Rong kinh rong huyet la mot tinh trang chay mau kinh nguyet khong binh thuong cuc ky thuong gap. Benh gi gay nen trieu chung nay? Bac si se gay tham kham gi de ket luan cung voi dieu tri? Neu nhu ban hoac nguoi trong gia dinh chang may mac phai tinh trang nay, day la bai viet danh cho ban. Cung thong ke ve nhung tham kham ket luan cung nhu bien phap dieu tri rong kinh rong huyet cung chung toi nhe.

I. Rong kinh la gi?
Rong kinh la hien tuong chu ky kinh nguyet cua co the chi em phu nu keo dai tren mot tuan cung voi luong mau khong con vuot qua 80ml/ chu ky kinh ( thong thuong trong khoang 50- 80ml / chu ky)

Rong kinh gap rat nhieu tai phai dep, tuyet doi voi chi em tung co gia dinh. Hien tuong nay cuc ky nguy hiem, co nguy co nguy hiem nghiem trong den suc khoe cua phu nu, gay cac benh ly nhu thieu mau, viem nhiem duong sinh duc, gay nen benh vo sinh,u xo da con, dan toi cam nhan kho chiu cho co the phu nu khi toi ky kinh nguyet.

II. Ket luan can nguyen
Sau luc hoi cac cau moi lien quan ve tien su benh cung nhu cac dau hieu cua ban, chuyen gia se tham kham phu khoa cung nhu khien cho kiem tra.

bac si chuyen khoa co the de nghi 1 hay nhieu xet nghiem sau day:
Thu thai. Mot so dau hieu xuat huyet am ho khong binh thuong deu co kha nang la dau hieu cua mot thai ky. Vi vay, truoc luc dinh vi tac nhan, bac si se loai tru kha nang co bau.
xet nghiem mau. Danh gia tinh trang mat mau khong du sat (neu co) vi thieu mau kinh qua muc. Dong thoi, tham kham mau con phat hien cac chung benh khac biet nhu can benh tuyen giap hay roi loan dong mau.
Pap’s test – kiem tra te bao co da con. 1 Que nho se dua qua am dao de lay mot so te bao co da con. Nhung te bao nay se duoc xet nghiem su viem nhiem, mot so ton thuong ung thu hay nhung ton thuong co the dan toi ung thu.
Sinh thiet noi mac tu cung. Noi mac tu cung la lop te bao lot mat trong tu cung. Lop te bao nay lien quan toi kinh nguyet tung thang cung nhu la noi phoi gay to trong thoi ky mang thai. Chuyen gia se dung mot mau mo te bao nay de dinh vi nhung benh nhiem trung hay ung thu da con.
Sieu am. Phuong tien hinh anh nay su dung song sieu am de xem xet kich thuoc, nhung bat thuong cua da con, voi trung va vung chau.

III. Can nguyen rong kinh
nguyen nhan pho bien dan toi rong kinh bao gom:

1. Su roi loan hormone
Trong mot chu ky kinh nguyet binh thuong, su can voi giua hormone estrogen cung voi progesterone se thay doi su u dong cua niem mac tu cung (noi mac tu cung) mac bong ra trong chu ky kinh.

Neu nhu roi loan noi tiet to, noi mac tu cung se tang sinh va mac bong ra vi xuat huyet kinh nguyet nang ne.

cac yeu to gay ra thay doi hormone gom co hoi chung buong trung da nang (PCOS), beo phi, khang insulin va nhung cau hoi tuyen giap.

2. Mat can bang cong dung buong trung
Neu buong trung khong giai xuat trung (rung trung) trong vong kinh, co the nguoi nu se khong tao ra hormone progesterone nhu trong nhung ngay kinh nguyet binh thuong. Viec do gay ra mat can bang hormone cung nhu co nguy co gay rong kinh.

3. U xo da con
nhung u buou khong ung thu (lanh tinh) cua tu cung xuat hien trong do tuoi sinh san cua phai dep. U xo da con co nguy co nang hon khi dan den ra mau kinh nguyet thong thuong hoac keo dai.

4. Polyp tu cung
Polyp co kich co nho, lanh dac tinh tren niem mac da con co nguy co dan toi chay mong kinh nguyet nang ne cung nhu lau ngay.

5. Lac noi mac da con

tinh trang nay dien ra khi mot so tuyen tu noi mac da con thay phia trong co da con. Lac noi mac tu cung co the gay ra mau tram trong cung voi cam giac dau cho nguoi bi.

6. Dung cu da con (DCTC)
Rong kinh la mot tac dung phu thuong bat gap cua van de lay dung cu tu cung khong co noi tiet to de ngua thai.

7. Bien chung thai ky
chay mau khi co thai co kha nang la bieu hien cua say thai hoac nhau thai toa lac o khu vuc bat thuong.

8. Ung thu
Ung thu co da con cung nhu ung thu da con co nguy co gay nen xuat huyet kinh nguyet qua muc, dac biet khi ban tung het kinh hoac da tung co ket trai kiem tra PAP khong binh thuong truoc do.

9. Roi loan chay mau vi di truyen
mot so thay doi ra mau – vi nhu benh von Willebrand (thieu nhan to dong mau) – co kha nang dan den chay mau kinh nguyet bat thuong.

10. Dung thuoc
nhung dang thuoc, bao gom thuoc chong viem, thuoc noi tiet to nhu estrogen cung voi progestin, thuoc chong dong mau nhu warfarin (Coumadin, Jantoven) hoac enoxaparin (Lovenox) co kha nang gay xuat huyet kinh nguyet nang ne hoac keo dai.

11. Boi can benh
cac co hoi y te khac, gom benh gan hay than, co kha nang moi lien quan den rong kinh.

12. Cac yeu to rui ro khac biet
Trong 1 chu ky thuong thi, viec xuat trung ra thuyen giam buong trung se kich thich san sinh progesterone cua co the, hormone nu chiu vai tro cao nhat trong van de giu chu ky deu dan. Luc khong co trung duoc giai ban, progesterone thieu co nguy co dan toi xuat huyet kinh nguyet nang.

Rong kinh tai tre vi thanh nien thuong hay la vi anovulation (mot thay doi dyshormonal cua nhung ngay kinh nguyet, trong so do 1 trai trung truong thanh chua the roi thuyen giam buong trung).

Rong kinh tai nu trong do tuoi sinh san thuong la do benh ly tu cung, bao gom u xo, polyp cung voi lac noi mac tu cung. Nhung, nhung thac mac khong giong, nhu ung thu da con, mat can bang chay mau, phan ung phu cua thuoc cung nhu benh gan hay than co nguy co la yeu to ho tro.

IV. Rong kinh rong huyet duoc chua nhu vay nao?
1. Tri rong kinh rong huyet tuy theo cac nhan to sau:
hien tuong suc khoe chung va nhung tien su y khoa dang luu y.
can nguyen cung nhu muc do nang ne cua bieu hien, nhung nguy hiem cua trieu chung den doi song cung nhu sinh hoat.
chuc nang chiu dung/dung nap cua benh nhan doi voi thuoc, tieu phau hoac mot so bien phap chua khac.
du dinh sinh con cua nguoi bi benh trong tuong lai.
yeu cau ca nhan cua nguoi benh.
bai viet nay la nhung phuong phap tri co the duoc ap dung (chi mang dac diem tham khao).

2. Lay thuoc
cac thuoc co kha nang duoc su dung de chua rong kinh rong huyet bao gom:

Thuoc khang viem non-steroid (NSAIDs). Cac thuoc nay co the han che luong mau kinh va giup giam dau don bung kinh.
Tranexamic acid.Thuoc co chuc nang cam mau, giup cho lam giam luong mau mat cung voi chi can phai su dung trong luc dang chay mau.
Thuoc vien ngua thai kieu vi. Phia ngoai tac dung phong tranh thai, vien phong tranh thai con giup cho dieu hoa kinh nguyet cung voi giam luong mau kinh cung voi giam sut so ngay hanh kinh.
Thuoc noi tiet progesteron duong dung. Hoc-mon progesteron duong su dung co giup cho thay doi su mat can bang hoc-mon. Do do, thuoc han che bieu hien rong kinh rong huyet.
dung cu tu cung phong thich hoc-mon (vong phong tranh thai noi tiet nhu vong Liletta hoac tam Mirena). Nhung dung cu nay phong thich 1 hoc-mon co tac dung tuong tu progesteron. Hoc-mon khien lop noi mac da con mong hon nen suy giam so luong mau, Mat khac suy giam dau don bung kinh.
Neu nhu tinh trang rong kinh rong huyet gay boi vi thuoc, bac si chuyen khoa co nguy co de nghi ngung thuoc dang su dung hoac doi thuoc khac biet. Neu chay mau kinh keo dai dan den thieu mau thieu sat, bac si chuyen khoa se ke them thuoc cung cap sat lien tiep. Dac biet khi chua mat mau tuy nhien nhung chi so kiem tra sat khong cao, ban cung co kha nang duoc cho them sat de phong chong.

3. Thu thuat
nguoi benh co kha nang nen chua voi phau thuat hay thu thuat Neu nhu chua noi khoa khong hieu qua. Co mot so giai phap chua tri sau:

Nong cung nhu nao buong tu cung. Chuyen gia se su dung dung cu nong co da con, Roi lay 1 dung cu khong giong de nao hoac hut lop te bao noi mac tu cung. Luc lop te bao nay duoc nao di, dau hieu xuat huyet se giam sut ngay tuc thi.
pha vo noi mac tu cung. Phuong phap nay lay tia laser, nhiet hay song cao tan de pha vo lop te bao noi mac da con.
Thuyen tac dong manh tu cung. Day la phuong phap bom thuoc lam cho tac dong mach tu cung, cat nguon chia se mau cho tu cung. Cach nay xem la tuong duong doi voi phau thuat cat tu cung. Tuy nhien, benh nhan khong nhat thiet trai qua cuoc mo cung nhu phuc hoi nhanh hon.
thu thuat cat tu cung: Day la phuong phap chua tan goc rong kinh rong huyet. No thuong hay duoc chi dan khi cac phuong phap khac khong thanh cong cung nhu co the nu khong con muon co them con. Co nguy co cat tu cung qua noi soi o bung hoac mo lo. Phau thuat cat da con cung se co cac bien chung nhu tat ca cuoc phau thuat khong giong, Mac du so truong hop khong cao.
Mat khac, tuy nguyen do gay nen rong kinh cuong kinh hoac rong huyet, mot so chua dac hieu khac biet co kha nang duoc ap dung nhu boc phi dai – co da con, cat polyp hoac cat di mot so phan mo bi benh o co tu cung…