BPH - chii? Zviratidzo, Mabatirwo prostatic hyperplasia isiri yekenza

Mukurapa kwemazuva ano, inowanzoshandiswa zvinyorwa, zvisinganzwisisiki kune munhuwo zvake asina uchi. Dzidzo. Chimwe chezvinyorwa izvi zvisinganzwisisiki ndeye BPH. Chii ichocho? Kutaura mumutauro wechiremba, ichi chinonzi benign prostatic hyperplasia. Asi mukati mevanhu inonzi "nyore" - adenoma yeprostate (inoita sarudzo "adenoma ye prostate gland"). Kazhinji adenoma yeprostate inokanganiswa nechirwere chakafanana neprotatitis. BPH inoratidzira kubata, uye haina kukura kunze kwekubatanidzwa kwechikamu chechikamu cheprostate (mune mamwe mazwi - epithelium glandular), uye prostatitis haisi chinhu kunze kwekuputika kweprostate gland. Usavhiringidza ivo.

BPH. Chii ichocho? Statistics

Sezvataurwa pamusoro apa, BPH inorwara neoplasm. Neyo mu prostate (zita rakafukidzirwa remhepo iyo yakawanda kwazvo inonzi prostate gland) majekiseni mashoma anoumbwa, iyo apo iwe uchikura uye unowedzera kufungidzira urethra.

Nemhaka yeizvi, murume ane zvirwere zvekuvhenekera. Chirwere ichi chinokura, uye izvi ndizvo zvinosiyanisa BPH kubva mumukenza.

BPH imwe yezvirwere zvakajairika mune urology nhasi. Maererano nehuwandu, inowanikwa munenge makumi mapfumbamwe nezana makumi mapfumbamwe evanhu muzera rakanaka. Mu20 muzana yemakwenzi, atrophy ye gland kana kuwedzera kwayo kunoonekwa panzvimbo peBPH.

Denda BPH inowanzoitika kune varume vanopfuura makore makumi mashanu.

Vanopfuura hafu yevarume kubva pamakore makumi mana kusvika kumakore makumi mashanu ekuberekwa vanotendeukira kumuongorori ane chirwere ichi, uye muzviitiko zvisingasviki chirwere chinogona kuwana vaduku.

Zvinokonzera BPH

Kusvika panguva ino, hazvibviri kuratidza zvikonzero chaiwo zvekusimbiswa kweBPH ye prostate gland, sezvo zvisiri pachena kusvika pakuguma. Zvinotendwa kuti chirwere ichi ndechimwe chezviratidzo zvekuguma kwemurume muvarume.

Zvimwe chete zvinokonzera ngozi ndeyero ye androgens muropa uye nguva yemunhu.

Kazhinji, nezera, murume wacho anowedzera zvishoma nezvishoma pakati peedrogen uye androgens, izvo zvinokonzera kukanganisa kwekukura nekushanda kwemasero emuchena.

Zvinonyatsozivikanwa kuti hapana kuwirirana pakati pe prostatic BPH uye zvepabonde zvemunhu, maitiro, maitiro akaipa, akatumirwa zvipfeko uye zvinoputira ZAP, uye hapana chimwe chepamusoro hachikuvadzi kuonekwa kwechirwere.

Pathogenesis

BPH prostate gland kakawanda inowanikwa mukati mawo, asi dzimwe nguva inogonawo kutora lateral lobes. Kukura kwebhendi hyperplasia kunoenderana neudenomatous proliferation (tumor) yezvinyorwa zveparaurethral. Somugumisiro, mhando yeglandu inoshandurirwa kune kunze, uye kumativi ose, capsule inoumbwa ichikomberedza adenoma ichikura.

Masero anonyanya kufungidzirwa eprostate gland tissue anewo yekukura zviri zviviri munzira yekuyerera uye chiropafadzo, uye ichi ndicho chikonzero chekufamba kwepamusoro kwemukati mukati mekuvhara uye kuwedzerwa kwepashure chikamu chechiremba.

Kune marudzi mazhinji e hyperplasia maererano nerudzi rwekukura kwayo:

• Subcubic fomu yeBPH. Chii ichocho? Nechirwere ichi, tumarara inokura mumucheto we rectum.
• Intravesical form BPH. Nhoroondo yechirwere inoratidzirwa nekukura kwechirwere kune bhanhire.
• Retrotrigonal fomu yeBPH. Chirwere chiri munyaya ino chinowanikwa zvakananga pasi pechuru chetatu chevanhu.

Kazhinji dzimwe nzira dzeBPH dzinogona kuonekwa mumunhu mumwechete panguva imwechete. Izvi zvinoitika apo bundu racho rinokura mumativi akaverengeka kamwechete.

BPH: zviratidzo

Zviratidzo zvechirwere ichi zvakananga zvichienderana nenzvimbo yechipfuva, kukura kwayo nekukura, pamwe nekuwedzerwa kwekushaya simba kwechirwere.

BPH ye prostate inogona kugoverwa muzvikamu zvitatu:

• Anogadziriswa, kana danho rokutanga. Chimiro chechirwere ichi chinoratidzirwa nekunonoka pakuvamba kwekucheka (kazhinji kuda kwekubudisa, kunyanya usiku - chiratidzo chinogutsa). NeBPH 1 degree prostate gland inowedzera muhukuru, inobata zvakasimba. Miganhu yaro yakanyatsorondedzerwa, uye kazhinji marpation ye gland (uye rwonzi rwaro rurefu) harina maturo. Panguva ino yechirwere ichi, chirwere chinoputirwa zvachose, uye hapana zvachose hapana marara anogara. BPH 1 degree inogona kudarika kubva pagore kusvika kune matatu.
• Anopiwa chikwereti, kana kuti danho rechipiri. Sezvo chironda chinenge chichikura, chinokonzera urethra kakawanda, uye chikafu hachikwanisi kuita zvakanaka uye chinodonhedzwa zvachose (masvingo aro anove panguva imwechete). Somugumisiro, nekugara kweBPH yegadziriro yechipiri, kurara kwemuguta kunoonekwa, nekuda kwokuti murwere anonzwa kusakwana kwekuvhara kwechidzitiro. Nemhaka yekumanikidzwa kwechiremba, varwere vanodhonza muzvikamu zviduku, uye mushure mekunge muroti uchinge uye vanotanga kumira pachena (chinokonzera ichi ndicho chikwata chinoputika). BPH yechidimbu chechipiri pane dzimwe nguva inowirirana nezviratidzo zvekusingaperi renal kusakundikana (kuenderera mberi kwayo).
• Inopomerwa, kana danho rechitatu. Icho chirwere chekuchenesa chakanyatsosimbiswa nekuda kwekugarisa urinha, urethra ichiri kuomeswa, uye urini inonyatsorodzwa, dzimwe nguva kunyange neine kutevera ropa. Panguva iyi, BPH inokonzera kuora mwoyo kwepabonde (kukundikana kwechirwere). Iko kunewo utera, kuora muviri kwakanyanya, kusava nenzara, kuvhiringidzika, anemia, yakaoma muromo.

Kuongororwa kwechirwere

Chikonzero chekuongororwa ndechekunyunyuta kwevarume avo vane chikwata chakanaka chekuongorora zviratidzo zve prostate adenoma (muChirungu I-PSS) yakasikwa. Chaizvoizvo, kuongororwa kweBPH kunoitwa mushure mekuongororwa kwechirwere chemuongorori, uyewo nzira dzakadaro dzekutsvakurudza:

1. Palpator (munwe) nzira yekuongorora yeprostate gland. Achitenda kwaari, vanachiremba vane pfungwa yekusagadzikana uye kukura kweganda, kuvapo kwebvuri pakati pemakona ayo, pamwe nekuwedzerwa kwekurwadziwa kwemazwi.
2. Zvidzidzo zverabhurasi yeBPH. Chii ichocho? Chokutanga pane zvose, iyo inowanzozivikanwa kuongorora urini. Uyewo, kuongorora ropa kunokonzerwa nehupenyu hwemagetsi kunoitwa kuti uone huwandu hwePSA (yakafananidzwa se prostate specific antigen).
3. Instrumental methods. Kazhinji kazhinji iyi inonzi cystoscopy uye urethroscopy. Nekubatsira kwavo unogona kutarisa maitiro ererera , nyika ye lobes ye gland uye mutsi wechipfuva. Nedzimwe nzira, unogona kugona kuwanda kwemuti wekusara.
4. Ultrasound kuongorora. Iyi ndeimwe yemhando dzemhando dzekushandisa, zvichibvumira kuti zvione zviyero zvelobe imwe yeglande, mamiriro ayo (kuvapo kwematombo, maitiro akakomba). Mukuwedzera kune yakakurumbira ultrasound, Truzui (transrectal) inoshandiswa zvakare.
5. X-ray nzira dzekutsvakurudza. Excretory urography (nekusiyana) uye kuongororwa radiography (pasina kupikisa) kunogona kubatsira kugona kuvapo kwezvinetso zveBPH, kurapwa kwakatanga. Kushandisa X-rays, mabwe anowanikwa mune bhanhire uye itsvo.

Kurapa kweBPH

Panguva iyo pane nzira dzakawanda dzokurapa chirwere ichi, chimwe nechimwe chaicho chinoshanda zvikuru pamatanho akasiyana eBPH. Kurapa kwechirwere ichi kunogona kugoverwa muzvikamu zvitatu:

• Kurapa zvinodhaka
• Nzira yekushanda yekurapa
• Mamwe maitiro asingashandisi ekurapa

Mishonga inowanzoshandiswa pachiratidzo chekutanga cheBPH.

Pakutanga kwekutanga kweBPH prostate kanzira yekurapa inotarirwa kuderedza kukura kwema hyperplastic prostate tissue, kuvandudza kupararira kweropa mune dzimwe nhengo dziri nhengo dziripo, kuderedza kuputika kweprostate uye chikwata, kubvisa kupera kwemuguta, kubvisa kuvhiringidzika, kubvisa kukonzera.

Mukuwedzera kumashandisirwo emishonga, murwere anorayirwa kuchengeta mararamiro ehupenyu, kurega doro uye kukuvadza (zvakanyanya mafuta, zvinonaka, zvinonaka) zvokudya, kusvuta.

Izvo zvinodiwawo kuderedza kudya kwemanzi mumasikati, kunyanya asati avata.

Mukuvapo kwechipatara uye zviratidzo zve laboratory ye androgen inoshaya, androgen-replacement therapy inorayirwa zvakare.

Kazhinji, zvakafanana nekurapa hyperplasia, kurapwa kwezvinetso zvaro zvinoitwa - cystitis, prostatitis kana pyelonephritis.

Dzimwe nguva (kurwisana nenheyo ye hypothermia kana kunwa doro), murwere angave nekukurumidza kuchengetedza urine. Muchiitiko ichi, murwere anofanirwa kukurumidza kupinda muchipatara uye catheterization yechipfuva.

Ngatinyatsoongororei rudzi rumwe rwemishonga.

Mishonga

Kazhinji kazhinji, mhando mbiri dzemishonga inoshandiswa kurapa BPH:

• Alpha-1-adrenoblockers (p., Tamsulosin, doxazosin, kana terazosin). Chiito chavo chinangwa chekuzorora musina kufara kweprostate uye mutsi wechipfuva, izvo zvinoita kuti nyore nyore kubuda mumuguta. Migumisiro yemishonga iyi inogona kuwedzerwa kana kupfupika.
• Inhibitors (blockers) ye 5-alpha-reductase (permixone, dutasteride kana finasteride). Iyi mishonga haibvumiri dihydrotestosterone (inonzi biologically active active testosterone) kuumba mumuviri wemunhu anorwara, kuitira kuti prostate gland inopera.

Nzira yekushanda yekurapa

Mune zvimwe zviitiko zvakanyanya, chirwere chimwe chemishonga hachigoni kudziviswa, uye, sekutonga, munhu anofanira kushandura kupindira kwekuvhiya. Izvi zvingave zvisina kukodzera kwehutachiona (adenomectomy) kana kuti rese resection ye prostate (prostatectomy).

Kune mhando mbiri dzekupindira kwekuvhiya:

• Kuvhiya pachena (transvesical adenomectomy) . Nekupindira kwakadaro, kusvikirwa kwehutundu hweglandu hunowanikwa kuburikidza nemadziro echando. Iyi mhuka ndiyo inonyanya kushungurudza, uye inoshandiswa chete mumatambudziko asina hanya. Kuvhima kwakasununguka kunopa mushonga wakakwana weBPH.
• Minimally invasive operation (umo mune zvisingabvumirwi kupindira). Inoitwa nekubatsirwa kwemazuva ano mavhidhiyo endoscopic nzira, pasina kutemwa. Kutsvaga kweprostate kuburikidza neutrera.

Ikoko kune rumwe rutivi rwekupindira kwekupindira, izvo zvisingagoni kuenzaniswa nepamusoro apa. Embolization ye arteri yeprostate inoshandiswa nevanoporesa endovascular (inotsanangurwa pamusoro apa neurologists) uye inosanganisira kuvhara mitsetse yeprostate nemaduku ediki emhando yehutachiona hwemhando yepamusoro (kuburikidza nehutano hwevakadzi). Hospitalization haifaniri, basa racho rinoshandiswa pasi peanesthesia yepamunharaunda uye harisi kushungurudza.

Pashure pemhando ipi zvayo yokuvhiya, kune ngozi shomanana yezvinetso, zvakadai sokusava nehanya, kusava nesimba kana kugadziriswa kwechiremba.

Kwete-operative nzira dzokurapa

Zvisiri-operative nzira dzokurapa dzinosanganisira zvinotevera:

- cryodestruction;

- Transurethral needle ablation;

- kurapwa kunowedzera kukwirira kwakanyanya ultrasound;

- nzira ye microwave coagulation ye prostate kana thermotherapy;

- kuiswa kweprostatic stents mukucheka;

- bhoro dilatation ye prostate.

Postoperative period

Nhamo, pane dzimwe nhanho dzechirwere, chirwere chinongodiwa chete. BPH chirwere chakakomba, uye kunyange mushure mekuvhiyiwa iwe unoda kutevera mitemo yakati kuti pakupedzisira kubvisa chirwere chacho uye kwete kumutsa kutsva-kuonekwa. Idzi pfungwa huru nhatu dzamunofanira kutevera mushure mekuvhiyiwa ndezvokudya zvakakodzera, mararamiro ane hutano uye nguva dzose kuenda kunechiremba.

Kudyidzana kwezvokudya mumazuva ekushanda kwakakosha zvikuru kune murwere, sezvo zvingaita zvakanyanya kuti zvive nekukurumidza kupora. Kudya mushure mekuvhiyiwa kunopedza zvachose kudya kwemafuta, zvinonhuwira, salori uye zvinonhuwira uye, zvechokwadi, doro. Inokurudzirwa kudya mafuta asina mafuta, fiber-rich-rich.

Kana iri basa, kana basa rako risingabatanidzi mitoro yepanyama, ipapo unogona kudzokera kubasa mushure memavhiki mashomanana mushure mekushanda. Apo sedentary inoshanda hafu yega yega inokurudzirwa kuti iite ushamwari. Mararamiro ehupenyu anogona kuita kuti kuve nekuwedzerwa kweropa mune nhengo, uko chirwere ichi chinowedzera. Mazuva mashomanana okutanga mushure mekuvhiyiwa, usatombofungidzira nezvekusimudza zvisikwa!

Rega kusvuta zvisingaiti munguva yemazuva anotevera (masvondo maviri mushure mekuvhiyiwa), kana iwe usingakwanisi kurega kukanganisa zvachose. Nicotine inokuvadza masvingo emidziyo yeropa, uye izvi zvinokanganisa kupararira kweropa kweprostate, zvichiita kuti zviputike.

Vanhu vazhinji vanofunga kuti mushure mokusunungurwa kwaBPH kunokosha kukanganwa nezvehutano nekusingaperi. Uyu maonero akaipa, uye basa repabonde remunhu rakadzorerwa zvachose mushure mechinguva. Zvisinei, kudzokazve zvepabonde hakusi kwemavhiki mana mushure mekushanda.

Chimwe chidimbu, chinofanirwa kubhadhara: iwe unogona kutyaira motokari isati yapfuura mwedzi mushure mokubviswa kweBPH.

Muzhinji, nguva inotevera inopera inenge inenge mwedzi, mushure mokunge murwere anogona kutodzokera kuupenyu huripo. Zvisinei, nyanzvi dzinokurudzira zvakasimba mararamiro ehutano, kuitira kuti arege kuitikazve kwechirwere.

Micturition mushure mekuvhiyiwa

Anenge pakarepo mushure mekuvhiya, urwizi runoramba huchiwedzera, uye kubuda kwechivako kunoitika nyore nyore. Mushure mokubviswa kwe catheter, kurwadziwa kunogona kuitika kwechinguva paunenge uchizora, chikonzero cheizvi ndechekufamba kwemuti kuburikidza neronda rekuvhiya.

Nyanzvi hadzibvumi kuitika kwekuvhiringidza kwekuvhenekera kana kukurudzirwa nokukurumidza kuti urinate panguva yekushanda kwenguva, zvinhu izvi zvinowanzoitika. Kana uchingotambudzwa nezviratidzo panguva yekurwara, nguva yako yekuzorora ichave yakareba. Nokufamba kwenguva, matambudziko ose achaparara uye iwe uchadzoka kune chimiro chechirwere chehupenyu.

Imwe nguva mushure mekupindira mumuguta kunogona kuva ropa. Ichi chinoshamisa chinosanganiswa nekupora kurapa. Inokurudzirwa kunwa semvura yakawanda sezvinobvira kuitira kuti ushambidze chikafu. Asi nekubuda ropa kwakanyanya, iwe unofanira kutanga uchingosangana nomudzidzisi.

Zvakafanotaurwa

Kuramba kwenguva refu kwemuti (muitiko apo kurapwa kweprostate adenoma hakuiti), pakuguma kunogona kutungamirira ku urolithiasis, umo mabwe anoita muchando, uye gare gare utachiona. Muchiitiko ichi, kushungurudza kwakakomba kunogona kuitwa nemurwere pasina kukodzera kwakakodzera ipo pyelonephritis. Ichi chirwere chinoramba chichiwedzera kukura kwepfungwa.

Mukuwedzera, prostate adenoma inogona kukonzera kukura kwakaipa - kenza yeprotate.

Zvakafanotaurwa nehutano hwakakwana uye panguva yakakodzera yehutachiwana hwakanaka kwazvo.

Kudzivirira zvirwere

Yakanakisisa prophylaxis yeBPH inowanzocherechedzwa neyanyanzvi uye kurapwa kwakakodzera kweprostatitis.

Uyezve zvakakosha kudya zvakanaka (kuderedza zvakakangwa zvakagadzirwa, zvakagadzirwa nemunyu, uye zvinonhuwira, zvinonaka uye zvinopfungaira), rega kusvuta uye doro. Nenzira yakawanda, mararamiro ane hutano anowedzera kuderedza njodzi yeBPH.

Saka, zvino munoziva kuti BPH. Zviratidzo nehosha, kurapwa, postoperative nguva uye kunyange kudzivirira anorondedzerwa zvizere kumusoro.

Chero zvazvingava, zivo iyi ichava chinobatsira. Stay utano!