Diu tr

1. Nguyn tc:
+ Ph thuc tui, s ln c thai, tnh trng thai nghn ca bnh nhn, mong mun c thai
trong tng lai, v tr v kch thc khi u
+ ht, no sinh thit nim mc bung t cung cm mu v gi XN m bnh hc chn
on phn bit
+ loi tr tin ung th, ung th c t cung qua XN paps, soi CTC hoc sinh thit
+ u nh khng cn thit iu tr m ch cn theo di
2. iu tr ni khoa

+ C: u nh, khng c bin chng, sp mn kinh hoc ch m

Nhm thuc C ch C Bit dc, liu dng

Thuc ni tit Lm gim kch thc khi u, phc U x TC c bin chng rong -Nomegestrol acetate (LutenylR) 5mg:
hi nim mc TC, gim HT cng huyt liu 1vin (ung)1 ln/ngy. Dng t ngy
kinh 15 -24 ca vng kinh
- DCTC c ni tit (Mirena) c s dng
gim bt th tch khi u v cng
kinh, ng thi nga thai.
-Progestins (chch, cy..) dng iu tr
cc triu chng nh nhng ngi mun
kt hp nga thai.
Cht ng vn cht ch vn Gn-RH to ra tc dng + iu tr trc m bc + Triptorelin (Diphereline) 3,75mg/ thng
GnRH ngc li cc hormone t nhin. nhn x to. tim bp.
Estrogen v progesterone gim, + Tr hon phu thut v + Leuprolide (Enantone) 3,75mg/thng
dng kinh nguyt, khi u x co li, nng th trng trc phu tim bp.
cc triu chng gim v thiu mu thut. + Goserelin (Zoladex) 3,6 mg/thng tim
thng c ci thin + Tin mn kinh. di da vng bng.
+ Chun b trc m ct t
cung ng m o, ni soi
bung t cung i vi nhn
x t cung > 5cm.
+ C chng ch nh phu
thut, cha mun phu
thut.
Khc Thay i nng ni tit t ngn Mifepriston- RU 486
+androgen trng rng, lm dng CKKN lm Testosterol
steroids khi u x nh li, gim xung huyt
+Antiprogestins hn ch chy mu
+ u: n gin d dung, trnh phu thut ko cn thit vi cc khi u nh
+Nhc: iu tr ko trit ngng thuc khi u tang kch thc tr li, t tin, nhiu tc
dng ph
3. Phu thut
 + C: UXTC to ~ thai 12 tun (d8cm), u x gy BC chn p, chy mu, u c cung, polype
bung TC, u di nim mc, u mc kt trong ti khung, u trong dy chng, u km v sinh
hoc sy thai ti din
+ Mc ch phu thut ly khi nhn x bo tn t cung hay ct t cung ton phn ty
thuc vo tnh trng bnh l v nguyn vng ca ngi bnh.
+ phu thut bo tn TC
- Bc nhn x
+ UXTC c v di thanh mc m bng.
+ UXTC di nim mc ni soi BTC.
+ UXTC thoi ha sa xung m o ct ng m o.

- Tc ng mch t cung

+ Ch nh
1- C chn on u x TC to 12 - 16 tun (siu m ti a 3 nhn x).
2- C chng ch nh gy m ton thn.
3- Nhn x ti pht sau phu thut bc nhn x.
4- Mun gi li TC.
5- BN t chi phu thut.
+ Chng ch nh
+ C ri lon ng mu.
+ Cc bnh l ni khoa cn iu tr trc.
+ Nghi ng bnh l c tnh.
+Phng php: t Catheter vo ng mch i lun n ng mch t cung,
ri bm vo cht plastic hay gel to ng cc mu lm gim nui dng u v kt
qu gim kch thc khi u x.
- Ni soi bung t cung ct NXTC di nim mc
+ Ph n c con.
+ iu tr triu chng xut huyt bt thng.

+ phu thut trit : ct TC bn phn hay ct TC hon ton( km 1 hoc c 2 bn phn ph)
ph thuc tui BN, mc tn thng phi hp