Zamkatimu
Endometritis ndi imodzi mwa matenda opweteka kwambiri a m'chiuno mwa amayi. Popanda chithandizo choyenera, matendawa amatha kupita ku siteji yowonjezereka ndikuyambitsa kusabereka.
Kawirikawiri, endometritis ndi kutupa kwa chiberekero cha chiberekero (endometrium). Zomwe zimayambitsa matendawa ndi matenda osiyanasiyana opatsirana omwe amalowa m'chiberekero - bowa, mabakiteriya, mavairasi.1. Nthawi zambiri, endometritis imachitika motsutsana ndi maziko a kuchepa kwa chitetezo chokwanira.
Zomwe zimayambitsa kukula kwa endometritis:
- kubereka kovuta;
- kulowererapo kulikonse mu uterine patsekeke (diagnostic ndi achire curettage, kuchotsa mimba);
- matenda m`munsi maliseche thirakiti;
- matenda opatsirana pogonana (monga gonorrhea kapena chlamydia);
- tizilombo toyambitsa matenda (tuberculous microbacteria, Escherichia coli, diphtheria bacillus, mycoplasma, streptococci, etc.);
- kusatsatira malamulo a ukhondo wapamtima.
Mu mankhwala amakono, pachimake ndi aakulu mitundu ya matenda amasiyanitsidwa.
Endometritis pachimake
Zimachitika mwadzidzidzi, nthawi zambiri motsutsana ndi maziko a kulowererapo mu chiberekero. Amadziwika ndi mawonetseredwe owoneka bwino azachipatala, omwe amakhala ndi zizindikiro za kuledzera kwa thupi.
Zizindikiro za endometritis pachimake:
- kuwonjezeka kwakukulu kwa kutentha;
- kuzizira;
- kukoka ululu m'munsi pamimba (ululu ukhoza kuperekedwa kumunsi kumbuyo, coccyx, inguinal dera);
- kufooka kwakukulu;
- kusowa chilakolako;
- purulent kumaliseche.
Matenda a endometritis
Matenda mawonekedwe a matenda nthawi zambiri asymptomatic ndipo nthawi zambiri zimachitika pakalibe chithandizo chokwanira cha kutupa pachimake.2.
- Kuchuluka kwa matenda a endometritis sikudziwika bwino. Malinga ndi olemba athu, 1 mpaka 70% ya odwala omwe ali ndi infertility kapena atalephera kuyesa kuthetsa mimba amapezeka kuti ali ndi endometritis. Matenda a endometritis amatha kupatsirana: mavairasi, mabakiteriya, matenda opatsirana pogonana, komanso autoimmune. Pambuyo pa kutha kwa mimba, mulimonsemo, matenda a "endometritis aakulu" amapangidwa, - zolemba Anna Dobychyna, dokotala wa obereketsa, dokotala wa opaleshoni, wachiwiri kwa dokotala wamkulu wa CER wa REMEDI Institute of Reproductive Medicine.
Zizindikiro za endometritis aakulu
- matenda a msambo;
- kumaliseche pang'ono musanayambe kusamba ndi pambuyo pake
- kusowa mimba ndi padera.
Ponena za chithandizo cha endometritis, katswiri wa zamaganizo-gynecologist amapereka mankhwala okhudzana ndi zomwe zimayambitsa matendawa. Itha kukhala antibacterial, hormonal, metabolic therapy, physiotherapy kapena mankhwala ovuta.
Kutalika kwa mankhwala zimadalira mbiri. Ngati wodwalayo analibe alowererepo mu uterine patsekeke, kuchotsa mimba, ndiye mmodzi msambo zokwanira kuchiza endometritis ndi mankhwala oyenera m`thupi kukonzekera.
Pankhani ya mbiri yolemetsa ya gynecology, chithandizo chikhoza kutha miyezi 2-3.
1. Mankhwala a endometritis mwa amayi
Chithandizo cha antibacterial
Pa gawo loyamba la chithandizo cha endometritis mwa amayi, maantibayotiki ambiri amagwiritsidwa ntchito. Katswiri wathu Anna Dobychina akuti mankhwala opha maantibayotiki pa nthawi yomwe ali ndi pakati amawonetsedwa pokhapokha ngati ma labotale amatsimikizira kuti tili ndi tizilombo toyambitsa matenda mu chiberekero cha uterine pamlingo wofunikira kwambiri.
Pofuna kuchiza endometritis mwa amayi, dokotala angapereke mankhwala oletsa tizilombo toyambitsa matenda omwe ali ndi maselo akuluakulu. Mankhwalawa ndi monga amoxicillin, clindamycin, gentamicin, ampicillin3. Chithandizo tikulimbikitsidwa kuyambira tsiku loyamba la kusamba.
Antifungal mankhwala
Pofuna kupewa candidiasis motsutsana ndi kugwiritsidwa ntchito kwa maantibayotiki, antifungal mankhwala amalembedwa: Nystatin, Levorin, Miconazole, Ketoconazole, Itraconazole, Fluconazole ndi ena.
Pamaso pa tizilombo toyambitsa matenda pambuyo mankhwala mankhwala, antiviral ndi immunomodulatory mankhwala ntchito, monga Acyclovir, Valciclovir, Viferon, Genferon.
2. Makandulo a endometritis
Kusankhidwa kwa suppositories kumaliseche kumadalira zizindikiro ndi mtundu wa tizilombo toyambitsa matenda. Pogwiritsa ntchito ma suppositories, zosakaniza zogwira ntchito sizimalowa m'matumbo, koma zimalowetsedwa mwachindunji m'magazi kuchokera kumaliseche, zomwe zimachepetsa chiopsezo cha dysbacteriosis ndi zotsatira zoipa pa chiwindi.
Mu gawo lachimake la matendawa, ma antibacterial suppositories amagwiritsidwa ntchito omwe amalepheretsa kubereka kwa tizilombo toyambitsa matenda. Pochiza matenda a endometritis, odana ndi yotupa, immunostimulating, antiseptic suppositories, monga Diclofenac, Galavit, Terdinan, Livarol, Lidaza ndi ena.
Mankhwala osiyanasiyana osiyanasiyana amagwiritsidwa ntchito pochiza kutupa kwa chiberekero. Mu gawo lowopsa la matendawa, ma antibacterial agents amagwiritsidwa ntchito. Ma suppositories nthawi zambiri amaperekedwa ngati chithandizo cha adjuvant.
3. Chithandizo chamankhwala
Thandizo la Metabolic ndi gawo lachiwiri la chithandizo, lomwe cholinga chake ndi kuthetsa kuwonongeka kwachiwiri, kuphatikiza kusokonezeka kwa metabolic. Ndi bwino kugwiritsa ntchito mavitamini, antioxidants, hepatoprotectors ndi michere (Wobenzym, Phlogenzym).
4. Physiotherapy
Malinga ndi obereketsa-amayi Anna Dobychina, pa matenda a endometritis, physiotherapy njira ndi chikoka chachikulu: maginito, lasers, ndi ultrasounds. Ntchito ya physiotherapy mu nkhani iyi ndi kusintha magazi a m'chiuno ziwalo, kusintha njira kusinthika kwa endometrium, komanso kuonjezera chitetezo cha m'thupi.4.
5. Chithandizo cha mahomoni
Mankhwala a mahomoni amagwiritsidwa ntchito nthawi zina kuti apititse patsogolo kukula kwa endometrium. Monga lamulo, pankhaniyi, kulera kwapakamwa kumaperekedwa, mwachitsanzo, Regulon ndi Novinet. Pokonzekera mimba, progesterone imagwiritsidwa ntchito.
Kupewa kwa endometritis
Kupewa endometritis akazi, choyamba, m`pofunika kuchita kupewa matenda opatsirana pogonana: kuchepetsa chiwerengero cha kugonana, ntchito makondomu, nthawi zonse kutenga swabs kwa matenda, ndipo ngati matenda, kulandira yake chithandizo. Komanso mbali yofunika ndi kupewa kuchotsa mimba, choncho muyenera kutenga nkhani ya kulera mozama.
- Zoonadi, mimba yosakula imakhala yovuta kwambiri kuti ipewe, choncho, ngati izi zichitika, m'pofunika kuyang'aniridwa nthawi zonse ndikutsatira malangizo onse a dokotala wa amayi. Zimenezi zidzachepetsa ngozi m’tsogolo,” akutero Anna Dobychyna.
Mafunso ndi mayankho otchuka
Mafunso otchuka okhudza endometritis mwa amayi amayankhidwa dokotala wa opaleshoni, obstetrician-gynecologist wa European Medical Center Oleg Larionov.
Kodi endometritis imayambitsa chiyani?
Endometritis pambuyo pobereka ndi wamba. Zimayamba chifukwa cha microflora, yomwe nthawi zambiri imakhala mu nyini, koma sichilowa m'malo osabala a chiberekero cha uterine panthawi yobereka. Ndi postporal endometritis, pali ululu waukulu m'munsi pamimba, kutuluka kwa purulent kapena magazi kuchokera kumaliseche, kutentha kwa thupi kumawonjezeka, ndipo kugunda kwa mtima kumawonjezeka.
Endometritis, yosagwirizana ndi mimba ndi kubereka, nthawi zambiri imakhala chifukwa cha matenda opatsirana pogonana. Zimayambitsidwa ndi chlamydia, gonorrhea ndi matenda ena. Komanso, chifukwa akhoza alowererepo zachipatala, mwachitsanzo, unsembe wa intrauterine chipangizo, hysteroscopy ndi curettage chiberekero, kuchotsa mimba.
Chifukwa chiyani endometritis ndi yoopsa?
Kodi endometritis imachiritsidwa nthawi yayitali bwanji?
Magwero a:
- Serebrennikova KG, Babichenko II, Arutyunyan NA Watsopano mu matenda ndi chithandizo cha endometritis aakulu mu infertility. Gynecology. 2019; 21(1):14-18. https://cyberleninka.ru/article/n/novoe-v-diagnostike-i-terapii-hronicheskogo-endometrita-pri-besplodii
- Plyasunova MP, Khlybova SV, Chicherina EN Kuyerekeza kuwunika kwa ultrasound ndi Doppler magawo mu endometritis yosatha. Akupanga ndi zinchito diagnostics. 2014: 57-64. https://cyberleninka.ru/article/n/effekty-kompleksnoy-fizioterapii-pri-chronicheskom-endometrite-ultrazvukovaya-i-dopplerometricheskaya-otsenka
- Zarochentseva NV, Arshakyan AK, Menshikova NS, Titchenko Yu.P. Matenda a endometritis: etiology, chipatala, matenda, chithandizo. Russian Bulletin wa obstetrician-gynecologist. 2013; 13(5):21-27. https://cyberleninka.ru/article/n/hronicheskiy-endometrit-puti-resheniya-problemy-obzor-literatury
- Nazarenko TA, Dubnitskaya LV Zotheka za chithandizo cha enzyme cha matenda a endometritis omwe ali ndi zaka zobereka. Mavuto a kubereka 2007; 13(6):25-28. https://gynecology.orscience.ru/2079-5831/article/view/27873