Lefu la Polycystic ovary

Polycystic ovary syndrome (PCOS) ke boemo boo ho bona mosali a ekelitseng maemo a lihormone tsa banna (androgens). Mathata a mangata a hlaha ka lebaka la keketseho ena ea lihormone, ho kenyelletsa:

• Mathata a ho ilela khoeli
• Ho hloka thari
• Mathata a letlalo a kang makhopho le kholo ea kholo ea moriri
• Palo e ntseng e eketseha ea li-cysts tse nyane mae a bomme

PCOS e hokahane le liphetoho maemong a lihormone tse thatafalletsang mae a bomme ho lokolla mahe a holileng ka botlalo. Mabaka a liphetoho tsena ha a hlaka. Lihormone tse amehang ke:

• Estrogen le progesterone, lihomone tsa basali tse thusang mae a bomme ho ntša mahe
• Androgen, hormone ea banna e fumanoang ka bongata ho basali

Ka tloaelo, lehe le le leng kapa a 'maloa a tsoa nakong ea potoloho ea mosali. Sena se tsejoa e le ovulation. Maemong a mangata, ho lokolloa ha mahe hona ho etsahala hoo e ka bang libeke tse 2 kamora ho qala ho ilela khoeli.

Ho PCOS, mahe a holileng tsebong ha a lokolloe. Sebakeng seo, ba lula ka har'a mae a bomme ka mokelikeli o monyane (cyst) o ba potileng. Ho ka ba le tse ngata tsa tsena. Leha ho le joalo, ha se basali bohle ba nang le boemo bona ba tla ba le mae a bomme a nang le chebahalo ena.

Basali ba nang le PCOS ba na le lipotoloho moo ovulation e sa etsahaleng khoeli e 'ngoe le e' ngoe e ka tlatsetsang ho nyopa Matšoao a mang a lefu lena a bakoa ke maemo a phahameng a lihormone tsa banna.

Boholo ba nako, PCOS e fumanoa ho basali ba lilemong tsa bo-20 kapa 30. Leha ho le joalo, e kanna ea ama le banana ba lilemong tsa bocha. Hangata matšoao a qala ha linako tsa ngoanana li qala. Basali ba nang le bothata bona hangata ba na le mme kapa khaitseli ea nang le matšoao a tšoanang.

Matšoao a PCOS a kenyelletsa liphetoho nakong ea ho ilela khoeli, tse kang:

• Ho se be le nako kamora ho ba le e le 'ngoe kapa tse' maloa tse tloaelehileng nakong ea bocha (amenorrhea ea bobeli)
• Linako tse sa tloaelehang tse ka tlang le ho feta, 'me tsa ba bobebe haholo ho ea boima haholo

Matšoao a mang a PCOS a kenyelletsa:

• Moriri o eketsehileng oa 'mele o melang sefubeng, mpeng, sefahlehong le ho potoloha malinyane
• Makhopho sefahlehong, sefubeng kapa mokokotlong
• Liphetoho tsa letlalo, joalo ka letšoao le lefifi kapa le letenya la letlalo le likhechana tse potileng mokokotlo, seboko, molala le matsoele

Nts'etsopele ea litšobotsi tsa banna ha e tloaelehe ho PCOS mme e kanna ea supa bothata bo bong. Liphetoho tse latelang li ka supa bothata bo bong ntle le PCOS:

• Moriri o mosesane hloohong litempeleng, o bitsoang lefatla la banna
• Keketso ea clitoris
• Ho teba ha lentsoe
• Fokotseha ka boholo ba matsoele

Mofani oa hao oa tlhokomelo ea bophelo o tla etsa tlhahlobo ea 'mele. Sena se tla kenyelletsa tlhahlobo ea pelvic. Tlhahlobo e ka bonts'a:

• Mae a bomme a atolositsoeng a nang le li-cysts tse ngata tse nyane tse boletsoeng ho ultrasound
• Clitoris e atolositsoeng (e sa tloaelehang haholo)

Maemo a latelang a bophelo a atile ho basali ba nang le PCOS:

• Ho hanyetsa insulin le lefu la tsoekere
• Khatello ea mali e phahameng
• Cholesterol e phahameng
• Ho nona le ho nona

Mofani oa hau o tla lekola boima ba 'mele oa hau le boima ba' mele (BMI) mme a lekanye boholo ba mpa ea hau.

Ho ka etsoa liteko tsa mali ho lekola maemo a lihormone. Liteko tsena li ka kenyelletsa:

• Tekanyo ea Estrogen
• Boemo ba FSH
• Boemo ba LH
• Tekanyetso ea banna (testosterone)

Liteko tse ling tsa mali tse ka etsoang li kenyelletsa:

• Ho itima lijo ka tsoekere (tsoekere maling) le liteko tse ling tsa ho se mamellane ha tsoekere le ho hanyetsa insulin
• Boemo ba lipid
• Teko ea bokhachane (serum hCG)
• Tekanyo ea prolactine
• Liteko tsa mosebetsi oa qoqotho

Mofani oa hau a ka boela a laela ultrasound ea letheka la hao ho sheba mae a bomme.

Ho nona le botenya ho atile ho basali ba nang le PCOS. Ho lahleheloa ke boima bo fokolang ho ka thusa ho phekola:

• Hormone ea fetoha
• Maemo a kang lefu la tsoekere, khatello e phahameng ea mali kapa k'holeseterole e phahameng

Mofani oa hau a ka fana ka lipilisi tsa thibelo ea bokhachane ho etsa hore linako tsa hau li be teng khafetsa. Lipilisi tsena li ka thusa ho fokotsa kholo e sa tloaelehang ea moriri le makhopho haeba u li noa likhoeli tse 'maloa. Mekhoa e melelele e sebetsang ea lihormone tsa kemolo, joalo ka Mirena IUD, e ka thusa ho emisa linako tse sa tloaelehang le kholo e sa tloaelehang ea lesela la popelo.

Moriana oa lefu la tsoekere o bitsoang Glucophage (metformin) le ona o kanna oa fuoa:

• Etsa linako tsa hau kamehla
• Thibela lefu la tsoekere la mofuta oa 2
• Thusa hore o theole boima ba 'mele

Meriana e meng e ka laeloang ho thusa ho etsa linako tsa hau khafetsa le ho u thusa ho ima ke:

• LH e lokolla li-analog (LHRH) tse tšoanang
• Clomiphene citrate kapa letrozole, e ka lumellang mae a bomme ho lokolla mahe le ho ntlafatsa menyetla ea hau ea bokhachane

Meriana ena e sebetsa hantle ha 'mele oa hau oa boima ba' mele (BMI) o le 30 kapa ka tlase ho (tlasa moeli o motenya).

Mofani oa hau a ka fana ka maikutlo a mefuta e meng ea kalafo bakeng sa kholo e sa tloaelehang ea moriri. Tse ling ke:

• Spironolactone kapa lipilisi tsa flutamide
• Setlolo sa Eflornithine

Mekhoa e atlehang ea ho tlosa moriri e kenyelletsa electrolysis le laser hair tlosa. Leha ho le joalo, kalafo tse ngata li ka hlokahala. Kalafo e theko e boima 'me liphetho ha se tsa kamehla.

Laparoscopy ea pelvic e ka etsoa ho tlosa kapa ho fetola ovary ho phekola ho hloka thari. Sena se ntlafatsa menyetla ea ho lokolla lehe. Liphetho ke tsa nakoana.

Ka kalafo, basali ba nang le PCOS hangata ba khona ho ima. Nakong ea bokhachane, ho na le kotsi e eketsehileng ea:

• Ho nyopa
• Khatello ea mali e phahameng
• Gestational lefu la tsoekere

Basali ba nang le PCOS ba na le monyetla oa ho nts'etsapele:

• Kankere ea Endometrial
• Ho hloka thari
• Lefu la tsoekere
• Mathata a amanang le botenya

Bitsa mofani oa hau haeba u na le matšoao a lefu lena.

Mae a bomme a Polycystic; Lefu la ovary ea Polycystic; Lefu la Stein-Leventhal; Lefu le nang le mahe a mangata; PCOS

• Litšoelesa tsa endocrine
• Laparoscopy ea 'mele
• Anatomy ea basali ea ho ikatisa
• Lefu la Stein-Leventhal
• Sebete
• Nts'etsopele ea folakha

Bulun SE. Physiology le pathology ea karolo ea basali ea ho ikatisa. Ho Melmed S, Auchus RJ, Goldfine AB, Loenig RJ, et al, li-eds. Buka ea Williams ea Endocrinology. La bo14 la ed. Philadelphia, PA: Elsevier; 2020: khaolo ea 17.

Catherino WH. Endocrinology ea ho hlahisa le ho hloka thari. Ka: Goldman L, Schafer AI, li-eds. Phekolo ea Goldman-Cecil. La 26th. Philadelphia, PA: Elsevier; 2020: khaolo ea 223.

Lobo RA. Lefu la Polycystic ovary. Ka: Lobo RA, Gershenson DM, Lentz GM, Valea FA, eds. Kakaretso ea mafu a basali. La 7th. Philadelphia, PA: Elsevier; 2017: khaolo ea 41.

Rosenfield RL, Barnes RB, Ehrmann DA. Hyperandrogenism, hirsutism, le lefu la ovary la polycystic. Ka: Jameson JL, De Groot LJ, oa Kretser DM, et al, eds. Endocrinology: Batho ba baholo le bana. La 7th. Philadelphia, PA: Elsevier Saunders; 2016: khaolo ea 133.