Colposcopy: Kuongororwa Kwakakura kweCervix, Vagina neVulva

Key tora kutora

• Colposcopy iongororo yekuongorora, kwete yemurabhoritari. Kuongororwa kunobva pa biopsy yakatumirwa ku histopathology.
• Colposcopy inowanzova danho rechipiri, zvichiitwa mushure mekuongororwa kwemuromo wechibereko kusina kujairika kana kuti muromo wechibereko usina kujeka, kwete seongororo yekutanga.
• Kuongororwa kwecolposcopy hakubvisi chirwere. Maronda ari mukati memugero wemuromo wechibereko, kana kuti akanyanya mumugero mushure mekuguma kuenda kumwedzi, anogona kushaikwa.
• Vakadzi vazhinji vanonzwa kumanikidzwa uye kurwadziwa kwenguva pfupi pane kurwadziwa kwakanyanya; biopsy inowedzera kunzwa kwekudzvanya kwenguva pfupi.
• Mhedzisiro inosiyana zvichienderana nemamiriro ekurapa emunhu mumwe nemumwe uye inofanira kududzirwa nachiremba akaronga maitiro acho.

Pakuona

Uyewo anozivikanwa se

• Kuongorora kweColposcopy, kuongorora kwecolposcopic
• Kuongororwa kwemuromo wechibereko; kuongororwa kwemuromo wechibereko nekuongorora hutachiona; kuongororwa kwemuviri kunotungamirirwa nekuongorora hutachiona ...
• Vulvoscopy (kana vulva iriyo inonyanya kutariswa)
• MuIndia, inowanzo bvunzwa se "colposcopy test", "cervix ki jaanch", "cervical check mushure mePap isina kurongeka"
• Zvakafanana asi zvakasiyana: Pap smear (pap test, cervical smear), HPV DNA test, VIA (visual inspection ne acetic acid), LEEP/LLETZ, cone biopsy

Chii chinonzi colposcopy

Colposcopy inoshandisa chiedza chakajeka uye kukura, kazhinji kacho kubva kashoma kusvika kanosvika makumi mana, kuongorora pamusoro pemuromo wechibereko neganda remukadzi neremurume. Kuisa acetic acid muropa kunoiswa. Nzvimbo dzine masero asina kujairika akawanda anochinja kuita machena (acetowhite) uye dzinogona kuratidza mapatani asina kujairika eropa. Kuisa iodine kunogona kuwedzerwa; epithelium yemukati yakakura inodya iodine, nepo nzvimbo dzisina kujairika kana dzisina kuibva kazhinji dzisingadyi iodine.

Nyanzvi yekuongorora masero emudumbu (colposcopist) inoongorora zvinoonekwa, semuenzaniso, sekuchinja kwakajairika, kuchinja kwemazinga akaderera, kana kuti zvinofungirwa kuti zvinopinda, uye inobva yatora biopsies diki kubva munzvimbo dzisina kujairika. Kana kusagadzikana kwacho kukasvika mumuromo wechibereko, endocervical curettage kana endocervical brush sampling zvinogona kuwedzerwa. Mune mamwe mayuniti, apo gomarara rinonyatsoonekwa uye mhedzisiro yekuongorora inokodzera, kubviswa kwe "kuona-uye-kurapa" kunogona kupihwa panguva imwe chete.

Colposcopy iongororo inoitwa nemunhu wega, zvichienderana nemurwere. Kubvumirana pakati pevanachiremba vakasiyana vemakolposcopist pakuongorora kwemaziso kunongova pakati nepakati, ndosaka kusimbiswa kwebiopsy kuchikosha uye nei colposcopic impression chete isingatariswe sechirwere.

Chikonzero nei colposcopy ichiitwa

• Kuongorora mhedzisiro yekuongororwa kwemuromo wechibereko isina kujairika: kuongororwa kwePap smear kusingawanzoitiki (ASC-US ine HPV ine njodzi huru, LSIL, ASC-H, HSIL, AGC) kana kuongororwa kweHPV kune njodzi huru nguva dzose, kunyanya HPV 16 kana 18.
• Kuongorora muromo wechibereko unotaridzika zvisina kunaka pakuongororwa: muromo wechibereko usina kurongeka, unokwenya, kana kuti wakaita sewakura, kunyangwe Pap smear yaive yakajairika.
• Kuongorora zviratidzo: kubuda ropa mushure mebonde, kubuda ropa pakati pekuenda kumwedzi, kubuda ropa mushure mekuguma kuenda kumwedzi, kana kubuda ropa risingaperi risingatsananguriki, kana zvimwe zvikonzero zvafungidzirwa.
• Kuziva chirwere usati warapwa: kusarudza kana cryotherapy, thermal ablation, LEEP/LLETZ kana cone biopsy zvakakodzera, uye kuti ingani tishu yekubvisa.
• Kutevera mushure mekurapwa ye cervical intraepithelial neoplasia, kazhinji pamwe nekuongororwa kweHPV.
• Kuongorora maronda emudumbu kana emudumbu: kuvaviwa kunoramba kuripo, mavara machena kana ane ruvara, kana maronda.

Ndiani anofanira kuongororwa uku?

• Vakadzi vakatumirwa kuchipatara mushure mekuongororwa kwePap smear kana kuongororwa kweHPV kune njodzi huru, zvichienderana nematanho ekutumira anoitwa nachiremba wavo.
• Vakadzi vane muromo wechibereko unoratidza kusafungira kuna chiremba ari kuongorora, zvisinei nemigumisiro yekuongororwa.
• Vakadzi vane ropa risingatsanangurike mushure mekubereka, pakati pemwedzi kana mushure mekupedza kuenda kumwedzi mushure mekuongororwa kwekutanga.
• Vakadzi vanorarama neHIV kana vari kurapwa nemasoja ekudzivirira muviri, vane njodzi huru yeHIV inogara iripo uye yekufambira mberi, uye vanowanzo tumirwa kune mamwe matunhu akaderera.
• Vakadzi vane nhoroondo yekurapwa kenza yemumuromo wechibereko vasati vatanga kurapwa vanoda kutariswa.
• Vakadzi vane VIA positive screening vari muzvirongwa zvinoshandisa VIA, uko colposcopy inowanikwa.

Colposcopy haisi bvunzo yekuongorora vanhu vose uye haisi chikamu chenguva dzose chekuongororwa kwehutano. Ndiani anoida, uye riini, inosarudzwa nachiremba ane mhinduro yekuongorora.

Izvo colposcopy isingakwanise kuona kana kusabvisa

• Colposcopy haiongorore chibereko, endometrium, machubhu kana maovari. Inotarisa pamusoro chete. Chirwere chemazai kana endometrial chinoda kuongororwa kwakasiyana.
• Kuongororwa kwecolposcopy kwakajairika kana kunogutsa hakubvisi kenza yemumuromo wechibereko isati yatanga kana kenza. Chirwere chiri mukati memugero we endocervical, chisingaonekwe nenyanzvi ye colposcopist, chinogona kushaikwa, dambudziko rinozivikanwa mushure mekuguma kuenda kumwedzi uye mushure mekurapwa kwemuromo wechibereko, apo squamocolumnar junction inodzokera mugomba.
• Colposcopy haigone kuratidza chirwere ichi chete kana chaonekwa. Haikwanise kuona CIN 1 kubva kuCIN 2 kana CIN 3 pasina histopathology, uye kuoneka kwemhando yepasi dzimwe nguva kunodarika chirwere chepamusoro.
• Rova sampuli dze biopsy chete panzvimbo dzakasarudzwa. Kuongororwa kweropa negative zvinoreva kuti hapana chakaipa chakaonekwa munyama yakatorwa, kwete kuti muromo wechibereko hauna chirwere. Kana zvabuda muongororo yako zvaive zvepamusoro uye kuongororwa kweropa kuchikurudzira, chiremba wako anogona kuramba achikurudzira kubviswa kweropa kana kuti kuteverwa pedyo.
• Colposcopy haina mhando yeHPV uye hazvikuudzi kana hutachiona hweHPV huchapera. Izvozvo zvinoda kuongororwa kweHPV.
• Colposcopy haisi nzira yekuongorora hutachiona hwepabonde. Chlamydia, gonorrhea, trichomonas neHIV zvinoda kuongororwa kwakanangana.
• Colposcopy haigadzirise kenza. Kana kenza ikawanikwa, mifananidzo uye kuongororwa pasi peanesthesia zvinodiwa kuti zvionekwe kuti chirwere chacho chakura zvakadii.
• Kuongorora kunogutsa hakuvimbiswi. Kubuda ropa, kuzvimba kwakajeka, kudonha kweropa kana muromo wechibereko usingaonekwe zvizere zvinogona kuita kuti kuongororwa kusakwane uye zvinoda kudzokororwa kana imwe nzira yakasiyana.

Kana zviratidzo zvakaita sekubuda ropa mushure mebonde kana kubuda ropa mushure mekusvika panguva yekupedza kuenda kumwedzi zvikaramba zvichiitika pasinei nekuongororwa kwakajairika kwe colposcopy uye biopsy, dzokera kuna chiremba wako. Zviratidzo zvinoramba zvichiitika zvinoda kuongororwazve, kwete kuvimbiswa.

Bvunzo dzakabatana asi dzakasiyana

Colposcopy ichienzaniswa nePap smear

Pap smear iongororo yekuongororwa: masero anobviswa mumuromo wechibereko oongororwa nachiremba wecytologist. Colposcopy iongororo yekuongororwa inoitwa nekuti bvunzo yekuongororwa kana chitarisiko chekiriniki chakakonzera kunetseka. Pap smear inoongorora masero asingaoni; colposcopy inotarisa nzvimbo isina kujairika. Inopindura mibvunzo yakasiyana uye haichinjiki.

Kuongororwa kweDNA yeColposcopy neHPV

Kuongororwa kweHPV kunotsvaga hutachiona hunokonzera kenza yese yemumuromo wechibereko uye kunofungidzira njodzi; hakuratidzi kana paine ronda. Colposcopy inotsvaga ronda racho. Mukadzi anogona kunge aine HPV-positive ne colposcopy yakajairika, uye kusanganiswa ikoko kunowanzoreva kutarisa pane kurapwa.

Colposcopy ichienzaniswa neVIA

VIA inoongororwa nemaziso ese mushure meacetic acid, inoshandiswa muzvirongwa zvekuongorora munharaunda uko colposcopy isipo. VIA haina kukura uye haina danho re biopsy, uye zvese positives dzenhema nenhema negative zvakajairika. VIA yakanaka inowanzo tungamira ku colposcopy kana kurapwa pasi pechirongwa chekuongorora nekurapa.

Kuongorora colposcopy kana LEEP/LLETZ kana cone biopsy

Kuongororwa kwecolposcopy ne punch biopsy kunobvisa zvidimbu zvidiki zvenyama. LEEP/LLETZ ne cold-knife cone biopsy zvinobvisa chidimbu chemuromo wechibereko, zvinoongororwa uye zvinorapwa, zvinowanzoda anesthesia yemunharaunda kana yemunharaunda, uye zvine njodzi dzakasiyana kusanganisira kubuda ropa zvakanyanya uye, nekubviswa kukuru kana kudzokorora, migumisiro pakubata pamuviri mune ramangwana. Izvi hazvisi zvakafanana uye hurukuro yekubvumirana yakasiyana.

Colposcopy inopesana ne hysteroscopy

Colposcopy inoongorora kunze kwemuromo wechibereko uye pamusoro pechikadzi nepanhengo dzechikadzi. Hysteroscopy inopfuudza teresikopu nepamuromo wechibereko kuti iongorore mukati medumbu. Kubuda ropa kusingawanzoitiki dzimwe nguva kunoda zvese zviri zviviri, pamwe nekuongororwa kwe endometrial.

Colposcopy ichienzaniswa ne ultrasound ye pelvic

Ultrasound inoratidza chibereko, ukobvu hwe endometrial uye maovari asi haigone kuratidza shanduko dzemasero emuromo wechibereko. Colposcopy inoratidza shanduko dzepamusoro asi kwete nhengo dzemukati. Hapana chimwe chinotsiva chimwe.

Kuongororwa kupi kunotanga zvichienderana nedambudziko rekiriniki

• Hapana zviratidzo, kuongororwa nguva dzose kunofanirwa kuitwa: Kuongororwa kweHPV uye/kana Pap smear kutanga. Colposcopy chete kana bvunzo yacho isina kunaka.
• Pap isina kujairika kana HPV ine njodzi huru: Colposcopy ndiyo danho rinotevera rakakodzera, pamatanho akaiswa negwara rinoteverwa nachiremba wako.
• Zvisingaonekwe zvakanaka kana kuti zvakaita sekukura kwechibereko: kuongororwa uye biopsy zvinotanga kutorwa; usamirira kuti ongororo ibude.
• Kubuda ropa mushure mekupedza kuenda kumwedzi: endometrium inofanira kuongororwa, ultrasound yechiuno uye endometrial sampling, uye cervix inoongororwa. Colposcopy chete haina kukwana.
• Kuenda kumwedzi kwakanyanya kana kusina kurongeka pasina kunetseka nezvemudumbu: kuongororwa kweropa ne ultrasound kunowanzotanga.
• Kuvaviwa kwepahuro kana kuti chigamba chichena: kuongorora vulvoscopy ne biopsy yechironda.

Maitiro ekugadzirira

Mirayiridzo yekugadzirira inoshanda uye inosiyana zvichienderana nezvikamu. Mirayiridzo yakanyorwa yechikamu chako ndiyo inotangira pane chero chaunoverenga pano.

• nguva: Mayuniti mazhinji anofarira zuva raunenge usingabudisi ropa zvakanyanya, nekuti ropa rinovhara maonero. Kubuda ropa zvishoma hazvirevi kuti nguva dzose unorega, fonera yuniti pane kupotsa nguva yakatarwa.
• Zvigadzirwa zvechikadzi: mayuniti mazhinji anokukumbira kuti usashandise ma tampons, ma douches, ma kirimu emudumbu, mapessaries uye mafuta ekuzora, uye kuti usashandise bonde, kwemaawa angangoita 24-48 usati watanga. Kana wakanyorerwa mushonga wekudumbu, usarega wega, bvunza chiremba kana colposcopy unit.
• Kurwadziswa: Mamwe mayuniti anoratidza mushonga unonyaradza marwadzo wakaita separacetamol awa imwe chete usati watora chero chinhu. Bvunza yuniti yako usati watora chero chinhu, uye taura nezvemishonga chero ipi zvayo ine allergy, asthma, chirwere cheitsvo kana nhoroondo yemaronda emudumbu.
• Udza chikwata pachine nguva Kana ukatora mishonga inobvisa ropa kana mishonga inorwisa maplatelet, une dambudziko rekubuda ropa, une pamuviri kana kuti ungave uri kuyamwisa, une HIV kana kuti wakatora mishonga inodzvinyirira immune system, uine latex kana iodine reaction, kana wakambotora mushonga wepamuromo wechibereko. Usachinje chero mushonga wakanyorerwa iwe pachako; chiremba ndiye anosarudza.
• Zvinhu zvinoshanda: Pfeka mbatya dziri nyore kuchinja, uye tora pedhi rekuchenesa. Kuva nemuperekedzi inzira yakajairika uye unogona kuuya nemumwe wako anoenderana nemutemo weyuniti.

Kana iwe uri nepamuviri

Colposcopy inogona kuitwa panguva yekuzvitakura kana yataurwa, uye kuongororwa pachakwo hakukuvadzi pamuviri. Kuongororwa kwepamuviri kunoshandiswa zvakanyanya nekuti muromo wechibereko une mimba unobuda ropa zviri nyore; kucheneswa kwechibereko kunodziviswa. Kurapwa kwekubvisa kenza kunowanzo miswa kunze kwekunge paine fungidziro yekuti une kenza. Udza chiremba kuti une mimba paunenge wabhuka.

Kana wakamboenda kumwedzi

Nyama yakatetepa, isina kusimba inogona kuita kuti kuongororwa kusanzwisisike uye kuve kwakaoma kunzwisisa, uye nzvimbo yekuchinja inowanzova mukati memugero. Vamwe vanachiremba vanopa mushonga mupfupi we oestrogen usati waongororwa. Ichocho chisarudzo chekunyorerwa nachiremba wako.

Kana uri kushandisa mishonga inobvisa ropa rakawanda kana kuti uine chirwere chekubuda ropa

Kuongororwa kweropa (biopsy) kune njodzi yakakura yekubuda ropa. Chigadzirwa ichi chinogona kuronga matanho ekubvisa ropa kana kuronga nguva nachiremba wako. Usambofa wakambomira mushonga unorwisa ropa kubva muropa wega.

Kana uri pasi pemakore makumi maviri nerimwe kana kuti usati wambotanga zvepabonde

Colposcopy haidiwi zvakanyanya kune vechidiki, uye kuongororwa kwe speculum kune mumwe munhu asina kumbobvira aita zvepabonde kunoda kukurukurirana kwakanyatsorongeka, dzimwe nguva nekuongororwa pasi peanesthesia.

Kana uine HIV kana kuti masoja emuviri akadzvinyirirwa

Nguva dzekuendeswa kune mumwe munhu kuchipatara dzakaderera, maronda anowanzova akawanda, uye nzvimbo yemukadzi, yemurume neyakabva nepadumbu zvingadawo kuongororwa. Nguva dzekutarisa mushure mekurapwa dzinowanzova pfupi.

Chii chinoitika panguva ye colposcopy

• Mvumo nenhoroondo: chiremba wecolposcopist anoongorora zvabuda muongororo yenyu, zviratidzo, mishonga uye mamiriro epamuviri, uye anotsanangura zvakarongwa.
• Nzvimbo: unorara pasofa wakatsigira makumbo, sekunge uri paPap smear. Madhirowa anoshandiswa.
• Speculum: speculum inoiswa kuti ivhure madziro emukadzi. Iyi ndiyo chikamu chinotsanangurwa nevanhu vazhinji sepressure kana dzihwa. Udza chiremba kana zvichirwadza, speculum diki kana mafuta anogona kushandiswa.
• Inspection: colposcope, iri kunze kwemuviri, yakatarisana nemuromo wechibereko. Saline ne green filter zvinogona kushandiswa kuongorora mitsipa yeropa.
• Asidhi yeAcetic: vhiniga yakasanganiswa inoiswa pamusoro. Inogona kurwadza kana kunzwa ichidziya kwenguva pfupi. Nzvimbo dzisina kujairika dzinogona kuchena mukati meminiti imwe kana mbiri dzinotevera.
• Iodine: Iodine yeLugol inogona kushandiswa mune mamwe mayuniti kuwedzera ruzivo. Taura chero maitiro akamboitwa neiyodine.
• Biopsy, kana zvichiratidzwa: Chidimbu chimwe kana kupfuura chenyama chinotorwa ne biopsy forceps. Vanhu vazhinji vanonzwa kubatwa kwenguva pfupi kana kurwadziwa kwepamuviri sekurwadziwa panguva yekutevera. Chimuti chesilver nitrate kana paste zvinogona kushandiswa kumisa kubuda kwemvura; izvi zvinogona kukonzera kubuda kwemvura kwakasviba kwemazuva mashoma.
• Kuongororwa kweEndocervical sampuli, kana zvichiratidzwa: Bhurashi kana kuti curette diki inoyedza mugero. Iyi ndiyo nzvimbo inonyanya kuva nekurwadziwa.
• Pedza: speculum inobviswa, zvawanikwa zvinotsanangurwa, pad inopihwa, uye unoudzwa kuti mhedzisiro ichagoverwa riini uye sei uye kuti ndiani wekubata kana ukabuda ropa rakawanda.

Ko colposcopy inotora nguva yakareba sei

Kuongorora pachakwo kunowanzo tora maminetsi gumi kusvika makumi maviri. Ne biopsy, endocervical sampling uye tsananguro, ronga maminetsi makumi maviri kusvika makumi matatu mukamuri, uye nguva yakareba mudhipatimendi rose kuti unyoreswe, ubvumidzwe uye uzorore kwenguva pfupi mushure mezvo. Kubviswa kwekuona nekurapa kunowedzera nguva. Vanhu vazhinji vanobuda muchipatara mukati meawa imwe chete kana maviri votyaira mota kana kudzokera kumba vega, kunze kwekunge vamboshandisa mushonga wekunyaradza kana weanesthesia.

Kunzwisisa mushumo wako

Mushumo we colposcopy unowanzova nezvikamu zviviri, uye zvinogona kusawirirana.

Chiratidzo che colposcopic

Uku ndiko kuongorora kwekuona kwechiremba wecolposcopist: kana kuongorora kwacho kwakaringana, kana nzvimbo yekuchinja yakaonekwa zvizere (inowanzo nyorwa serudzi rwe1, 2 kana 3), uye kana zvakawanikwa zvaive zvakajairika, zvemhando yepasi, zvemhando yepamusoro, zvinofungidzirwa kuti zvakapinda, kana kuti zvakaratidza zvimwe zvinhu zvakaita sekuzvimba, polyp, condyloma kana atrophy. Pfungwa yacho inoenderana nepfungwa dzemunhu uye inoenderana nemurwere. Inotungamira biopsy; haigadzirise kuongororwa.

Mushumo weHistopathology

Izvi zvinotsanangura tissue ye biopsy uye ndicho chikamu chinosarudza manejimendi. Mashoko akajairika anosanganisira:

• Zvakaipa kune dysplasia / cervicitis isingaperi: hapana shanduko yakaongororwa munyama isati yatanga kenza. Kuzvimba kwakajairika uye kazhinji hakusi kunotyisa.
• CIN 1 kana LSIL: kuchinja kwemhando yakaderera, kazhinji kunokonzerwa neHPV. Chikamu chikuru chinodzikira chega, kunyanya kuvakadzi vechidiki, saka kuongororwa kunowanzo sarudzwa pane kurapwa.
• CIN 2: chikamu chepakati. Zvichienderana nezera, hurongwa hwekubereka uye huwandu hwemaronda, chiremba wako anogona kukurudzira kurapwa kana kuongororwa.
• CIN 3 / HSIL: kenza yepamusoro-soro isati yatanga. Kurapa, kazhinji kubvisa kana kubvisa nhengo dzemuviri, kunokurudzirwa.
• Adenocarcinoma in situ kana kuti invasive carcinoma: zvinoda rubatsiro rwenyanzvi dzezvirwere zvegomarara revakadzi uye kuongororwa kwakawanda.

Mamwe marabhoritari anowedzera p16 immunostaining kubatsira kuparadzanisa maronda chaiwo epamusoro kubva kune mamwe maronda akafanana. Giredhi itsananguro yenyama, kwete kufanotaura remangwana rako. CIN haisi kenza, uye CIN 1 haisi "kenza yedanho rekutanga", kuverenga zvisirizvo kunowanzoitika uye kunoshungurudza. Chiremba wako anokurapa anodudzira mushumo pamwe chete nemamiriro ako eHPV, zera, mhedzisiro yekare uye zvirongwa zvepamuviri.

Kana mhedzisiro ye colposcopy inogona kutsausa

Zvakawanikwa zvinogona kutaridzika zvisina kujairika

• Kusakura kweganda remazamu uye epithelium inoporesa yakajairika inogona kuchinja kuva chena uye inogona kunzi chirwere.
• Utachiona hunoshanda kana kuti cervicitis yakatsvuka: kusanganisira trichomonas ne candida, zvinoburitsa kutsvuka, zvinobaya mitsipa yeropa uye nzvimbo chena dzinotevedzera neoplasia.
• Nguva pfupi yadarika yepabonde, kushandisa tampon, mafuta ekuzora kana mafuta ekuzora zvinogona kuchinja chitarisiko chepamusoro uye mavara.
• Kurapwa kwemumuromo wechibereko kare kana kuti kuisirwa mudziyo wemukati mechibereko zvinogona kukonzera mavanga, granulation uye kusarongeka kwetsinga dzeropa.
• Kupera simba mushure mekuguma kuenda kumwedzi kana panguva yekuyamwisa inokonzera nyama dzisina kusimba, dzine mavanga uye nzvimbo dzisina iodine.
• Kuberekwa kunowedzera kusimba kwetsinga dzeropa, kuonekwa kwemasero etsinga uye kuchinja kwemasero, izvo zvinogona kutsanangurwa zvakanyanya nemunhu asina ruzivo.

Zvakawanikwa zvinogona kutaridzika sezvisiri zvenguva dzose kana kuti chirwere chisina kunyatsojeka

• Maronda mukati memugero we endocervical Hazvionekwi, ndicho chikonzero chikuru chinoita kuti colposcopy "yakajairika" igone kuitika pamwe chete nechirwere chepamusoro.
• Nzvimbo yekushandura rudzi rwechitatu: chinowanzoitika mushure mekupedza kuenda kumwedzi uye mushure mekubviswa kwechibereko kare, zvinoreva kuti panosangana nhengo dzechibereko hapagone kuonekwa uye kuongororwa kwacho hakuna kukwana.
• Kubuda ropa, manyoka kana kusaona zvakanaka inogona kuvanza maronda madiki.
• Adenocarcinoma uye adenocarcinoma in situ kazhinji hadzina chitarisiko chekare che acetowhite uye dzakaoma kuona kupfuura maronda ane squamous.
• Chikanganiso chekutora sampuli: Kuongororwa kweropa kubva kumucheto kwete kubva pachikamu chakaipisisa chechironda kunogona kuderedza huwandu hwechirwere.
• Kuongororwa kwemuviri kushoma kana kudiki zvakanyanya kuderedza kuonekwa kwechirwere; kutora biopsy inopfuura imwe chete kunovandudza.
• Ruzivo rwemushandi runokosha. Kururama kweColposcopic kunosiyana pakati pevaongorori.

Nekuda kwezvipingamupinyi izvi, colposcopy inokurudzira mushure mekuongororwa kwepamusoro inowanzoteverwa nekuongororwazve, kutorwa kwesampuli ye endocervical kana kubviswa panzvimbo pekubuda.

Njodzi nekuchengetedzeka

Colposcopy inzira yekuvhiyiwa isina njodzi yakawanda inoitirwa kunze kwechipatara, asi njodzi yacho inoenderana nezvinoitwa panguva yacho. Mhedzisiro uye kupora zvinosiyana zvichienderana nemamiriro ezvinhu ekurapa emunhu mumwe nemumwe.

Colposcopy isina biopsy

Njodzi dziri shoma. Tarisira kumanikidzwa kubva ku speculum, kurwadza kwenguva pfupi kubva ku acetic acid, uye dzimwe nguva kuona madonhwe mashoma. Kunetseka, kunzwa kushoma uye dzungu renguva pfupi ndizvo zvinonyanya kukonzera matambudziko.

Colposcopy ne biopsy ye punch

Tarisira kurwadziwa kwemuviri panguva yekuongorora ropa uye kubuda ropa zvishoma kana kubuda ropa rakasviba kwemazuva mashoma. Kashoma kubuda ropa kwakanyanya uye kunoda kuongororwazve. Kutapukirwa hakuwanzoitiki asi zvinogoneka, kurwadziwa kunowedzera, fivha kana kubuda ropa rakashata zvinofanira kutaurwa. Njodzi yekubuda ropa yakanyanya panguva yekuzvitakura, pamishonga inorwisa ropa rinouraya ropa uye muzvirwere zvekubuda ropa.

Kuongororwa kwe endocervical curettage kana brush sampling

Zvinowedzera kurwadziwa kwedumbu, uko kunogona kugara kwemaawa mashoma, uye njodzi diki yekubuda ropa. Hazvidzivirirwi panguva yekuzvitakura.

Kurapwa kwekubvisa kenza kwakaitwa panguva imwe chete yekushanya (LEEP/LLETZ)

Mhando yakasiyana uye ine njodzi huru: kubuda ropa kunogona kuitika mazuva mashoma gare gare, hutachiona, stenosis yemuromo wechibereko, uye, kunyanya nekuchekwa kwakadzama kana kakawanda, njodzi yakawedzerwa yekusununguka nguva isati yakwana mupamuviri wepashure. Kurapa kwekubvisa dumbu kwakadai sekupisa kana cryotherapy kune mhando yako, kusanganisira kubuda kwemvura yakawanda kwemavhiki akati wandei. Izvi zvinofanirwa kukurukurwa uye kubvumidzwa zvakasiyana, kwete kupetwa kuita "colposcopy yakachengeteka".

Aftercare

Shandisa mapedhi pane kushandisa matamponi, uye tevera mazano echikwata chako panyaya dzebonde, kushambira uye kurovedza muviri kwakasimba, kazhinji kwemazuva mashoma mushure mekuita biopsy uye kwenguva yakareba mushure mekuchekwa. Hapana zvinorambidzwa pakudya.

Mamiriro ezvinhu anokosha

Kuberekwa

Chinangwa panguva yekuzvitakura ndechekubvisa kenza inopararira, kwete kurapa kenza isati yatanga. Kuongororwa kwemuviri kunotorwa chete kana zvichidikanwa, kurapwa kwe endocervical hakuitwe, uye kurapwa kweCIN kunowanzo miswa kusvika mushure mekusununguka nekuongororwazve mushure mekusununguka.

Vechidiki nevasikana vechidiki

Kutapukirwa neHPV uye kuchinja kwemhando yakaderera kwakajairika muboka iri uye kazhinji kunobuda pasina kurapwa. Kurapwa zvakanyanya kune migumisiro yakwo yekusununguka, saka kutarisirwa kunowanzo sarudzwa.

Vakadzi vakwegura uye vapedza kuenda kumwedzi

Kupera simba, kuvharika kwechikadzi uye nzvimbo yekuchinja yakavanzwa mugomba remugero zvese zvinoderedza kukwana kwekuongorora. Dzimwe nguva kunodiwa dzimwe nzira dzekutora sampuli kana kubvisa tsvina kuti uongorore chirwere.

Vakadzi vanorarama neHIV kana kuti vari panjodzi yekudzivirira zvirwere mumuviri

Mwero wepamusoro weHPV inoramba iripo, chirwere chemultifocal uye multizonal, uye kudzoka kwechirwere mushure mekurapwa. Kuongororwa kwechikadzi, vulval uye perianal kunowanzo batanidzwa, uye kuteverwa kuri pedyo.

Vakadzi mushure mekuvhiyiwa kwechibereko

Colposcopy yenzvimbo yekuberekesa inogona kuratidzwa kana kubviswa kwechibereko kwakaitwa paCIN kana kuti kana nzvimbo yekuberekesa isina kurongeka. Hapana muromo wechibereko wekuongorora.

Vakadzi vane mudziyo wemukati mechibereko

IUD haidziviriri colposcopy uye haiwanzodi kubviswa kuti iongororwe. Udza chiremba kuti yavapo.

Vakadzi vane matambudziko ekubuda ropa, CKD kana vari pa dialysis

Kusashanda zvakanaka kwemaplatelet muchirwere cheitsvo chakanyanya kukura uye kushandiswa kwemishonga inoderedza ropa kuti ropa risaungane nedialysis kunowedzera njodzi yekubuda ropa kubva mu biopsy. Kuronga nachiremba ari kurapa kunokurudzirwa.

Colposcopy muIndia

• Mutoro wezvirwere. Gomarara remuchibereko richiri rimwe regomarara rinowanzoonekwa pakati pevakadzi muIndia. GLOBOCAN 2020 (IARC) yakafungidzira kuti vanhu vanosvika 123,900 vane gomarara remuchibereko uye vanhu vanosvika 77,300 vakafa muIndia mugore iroro. Huwandu hwevanhu vakawanda muIndia huchiripo padanho repamusoro, ndosaka kuita ongororo isina kujairika kuchikosha.
• Kuvharwa kwekuongorora kwakaderera. Vakadzi vazhinji vanosvika pakuongorora chirwere checolposcopy muIndia havasati vamboongororwa Pap smear kare, uye kuendeswa kwechirwere ichi kunokonzerwa nezviratidzo kana kuti muromo wechibereko usingaratidzike zvakanaka pane kuongororwa kwakarongwa. Izvi zvinowedzera mukana wekuti pave nechirwere chakakomba muboka iri vasati vaongororwa.
• Mamiriro echirongwa. Kuongororwa kwehurumende pasi pechirongwa chenyika chezvirwere zvisingatapuriranwe kwagara kuchishandiswa VIA padanho rehutano hwevanachiremba, vachiendeswa kuchipatara kuti vanoongororwa necolposcopy. Kuwanikwa kwecolposcopy nekwavanachiremba vakadzidziswa colposcopy hakuna kufanana pakati pemaguta makuru, zvipatara zvematunhu nenzvimbo dzekumaruwa.
• Kushaya ropa uye kudya kunovaka muviri. Kushaya iron mumuviri kwakajairika pakati pevakadzi vekuIndia. Kushaya iron mumuviri kwagara kuripo kunoita kuti kubuda ropa mushure me biopsy kusanyanya kunaka, taura nezvazvo, uye taura nezve chero katsika kekubuda ropa.
• Utachiona hunoomesa dudziro. Cervicitis inobva ku trichomonas, bacterial vaginosis kana chlamydia inowanzoitika uye inogona kuita kuti muromo wechibereko utaridzike zvisina kujairika. Rufu rwepabonde, kunyange rusingawanzoitiki, runogona kukonzera maronda emuromo wechibereko anotevedzera kenza; kurapwa kwechirwere cheTB kunogona kunge kuri kutoitwa mune vamwe varwere uye kunofanira kuziviswa.
• Kubaiwa jekiseni reHPV. Majekiseni eHPV, kusanganisira jekiseni remajekiseni rakagadzirwa nevanhu veko, anowanikwa muIndia. Kubaiwa majekiseni kunoderedza njodzi yeramangwana asi hakubvisi kudiwa kwekuongororwa, uye hakurapi gonda riripo.
• Nzvimbo dzemitemo uye dzekuchengetedza zvakavanzika. Colposcopy kuongororwa kwezvirwere zvevakadzi uye haiwire pasi pePC-PNDT Act 1994, iyo inotonga maitiro ekuongorora pamuviri uye ekusarudza bonde. Chero ultrasound inoitwa pamwe chete nekutarisirwa kwako inowira pasi peMutemo iwoyo. Ruzivo rwehutano hwemunhu rwunounganidzwa panguva yekunyoresa uye mishumo runotongwa neDigital Personal Data Protection Act, 2023. Pasi pemitemo yehunyanzvi yeNMC une kodzero yekuperekedzwa, kuvanzika panguva yekuongorora, uye kopi yemishumo yako.
• Mutauro nekubvumirana. Kumbira tsananguro uye fomu rekubvumidza mumutauro waunonzwisisa. "CIN 1" uye "kenza" hazvisi chinhu chimwe chete, uye izvi zvakakodzera kujekeswa pakushanya kwako.

Mutengo neinishuwarenzi muIndia

Mari dzinosiyana zvakanyanya pakati pezvivakwa zvehurumende, matrust, makiriniki akazvimirira uye zvipatara zvemakambani, uye pakati pemaguta. Hurumende nenzvimbo dzinotsigirwa nerubatsiro dzinogona kupa colposcopy mahara kana kuti pamutengo wepasi. Pane kutaura nhamba ingasashanda kwauri, kumbira dhipatimendi kuti rikupe fungidziro yakanyorwa usati waonana.

Chii chinoita kuti mutengo uderere?

• Kuongororwa kwecolposcopy chete kana uchienzanisa necolposcopy uchishandisa biopsy: histopathology inobhadharwa zvakasiyana, kazhinji pachikamu chimwe nechimwe chemuenzaniso.
• Nhamba ye biopsy uye kana kutorwa kwesampuli ye endocervical kuchibatanidzwa.
• Mamwe mabasa emurabhoritari zvakaita se p16 kana mamwe immunohistochemistry, kana kuwedzerwa kuongororwa kweHPV.
• Kurapwa kwekushanya kumwe chete: LEEP/LLETZ, thermal ablation kana cryotherapy, uye ingave nzvimbo yekuchengetera vana masikati kana nzvimbo yekuvhiyiwa-yemitambo, anesthesia uye zvinoshandiswa.
• Mari yekupa mazano, guta, uye rudzi rwesangano.
• Kushanya kwekutevera uye kudzokorora colposcopy panguva yekutarisa.

inishuwarenzi

• Colposcopy yekuongororwa kwevarwere vari kunze kwechipatara kazhinji haifukidzwi neinishuwarenzi yehutano inobhadharwa, iyo inobhadhara zvakanyanya kutarisirwa kwavanorapwa. Varidzi vemari yekurapa vari kunze vanosiyana.
• Colposcopy ine kurapwa kwekubviswa kwechiso kunoitwa sekiriniki inowanzo bvumidzwa; mvumo yekutanga inowanzo dikanwa.
• Zvirongwa zvehurumende zvakaita seAyushman Bharat PM-JAY zvinovhara mapakeji akatsanangurwa muzvipatara zvakagadziriswa; zvinosimbisa kukodzera uye mapakeji acho akaiswa nedhipatimendi reinishuwarenzi rechipatara.
• Chengeta gwaro rekutumira, mushumo wekuongorora uye mushumo we histopathology, zvichemo zvinowanzo bvunzwa pasina zvakanyorwa.

Ngano nezvokwadi

Mibvunzo inowanzobvunzwa

Ko colposcopy inorwadza here?

Vakadzi vazhinji vanotsanangura kumanikidzwa kubva ku speculum uye kurwadza kwenguva pfupi kubva ku acetic acid pane kurwadziwa. Kana ukaitwa biopsy, tarisira kubatwa kupfupi uye kurwadziwa sekurwadziwa kwekuenda kumwedzi, kunogara masekondi kusvika kumaminitsi mashoma. Udza chiremba panguva yekuvhiyiwa kana usina kugadzikana, nzvimbo, saizi ye speculum uye kufamba kunogona kugadziriswa.

Ndingaitwa colposcopy here panguva yekubuda ropa?

Kubuda ropa rakawanda kunovhara muromo wechibereko uye mayuniti anowanzo chinja nguva. Kuonekwa kwechiedza kazhinji hakudzivisi kuongororwa kunobatsira. Ridzai jira re colposcopy pachinzvimbo chekudzima wega. Kana wakambotumirwa kunobuda ropa mushure mekupedza kuenda kumwedzi kana kuti usina kutsanangura, chengeta nguva yekuonana uye tsanangura kubuda ropa kwacho.

Chii chinorehwa neacetowhite area pamushumo wangu?

Acetowhite zvinoreva kuti nyama yakashanduka kuita chena mushure mekunge vhiniga yaiswa. Izvi zvinoitika kana paine shanduko isati yatanga kenza, asiwo kana nyama yakapora, metaplasia isati yakura uye hutachiona. Kuchena kweaceto chete hakusi kuongororwa. Biopsy histopathology ndiyo inosarudza kuti nzvimbo yacho chii chaizvo uye kana kurapwa kuchidikanwa.

Ndinoda kuongororwa ne biopsy nguva dzese here?

Kwete. Kana kuongororwa kwacho kuri kwakajairika uye kutumirwa kwacho kuri kwegiredhi rakaderera, chiremba wako haafanire kutora biopsy uye panzvimbo pezvo oronga kuongororwazve. Kana paine chisina kujairika, mumwe munhu anofanira