Adenomatous polyp: Zviratidzo neMarapirwo

Zvichida mumwe nomumwe wedu anonzwa kusanzwa, inoganhurana nokutya pamusoro pokunzwa chirwere "kenza." Masayendisiti munyika yose vari kutambura chinotiudza kwainobva uye sei kubatwa 100% zvinovimbisa, asi, nhamo, kusvikira zvinobva mwoyo. Chirwere "adenomatous polyp" asingarambi kuridza saka kusuwa, uye vanhu vashoma zvikuru asina chokuita nemishonga inogona kutsanangura chii. Zvichakadai, chirwere ichi kunoonekwa sechinhu precancerous ezvinhu, saka zviri ngozi chaizvo. Vaya vakawana, unofanira kutora chakatanga kuitwa kuchengetedza utano uye zvichida hwavo.

Zvinoitwa polyps

At paro, dziri polyps ari mumuviri womunhu - rainge rakura nokuda kwechimwe chikonzero mucosa nzvimbo. Ndiko, vanogona kuonekwa chero mumuviri, akafukidza mucous. Maererano zvokurapa uwandu, kunyanya dambudziko kunopa adenomatous polyp, zvimwe anonzi adenoma, uye ane bundu benign. Shoko rokuti "benign" zvinoreva kuti mune dzimwe nzvimbo dzomuviri pakarepo vakatanga kuudzawo masero zvisingadzorwi, asi kusvikira vari zvakakwana kana zvisina kukwana kuramba mashandiro njodzi nhengo kana zvinyama uye metastasize. Ichi chinokosha zvikuru chinhu kwavari ane mukana zvizere kuporesa. Naizvozvo adenomatous polyp - achiri kwete mutongo. Zvisinei, pasina nezviyero, ruzhinji benign anomera yokuva nyanyisa. Saka, polyps, kukura iyo yakasvika 1 masendimita, ane yakakwirira ndingangokuvara invasive kenza, kureva, avo kuti kare metastasize. Zvisinei, vashoma kukura akavaka-mumwe 100% vimbiso kuchengeteka haaiti, nekuti pane zviitiko apo kenza kwakasimbiswa kubva chete polyp villi.

kupatsanura

Mucous membranes evanhu uye multi-layered zvichienderana muviri vanofukidza, vane yakasiyana nemamiriro epithelium. Adenoma inokura mucosal epithelium iyo chinomirirwa glandular mamiriro, kureva izvozvo zvinosanganisira mumasero zhinji. Saka polyps munogona mudumbu, nduru dundira, kuti ura, ari urogenital nharaunda.

Kune vakawanda kupatsanura nzira kunze nzvimbo:

1. Maererano mhando hwaro pamusoro makumbo (hunde) kana yakafara kuchikuva (ndakagara). Zvinofungidzirwa kuti nokukurumidza nokutanga ndakagara metastases adenomatous polyp. Mufananidzo pamusoro inoratidza chii sokunge hombe ndakagara polyp pamusoro intestinal pamadziro.

2. size: duku, unosvikirwa, hombe. Nepo adenomas asingasviki 1 masendimita, ivo muduku zvichida kuva kenza. Mukusiyana, pakati adenomas hombe pane 1 masendimita anenge 13% kenza masero, uye vanopfuura 2 cm mukana degeneration mune kenza akatotanga asvika 51%.

3. In chitarisiko: idenderedzwa, denderedzwa, howa serin'i, paukobvu, nyoro.

4. Localization: kuroorwa, munhukadzi, muzvizhinji. Recent vakaderera kupinda kenza anenge 2 nguva kakawanda.

morphological zvinhu

Adenomatous polyp muura, dumbu, zvachose zvose mitumbi kurongwa munzira dzakasiyana hunovhiringidza zvikuru fungidziro hwokuponesa nzira,. Vane vakadaro:

1. glandular. It rine muzvizhinji kwemasero uye akapfuma mumidziyo ropa, connective tishu. Vari rakakamurwa benign, pamwe zviratidzo atypia (masero vanorasikirwa chimiro chavo, cores avo akanamwa) uye malingatsiey (atypical masero uye mumasero vanonyudzwa mune tsandanyama uye submucosal akaturikidzana pamusoro Epiderme e, ndiko kuti chokwadi, kugadzirira metastasize).

2. villous. polyps izvi anotarira velvety, sezvinoita musoro konifurawa, kazhinji vane ine penyika. Fungidziro malingatsii navo pamusoro 60%.

3. glandular villous.

4. hyperplastic. Vashomashoma, simba, ane zvinoitika nemamiriro mucosa.

5. hwanana. Malingiruyut hahuzi kwemasero cystic uye batana stroma.

6. fibrous. Muna stroma vane zvakawanda chaizvo rakawedzerwa midziyo, zvichikonzera patakafanana anogumbura infiltration.

7. Nhema.

zvinokonzera

Sei polyps dzinotanga kukura kusvikira hapana mhinduro chaiwo. Mamwe masayendisiti anodavira kuti kuonekwa mune vanhu vari kukwegura, vamwe vanoramba ichi. Statistics anoti vana vaduku mukana wokuwana adenoma ndiyo 28% mune vanhu pasi pemakore 30 - 30%, uye vakwegura anopfuura 70 okuberekwa - 12.8 chete%. The kunonyanyisa Nhamba adenomas dzakaonekwa pakati makore 40-50.

Kureva adenomatous polyp pamusoro mugaranhoko kana mumwe muviri anogona kuonekwa chero zera, kunyange vacheche (anozivikanwa nyaya chirwere chokumisa polyp muna 2-mwedzi-kare mafufu mudumbu). The ungangotarisa Zvikonzero masayendisiti dzinosanganisira:

- zvokurwara panguva embryo kukura;

- nhodzera (vana vane vabereki akatarisana BPH, zviri zvakare zvichida kugamuchira anenge 2 nguva yakakwirira);

- kuzvimba gastrointestinal nadzo (gastritis, colitis, nemanyoka, pamwe defecation matambudziko nevamwe);

- Kudya kukodzera;

- kutyora patsva pakati mucous mudumbu uye ura pashure mwoyo.

Adenomatous polyp mudumbu

muviri ichi ari wokutanga kunzvimbo iri kubatwa kusvika chimiro adenomas. Maererano nomumwe classifications kwakavakirwa morphological vatambi, rokuongorora marudzi aya polyps mudumbu:

- tubular;

- papillary;

- yakavhenganiswa (papillotubulyarnye).

It riri mudumbu zviri gogonera. Saka, muna rokumusoro rechitatu 2241 varwere amutsvaka akawanikwa 2.1% kubva polyps pakati chetatu nhamba idzi yakasvika 17%, ukuwo yepazasi rechitatu raiva 66,8% pakati pathologies.

The akaipa bundu rinowanikwa mudumbu kuti itsanangudzo zano: renguva dzose epithelium - polyp inotungamirwa - kwaro zveEl carcinoma - Cancer. Kakawanda yakadaro Muchiitiko iri kukura kwemakore maviri, vaifanira matatu, asi pane dzimwe nguva apo munhu polyposis vanhu akararama makore anenge 20.

VaBennett mudumbu adenomas zvavo - genetics, zvokurwara kukura embryo pamwero, anogumbura zvirwere, kunyanya gastritis, hakuvaki zvokudya, udhakwa, chirwere gastrointestinal chirwere. Uyewo, maererano masayendisiti, ndiwo Kuwedzera pamusoro mucous mudumbu kubudikidza dzakasiyana-siyana neuropsychiatric zvirwere.

zviratidzo

Hapana kurapwa mufananidzo chete anoratidza kuti mudumbu rakura adenomatous polyp. Zviratidzo neimwe murwere anogara nomumwe. Pakati Zvinonyanyozivikanwa:

- marwadzo (kuti 88,6%);

- kunzwa kuti mudumbu izere, kunyange pashure kudyiwa usingashandi yakawanda zvokudya;

- ungaderedza havi;

- belching;

- svoto;

- zvakawedzera slyunoobrazovanie;

- flatulence;

- chirungurira;

- risingafadzi kuravira pamuromo.

Pain kazhinji anooneka pashure zvokudya uye maawa maviri vazvichengete, ipapo kuserera.

Kuwedzera zviratidzo yo polyps vari varwere zvakafanana zviratidzo akacherechedza kuti mumuviri pane dambudziko. Izvi kuneta, simba, uye dzimwe nguva fivha, kushaya hope, kutemwa nomusoro, mwoyo, causeless.

Pane vnezheludochnye zviratidzo iyo munhu anogona chifungidziro pamberi polyposis, kunyanya kana nhaka. Izvi patepi ganda (kunhivi miromo, mhuno, matama, muchipfuva, maoko, shure, dumbu, mutsipa) muchimiro freckles, chero ekunze uye chero mumwaka handishanduki nechitarisiko chavo.

Diagnostics

Adenomatous polyps chero nhengo kwakaoma zvisingaiti kuona pasina Hardware Diagnostics. zvinosanganisira ndezvedumbu:

- ultrasonography;

- X-ray ine barium gobvu mvura (zvinobudirira anenge 4,6% dzokushungurudzwa);

- gastroscopy;

- fibrogastroscopy;

- biopsy;

- gastrolaparoskopiya.

No zvisinganyanyi kukosha, uye rabhoritari kuongorora gastric muto, ropa, uye maitiro kuti zvemashiripiti ropa mudumbu mukati.

The kunonyanyisa mugumisiro rinopa imwe ongororo yakaitwa kubudikidza nzira dzakawanda.

Adenomatous muura polyps

chirwere ichi ndicho chechipiri "vanokudzwa" nzvimbo pashure gastric polyposis. Maererano nenhamba, polyps ari muura vari vanyorwe maitikiro ichi:

- Women - 46%;

- Varume - 53%.

The kutsamira pane kukura chirwere nokuchembera iri sezvinotevera:

- varwere 41 kusvika 60 makore - 56%;

- kubva 31 kusvika 40 makore - 23%;

- kubva 14 kusvika 30 makore - 10%.

Degeneration pamusoro polyps ari akaipa bundu ane zvimwe kuvimba kwavo nhamba. Saka, kana mune mugaranhoko 5 kana kupfuura masangano aya, ivo kuva kenza muna 100% nyaya.

Ari muura polyps riri kuparadzirwa vanoiswa. Saka, muna vachikwira chikamu chakanyorwa 13% vose nyaya iri transverse muura mugove - 13.5%, muna sigmoid chikamu uye mugaranhoko - 73,5%. The zvinokonzera polyps ari muura vari ndezvomuzana kufanana iri chiitiko pavo mudumbu, asi pakutanga kunopiwa kune vanachiremba anogumbura zvirwere. Saka, pakati 455 examinees akawana polyps, 30% vanotambura zvirwere (colitis, proctosigmoiditis, uye vamwe), uye 16.4% chibhokisi nemanyoka. It wakaita basa guru, uye murombo muviri. Nokuda kwechikonzero ichi, colitis inowanikwa inopfuura 50% nyaya.

Zviratidzo uye chirwere kuti polyps vari ura

Mamirire zvinhu chete intestinal polyposis kwete. Kazhinji nguva refu, varwere havanzwi zviratidzo kuti ivo vakatanga kukura adenomatous polyp. The chinonyanya maitiro Zviratidzo chirwere:

- ropa mutsvina yadzo (89%);

- kukura chirwere anogona ropa panguva kana mushure bowel mafambiro;

- manyoka kana kupatira (55.2%);

- marwadzo mudumbu;

- unopfuta uye / kana kuvaviwa pamusoro horo (65%);

- kupererwa neropa (7%);

- svoto;

- chirungurira;

- nomusoro;

- belching;

- flatulence;

- kurwadziwa mugaranhoko, kuripa rezasi musana uye sacrum.

Diagnostics zvinosanganisira palpation, Ultrasound, X-ray, sigmoidoscopy, kuonana Beta-radiometry, colonoscopy, fibrocolonoscopy, rabhoritari nemiedzo.

Polyps ari gallbladder

Adenomatous polyp of gallbladder - isingawanzowanikwi chirwere, zvichiitika isingasviki 1% wevarwere vose polyposis. Maererano nenhamba, zvakawanda chirwere chinobata vanhu makore 45. The gallbladder - muviri vashomashoma, mune vakuru ndiko masendimita 14 chete refu uye 5 masendimita pahupamhi. Maererano sechivako afanane muhombodo mutete namasvingo, rakasiyana muviri, kuti tapered mitsipa uye rakamanikana chaizvo chikamu iyo yakatanga bile mutsinga dzinofamba nemukaka. Mamiriro yakaomesesa anonzi kuva nzvimbo polyps iri cervix kana mutsinga dzinofamba nemukaka. Panyaya iyi, kuti goho kukurukurirana kwacho bile kupinda ura, uye murwere ane jaundice ganda nevachena kwemaziso. Kuwedzera kune izvi inoti, pane zvimwe zviratidzo kuti nduru zvichida yakawedzera polyp:

- vachirwadziwa marwadzo;

- renal colic;

- svoto (kunyanya mangwanani);

- shungu mumuromo;

- fufune.

Zvinokonzera chirwere ave zvomoto muchetura uye mucosa, zvemamiriro muviri, kudya, nhodzera.

Chirwere chinoitwa nevanhu Ultrasound, ultrasonography. Treatment ari kunyanya zvomusejari, wakaumbwa iri kubviswa gallbladder. Chete dzimwe nguva, chiremba wako anogona mishonga pachinzvimbo Kuvhiya kugamuchirwa - "ursosan" kana "Ursofalk".

mabatiro

Zvichienderana nzvimbo, kukura uye zvimwe zvinhu zvechadenga chiremba prescribes kurapa adenomatous polyp. Kana akawanikwa ari mudumbu, kuvhiya oga zvinobvira, sezvo pasina kurapwa haangaiti kuita polyp kukura shure. Mapiritsi chete kwenguva kuvandudza zvizere, asi regai yekuzvidzivirira degeneration kupinda kenza anomera. Kana Detective kuroora polyp kubviswa rinoitwa chete nayo, uye kana Detective akawanda growths - gastric resection.

Chimwe nzira kurapwa - polypectomy ane endoscope. It zvinoratidzwa kuti stebelnyh polyps siyana kukura kubva 0.5 masendimita uye kunoratidzwa kubvisa pavo resimbi hinji. Mune zvimwe zviitiko, zviri rinoitwa pamusoro outpatient hwaro. Biopsy avhiyiwa ichi chinodikanwa. Izvi chete nzira kurapwa kuti polyps vari ura diki uye muura. Muna mugaranhoko, kana munhu adenoma pana chinhambwe masendimita 10 kubva horo, zvinokwanisika excision pasi zvomunharaunda yokutindivadza.

growths Small Akabvisa kushandisa electrocautery.

Pakati kurapwa ano kuti kubviswa polyps Laser kuverengwa anogona rwakakurudzira, nemagetsi nomunhu kana redhiyo mafungu.

Chero zvazvingava, pashure matambudziko murwere anonzi vaitofanira kudya.

Zvinofungidzirwa kuti benign polyps huru ura inogona kurapika enemas pamwe celandine, izvo zvinofanira kuitwa panguva mwero 25-30. Kugadzirisa rakagadzirirwa sezvinotevera: 50 magiramu egirini madzinde kink vari nyama mukuyi, ndidire 300 ml kufashaira mvura, mira kusvikira inotonhorera, firita. 2 maawa pamberi kuchirapa enemas kuita kucheneswa. The Kugadzirisa celandine murwere unofanira kuchengeta pachako maawa 1,5, uye vana - kusvika maminitsi 30. Miitiro kuitwa rimwe zuva.

Zvakakosha: varwere vazhinji, nzira iyi haana kuratidza, uye vaifanira kuita kuvhiyiwa kubvisa polyps kuti akakura kupinda nyanyisa anomera.