Mukati
Endometritis ndechimwe chezvirwere zvinotapukira zvepelvic muvakadzi. Mukusavapo kwekurapa kwakakodzera, chirwere chinogona kupinda muchikamu chisingaperi uye chinokonzera kusabereka.
Kazhinji, endometritis kuzvimba kwemukati wechibereko (endometrium). Chikonzero chekukura kwechirwere chetachiona chakasiyana-siyana chinotapukira chinopinda muchibereko - fungi, mabhakitiriya, mavhairasi.1. Kazhinji, endometritis inoitika pakatarisana nekuderera kwekuderera kwekudzivirira.
Zvinhu zvine njodzi pakukura kwe endometritis:
- kubereka kwakaoma;
- chero kupindira mu uterine cavity (diagnostic uye therapeutic curettage, kubvisa pamuviri);
- kuderera kwehutachiona hwepabonde;
- zvirwere zvepabonde (zvakadai segonorrhea kana chlamydia);
- mamwe ma microorganisms (tuberculous microbacteria, Escherichia coli, diphtheria bacillus, mycoplasma, streptococci, nezvimwewo);
- kusatevedzera mitemo yehutsanana hwepedyo.
Mukurapa kwemazuva ano, maitiro akaoma uye asingagumi echirwere anosiyaniswa.
Acute endometritis
Inoitika kamwe kamwe, kazhinji inopesana nemashure ekupindira muchibereko. Iyo inoratidzirwa neyakajeka kuratidzwa kwekiriniki, pakati peiyo zviratidzo zvekudhakwa kwemuviri zvakanyanya.
Zviratidzo zve acute endometritis:
- kuwedzera kwakanyanya kwekushisa;
- kutonhora;
- kudhonza marwadzo muzasi mudumbu (marwadzo anogona kupiwa kuzasi, coccyx, inguinal region);
- Kazhinji kushaya simba;
- kurasikirwa nenzara;
- purulent vaginal discharge.
Chronic endometritis
Chirwere chisingaperi chechirwere chinowanzova chisingaiti uye chinowanzoitika kana pasina kurapwa kwakakwana kwekuputika kwakanyanya.2.
- Kuwanda kwechirwere che endometritis hachinyatsozivikanwa. Maererano nevanyori vedu, kubva pa1 kusvika ku70% yevarwere vane infertility kana mushure mekuedza kusina kubudirira kubvisa pamuviri vanoonekwa kuti vane endometritis isingaperi. Chronic endometritis inogona kutapukira: mavhairasi, mabhakitiriya, zvirwere zvepabonde, uyewo autoimmune. Mushure mokubvisa pamuviri, chero zvakadaro, kuongororwa kwe "chronic endometritis" kunoitwa, - zvinyorwa Anna Dobychyna, obstetrician-gynecologist, chiremba wokuvhiya, mutevedzeri mukuru weCER yeREMEDI Institute of Reproductive Medicine.
Zviratidzo zvekusingaperi endometritis
- kuvhiringidzika kwekuenda kumwedzi;
- mvura shoma shoma pamberi uye mushure mekuenda kumwedzi
- kushaya pamuviri uye kubva pamuviri.
Kutaura nezvekurapa kwe endometritis, chiremba-gynecologist anorayira zvinodhaka zvichienderana nechikonzero chechirwere. Inogona kuva antibacterial, hormonal, metabolic therapy, physiotherapy kana yakaoma yemishonga.
Nguva yekurapa inobva pane zvakaitika kare. Kana murwere asina kupindira mu uterine cavity, kubvisa pamuviri, ipapo imwe nguva yekuenda kumwedzi yakakwana kurapa endometritis uye kugadza zvakakodzera hormonal kugadzirira.
Muchiitiko chenhoroondo yakaremerwa yegynecological, kurapwa kunogona kupedza mwedzi 2-3.
1. Mishonga ye endometritis muvakadzi
Antibacterial therapy
Pachikamu chekutanga chekurapa kwe endometritis muvakadzi, maantibioti e-broad-spectrum anoshandiswa. Nyanzvi yedu Anna Dobychina anocherekedza kuti kurapa kwemishonga inorwisa mabhakitiriya panguva yekuzvitakura kunoratidzwa chete muzviitiko zverabhoritari kusimbiswa kweiyo microbial pathogen mu uterine cavity mune yekiriniki yakakosha titer.
Kurapa endometritis muvakadzi, chiremba anogona kupa mishonga inorwisa mabhakitiriya yakakura nepamusoro-soro yekupinda. Mishonga iyi inosanganisira amoxicillin, clindamycin, gentamicin, ampicillin3. Kurapa kunokurudzirwa kutanga kubva pazuva rokutanga rokuenda kumwedzi.
Antifungal zvinodhaka
Nekudzivirira kwecandidiasis pamusoro pekushandiswa kwemishonga inorwisa mabhakitiriya, mishonga inorwisa mabhakitiriya inorayirwa: Nystatin, Levorin, Miconazole, Ketoconazole, Itraconazole, Fluconazole nevamwe.
Muhupo hwehutachiona hwehutachiona mushure memishonga inorwisa mabhakitiriya, antiviral uye immunomodulatory zvinodhaka zvinoshandiswa, zvakadai seAcyclovir, Valciclovir, Viferon, Genferon.
2. Makenduru e endometritis
Kusarudzwa kwevaginal suppositories kunoenderana nezviratidzo uye rudzi rwepathogen. Paunenge uchishandisa suppositories, iyo inoshandiswa inoshandiswa haipindi mumatumbo, asi inotorwa zvakananga muropa kubva kumudzimai, izvo zvinoderedza dambudziko rekuita dysbacteriosis uye migumisiro yakaipa pachiropa.
Muchikamu chakaoma chechirwere, antibacterial suppositories inoshandiswa inodzvinyirira kubereka kwezvirwere. Mukurapa kwechimiro chisingaperi che endometritis, anti-inflammatory, immunostimulating, antiseptic suppositories, yakadai seDiclofenac, Galavit, Terdinan, Livarol, Lidaza nevamwe, inowedzerwa.
Mishonga yakawanda yakasiyana-siyana inoshandiswa kurapa kuzvimba kwechibereko. Muchikamu chechirwere chechirwere, systemic antibacterial agents inoshandiswa. Suppositories inowanzo kurongerwa seadjuvant kurapwa.
3. Metabolic therapy
Metabolic therapy ndiyo yechipiri nhanho yekurapa, iyo ine chinangwa chekubvisa chechipiri kukuvara, kusanganisira metabolic kusagadzikana. Inokurudzirwa kushandisa mavitamini, antioxidants, hepatoprotectors uye enzymes (Wobenzym, Phlogenzym).
4. Physiotherapy
Maererano neobstetrician-gynecologist Anna Dobychina, mukurapa endometritis, physiotherapy maitiro ane simba guru: magineti, lasers, uye ultrasounds. Basa re physiotherapy munyaya iyi nderekuvandudza kubuda kweropa kwenhengo dzepelvic, kuvandudza nzira dzekuvandudzwa kwe endometrium, pamwe nekuwedzera kudzivirira kwemuviri.4.
5. Hormone therapy
Hormone therapy inoshandiswa mune dzimwe nguva kuchengetedza uye kugadzirisa kukura kwe endometrium. Sezvo mutemo, munyaya iyi, zvinosanganiswa zvekudzivirira pamuviri zvinorayirwa, somuenzaniso, Regulon uye Novinet. Pakuronga kubata pamuviri, progesterone inoshandiswa.
Kudzivirira endometritis
Kuti udzivise endometritis muvakadzi, kutanga kwezvose, zvakakosha kuita kudzivirira zvirwere zvepabonde: kuderedza nhamba yepabonde, kushandisa makondomu, nguva dzose kutora swabs kune zvirwere, uye kana pane utachiona, kurapwa panguva yakakodzera. Uyewo chinhu chakakosha ndechekudzivirira kubvisa pamuviri, saka unoda kutora nyaya yekudzivirira pamuviri zvakanyanya.
- Ehe, nhumbu isiri kukura yakanyanya kuoma kudzivirira, saka, kana izvi zvikaitika, zvinodikanwa kuti ugare uchitariswa uye uteedzere zvese zvinokurudzirwa neabstetrician-gynecologist. Izvi zvichaderedza njodzi mune ramangwana,” anodaro Anna Dobychyna.
Mibvunzo nemhinduro dzakakurumbira
Mibvunzo yakakurumbira pamusoro pe endometritis muvakadzi inopindurwa chiremba anovhiya, obstetrician-gynecologist weEuropean Medical Center Oleg Larionov.
Chii chinokonzera endometritis?
Endometritis mushure mokuberekwa kwemwana inowanzoitika. Inokonzerwa ne microflora, iyo inowanzova mukati memukadzi, asi haipindi munzvimbo isina kuchena ye uterine cavity panguva yekusununguka. Ne postporal endometritis, kune marwadzo akakomba mudumbu rezasi, akawandisa purulent kana kubuda ropa kubva kunhengo yesikarudzi, tembiricha yemuviri inokwira, uye kurova kwemoyo kunowedzera.
Endometritis, isingabatanidzi kubata pamuviri uye kubereka, inowanzova mugumisiro wezvirwere zvepabonde. Inokonzerwa nechlamydia, gonorrhea uye zvimwe zvirwere. Uyewo, chikonzero chinogona kunge chiri kupindira kwezvokurapa, somuenzaniso, kuiswa kwechigadzirwa che intrauterine, hysteroscopy ne curettage yechibereko, kubvisa pamuviri.
Sei endometritis ine ngozi?
Endometritis inorapwa kwenguva yakareba sei?
Zvitubu zve:
- Serebrennikova KG, Babichenko II, Arutyunyan NA Itsva mukuongororwa uye kurapwa kwekusingaperi endometritis mukushaya mbereko. 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 Kuenzanisa kuongorora kwe ultrasound uye Doppler parameters mune chisingaperi endometritis. Ultrasonic uye inoshanda 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. Chronic endometritis: etiology, kiriniki, kuongororwa, kurapwa. Russian Bulletin ye obstetrician-gynecologist. 2013; 13(5):21-27. https://cyberleninka.ru/article/n/hronicheskiy-endometrit-puti-resheniya-problemy-obzor-literatury
- Nazarenko TA, Dubnitskaya LV Mikana ye enzyme therapy yekusingaperi endometritis mune varwere vezera rekubereka. Matambudziko ekubereka 2007; 13(6):25-28. https://gynecology.orscience.ru/2079-5831/article/view/27873