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Lạc nội mạc tử cung: yếu tố nguy cơ và dấu hiệu nhận biết?  

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07:11 25/11/2014

Lạc nội mạc tử cung là do máu kinh (có lẫn những mảnh nhỏ của nội mạc tử cung bong ra) bị chảy ngược trở lại. Thường nó chảy vào ống dẫn trứng, qua ống dẫn có thể thấm và.. [..]

Lạc nội mạc tử cung là do máu kinh (có lẫn những mảnh nhỏ của nội mạc tử cung bong ra) bị chảy ngược trở lại. Thường nó chảy vào ống dẫn trứng, qua ống dẫn có thể thấm vào khoang bụng, bàng quang, trực tràng và có thể "chạy" tới buồng trứng.

Yếu tố nguy cơ:

-   Tiền sử gia đình có người mắc bệnh LNMTC.

-   Phổ biến ở phụ nữ da trắng hơn da vàng và da đen.

-   Phụ nữ có chỉ số BMI thấp (gầy, cao)

-   Cấu trúc đường sinh dục bất thường và tắc nghẽn hành kinh

-   Chưa sinh đẻ, hiếm muộn, ít sinh con có nguy cơ cao hơn sinh nhiều.

Dấu hiệu nhận biết

Lâm sàng: Bệnh nhân có thể đi khám vì đau hoặc hiếm muộn. Tuy nhiên có những trường hợp LNMTC không có triệu chứng cơ năng ngay cả khi có một nang LNMTC khá to.

-  Đau: bệnh nhân có thống kinh, đau trằn vùng hạ vị hoặc giao hợp đau. Mức độ đau trong LNMTC không tương xứng với thể tích khối u mà liên quan với mức độ xâm nhiễm của tổn thương vào cùng đồ, vách âm đạo trực tràng.

Triệu chứng tiêu hóa: thường mơ hồ, có thể buồn nôn, ói, chướng bụng, khó tiêu. Đau khi đi tiêu có thể gợi ý tổn thương LNMTC ở vách trực tràng âm đạo hoặc ở cùng đồ Douglas. Đi cầu ra máu có thể gợi ý tổn thương ruột

-  Triệu chứng tiết niệu: 1%, đau khi đi tiểu 25%, đôi khi có tiểu máu vào thời kỳ hành kinh.

-  Triệu chứng khác: ho ra máu trong LNMTC ở phổi. Một số cơ quan khác hiếm gặp hơn như gan, cơ hoành, tứ chi, cột sống, não…

Cận lâm sàng

- Siêu âm: khối echo kém, thành trơn láng, chứa dịch dạng vân mây. Những nang lâu ngày có thể có hình dạng thay đổi, thành nang có thể có góc cạnh do PM bị dính, co kéo, thành nang trở nên dày, echo đặc.

- Định lượng CA-125 ít có giá trị chẩn đoán LNMTC mặc dù CA-125 tăng trong LNMTC.

- Nội soi ổ bụng: là tiêu chuẩn vàng để chẩn đoán LNMTC, có ưu thế trong chẩn đoán thể nông. Thời điểm nội soi tốt nhất là nửa đầu chu kỳ kinh vì nếu có LNMTC, tổn thương sẽ được phá hủy.

Nguồn: Tổng hợp

Chú ý: Trên đây là những thông tin  mà các bạn có thể tham khảo, để biết thêm chi tiết và được hướng dẫn cụ thể, hãy gọi đến tổng đài 1900.6180 để  nhận được tư vấn trực tiếp từ các bác sĩ.


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