Molar cev xeeb tub yog vim muaj kev txawv txav tshwm sim thaum lub sij hawm fertilization uas ua rau kev loj hlob txawv txav ntawm cov placenta. Muaj ob hom kev xeeb tub molar:

• Ua tiav cov cev xeeb tub (lossis ua tiav hydatidiform mole) tshwm sim los ntawm kev yug me nyuam ntawm lub zes qe menyuam (tsis muaj nucleus thiab yog li tsis muaj cov khoom siv caj ces) thiab ib lossis ob lub spermatozoa haploid (muaj ib daim qauv ntawm txhua tus chromosome). Cov khoom ntawm cev xeeb tub no tsis muaj lub embryo tab sis tsuas yog cov placenta uas tsim muaj ntau yam hlwv (hu ua "grape cluster").
• ib nrab molar cev xeeb tub (los yog ib nrab hydatidiform mole) tshwm sim los ntawm fertilization ntawm lub qe ib txwm thiab ob spermatozoa los yog ib qho phev txawv txav. Muaj ib lub embryo, tab sis nws tsis siv tau, thiab cov placenta tab tom loj hlob txawv txav.

Hauv ob qho tib si lub qe tsis muaj cov khoom siv caj ces tag, yog li kev xeeb tub yog qhov ua tsis tiav.

Molar cev xeeb tub tuaj yeem tshwm sim nws tus kheej hauv ntau hom:

• Nyob rau hauv nws daim ntawv raug nws ua rau hnyav hnyav hnyav lub luag hauj lwm rau anemia thiab nce nyob rau hauv lub ntim ntawm lub tsev menyuam. Qee zaum pom muaj qhov tshwm sim ntawm cev xeeb tub los yog toxemia ntawm cev xeeb tub. Ib qho endovaginal pelvic ultrasound ua raws li kev ntsuas ntawm tag nrho cov ntshav hCG yuav ua rau nws muaj peev xwm ua rau kev kuaj mob ntawm molar cev xeeb tub.
• nyob rau hauv daim ntawv ntawm ib tug spontaneous nchuav menyuam. Nws yog tom qab ntawd pathology ntawm cov khoom curettage uas yuav tso cai rau kev kuaj mob ntawm molar cev xeeb tub.
• Nyob rau hauv daim ntawv asymptomatic, molar cev xeeb tub yuav pom los ntawm lub caij nyoog ntawm ultrasound.

Title kab lus thib peb

Kev txhawb nqa dab tsi?

Peb kab lus

Ua kom tiav lossis tsis tiav, molar cev xeeb tub tsis tuaj yeem siv tau, yog li ntawd yuav tsum tau ceev nrooj tshem tawm cov khoom ntawm cev xeeb tub. Qhov no yog ua los ntawm uterine aspiration ua nyob rau hauv ultrasound tswj. Ib qho anatomopathology ntawm cov khoom ntawm cev xeeb tub feem ntau yog ua los txhawm rau kuaj xyuas hom mole.

Kev kuaj xyuas ultrasound tau ua tiav hauv 15 hnub tom qab kev mob siab rau txhawm rau txheeb xyuas qhov tsis muaj kev tuav pov hwm, muaj teeb meem tsis tu ncua ntawm molar cev xeeb tub. Nyob rau hauv qhov kev tshwm sim ntawm kev tuav pov hwm, ib tug thib ob aspiration yuav ua tau.

Tom qab tshem tawm ntawm mole, qib ntawm hCG yog saib xyuas zoo ntawm tus nqi ntawm kev kuaj ntshav txhua lub lim tiam. Qhov kev soj ntsuam no yuav tsum tau txuas ntxiv tom qab tus nqi tau tsis pom zoo (piv txwv li 3 tus nqi tsis zoo):

• rau 6 lub hlis nyob rau hauv qhov kev tshwm sim ntawm ib nrab hydatidiform mole;
• rau 12 lub hlis nyob rau hauv cov ntaub ntawv ntawm tiav hydatidiform mole;
• rau 6 lub hlis yog tias, nyob rau hauv cov ntaub ntawv ntawm tag nrho hydatidiform mole, qib hCG ua tsis zoo nyob rau hauv 8 lub lis piam (2).

Ib qho chaw ruaj khov lossis txawm tias nce qib hCG qhia tau hais tias gestational trophoblastic qog, ib qho teeb meem ntawm lub cev xeeb tub uas cuam tshuam ze li ntawm 15% ntawm tag nrho moles thiab 0,5 mus rau 5% ntawm ib nrab moles (3). Nws tshwm sim tias cov ntaub so ntswg nyob hauv lub tsev menyuam, proliferates thiab hloov mus rau hauv cov ntaub so ntswg ntau dua lossis tsawg dua thiab tuaj yeem cuam tshuam cov phab ntsa ntawm lub tsev menyuam thiab qee zaum cov kabmob nyob deb. Qhov no yog hu ua invasive mole, lossis choriocarcinoma. Tom qab ntawd ib qho kev kuaj xyuas yuav raug ua thiab nyob ntawm qhov tshwm sim, chemotherapy yuav ua. Nyob ntawm qhov kev pheej hmoo ntawm cov qog (tsim raws li FIGO 2000 tus qhab nia), tus nqi kho tau kwv yees li ntawm 80 thiab 100% (4). Tom qab qhov kawg ntawm kev kho mob, ib lub sij hawm saib xyuas nrog ib lub hlis twg ntawm hCG raug pom zoo rau 12 mus rau 18 lub hlis.

Sai li qhov kev soj ntsuam ntawm mole tiav lawm, nws muaj peev xwm pib cev xeeb tub tshiab. Qhov kev pheej hmoo ntawm kev xeeb tub dua yog tsawg: ntawm 0,5 thiab 1% (5).

Nyob rau hauv cov xwm txheej ntawm cov qog trophopblastic, kev kho mob nrog kws khomob tsis cuam tshuam rau fertility. Lwm qhov kev xeeb tub yog li ntawd ua tau tom qab qhov kawg ntawm lub sijhawm saib xyuas. Txawm li cas los xij, ntau npaum li cas ntawm hCG cov tshuaj hormones yuav tsum tau nqa tawm thaum 3 lub hlis ntawm cev xeeb tub thiab tom qab ntawd tom qab cev xeeb tub, ob lub sijhawm muaj kev pheej hmoo rov tshwm sim ntawm tus kab mob.