U xơ tử cung

U xo tu cung Hdf: Tdi di kham sdc khde djnh kjf, ph^t hidn cduxdtO

cung kk^ thudc 1cm x 1,2cm. Xin cho bi& tinh trang cd

nguy hiSm khdng? Cach diSu tn ra sao? Cd inh hudng

dSn viec mang thai hay khdng?

TrUdng Thj Hong Ph.

DAP; U xtf td cung la khtfi u lanh tinh d td cung,

thudng gap d phu nd trong do tuoi sinh de, td 30 - 50

tutfi. Yeu ttf chinh inh hudng dtfn sU phdt tritfn eua

khtfi u xtf td cung Id tinh trang titft estrogen - la mtft

ntfi titft ttf sinh due do buli ^ trdiig titft ra, se thuc

diy khoi u phat trien. Thtfng thudng, u xtf ctf khuynh

hudng to Idn td td, dac bidt se to ra nhanh trong khi

mang thai va eo khuynh hudng nho lai khi vdo tutfi

man kinh (do Iddng estrogen do cd thtf titft ra tang

eao trong thai ky va giim xutfng khi man kinh).

Hi?n nay, khuynh hddng dilu tri u xtf td eung Id

ehi giii quytft khtfi u khi ctf bitfn chdng hay khi anh

hddng dtfn kha ndng sinh san. Nguydn tac dilu tri

Id liy di khtf^i u, c6 the dl lai td cung hay cat td cung

tuy theo ngddi bdnh ctf mutfn sinh con hay khong hoac

tinh trang khtfi u.

Cde budc diiu tri u xtf td cung gom:

- Theo doi: khi khtfi u eon nho vd ehua gdy anh

hudng ^ cho ngudi b?nh. Viec khdm dinh ky 3 thang/

lin se eho phep theo doi td'c dd phdt trien cua u vd

phdt hien bitfn chdng (neu co). Khi co edc tridu chiftig,

ctf thtf dung thutf^c dilu tri tridu ehdng nhU thutfc giam

dau non-steroids hoac paracetamol, dilu tri rong kinh..

- Biiu tri hang thud'c Id cac loai npi tilt ttf sinh

due, dUa vdo ctf the ngUdi benh dtf gdy dc che rung

trdng, buong trdng tam thdi khong tie't estrogen,

nhdm Iam cho khtfi u nhd lai (gitfng nhd tinh trang

man kinh). Sau khi ngitog thuo'c, butfng trdng se Iam

Ndi soi Idng tO cung

vi$c trd lai va khtfi u titfp tuc phdt tritfn. Ddy Id cdch

diiu tri tam thdi nham ldm gidm kich thudc khtfi u dtf

de dang phau thudt sau do. Tuy nhitfn, thutfc cung Idm

eho ngudi bdnh ctf nhdng bitfu hidn gitfng man kinh

nhu btfc htfa, trim cam, khd ngd, dau khdp, gidm tinh

due. Cac Ioai thutfc khdng hormon (mifepriston)iCung

etf thtf ldm chdm sU phdt tritfn cua u. Tit ci nhi2ng

Ioai thutfc ke trdn chi tam thdi Iam giim tridu chdng

eua u xd, hoac Idm ch^ra sd phdt triln cua u xo, kbi

ngddi btfnh ngung dilu tri, u xd se phdt tritfn tid l^i.

- Dieu tri phau thuqt cd nhilu dang. Bdc nhdn xa

td cung Id chl btfc khtfi u xtf vd dl td cung lai. PhUdng

phdp nay dp dung cho nhdng phu nd ctfn trd, ctfn c6

nhu ciu sinh dl. PhSu thudt cdt tH cung bdn phdn

hay todn phdn. Ngay nay, khuynh hudng cdt tH cung

bdn phdn vdi muc dich de lai mtft phin etf td eung

khtfng ctfn duoc Ua ehutfng, do vide dl lai ctf t^ cung

CO the gdy viem nhilm hay ung thu etf td cung sau

ndy. Vide liy di buing trdng khi phiu thudt cdn tiiy

vao dtf tutfi cua btfnh nhdn. Ntfu bdnh nhdn cdn trd,

se de lai buong trdng, nham duy tri n^i titft ttf sinh

due nd, khtfng gdy ra tinh trang man kinh qud sdm.

Cdt ta cung todn phdn la phUdng phdp dilu tri tri§t

de u xtf td cung, ddnh cho nhitog bdnh nhdn ctf u xcr

to, cudng kinh hodc rong kinh dd dpi, gin hodc da vio

tutfi man kinh, khtfng etf nhu ciu sinh con. Cd nhilu

each de cit td eung: cit td eung qua dUdng ml bung,

cat td cung qua ntfi soi hoac qua nga am dao. Phiu

thu^t duoc chi dinh khi u xtf to htfn td cung ctf thai

12 tuin, khi u xtf gay bitfn ehdng chdn dp ed quan ldn

cdn, khi u xtf gay dau nhieu, kinh nhilu hodc thitfu

mdu, hoac nghi ngd dc tinh. Khi khtfi u qud to se khd

phiu thudt vi ctf thtf gdy ttfn thUtfng ctf quan Ifin ctfn

nhu ddt nitfu quin, rdch bdng quang, rich trt^ trdng.

- Ap dinh ngi mgc tu! cung: ddng dung cu sinh

nhitft phd huy ntfi mac td cung. PhUtfng phdp ndy dp

dung cho nhitog tniitng hdp u xtf dddi nitfm mac gfiy

rong kinh rong huytft vd khdng ctf nhu ciu sinh dd.

THUOC & SCfC KH6 E stf 498 (15.4.2014)