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"lead": "Злокачественное новообразование шейки матки- онкологическое заболевание.",
"description": "Злокачественное новообразование шейки матки- онкологическое заболевание. В структуре онкологической заболеваемости женщин злокачественные опухоли шейки матки составляют почти 15% и среди поражений органов репродуктивной системы стабильно занимают третье место после рака молочной железы и рака эндометрия.",
"etiology": "<p>Ведущую роль в канцерогенезе рака шейки матки отводят вирусу папилломы человека как наиболее частому виду инфекций, передающихся половым путем Возбудитель вируса папилломы человека — группа ДНКсодержащих вирусов, относящихся к семейству Papavaviriade (HPV — human papilloma virus), обладающих способностью инфицировать и трансформировать эпителиальные клетки шейки матки.</p>",
"pathogenesis": "",
"diagnostics": "<p>При выяснении анамнеза необходимо обратить внимание на перенесённые заболевания, нарушения менструальной и репродуктивной функций, изменения в работе кишечника и мочевого пузыря, возраст больной, семейное положение, образ жизни.</p>\r\n<p>Шейка матки доступна для визуальных и инвазивных методов исследования, что способствует выявлению РШМ на ранних стадиях. Ранняя диагностика включает несколько различных исследований.</p>\r\n<p>Расширенная кольпоскопия позволяет изучать состояния эпителия шейки матки под 7,5–40кратным увеличением. Особое внимание уделяют зоне трансформации. Для повышения информативности исследования используют ряд специфических проб. Одна из них состоит в аппликации на шейку матки 3–5% раствора уксусной кислоты, что позволяет оценить состояние терминальной сосудистой сети, питающей эпителий шейки матки.</p>\r\n<p>В качестве опухолевого маркёра плоскоклеточного рака шейки матки в сыворотке крови пациентки определяют уровень специфического Аг — SCC. В норме он не превышает 1,5 нг/мл.</p>\r\n<p>При подозрении на предопухолевую патологию или рака шейки матки необходимо проводить углублённую диагностику (биопсия шейки матки, выскабливание цервикального канала).</p>\r\n<p>Гистологическое исследование считают заключительным и решающим методом диагностики РШМ, позволяющим определить характер морфологических и структурных изменений.</p>\r\n<p>Стадию РШМ определяют с помощью УЗИ, рентгенографии лёгких, цистоскопии, ирригоскопии. По показаниям выполняют КТ и МРТ.</p>",
"treatment": "<p>При раке шейки матки IА1 стадии (без неблагоприятных факторов прогноза) у лиц молодого, репродуктивного возраста, соматически отягощённых больных может быть выполнена высокая конусовидная ампутация шейки матки. После этой операции (в пределах здоровых тканей) показано строгое динамическое наблюдение.</p>\r\n<p>Для сохранения репродуктивной функции можно выполнить высокую конусовидную ампутацию шейки матки с забрюшинной или лапароскопической тазовой лимфодиссекцией.</p>\r\n<p>Стандартное хирургическое лечение РШМ IB1 стадии: расширенная экстирпация матки с придатками.</p>\r\n<p>У больных репродуктивного возраста яичники могут быть сохранены и выведены за пределы таза (возможно проведение послеоперационной лучевой терапии). Транспозиция яичников может быть выполнена при плоскоклеточном раке высокой и умеренной степени дифференцировки и отсутствии опухолевой сосудистой эмболии.</p>\r\n<p>Выбор метода лечения зависит от возраста, соматического статуса, мнения больной. Тактику лечения определяют на консилиуме.</p>",
"prevention": "<p>Риск заболеть раком шейки матки наиболее высок у женщин группы риска (раннее начало половой жизни, частая смена сексуальных партнеров, наличие инфекций, передающихся половым путем, первые роды в очень раннем возрасте, частые аборты). Основным способом профилактики рака шейки матки считают своевременное выявление фоновых, особенно предраковых, процессов и их лечение. Не менее важно использование барьерных средств контрацепции, препятствующих распространению инфекций, передающихся половым путем к которым относят и вирус папилломы человека, считаемый этиологическим фактором развития вируса папилломы человека. </p>",
"clinical_picture": "<p>Рак шейки матки принадлежит к опухолям, которые длительное время протекают бессимптомно. Появление клинических симптомов и жалоб говорит о далеко зашедшем опухолевом процессе. Наиболее часто больные предъявляют жалобы на обильные , кровянистые выделения и боли.</p>\r\n<p>Первые симптомы рака шейки матки. носят жидкий, водянистый характер и обусловлены лимфореей из участка опухоли, подвергшегося некрозу или распаду.</p>\r\n<p>Кровотечения — самый частый клинический симптом. Кровотечения при раке шейки матки носят характер многократно беспорядочно повторяющихся кровянистых выделений, усиливающихся в предменструальном и постменструальном периодах. В начале заболевания кровянистые выделения часто носят характер контактных, возникают после полового акта, натуживания или пальцевого исследования шейки матки.</p>\r\n<p>Боли по своему характеру, локализации, интенсивности бывают различны, бывают локализованы в поясничной области, крестце и под лоном.</p>\r\n<p>Поздние симптомы рака шейки матки. Развиваются в результате регионарного метастазирования, прорастания соседних органов, присоединения воспалительного компонента. К ним относят боли, тела, появление отёков конечностей, нарушения работы кишечника, мочевыделительной системы.</p>\r\n<p>Общие симптомы рака шейки матки. К ним относят общую , повышенную \"></a>, .</p>",
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