Mukati
Epididymitis ironda rekuzvimba rekuumbwa kwakakosha rinoita sechubhu nhete iri pamusoro uye kuseri kwechembere uye inoshanda kukurudzira nekuibva spermatozoa - epididymis (epididymis).
Epididymitis inowanzoitika muvarume vane makore 19 - 35 makore. Pathology pazera rino ndicho chikonzero chinowanzokonzera kuchipatara. Zvishoma zvishoma, chirwere ichi chakanyorwa kune vakwegura, uye epididymitis inenge isingamboitike muvana.
Mhando uye zvikonzero zve epididymitis
Chirwere chacho chinogona kuva nezvikonzero zvakasiyana-siyana, zvose zvinotapukira (nekuda kwehutachiona hwehutachiona hwehutachiona, mabhakitiriya, fungi), uye husina hutachiona. Bacterial epididymitis ndiyo inonyanya kuzivikanwa. Zvinotendwa kuti kune vechidiki (15 - 35 makore), chirwere chacho chinowanzotsamwiswa nezvirwere zvepabonde (STIs), zvakadai sechlamydia, gonorrhea, etc. Muvakwegura nevana, dambudziko rinosanganiswa nehutachiona hunowanzokonzera. zvirwere zveurinary system (semuenzaniso, enterobacteria). Chikonzero che epididymitis chinogonawo kuve chakananga pathologies, senge tuberculous (tuberculous epididymitis), nezvimwewo.
Dzimwe nguva a conditionally pathogenic (inogara iripo mumuviri, asi isingawanzo kutungamira kuchirwere) fungus yerudzi Candida inova iyo causative mumiriri weiyo pathology, vobva vataura nezvecandidal epididymitis. Muchiitiko ichi, kushandiswa kusina musoro kwemishonga inorwisa mabhakitiriya, kuderera kwekudzivirira, kunogona kukonzera kukura kwechirwere.
Zvichida kuitika kwechirwere chechirwere mu epididymis inopesana nemashure e: • mumps ("mumps") - kuputika kweparotid glands; • angina; • furuwenza; • chirwere chemabayo; • kunyanya kazhinji zvirwere zvenhengo dziri pedyo - urethritis (chirwere chechirwere chegomba), vesiculitis (seminal vesicles), prostatitis (prostate gland), nezvimwewo.
Dzimwe nguva hutachiona hunopindawo mu appendage semugumisiro wemamwe manipulations: endoscopy, catheterization, bougienage ye urethra (nzira yekuongorora inoitwa nekuisa chimbo chakakosha - bougie).
Epididymitis isiri-infectious, somuenzaniso, inogona kuitika: • kana ichirapwa nemishonga yakadai seAmiodarone ye arrhythmias; • mushure mekuita sterilization nekubvisa / kusungirirwa kwevas deferens (nekuda kwekuunganidza unresorbed spermatozoa) - granulomatous epididymitis.
Kune acute (nguva yechirwere haipfuuri mavhiki matanhatu) uye epididymitis isingaperi, iyo inoratidzirwa nechirwere chikuru chezvose zviri zviviri, kazhinji inokura netuberculous maronda, syphilis (nguva inopfuura mwedzi mitanhatu).
Zvichienderana nekuoma kwekuratidzwa, epididymitis yakapfava, ine mwero uye yakaoma inosiyaniswa.
Risk Factors
Sezvo epididymitis kazhinji kazhinji mhedzisiro yenjovhera, njodzi huru yekukura kwechirwere chegomarara ibonde risina kudzivirirwa. Dzimwe nguva dzinokurudzira: • kukuvara kwechiuno, perineum, scrotum, kusanganisira semugumisiro wekuvhiya (adenomectomy, nezvimwewo); • kukanganisa mukugadzirwa kweurogenital system; • kukanganisa kwemaitiro eurinary tract (tumor, prostate hyperplasia, nezvimwewo); • kupindira kwekuvhiya kwemazuva ano panhengo dzeurinary; • kushandiswa kwezvokurapa - kukurudzirwa kwemagetsi (apo ma-multidirectional contractions e-vas deferens anoitika, izvo zvinogona kutsamwisa "kuyamwa" kwema microbes kubva muurethra), kuiswa kwemishonga mu urethra, catheterization, massages, nezvimwewo; • prostate hyperplasia; • hemorrhoids; • kusimudza uremu, kushungurudzika kwemuviri; • kakawanda coitus interruptus, erections pasina kusangana; • kuderera kwekudzivirirwa kwemuviri semugumisiro wechirwere chakakomba (chirwere cheshuga, AIDS, nezvimwewo), hypothermia, kupisa, nezvimwewo.
Zviratidzo zve epididymitis
Kutanga kwechirwere kunozviratidza sezviratidzo zvakakomba, izvo, kana pasina kurapa kwakakwana, kunowedzera kuipa. Ne epididymitis, panogona kuva ne: • marwadzo asina kusimba kune rumwe rutivi rwe scrotum / mu testicle neine irradiation kune groin, sacrum, perineum, pasi kumashure; • kurwadziwa kwakanyanya munzvimbo yakakanganiswa; • kurwadziwa kwepelvic; • tsvuku, kuwedzera kwekushisa kwenzvimbo ye scrotum; • kuputika / kuwedzera muhukuru, induration ye appendage; • tumor-yakafanana kuumbwa mu scrotum; • chills uye fever (kusvika ku39 degrees); • kuderera kwehutano huzhinji (kushaya simba, kurasikirwa kwechido, misoro); • kuwedzera mu inguinal lymph nodes; • kurwadziwa panguva weti, defecation; • kuwedzera weti, kamwe-kamwe kukurumidza; • kurwadziwa panguva yepabonde uye ejaculation; • kuonekwa kweropa muurume; • kubuda kubva kunhengo yesikarudzi.
Chiratidzo chekuongorora ndechekuti kukwidziridzwa kwe scrotal kunogona kutungamirira kukusununguka kwechiratidzo (positive Pren's sign).
Muchirwere chisingaperi chechirwere, zviratidzo zvechinetso zvinogona kunge zvisinganyanyi kutaurwa, asi kusuruvara uye kuwedzera kwe scrotum, uye kazhinji kacho kunowanzoita weti, kunopfuurira.
Zvakakosha! Kurwadziwa kwakanyanya mumachende chiratidzo chekurapwa nekukurumidza!
Nzira dzekuongorora uye kuona chirwere
Chiyero chekutanga chekuongorora mukuita kuongororwa ndeyekuongorora kwechiremba kwerutivi rwakakanganiswa rwechecheche, lymph nodes mugoro. Kana epididymitis nekuda kwekuwedzera kweprostate ichifungidzirwa, rectal kuongorora kunoitwa.
Uyezve, nzira dzemurabhoritari dzinoshandiswa: • smear kubva muurethra kuti iongorore microscopic uye kuparadzanisa causative agent yeSTIs; • PCR diagnostics (kuonekwa kwepathogen ne polymerase chain reaction); • kuongororwa kwekliniki uye biochemical yeropa; • urinalysis (yakajairwa, "3-mukombe bvunzo" nekutevedzana weti mumakapu matatu, kudzidza tsika, nezvimwewo); • kuongororwa kweseminal fluid.
Instrumental diagnostics inosanganisira zvinotevera: • Ultrasound ye scrotum kuti ione maronda, danho rekuputika, maitiro emamota, kuongorora kwekufamba kweropa velocity (Doppler study); • kuongorora nyukliya, umo chidimbu chiduku chechinhu chinopisa chinoshandiswa uye kubuda kweropa mumachende kunoongororwa uchishandisa midziyo yakakosha (inobvumira kuongorora epididymitis, testicular torsion); • cystourethroscopy - sumo kuburikidza neurethra yechiridzwa che optical, cystoscope, kuongorora nzvimbo dzemukati dzenhengo.
Computed tomography uye magnetic resonance imaging hazvinyanyi kushandiswa.
Kurapa kwe epididymitis
Kurapa kwe epididymitis kunoitwa zvakanyanya pasi pekutariswa kwenyanzvi - urologist. Mushure mekuongororwa, kuzivikanwa kwepathogen, pane kureba, kusvika kumwedzi kana kupfuura, nzira yemishonga inorwisa mabhakitiriya inorayirwa.
Kugadzirira kunosarudzwa zvichifunga nezvekunzwa kwepathogenic microorganism, kana rudzi rwepathogen harungagoni kusimbiswa, ipapo bhati-spectrum antibacterial agent inoshandiswa. Mishonga mikuru yekusarudza epididymitis, kunyanya pamberi pezvimwe zvirwere kubva kune urogenital system uye kune vechidiki, mishonga inorwisa mabhakitiriya yeboka re fluoroquinolone. Tetracyclines, penicillins, macrolides, cephalosporins, sulfa mishonga inogonawo kurongerwa. Mumamiriro ezvinhu apo chirwere chinokonzerwa nenjovhera, nzira imwe chete yekurapa nemurwere wepabonde inodiwa.
Uyewo, kuti asunungure nzira yekuzvimba uye kubvisa marwadzo, chiremba anokurudzira kwete-steroidal anti-inflammatory drugs (yakadai se indomethacin, nimesil, diclofenac, nezvimwewo), nekurwadziwa kwakanyanya, kuvharwa kwenovocaine ye spermatic cord kunoitwa. Inogona kuwedzerwa kukurudzirwa: • kutora mavitamini; • physiotherapy; • enzymatic, absorbable (lidase) uye mamwe magadzirirwo.
Nechirwere chinyoro chechirwere, kuchipatara hakudiwi, asi kana mamiriro acho akawedzera (kupisa kunokwira pamusoro pe 39 degrees, kudhakwa kwese kuratidzwa, kuwedzera kukuru kwe appendage), murwere anotumirwa kuchipatara. Kana pasina mhedzisiro, imwe antibiotic inogona kudiwa. Kana chirwere chacho chikaramba chiripo, kunyanya nemakumbo maviri, pane kusava nechokwadi kwechimiro chechirwere chechirwere chetachiona. Mumamiriro ezvinhu akadaro, kubvunzurudza phthisiourologist kunodiwa uye, pakusimbiswa kwekuongororwa, kugadzwa kwemishonga inorwisa-tuberculosis chaiyo.
Kurapa kwechimiro chisingaperi kunoitwa nenzira yakafanana, asi inotora nguva yakareba.
Mukuwedzera pakutora mishonga, murwere anofanira kutevedzera mitemo inotevera: • cherechedza zororo remubhedha; • kupa nzvimbo yakakwirira ye scrotum, semuenzaniso, kuburikidza netauro rakamonwa kuita roller; • kusabvisa zvinorema; • kunyatsocherechedza kuzorora kwakakwana kwepabonde; • kusabvisa kushandiswa kwezvinonhuwira, zvokudya zvine mafuta; • chengetedza kunwa mvura yakakwana; • shandisa inotonhorera compresses / ice kune scrotum kubvisa kuzvimba; • kupfeka suspensorium - bhanhire rakakosha rinotsigira scrotum, iyo inochengetedza iyo yose ye scrotum, inodzivirira kubva pakuzununguka pakufamba; • kupfeka tight elastic shorts, kushambira trunks (inogona kushandiswa kusvikira zviratidzo zvinorwadza zvapera).
Sezvo mamiriro acho achivandudza, chiedza chekudzidzira muviri chinobvumirwa: kufamba, kumhanya, kunze kwebhasikoro. Zvakakosha kudzivirira general and local hypothermia panguva yekurapa chikamu uye pakupera kwayo.
Mushure mekupedza chirongwa chemishonga inorwisa mabhakitiriya, mushure memavhiki matatu, unofanira kubvunza chiremba kuti uongorore zvakare (weti, ejaculate) kuitira kusimbisa kubviswa kwakakwana kwehutachiona.
Mishonga yechivanhu inogona kushandiswa chete sekuwedzera kune iyo huru yekurapa kosi uye chete mushure memvumo yeanoenda chiremba. Varapi vechivanhu vane epididymitis vanokurudzira kushandisa decoctions kubva: • lingonberry leaf, tansy maruva, horsetail; • nettle mashizha, mint, linden blossom uye mamwe magadzirirwo emishonga.
Nekuvandudzwa kwedambudziko rakadaro se purulent abscess, kuvhurwa kwekuvhiya kwe suppuration kunoitwa. Mumamiriro ezvinhu akaoma, zvingave zvakakosha kubvisa chikamu kana zvose zvakakanganiswa appendage. Mukuwedzera, kuvhiyiwa kunoshandiswa ku: • kugadzirisa kusakanganiswa kwemuviri kunokonzera kukura kwe epididymitis; • kana zvichifungidzirwa kuti testicular torsion/attachment (hydatids) ye epididymis; • mune mamwe mamiriro ezvinhu ane tuberculous epididymitis.
Matambudziko
Sezvo mutemo, epididymitis inobatwa zvakanaka nemishonga inorwisa mabhakitiriya. Zvisinei, mukusavapo kwehutano hwakakwana, zvinetso zvinotevera zvinogona kukura: • kuchinja kwechirwere kune chimiro chisingaperi; • kuitika kwemaviri maviri; • orchiepididymitis - kupararira kwemaitiro ekuputika kune testicle; • testicular abscess (purulent, zvishoma kuzvimba kwezviviri zvenhengo); • kukura kwekunamatira pakati pe testicle uye scrotum; • testicular infarction (tissue necrosis) semugumisiro wekusagadzikana kweropa; • atrophy (kuderera kwezviyero zve volumetric, zvichiteverwa nekuputsika kwekugadzirwa kwembeu uye kuderera kwekugadzirwa kwe testosterone) ye testicles; • kuumbwa kwefistulas (yakamanikana pathological canals ine purulent discharge) mu scrotum; • Kushaya mbereko imhaka yezvose zviri zviviri kudzikira kwekugadzirwa kwembeu uye kuumbwa kwezvipingamupinyi kuti ienderere mberi zvakanaka.
Kudzivirira epididymitis
Matanho makuru ekudzivirira epididymitis anosanganisira: • mararamiro ane hutano; • bonde rakachengeteka; • akarayira hupenyu hwepabonde; • kuonekwa nenguva uye kubviswa kwezvirwere zvinowanzoitika weti; • kudzivirira kukuvadzwa kwemachende (kupfeka midziyo yekudzivirira paunenge uchiita mitambo inoshungurudza); • kuchengetwa kwezvinodiwa zvehutsanana hwemunhu; • kubviswa kwekupisa, hypothermia; • kudzivirira / kurapa kwakakwana kwezvirwere zvinotapukira (kusanganisira vaccination against mumps), nezvimwewo.