tumeurs osseuses main diu

8/18/2019 Tumeurs Osseuses Main DIU

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X^@N^TQ BQQN^QNQ HN@GCL

Afrcstcgl Hu`bltcnr, @H, YfH - Anltrn hn kg @gcl JughnkGvna k–gchn clnstc`gdkn hn Agrbkcln Knaknraq, Y



KNQ X^@N^TQ BQQN^QNQ QBLX YKTGTNQ É KG @GCL

• Ygrtcns `bkkns? :9% (hblt mystns :9%)

• Yngu ? 4> é 19 %

• Bs ? 7 é >%

• Kns tu`nurs bssnusns é kg `gcl rnprãsnltnlt 8% hns tu`nurbssnusns

• @ 0 E, pgs hn kgtãrgkctã, Unrs kg trnltgcln, surtbut kns p(:9%)



HNUGLX ^LN X^@N^T BQQN^QN, CK GLGKSQNT

• Kn typn hn hnstruatcbl bssnusn

• Kg `gtrcan tu`brgkn

• Nxpglscbl bu kg rupturn hn kg abrtcagkn• Kg rãgatcbl pãrcbstãn

• Kns tcssus `bus ghoganlts

• Kg tgckkn nt kg ebr`n hn kg kãscbl• K–nxcstnlan hn akbcsbls, snptg,

trgdãaukgtcbls

• Kn agrtckgjn abloujgk



YTCLACYGKNQ X^@N^TQ ÃYCY



YTCLACYGKNQX^@N^TQ @ÃXGY



YTCLACYGKNQ X^@N^TQ HCGY



AKGQQCECAGXCBL HNQ X^@N^TQ BQQN^QNQ (8Æ@N

Afblhrbjãlcqun Afblhrb`n, nxbstbsn, afblhrb`gtbsn sylbvcgkn, afblhrbdkgstb`nafblhrbsgrab`ns,…

Bstãbjãlcqun Bstãb`n, bstãb`n bstãbâhn, bstãbdkgstb`n, bstãbsgrab`ns,…

Ecdrbjãlcqun Ecdrb`n hns`bpkgstcqun, drbsgrab`n

Ecdrbfcstcbaytcqun Ecdrb`n lbl bssc glt, fcstcbaytb`n dãlcl hns bs

Qgrab`n h–Nwclj

Fã`gtbpbâãtcqun @yãkb`n, pkgs`baytb`n, ky`pfb`n lbl-fbhjmclcnl

Tcafns nl a/ jãgltns bstãbakgstcqun Xu`nurs é ankkukns jãgltns hns bs

Lbtbafbrhn Afbrhb`n, …Ugsaukgcrns Fã`gljcb`ns, gljcbsgrab`n

@ybjãlcqun, kcpbjãlcqun,ãpctfãkcgkns Kncb`ybsgrab`n, Kcpb`n, Kcpbsgrab`n, ghg`gltclb`n

Clhã lcns Mystn glãvrcs`gk, mystn bssnux, hyspkgscn drnusn, Fcstcba



AKGQQCECAGXCBL HNQ X^@N^TQ BQNKBL OGEEÃ & KCAFXNLQXN

Agrtckgjclnusn

Afblhrb`nBstãbafblhrb`nAfblhrbdkgstb`n

Ecdrb`n afblhrb-`cxbchn

Afblhrbsgrab`n

BssnusnBstãb`n bstãbchnBstãbdkgstb`n Bstãbsgrab`n

Ecdrnusn Hyspkgscn drnusn Ecdrbsgrab`n

Gutrn tcssu hgls k–bsMystn sylbvcgkMystn ãpchnr`bâhn

Gljcb`n…



KNQ AFBLHTB@NQ

Ckbts hn agrtckgjn fygkcl sãpgrãs hn kg pfysn kbrs hnarbcssglan nt quc pnrscstnlt gpræs kg enr`nturn hu

agrtckgjn abloujgk



KG YK^Q ETÃW^NLXN HNQ X^@N^TQ

BQQN^QNQ HN KG @GCL -KBAGKCQGXCBL YTÃEÃTNLXCNKKN É KG

@GCL HNQ AFBLHTB@NQ

• 59 é 39 % hns tu`nurs bssnusns hn kg`gcl

• Ag`pdnkk (733>)? 84 /69

• C@ (4991)? :9 / 749

Ag`pglgaac? 76 ags / 4>7 nl hnfbrs hn kg `gcl



QÃTCN CLQXCX^X HN KG @

:9 AGQ

• Qnxn ? >5 E / 78 F (Kcttãrgturn @ 0 E)

• Gjn ? 77 gls - :: gls (87.6)- nl jãlãrgk 49-19gls

• Aøtã ? H 13 / J 17



KBAGKCQGXCBL• Ykutøt sur kns hbcjts

audctgux (guj`nltgtcbl

hn erãqunlan hn rghcgknl audctgk)

•Y7 < @ãtg < Y4 < Y1

• Ebr`n typcqun? Y7gurcaukgcrn

Qãrcn @gyb Akc



QÃTCN CLQXCX^X HN KG @G

KBAGKCQGXCBL

• Y7 ? 49 (46%)

•Y4 ? 49 (46%)



QÃTCN CLQXCX^X HN KG @

KBAGKCQGXCBL

• Y7 ? 49 (46%)

• Y4 ? 49 (46%)

•Y1 ? 3 (71%)

• @ãtgagrpcnl ? 3 (71%)* Kct ? `ãtgagrpcnl 41%



QÃTCN CLQXCX^X HN KG

KBAGKCQGXCBL• Y7 ? 49

• Y4 ? 49• Y1 ? 3

• @ãtgagrpcnl ? 3

• Ybcjlnt ? 1



QS@YXØ@NQ

• Ergaturn pgtfbkbjcqun ? 19%

• Hbuknur



QS@YXØ@NQ• Ergaturn pgtfbkbjcqun ? 19%

• Hbuknur • Xu`ãegatcbl (Y1)

• Hãabuvnrtn ebrtuctn +++ agr kg tu`nur rnstnsbuvnlt qucnsanltn gpræs kg enr`nturn hu agrtckgabloujgk



HCGJLBQXCA TGHCBJTGYFC

• Grju`nlt hn erãqunlan• C`gjn kytcqun,

•G prãhb`clglan`ãtgpfysgcrn



• C`gjn kytcqun

• Ykutøt `ãtgpfysgcrn

• Ykus bu `bcls pbkyayakcqun

• Agkac agtcbls cltrg- tu`brgkns pbsscdkns

HCGJLBQXCA TGHCBJTGYFCW^N




• C`gjn kytcqun



• Agkac agtcbls cltrg-tu`brgkns• Ybuvglt sbuefflnr kg abrtcagkn

sgls k–nlvgfcr (ãrbscbl nlhbstgkn)



• C`gjn kytcqun



• Agkac agtcbls cltrg-tu`brgkns

• Ybuvglt sbuefflnr kg abrtcagknsgls k–nlvgfcr

• Ecl kcsnrã sakãrnux pãrcpfãrcqun




EBT@NQ TGHCBJTGYFCW

• Afblhrb`nfgdctunkkn`nlt anltrgk

nt `ãtgpfysgcrn



EBT@NQ TGHCBJTGYFCW

• Nxanltrã +/-ãpcpfysgcrn



EBT@NQ TGHCBJTGYFCW

• Ybkyanltrcqun



EBT@NQ TGHCBJTGYFCW

• Jãglt



G^XTN C@GJNTCN 2

• Qagllnr < CT@ pburãvgkunr k–cltãjrctã bssnusn

• CT@ < Qagllnr sc hbutn surul afblhrbsgrab`n



G^XTNQ EBT@NQ HNAFBLHTB@N



AFBLHTB@NQ @^KXCYKNQ? YK^QCKBAGKCQGXCBLQ

• Qur kn `ï`n bs




• Qur kn `ï`n rgybl




• Qur kg `ï`n `gcl



EBT@NQ YGTXCA^KCÆT

AFBLHTB@NQ @^KXCYK• @gkghcn h–Bkkcnr

• Afblhrb`ns `uktcpkns sur ul

fã`c-abrps (hcstrcdutcblgsy`ãtrcqun) -`gcl gttncltnhgls 69-39% hns ags

• Yrãvgknlan 7/799,999

• Hãebr`gtcbls squnknttcquns,gsy`ãtrcn hn kbljunur hns`n`drns, nt rcsqun h'ãvbkutcblvnrs ul afblhrbsgrab`n (19%)



@gkghcn h–Bkkcnr



EBT@NQ YGTXCA^KCÆTNQ HN AFBL@^KXCYKNQ

• Qylhrb`n hn @geeuaac (7667), 4>9 ags hãarcts,@ 0E

• Afblhrb`ns `uktcpkns gssbacãs é fã`gljcb`nshns pgrtcns `bkkns (lbhukns sbus-autglãs hnebr`n crrãjukcærn, prbtudãrglt nt dknu eblaã gulcvngu hns nxtrã`ctãs hcstgkns)

• Hãdut prãaban 7-> gls (4>% prãsnlts é kglgcssglan)

• Kãscbls squnknttcquns nt vgsaukgcrns sbltgsy`ãtrcquns.

• Xrglsebr`gtcbl `gkcjln (afblhrbsgrab`n bubstãbsgrab`n)" 799%



NUBK^XCBL QYBLXGLÃN

• Nxpglscbl• Agkac agtcbls

• Clvbkutcbl 2



XTGCXN@NLX 2

• Aurntgjn snuk

• Aurntgjn - ab`dkn`nlt

• Tãsnatcbl « nl dkba ½ + jrneen abrtcab-spbljcnu

• Gdstnltcbl +++ survnckkglan snukn



KN A^TNXGJN• Hbct ïtrn ab`pknt

• Enlïtrn abrtcagkn kgtãrgkn (bl kg hãabupn gu dcstbur

• Aurnttns hn tgckkn hceeãrnltns -Bl aurnttn, Bl aurnttn,Bl aurnttn,Bl aurnttn,Bl aurnttn… Ousqu–é ãpucsn`nlt hu stbam

• (Hnuxcæ`n gdbrh sc dnsbcl)

• Clonatcbl h–ngu sbus prnsscbl pbur kgvnr é kg l



GQYNAX YNT-BYÃTGXB

• Gspnat `garbsabpcqun ?agrtckgjn fygkcl

• Xcssu agrtckgjclnux dkglafätrn trglskuachn

• Ercgdkn

• Kc`ctns crrãjukcærns (kbjnttnscltrg-bssnusns) Hr. @grm T. Zcam

@gkghcn h–Bkkcnr



KN A^TNXGJN QN^K Q^E• Kg agvctã nst abkblcsãn pgr hns ankkukns-sb

quc sn hceeãrnlacnlt nl bstãbdkgstns (Xbrhgc,

Yrã-

bp

7 `

1 `



KN A^TNXGJN QN^K Q^E

• Ygs h–utckctã hu spbljcnux é kg sbkchctã hn k

• A–nst k–cltãjrctã abrtcagkn quc nst c`pbrtgl(Drbbms H, G. nt gk. ODOQ 73:9 - @brjgl ODOQ 73

• Xgux hn ablsbkchgtcbl 0 tgux hn rnstgurgtcbabrtnx (Jbtb X nt gk OFQ 4994)



KN A^TNXGJN QN^K Q^E• Ygs hn hceeãrnlan hgls kns sãrcns pudkcãns(Fgssnkjrnl OFQ (G`)

7337, Qncmyg OFQ (Dr)733:, Jbtb OFQ (Dr) 4994)

• Nvctn?

• Kg `brdchctã h–ul prãkævn`nlt (49% sur afutns ckc

• Kn abýt h–uln jrneen

• Kg `csn nl pkgan h–ul abrps ãtrgljnr !



KN A^TNXGJN QN^K Q^E

• Xbrhgc? ? 85 pgtcnlts lbljrneeãs,

• 64% juãrcsbl,

• 75% pnrscstglan h–ulhãenat,

• 4 % rãachcvn

Yrã-bp

7 gl



QÃTCN CLQXCX^X HN KG

• 74 ags gvna jrneen / 7> ags sgls jrneen

• 76 fb``ns, 3 en``ns

• 4 jrbupns ab`pgrgdkns? äjn, snxn, tgckkn ntkbagkcsgtcbl hn kg tu`nur



TÃQ^KXGXQLb.be

agsns

@nglgjn(yrs)

@nglvbku`n(``1)

@ngl E^(wms)

@nglpbst-bprnabvnry

(wms)

Akclcagkbutab`n

sabrn

Tghcbkbjcagk

butab`nsabrn

Xbrhgcsabrn

Aurnttgjnblky

74 11.:rgljn77 - >9

7744rgljn

5:>-78>618rgljn

48 - 7985.7rgljn

4 - 746nxankknlt

4 jbbh:nxankknlt

1 jbbh6jrbup7

Aurnttgjn +dblnjrget

7>18.8rgljn74 ‑ >5

7958

rgljn519-7>59

791rgljn48 - 856

>.3rgljn1 - 74

79nxankknlt1 jbbh

6nxankknlt8 jbbh

79 jrbup7 / 1

jrbup 4 /7 jp 1(@N)

Hceenrnlan (p;9.9>)

lb scjlhcee

lb scjlhcee lb scjl hcee lb scjl

hcee lb scjl

hcee lb scjl

hcee



Yrã-bp

8 `bcspbstbp



Yrã-bp

7 gl

1 @bcs



W^N EGCX-BL Q–CK S G ^LN ETGAX^

• Lbl hãpkgaãn kn + sbuvnlt

• C``bdckcsgtcbl 7 `bcs

• Yucs rããhuagtcbl

• Wuglh kn pgtcnlt nst sbupkn,aurntgjn sgls syltfæsn

Nvctnr kn pkus pbsscdkn k–cltnrvnltcbl nl urjnlan quc lãanssbssnusn nt uln bstãbsyltfæsn træs hce ackn (5:% hn ab`pkcag

urjnlan vs 79% nl snablhgcrn - Gdkbvn nt gk. G` O Brtfb4999=43?::7-::4)



TÃACHCUNQ 2• >-78% - prbdgdkn`nlt kcã é ul aurnttgjn clsue sglt

• Qurvnckkglan rghcb ousqu–é > gls• Guaul trgctn`nlt ghouvglt (pfãlbk, ac`nlt,…) l–g

prbuvã ïtrn h–ul qunkablqun cltãrït

• Tãachcvn 0 sn `ã nr hn kg pbsscdckctã h–ulafblhrbsgrab`n hn dgs jrghn



KÃQCBLQ AGTXCKGJCLNYK^Q TGTNQ



AFBLHTB@N O^VXG-ABTXCA• Kcaftnlstncl, 73>4

• Tgrn? 4% hns afblhrb`ns, 49-19 gls,4@/7E -" 4>% é kg `gcl bu gux

pcnhs• Hãvnkbppã nltrn abrtcagkn nt pãrcbstn

• Tx ? ãrbscbl abrtcagkn & agkac agtcblshcssã`clãns (>9%) - sbuvnlt kcsnrãnltrn tu`nur nt `ãhukkgcrn

• XXX? nxacscbl ab`pkætn n`pbrtglt ulpnu kg abrtcagkn sgcln

AFBLHTB@N HNQ YGTXCNQ @



AFBLHTB@N HNQ YGTXCNQ @

• Tgrn, dãlcl, 35% tbuafnltkns `gcls (69%) bu kns pcnhs

• F 0 E, 19-59 gls• Qurtbut egan pgk`gcrn, gutbur

hns tnlhbls (brcjcln hgls kn

tcssu sylbvcgk prbdgdkn)• @gssn clhbkbrn, ; 1 a` hn

hcg`ætrn



X^@N^T HN LBTG (DC GTN YGTBQXNGK



X^@N^T HN LBTG (DC__GTN YGTBQXNGKBQXNBAFBLHTB@GXB^Q YTBKCENTGXCBL

• Lbrg, 7361

• Yfgkgljn bu `ãtgagrpcnls

• 19-89 gls, F 0 E

• Ybst-trgu`gtcqun (fã`brrgjcnpãrcbstãn) bu Xu`brgk (kãscblsafrb`bsb`cquns hgls kns trgvguxrãanlts)

• @gssn clhbkbrn

X^@N^T HN LBTG (DC GTN YGTBQXNGK



X^@N^T HN LBTG (DC__GTN YGTBQXNGKBQXNBAFBLHTB@GXB^Q YTBKCENTGXCBL

• Kãscbl lbhukgcrn, hnlsn é kgsuregan hn k–bs

• Ygs hn abltcluctã gvna k–bsabrtcagk bu `ãhukkgcrn sbus- oganlt (! bstãbafblhrb`ns)

• Ygs h–n`prncltn sur k–bs (!

afblhrb`n pãrcbstã)• Nxacscbl « gjrnsscvn ½ gvna

gdkgtcbl hu `glafblagrtckgjclnux - Tãachcvn# 79%

Xu`nur hn Lbrg



g



BQXÃBAFBLHTB@NQ



BQXÃBAFBLHTB@NQ

• Tgrns, 1-:% hns tu`nurs bssnusns hn kg`gcl nt 8% hns bstãbafblhrb`ns sblt ékg `gcl

• Hãenat hn k–gllngu agrtckgjclnux qucpnr`nt é hu agrtckgjn ãpcpfysgcrn hn

pgssnr é trgvnrs$ abltcluctã abrtcagkn ntspbljcnusn gvna k–bs « føtn ½ gvna ulagpuafbl agrtckgjclnux



AKCLCW^N• Quont onuln (; 49 gls)

• Bs nl arbcssglan

• Nxtrã`ctã hcstgkn hns `ãtgagrpcnls ; prbxc`gkn hnspfgkgljns

• Xu`nur clhbkbrn pbuvglt crrctnr kns tcssus ghoganlts(crrctgtcbl lnrvnusn, gaarbafgjn hns tnlhbls, trbudknsrbtgtbcrns hns hbcjts, kc`ctgtcbl `ãaglcqun hn kg `bdc



TGHCB• Qnukn kg pgrtcn bssnusn nst vcscdkn

• (abltbur hn kg abceen pgrebcs vcscdkn)• Qnssckn bu pãhcaukãn

• Xrg`n spbljcnusn nl abltcluctã gvna k–bs lbr`g

• Tnafnrafnr h–gutrns nxbstbsns +++



@GKGHCN HNQ NVBQXBQNQ @

• @utgtcbls hn NVX hns jnlns 7 nt 4

• Hãdut prãaban (; 79 gls)

• Xrbudkns hn arbcssglan hns bs +++

• Gttncltn hn kg `gcl hgls 69% hns ags

• Xrglsebr`gtcbl `gkcjln (>-4>% vs 7-4% pbur kãscblcsbkãn) vnrs 4>-19 gls



HCGJLBQXCA HCEEÃTNL

• Xu`nur hn LBTG (dczzgrn pgrbstngkbstnbafblhrb`gtbus prbkcenrgtcbl)

• @ybsctn bssc gltn

• Qgrab`n pãrcbstã

XTGCXN@NLX



XTGCXN@NLX L–NLKNUNT W^N KNQ BQXÃBAFBLHTB

QS@YXB@GXCW^NQ

• Nxãræsn nl dkba?• Yãrcbstn - abceen agrtckgjclnusn - nxbstbsn

• Qgls hcssnatcbl (sclbl rcsqun hn rãachcvn)



NVBQXBQN QB^Q-^LJ^ÃG

• Brcjcln hceeãrnltn 2 (hcstgkn nt lbl prbxc`gkn)

• Qbukævn k–bljkn , kn hãebr`n

• Qbuvnlt hbukburnux

• :9% gu jrbs brtnck, 79% brtncks, 49% hbcjts (brcjcln trgu`

• Hce auktã hcgjlbstcqun nl k–gdsnlan hn rghcbs +++?dbtrcb`yab`n, blyafb`yabsn, vnrrun,`ãkglb`n…

Ubcr prãsnltgtcblXu`nurs hn k–bljkn



NVBQXBQN QB^Q-^LJ^ÃG

• Xu`nur bssnusn NXagrtckgjclnusn (lbl vcscdkn, kg tu`nur nst tbuoburs pkusjrbssn qu–gttnlhu)

• Nl abltcluctã gvna kgfbuppn

XXX HNQ NVBQXBQNQ QB^Q ^LJ^



XXX HNQ NVBQXBQNQ QB^Q-^LJ^

• Nxacscbl nl dkba

• Qbuknvnr kg tgdknttn

• Qbuknvnr kn kct (clacscbl nljunukn hn rnqucl)

• Bstãbtb`ns + aurnttn

• Tnpbsnr kn kct nt kg tgdknttn(blt gussc ãtã prbpbsãs hnsUGA, hns jrneens hn kct,…)



AFBLHTBDKGQXB@N



AFBLHTBDKGQXB@N• Xu`nur ãpcpfysgcrn dãlcjln, sãpgrãn hns XAJ pgr Oge

Kcaftnlstncl nl 7384, tbuafglt surtbut kns fb``ns onuln« Dgr @ctzvgf prnsnlt ½ (@glmcl)

• 39% nltrn > nt 4> gls

• Hãvnkbppãn gux hãpnls hu agrtckgjn abloujgk• Tgrn? rãvãkãn pgr hns hbuknurs, ul bnhæ`n (79%), ul

ãpglafn`nlt bu uln rgchnur pkus rgrn`nlt

ATCXÆTNQ TGHCB HNQ



ATCXÆTNQ TGHCB HNQAFBLHTBDKGQXB@NQ

• Kãscbl kytcqun, nxanltrcqun, h–ulnãpcpfysn h–ul bs kblj (é kg `gcl, tnlh é ïtrn pkus `ãtgpfysgcrn)

• Qakãrbsn pãrcpfãrcqun ln,pgrebcs ebr`gtcbl bssnusn

• Agkac agtcbls tu`brgkns (4>->9%hns kãscbls)

• ! Fypnr xgtcbl cltnlsn nl CT@

• @ãtgstgsns puk`blgcrns pbsscdkns

XTGCXN@NLX HNQ AFBLHTBDKGQ



XTGCXN@NLX HNQ AFBLHTBDKGQ

• Kãscbl dãlcjln gjrnsscvn snkblNllnmclj hbla rãsnatcbl `grjclgkn scpbsscdkn

• Gspnat `garbsabpcqunfã`brrgjcqun, sn`c-kcquchn

• Wunkquns suaaæs pgr aurnttgjn `gcs59% hn rãachcvn sc aurntgjn snuk vs

4>% sc aurntgjn + jrneen (Fuvbs,ABTT 73:1)

• 9% vs 47% sc ac`nlt é kg pkgan h–ulnjrneen bssnusn (Tg`gppg, ODOQ 4999)



AFBLHTBQGTAB@N

AFBLHTBQGTAB@N



AFBLHTBQGTAB@N

• Ygtcnlts gjãs

• Xu`ãegatcbl sbuvnlt snlscdkn

• Nxpglscbl knltn `gcs ablstgltn

• Tghcb? Jrbssn tu`nur, jãbhns

crrãjukcærns, kysn abrtcagkn nt `gssnhgls kns pgrtcns `bkkns +++

• Ykuscnurs sbus-typns



Nvbkutcbl h–ul afblhrbsgrab`n



X^@N^TQ H–BTCJCLNBQQN^QN



BQXÃB@N BQXÃBÂHN

BQXÃB@N BQXÃBÂHN



BQXÃB@N BQXÃBÂHN

• Fncln 734:

• 4æ`n nl erãqunlan é kg`gcl (79%). 79-7>% hnsBB survcnllnlt é kg `gcl

• 49-19 gls

• 4-8 @ / 7 E

Hr Ngtbl

BQXÃB@N BQXÃBÂHN



BQXÃB@N BQXÃBÂHN

KBAGKCQGXCBLQ• Yfgkgljns (prbxc`gkns) >9%,

• @ãtgagrpn 4>%,

• Agrpn 4>%, surtbut kn sagpfbâhn



QS@YXØ@NQ• Kg hbuknur +++

• Ynr`glnltn, cltnlsn

• Kbagkcsãn• Ykus ebrtn kg luct

• Qbukgjãn pgr k–gspcrcln nt kns GCLQ

• Kcãn é kg prãsnlan hn drns lnrvnusns gvna kns vgcssngux tu`bsnlscdkns gux Yrbstgjkglhclns nt Ayakb-bxyjãlgsn

G^XTNQ QCJLNQ AKCLC



G^XTNQ QCJLNQ AKCLC

• Fypnrtrbpfcn hns pgrtcns`bkkns gux pfgkgljns



HCGJLBQXCA YGTEBCQ YK^Q HCE



HCGJLBQXCA YGTEBCQ YK Q HCE

• Ygs hn sakãrbsn (ebr`n sbuspãrcbstãn)



G^XTN C@GJNTCN

• Qacltcjrgpfcn? fypnr xgtcblcltnlsn kbagkcsãn g-spãac qun



G^XTN C@GJNTCN

• Kn sagllnr

• EGCX KN HCGJLBQXCA

Bstãb`n Bstãbâhn hu pcscebr`n



Bstãb n Bstãbâhn hu pcscebr n



XTGCXN@NLX

• Tãsnatcbl nl dkba

• Gspnat typcqun hu lchus rbujn pnut ïtrn `gsqupgr kg sakãrbsn pãrcpfãrcqun.

• Abltrøkn rghcb hn kg pcæan• Hcspgrctcbl c``ãhcgtn hn kg hbuknur



MSQXN ÃYCHNT@BÂ

Ã Â



MSQXN ÃYCHNT@BÂ• 1æ`n tu`nur bssnusn nl

erãqunlan

• Egct suctn é ul trgu`gtcs`ngvna pãlãtrgtcbl hn ankkuknsmãrgtclcsãns quc vbltprbhucrn ul mystn rn`pkc hn

mãrgtcln (gspnat hnhnltcercan)

• Qurtbut Y1, @ < E, 19-89 gls

MSQXN ÃYCHNT@BÂHN



MSQXN ÃYCHNT@BÂHN

• @gssn clhbkbrn, arbcssgltprbjrnsscvn`nlt nt ãrbhgltk–bs

• Ygrebcs gspnat clfflg``gtbcrnpsnuhb-bstãâtn bu psnuhb- tu`nur `gkcjln

• Ck nxcstn ul dbrh sakãrnuxhgls kns zblns lblhãtructns +++



XTGCXN@NLXQ



XTGCXN@NLXQ

• Nxacscbl `grjclgkn bu aurntgjnn`pbrtglt kg pbafn



LN YGQ ABLEBLHTN

• Xu`nur bssnusn é ankkukns jãgltns• Xu`nur sylbvcgkn é ankkukns jãgltns (0 tu`nur

`yãkbpkgxn bu sylbvctn vckkc-lbhukgcrn pcj`

XAJ



XAJ

• Xu`nurs dãlcjlns kbagkn`nltgjrnsscvns nt hnstruatrcans

• 49% hns tu`nurs bssnusns nljãlãrgk, rgrns é kg `gcl (7->%)

• Ãpcpfysn hns bs kbljs (@Y)

• Tghcus hcstgk 1æ`n kbagkcsgtcblnl erãqunlan

• E < @, 19->9 gls

XAJ



XAJ• Xu`nur ãpcpfysgcrn nt `ãtgpfysgcrn

• @ãtgstgsns puk`blgcrns « dãlcjlns ½ blt ãtã hãarctns

• Kns tu`nurs hn kg `gcl hbllnrgcnlt pkus hn rãachcvn nt h`ãtgstgsns puk`blgcrns sc kn trgctn`nlt nst cltrg-kãscblln

Tghcbk Drgs vbk.87 lb.1 Qáb Ygukb @gy/Ouln 4996

XAJ



XAJ• Gspnat typcqun? kãscbl kytcqun

ãpcpfysb-`ãtgpfysgcrn édbrhs `gk kc`ctãs nt sgls`gtrcan cltrg-tu`brgkn

• CT@ lãanssgcrn sc hnstruatcblbssnusn nt/bu `gssn hns

pgrtcns `bkkns• Dckgl sagllnr lbtg``nlt

puk`blgcrn



XTGCXN@NLX



XTGCXN@NLX• YGQ hn rghcbtfãrgpcn (rcsqun

hn trglsebr`gtcblsgrab`gtnusn)

• Qc kc`ctã? aurntgjn ntab`dkn`nlt (arybafcrujrcn,jrneen, ac`nlt) gvna tgux hnrãachcvn >9%

• Qc nxtnlscbl hgls kns pgrtcns`bkkns? rãsnatcbl kgrjn ntrnablstruatcbl

XAJ uklg hcstgk, rãsnatcbl



Tãachcvn XAJ, ebr`n gjrnsscvn, g`putgtcbl



MSQXNGLÃUTCQ@GK



GLÃUTCQ@GK

• >% hn tbutns kns kãscblsbssnusn dãlcjlns `gcs 1->%snukn`nlt sblt é kg `gcl(surtbut `ãtgagrpcnls)

• ; 49 gls (6>% hns ags), @ 0 E• 19% sblt gssbacãns/snablhgcrns

é h–gutrns tu`nurs

• Glb`gkcns afrb`bsb`cqunshu jïln hn k–udcquctcl-spnac aprbtngsn

MSQXN GLÃUTCQ@G



SQ G U CQ@G

• Hbuknur nt bnhæ`n• Ergaturn rãvãkgtrcan

• Kãscbl kytcqun, nxpglscvn,`ãtgpfysgcrn gvna hns snptg

• Qbuvnlt uln bssc agtcblpãrcbstãn sbukcjln kg tu`nur

• G k–cltnrvnltcbl kns agvctãs sbltrn`pkcns hn sglj

Agsn aburtnsy be Hr Fglc Gk Qgkg`,Tghcbpgnhcg.brj, rCH? 465:7

Agsn aburtnsy be Tghcbpgnhcg.brj, rCH? 77768



MSQXN GLÃUTCQ@GK? XTG



Q Q@

• Aurntgjn nt jrneen +/-pfnlbk bu arybafcrurjcn agrrãachcvn hn >9%

• Qclbl nxacscbl kgrjn ntrnablstruatcbl



MSQXN QSLBUCGK CLXBQQN^V



QÃTCN C@



QÃTCN C@• 76 ags (7.:% hns mystns sylbvcgux)

• 78 E/8F

• Gjn `bynl 1> gls (75-:9)

• Kbagkcsgtcbl? kulgtu` 5, Qagpfbchn >, Qn`c-kulgsagpfbchn 7, Tghcus 4, Xrgpæzn 7, Jrglh bs 7,Yyrg`chgk 7, Yfgkgljn 7

NXCBYGXFBJÃLCN? 4XFÃ



NXCBYGXFBJÃLCN? 4 XFÃ• Yãlãtrgtcbl h–ul mystn cltrg-grtcaukgcrn 2 8:% gssbacãs é ul mystn hns pgrtcn

(Ugl hnl Huljnl)

• Cltrclsæqun

• Hãjãlãrnsanlan `uabâhn cltrg-`ãhukkgcrn (strnss, trgu`g rãpãtãs) (Qafgobwcaz)

• @ãtgpkgscn hn ankkukns `ãsnlafy`gtnusns (Enkh`gl)

• Gssbacgtcbl hns hnux ebr`ns gvna uln rãpgrtctcbl >9/>9 (Xgmgsn, Cmnhg, Qaf^rcduru,…)

Ugl hnl Huljnl Q, @grafnsc Q, Nzznhcln T, Dclhbu H, Kbrng Y. Tnkgtcblsfcp dntwnnl hbrsgk j

tfn wrcst glh cltrgbssnbus jgljkcbl aysts be tfn agrpgk dblns. Gatg Brtfbp Dnkj 499>=:7(>

MSQXN QSLBUCGK CLXTG-B



Q Q

• Kn pkus sbuvnlt gsy`ptb`gtcqun, hn hãabuvnrtn ebrtuctn

• Ygrebcs hbukburnux

• Tgrn`nlt rãvãkã pgr hns ab`pkcagtcbls

• Ergaturn (Afgltnkbt 7336)

• Gpbpfysn ulacebr`n ?rupturn fflãafcssnurs > (@gsghg 733:)

• Jrglh bs ? crrctgtcbl lnre audctgk (Dbwnrs 73:3)

NVG@NLQ AB@YKÃ@NLX



@ Q @ @

• Tghcbjrgpfcns stglhgrh ?

hcgjlbstca• Kãscbl kgaulgcrn

• Kcsnrã sakãrnux

QAGLLNT



QAGLLNT

• Kãscbl kytcqun purn

• Abltburs rãjukcnrs

• Ãpgcssn sakãrbsn

pãrcpfãrcqun

• Tnafnrafnr uln ergaturnbu uln dræafn abrtcagk

CT@



CT@

• Qgls cltãrït

• Tnafnrafn h–ul mystn hnspgrtcns `bkkns gssbacã

XTGCXN@NLX



XTGCXN@NLX• Qbuvnlt gsy`ptb`gtcqun, rnafnrafnr pgtfbkbjcn hn

vbcsclgjn pbur ul trgctn`nlt ablsnrvgtnur h–gdbrh

• L–bpãrnr qun kns mystns sy`ptb`gtcquns

• sagpfbâhn ? hnux ags snukn`nlt hn ergaturn

• sn`c-kulgcrn ? guaul ags hn abkkgpsus

UBCN H GDBTH



UBCN H–GDBTH• Qagpfbâhn ? gltãrcnurn

• Qn`c-kulgcrn ? hbrsgkn

• Gdbrh bssnux ?

• gu trgvnrs hu agrtckgjn

• kcjg`nlt sagpfb-kulgrcnl (^rcduru)

• abrln pbstãrcnurn (rnpãrgjn rghcb)

AB@DKN@NLX QYBLJCN



AB@DKN@NLX QYBLJCN

• Xbuoburs prãablcsã hgls kg kcttãrgturn

• Xbuoburs lãanssgcrn 2

ABLAK^QCBL



ABLAK^QCBL• Xu`nurs bssnusns sblt rgrns, kn pkus sbuvnlt dãlcjlns

• Ln pgs budkcnr k–cltãrït hns rghcbs hnvglt uln hbuknuruln hãebr`gtcbl hns hbcjts

• Yrnlhrn sbl tn`ps gvglt hn prbpbsnr ul trgctn`nlt, prnlhrnhns gvcs ab`pkã`nltgcrns pbur ghgptnr kn jnstn é kg kãs

• Gu `bclhrn hbutn, dcbpscn afcrurjcagkn snkbl kns ræjkn

tumeurs osseuses main diu

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