Adenomatous polyp: Zizindikiro ndi Chithandizo

Mwina aliyense wa ife akuona kusapeza, kumalire ndi mantha atamva matenda "khansara." Asayansi padziko lonse akuvutika ndi yankho kumene ikuchokera ndi mmene ankachitira ndi 100% chitsimikizo, koma, kalanga, mpaka zotsatira zake zimakhala zokhumudwitsa. Matendawa "adenomatous polyp" sizikumveka kwambiri wachisoni, ndi anthu ochepa kwambiri kumphatikiza ndi mankhwala akhoza kufotokoza chomwe icho chiri. Nthawiyi, matenda imatengedwa chikhalidwe precancerous, choncho ndi woopsa kwambiri. Amene tapeza, muyenera kuchitapo kanthu mwamsanga kuti apulumutse thanzi komanso mwina miyoyo yawo.

Makhalidwe tizilombo ting'onoting'ono

Pakati pake penipeni, ndi tizilombo ting'onoting'ono mu thupi - izo anakulira ena chifukwa mucosa malo. Ndiko kuti, iwo akhoza kuoneka paliponse mu thupi, yokutidwa ndi mucous. Malinga ndi zomwe zachipatala, makamaka mavuto ambiri amapereka adenomatous polyp, mwinamwake kutchedwa adenoma, ndipo ndi mtima wabwino chotupa. Mawu akuti "mtima wabwino" zikutanthauza kuti m'malo ena thupi mwadzidzidzi anayamba kuuza maselo mosatonthozeka, koma mpaka kwathunthu kapena pang'ono nawobe ntchito ya chiwalo akhudzidwa kapena minofu ndi metastasize. Izi Mbali yofunika kwambiri a iwo ali ndi mwayi kuchiritsa kwathunthu. Choncho adenomatous polyp - akadali chiweruzo. Komabe, popanda miyeso, ambiri a zotupa chosaopsa kukhala yoopsa. Choncho, ndi tizilombo ting'onoting'ono, kutalika kwa amene anafika 1 cm, muli Mwina mkulu maselo olanda khansa, ie, amene kale metastasize. Komabe, kukula yaing'ono ya kumanga mmwamba chitsimikizo 100% ya chitetezo satero, chifukwa pali milandu kumene khansara zachitika ku umodzi polyp villi.

Gawo

nembanemba Mucous anthu ndi Mipikisano magawo malingana thupi zimene iwo kuphimba, ndi dongosolo losiyana la epithelium lapansi. Adenoma limakula pa mucosal epithelium amene ukufanizidwa ndi dongosolo glandular, mwachitsanzo amaphatikizapo zopangitsa ambiri. Motero, ndi tizilombo ting'onoting'ono angayambe mmimba, chikhodzodzo ndulu, ndi intestine, m'chigawo urogenital.

Pali zingapo muyezo gulu kupatula malo awa:

1. Malinga ndi mtundu wa maziko pa miyendo (tsinde) kapena nsanja lonse (wongokhala). Akukhulupirira kuti mofulumira Kuyambitsa ndi amangokhala metastases adenomatous polyp. chithunzi pamwambapa chimasonyeza chimene chimaoneka lalikulu amangokhala polyp pa khoma matumbo.

2. Kukula: wamng'ono, sing'anga lalikulu. Ngakhale adenomas zosakwana 1 cm, ali wochepetsetsa kukhala khansa. Mosiyana, mwa adenomas zazikulu kuposa 1 masentimita pafupifupi 13% maselo a khansa, ndipo kuposa 2 cm Mwina alibe ku khansara kale anafika 51%.

3. Mu maonekedwe: ozungulira, chowulungika, bowa woboola pakati, wandiweyani, zofewa.

4. kutanthauzira: wosakwatiwa, wamkazi, ambiri. yachabechabe Recent khansa za nthawi 2 zambiri.

mbali morphological

Adenomatous polyp m'matumbo, m'mimba, mwamtheradi onse matupi anakonza m'njira zosiyanasiyana imawakhudza kuti madokotala ananena zawo kuti apeze. Iwo ali ngati:

1. glandular. Amakhala ndi kuchuluka kwa zopangitsa ndi wolemera mu mitsempha ya magazi, minofu connective. Iwo agawidwa mu mtima wabwino ndi zizindikiro za atypia (maselo kutaya mawonekedwe awo, mitima yawo munasindikizidwa) ndi malingatsiey (atypical maselo zopangitsa amizidwa akulu ndi submucosal zigawo za khungu, kuti ndi zoona, akukonzekera metastasize).

2. villous. tizilombo ting'onoting'ono Izi zikuwoneka velvety, ngati mutu wa kolifulawa, kawirikawiri amakhala pamwamba akhakula. Mwina malingatsii iwo pamwamba 60%.

3. glandular villous.

4. hyperplastic. laling'ono kwambiri, zofewa, amawagwiritsitsa kapangidwe wabwinobwino wa mucosa lapansi.

5. ana. Malingiruyut suli wa zopangitsa enaake ndi wandiweyani stroma.

6. fibrous. Mu stroma ali kwambiri kwambiri kukodzedwa ziwiya, kuchititsa amafanana yotupa kusalola.

7. Zonama.

zimayambitsa

Chifukwa tizilombo ting'onoting'ono kuyamba kukula mpaka palibe yankho lenileni. Asayansi ena amakhulupirira kuti akaonekere anthu ukalamba, ena kukana ichi. Ziwerengero limanena kuti ana mwayi kupeza adenoma ndi 28% anthu osakwana zaka 30 - 30%, ndi akale okalamba zaka 70 - 12,8 yekha%. The pazipita angapo adenomas wapezeka zaka zapakati pa zaka 40-50.

Ie adenomatous polyp ya rectum kapena thupi ena akhoza kuoneka pa msinkhu wina uliwonse, ngakhale makanda (kudziwika choncho matenda tsinde polyp mu nyenyeswa 2-miyezi mmimba). The zambiri zifukwa asayansi monga:

- kudwala pa chitukuko embryonic;

- chibadwa (ana omwe makolo anakumana ndi BPH, kumakhalanso nawonso za nthawi 2 apamwamba);

- kutupa kwa ziwalo m'mimba (gastritis, matenda a m'matumbo, kamwazi ndi mavuto defecation ndi ena);

- zakudya zosayenera;

- kuphwanya kusinthika kwa mucous ya m'mimba ndipo matumbo pambuyo amadza ndi.

Adenomatous polyp m'mimba

Thupi ili mu malo oyamba pa kutengera za ku maonekedwe a adenomas. Malinga ndi limodzi la classifications ndi zochokera otchulidwa morphological, matenda awa mitundu tizilombo ting'onoting'ono m'mimba:

- tubular;

- papillary;

- wosanganiza (papillotubulyarnye).

Malowa ali pamtunda mmimba ndi m'goli. Choncho, lachitatu kumtunda kwa odwala 2241 anafufuza anazipeza 2.1% tizilombo ting'onoting'ono wachitatu pakati Chiwerengerochi anafika 17%, pamene wachitatu m'munsi unali 66,8% ya pathologies.

Chotupa zilonda akupezeka m'mimba kwa chiwembu chosavuta: yachibadwa epithelium - polyp mapangidwe - mu carcinoma ake likukula mofulumira - Cancer. Nthawi zambiri ngati sewero ndi kusiyana kwa zaka ziwiri, munthu pazipita atatu, koma pali zina kumene polyposis anthu ankakhala zaka 20.

Zimayambitsa adenomas m'mimba ambiri - chibadwa, kudwala mu chitukuko cha mlingo wosabadwayo, matenda yotupa, makamaka gastritis, chakudya zilakolako zoipa, kumwa mowa mwauchidakwa, aakulu m'mimba matenda. Komanso, monga asayansi, ndi kukukulirakulira wa mucous mmimba mwa zosiyanasiyana matenda neuropsychiatric.

zizindikiro

Palibe umodzi matenda chithunzi zimasonyeza chakuti m'mimba chakula adenomatous polyp. Zizindikiro za wodwala aliyense nthawi zonse payekha. Pakati ambiri ndi:

- ululu (kuti 88,6%);

- poganiza kuti m'mimba ndi full, ngakhale pambuyo kumwa ndalama kochepa chakudya;

- utachepa kudya;

- belching;

- nseru;

- kuchuluka slyunoobrazovanie;

- flatulence;

- kutentha;

- ndi kukoma zosasangalatsa pakamwa.

Ululu umatchulidwatchulidwa pambuyo chakudya ndi maola awiri khalani, ndiye kutha.

Kuwonjezera zizindikiro khalidwe tizilombo ting'onoting'ono odwala ndi zizindikiro zosonyeza munaonapo kuti thupi pali vuto. Izi kutopa, kufooka, ndipo nthawizina malungo, kusowa tulo, mutu, maganizo, causeless.

Pali vnezheludochnye zizindikiro ndi amene angathe kuganiza pamaso pa polyposis, makamaka ngati cholowa. malo pa khungu (padziko milomo, mphuno, masaya, chifuwa, manja, kumbuyo, m'mimba, khosi) mu mawonekedwe a madontho madontho, nyengo iliyonse ndi nyengo iliyonse sasintha maonekedwe awo.

diagnostics

tizilombo ting'onoting'ono Adenomatous mu chiwalo chilichonse kuli kovuta kudziwa popanda diagnostics ndi hardware. chimaperekedwa kwa m'mimba:

- ultrasonography;

- X-ray ndi barium madzi wandiweyani (mwaluso pafupifupi 4.6% ya milandu);

- gastroscopy;

- fibrogastroscopy;

- biopsy;

- gastrolaparoskopiya.

N'kofunika, ndi zasayansi kusanthula madzi chapamimba, magazi, ndi zimene magazi zamatsenga mu nkhani m'mimba.

The chifukwa pazipita amapereka kafukufuku ndi njira zingapo.

Adenomatous m'matumbo tizilombo ting'onoting'ono

matenda ndi wachiwiri "wolemekezeka" malo pambuyo polyposis muzituluka. Malinga ndi kafukufuku, ndi tizilombo ting'onoting'ono mu m'matumbo anawerengedwa ndi pafupipafupi izi:

- Women - 46%;

- amuna - 53%.

The kudalira pa chitukuko cha matenda ndi zaka motere:

- odwala 41 kwa zaka 60 - 56%;

- kuchokera 31 zaka 40 - 23%;

- kuchokera zaka 14 mpaka 30 - 10%.

Alibe tizilombo ting'onoting'ono mu chotupa zilonda ali ndi kudalira chiwerengero chawo. Choncho, ngati mu rectum 5 kapena zambiri mabungwe awa, iwo khansa 100% ya milandu.

Mu m'matumbo tizilombo ting'onoting'ono ndi ankagawiranso omangidwa. Motero, kukwera mbali ya cholembedwa 13% milandu onse mu yopingasa m'matumbo gawo - 13.5%, mu sigmoid mbali rectum - 73,5%. Zimayambitsa tizilombo ting'onoting'ono mu matumbo pafupifupi chimodzimodzi monga mwa mwambo iwo mmimba, koma chofunika chimaperekedwa kwa madokotala matenda yotupa. Choncho, mwa examinees 455 amene anapezeka ndi tizilombo ting'onoting'ono, 30% amavutika ndi matenda aakulu (matenda a m'matumbo, proctosigmoiditis, ndi ena), ndi 16.4% katsabola kamwazi. Iwo zatenganso mbali, ndi zakudya m'thupi. Pachifukwa chimenechi, matenda a m'matumbo opezeka oposa 50% ya milandu.

Zizindikiro ndi matenda ndi tizilombo ting'onoting'ono mu intestine ndi

mbali khalidwe okha polyposis matumbo ayi. Nthawi zambiri nthawi yaitali, odwala samaona zizindikiro Kuti iwo anayamba kukula adenomatous polyp. Zizindikiro kwambiri khalidwe la matenda:

- magazi mu chimbudzi (89%);

- chitukuko cha matenda magazi nthawi kapena patapita matumbo gulu;

- m'mimba kapena kudzimbidwa (55.2%);

- ululu pamimba;

- yoyaka ndi / kapena kuyabwa wa chotulukira (65%);

- magazi m'thupi (7%);

- nseru;

- kutentha;

- mutu;

- belching;

- flatulence;

- ululu rectum, anakafika kumbuyo m'munsi ndi sacrum.

Diagnostics monga palpation, ultrasound, X-ray, sigmoidoscopy, kukhudzana Yoyeserera-radiometry, colonoscopy, fibrocolonoscopy mayesero zasayansi.

Tizilombo ting'onoting'ono mu ndulu ya

Adenomatous polyp a ndulu ya - matenda osowa, kunachitika zosakwana 1% odwala onse ndi polyposis. Malinga ndi kafukufuku, matenda zambiri zimakhudza anthu zaka 45. The ndulu - thupi ochepa, akuluakulu ndi masentimita 14 yaitali ndi masentimita 5 m'lifupi. Malinga ndi kapangidwe izo akufanana thumba ndi makoma woonda, thupi onse khosi tapered ndi mbali yaing'ono kwambiri umene unalembedwa ya ndulu ritsa. The mavuto ambiri amaona kuti kukhala malo a tizilombo ting'onoting'ono mu chiberekero kapena ritsa. Pankhaniyi, linanena bungwe ndi oletsedwa ya ndulu mu intestine, ndi wodwalayo matenda a chikasu ndiyo wa khungu ndi azungu cha maso. Komanso Mbali imeneyi, pali zizindikiro zina kuti ndulu mwina kuchuluka polyp:

- kupweteka ululu;

- colic aimpso;

- nseru (makamaka m'mawa);

- kuwawa pakamwa;

- kudzimbidwa.

The zimayambitsa matenda angakhale chofuna ndulu ndi mucosa, nthenda kagayidwe, zakudya, chibadwa.

Matendawa amapangidwa ndi ultrasound, ultrasonography. Mankhwala makamaka opaleshoni, wopangidwa mwa kuchotsa ndulu ya. Only zina, dokotala anu angakupatseni mankhwala m'malo opaleshoni phwando - "ursosan" kapena "Ursofalk".

chithandizo

Malinga ndi malo, kukula ndi makhalidwe ena a dokotala n'kukulemberani mankhwala adenomatous polyp. Ngati anapeza mmimba, opaleshoni yekha n'kotheka, popeza palibe mankhwala sadzakhala kupanga polyp kukula kumbuyo. Mankhwala okha yochepa Kuonjezera apo, koma osati kuchepetsa chiopsezo alibe mu zotupa khansa. Pamene kupeza umodzi polyp kuchotsa ikuchitika yekha, ndipo pamene kupeza zophuka angapo - chapamimba resection.

njira ina mankhwala - polypectomy ndi endoscope ndi. Iwo anasonyeza kuti tizilombo ting'onoting'ono stebelnyh kuyambira kukula masentimita 0,5 ndi tichipeza mu kuchotsa iwo ndi hinge zitsulo. Mu zina, amachitidwa pa outpatient maziko. Biopsy pambuyo opaleshoni chofunika. Izi njira yomweyo ya chithandizo cha tizilombo ting'onoting'ono mu intestine ang'ono ndi m'matumbo. Mu rectum, ngati adenoma ndi opezeka pa mtunda wa masentimita 10 kuchokera chotulukira, ndi zotheka excision pansi mankhwala oletsa ululu pamalopo.

zophuka Small kuchotsedwa ntchito electrocautery.

Mwa mankhwala amakono kuti kuchotsa tizilombo ting'onoting'ono laser kuwerenga akhoza chinachititsa, zikhumbo magetsi kapena mphepo.

Mulimonsemo, pambuyo mmene wodwalayo zimachitika zakudya kwambiri.

Akukhulupirira kuti chosaopsa tizilombo ting'onoting'ono mu m'mimba angathe kuchiritsidwa enemas ndi celandine, zomwe zichitike pa mlingo wa 25-30. Njira yothetsera anali wokonzeka motere: magalamu 50 masamba obiriwira ndipo zimayambira kink mu nyama chopukusira, kutsanulira 300 ml ya madzi otentha, kudikira mpaka ozizira, fyuluta. hours 2 pamaso pa enemas achire kuchita kuyeretsedwa. Yankho celandine mtima tiyenera kugwira nokha maola 1.5, ndi ana - kwa mphindi 30. Njira akutsatiridwa tsiku.

Nkofunika: odwala ambiri, njira imeneyi Sanatumikire, ndipo iwo anali kuchita opaleshoni kuti achotse tizilombo ting'onoting'ono kuti anakulira mu zotupa zilonda.