Ukwelashwa kwe-chin
Uma ukuxilongwa kwe-CIN kuqinisekisiwe, ukuxoshwa kwendawo, ukuqothulwa kwamapayipi, ukukhwabanisa noma i-electrocoagulation yokugxila kwe-lesion ngokuvamile kuvame. Uma kungekho ukwelashwa, i-CIN III idlulela emdlalweni wokuhlasela. Ukwelashwa okuphumelelayo kwezigaba eziphezulu ze-CIN kunciphisa kakhulu ingozi yokuthuthukisa umdlavuza ongenayo. Noma kunjalo, ingozi ihlala ingaphezulu kunezinga labantu, ngakho-ke ukuqapha kwesiguli kuyadingeka okungenani iminyaka emihlanu emva kokuphela kokwelashwa.
Umdlavuza omncane
Iziguli ezinomdlavuza we-microinvasive ziboniswa ukukhipha umlomo wesibeletho (ukukhishwa kwengxenye ephakathi). Uma imiphumela ye-microscopy iqinisekisa ukuthi zonke izicubu ezithintekile zisusiwe, ukwelashwa okwengeziwe akudingeki.
• Lo mdwebo ubonisa isilonda nesisu ngokuzungeza ukuvulwa komsele womlomo wesibeletho. Izinguquko ezinjalo zihlolwe ngokucophelela nge-colposcopy, bese kuthi ukwelashwa okufanelekile kunqunywe.
Izimpawu zesifo somdlavuza ohlasela
Ngokuvamile izimpawu zesifo somdlavuza womlomo wesibeletho sihlasela:
• Ukusuka - kungenziwa ngemuva kokulala ngokocansi (postcoital), esikhathini sokungena esikhathini (kokuphakathi) noma emva kokuqala kokuya esikhathini (postmenopausal);
• ukukhulelwa kwamagciwane okuphuma emzimbeni.
Ekuqaleni kwesifo, ubuhlungu be-syndrome ngokuvamile abukho.
• Izindlela zokuhlinza laser ngokusebenzisa imishini colposcopic zingasetshenziswa ukuphatha CIN. Ukuze kubonakale, izizinda zezintambo zinezidakamizwa ezikhethekile. On ukwelashwa okuphumelelayo ukwelashwa kanye radiotherapy.
Hysterectomy
Ukuhlinzwa kuyindlela yokukhetha abesifazane abasha, abanamandla ngokomzimba. Izinzuzo zale ndlela zihlanganisa:
• ukungabi khona kwezinguquko zezimoto kanye nokwehlisa isisindo ngemuva kokwelapha imishanguzo;
• ukulondolozwa komsebenzi wama-ovari - uma inqubo ye-pathological engadluli kuma-ovari, futhi asusiwe;
• akukho nengozi yokuthuthukisa isifo esisha esibulalayo esenziwa yi-irradiation esikhathini eside.
Ukungenelela kokuhlinzwa komdlavuza wesibeletho kuqukethe i-hysterectomy enkulu (ukususwa kwesibeletho) nokuziqhenya kwama-lymph nodes we-pelvic. Umdlavuza womlomo wesibeletho uvame ukuhluma ezindaweni ezizungezile. Amangqamuzana amathumba angaphinde asakaze kuma-lymph nodes, isibonelo, atholakala eduze kwemibhobho emikhulu ye-pelvis.
Izinhloso zokwelapha ukwelashwa
Umgomo wokwelapha ukwelashwa ukukhipha ngokuphelele lesi sifo esibi kanye nengxenye yezincubu ezinempilo. Ngakho-ke, nge-hysterectomy enkulu, umlomo wesibeletho, isisu, izicubu ezizungezile, i-vaginal vault, kanye namagqabhezana e-pelvic asuswa. I-biopsy yama-para-aortic lymph nodes ingenziwa. Iziguli ezinama-metastase noma izicubu ezihamba ngaphesheya kokungenelela okungenzeka okudinga ukwelashwa zidinga i-radiotherapy eyengeziwe. Iziguli ezincane, ezingenayo i-nulliparous ngenqubo yomdlavuza ngaphambi kwesigaba se-lb ezifisa ukuhlala zivundile zingadluliselwa umlomo wesibeletho. Kulo msebenzi, umlomo wesibeletho ususwe kanye nengxenye ye-paracervical (etholakala emgodini wesibeletho) nasendlini yokulala. Ingxenye esele yebhinqa ixhunywe emzimbeni wesisu futhi i-suture ifakwa emkhawulweni ophansi wesibeletho ukugcina ikhono layo lokukhulelwa. Ama-lymph nodes ama-pelvic angasuswa endoscopically. Ngesikhathi sokukhulelwa, isiguli sigcinwa ngokucophelela ukuze sigweme ukusongelwa kokukhulelwa kwesisu, futhi ukulethwa kungenxa yesigaba sokudla. Kodwa-ke, ukuxoshwa komlomo wesibeletho akuboniswa kubo bonke abesifazane, futhi i-hysterectomy enkulu ihlala iyindlela yokuzikhethela. Inhloso yokwelapha imishanguzo ukubhujiswa kwamangqamuzana e-tumor, kanye ne-radiation of tissue lapho inqubo enonya ingase isakaze khona. Ngezigaba zomdlavuza, okuyinto ephikisanayo nokungenelela kokuhlinzwa, kanye nenqubo ehamba phambili.
Imiphumela Yecala
Imiphumela emibi yokwelashwa kwemisebe:
• isifo sohudo;
• Ukuvuthwa njalo;
• Ukucwiliswa nokucwiliswa kwesisu (lokhu kungaholela ekutheni i-dyspareunia - imizwelo ebuhlungu ngesikhathi sokulala ngokocansi).
Ukwelapha Ukuhlanganiswa
Ucwaningo lwamuva luye lwabonisa ukuthi inhlanganisela ye-radiotherapy kanye ne-chemotherapy ne-cisplatin (i-platinum-based-drug) ivumela imiphumela engcono kune-radiotherapy yedwa. Ukuchazwa kweziguli ezinekhanda lomlomo wesibeletho kuncike kakhulu esiteji senqubo embi ngenkathi yokwelashwa. Uma i-tumor isakazeke kuma-lymph nodes, isilinganiso seminyaka emihlanu sokusinda sincishiswe ngesigamu esigabeni ngasinye ngokusho kwesigaba se-FIGO. Ukubandakanya i-para-aortic lymph nodes kubonisa ukusakazeka okuphawulekayo kwenqubo - iziguli ezimbalwa ziphila isikhathi eside kuneminyaka emihlanu emva kokuxilongwa. Ukutholakala kwamangqamuzana e-tumor egazini noma lymph kuyisibonakaliso sokubandakanyeka kwezitho zamakhemikhali. Izinga lokuhlukaniswa kwesisu (ngokuya kwesakhiwo saso esiseduze nezicubu ezijwayelekile) nakho kubaluleke kakhulu. Ukuchazwa kwezicubu ezincane eziphansi kuncane kakhulu kunezicubu ezihlukene kakhulu.