More than 30% of women of child-bearing age have 肌瘤. Some women have 肌瘤 tumours but are ignorant of it because the tumours are still small 和 not yet diagnosed. With the record at hand, it has been forecasted that 30 – 80% of women will develop 肌瘤 sometime during their reproductive years, although only about one-third of these 肌瘤 are large enough to be detected by a health care provider during a physical examination.
In most cases of 肌瘤, the tumours are benign (non-cancerous). Benign tumours are not associated with cancer 和 have nothing to with the development of uterine cancer.
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Fibroid tumours are usually classified into four different 类型; Sub-serosal 肌瘤, Intramural 肌瘤, Pedunculated 肌瘤, 和 Sub-mucosal 肌瘤.
- Intramural 肌瘤: Intramural tumours are those growing deep in the womb or within the muscular walls of the womb. They are the most common type of 肌瘤. They are also the most difficult to remove. Intramural 肌瘤 may grow larger 和 stretch your womb. They constitute most of the hysterectomies performed in the hospitals today. In addition to all the symptoms listed above, these kinds of tumours can cause haemorrhage, belly pressure, 和 painful intercourse.
- Sub-serosal 肌瘤: Sub-serosal 肌瘤 are those growing outside the uterus called the serosa. They are the most easily accessible type of 肌瘤 和 are often removed via 手术 through a process known as laparoscopic myomectomy. They may grow large enough to make your womb appear bigger on one side. Symptoms include pelvic pain, lower back pain, urinary frequency, congestion, bloating 和 indigestion.
- Pedunculated 肌瘤: 这些类型的肌瘤像茎一样从子宫壁延伸。它们通过花梗附着在子宫壁上。它们可能在子宫内膜腔内发现或在子宫外生长到骨盆中。那些在子宫内生长的被称为有蒂的 sub-mucosal 肌瘤以及在子宫外发展的肌瘤被称为浆膜下 有蒂的肌瘤。带蒂的肌瘤是最容易发生的肿瘤，因为它们很容易通过称为腹腔镜或宫腔镜检查的过程通过外科手术切除。症状包括特定区域的疼痛或压力或出血，具体取决于肿瘤的位置。
- Sub-mucosal 肌瘤: Sub-mucosal 肌瘤 are those growing adjacent to the endometrial lining (i.e. myometrium or middle muscle layer of the uterus). They are the major cause of 月经大量出血. Sub-mucosal tumours aren’t as common as the other 类型. These tumours impinge on the endometrial cavity 和 will produce long heavy periods, aches, clots, 和 cervical pressure.
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What 原因 肌瘤 tumours?
- 遗传变化： A large number of 肌瘤 show alterations in genes that differ from those in normal uterine muscle cells.
- 家庭 历史： 肌瘤可能在家庭中流传。如果您的母亲，姐姐或祖母有这种病史，您也可以发展这种病。
- 激素: 雌激素 和 黄体酮, the two human 荷尔蒙 that stimulate the development of the uterine lining during each menstrual cycle in preparation for 怀孕, has been implicated to promote the growth of 肌瘤. Fibroids contain more 雌激素 和 黄体酮 receptors than normal uterine muscle cells do. Fibroids tend to shrink after menopause due to a decrease in the development of these 荷尔蒙.
- 怀孕: 怀孕 increases the production of 雌激素 和 黄体酮 in your body. Fibroids may develop 和 grow rapidly while you’re pregnant.
- 其他增长因素： Chemicals that help the body maintain tissues, 如 insulin-like growth factor, may also affect 肌瘤 growth.
Who is at risk of having 肌瘤 tumours?
Women are at greater risk for developing 肌瘤 if they have one or more of the following risk factors:
- a family history of 肌瘤
- 高 体重
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一些肌瘤无症状。也就是说，许多患有肌瘤的女性没有任何症状，尤其是那些肿瘤很小的女性或更年期的女性。症状可能受肌瘤的位置，大小和数量影响。 例如，粘膜下肌瘤可能导致 月经大量出血 and 麻烦受孕。一些女性只有轻微的症状，而另一些女性则具有更严重，更麻烦的症状。 子宫肌瘤最常见的症状包括：
预防 fibroids may not be possible, but only a small percentage of these tumours require 治疗. But, by making healthy lifestyle choices, 如 maintaining a normal weight 和 eating fruits 和 vegetables, you may be able to decrease your fibroid risk.
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Fibroids are most often detected during a regular pelvic examination. This exam is used to check the condition, size, 和 shape of your uterus. This, along with an abdominal examination, may indicate a firm, irregular pelvic mass to the physician. In addition to a complete health background 和 physical 和 pelvic 和/or abs assessment, diagnostic procedures for uterine 肌瘤 may include:
- X-Ray . Electromagnetic energy used to produce images of bone 和 internal organs upon the film. This can be sued to produce pictures of your uterus, ovaries, 和 other pelvic organs.
- Magnetic Resonance Imaging (MRI): A non-invasive method that produces a two-dimensional view of an interior organ or structure. This can be used to produce pictures of your uterus, ovaries, 和 other pelvic organs.
- X-ray examination of the uterus 和 fallopian tubes that uses dye 和 is often performed to rule out tubal obstruction.
- Visual examination of the canal of the cervix 和 the interior of the uterus using a viewing instrument (hysteroscope) inserted through the vagina.
- 血液检查（检查缺铁性贫血 如果是由肿瘤引起的大量出血）。
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Treatment of 肌瘤 depends on your age, size of the 肌瘤, 和 your overall health. You may receive a combination of 治疗s.
Certain home remedies 和 natural 治疗s can have a positive effect on 肌瘤; they include; 针刺，瑜伽，按摩，中药配方桂枝附灵汤（GFLT）， heat for cramps (avoid 热 if you experience heavy bleeding). Dietary changes can help as well. Avoid meats 和 high-calorie foods. Instead, opt for foods high in flavonoids, green vegetables, green tea, 和 cold-water fish such as tuna or salmon.
管理压力水平 and 如果您超重，则可以减轻体重 can also benefit women with 肌瘤.
可以开一些调节激素水平的药物来缩小肌瘤。 Gonadotropin-releasing hormone (GnRH) agonists, 如 leuprolide (Lupron), will cause your 雌激素 和 黄体酮 levels to drop. This will eventually stop menstruation 和 shrink 肌瘤.
Other options that can help control bleeding 和 pain, but won’t shrink or eliminate 肌瘤, include:
- An 宫内节育器（IUD）释放激素孕激素
- Over-the-counter (OTC) anti-inflammatory pain relievers, 如 ibuprofen(Advil)
Surgery to remove very large or multiple growths may be performed. This is known as a myomectomy. An abdominal myomectomy involves making a large incision in the abdomen to access the uterus 和 remove the 肌瘤. The 手术 can also be performed laparoscopically, using a few small incisions into which surgical tools 和 a camera are inserted. 手术后肌瘤可能会长回来。
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A newer 和 completely noninvasive surgical procedure is forced ultrasound 手术 (FUS). You lie down inside a special MRI machine that allows doctors to visualize the inside of your uterus. High-energy, high-frequency sound waves are directed at the 肌瘤 to ablate or destroy them.
Similarly, myolysis shrinks 肌瘤 using an electric current or laser, while cryomyolysis freezes the 肌瘤. 子宫内膜消融 involves inserting a special instrument into your uterus to destroy the uterine lining using 热, electric current, or hot 水.
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另一个手术选择是 子宫动脉栓塞术. In this procedure, small particles are injected into the uterus in order to cut off the 肌瘤’ blood supply.