Kua kitea pea e koe to taakuta mo te rere o te uterine rereke penei
- He taimaha atu i te toto o te menstrual
- Te tipu i waenganui i to wa waa
- Nga toto o te menopausal
Mena kei a koe, ka taea pea ki a koe te whakamatau i te hyperplasia endometrial.
Aronga
Ko te hyperplasia endometrial ko te kino o te whitiki o to opu me te endometrium .
Ko to tautuhi ko te aha e hangaia ana, e whakaatu ana i ia marama ki te urupare ki o huringa o te huka hou.
Ko te waahanga nui o to menstrual marama rere. He mea tino tika mo te whitiki o to pokapū kia nui ake, kia nui ake ranei i te haurua tuatahi o to huringa matomato
Engari, ki te mea he rereke i roto i te whakaoho o te mutunga o te endometrium ka taea e te kino te puta. Ko tenei whakarerekëtanga ko te matotoru o te mutunga o te endometrium, a ka kiia ko te hyperplasia endometrial.
Ko taau ovaries e whakaputa ana i te estrogen me te progesterone hei whakautu ki nga hormones whakaongaonga mai i te roro. Ko tenei whakarerekētanga me te waahi-waahi mo te whanaketanga o te estrogen me te progesterone ko te aha e tae mai ai to wa waa, i nga ra 28 katoa.
Tuhinga o te Hapa Korero
Ko te korenga o te hormonal e kawe ana mo te hyperplasia endometrial ko te neke atu o te estrogen ki te progesterone
Ko te Estrogen te hormone e kawenga ana ki te whakawhitinga i te mutunga o te endometrium i te wa tuatahi o to huringa.
Ina paahitia me te moni tika o te whakatairanga ka whakatupuria e te mutunga o te endometrium, engari kaore e whakaaetia mo te tipu kino ake. Engari, ki te nui atu te nui o te hinengaro o te estrogen, kei te whakahekehia te taina, a kei te haere tonu te pupuhi. I te wa ka timata te pakaru o te tarai ki te whakawhanake i nga huringa rereke.
Ngā Uara Risk
Ko nga tikanga e whai ana i te nui o te estrogen e taea ai te kawe ki te hyperplasia endometrial:
Te nui
Ka huri te kikokiko i etahi atu homoni ki te estrogen. Ko tenei ka hua ake i te estrogen e whakatairanga ana i te taiao o te pokapū ki te tua atu o te hauhaki-a-te-rangi e whakaputaia ana e ou ovaries. Mena kua neke atu i te 35 o to BMI, he nui ake te painga o te whakawhanaketanga o te hyperplasia endometrial i whakaritea ki a koe i te taimaha tinana pai.
Anovulation
He maha nga take e kore ai koe e ako. Mena kaore koe e akoako i taau kura kaore e whakanui ake i tana whakaputa i te progesterone. Ko tenei tipu i roto i te progesterone he mea tika mo te whitiki o to pokapū ki te whakaheke. I etahi atu kupu, kaore koe e whiwhi i to waa. I roto i etahi momo o te tere o te rauroto, kaore pea he pupuhi i roto i te progesterone e taea ai he nui atu te nui o te estrogen. Ko tenei estrogen huakore ka puta mai i roto i te paheketanga kino o te endometrium. I te mutunga, ka whai koe i etahi ahua o te rere o te uterine. Ko nga tauira tawhito o te rere me tenei ahuatanga o te whakawhitinga tae atu ki nga waahanga rereke me te taimaha taimaha ranei i waenganui o nga wa. Ko nga take tawhito o tenei ahuatanga o te taapenga o te hormonal ko:
Nga Hormones
Ka tino kaha te tango i te whakakapi o te hinetene hei whakanui ake i ö taumata o te estrogen e pä ana ki ö taumata progesterone.
Ko te aha tena mehemea kei te whai tonu koe i te pokapū ka hiahia koe ki te tango i tetahi ahua o te progesterone hei aukati i to whakawhitinga i te mutunga o te mutunga.
Ko tetahi atu rongoā homoni e taea ai te whakatipu i te mate o te endometrium ko Tamoxifen . Ko Tamoxifen he tarukino e kiia ana ko te modulator receptor modulator ranei SERM. Ko nga SERMs he raau taero e pa ana ki nga waahanga o te tinana o te haurore o te tinana o te hinengaro. Kei te whakamahia te Tamoxifen i te maimoatanga o nga mate pukupuku mate pukupuku o te homone no te mea e whakahē ana i nga paanga o te estrogen i roto i te kiri o te u. Engari, ko te Tamoxifen e whakaihiihi ana i nga kaitautoko o te estrogen i roto i te taatai o te pokapū kia mahi ai ia ano he estrogen ka taea ai te mate pukupuku endometrial.
Mena kei te whakamahi koe i te hauora whakakapi homoni ranei Tamoxifen me te whakawhanake i te rere o te uterine rereke he mea tino nui kia kite koe i to taakuta me te aromatawai.
Ko te whanaketanga o te whanaketanga ovarian
Ko te korenga o nga tote e kore he take tino nui o te hyperplasia endometrial. Heoi ano, he maha nga pukupuku o te pukupuku o te ovarian e hua ana i te estrogen.
Te whakamātautau
Ka kite koe i to taakuta me nga amuamu o te rere o te uterine rereke kaore koe e whai i te koiora o te taatai o to tuawhitu. Ka taea e to taakuta te taunaki i tetahi koiora endometrial tari ranei, i tetahi waahanga taraiwa iti ranei e karanga ana he hikurokiro me te rongoa me te tauira o te endometrium.
Koiora o Endometrial
He tikanga tino pai te mahi a te tari-a-tari. I te nuinga o te waa, he pai rawa te toenga.
I roto i taku mahi, ka kitea e ahau ko te hiahia me te manukanuka o te tukanga he kino rawa ake i te koiora. Ki te hiahia koe ki te whai i te biopsy endometrial, he pai ki te tango i te 600 mg o te ibuprofen me te paramanawa iti mo te haora i mua i te tukanga. Ka hiahia pea koe ki te kawe mai i tetahi putea whakamahana iti ki a koe ranei hei awhina i te whakaiti i te pupuhi i te wa i muri i te tukanga. Ka taea pea e to taakuta te hoatu ki a koe i te wa o te koiora.
Ko te whakarite mo te koiora he rite tonu mo te whakamahinga o te papanga. I muri i te whakanohohia o te raupapaku kia horoia atu e to taakuta to taera me te taraiwa. Mena pea ka tuhia e to taakuta he pupuhi hei pupuri i to putea i te wa e whakauruhia ai te taputapu waitohu iti. Ka ite pea koe i etahi raruraru. Kaore koe e mahara he mea nui engari ka whai waahi koe. Ko te raruraru ka puta mai i nga wa o te ngawari o te waahi ki te kaha nui o te mamae me te mamae o te mamae. Ko te rongo pai ko te tukanga he tere tonu, me te nuinga o te wa iti iho i te meneti kotahi. Ko te tango i te ibuprofen i mua i te tukanga me te whakamahi i te whakamahana mahana i te wa o te tukanga, ka tino awhina i te mamae.
Tuhinga o mua
E tohu ana to taakuta kei te whai koe i te waahi hikaroki me te whakamamutunga endometrial hei utu mo te koiora endometrial. Koinei te raupapa mahinga mahi ra i taua ra, me etahi mahi hauora, kei te mahi ano hoki i te tari, kaua i te ruma mahi. Ko te painga o te hirokiroki ko te mea ka taea e to taakuta te tirotiro tika i te whitiki o te urupuku kia tino mohiohia nga waahanga katoa o te endometrium. Ka taea e etahi o nga wahanga ka whakaatuhia e to taakuta i tenei waahanga paku atu.
Ko te hyperplasia endometrial e kore e taea te tirotiro i te whakamatautau toto, i te ultrasound ranei. Engari, ka taea e to taakuta te taunaki i etahi whakamatautau toto kia whakahaere i etahi atu take o te rere o te uterine. Ka taea ano hoki e to taakuta te tono i tetahi whakawhitinga purongo whakawhiti hei awhina i roto i te whakamatau i te take o to mate rereke o te uterine.
Ko te hyperplasia endometrial anake ka taea te tirotirohia i muri i te tohua o to endometrium me te aromatawaihia i raro i te microscope e te pathologist.
Ngā momo
I te wa e titiro ana te kairangahau i te tauira o to waahi o raro i raro i te microscope ka titiro ratou ki nga huringa i nga waahanga e rua o to pito o te mutunga, o te awa me te kiko tautoko e kiia ana he stroma. Ko te hyperplasia endometrial ka kitea i te wa ka nui atu nga karaehe e whai ana ki te stroma kaore i kitea e koe i roto i te painga o te mutunga o te motumetrium. Ka korero te pathologist mehemea kei te kitea nga pūtau e puta mai ana i roto i tenei teitei o te mutunga o te endometrium e arahina ana ki nga whakarōpūtanga e rua o te hyperplasia endometrial:
- Te waipiro me te kore o te mokupuku
- Te matepukupuku taiao
He mea nui ki te mahara ko te hyperplasia endometrial ehara i te mate pukupuku endometrial engari kei te whakaarohia he tino mate. Ko te tikanga, i etahi wa o te nui o te pukupuku o te mate pukupuku, kaore pea i te waahi o te mate pukupuku endometrial.
Nga maimoatanga
He mea tino nui kia aruhia, kia tukinotia ranei nga hyperplasia endometrial katoa.
Ko te hyperplasia endometrial i waho i te waahi
I te mea kaore he tumatakotanga o te waatea, ko te tupapaku o te hyperplasia endometrial ka mutu te mate pukupuku endometrial. Ko nga taunakitanga e whakaatu ana ko te 5% anake o nga wahine e whai ana i te hyperplasia endometrial i waho i te mokupuku ka whakawhanake i te mate pukupuku endometrial. He mea pea ka whakatauhia e tenei momo o te hyperplasia endometrial i ona ake ake wa.
Ko te rarangi tuatahi o te maimoatanga ko te titiro mo nga mea aarea e whakarereketia ana.
Hei tauira, mehemea he tino taumaha rawa koe, he nui te taimaha, ka ngaro te taumaha ka whakaheke i te hauhaoha nui o te pukupuku hinu. Ma tenei ka tuku i te whitiki o to urupa ki te tautuhi ano. Waihoki, mehemea kei te tango koe i te hopi whakakapi ka taea e to taakuta te whakatika i to horopeta me te taunaki kia mutu to whakamahi.
Ka taunakitia e to taakuta te whakamahi i nga maimoatanga o te reerainatanga hei whakakore i te painga o te hauhautanga o te hauhautanga o te haurangi ki runga i to oomuku. Ko te take ka whakaarohia e to taakuta ko te atawhai i a koe me te waitohu me te:
- Kaore i te mahi te tirohanga me nga huringa oranga
- Kei te whai koe i te rere o te uterine
- E hiahia ana koe ki te hua tere
Ko nga momo e rua o te progesterone e whakaarohia ana mo te maimoatanga o te hyperplasia endometrial i waho i te atypia ko te progesterone waha, ko te IUD hoki te progesterone. Ko nga taunakitanga e pai ana ma te whakamahi i te IUD o te kiripuaki IUD ( Mirena ). Mena he kaute koe me te BMI 35 35 kaore pea e pai te mahi maimoatanga o te waahi ki te kore e riro te taimaha. Me korero me to taakuta ko te ahua o te maimoatanga o te waahi mo te pai.
Ahakoa i whiriwhiria e koe te kitenga me te maimoatanga me te progesterone me whai tonu koe me te whakamamutunga endometrial wawao kia mohio kua kore te hyperplasia endometrial a kaore e hoki mai.
E ai ki nga tohunga, kaua e whakaekea te histerectomy hei waahanga maimoatanga tuatahi mo te hyperplasia endometrial i waho i te waahi mo te whai huatanga o te maimoatanga o te progesterone me te waahi iti o te whakawhanaketanga mate pukupuku endometrial. Engari, e whakaae ana nga tohunga kei reira etahi waahi e taea ai e te hysterectomy te whiringa maimoatanga tino tika mo nga wahine e whai tamariki ana. Ka taea e to taakuta te taunaki i te hysterectomy ki te:
- I te wa e whai ake ana, ka whakawhanake koe i te hyperplasia taiao
- Kaore i te pai ake te hyperplasia i muri i te 12 marama o te maimoatanga o te waahi
- He nui te mate o te mate
- Ka whakawhanake ano koe i te hyperplasia endometrial i muri i te pai o te mahi
- Kaore e hiahia ana koe ki te whakamutu i nga tiiora endometrial e hiahiatia ana me te maimoatanga progesterone.
Ko te hyperplasia endometrial me te atypia
He nui atu te nui o te kino o te whakawhanake i te mate pukupuku endometrial ki te whai koe i te hyperplasia me te atypia Ko te whakahaerenga he iti atu te kaha mo te raru nui. Ko te tikanga, e taunaki ana nga tohunga ki te hihikete hei maimoatanga tuatahi mo te hyperplasia taiao i roto i nga wahine e whai tamariki ana.
Mena kua tohaina koe me te hyperplasia taatai me te whakamahere tonu i te ngana ki te hapu, ka pai pea te tukatuka ki a koe me te progesterone, he pai ki te IUD.
Ka whai ake koe i te whakamahinga o te mutunga o te endometrial kia mohio ai he pai te tukinga o te hyperplasia atypical. Ka tohu pea taau taakuta kia kite koe i te kaitoi huawhenua me te whakaoti i to whanau i te waa ka taea e koe. Ko te mea pea ka whakaarohia e to taakuta he histerectomy i muri i to mahi i te whai tamariki me te mea he tino pai ake te whakahou o te hyperplasia endometrial atypical.
No te mea ko te rere o te uterine te rere o te tohu tino nui ka whai koe i te hyperplasia endometrial, he mea nui kia kite i to taakuta hei matapaki i enei huringa i to toto. Ka taea e to taakuta te whakatau mehemea me whai ake he whakamatautau me te aromatawai.
Kaupapa:
Gallos, ID., Et al, 2016.BGSE / RCOG Aratohu Whahonui: Te Whakahaere o te Hyperplasia Endometrial [Rarangi] Ranaana: BGSE / RCOG. Kei te https://www.rcog.org.uk/en/guidelines-research-services/guidelines/gtg67/