Sestrinska skrb bolesnica s karcinomom cerviksa uterusa

Karcinom vrata maternice treći je najčešći karcinom u žena u svijetu. Glavnim uzročnikom smatra se Humani papiloma virus (HPV). Genitalni sojevi HPV-a podijeljeni su u tri skupine: sojevi visokog onkogenog rizika, mogući karcinogeni sojevi i sojevi niskog onkogenog rizika. Sojevi 16 i 18 odgovorni su za oko 70% karcinoma cerviksa podrijetla pločastih stanica i oko 86% adenokarcinoma vrata maternice. Infekcija HPV-om danas je najčešća spolno prenosiva bolest. U većini slučajeva infekcija HPV-om prolazi spontano. Za razvoj preinvazivnih lezija vrata maternice (CIN – cervikalna intraepitelna neoplazija) i potom karcinoma potrebna je trajna infekcija visokoonkogenim sojevima HPV-a. Zloćudni tumor cerviksa obično raste sporo tijekom nekog vremenskog perioda. Prije nego se stanice zloćudnog tumora otkriju u cerviksu, tkiva cerviksa prolaze promjene kod kojih se počinju pojavljivati stanice koje nisu normalne. Ovaj oblik tumora je 100% izlječiv i obično nema potrebe za histerektomijom. Displazija, ovisno o njenoj jačini, može se riješiti bez liječenja. Međutim ona ipak puno češće progredira u zloćudni tumor "carcinoma in situ" (CIS) koji je lokalno neproširen. Karcinom grlića maternice je karcinom koji se može otkriti i spriječiti. Ako se otkrije na vrijeme, s velikim uspjehom moţe biti liječen. Najčešće, karcinom grlića maternice u svojoj najranijoj i najlakše izlječivoj fazi ne uzrokuje nikakve simptome. Ukoliko postoje simptomi, najčešći su: stalni vaginalni iscjedak i nenormalno vaginalno krvarenje. Često nema nikakvih simptoma karcinoma grlića maternice dok bolest nije već uznapredovala. Velika većina žena u kojih je danas dijagnosticiran karcinom grlića maternice nisu vršile redovite ginekološke preglede sa Papa testom. Liječenje karcinoma grlića maternice ovisi o vrsti zloćudnog tumora, stadiju, veličini i obliku tumora, starosnoj dobi i općem zdravstvenom stanju žene, kao i njenoj želji za budućim rađanjem. U najranijim stadijima, bolest je izlječiva uklanjanjem ili uništavanjem prekanceroznog i kanceroznog tkiva. Veoma važnu ulogu kako u liječenju tako i u prevenciji raka vrata maternice imaju medicinske sestre. Primarna i sekundarna prevencija i edukacija ženske populacije kako mlađih djevojaka, žena u reproduktivnoj dobi i starijih žena zahtjeva znanje i profesionalnost medicinskih sestara. Za ulogu medicinske sestre u zdravstvenom timu, u preoperativnoj pripremi bolesnica kod kirurškog liječenja treba staviti naglasak na to da je ona preliminarna u konačnom ishodu procesa zdravstvene njege, te da individualnim i holističkim pristupom bolesniku osigurava adekvatnu preoperativnu pripremu, što dovodi do sigurnije intraoperacijske skrbi, kao i smanjenju komplikacija u postoperativnoj njezi.Cervical carcinoma is the third most frequent carcinoma in women worldwide. The main cause is HPV. Genital HPV strains are divided into three groups: high oncogenic risk strains, potentially carcinogenic strains, and low oncogenic risk strains. Strains 16 and 18 are responsible for about 70% of cervical epithelial cancers, and about 86% of cervical adenocarcinomas. Nowadays the HPV infection is the most frequent sexually transmitted disease. Remission can be spontaneous in most of the HPV cases. Pre-invasive cervical lesions (CIN - cervical intraepithelial neoplasia) and subsequent carcinoma develop after a persistent infection with highly oncogenic HPV strains. Malignant tumor of the cervix usually grows slowly over a period of time. Before malignant cells are detected in the cervix, the tissues of the cervix undergo changes in which gas begins to form cells that are not normal. This form of cancer is 100% curable and usually no need for a hysterectomy. Dysplasia, depending on its severity, can resolve without treatment. However, it often progresses to a malignant tumor "carcinoma in situ" (CIS), which is locally unexpanded. Cervical cancer is a cancer that can be detected and prevented. If detected in time, with great success can be treated. Most often, cervical cancer in its earliest and most easily curable stage does not cause any symptoms. If there are symptoms, the most common are: regular vaginal discharge and abnormal vaginal bleeding. Often there are no symptoms of cervical cancer until the disease is advanced. The vast majority of women who have today been diagnosed with cervical cancer did not put regular gynecological examination with Pap test. Treatment of cervical cancer depends on the type of cancer, the stage, the size and shape of the tumor, the age and general health of the woman, and her desire for future childbearing. In its earliest stages, the disease is curable by removing or destroying the pre-cancerous or cancerous tissue. Very important role in the treatment and in the prevention of cervical cancer have nurses. Primary and secondary prevention and education of the female population as young girls , women of reproductive age and older women requires knowledge and professionalism of nurses. For the role of nurses in the health care team , in the preoperative preparation of patients, surgical treatment should be emphasized that it is preliminary to the final outcome of the process of health care, and that individual and holistic approach to the patient ensures adequate preoperative preparation , which leads to a safer intraoperative care , and reducing complications in the postoperative care