Nā lāʻau lapaʻau

No ka hapa nui uterine fibroids mai hana i nā hōʻailona (ua ʻōlelo ʻia lākou he "asymptomatic"), hāʻawi pinepine nā kauka i ka "mālama makaʻala" i ka ulu ʻana o ka fibroid. ʻO ka maʻamau, ʻaʻole pono ka mālama ʻana i kahi fibroid i loaʻa ʻole nā ​​hōʻailona.

Ke koi ʻia ka lāʻau lapaʻau, ʻo ka hoʻoholo ʻana e koho i kekahi ma luna o kekahi e pili ana i nā kumu like ʻole: ke koʻikoʻi o nā hōʻailona, ​​​​ka makemake e hānau keiki a ʻaʻole paha, nā makahiki, nā makemake pilikino, etc.hysterectomy, ʻo ia hoʻi, ka wehe ʻana i ka ʻōpū, hāʻawi i kahi hopena paʻa.

Nā ʻōlelo aʻoaʻo no ka hōʻoluʻolu ʻana i nā ʻōuli

• Hiki ke kōkua i ka hoʻopau ʻana i ka ʻeha ka hoʻohana ʻana i nā ʻōpala mehana (a i ka hau) i nā wahi ʻeha. eha.
• ʻO nā lāʻau lapaʻau kūʻai aku e kōkua i ka hoʻomaha ʻōpū ʻōpū a me ka ʻeha hope. Aia kēia mau lāʻau lapaʻau i ka acetaminophen a i ʻole ka paracetamol (me Tylenol®,) a me ka ibuprofen (e like me Advil® a i ʻole Motrin®).
• E kue aku i ka Ka hoʻomau, pono ʻoe e ʻai i ʻelima a ʻumi mau ʻāpana o nā huaʻai a me nā mea kanu i kēlā me kēia lā, a me ka nui o ka fiber dietary. Loaʻa kēia mau mea i loko o nā huahana cereal palaoa holoʻokoʻa (berena palaoa a me ka pasta, laiki brown, laiki hihiu, bran muffins, etc.).

  NB No ka hele pū ʻana i kahi meaʻai momona i ka fiber, pono ia e inu nui i mea e pale ai i ka hoʻopaʻa ʻana i ka ʻāpana digestive.

• inā ka Ka hoʻomau hoʻomau, hiki iā mākou ke hoʻāʻo i kahi laxative nui (a i ʻole ballast), e pili ana i ka psyllium no ka laʻana, e hana mālie. ʻOi aku ka hoʻonāukiuki a ʻaʻole ʻōlelo ʻia nā laxatives hoʻoulu. No nā ʻōlelo aʻoaʻo ʻē aʻe, e ʻike i kā mākou Constipation fact sheet. ʻAʻole maikaʻi kēia mau ʻōlelo aʻoaʻo i ka wā e loaʻa ai i kahi fibroid nui, no ka mea, pili ka constipation i ka hoʻoemi ʻana i ka ʻāpana digestive, ʻaʻole i ka ʻai ʻino a i ʻole ka hele ʻana.
• Ina o 'koi pinepine e mimi, inu maʻamau i ka lā akā e pale i ka inu ʻana ma hope o ka hola 18 pm i ʻole e ala pinepine i ka pō.

nā lāʻauʻona

Hana nā lāʻau lapaʻau i ka hoʻoponopono ʻana i ka pōʻaiapili kāne e hōʻemi i nā hōʻailona (ʻoi aku ka nui o ke koko menstrual), akā ʻaʻole lākou e hoʻemi i ka nui o ka fibroid.

ʻEkolu mau hopena no nā wahine i loaʻa i ka fibroids pilikia:

- ka IUD (Mirena®). Hiki ke hoʻokomo wale ʻia i loko o ka ʻōpū ma ke ʻano ʻaʻole submucosal ka fibroid (contraindication formal) a ʻaʻole nui loa nā fibroids. Hoʻokuʻu mālie kēia IUD i kahi progestin e alakaʻi i kahi hōʻemi nui o ke koko. Pono e hoʻololi i kēlā me kēia ʻelima makahiki.

- hiki ke kuhikuhi ʻia ka waika tranexamic (Exacyl®) no ka lōʻihi o ke kahe.

- mefenamic acid (Ponstyl®), hiki ke kuhikuhi ʻia kahi lāʻau anti-inflammatory i ka wā o ke koko.

Inā nui loa ka fibroid a i ʻole he koko koʻikoʻi, hiki ke kuhikuhi ʻia nā lāʻau lapaʻau ʻē aʻe e hoʻemi i ka nui o ka fibroid ma mua o ka hana ʻana. Hiki ke kuhikuhi ʻia kahi pākuʻi hao i nā wahine i loaʻa i ke koko nui, i mea e uku ai i ka nalowale o ka hao i loko o ko lākou kino.

ʻO ka mālama mua ʻana i nā fibroids uterine.

- Gn-RH analogues (gonadorelin a i ʻole gonadoliberin). ʻO Gn-RH (Lupron®, Zoladex®, Synarel®, Decapeptyl®) he hormone e hoʻemi ana i nā pae estrogen i ka pae like me ka wahine postmenopausal. No laila, hiki i kēia lapaʻau ke hoʻemi i ka nui o nā fibroids e 30% a 90%. Hoʻopau kēia lāʻau lapaʻau i ka menopause pōkole a hele pū ʻia me nā hōʻailona, ​​​​e like me ka wela wela a me ka iwi haʻahaʻa. He nui kona mau hopena ʻaoʻao, e kaupalena ana i kona hoʻohana lōʻihi. No laila ua kuhikuhi ʻia ʻo Gn-RH i ka wā pōkole (emi iho ma mua o ʻeono mahina) oiai e kali ana no ka ʻoki. I kekahi manawa hoʻohui ke kauka i ka tibolone (Livial®) i nā analogues Gn-RH.

- Danazol (Danatrol®, Cyclomen®). Kāohi kēia lāʻau lapaʻau i ka hana ʻana o ka estrogen e nā ovaries, ka mea maʻamau ka hopena i ka hoʻopau ʻana i nā pōʻai menstrual. Hiki ke kōkua i ka hōʻemi ʻana i ke koko, akā ʻeha kona hopena ʻaoʻao: ka piʻi ʻana o ke kaumaha, ka wela wela, ka piʻi ʻana o ka cholesterol kiʻekiʻe, ka huehue, ka ulu nui ʻana o ka lauoho ... He mea maikaʻi ma luna o 3 mau mahina, e hōʻemi i nā hōʻailona o ka fibroids, akā ʻaʻohe aʻo i loiloi i kāna ka hopena no ka manawa lōʻihi. ʻIke ʻia he ʻoi aku ka nui o nā hopena ʻaoʻao a ʻoi aku ka maikaʻi ma mua o nā analogues GnRH. No laila ʻaʻole ʻōlelo hou ʻia

ʻoki kino

Hōʻike nui ʻia ka ʻoki ʻana no ke kahe ʻana ʻole o ke koko, ʻaʻohe keiki, ʻeha ʻeha nui a i ʻole ka ʻeha hope.

La myomectomy ʻo ka wehe ʻana i ka fibroid. Hiki i ka wahine makemake e hanau keiki. Pono ʻoe e ʻike ʻaʻole ʻo ka myomectomy kahi hopena paʻa mau. Ma 15% o nā hihia, ʻike ʻia nā fibroids ʻē aʻe a ma 10% o nā hihia, e hoʻopili hou mākou ma ke kaʻina hana.6.

Ke liʻiliʻi nā fibroids a me ka submucosal, hiki ke hana i ka myomectomy e ka hysteroscopy. Hysteroscopy Hoʻohana ʻia ka mea hana me kahi kukui liʻiliʻi a me kahi pahupaʻiwikiō i hoʻokomo ʻia e ke kauka i loko o ka ʻōpū ma o ka ʻōpū a me ka ʻōpū. ʻO nā kiʻi i hoʻolālā ʻia ma ka pale a laila alakaʻi i ke kauā. ʻO kekahi hana ʻē aʻe, ʻo ka laparoscopy, hiki ke hoʻokomo ʻia ka mea hana ma o kahi ʻoki liʻiliʻi i hana ʻia ma ka ʻōpū o lalo. I nā hihia kahi i hiki ʻole ai ka fibroid i kēia mau ʻenehana, hana ke kauka i kahi laparotomy, ka wehe maʻamau o ka pā o ka ʻōpū.

THEembolizationʻO ka fibroids kahi hana endosurgical e hoʻomaloʻo i nā fibroids me ka wehe ʻole ʻana iā lākou. Hoʻokomo ke kauka (he mea radiologist interventional) i kahi catheter i loko o kahi aʻa e hoʻoinu ai i ka ʻōpū i mea e hoʻokomo ai i nā microparticles synthetic i loaʻa ka hopena o ka pale ʻana i ke aʻa e hāʻawi ana i ka fibroid. ʻO ka fibroid, ka mea i loaʻa ʻole i ka oxygen a me nā meaʻai, e nalowale mālie ana ma kahi o 50% o kona nui.

Ma waho aʻe o ka mālama ʻana i ka ʻōpū, ʻoi aku ka ʻeha o kēia kaʻina hana ma mua o ka myomectomy. ʻO ka hoʻōla ʻana o ʻehiku a ʻumi lā ua lawa. Ma ka hoʻohālikelike ʻana, pono ka hysterectomy ma kahi o ʻeono mau pule o ka convalescence. Wahi a kahi noiʻi i paʻi ʻia ma 2010, hāʻawi ka uterine artery embolization (UAE) i nā hopena e like me nā makahiki ʻelima i hoʻohālikelike ʻia me ka hysterectomy, e ʻae ai i ka mālama ʻana i ka ʻōpū. Eia naʻe, ʻaʻole hiki ke hoʻohana ʻia kēia ʻenehana no nā fibroids āpau. No ka laʻana, ʻaʻole ʻōlelo ʻia no ka mālama ʻana i nā fibroids submucosal.

Hiki ke hana ʻia kekahi ʻano i kapa ʻia ʻo uterine artery ligation ma ka laparoscopy. Aia ia me ka hoʻokomo ʻana i nā clips ma nā ʻaʻa. Akā ʻoi aku ka maikaʻi ma mua o ka embolization i ka manawa.

- ʻO ka wehe ʻana o ka endometrium (ka uhi o ka ʻōpū) i kekahi mau hihia, kūpono paha i nā wahine makemake ʻole i nā keiki hou i mea e hōʻemi ai i ke koko kaumaha. Ke wehe ʻia ka endometrium ma ke ʻoki ʻana, ʻaʻole hiki ke hāpai ʻia ke koko menstrual i ka nui o nā hihia. Hana nui ʻia kēia ʻokiʻoki i nā hihia o ke koko kaumaha a me nā fibroids liʻiliʻi liʻiliʻi liʻiliʻi.

Loaʻa pinepine ʻia nā ʻano hana hou aʻe:

ʻO Thermachoice® (hoʻokomo ʻia kahi baluna i loko o ka ʻōpū a laila hoʻopiha ʻia me ka wai wela i 87 ° no kekahi mau minuke), Novasure® (ka luku ʻana i ka fibroid e ka radiofrequency me kahi electrode i hoʻokomo ʻia i loko o ka ʻōpū), Hydrothermablabor® (saline serum a wela i 90 ° i hoʻokomo ʻia i loko o ka ʻōpū o ka ʻōpū ma lalo o ka mana o ke kāmela), thermablate® (balloon inflated me ka wai ma 173 ° i hoʻokomo ʻia i loko o ka lua o ka ʻōpū).

ʻO nā ʻano hana ʻē aʻe o ka myolysis (ka luku ʻana i ka myoma a i ʻole fibroma aia nō i ke kahua o ka noiʻi): myolysis ma ka microwave, cryomyolysis (ka luku ʻana i ka fibroid ma ke anuanu), myolysis ma ka ultrasound.

- ʻO ka Hysterectomy, a i ʻole ka wehe ʻana i ka ʻōpū, ua mālama ʻia no nā hihia koʻikoʻi kahi i hiki ʻole ai nā ʻenehana mua, a no nā wahine makemake ʻole e hānau keiki. Hiki iā ia ke ʻāpana (mālama ʻia o ka pūpū) a i ʻole piha. Hiki ke hana ʻia ka hysterectomy ma ka ʻōpū, ma o kahi ʻoki i hana ʻia ma ka ʻōpū o lalo, a i ʻole ma ka waha, me ka wehe ʻole ʻia o ka ʻōpū, a i ʻole ma ka laparoscopy ke hiki i ka nui o ka fibroid. ʻO kēia ka hopena "radical" e kū'ē i nā fibroids, no ka mea ʻaʻole hiki ke hoʻi hou ma hope o ka wehe ʻana o ka ʻōpū.