Ngokwakheko lwezilwanyana zokubeleka kwabantwana besifazane abaneminyaka yobudala bokubeletha, ubude be-endometritis buhluka ukusuka kwi-3% ukuya kwi-70%, ngenxa yokuhlukahluka okukhulu kwinani lokuqwalasela, ukuxakeka kobuninzi bokuqinisekisa ukuxilongwa, ukungafani kwezigulane kunye nezinto ezihlalutyo. Nangona ukwandiswa kwesiseko se-pharmacological, i-endometritis, iimpawu kunye nokunyanga oko kungahluka kakhulu kuxhomekeke kwizibonakaliso zekliniki, amayeza asebenzayo ahlangabezana nobunzima obunzima bokuxilongwa kunye nokunyangwa kwesi sifo. Oku kuchazwa yimiba ye-endometritis kwiimeko zanamhlanje: ukunyuka kwenyuka kwe-pathogenic microflora kwiziyobisi, ukuguqulwa kwesakhiwo se-etiologic yesifo ngokunyuka kwindalo ye-viral, kunye nexesha elide lokunyanga.
Yintoni i-endometritis kubafazi?
I-Endometritis yintsholongwane yeklinikhi kunye ne-morphological syndrome ebonakala yinkimbinkimbi yeenguqu kwi-endometrium yemvelaphi evukayo, ekhupha ukuphulwa kobuchule "bokufumana" kunye nokuguqulwa kwimizimba yesikhumba. Esi sifo sikhokelela ekunciphiseni kwenzalo yabasetyhini, ukungasebenzi kwemisebenzi yokuya esikhathini, ukulahleka kwamathambo, ukukhubazeka kokukhula komntwana, ukungabikho komntwana. Ngethuba elifanayo, ukuphumelela kwe-endometrial therapy akugqithisi ama-60-68%.
I-endometritis enobuchule: iimpawu kunye nonyango
Inqubo ephambili yokuvuvukala, engahambi ngaphaya kwesibeleko, ikhula ngenxa yenyuka yegosa elithathelwanayo ecaleni lomngcingo wesibeleko. Ngokugqithiseleyo, iibhaktheriya zingena kwi-endometrium nomonakalo kwingqibelelo yesithintelo somlomo - ngexesha lokukhipha isisu, ukutshixa umzimba wesisu kunye nentamo yomsila, ukufaka i-intrauterine kunye nezinye iindlela zokungenelela.
Iimpawu ze-endometritis enzima:
- ukunyuka okuthe ngqo kumbindi;
- ukuphosa, intlungu kwisisu esezantsi;
- ukubonakala kwe-purulent ehlukileyo kwi-genital tract.
Amanyathelo okuchonga:
- ukuqokelela i-anamnesis (ukungabikho / ukungena kwe-intrauterine ukungenelela, i-necrosis ye-nodeous node);
- Ukuhlolwa kwezesifo (kubonisa i-uterus ekhulisiweyo);
- uphando lwe-bacteriological (lubonisa iintlobo zee-microbial flora);
- I-ultrasound yeenxalenye zeplavic;
- i-laparoscopy (yenza kube lula ukuhlolisisa ama-appendages, ingabandakanyi ezinye ii-pathologies zokugulisa);
- biopsy endometri.
Unyango kunye nokugxekwa
I-endometritis efanelekileyo ifuna i-antibiotics. Inkqubo yokuvuvukala ichaphazela umgca we-basal we-endometrium ngenxa yokusuleleka ngeentsholongwane ezingabalulekanga / ezithile. Izixhobo ezikhuselekileyo ze-endometrium zihambelana ngqo nemiphumo ye-hormone yesondo, "sebenzisa" ngokubambisana nenani leeseli ezithintela iindidi ezinobungozi. Ngokuqala kokuya esikhathini, le mqobo iyalala, okwenza ukuba utyholongwane lwembrane enqabileyo lwenzeka. Inkqubo yokwenza unyango iquka unyango lwe-antibiotic kunye ne-physiotherapy. Ukugxekwa kukuhle: ngokunyanga okwaneleyo kunye nexesha elifanelekileyo, ukuhlaziywa ngokupheleleyo kwenzeka kwiintsuku ezingama-7-10.
I-endometritis engapheliyo: iimpawu kunye neyeza
I-endometritis engapheliyo isifo apho ngenxa yezilonda ezithintekayo ezithintekayo ze-endometrium, ukutshintshwa kwezinto ezisesekondari ezenzekayo kuphazamisa isimo se-receptor kunye nokuguqulwa kwesimo somzimba we-uterine. Kwimiba engama-95%, i-ChE iyingqayizivele, icatshulwa ngama-microorganism, isasazeka ngezesondo, kwaye ivela emva kokunyanzeliswa kwe-intrauterine. Kwi-5% yamatyala, i-ChE ikhula ngenxa yokusuleleka kwintsholongwane ye-lymphogenic, i-hematogenic, yehla kwi-foci e-extragenital. Ukukhupha izinto ezingabalulekanga kunye neenkcukacha ezithile, ezibangelwa yi-mycoplasmas, i-fungi, i-bacteria, ii-virus, i-endometritis engapheliyo.
I-Endometrite ye-uterus - iimeko eziphambili:
- ukunciphisa ukukhusela kwamalungu omzimba;
- izimo zokuphila ezingenelisekanga, imikhwa emibi, ukungondleki;
- Izifo ezithintekayo;
- i-neuroendocrine pathologies, i-blood pressure hypertension;
- isifo sesifo sesifo;
- Ukungaphumeleli ngokuzenzekelayo, ii-STD, i-anemia, izifo ze-bronchopulmonary;
- izifo zenkqubo yokuzala isetyhini;
- Ukusetyenziswa kwexesha elide leengqungquthela ze-intrauterine, zidluliselwe kwicandelo eliqhelekileyo;
- inani elikhulu lokungenelela kwezixhobo kwi-uterine cavity;
- iingxaki emva kokubeletha / ukukhulelwa kwezilwanyana ezithintekayo;
- ukusuleleka kwintsholongwane / isisu;
- Ulwaphulo lwe-radiation kwindawo ye-pelvic.
Iimpawu ze-endometritis engapheliyo:
- ukuphulwa komsebenzi wokuya esikhathini. Ubukho bokugxininisa ukugqithisa kwi-pelvis encinci kubangela ukungasebenzi komjikelezo wesini kwi-50-60% yezigulane-oku kubonakaliswa ngu-amenorrhea, algodismenorei, i-oligomenorrhea. Izikhalazo eziqhelekileyo ziphakathi kunye noqhagamshelwano lwe-spotting, inyanga zonke, iintlungu zeplavic eziqhubekayo;
- ubuhlungu besisu, ukuphuma kwamanzi okungaqhelekanga;
- ukuphazanyiswa komsebenzi wegciwane lesisu. Ukuphazamiseka ngexesha lokunyakaza kwebilini, ukunqandwa, ukuqhaqhafaza, ukuguquka, ukunciphisa ukutya;
- iimeko ezinjenge-influenza. Umkhuhlane, umkhuhlane, i-body aches, i-malaise jikelele.
I-endometritis engapheliyo: iimpawu kunye nonyango, ukuxilongwa
Ukuxilongwa kwe-endometritis engapheli kusekelwe ekuhlaziyweni kwembali yesigulane, iimpawu zekliniki, ukufundwa kwe-endometrium, ngokuqhubekayo ngomhla we-7-10 womjikelezo.
Iingqinisiso zokuxilongwa kwe-endometritis engapheliyo:
- ukuvuvukala kungena ngaphakathi, okubandakanya izakhi ze-lymphoid ezikujikeleze imithana yegazi kunye neengqungquthela, kaninzi kuninzi. Ebonakalayo, i-foci ifana ne-follicle kwaye ikwazo zonke iindawo zecala lokusebenza;
- ubukho bezinto zeseli yeplasma;
- kugxininiso olukhawulelweyo lwe-stroma, olunexesha elide leprogram yokuvuvukala, kwezinye iimeko, iindawo ezinkulu ezinomdla;
- ukuguqulwa kwamathambo eemibhobho zomoya ezibonakalayo malunga nemvelaphi yeempawu ezinzima kunye nokuqhubekeka kwexesha lokugqibela kwe-endometritis.
U kunyango lwe zithethe
Umgangatho wegolide ekhatyweni kwe-ChE yindlela yokunyathela ngamanqanaba okujoliswa ekupheliseni izizathu zokuvuvukala nokuphelisa imiphumo yenkqubo yokuvuvukala, kubandakanywa ukususwa kweetysikemia, umonakalo okwesibini, ukuveliswa kwakhona kwezixhobo ze-receptor kunye ne-hemodynamics yendawo ye-endometrium. Iskimu esinzima kufuneka sibe ne-pathogenically and etiologically justified and based on the results of an examination thoroughly.
Amanyathelo okwelapha CHE:
- Ukupheliswa kommeli owonakalisayo okanye ukwehla kwimisebenzi yentsholongwane. Ulwaphulo lwe-antimicrobial kufuneka luqinisekise ukukhutshwa kwezinto ezininzi ze-pathogenic, eziquka i-trichomonads, i-chlamydia, i-streptococci, i-gonococci kunye ne-virus. Kwezinye iimeko, oogqirha banika iikhosi ezininzi kunye nokutshintsha kwamaqela ezonyango, ukhetho oluxhomekeke kwiziphumo zovavanyo lwe-microbiological of the uterine cavity kunye nesondo, isigaba senkqubo yokuvuvukala kunye neempawu zesithombeni seklinikhi. Ngokufanayo, ukulungiswa kwamandla okukhusela omzimba kwenziwa.
Iziyobisi: inhlanganisela ye-nitroimidazoles (i-Metronidazole, i-Ornidazole) kunye ne-fluoroquinolones (i-Ciprofloxacin, i-Ofloxacin, i-Levofloxacin), ukudibanisa kwama-penicillin ekhuselekileyo kunye nama-macrolides (i-Spiramycin, i-Roxithromycin). Ukuba ukusuleleka kwintsholongwane kukhoyo, iilucleoside analogues zisetyenziselwa (Valtrex, Acyclovir).
Ukuhlaziywa kwezinto ezinokuthi zingabikho komzimba we-endometrium kunye nokupheliswa kwemiphumo yezilwanyana: ukubuyiswa kwe-metabolism, umsebenzi kunye ne-hemodynamics ye-receptors yezicubu. Izigulane ezinokuphulwa ngokucacileyo komsebenzi wokuzala, zonyango olongezelelweyo lwe-hormone ye-hormone, eyenzelwe ukwandisa amathuba okufakelwa.
Ukulungiselela: izidakamizwa zamachiza (Actovegin)
I-Physiotherapy: magnetotherapy, unyango lwe-electropulse.
Iindlela eziphambili zonyango oluyimpumelelo: ukwehla okukhulu kumsebenzi we-arhente echaphazelayo, ukuxhaswa kwezibonakaliso zeklinikhi zesifo, ukubuyiswa kwe-echography kunye nesakhiwo se-morphological of the tissu, ukuvuselelwa kokuzala.
Amakhandlela ngeCE
Amakhandlela ekunyangeni i-endometritis engapheli asetyenziswa njengeyongeziweyo yendawo yendawo ukuze aphumelele ukubuyisela ngokukhawuleza. Ziyakuthintela ukungcoliswa kwamagciwane ngamachiza ezinobungozi ezibangelwa imvelaphi yokuthatha i-antibiotics, ungavumeli ukuphuhliswa kweengxaki ezinzulu kunye nomonakalo wesibini kwisibeleko ngama-bacterial agents kwi-genitalia engaphantsi.
Ziziphi iimeko iibhandlela ezisetyenziswayo:
- i-endometritis enzima, ehamba ne-vaginal dysbiosis;
- ukuvuvukala komlomo wesibeleko / isisu;
- endometritis engapheliyo;
- ukubambelela kwi-uterine cavity / cavity ye-pelvis encinci.
Iintlobo zesincediso zamaginjini:
- zidibene. Iqulethe: i-Neomycin (i-aminoglycoside antibiotic), i-Ternidazole (isicatshulwa se-antimicrobial), i-Prednisolone (i-agent ye-glucocorticoid), i-Nystatin (i-antifungal drug);
- ne-antiseptic. Amakhandlela nge-betadine (i-ejenti ene-iodine) kunye ne-chlorhexidine (i-antiseptic);
- nezityalo zonyango. Unokuphucula, ukuphilisa, ukulwa ne-antimicrobial, impembelelo echasayo.
Iidemon ze-vaginal suppositories azikwazi ukuthathwa njengeyona ndlela eyona ndlela yokwelapha ye-CHE. Banike kubo kuphela ingcali, ngokuqwalasela isiteji, umfanekiso weklinikhi kunye nenhlalakahle yempilo yowesifazane. Ubude obude bonyango ngamakhandlela ziintsuku eziyi-12-14.
I-postpartum endometritis: iimpawu kunye neyeza
I-postpartum endométritis kukuvuvukala kwe-uterine mucosa eyenzeka emva kokuziswa. Kwi-10-12% yamatyala inkqubo yokuvuvukala ihambela kwisigxina se-muscular of the uterus, eshukumisa ukuphuhliswa kwe-endomyometritis. I-PE ifunyanwe rhoqo - ibangelwa yimilinganiselo yamanani: ukusetyenziswa ngokubanzi kwezixhobo zokuxilonga ezingenayo, ukwanda kwimiba yokuhlinzwa ngexesha lokunikezelwa, ukuqokelela kweengxaki ezinqandekiyo zokulwa namachiza ezincinci kwizibhedlele, ukusetyenziswa kwee-corticosteroids ezibonakaliswe ngamanyathelo omzimba. Waba neenguqu ezinamandla kunye nabafazi abasetyhini - namhlanje abafazi abaneendlela ezahlukeneyo zokungabikho komntwana, kunye ne-pathologies yangaphandle, emva kokulungiswa kwe-hormone ye-miscarriages, kunye nosuleleko lwe-virus, obunomngcipheko ophezulu wokufumana iingxaki ezithintekayo.
I-Endometritis emva kokubeleka - iimpawu ze-symptomatology
Ngomhla ka-5-10 emva kokubeleka, iqondo lokushisa liphakama ukuya kuma-38-39 degrees, i-chill eqinile iqala, ukunyuka kwempsi kuya kwenyuka kuma-85-100 ngeengqungquthela ngomzuzu. Egazini, inani lama-leukocyte kunye nesantya se-sedimentation ye-erythrocyte landa, utywala lwe-uterine kunye ne-spotting zihleliwe. I-endometritis enobukhulu "iqala" ngosuku lwesibini emva kokuhambisa. Kwi-25% yamatyala ikhula emva kwecandelo lesiganeko okanye umsebenzi obanzi. Ubuthathaka, intloko, iintlungu zesisu, i-anorexia, i-chills, i-tachycardia, umkhuhlane ophezulu (ngaphezulu kwama-degrees angama-39). Emva kweentsuku ezingama-1-2, izicwangciso ze-uterine ziba zihlambulukile. I-postpartum endometritis ivame ukuxiliswa yi-paresis yamathumbu, ekhokelela ekungeneni kwe-microbes kwi-peritoneal cavity kunye ne-peritonitis.
Unyango lwe-endometritis yangemva kwesithuba
Ulwaphulo lwe-PE lufanele lube lubanzi, lujolise ekuhlaleni ukugxilwa, ukungahambisani ne-agent echaphazelayo, ukusetyenziswa kwamalungu omzimba kunye nokuxutywa kwe-detoxification. Amacandelo athile enyango yonyango ngokuphindaphindiweyo, i-antibacterial, infusion (infravenous infusion), unyango lwezilwanyana ezinciphisa umbele. Ngamanye amaxesha unyango olukhuselweyo lwe-uterus luboniswa, iintlobo ezinzima ze-endometritis zidinga ukusebenzisa i-plasmapheresis-ukususwa kweengxenye ezingavamile ze-plasma yegazi, i-microbes, i-toxins, i-cryoglobulins. Ukusebenza kwonyango kuqikelelwa kwiintsuku ezingama-7, ngokungabikho kwesiphumo esihle, umbuzo wokususa isibeletho ulungiswa.
Unyango lwe-endometritis kunye nezilwanyana zomntu
Izindlela zabantu zokuphatha i-endometritis zisebenza kakuhle, ukuba zisetyenziselwa emva kokuthintana nodokotela oza kukhetha ukudibanisa kakuhle kweethilebhethi kunye nezilwanyana zomntu.
Ukuxhamla kwemveliso. Thatha isipuni sesinqabileyo seqabunga lamanzi, uthele i-250 milliliters yamanzi abilayo, gxiba iiyure eziyi-12-14. Yenza ukufakelwa kumbilisa, ususe ekushiseni, ugxininise imizuzu eyi-10 ukuya kwimizuzu emibini. Sebenzisa kathathu ngosuku nge-100 milliliters. Ukutya, unokongeza ushukela okanye ubusi. Ukuchasana: ukunyamezela komntu, ukukhulelwa kwegazi, ukukhulelwa.
Ukuqokelela izityalo. Izityalo zonyango ziyabhubhisa usulelo, buyisele ingqibelelo ye-mucosa, yeka inkqubo yokuvuvukala:
- i-valerian ingcambu, i-yarrow, i-mint, i-heather iintyatyambo, amaqabunga e-birch, i-buckthorn bark, amaqabunga ama-blackberry;
- utshani lweengcambu, iingcambu ze-valerian, amaqabunga ama-mint, i-buckthorn bark;
- ingca emsikeni, imifuno ye-tansy, izimpande zelayisorice, aira.
- Umhluzi we-St. John's wort. Thatha i-spoonful enkulu yamacube, uthele iirazi yamanzi abilayo, ubeke umlilo, ubilise imizuzu eyi-15-20, cima. Phuza umhluzi kathathu ngosuku nge-50 milliliters kwisisu esingenalutho.
Ukuxutywa kwefern. Amaqabunga e-tablespoon of fern (ochotshoziweyo) aphuza ama-milliliters ama-250 wamanzi abilayo, agxininise imizuzu engama-15-20, cima. Yidla ama-50-70 milliliters kane ngosuku ngaphambi kokutya. Inkqubo yokonyango imihla 14-21.
Iipampu ezinezenzo zokulwa ne-antibacterial:
- negalikhi. Ukuqhaqhazela kunye nokusuleleka. I-peel i-clove yegalikhi, unqunywe kwiindawo ezi-2-3, udibaniswe kwioli yezolimo, ungene kwi-gauze, ufake iisini ngeeyure eziyi-10-12;
- neoli ye-buckthorn yeoli. Ukukhawuleza ukuphulukisa i-mucosal;
- nesityalo. Soothe kwaye uncedise ukuphiliswa kwesibeletho somzimba. Geza amaqabunga amatsha we-plantain, ugaya, udibanise neoli. Ukuguqula umxube obangelwa kwi-gauze, kufakwa kwisini ngenxa yeeyure eziyi-10-12.
I-Endometritis kunye ne-endometriosis: yintoni umehluko?
Ngaphandle kwamagama afanayo, i-endometriosis kunye ne-endometritis zizifo ezihluke ngokupheleleyo. Ngeempawu zayo, i-endometriosis ifana ne-neoplasms engathandekiyo, ayinxulumene neenkqubo zokuvuvukala kwe-etiology kwi-endometrium, ihluke kuzo ngekliniki kunye ne-laboratory-diagnostic data.
Iintlukwano ezinkulu
I-Endometriosis - ukwakheka kwee-node eziphathekayo, ezifanayo kwisakhiwo kwi-mucosa ye-uterine. Iimfomfom zakha kwimvelaphi yokungaqhelekanga kwe-hormonal, ezikuyo kwingingqi ye-pelvic - ukusuka kwi-uterus kunye nama-ovari ukuya kwisibilini nangomathumbu. I-pathogenesis yesifo ayiqondanga ngokupheleleyo, oogqirha bakholelwa ukuba i-endometriosis inesiphene kwi-immune system. Ngenxa yokuphazamiseka kwe-immune, i-endometrium iyacuthwa. I-Endometritis yinkqubo yokuvuvukala komlenze wesisu osulelayo, okhokelela kwi-endometrial hyperplasia.
Umfanekiso jikelele
Ngexesha lokuya esikhathini kunye ne-endometriosis, i-membrane eqhelekileyo ye-mucous iyanqatshwa, kunye nokuphuma kwegazi iiseli ze-endometriya ziphinde zifake ama-tublopian tubes, zilungele kwaye ziqale ukwahlula, "ukwakha" amathambo amasha kufuphi nokucwangciswa kwi-endometrium. I-node yenziwa - i-endometriosis iyaqhubeka. Ukuveliswa kwenkqubo ye-pathological kwandisa imeko: inani leenombolo zikhula kwi-geometric progression, ubukhulu be-endometrium buncibilika. Nge-endometritis, ngenxa yokwanda okwenene kwinqanaba lomlenze we-uterine, ukunyuka kwexesha lokuya esikhathini kunqunyiwe. Igobolondo ikhutshwe kwaye ibuyiselwe kwezinye iindawo, kunye nokukhulelwa kwamanzi rhoqo.
Iingxaki
I-Endometritis: ingqwalasela yokuvuvukala ingabandakanyi ukuba ukufakwa kwesiqhelo kwe-embryom kwi-endometrium.
I-Endometriosis: i-endometrium ebuthakathaka ilahlekelwa yikhono lokufaka i-embryo ngokwayo kwaye ibambe. Ephaswe kuyo yonke indawo ye-pelvic, iisalathisi zibonakalisa ukulungele ukuthatha "ukuthatha" umntwana, obangela ukungalingani ngokupheleleyo kwiinkqubo zomzimba.
Ngaba ndiyakhulelwa i-endometrium?
Phakathi kwabasetyhini abane-endometritis, i-97% ngabasetyhini / amantombazana eneminyaka yobudala ekuzaleni kuphela abagxininisa ukubaluleka kwesi sifo ngokwempembelelo yayo ekuzaleni. Ngaba ukhulelwe nge-endometrium? Ngokwemfundiso, ewe. Ubumnene be-endometrium kunye nemisebenzi yokuzala zigcinwe kwinqanaba lokuqala lesi sifo ngenxa yobungqina beendlela zokuhlawulela, ukusebenza okuxhomekeke ngqo kumsebenzi wabasebenzi abachaphazelayo, urhulumente wesistim somzimba, kunye nokwanela kwemimiselo ye-hormone.
I-endometritis engapheliyo ne-IVF
Ngokutsho kwe-WHO, ubude bomtshato ongaphantsi kwelizwe lethu linomdla ocacileyo wokunyuka, okhokelela ekunyuseni kwinani leenkqubo eziqhubekayo zokuzalisa. Ngelishwa, ipesenteji yokufakelwa kwe-embrosiyo engenakuphumelela iphezulu kakhulu - ngokwemyinge i-50-60%. Esinye sezizathu eziphambili zokungaphumeleli kweenkqubo ze-IVF yi-pathology ye-endometrium, i-endometritis kuquka. Ukuqhubeka kokuhlala ixesha elide kunye nexesha eliqhelekileyo (ukufumana) iintsholongwane kunye neebhaktheriya kwi-endometrium kubangela ukuguqulwa okukhulu kwesakhiwo sesisu, ukukhusela ukufakelwa okunempilo kunye neentente zeembrusi. Ulwaphulo lokuguqulwa kwe-cyclic kunye nokwanda (ukuhlaziywa kwakhona) kwe-endometrium kuncitshisa ubude bokufakelwa kwempumelelo kwaye kunciphisa ukusebenza kwe-IVF ngokubanzi.
Iimbangela zokungabikho komsebenzi kwi-endometrium:
- umonakalo kumsebenzi we-receptor wesibeleko esinokungasebenzi kakuhle kwemisebenzi ye-hormonal;
- ngaphezu kwezinga eliqhelekileyo le-estradiol, elinomphumo ongalunganga emsebenzini womzimba ophuzi ngexesha lesibini kwisigidi;
- ukuguqulwa kweenqanawa zomoya ezingabandakanyeki nokuxinzezeleka kwengcinezelo;
- ukuphulwa kwegazi oluqhelekileyo kwisibeletho;
- uphuhliso kwi-uterine cavity of adhesions ephazamisa inkqubo yokuqaliswa kwe-oocyte;
- ukutshatyalaliswa komonakalo we-spermatozoa ebanjwe kwisigxina se-uterine;
- ukuguqulwa kwamathambo e-fallopian ngenxa yokufudukela kwintsholongwane kumalungu angummelwane.
Ingozi enkulu kunazo zonke i-ChE, njengoko iqhubeka nomfanekiso wekliniki ephazamisekileyo. Kwi-endometritis enzima, ibhinqa ixhala malunga neempawu ezibonakaliswe ngokucacileyo ezenza ukuba aphendule oogqirha. Ukongezelela, inkqubo enzima, ngokungafaniyo nesigxina, iyaphendula kangcono kunyango.
Inkqubo yokuhlola i-pre-IVF
Izigulane ezinokuhluleka / ukungaphumeleli kwimiba yeembumba kwimbali yabo yezonyango kufuneka zilungiselelwe ukulungiselela ukulungiselela (ukulungiselela ukukhulelwa), ezibandakanya amanyathelo okukhusela, ukuxilonga kunye nokwelapha. Emva kokulungiswa kwangaphambili, ukuphumelela kwemvavanyo yokuqala ye-IVF ngokumalunga nemvelaphi ye-endometritis ngu-45-50% ngokulinganayo.
Amanyathelo oviwo:
- I-ultrasound ye-uterus / appendages, uhlalutyo lwe-bacteriological of aspirate ukusuka kwisibilini se-uterine kunye nokuhlukana kwintsholongwane;
- Uvavanyo lwe-dopplerometry lwee-appendages kunye nesibindi ngokuzimisela ukuhamba kwegazi kwingingqi ye-pelvic;
- ukuvavanya kwimeko yomzimba;
- ukuzimisela kwinqanaba le-hormone ye-pituitary gland, i-thyroid gland; iihomoni zesondo;
- Ukuphononongwa kweempawu ze-biopsy ukungahoywa kwezilwanyana.
Iimpawu ze-IVF kwi-endometrium
Inkxaso yeHormon yeenyanga ezi-3-5. Ukulungiselela kukhethwe ngokuqwalasela idatha yeemvavanyo zebhoratri kunye nobudala bhinqa. Ivumela ukuvuselela ububele be-uterine receptors kwimiphumo ye-hormonal:
- abafazi abanomlinganiselo oqhelekileyo we-endometrium (i-millimitha ezili-8 okanye ngaphezulu) kunye nokujikeleza kwegazi ngokuqhelekileyo kwimida ye-basal imiselwe iDydrogesterone ngaphakathi, 10 mg kabini ngosuku. Inkqubo yokwelashwa - iintsuku ezili-10 (ukususela kumjikelezo we-16 kuya kwe-25 umjikelezo womhla);
- Izigulane ezinobunzima be-endometrili ubukhulu bumelelwe i-Femiston kwipilisi kanye ngosuku (iikhosi ezingama-28) okanye ukunyanga kwesigaba se-hormones (i-Estradiol + Dydrogesterone);
- Abasetyhini abanembali yentlangano yokunciphisa ukuhamba kwegazi kwiinqanawa kunye nokuncipha kobunzima be-endometrium, baqaphele unyango lwe-metabolic kunye nekhosi yokumisa umzimba.
- Ukuchithwa okuqinisekisiweyo kokuhamba kwegazi kudinga unyango olufanelekileyo ngama-anticoagulants, i-antiplatelet agents kunye ne-agent ye-phlebotonic.
- Ekubeni kwintsholongwane ye-pathogenic kwi-uterus inika izidakamizwa ze-antiviral kunye ne-antibacterial.
- Ngenxa yokuphambuka ekusebenzeni kwenkqubo yokuzivikela omzimba, unyango lwe-immunomodulatory lwenziwa.
- Nika iinkqubo zephysotherapy ezikhuthaza ukuhamba kwegazi kunye nokwandisa umzimba wentsholongwane.
I-Endometritis, iimpawu kunye nonyango oluxhomekeka kakhulu kwi-kliniki yomfanekiso-isifo esibi kunye nesichukumisayo, esikhokelela ekungabikho komntwana kunye nokukhulelwa komzimba. Ukuxilongwa ngokukhawuleza, i-regimen yonyango engalunganga ingakhokelela ekuveleni kweefom zentsholongwane jikelele, ngoko kwiimpawu zokuqala ze-alamu mazixubushe ngokukhawuleza ugqirha kwaye uqale izifundo zonyango.