Matenda a endometritis mwa akuluakulu

Kodi matenda a endometritis ndi chiyani

Matenda a endometritis ndi kutupa kosatha kwa endometrium (mkapo wa chiberekero). Kutupa kosatha kumatha kusokoneza kukhazikitsidwa kwa dzira la mwana wosabadwayo ndikukula kwake. Kuonjezera apo, kutupa kosalekeza kumachepetsa thupi, kungayambitse mavuto aakulu.

Chizindikiritso cha endometritis aakulu nthawi zambiri ikuchitika ndi microscopic kapena histological kufufuza. Chitsanzo cha endometrium chimapezeka kuchokera ku biopsy kapena panthawi ya hysteroscopy. Pansi pa microscope, chitsanzo cha endometrium chikhoza kuipitsidwa ndikuwunikidwa chifukwa cha kukhalapo kwa maselo a chitetezo cha mthupi omwe amadziwika kuti maselo a plasma. Chitsanzo cha endometrial chodzaza ndi maselo a plasma ndi chizindikiro cha endometritis yosatha. Zikhalidwe kuchokera ku nyini kapena khomo pachibelekeropo si chizindikiro chodalirika cha endometritis aakulu.

Tisanamvetsetse kutupa kosatha komanso gawo lofunikira pa thanzi la ubereki, choyamba tiyenera kumvetsetsa kuti kutupa ndi chiyani. Mwachilengedwe chake, kutupa ndiko kuyesa kwa thupi kudziteteza ku matenda, zonyansa, ndi kukonza maselo owonongeka. Kutupa ndi mbali ya chitetezo cha mthupi.

Pachiyambi, kutupa kumapindulitsa. Mwachitsanzo, pamene thupi lanu likuyesera kulimbana ndi matenda oyambitsidwa ndi mabakiteriya kapena mavairasi. Komabe, nthawi zina kutupa kungayambitse kuwonongeka kwa minofu ngati kumakhala kosalekeza. Ikhoza kusungidwa ngakhale chifukwa choyambirira chatha. Pamenepa, kutupa kungakhale kovulaza.

Kutupa kungakhale koopsa kapena kosatha.

Kutupa kwakukulu. Zimayamba mwadzidzidzi, mwadzidzidzi ndipo mwamsanga zimakhala zovuta kwambiri. Zizindikiro zimakhalapo kwa masiku ochepa chabe, koma nthawi zina zimatha nthawi yaitali.

Pali 5 zizindikiro zazikulu ndi zizindikiro za kutupa pachimake:

• ululu - mankhwala amamasulidwa omwe amalimbikitsa mitsempha ya mitsempha, yomwe imayambitsa kupweteka;
• redness - kuwonjezeka kwa magazi kumalo okhudzidwa kumayambitsa kufiira;
• kutentha - kuwonjezeka kwa magazi kumalo okhudzidwa kumayambitsanso kutentha kwapakati;
• edema - amayamba chifukwa cha kutuluka kwa madzi m'mitsempha yamagazi;
• kukanika.

Kutupa koopsa nthawi zambiri kumakhala kosavuta kuzindikira ndikuchiza.

Kutupa kosatha. Kutupa kosatha kumatanthauza njira yayitali yomwe imatha miyezi kapena zaka. Izi zikhoza kukhala chifukwa cha kulephera kuthetsa zomwe zinkayambitsa kutupa kwakukulu (mabakiteriya osalekeza, osaponderezedwa bwino), kupsa mtima kosalekeza komwe kumapitirirabe, kapena pamene chitetezo cha mthupi chikaukira minofu yathanzi, ndikumaganiza kuti ndi tizilombo toyambitsa matenda.

Kutupa kosatha kumatha kukhala kovuta kuzindikira ndipo chithandizo chothandiza sichipezeka nthawi zonse.

Kutupa kukukhala chinthu chodziwika bwino chomwe chimathandizira kulephera kubereka, kuphatikiza zifukwa zingapo zomwe zimayambitsa kusabereka monga matenda otupa m'chiuno, polycystic ovary syndrome, kunenepa kwambiri, endometriosis, komanso kutaya mimba mobwerezabwereza. Posachedwapa, kutupa kosatha kwa uterine mucosa kwakhala kochititsa chidwi kwambiri. Izi zimatchedwa matenda a endometritis.

Zifukwa za endometritis aakulu mwa akuluakulu

Mzere wa chiberekero ndi udindo kukulitsa luso la mluza kuti imzake. Kupanga kwa estrogen ndi progesterone ndi thumba losunga mazira kumayambitsa kusintha kwa chiberekero cha chiberekero chofunikira kuti apangidwe. Kusintha komwe kumachitika mucosa ya chiberekero ndizovuta kwambiri komanso zosadziwika bwino. Kafukufuku wina wapeza kutupa kosatha kwa amayi omwe ali ndi implants zolephera. Amakhulupiriranso kuti kutupa kwa chiberekero cha chiberekero kumawonjezera chiopsezo cha padera.

Pali zifukwa zingapo zomwe zimayambitsa endometritis ndipo zambiri zimagwirizanitsidwa ndi matenda omwe amayamba chifukwa cha tizilombo toyambitsa matenda kapena tizilombo toyambitsa matenda. Khomo lachibelekero, kapena potulukira m’chibaliro cha mkazi, lomwe limalumikiza khomo la chiberekero ndi nyini, nthawi zambiri limakutidwa ndi ntchofu ndipo limalepheretsa mabakiteriya kusamukira ku endometrium. Ma catheters a intrauterine insemination kapena embryo transfer bypass by cervical pylorus ndipo angayambitse matenda. Ngati wodwalayo ali padera, khomo pachibelekeropo akhoza dilate kulola evacuated wa zimakhala za wakufa mwana wosabadwayo, koma bakiteriya matenda ndi kukwera njira ndi zotheka. Zotsalira za latuluka ndi nembanemba pambuyo mimba komanso kugwirizana ndi matenda.

Kawirikawiri, endometritis imayamba chifukwa cha matenda. Ikhoza kukhala chlamydia, chinzonono, chifuwa chachikulu, kapena kusakanikirana kwa mabakiteriya omwe amapezeka m'maliseche. Kutupa kumachitika pakapita padera kapena kubereka, koma si zachilendo pambuyo powawa kwa nthawi yayitali kapena kuchitidwa opaleshoni. Chiwopsezo chokhala ndi endometritis chimakhala chachikulu pambuyo pa opaleshoni ya m'chiuno, yomwe imachitidwa kudzera pa khomo lachiberekero. Njira izi zikuphatikizapo:

• dilatation ndi curettage pa kuchotsa mimba;
• endometrial biopsy;
• hysteroscopy;
• kukhazikitsa chipangizo cha intrauterine (IUD);
• kubereka (nthawi zambiri pambuyo pa opaleshoni kuposa kubereka kwa ukazi).

Endometritis ikhoza kuchitika nthawi yomweyo ndi matenda ena a m'chiuno.

Zizindikiro za endometritis aakulu kwa akuluakulu

Kupatula kukulitsa, pangakhale palibe zizindikiro. Pa nthawi yowonjezereka, zizindikiro zotheka zingaphatikizepo:

• kuphulika;
• kukha mwazi kwachilendo kapena kumaliseche;
• kusapeza bwino ndi matumbo (kuphatikiza kudzimbidwa);
• malungo aakulu;
• kusapeza bwino, nkhawa, kapena kusamva bwino;
• kupweteka m'munsi pamimba kapena m'chiuno (kupweteka kwa chiberekero).

Chithandizo cha matenda endometritis akuluakulu

Chithandizo chimaphatikizapo kuchotsa gwero la matendawa (zotsalira za placenta, dzira la fetal, hematomas, coils) ndikutsatiridwa ndi njira yochepa ya maantibayotiki. Nthawi zina, "umboni wa machiritso" wachiwiri wa endometrial biopsy umachitika pambuyo poti maantibayotiki atsirizidwa kuti atsimikizire kuti endometrium yabwino. Kugwiritsiridwa ntchito kwa Empiric antibiotic nthawi zambiri kumagwiritsidwa ntchito pakangopita nthawi yochepa kuti mwana asamutsidwe mu ndondomeko ya IVF kuti athetse endometritis yocheperako panthawi ya kuikidwa.

Diagnostics

Pali zoyezetsa magazi zomwe sizikhala zizindikiro zenizeni za kutupa. Chimodzi mwa zolembera zimatchedwa erythrocyte sedimentation rate (yomwe imadziwikanso kuti ESR). ESR siyothandiza kwambiri pophunzira amayi azaka zakubadwa, chifukwa imakhudzidwa ndi milingo ya estrogen.

Chizindikiro china chotchedwa C-reactive protein kapena CRP sichidalira kuchuluka kwa timadzi, kotero ndi chizindikiro chodalirika cha kutupa kwa amayi. CRP yokwera kwambiri (> 10) nthawi zambiri imakhala chizindikiro cha matenda oopsa. Kukwera pang'ono kungakhale chizindikiro cha kutupa kwapang'onopang'ono kosatha.

Mzere wa chiberekero ukhoza kuwonedwa mwachindunji mwa kuika telesikopu ya fiber optic m'kati mwa chiberekero. Izi zimatchedwa hysteroscopy. Nthawi zina njira imeneyi angagwiritsidwe ntchito matenda endometritis aakulu. Mwachitsanzo, kukhalapo kwa micropolyps ndi chizindikiro chodalirika cha endometritis.

Hysteroscopy ingagwiritsidwenso ntchito kupeza chitsanzo kapena biopsy ya chiberekero cha chiberekero, chomwe chingathe kuwonedwa ndi microscope. Mu chiberekero cha chiberekero, mtundu umodzi wa maselo oyera a magazi omwe ndi chizindikiro cha kutupa kosatha ndi maselo a "plasma". Maselo a plasma amatha kuwonedwa poyang'ana kachidutswa kakang'ono ka chiberekero pansi pa maikulosikopu. Komabe, chifukwa cha kukhalapo kwa maselo ena ofanana nawo, sikophweka nthawi zonse kudziwa kukhalapo kwa chiwerengero chachilendo cha maselo a plasma. Ma cell a plasma amakhala ndi cholembera pamwamba pake chotchedwa CD138. Zitsanzo za minofu ya endometrial zitha kuipitsidwa kuti zidzipatula CD138. Iyi ndi njira yodalirika yodziwira matenda a endometritis.

Mankhwala amakono

Ngati chifukwa chenicheni cha kutupa chikhoza kudziwika, chithandizo cha chifukwa chake chiyenera kuthetseratu kutupa komwe kumagwirizanitsidwa. Mwachitsanzo, ngati matenda a bakiteriya apezeka, mankhwala opha tizilombo angayesedwe. Kafukufuku waposachedwapa wasonyeza kuwonjezeka kwa mimba ndi kubadwa pamene amayi omwe ali ndi CRP otsika kwambiri adalandira aspirin ya mlingo wochepa asanatenge pakati. Komabe, palibe kusintha komwe kunawonedwa mwa amayi onenepa. Pakafukufuku wa nyama, zidapezekanso kuti kukhudzana ndi mapulateleti olemera a plasma (PRP) amapondereza kupanga mapuloteni ena opangidwa mu chiberekero cha chiberekero chifukwa cha kutupa.

Kodi chithandizo cha maantibayotiki cha endometritis chosachiritsika chimagwiradi ntchito? Ndemanga yaposachedwa ya maphunziro angapo omwe akuyang'ana kuchiza matenda a endometritis ndi maantibayotiki adapeza kuti amayi omwe anali ndi umboni wa chithandizo (kubwereza biopsy kunawonetsa kutupa kunali kodziwikiratu) anali ndi mwayi wopitilira 6 kukhala ndi pakati kapena kubadwa kwamoyo poyerekeza ndi amayi omwe ali ndi endometritis osatha. amene sanalandire chithandizo.

Kupewa matenda endometritis akuluakulu kunyumba

Ndikofunika kusamalira thanzi lanu poyendera gynecologist chaka chilichonse. Endometritis imatha kuyambitsidwa ndi matenda opatsirana pogonana (matenda opatsirana pogonana). Kuteteza endometritis ku matenda opatsirana pogonana:

• kuchiza matenda opatsirana pogonana panthawi yake;
• onetsetsani kuti ogonana nawo akulandira chithandizo cha matenda opatsirana pogonana;
• Yesetsani kugonana motetezeka, monga kugwiritsa ntchito makondomu.

Amayi amene anachitidwa opaleshoni akhoza kupatsidwa mankhwala opha tizilombo tisanawachite kuti asatenge matenda.

Mafunso ndi mayankho otchuka

Anayankha mafunso okhudza endometritis aakulu gynecologist, PhD Mikhail Gavrilov.