Chronic endometritis muvanhu vakuru

Chii chinonzi chronic endometritis

Chronic endometritis Kuzvimba kusingaperi kweendometrium (iyo lining yechibereko). Kuzvimba kwenguva refu kunogona kukanganisa kuisirwa kwakajairika kwe "embryo" uye kukura kwayo kunotevera. Mukuwedzera, kuzvimba nguva dzose kunopedza muviri, kunogona kukonzera matambudziko makuru.

Kuzivikanwa kwechirwere che endometritis chinowanzoitwa ne microscopic kana histological kuongorora. Muenzaniso we endometrium unowanikwa kubva kubiopsy kana panguva ye hysteroscopy maitiro. Pasi pemaikorosikopu, sampuli ye endometrium inogona kusvibiswa uye kuongororwa nekuda kwekuvapo kweasingaperi masero ekudzivirira ekudzivirira anozivikanwa se plasma masero. Muenzaniso we endometrial uzere nemaseru eplasma unoratidza chirwere chisingaperi che endometritis. Tsika kubva kumukadzi kana cervix haisi chiratidzo chakavimbika chekusingaperi endometritis.

Tisati tanzwisisa kuzvimba kusingaperi uye basa rayo rakakosha muhutano hwekubereka, tinofanira kutanga tanzwisisa kuti kuzvimba chii. Nemasikirwo awo chaiwo, kuzvimba kuedza kwemuviri kuzvidzivirira pautachiona, zvinoshatirisa, uye kugadzirisa masero anenge akuvadzwa. Kuzvimba chikamu chemhinduro dzemuviri wedziviriro.

Pakutanga, kuzvimba kunobatsira. Semuenzaniso, kana muviri wako uchiedza kurwisa hutachiona hunokonzerwa nemabhakitiriya kana mavhairasi. Nekudaro, dzimwe nguva kuzvimba kunogona kukonzera kumwe kukuvadzwa kwetishu kana kukava kusingaperi. Inogona kuchengetedzwa kunyange mushure mokunge chikonzero chepakutanga chanyangarika. Mumamiriro ezvinhu aya, kuzvimba kunogona kukuvadza.

Kuzvimba kunogona kuva kwakakomba kana kusingaperi.

Acute kuzvimba. Inotanga kamwe kamwe, pakarepo uye nokukurumidza inova yakaoma. Zviratidzo nezviratidzo zviripo kwemazuva mashoma, asi mune dzimwe nguva zvinogona kugara kwenguva refu.

Pane 5 zviratidzo zvikuru uye zviratidzo zveacute kuzvimba:

• kurwadziwa - makemikari anosunungurwa anokurudzira kuguma kwetsinga, izvo zvinokonzera marwadzo;
• tsvuku - kuwedzera kweropa kune nzvimbo yakakanganiswa kunokonzera tsvuku;
• kupisa - kuwedzera kweropa kune nzvimbo yakakanganiswa inotungamirirawo kudziya kwenzvimbo;
• edema - inokonzerwa nekubuda kwemvura kubva mumidziyo yeropa;
• kusagadzikana.

Kuzvimba kwakanyanya kunowanzo kuve nyore kuziva uye kurapa.

Kuzvimba kwenguva refu. Chirwere chisingaperi chinoreva maitiro akareba anotora mwedzi kana makore. Izvi zvinogona kunge zvakakonzerwa nekutadza kubvisa changa chichikonzera kuzvimba kwakanyanya (bhakitiriya rinoramba riripo, rakadzvanyirirwa zvisina kunaka), kushatirwa kwakadzika kunoramba kuripo, kana kuti immune system inorwisa matishu ane hutano, ichifunga kuti kune utachiona hunokuvadza.

Kuzvimba kwenguva refu kunogona kuve kwakaoma kuongororwa uye kurapwa kunoshanda hakuwanzo kuwanikwa.

Kuzvimba kuri kuita chinhu chinonyatso zivikanwa chinokonzera kusashanda zvakanaka kwembereko, kusanganisira zvakati wandei zvinokonzeresa kushaya mbereko senge pelvic kuzvimba chirwere, polycystic ovary syndrome, kufutisa, endometriosis, uye kurasikirwa nemimba. Munguva pfupi yapfuura, kusingaperi kuzvimba kweuterine mucosa kwave kuchinyanya kufarira. Izvi zvinonzi chronic endometritis.

Zvikonzero zvekusingaperi endometritis kune vanhu vakuru

Rudzi rwechibereko rune basa rekugadzira kugona kwe embryo kuisirwa. Kugadzirwa kweesrogen uye progesterone nemaovari kunokonzera shanduko mumucheka wechibereko unodiwa pakuisirwa. Shanduko dzinoitika muuterine mucosa dzakanyanya kuoma uye hadzinzwisisike. Zvimwe zvidzidzo zvakaratidza kuzvimba kusingaperi muvakadzi vane ma implants akakundikana. Zvinotendwawo kuti kuzvimba kwemukati wechibereko kunogona kuwedzera njodzi yekubva pamuviri.

Pane zvakati wandei zvinokonzeresa endometritis uye zvizhinji zvacho zvine chekuita neutachiona hunokonzerwa netogenic flora kana mukana. Muromo wechibereko, kana kuti pakavhurika muchibereko chemukadzi kunobatanidza mhango yechibereko kusikarudzi, kazhinji kacho kakavharwa nemako uye kunodzivirira kuti utachiona husatamire mugomba re<em>endometrial. Macatheter e intrauterine insemination kana embryo transfer bypass cervical pylorus uye anogona kukonzera utachiona. Kana murwere ane pamuviri, muromo wechibereko unogona kuwedzera kuti ubvumire kubudiswa kwemasumbu emucheche akafa, asi hutachiona hwehutachiona nenzira inokwira inogoneka. Zvisaririra zvepa placenta uye membranes mushure mekuzvitakura zvinosanganiswa nehutachiona.

Kazhinji, endometritis inokonzerwa nehutachiona. Inogona kunge iri chlamydia, gonorrhea, tuberculosis, kana musanganiswa wemabhakitiriya akajairika. Kuzvimba kunowanzoitika mushure mekupfupfudzika kana kuzvara mwana, asi zvakare hazvishamisi mushure mekurwadziwa kwenguva refu kana Kesariya. Dambudziko rekuita endometritis yakakura mushure mekuvhiyiwa kwepelvic, iyo inoitwa kuburikidza nemuromo wechibereko. Matanho aya anosanganisira:

• dilatation uye curettage panguva yekubvisa pamuviri;
• endometrial biopsy;
• hysteroscopy;
• kuiswa kwe intrauterine device (IUD);
• kuzvara (kazhinji mushure mechikamu cheKesariya kupfuura kusununguka kwemukadzi).

Endometritis inogona kuitika panguva imwe chete nedzimwe zvirwere zvepelvic.

Zviratidzo zvekusingaperi endometritis kune vanhu vakuru

Kunze kwekuwedzera, panogona kunge pasina zviratidzo. Munguva yekuwedzera, zviratidzo zvinogona kusanganisira:

• bloating;
• kubuda ropa kusingawanzoitiki kana kubuda;
• kusagadzikana nekufamba ura (kusanganisira kuvimbiswa);
• high fever;
• kusagadzikana kwese, kufunganya, kana kusanzwa zvakanaka;
• kurwadziwa mudumbu rezasi kana pelvis (kurwadziwa muchibereko).

Kurapa kwekusingaperi endometritis kune vanhu vakuru

Kurapa kunosanganisira kubvisa chitubu chechirwere (zvisaririra zvepa placenta, fetal egg, hematomas, coils) inoteverwa nekanguva pfupi yemishonga inorwisa mabhakitiriya. Mune zvimwe zviitiko, chechipiri "chiratidzo chekurapa" endometrial biopsy inoitwa mushure mekunge nzira yemishonga inorwisa mabhakitiriya yapera kuti ive nechokwadi che endometrium yakajairika. Kushandiswa kweEmpiric antibiotic kunowanzo shandiswa nguva pfupi isati yaendeswa embryo mumaprotocol eIVF kudzivirira chero endometritis idiki panguva yekuiswa.

Diagnostics

Kune kumwe kuongororwa kweropa izvo zvinowanzoitika zvisiri-chaiyo zviratidzo zvekuzvimba. Chimwe chezvicherechedzo chinonzi erythrocyte sedimentation rate (inozivikanwawo seESR). ESR haina kunyanya kubatsira pakudzidza vakadzi vezera rekubereka, sezvo inobatwa nemazinga eesrogen.

Imwe mucherechedzo inonzi C-reactive protein kana CRP yakazvimirira pamazinga ehomoni, saka chiratidzo chinovimbika chekuzvimba muvakadzi. Iyo yakanyanya CRP level (> 10) kazhinji chiratidzo chechirwere chetachiona. Kukwirisa zvine mwero kungave chiratidzo chekudzika-giredhi kusingaperi kuzvimba.

Rudzi rwechibereko runogona kuonekwa zvakananga nekuisa teresikopu yefiber optic mugomba rechibereko. Izvi zvinonzi hysteroscopy. Dzimwe nguva nzira iyi inogona kushandiswa kuongorora chisingaperi endometritis. Semuenzaniso, kuvapo kwe micropolyps chiratidzo chakavimbika chekusingaperi endometritis.

Hysteroscopy inogonawo kushandiswa kuwana sampuli kana biopsy yemucheka wechibereko, iyo inogona kutariswa pasi pemaikorosikopu. Muchikamu chechibereko, imwe rudzi rwesero jena reropa iro chiratidzo chekuzvimba kusingaperi "plasma" masero. Masero eplasma anogona kuonekwa nekutarisa chidimbu chemukati wechibereko pasi pemaikorosikopu. Zvisinei, nekuda kwekuvapo kwemamwe masero akafanana-anotarisa, hazvisi nyore nguva dzose kuziva kuvapo kwenhamba isina kukwana yemasero eplasma. Maseru eplasma ane mucherechedzo pamusoro wawo unonzi CD138. Sample ye endometrial tissue inogona kusvibiswa kuparadzanisa CD138. Iyi ndiyo nzira yakavimbika yekuongorora chirwere che endometritis.

Mishonga yemazuva ano

Kana chikonzero chaicho chekuputika chinogona kuonekwa, kurapwa kwechikonzero kunofanira kuguma nekugadzirisa kwekuvhiringidza kwakabatana. Semuenzaniso, kana hutachiona hwehutachiona hukawanikwa, kurapa kwemishonga inorwisa mabhakitiriya kunogona kuongororwa. Ongororo ichangoburwa yakaratidza kuwedzera kwepamuviri uye kuberekwa kwemazinga apo vakadzi vane CRP yakakwira mazinga vakagamuchira yakaderera-dose aspirin vasati vava nepamuviri. Zvisinei, hapana kuvandudzika kwakaonekwa muvakadzi vakafutisa. Muchidzidzo chemhuka, zvakaonekwawo kuti kuratidzwa kweplatelet rich plasma (PRP) inodzvinyirira kugadzirwa kwemamwe mapuroteni anogadzirwa mumucheka wechibereko nekuda kwekuzvimba.

Ko kurapwa kwemishonga inorwisa mabhakitiriya yekusingaperi endometritis inoshanda chaizvo? Ongororo ichangoburwa yeongororo dzakati wandei dzakatarisa kurapa chisingaperi endometritis nemishonga inorwisa mabhakitiriya yakawana kuti vakadzi vaive nehumbowo hwekurapa (re-biopsy yakaratidza kuzvimba yaive pachena) vaive mukana ka6 wekuve nemimba inoenderera kana kuberekwa kwehupenyu zvichienzaniswa nevakadzi vane chisingaperi endometritis. iyo isina kurapwa.

Kudzivirirwa kwekusingaperi endometritis muvakuru kumba

Zvakakosha kutarisira hutano hwako nekushanyira gynecologist gore negore. Endometritis inogona kukonzerwa nenjovhera (sexually transmitted infections). Kudzivirira endometritis kubva kuzvirwere zvepabonde:

• kurapa njovhera nenguva;
• iva nechokwadi chokuti vanorara navo varapwa zvirwere zvepabonde;
• Dzidzira tsika dzepabonde dzisina njodzi, dzakadai sekushandisa makondomu.

Vakadzi vanenge vavhiyiwa vanogona kupihwa mishonga inorwisa mabhakitiriya vasati vaitwa kuti vadzivirire zvirwere.

Mibvunzo nemhinduro dzakakurumbira

Akapindura mibvunzo nezve chronic endometritis gynecologist, PhD Mikhail Gavrilov.