Lạc nội mạc tử cung hiện nay là vấn đề được quan tâm của rất nhiều chị em phụ nữ trong độ tuổi sinh sản vì cứ mười người thì sẽ có một người bị lạc nội mạc tử cung (10%). Đầu tiên phải bàn đến thuật ngữ có vẻ lạ lùng này.
BỆNH LẠC NỘI MẠC TỬ CUNG LÀ GÌ?
Lạc nghĩa là đi lạc, nội mạc tử cung là lớp mô lót bên trong lòng tử cung, thứ mà mỗi tháng khi phụ nữ hành kinh sẽ được tống xuất ra ngoài cùng với máu kinh. Vì một lý do nào đó mà nội mạc tử cung sẽ phát triển ở bên ngoài lòng tử cung như trong cơ tử cung, vòi trứng, buồng trứng, vùng chậu, trực tràng, bàng quang thậm chí phổi, não, dạ dày… Ngoài ra còn gặp thêm lạc nội mạc tử cung ở thành bụng vị trí vết mổ lấy thai hay vết may tầng sinh môn.
Cho đến nay khoa học vẫn chưa thể tìm ra nguyên nhân lạc nội mạc tử cung một cách chính xác và đầy đủ nhưng có một số giả thuyết được phần đông ủng hộ như sau:
- Trào ngược máu kinh: nghĩa là những mô nội mạc tử cung trào lên vòi trứng rồi rỉ ra ngoài vùng chậu, một số mô có thể cấy ghép vào vùng chậu và phát triển thành mô lạc nội mạc tử cung
- Mô nội mạc tử cung có thể di chuyển theo đường máu hoặc bạch huyết để đến những cơ quan khác tương tự cách di căn của tế bào ung thư.
- Bất cứ cơ quan nào cũng có thể có sự chuyển dạng và phát triển thành mô giống nội mạc tử cung.
- Sự cấy ghép trực tiếp mô nội mạc tử cung vào vị trí đích như trường hợp lạc nội mạc tử cung ở vết mổ hay vết may tầng sinh môn.
BIỂU HIỆN LẠC NỘI MẠC TỬ CUNG
Vì mang bản chất giống như nội mạc tử cung nên nó chịu tác dụng của nội tiết tố buồng trứng nhất là estrogen, mỗi khi người phụ nữ tới chu kỳ thì mô lạc nội mạc tại vị trí đi lạc cũng sẽ có phản ứng viêm, chảy máu và bong tróc có thể gây đau tại vị trí đó.
Có những người bị lạc nội mạc tử cung nhưng chẳng hề có bất cứ triệu chứng gì trong khi có những người triệu chứng vô cùng nặng nề ảnh hưởng nhiều đến đời sống vợ chồng lẫn sinh hoạt thường ngày. Mức độ nặng nhẹ của lạc nội mạc tử cung không liên quan với triệu chứng đau của bệnh nhân.
Những biểu hiện lạc nội mạc tử cung hay gặp là:
- Đau bụng hoặc đau lưng khi hành kinh hoặc có thể đau ngoài kỳ kinh
- Đau trong khi quan hệ hoặc sau khi quan hệ
- Đau vùng chậu dai dẳng
- Có thể đi tiểu có ít máu do lạc nội mạc ở bàng quang hoặc đau thốn ở hậu môn khi gắng sức như đi cầu do lạc nội mạc ở thành trực tràng trong khi đang hành kinh
- Xuất huyết tử cung bất thường hay gặp là xuất huyết trước kỳ kinh
- Hiếm muộn
Một số dạng lạc nội mạc tử cung hay gặp:
- Lạc nội mạc tử cung trong cơ tử cung
- Lạc nội mạc tử cung ở buồng trứng
CHẨN ĐOÁN LẠC NỘI MẠC TỬ CUNG BẰNG CÁCH NÀO?
Siêu âm đầu dò
Thường hay được sử dụng
MRI
Đôi khi được sử dụng
CT Scan
Ít sử dụng
Nội soi ổ bụng
Đây là tiêu chuẩn vàng đối với những trường hợp không phát hiện sang thương trên siêu âm hoặc MRI nhưng hiếm khi thực hiện đơn lẻ mà chỉ kết hợp để chẩn đoán trước khi điều trị hiếm muộn
KINH NGHIỆM CHỮA LẠC NỘI MẠC TỬ CUNG
Nếu ai là bệnh nhân lạc nội mạc tử cung mới hiểu nỗi thấu khổ của căn bệnh quái ác này, nó giống như một lời nguyền đe dọa cuộc sống của người phụ nữ. Việc điều trị lạc nội mạc tử cung dựa theo vấn đề mà nó gây ra cho khổ chủ, hai vấn đề cần phải điều trị là:
- Đau
- Hiếm muộn
Điều trị đau
- Điều trị đau và hạn chế sự phát triển của lạc nội mạc bằng cách sử dung thuốc ngừa thai viên kết hợp uống hàng ngày liên tục không gây ra kinh hoặc có khoảng nghỉ không nội tiết để duy trì kinh nguyệt bình thường, tuy nhiên khi gây ra kinh do thuốc thì lượng máu kinh sẽ ít, ngắn ngày đi và không đau bụng kinh.
- Điều trị bằng progestin đơn thuần như Dienogest, uống mỗi ngày một viên liên tục hoặc đặt vòng mirena
- GnRH đồng vận như zoladex
Điều trị hiếm muộn
Việc điều trị hiếm muộn trên bệnh nhân lạc nội mạc tử cung khá phức tạp nên cần được điều trị nơi bác sĩ chuyên khoa giàu kinh nghiệm.
Mổ lạc nội mạc tử cung là quyết định cuối cùng sau khi không còn phương pháp khác tốt hơn, không phải là lựa chọn đầu tay vì sau mổ tổn thương có thể quay trở lại rất nhanh, việc mổ lạc nội mạc tử cung nhất là ở buồng trứng có thể gây giảm dự trữ buồng trứng vô hình dẫn đến giảm khả năng mang thai tự nhiên sau này hoặc gây khó khăn trong việc điều trị hiếm muộn, gây mãn kinh sớm hơn tuổi dự kiến của cơ thể.
MANG THAI KHI BỊ LẠC NỘI MẠC TỬ CUNG
Việc mang thai khi có lạc nội mạc tử cung có thể xảy ra tự nhiên hoặc nhờ hỗ trợ sinh sản. Môi trường lạc nội mạc tử cung vốn không tốt cho sự làm tổ và phát triển của phôi tuy nhiên khi thai phát triển được thì quá trình mang thai có thể giúp căn bệnh này trở nên nhẹ nhàng hơn. Đối với những trường hợp lạc nội mạc tử cung nặng thì việc mạng thai sẽ có những yếu tố nguy cơ như: dọa sanh non và sanh non, thai chậm phát triển trong tử cung…
Bạn cứ khám thai bình thường bên cạnh việc theo dõi sự phát triển hay thoái triển của lạc nội mạc.
TÔI NÊN ĂN UỐNG NHƯ THẾ NÀO?
TÔI NÊN ĂN UỐNG NHƯ THẾ NÀO NẾU ĐƯỢC CHẨN ĐOÁN LẠC NỘI MẠC TỬ CUNG? Đây là vấn đề được khá nhiều chị em phụ nữ hiện đại quan tâm vì dinh dưỡng là chủ chốt trong việc mang tới sức khỏe. Bản chất của lạc nội mạc tử cung là cơ thể đã có quá nhiều chất được tạo ra bởi phản ứng viêm mạn tính nên việc ăn uống phải hết sức lành mạnh, tránh những chất làm tăng viêm.
Nên ưu tiên các loại hạt, các chất chống oxy hóa và tăng cường omega 3, vitamin E, C, tránh những chất béo xấu có trong các loại đồ ăn chiên xào chế biến sẵn.
Sống, chiến đấu và đồng hành cùng lạc nội mạc tử cung là hành trình khó khăn cho đến khi mãn kinh. Việc nắm bắt những thông tin đúng giúp ích cho việc điều trị tránh hoang mang lạc lối là điều chị em cần.
Tôi chúc chị em phụ nữ có cuộc sống tốt đẹp hơn nếu không may vướng phải căn bệnh này!
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