Iipolisi ze-Adenomatous: iimpawu kunye nonyango

Mhlawumbi, ngamnye wethu ufumana iimvakalelo ezingekho phantsi kokutya emva kokuva ukuxilongwa "kwesifo esibi". Kulo lonke ihlabathi, izazinzulu ziyazama ukuqonda ukuba zivela phi na indlela yokuphatha ngayo isiqinisekiso esisi-100%, kodwa ke, zide zifike ziphumo. Ukuxilongwa kwe "polyp adenomatous" ayivumi ukuba inzima, kwaye bambalwa abangabandakanyiswa neyeza bangachaza oko. Kodwa okwangoku oko kugula kuthathwa njengesimo esinqabileyo, ngoko kuyingozi kakhulu. Abo bafumene isidingo sokuba bathathe isinyathelo ngokukhawuleza ukugcina impilo, kwaye mhlawumbi babo ubomi.

Iimpawu zeepolisi

Ngomxholo walo, iipolisi emzimbeni womntu ziyinxalenye yesikhumba esinyanyisiweyo esakhula ngesizathu esithile. Oko kukuthi, bangabonakala kuyo nayiphi na into ehlanganiswe neembumba. Ngokutsho kweenombolo zonyango, i-polyp adenomatous, ngaphandle kwalokho ebizwa ngokuba yi-adenoma kwaye ibonisa isifo esibi, ibangela iingxaki ezininzi. Incazelo ethi "inobungqina" ithetha ukuba kwindawo ethile imizimba yaqala ukuhlula iiseli ngokungalindelekanga, kodwa xa zigcina ngokupheleleyo okanye zigcina imisebenzi yecandelo okanye izicubu ezichaphazelekayo kwaye zinganiki i-metastasis. Le nto ibalulekileyo ebanika ithuba lokubaphilise ngokupheleleyo. Ngako oko, i-polyp adenomatous ayikho isivakalisi. Nangona kunjalo, ngaphandle kokuthatha isenzo, amaninzi amanxeba anomzimba ayingozi. Ngoko, ii-polyps, ubukhulu bezinto ezifikelele kwi-1 cm kuphela, ziqulethwe ngamaseli omhlaza omninzi aphezulu, oko kukuthi, abo basebenzise imitha. Enyanisweni, ubungakanani obuncinci bokubumba abuniki isibonelelo se-100% sokukhusela, kuba kukho iimeko xa umhlaza uphuhliswa kwi-single villi polyp.

Ukwahlula

Iimbumba zamathambo kubantu zixutywa ngamaninzi kwaye zixhomekeke kwilungu abazifihlayo, zine-epithelium ehlukeneyo kwisakhiwo. I-adenoma ikhula kulawo maqabunga e-mucous, i-epithelium apho imelwe isakhiwo se-glandular, oko kukuthi, kubandakanya ezininzi iingqungquthela. Ukuqhubela phambili kule ndawo, iipolps zingabonakala kwisisu, kwi-gallbladder, emathunjini, kwiimpawu ze-genitourinary system.

Ukongeza kwendawo, kukho inqobo yeendlela zokukhetha:

1. Ngohlobo lwesiseko: emilenzeni (intambo) okanye kwiqonga elibanzi (sessile). Kukholelwa ukuba i-polystatic sedentary poenomatous polyp iqala ngokukhawuleza. Isithombiso esingasentla sibonisa indlela i-polyp enkulu ye-posi ejongene ngayo nodonga lwamathumbu.

2. Ngokwesayizi: encinci, ephakathi, enkulu. Nangona i-adenomas ingaphantsi kwe-1 cm, banethuba elincinci lokuba libi. Ngakolunye uhlangothi, phakathi kwama-adenomas ngaphezu kwe-1 cm, malunga ne-13% abanomdlavuza wesifo, kwaye ngaphezu kwe-2 cm ubunokwenzeka bokuguqulwa komhlaza sele sele u-51%.

3. Kubonakala: i-spherical, oval, i-mushroom-shaped, dense, soft.

4. Indawo: engatshatanga, eyinyani, ezininzi. Ukugqibela kuhlaselwa ngumhlaza malunga namaxesha angama-2 ngokuphindaphindiweyo.

Izimpawu zomzimba

Iimbumba ze-intlina ezinomsoco, isisu, zonke iziko zilungiswe ngokuhlukileyo, ezichaphazela kakhulu ukugxekwa kokubuyiswa. Zizo:

1. Iingqungquthela. Ziqulethwe ngobuninzi beengqungquthela kunye nezicubu ezinxulumene nezithambo zegazi. Zahlukaniswa zibe yi-benign, kunye neempawu ze-atypia (iiseli zilahlekelwa ukuma kwazo, i-nuclei yazo ziqiniswe) kunye ne-malingling (ii-atypical cells kunye neengqungquthela zixutywa kwiimpawu ze-muscular and submucosal ze-epidermis, oko kunjalo, zilungiselela izidalwa ze-metastasis).

2. Ziyi-insecticide. Ezi iipolisi zinyuka ngaphandle, zifana neentloko zekholifulawa, zihlala zinobunzima. Ubungakanani bokukhula buphezulu ngaphezu kwama-60%.

3. I-glandular-evundous.

4. I-Hyperplastic. Ncinci kakhulu, ithambile, ulondoloze isakhiwo esifanelekileyo se-mucosa.

5. Abantwana. Ayikho ingxaki, iqulethi ye-cystic kunye ne-stroma.

6. Fibrous. Kwi-stroma, kukho iinqanawa ezininzi ezikhulisiweyo, kungenxa yoko zifana nokungenwa kwesibindi.

7. U buxoki.

Izizathu zokubonakala

Kutheni iipolisi ziqala ukukhula, ngelixa kungekho zimpendulo ezichanekileyo. Ezinye izazinzulu zikholelwa ukuba zivela kubantu abadala, abanye bayayichasa. Izibalo zibonisa ukuba kubantwana abancinane ithuba lokubona i-adenoma ngu-28%, kubantu abangaphantsi kweminyaka engama-30 ubudala bangama-30%, kwaye sele bekhulile kwiminyaka engama-70 kuphela-kuphela i-12.8% kuphela. Inani eliphezulu lamadenomas liyiminyaka engama-40-50.

Oko kukuthi, i- polyp adenomatous ye-rectum okanye enye inxalenye ingabonakala kumntu weliphi na ubudala, kwanabantwana (iimeko ze-polyp diagnosis kwi-2-year-old-crumb esiswini). Kwizizathu ezinokwenzeka kakhulu, izazinzulu zithi:

- I-Pathology kwi-embryonic development;

- i-heredity (kubantwana abanabantwana ababenayo i-adenoma, amathuba okufumana oku malunga namaxesha ama-2 ngaphezulu);

Iinkqubo zokuvuvukala kwindlela yokuxhamla esiswini (isisu, i-colitis, isifo segazi, iingxaki zokuchasana nabanye);

- ukungondleki;

- Ukuphazamiseka kokuhlaziywa kweempawu zomzimba zesisu kunye namathumbu emva kwemiphumo.

I-adenomatous stomach polyp

Eli lilungu lisekuqaleni ngokuxhomekeke kwimimiselo ye-adenomas. Ngokutsho kwesinye sezigaba ezisekelwe kwiimpawu ze-morphological, ezi ntlobo ze-polyps zesisu ziyafunyanwa:

- tubular;

- papillary;

- ezixubileyo (papillotubular).

Zifumaneka kwisisu ngokungenalutho. Ngaloo ndlela, kwisigxina sayo esiphezulu se-2,241 izigulane zihlolwe, iipolps zifunyenwe kwi-2.1%, kumgangatho wesithathu, la manani afinyelele kwi-17%, kwaye kwisithathu esezantsi sele sele i-66.8% yeephologi.

Ukuphuhliswa kwezicubu ezibi kwisisu zisenzeka ngokwelolu hlobo olulula: i-epithelium evamile - ukwakheka kwe-polyp - ukugqitha kwayo kwi-carcinoma - umhlaza. Ngokuqhelekileyo imeko enjalo ikhula kwiminyaka emibini, ubuninzi beemithathu, kodwa kukho iimeko ezizimeleyo xa abantu behlala nepolitiki iminyaka engama-20.

Izimbangela zokubonakala kweentlobo zezilonda zesisu zisesidlangalaleni - izidalwa, izifo ezithintekayo ekuphuhlisweni kwinqanaba, izifo ezivuthayo, ikakhulukazi i-gastritis, ukutya okunobungozi, ukusela utywala, izifo ezingasondli zesisu. Kwakhona, ngokweengcali zenzululwazi, ukukhula kwe-mucous esiswini kuququzelelwe zizifo ezahlukeneyo ze-neuropsychic.

Iimpawu

Akukho klinikhi enye yeklinikhi ebonisa ukuba i-polyp adenomatous ikhulile kwisisu. Iimpawu zesigulane ngasinye zihlala zodwa. Phakathi kwezinye eziqhelekileyo sinokuhlukanisa:

Isifo sesifo (ukuya kuma-88.6%);

- ukuziva ukuba isisu sesele sigcwele, nangona emva kokutya ukutya okuncinci;

- ukunciphisa ukutya;

- ukubetha;

- isicefezi;

- salivation eyandisiweyo;

- ukunyaniseka;

- Ukuqumba;

- i-aftertaste engathandekiyo emlonyeni womlomo.

Ubunzima buvame ukubonakala emva kokutya kwaye luhlala iiyure ezimbalwa, ngoko luyekelela.

Ukongeza kwiimpawu ezibonakalisa iipolisi, izigulane zinemiqondiso eqhelekileyo yokuba umzimba unenkinga. Ukukhathala, ubuthathaka, ngamanye amaxesha okushisa, ukungabonakali, intloko, ukunyaniseka okungafanelekanga.

Kukho iimpawu ezongezelelweyo, ngokubhekiselele kulokuba kunokwenzeka ukukrokra ubukho be-polyposis, ingakumbi ukuba ifa. Iphawula elukhumbeni (malunga nomlomo, impumlo, izihlunu, isifuba, intende, umva, isisu, intamo) ngendlela yefakeli, kunoma yiphina imozulu kwaye nawuphi na ixesha alinakuguqula ukubonakala kwalo.

Diagnostics

I-polyp adenomatous kunoma yiphina inxalenye ayinakukwazi ukuyijonga ngaphandle kokuxilongwa kwezixhobo. Ngenxa yesisu, iquka:

- Ultrasound;

- I-X-ray enefuthe elincinci ye-barium (ngokufanelekileyo malunga ne-4.6% yamatyala);

- Gastroscopy;

- Fibrogastroscopy;

- biopsy;

- gastrolaparoscopy.

Akubalulekanga kangako iimvavanyo zelabhoratri yerusi yesisu, igazi neempendulo kwigazi elifihlakeleyo kwizinto zesisu.

Isiphumo esiphezulu sinikezelwa ngeendlela eziliqela ngexesha elilodwa.

Iipolisi ezinama-adenomatous amathumbu amakhulu

Esi sifo sisekwesibili "indawo ehloniphekileyo" emva kwe-polyposis yesisu. Ngokwezibalo, ama-polyps emathunjini amakhulu aqoshwe ngolo hlobo:

- abafazi - 46%;

- Amadoda - 53%.

Ukuxhomekeka kokuphuhliswa kwesi sifo kwiminyaka lulandelayo kulandelayo:

- izigulane ezingama-41 ukuya kwi-60 ubudala-56%;

- ukusuka kwi-31 ukuya kwi-40 iminyaka-23%;

- ukusuka kwi-14 ukuya kwe-30 iminyaka-10%.

Ukuchithwa kwee-polyps kwi-tumor ebulalayo kunokuxhomekeka kwezinye kwinani labo. Ngoko ke, ukuba kwi-rectum 5 okanye ngaphezulu kwezi zifundo, zikhula zibe ngumhlaza kwi-100% yamatyala.

Kwi-colon, iipolisi nazo zihanjiswa ngokungalingani. Ngaloo ndlela, i-13% yazo zonke iimeko zibhalwe kwinqanaba elenyukayo, 13.5% kwi-ridge ejikelezayo, i-73.5% kwisahlulo se-sigmoid kunye ne-rectum. Izimbangela zokubonakala kweeplastiki emathunjini zifana nokuba zivela nini kwisisu, kodwa eziphambili zonyango zinikezelwa kwizifo ezivuthayo. Ngako-ke, phakathi kwama-455 ahlola izigulane ezazinama-polyps, ama-30% aphethwe zizifo ezingapheliyo (i-colitis, i-proctosigmoiditis kunye nabanye), kwaye i-16.4% yayinesifo somhlaza. Inendima ebalulekileyo yinkqubo yokungondleki. Ngenxa yoko, i-colitis ifunyenwe kuma-50% amacala.

Iimpawu kunye nokuxilongwa kwe-polyps emathumbu

Iimpawu ezibonakalisa kuphela i-polyposis yamathumbu ayinayo. Amaxesha amaninzi izigulane aziveki zibonakaliso ukuba ziye zaqala ukukhula i-polyp adenomatous. Iimpawu eziqhelekileyo zesifo:

- igazi kwizilwanyana (89%);

- ngokuphuhliswa kwesi sifo, ukuphuma kwamanzi kungenzeka emva okanye emva kokuchaswa;

- isifo sohudo okanye ukuqhawulwa (55.2%);

Intlungu kwi-peritoneum;

Ukutshisa kunye / okanye ukutshaya kwi-anus (ukuya kuma-65%);

I-Anemia (7%);

- isicefezi;

- Ukuqumba;

- intloko;

- ukubetha;

- ukunyaniseka;

Intlungu kwi-rectum, ukubuyisela kunye ne-sacrum.

I-Diagnostics ifaka i-palpation, i-ultrasound, i-radiography, i-sigmoidoscopy, i-radiometry ye-beta, i-colonoscopy, i-fibroconoscopy, iimvavanyo zelabhoratri.

I-Polyps kwi-gallbladder

I-poly-adenomat polyp ye-gallbladder isifo esingavamile esenzeka ngaphantsi kwe-1% yezigulane ezine-polyposis. Ngokwezibalo, ngokuphindaphindiweyo isifo sichaphazela abantu emva kweminyaka engama-45. I-gallbladder iyilungu elincinci kakhulu, kubantu abadala li-14 cm kuphela ubude kwaye lifikelela kwi-5 cm ububanzi. Ngokwakheka kufana nesibhanki esincinci ngeendonga ezinqabileyo, umzimba obanzi, intamo yentambo kunye nxalenye encinci kakhulu, apho i-bile duct ivela khona. Isimo esinzima kunabo bonke indawo ye-polyps kwi-cervix okanye kwi-conduit. Ngexesha elifanayo, umphumo we-bile uvinjiwe emathunjini, kwaye izigulane zinamaqabunga e-icteric kunye nama-protein. Ukongeza kule mpawu, kukho nezinye iimpawu ukuba i-gallbladder inokuba nepolitiki:

- ubuhlungu obuhlungu;

- I-coal colic;

- isicasiso (ikakhulukazi kusasa);

Ukukrakra emlonyeni;

- isifo sokugula.

Izimbangela zesifo ziyakwazi ukutshaya i-bile kunye ne-membranes yayo, ukungcola okungalunganga, ukutya okunengqiqo, ukuzala.

Ukuxilongwa kwenziwa nge-ultrasound, ultrasonography. Unyango luyilo ngokugqithiseleyo, olubandakanya ukususwa kwe-gallbladder. Kwimeko ezithile kuphela ugqirha unokwenza umyalelo wezayeza endaweni yokuhlinzwa - "Ursosana" okanye "Ursofalka".

Unyango

Ngokuxhomekeka kwendawo, ubukhulu kunye nezinye iziganeko, ugqirha ubeka unyango lwe-polyps ezinamandla. Ukuba itholakala esiswini, unyango oluphela kuphela lunokwenzeka, kuba akukho ziyobisi eziya kuphoqa i-polyp ukuba ikhule. Iibhulethi ziphucula ngokufutshane umzobo wonke, kodwa unganciphisi umngcipheko wokuguqulwa kwe-tumor ibe ngumhlaza. Ukuba i-polyp enye ifunyenwe, i-polyp kuphela isuswe, kwaye ukuba kukho ukukhula okubanzi, isisu sithengiswa.

Enye indlela yokonyango i-polypectomy ngoncedo lwe-endoscope. Kuboniswe kwi-polyps yesiqu kunye nobukhulu be-0.5 cm kwaye iquka ukukhutshwa kwabo ngetsimbi yentsimbi. Kwezinye iimeko, kwenziwa kwimeko yokugula. I-biopsy emva kokuba lo msebenzi unyanzelekile. Zinye iindlela zokuphatha iipolisi kwi-intestine encinci nenkulu. Kwi-rectum, ukuba i-adenoma ifunyenwe kude kumgama we-10 cm ukusuka kwi-anus, inokudityaniswa phantsi kwe-anesthesia yendawo.

Ukukhula okuncinci kususwe yi-electrocoagulation.

Phakathi kweendlela zonyango zanamhlanje, izibonakaliso zinokunikezwa ukuba zisuse iipolisi ngama-laser, iimpembelelo zombane okanye amaza omsakazo.

Kwimeko nayiphi na imeko, emva kokuvelela, isigulane sinikwa ukutya okunzulu.

Kukho uluvo lokuba i-polyps ezinobunzima emathunzini amakhulu angaphiliswa kunye ne-celandine, ekufuneka yenziwe 25-30 nganye. Isisombululo silungiselelwe ngale ndlela: 50 amagremu amaqabunga aluhlaza kunye ne-torsion kwi-grinder yenyama, uthele i-300 ml yamanzi abilayo, ulinde ude uphephe, ucoce. 2 iiyure phambi kwe-enema, i-enema ehlambulukileyo yenziwa. Isisombululo se-celandine kufuneka sigcine isigulana singabikho kwiiyure eziyi-1.5, kunye nezingane-ukuya kwi-30 imizuzu. Iinkqubo zenziwa nganye imihla.

Kubaluleke kakhulu: kwizigulane ezininzi le ndlela ayifanelekanga, kwaye kwafuneka benze utyando ukususa iipolysi ezazikhulile zibe zizicubu ezinzima.