Nā fibroids ʻōterine

Uterine fibroids he mau ʻōpuʻu e ulu ana i loko o ka ʻōpū o ka wahine (kōpū). ʻAʻole maʻamau kēia mau ulu ʻana i ka maʻi ʻaʻai (benign).

Maʻa mau nā fibroids utterine. ʻO ka nui o hoʻokahi i loko o ʻelima mau wahine i loaʻa i nā fibroids i ko lākou hānau ʻia ʻana i nā makahiki. Loaʻa ka hapalua o nā wahine āpau i nā fibroids i ka makahiki 50.

ʻAno ʻole ʻo Fibroids i nā wahine ma lalo o ka makahiki 20. ʻOi aku ka nui o lākou i nā ʻAmelika ʻAmelika ma mua o ka White, Hispanic, a me nā wahine ʻAsia.

ʻAʻohe mea i ʻike pono i ke kumu o nā fibroids. Ua manaʻo ʻia na lākou e:

• Hormones i ke kino
• Nā Genes (holo paha i loko o nā ʻohana)

Hiki i nā Fibroids ke liʻiliʻi loa e pono ai i kahi microscope e ʻike iā lākou. Hiki iā lākou ke ulu nui loa. Hoʻopiha paha lākou i ka kōpū holoʻokoʻa a kau paha i mau paona a i nā kilokika. ʻOiai hiki i hoʻokahi fibroid ke hoʻomohala, pinepine ka ʻoi aku ma mua o hoʻokahi.

Hiki i nā Fibroids ke ulu:

• I ka paia o ka uterus (myometrial)
• Ma lalo pono o ka uhi o ka uterine (submucosal)
• Ma lalo pono o ka uhi waho o ka kōpū (subserosal)
• Ma kahi koʻokoʻo lōʻihi ma waho o ka kōpū a i ʻole i loko o ka kōpū (pedunculated)

ʻO nā ʻōuli maʻamau o nā fibroids uterine he:

• Kahe i waena o nā wā
• Kahe nui ke kahe i kou wā, i kekahi manawa me ke koko koko
• Nā wā e lōʻihi paha ka lōʻihi ma mua o ka maʻamau
• Pono e mimi hou pinepine
• Pākuʻi pelvic a ʻeha paha me nā wā
• Ke piha a i ʻole kaomi i kou ʻōpū haʻahaʻa
• ʻEha i ka wā o ka moekolohe

I ka manawa pinepine, hiki iā ʻoe ke loaʻa nā fibroids a ʻaʻohe ou ʻōuli. Hiki i kāu kauka olakino ke loaʻa iā lākou i ka wā o ka hoʻokolohua kino a i ʻole nā ​​hoʻokolohua ʻē aʻe. Kūleʻa pinepine nā fibroids a ʻaʻole kumu i nā hōʻailona i nā wahine i hele i loko o ka menopause. Ua hōʻike ʻia kahi noiʻi hou e hōʻemi ana kekahi mau fibroids liʻiliʻi i nā wahine premenopausal.

E hana ana kāu mea hāʻawi i kahi hōʻike pelvic. Hōʻike paha kēia i kāu loli i ke ʻano o kou ʻōpū.

ʻAʻole maʻalahi nā Fibroid i nā manawa āpau. Hiki i ka momona ke hana i nā fibroids paʻakikī e ʻike. Pono ʻoe i kēia mau hoʻāʻo e nānā i nā fibroids:

• Hoʻohana ka ultrasound i nā nalu kani e hana i kiʻi o ka uterus.
• Hoʻohana ʻo MRI i nā mākēneki mana a me nā nalu lekiō e hana i kiʻi.
• Saline infusion sonogram (hysterosonography) - Hoʻokomo ʻia ʻo Saline i loko o ka kōpū e maʻalahi ai ke ʻike ʻana i ka pūpū me ka hoʻohana ʻana o ka ultrasound.
• Hoʻohana ka Hysteroscopy i kahi ʻōmole lahilahi a lahilahi i hoʻokomo ʻia ma o ka ʻōpū a i loko o ka kōpū e nānā ai i loko o ka pūpū.
• Lawe ka biopsy endometrial i kahi ʻāpana o ka uhi o ka kōpū e nānā ai no ka maʻi ʻaʻai inā loaʻa ʻoe i ke kahe koko ʻole.

He aha ke ʻano o kāu mālama ʻana e pili ana:

• Kou makahiki
• ʻO kou olakino laulā
• Kou mau hōʻailona
• ʻAno o nā fibroids
• Inā hāpai ʻoe
• Inā makemake ʻoe i nā keiki i ka wā e hiki mai ana

ʻO ka mālama ʻana i nā ʻōuli o nā fibroids e komo pū paha:

• Nā polokalamu Intrauterine (IUD) e hoʻokuʻu i nā homone e kōkua i ka hoʻēmi ʻana i ke kahe nui a me ka ʻeha.
• Tranexamic acid e hoʻemi i ka nui o ke kahe o ke koko.
• Pākuʻi hao e pale a mālama i ka anemia ma muli o nā wā kaumaha.
• Nā mea hōʻoluʻolu ʻeha, e like me ka ibuprofen a i ʻole naproxen, no ka cramp a i ʻole ka ʻeha.
• Ke kali nei ke kiaʻi - Ua ukali paha ʻoe i nā hoʻokolohua pelvic a i ʻole ultrasounds e nānā i ka ulu ʻana o ka fibroid.

Nā lāʻau lapaʻau a i ʻole hormonal therapies i hiki ke kōkua i ka hōʻemi ʻana i nā fibroids i:

• Nā lāʻau kaohi hānau e kōkua i ke kaohi i nā wā kaumaha.
• ʻO kahi ʻano IUD e hoʻokuʻu i kahi mahele haʻahaʻa o ka hormone progestin i loko o ka kōpū i kēlā me kēia lā.
• Nā pana Hormone e kōkua i ka hoʻoliʻiliʻi fibroids e ka hoʻōki ʻana i ka ovulation. ʻO ka pinepine, hoʻohana ʻia kēia hoʻomaʻamaʻa no kahi manawa pōkole e hōʻemi i nā fibroids ma mua o ke kahakaha ʻana. Hiki iā lākou ke hoʻohana lōʻihi ke hoʻohui ʻia nā hapa liʻiliʻi o ka estrogenone hormonone e hoʻemi i nā hopena ʻaoʻao.

ʻO ke ʻoki a me nā kaʻina hana i hoʻohana ʻia e mālama i nā fibroids:

• Hysteroscopy - Hiki i kēia kaʻina hana ke wehe i nā fibroids e ulu ana i loko o ka kōpū.
• Hoʻopau endometrial - Hoʻohana ʻia kēia kaʻina hana i kekahi manawa e mālama i ke kahe nui e pili ana i nā fibroids. ʻOi aku ka maikaʻi ke hana ka liʻiliʻi o ka fibroids i ka nui. Hoʻomaha pinepine ia i ka menstruation.
• Hoʻokomo ʻia ke aʻa Uterine - Hoʻopau kēia hana i ke kahe o ke koko i ka fibroid, e hoʻoliʻiliʻi a make. He koho maikaʻi paha kēia inā makemake ʻoe e hōʻalo i ke kaha ʻana a ʻaʻole ʻoe e hoʻolālā e hāpai.
• Myomectomy - Hōʻalo kēia keʻoki i nā fibroids mai ka pūpū. He koho maikaʻi paha kēia inā makemake ʻoe e hānau keiki. ʻAʻole ia e pale i ka ulu ʻana o nā fibroids hou.
• Hysterectomy - Hōʻalo loa kēia ʻoki i ka uterus. He koho paha ia inā ʻaʻole ʻoe makemake i nā keiki, ʻaʻole holo pono nā lāʻau, ʻaʻole hiki iā ʻoe ke loaʻa nā kaʻina hana ʻē aʻe.

Ke loiloi ʻia nei nā lāʻau hou, e like me ka hoʻohana ʻana o ka ultrasound kālele ʻia, i nā noiʻi maʻi ʻana.

Inā loaʻa iā ʻoe nā fibroids me ka ʻole o nā hōʻailona, ​​ʻaʻole pono ʻoe e lapaʻau.

Inā loaʻa iā ʻoe nā fibroids, ulu paha lākou inā hāpai ʻoe. Loaʻa kēia i ke kahe o ke kahe o ke koko a me nā pae estrogen kiʻekiʻe. Hoʻi pinepine nā fibroids i kā lākou nui ma hope o ka hānau ʻia o kāu pēpē.

Nā pilikia o nā fibroids:

• ʻOi loa ka ʻeha a i ʻole ke kahe koko nui e pono ai ke ʻoki kūpilikia.
• Ke wili ʻana o ka fibroid - Hiki i kēia ke kumu i nā kīʻaha koko i hānai ʻia i ka tumo. Pono ʻoe i ke ʻoki inā kū kēia.
• Anemia (ʻaʻole lawa ka ʻula o ke koko) mai ke kahe nui ʻana.
• Nā maʻi maʻi urinary - Inā kaomi ka fibroid ma luna o ka puhā, hiki i ka paʻakikī ke hoʻokuʻu loa i kāu kīʻaha.
• Infertility, i nā manawa kakaikahi.

Inā hāpai ʻoe, aia kahi liʻiliʻi liʻiliʻi e hana nā fibroids i nā pilikia:

• Hiki iā ʻoe ke hāʻawi i kāu pēpē i ka wanaʻao no ka mea ʻaʻole lawa ka lumi i loko o kou ʻōpū.
• Inā pale ka fibroid i ke kahawai hānau a kau i ka pēpē i kahi kūlana weliweli, pono paha ʻoe e loaʻa kahi ʻāpana cesarean (ʻāpana C).
• Loaʻa paha iā ʻoe ke kahe nui o ke koko ma hope pono o ka hānau ʻana.

Kāhea i kāu mea hāʻawi inā loaʻa iā ʻoe:

• Kaumaha nui, hoʻonui i ka cramping, a i ʻole ke kahe ʻana ma waena o nā wā
• Ka piha a kaumaha paha i kou wahi ʻōpū o lalo

Leiomyoma; Fibromyoma; Myoma; ʻO Fibroids; ʻO ke kahe ʻana o ka uterine - fibroids; ʻO ke kahe o ke kīnā - fibroids

• Hysterectomy - ʻōpū - hoʻokuʻu
• Hysterectomy - laparoscopic - hoʻokuʻu
• Hysterectomy - heʻe - hoʻokuʻu
• ʻO ke komo ʻana o ke aʻa Uterine - hoʻokuʻu

• Pelvic laparoscopy
• Anatomia hānau wahine
• Nā kūpale Fibroid
• Uterus

ʻO Dolan MS, Hill C, Valea FA. Nā lehele wahine gynecologic Benign: ʻāpau, ʻōpua, ʻehaʻeha, uterus, oviduct, ovary, kiʻi ultrasound o nā pelvic. I: Lobo RA, Gershenson DM, Lentz GM, Valea FA, eds. Gynecology Comprehensive. ʻEpekema 7 Piladelapia, PA: Elsevier; 2017: chap 18.

Moravek MB, Bulun SE. Nā fibroids ʻōterine. I: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Makua a Pediatric. ʻEpekema 7 Piladelapia, PA: Elsevier Saunders; 2016: chap 131.

Kiu JB. ʻO ke kuleana o ka uterine artery embolization i ka mālama ʻana i nā fibroids uterine. ʻO Clin Obstet Gynecol. 2016; 59 (1): 93-102. PMID: 26630074 pubmed.ncbi.nlm.nih.gov/26630074/.

ʻO Stewart EA. ʻOihana hoʻomaʻamaʻa. Nā fibroids ʻōterine. N Engl J Med. 2015; 372 (17): 1646-1655. PMID: 25901428 pubmed.ncbi.nlm.nih.gov/25901428/.

ʻO Verpalen IM, Anneveldt KJ, Nijholt IM, et al.ʻO ka ultrasound (MR-HIFU) ʻano nui o ka resonance magnetic resonance-fibergs uterine me nā kuʻuna lapaʻau mālama ʻole: kahi loiloi ʻōnaehana a me nā meta-analysis. Eur J Radiol. 2019; 120: 108700. hana: 10.1016 / j.ejrad.2019.108700. PMID: 31634683 pubmed.ncbi.nlm.nih.gov/31634683/.