Adenomatous polyp: Cov tsos mob thiab kev kho mob

Tej zaum peb txhua tus xav tias tsis xis nyob, bordering nrog ntshai rau lub rooj sib hais qhov mob "ib tug mob cancer." Zaum ib ncig ntawm lub ntiaj teb no yog muaj ib tug clue qhov twg nws tawm los ntawm thiab yuav ua li cas nws yog kho nrog 100% guarantee, tab sis alas, kom deb li deb tau lub ntsiab yog disappointing. Mob "adenomatous polyp" tsis sound li tu siab heev, thiab heev ob peb cov neeg tsis txuam nrog cov tshuaj yuav piav dab tsi nws yog. Meanwhile, tus kab mob no yog ib tug precancerous mob, ces nws yog tsis tshua muaj txaus ntshai. Cov neeg uas tau pom nws, koj yuav tsum coj tam sim ntawd txiav txim kom tau khaws cia rau hauv lub noj qab haus huv thiab tejzaum lawv lub neej.

Cov yam ntxwv ntawm polyps

Thaum nws cov tub ntxhais, cov polyps nyob rau hauv tib neeg lub cev - nws tau zus vim lub mucosa ntawm qhov chaw. Hais tias yog, lawv muaj peev xwm tshwm sim nyob qhov twg nyob rau hauv lub cev, them nrog txheej. Raws li kev kho mob statistics, tshwj xeeb tshaj yog ib tug ntau ntawm teeb meem muab adenomatous polyp, txwv tsis pub hu ua ib tug adenoma, thiab yog ib tug benign qog. Lub sij hawm "benign" txhais tau tias nyob rau hauv ib co chaw hauv lub cev mam li nco dheev pib qhia hlwb uncontrollably, tab sis txog thaum lawv muaj tag nrho los yog cov khaws cov nuj nqi ntawm lub cov hloov khoom nruab nrog los yog nqaij thiab metastasize. Qhov no tseem ceeb heev feature ntawm lawv muaj ib lub caij nyoog rau tag nrho kho. Yog li ntawd adenomatous polyp - tseem tsis yog ib tug kab lus. Txawm li cas los, tsis muaj kev ntsuas, feem ntau ntawm cov benign qog ua phem. Yog li ntawd, polyps, qhov ntev ntawm uas hu 1 cm, muaj ib tug siab ntau yam ntawm tus mob hlwb, piv txwv li, cov neeg uas twb metastasize. Txawm li cas los, lub me me luaj li cas ntawm cov build-up ib tug 100% guarantee ntawm kev ruaj ntseg tsis tau, vim hais tias muaj mob qhov twg mob cancer tau tsim los ntawm ib tug polyp villi.

kev faib

Txheej nyias nyias ntawm tib neeg thiab ib tug multi-layered nyob rau hauv lub cev uas lawv them, muaj ib tug txawv qauv ntawm cov epithelium. Adenoma hlob nyob rau mucosal epithelium uas yog sawv cev los ntawm lub glandular qauv, xws li nws muaj xws li ntau yam qog. Raws li, qhov polyps yuav tshwm sim nyob rau hauv lub plab, tsib lub zais zis, cov hnyuv, nyob rau hauv lub urogenital cheeb tsam.

Muaj ib tug xov tooj ntawm kev faib kev tsuas yog rau qhov chaw:

1. Raws li cov hom lag luam: legged (qia) los yog ib tug broad platform (sedentary). Nws yog ntseeg hais tias sai pib li ib tug sedentary metastases adenomatous polyp. Lub yees duab saum toj no qhia tau hais tias seb nws zoo li ib tug loj sedentary polyp rau lub plab hnyuv phab ntsa.

2. Nyob rau qhov luaj li cas: me me, nruab nrab, loj. Thaum adenomas tsawg tshaj li 1 cm, lawv yog tsawg kawg yog yuav ua mob. Rau hauv sib piv, ntawm cov adenomas loj tshaj 1 cm yog hais txog 13% ntawm lub mob hlwb, thiab ntau tshaj 2 cm probability degeneration nyob rau hauv ib tug mob cancer twb mus txog 51%.

3. Nyob rau hauv tsos: kheej kheej, oval, mushroom-zoo li tus, tuab, mos mos.

4. chaw: ib, poj niam, ntau tshaj ib tus. Tsis ntev los no degenerate rau hauv cancer txog 2 lub sij hawm ntau.

morphological nta

Adenomatous polyp cov nyuv, lub plab, kiag li tag nrho cov kabmob teem nyob rau hauv ntau txoj kev, uas zoo heev muaj feem xyuam rau cov raug rau rov qab. Lawv muaj xws li:

1. glandular. Nws muaj ib tug plurality ntawm qog thiab nplua nuj nyob rau hauv cov hlab ntsha, cov connective cov ntaub so ntswg. Lawv muab faib ua benign, nrog tej yam tshwm sim ntawm atypia (hlwb tsis tau lawv lub zoo lawm, lawv cores raug muab khi) thiab malingatsiey (atypical hlwb thiab qog yog immersed nyob rau hauv lub npag thiab submucosal khaubncaws sab nraud povtseg ntawm cov epidermis, uas yog, nyob rau hauv qhov tseeb, npaj rau metastasize).

2. villous. Cov polyps zoo velvety, zoo li ib lub taub hau ntawm zaub paj, feem ntau muaj ib tug ntxhib saum npoo av. Muaj tseeb malingatsii lawv saum toj no 60%.

3. glandular villous.

4. hyperplastic. Heev me me, mos mos, khaws tej qauv ntawm cov mucosa.

5. hluas. Malingiruyut tsis muaj cystic qog thiab tuab stroma.

6. fibrous. Nyob rau hauv lub stroma muaj ib tug ntau ho txhab hlab ntsha, ua li inflammatory infiltration.

7. cuav.

ua rau

Yog vim li cas polyps pib loj hlob kom txog thaum tsis muaj caij nyoog lo lus teb. Ib txhia zaum ntseeg hais tias lawv yuav tshwm sim nyob rau hauv cov neeg nyob rau hauv cov laus hnub nyoog, lwm leej lwm tus tsis kam ua qhov no. Txheeb cais hais tias nyob rau hauv cov me nyuam yaus lub sij hawm mus nrhiav cov adenoma yog 28% nyob rau hauv cov neeg nyob rau hauv 30 xyoo - 30%, thiab nyob rau hauv cov neeg laus dua 70 xyoo - tsuas yog 12,8%. Qhov siab tshaj plaws pes tsawg tus ntawm adenomas kuaj ntawm cov muaj hnub nyoog ntawm 40-50 xyoo.

Xws li adenomatous polyp ntawm lub qhov quav los yog lwm yam lub cev muaj peev xwm tshwm sim thaum twg los tau lub hnub nyoog, txawm nyob rau hauv cov me nyuam mos (lub npe hu cov ntaub ntawv kuaj mob Qia polyp nyob rau hauv 2 lub hlis-laus noj nyob rau hauv lub plab). Cov feem ntau yuav yog vim li cas zaum muaj xws li:

- pathology thaum lub sij hawm embryonic txoj kev loj hlob;

- caj (cov me nyuam uas lawv niam txiv muag nrog BPH, nws yog tseem yuav tau txais txog 2 sij hawm ntau dua);

- o ntawm lub hnyuv kabmob (gastritis, mob plab, dysentery, nrog defecation teeb meem thiab lwm tus);

- kev noj cov zaub mov;

- kev ua txhaum ntawm lub lwm ntawm lub qog ua kua ntawm lub plab thiab cov hnyuv tom qab ib qho kev cuam tshuam.

Adenomatous polyp ntawm lub plab

Qhov no lub cev yog nyob rau hauv thawj qhov chaw ntawm lub predisposition mus rau lub tsos ntawm adenomas. Raws li ib tug ntawm cov classifications raws li morphological cim, kev tshawb nrhiav cov hom polyps ntawm lub plab:

- tubular;

- papillary;

- mixed (papillotubulyarnye).

Nws yog nyob rau hauv lub plab nws yog sis tsis ncaj. Yog li, nyob rau sab qaum feem peb ntawm cov 2241 tus neeg mob soj ntsuam tau pom nyob rau hauv 2.1% ntawm polyps nyob rau hauv nruab nrab thib peb ntawm cov nuj nqis mus txog 17%, thaum nyob rau hauv lub qis feem peb ntawm nws yog 66,8% ntawm pathologies.

Cov kab mob qog hlav tshwm sim nyob rau hauv lub plab rau ib tug yooj yim to taub tswvyim: qub epithelium - polyp tsim - nyob rau hauv nws cov escalating carcinoma - Cancer. Feem ntau cov feem ntau xws li ib tug scenario yog tsim rau ob lub xyoos, ib tug tshaj plaws ntawm peb, tab sis muaj tej lub sij hawm uas ib tug polyposis neeg nyob txog 20 xyoo.

Ua rau lub plab adenomas nyob rau hauv general - noob caj noob ces, pathology nyob rau hauv txoj kev loj hlob ntawm lub embryo theem, inflammatory kab mob, mas gastritis, tsis zoo khoom noj khoom haus, kev haus dej caw, mob hnyuv kab mob. Tsis tas li ntawd, raws li cov kws tshawb fawb, nws yog ib lub widening ntawm lub qog ua kua nyob rau hauv lub plab los ntawm ib tug ntau yam ntawm neuropsychiatric ntshawv siab.

cov tsos mob

Yog tsis muaj ib cov kev soj ntsuam daim duab indicative ntawm qhov tseeb hais tias lub plab loj hlob adenomatous polyp. Cov tsos mob ntawm txhua tus neeg mob yog ib txwm ib tug neeg. Ntawm cov feem ntau yog:

- mob (rau 88,6%);

- xav tau tias lub plab yog tag nrho, txawm tom qab noj nqos tau cov tsawg heev cov nqi ntawm cov khoom noj khoom haus;

- tsis qab los noj mov;

- belching;

- xeev siab;

- nce slyunoobrazovanie;

- flatulence;

- kub siab;

- ib tug unpleasant saj nyob rau hauv lub qhov ncauj.

Mob feem ntau tshwm tom qab ib tug noj mov thiab ob teev tuav, ces zuj zus lawm tso.

Nyob rau hauv tas li ntawd mus rau lub tsos mob yam ntxwv ntawm polyps nyob rau hauv cov neeg mob uas ntau cov tsos mob pom hais tias nyob rau hauv lub cev muaj ib qho teeb meem. Qhov no qaug zog, tsis muaj zog, thiab tej zaum kuj ua npaws, insomnia, mob taub hau, kev nyuaj siab, causeless.

Muaj vnezheludochnye tej yam tshwm sim los ntawm cov uas ib tug yuav xav tias hauv lub xub ntiag ntawm polyposis, tshwj xeeb tshaj yog yog hais tias nws yog roj ntsha. Qhov no qhov chaw ntawm daim tawv nqaij (nyob ib ncig ntawm ob daim di ncauj, qhov ntswg, lub puab tsaig, hauv siab, ob txhais tes, rov qab, mob plab, caj dab) nyob rau hauv daim ntawv ntawm cov quav hnav, nyob rau hauv tej huab cua thiab nyob rau hauv tej lub caij tsis hloov lawv cov tsos.

diagnostics

Adenomatous polyps nyob rau hauv tej khoom hauv nrog cev yog yuav luag tsis yooj yim sua mus ntes tsis tau ib tug kho vajtse diagnostics. nws muaj xws li rau lub plab:

- ultrasonography;

- X-ray nrog barium tuab kua (zoo kwv yees li 4.6% ntawm cov neeg);

- gastroscopy;

- fibrogastroscopy;

- me;

- gastrolaparoskopiya.

Tsis muaj tsawg ib qho tseem ceeb, thiab kuaj tsom ntawm pais plab kua txiv, cov ntshav, thiab cov tshuaj tiv thaiv rau Occult ntshav nyob rau hauv lub plab txheem.

Qhov siab tshaj plaws tshwm sim muab ib daim ntawv ntsuam los ntawm ob peb txoj kev.

Adenomatous nyuv polyps

Tus kab mob no yog tus thib ob "honorable" qhov chaw tom qab pais plab polyposis. Raws li statistics, polyps nyob rau hauv cov nyuv sau npe nrog no zaus:

- cov poj niam - 46%;

- cov txiv neej - 53%.

Lub dependence ntawm txoj kev loj hlob ntawm tus kab mob los ntawm lub hnub nyoog yog raws li nram no:

- cov neeg mob 41 mus rau 60 xyoo - 56%;

- los ntawm 31 mus 40 xyoo - 23,%;

- los ntawm 14 mus rau 30 xyoo - 10%.

Degeneration ntawm polyps nyob rau hauv lub kab mob qog hlav muaj ib co dependence rau lawv tus xov tooj. Yog li ntawd, yog hais tias nyob rau hauv lub qhov quav 5 los yog ntau tshaj ntawm cov koom haum, lawv tsim mus rau hauv cancer nyob rau hauv 100% ntawm cov neeg.

Nyob rau hauv cov nyuv polyps yog tseem muab faib unevenly. Yog li, nyob rau hauv lub ascending ib feem ntawm lub kaw 13% ntawm txhua tus neeg mob nyob rau hauv lub transverse nyuv feem - 13,5%, nyob rau hauv lub sigmoid ib feem thiab qhov quav - 73,5%. Cov ua polyps nyob rau hauv cov hnyuv yog kwv yees li tib yam li nyob rau hauv cov kev tshwm sim ntawm lawv nyob rau hauv lub plab, tab sis qhov muaj feem thib yuav muab rau cov kws kho mob inflammatory kab mob. Piv txwv li, ntawm cov 455 examinees leej twg pom polyps, 30% raug kev txom nyem los ntawm tus kab mob mob (mob plab, proctosigmoiditis, thiab lwm tus), thiab 16.4% chickenpox dysentery. Nws ua si ib tug loj luag hauj lwm, thiab cov neeg pluag kev noj haus. Vim li no, mob plab nyob rau hauv ntau tshaj li 50% ntawm cov neeg.

Cov tsos mob thiab tus mob ntawm polyps nyob rau hauv cov hnyuv

Yam ntxwv nta tsuas yog rau cov plab hnyuv polyposis tsis. Feem ntau ib tug ntev lub sij hawm, cov neeg mob feem ntau tsis muaj cov cim qhia tau tias, lawv pib loj hlob adenomatous polyp. Qhov tseem yam ntxwv cov tsos mob ntawm tus kab mob:

- ntshav nyob rau hauv cov quav (89%);

- txoj kev loj hlob ntawm tus kab mob tau los ntshav thaum lub sij hawm los yog tom qab ib tug plob tsis so tswj zog;

- raws plab los yog cem quav (55.2%);

- mob nyob rau hauv lub plab mog;

- burning thiab / los yog khaus qhov quav (65%);

- ntshav liab tsawg (7%);

- xeev siab;

- kub siab;

- mob taub hau;

- belching;

- flatulence;

- mob nyob rau hauv lub qhov quav, extending mus rau lub sab rov qab thiab sacrum.

Diagnostics xws li palpation, ultrasound, X-ray, sigmoidoscopy, hu rau Beta-radiometry, xoos hnyuv laus, fibrocolonoscopy, kuaj kev kuaj.

Polyps nyob rau hauv lub gallbladder

Adenomatous polyp ntawm lub gallbladder - ib tug tsawg tus kab mob, uas tshwm sim nyob rau hauv tsawg tshaj li 1% ntawm tag nrho cov neeg nrog polyposis. Raws li statistics, ntau tus kab mob muaj feem xyuam rau cov neeg tshaj 45 xyoo. Lub gallbladder - ib tug heev me me lub cev, rau cov neeg laus nws yog cia li 14 cm ntev thiab 5 cm nyob rau hauv dav. Raws li cov qauv nws tsa ib lub hnab nrog nyias cov phab ntsa, ib tug dav lub cev, lub tapered caj dab thiab ib tug heev nqaim ib feem ntawm uas hnub rov qab kua tsib ciav. Cov feem ntau nyuaj teeb meem no yog hais tias yuav qhov chaw ntawm lub polyps nyob rau hauv lub ncauj tsev menyuam los yog duct. Nyob rau hauv cov ntaub ntawv no, tso zis yog sim cov kua tsib mus rau hauv cov hnyuv, thiab tus neeg mob muaj mob daj ntseg ntawm daim tawv nqaij thiab lub ntsiab muag dawb. Nyob rau hauv tas li ntawd mus rau qhov feature, muaj lwm yam tshwm sim uas lub tsib tejzaum nce polyp:

- mob tej kev mob;

- lub raum Colic;

- xeev siab (tshwj xeeb tshaj yog nyob rau hauv lub yav sawv ntxov);

- bitterness nyob rau hauv lub qhov ncauj;

- kem plab.

Cov ua ntawm tus kab mob tej zaum yuav ua kub lug tsib thiab mucosa, txawv txav metabolism, noj cov zaub mov, tsev neeg keeb kwm.

Kuaj los ntawm ultrasound, ultrasonography. Kev kho mob mas yog phais, muaj raws nyob rau hauv lub tshem tawm ntawm lub gallbladder. Tsuas yog nyob rau hauv tej rooj plaub, koj tus kws kho mob yuav muab tshuaj rau noj tshuaj es tsis txhob ntawm kev phais txais tos - "ursosan" los yog "Ursofalk".

kev kho mob

Nyob rau hauv lub qhov chaw, qhov ntev thiab lwm yam ntxwv ntawm tus kws kho mob prescribes ib tug kev kho mob adenomatous polyp. Yog hais tias nws yog nyob rau hauv lub plab, kev phais ib leeg yog ua tau, vim tsis muaj tshuaj yuav tsis ua ib tug polyp loj hlob rov qab. Ntsiav tshuaj mus ib ntus xwb los txhim kho lub zuag qhia tag nrho duab, tab sis tsis txo qhov uas yuav muaj ntawm degeneration rau hauv cancer hlav. Thaum tau tebchaws ib polyp tshem tawm yog nqa tawm tsuas yog nws, thiab thaum tebchaws ntau growths - pais plab resection.

Lwm txoj kev kho mob - polypectomy nrog ib tug endoscope. Nws yog qhia rau stebelnyh polyps xws li nyob rau hauv loj ntawm 0.5 cm thiab muaj nyob rau hauv tshem lawv los ntawm ib tug hlau khawm. Nyob rau hauv tej rooj plaub, nws yog ua rau ib tug pw hauv paus. Me tom qab lub lag luam no yog yuav tsum tau. Cov tib txoj kev ntawm kev kho mob ntawm polyps nyob rau hauv cov hnyuv thiab cov nyuv. Nyob rau hauv lub qhov quav, yog ib tug adenoma yog nyob rau ntawm ib tug deb ntawm 10 cm los ntawm lub qhov quav, nws yog tau excision nyob rau hauv lub zos tshuaj loog.

Me growths tshem tawm siv electrocautery.

Cov niaj hnub kho mob rau cov kev tshem tawm ntawm polyps laser readings tej zaum yuav sim hawm caij nyoog, hluav taws xob impulses los yog xov tooj cua tsis.

Nyob rau hauv txhua rooj plaub, tom qab tej yam ntawm tus neeg mob ntaus nqi mus rau ib tug nruj kev noj haus.

Nws yog ntseeg hais tias benign polyps nyob rau hauv txoj hnyuv loj muaj peev xwm yuav kho enemas nrog celandine, uas yuav tsum tau ua nyob rau tus nqi ntawm 25-30. Cov tshuaj twb npaj raws li nram no: 50 grams ntawm cov nplooj ntsuab thiab stems kink nyob rau hauv ib tug nqaij li, ncuav 300 ml ntawm boiling dej, tos kom txog thaum txias, lim. 2 teev ua ntej lub kho enemas ua ib tug cleansing. Cov tshuaj celandine neeg yuav tsum tuav koj tus kheej mus rau 1.5 sij hawm, thiab cov me nyuam - mus txog rau 30 feeb. Cov txheej txheem yog nqa tawm nyob rau hauv ib hnub twg.

Nws yog ib qho tseem ceeb: muaj ntau cov neeg mob, cov qauv no tsis ua pov thawj, thiab lawv yuav tsum tau ua kev phais kom tshem tawm polyps uas loj hlob mus rau hauv phem hlav.