ze-adipose. Uma kunezicubu eziningi ze-adipose, khona-ke kuzoba ne-estrogen eyengeziwe, ngakho-ke amathuba okugula aphezulu.
Ulashwa kanjani umdlavuza wesibeletho
Ukwelashwa kuncike esigabeni somdlavuza, isimo sempilo, nokuthi owesifazane unazo yini izingane. Imvamisa, iziguli ziphuma ngokuhlinzwa kwesimila kuhlanganiswe nokwelashwa ngamakhemikhali ukuze kubulawe amaseli asele. Kakade esigabeni sesithathu, ama-metastase, njengomthetho, akhulela emgodini wesisu, futhi kulokhu udokotela angase ancome enye yezindlela ze-chemotherapy - indlela ye-HIPEC.
I-HIPEC i-hyperthermic intraperitoneal chemotherapy. Ukulwa namathumba, isisu sesisu siphathwa ngesisombululo esishisayo sezidakamizwa ze-chemotherapy, okuthi, ngenxa yokushisa okuphezulu, zibhubhise amangqamuzana omdlavuza.
Inqubo iqukethe izigaba ezintathu. Okokuqala ukususwa ngokuhlinzwa kwama-neoplasms ayingozi abonakalayo. Esigabeni sesibili, ama-catheter afakwa emgodini wesisu, lapho kunikezwa isisombululo somuthi we-chemotherapy oshiselwe ku-42-43 ° C. Lokhu kushisa kuphakeme kakhulu kuno-36,6 ° C, ngakho izinzwa zokulawula izinga lokushisa nazo zifakwa emgodini wesisu. Isigaba sesithathu ngesokugcina. I-cavity iyagezwa, i-incision i-sutured. Inqubo ingathatha amahora angu-XNUMX.
Ukuvimbela umdlavuza wesibeletho
Ayikho iresiphi elula yokuthi ungazivikela kanjani kumdlavuza wesibeletho. Kodwa njengoba nje kunezici ezandisa ingozi, zikhona nalezo eziyehlisayo. Ezinye zilula ukuzilandela, ezinye zizodinga ukuhlinzwa. Nazi ezinye izindlela zokuvimbela umdlavuza wesibeletho.
Ukugwema izinto eziyingozi: ukukhuluphala ngokweqile, ukudla okungenakulinganisela, noma ukuthatha i-HRT ngemva kokunqamuka kokuya esikhathini.
Thatha izinto zokuvimbela inzalo. Abesifazane abawasebenzisile iminyaka engaphezu kwemihlanu banengxenye yengozi yomdlavuza wesibeletho kunabesifazane abangakaze bawasebenzise. Kodwa-ke, ukuphuza izinto zokuvimbela inzalo akuwakhulisi kakhulu amathuba okuba nomdlavuza webele. Ngakho-ke, azisetshenziselwa kuphela ukuvimbela umdlavuza.
Hlanganisa amashubhu e-fallopian, ususe isibeletho nama-ovari. Ngokuvamile, le ndlela isetshenziswa uma owesifazane enengozi enkulu yomdlavuza futhi esevele enezingane. Ngemva kokuhlinzwa, ngeke akwazi ukukhulelwa.
Ukuncelisa ibele. ukuthi ukondla unyaka kunciphisa ingozi yomdlavuza wesibeletho ngo-34%.
Vakashela udokotela wakho wezifo zabesifazane njalo. Ngesikhathi sokuhlolwa, udokotela uhlola usayizi nesakhiwo sama-ovari nesibeletho, nakuba izicubu eziningi zakuqala kunzima ukuzibona. I-gynecologist kufanele inikeze i-ultrasound ye-transvaginal yezitho ze-pelvic ukuze ihlolwe. Futhi uma owesifazane eseqenjini elisengozini enkulu, ngokwesibonelo, unokuguqulwa kwezakhi zofuzo ze-BRCA (izakhi zofuzo ezimbili i-BRCA1 ne-BRCA2, igama layo elisho "ufuzo lomdlavuza webele" ngesiNgisi), ngakho-ke kuyadingeka ukwengeza. baphumelele ukuhlolwa kwegazi kwe-CA-125 kanye nomaka wesimila HE-4. Ukuhlolwa okujwayelekile, okufana ne-mammography yomdlavuza webele, kusesekhona kumdlavuza wesibeletho.