Unyango lwe-chin
Ukuba ukuxilongwa kwe-CIN kuqinisekiswa, ukuchithwa kwendawo, ukuchithwa kwelaser, ukuchithwa okanye ukuchithwa kwe-electrocoagulation yegxininiso yesilonda ngokuqhelekileyo yenziwa. Ukungabikho kwonyango, i-CIN III idlula kwisifo somhlaza. Uphulo olusebenzayo lwezigaba eziphezulu ze-CIN luyanciphisa kakhulu umngcipheko wokuhlaselwa ngumhlaza ongenayo. Nangona kunjalo, umngcipheko uhlala uphezulu kunomyinge kubemi, ukubeka esweni isigulane kuyimfuneko ubuncinane kwiminyaka emihlanu emva kokuphela kokonyango.
Umhlaza we Microinvasive
Izigulane ezinomdlavuza we-microinvasive ziboniswa ukukhutshwa komlomo wesibeleko (ukususwa kwenxalenye ephambili). Ukuba iziphumo ze-microscopy ziqinisekisa ukuba zonke izicubu ezichaphazelekayo zisusiwe, akukho unyango olungaphezulu.
• Umzekeliso ubonisa isilonda kunye nokuqhwala ngokujikeleza kwendawo yomngcingo wesibeleko. Olu tshintsho luhlolisiswa ngokucophelela kwi-colposcopy, kwaye ke unyango olufanelekileyo lubekwe.
Iimpawu zomhlaza wesifo
Ngokuqhelekileyo iimpawu zesifo somhlaza wesibeleko singena:
• Ukuphuma kwegazi - kunokuvela emva kokulala ngesini (postcoital), kwixesha eliphakathi kwexesha (phakathi kweminyaka) okanye emva kokuqala kokunyuka komzimba (postmenopausal);
• ukukhulelwa kwamathambo kwisisu.
Kwimigangatho yokuqala yesifo, isifo sesifo kaninzi asikho.
• Izindlela zokuhlinzwa ngokusetyenziswa kwelaser usebenzisa izixhobo ze-colposcopic zingasetyenziswa ekuphatheni i-CIN. Ukubonwa, iindawo zokuhlala zihlala zihlambuluke ngamadayimenzi akhethekileyo. Ngonyango ogqityiweyo kunye no-radiotherapy.
Hysterectomy
Ugqirha yindlela yokhetho kubasetyhini, abasetyhini abanamandla. Iinzuzo zale ndlela ziquka:
• ukungabikho kweenguqu ezincinane kunye nokunciphisa ubulili emva kokunyanga kwamayeza;
• Ukulondolozwa komsebenzi wee-ovari - ukuba inkqubo ye-pathological does not extend to ovaries, kwaye ayisuswanga;
• akukho mngcipheko wokuhlamba isifo esitsha esibi esicatshiswa yi-irradiation kwixesha elide.
Ingenelelo yokuphanda kwintsholongwane yomlomo wesibeleko iqukethe i-hysterectomy enkulu (ukususwa kwesibindi) kunye nokuchithwa kweemfele ze-pelvic. Umhlaza womlomo wesibeleko ukhula ukukhula kwiimveliso ezizungezile. Iiseli ezixhamlayo zingasasazeka nakwiimpawu zesikhumba, umzekelo, ezifumaneka kwimibhobho emikhulu yentloko.
Iinjongo zokunyangwa ngonyango
Injongo yokunyangwa ngonyango kupheliswa ngokupheleleyo kwesifo esibi kunye nenxalenye yeethambo eziphilileyo. Ngaloo ndlela, nge-hysterectomy enkulu, i-cervix, isibeleko, izicubu ezizungezile, igodlo lomfazi, kunye ne-lymph nodes ezikhutshwayo. I-biopsy ye-par-aortic lymph nodes ingenziwa. Izigulane ezineemitha zesifo okanye izidumbu ezithatha ngaphaya kobuninzi bokungenelela ngonyango kufuna i-radiotherapy eyongezelelweyo. Izigulane ezincinci, ezingenayo iprogram yomhlaza ngaphambi kwesigaba se-lb ezinqwenela ukuhlala zikhula ziyakunqunywa umlomo wesibeleko. Kule ntshukumo, umlomo wesibeleko ususwe kunye nenxalenye ye-paracervical (ejikeleze umlomo wesibeleko) kunye nesigodlo sesisu. Inxalenye eseleyo yobhinqa ixhamene nomzimba wesisu kwaye i-suture ifakwa kwicala elingaphantsi lombelethi ukuze ulondoloze ikhono layo lokuthwala ukukhulelwa. Ama-lymph nodes angama-pelvic angasuswa kwi-endoscopically. Ngethuba lokukhulelwa, isigulane siyigcinwa ngokucophelela ukuze sigweme isongelo sokukhulelwa kwesisu, kwaye ukuhanjiswa kungenxa yecandelo lokutya. Nangona kunjalo, ukuxothwa komlomo wesibeleko akubonakalwanga kubo bonke abafazi, kwaye ukugqithisa okukhulu kwe-hysterectomy kuyindlela yokukhetha. Injongo yonyango lomlambo yonakaliso lwama-tumor cells, kwakunye ne-irradiation of tisses apho inqubo engafanelekiyo inokusasazeka ngayo. Kwinqanaba lomhlaza, elichazwe ngongenelelo lophulo, kunye nenkqubo ehamba phambili.
Iziphumo eziPhakathi
Imiphumo emibi yonyango lomlambo:
• urhudo;
• Ukuvuthwa rhoqo;
• Ukucwina nokunciphisa ubulili (oku kungakhokelela kwi-dyspareunia - inzingo ezibuhlungu ngexesha lokwabelana ngesondo).
Uluhlu lweNyango
Izifundo zakutsha zibonise ukuba ukudibanisa i-radiotherapy kunye ne-chemotherapy kunye ne-cisplatin (i-platinum-based-drug) ivumela iziphumo ezingcono kune-radiotherapy yedwa. Ukugxekwa kwezigulane zomhlaza wesibeleko kuncike kakhulu kwisigaba senkqubo embi ngexesha lokunyanga. Ukuba i-tumor isasazeke kwi-lymph nodes, izinga lokusinda leminyaka emihlanu liyancishiswa ngesiqingatha kwinqanaba ngalinye ngokwemiqathango yeFIGO. Ukubandakanya i-para-aortic lymph node kubonisa ukuxhaphaka okukhulu kwenkqubo - kakhulu izigulane zihlala ixesha elingaphezu kweminyaka emihlanu emva kokuxilongwa. Ukufunyanwa kweeseli zesisu kwigazi okanye i-lymph kukuphawuleka kokubandakanyeka kwamalungu e-lymph nodes. Iqondo lokuhlukanisa i-tumor (ngokubhekiselele kwisakhiwo sayo sisondele kwimizimba evamile) nayo ibaluleke kakhulu. Ukugxekwa kwamathambo angaphantsi kwe-borski akuvumelekanga kunokuba izifo ezihluke kakhulu.