Okuqukethwe
I-Endometritis ingenye yezifo ezivame kakhulu zokuvuvukala kwe-pelvic kwabesifazane. Uma kungekho ukwelashwa okufanele, lesi sifo singangena esigabeni esingapheli futhi sibangele ukungazali.
Ngokuvamile, i-endometritis ukuvuvukala kolwelwesi lwesibeletho (endometrium). Isizathu sokuthuthukiswa kwalesi sifo yizifo ezihlukahlukene ezithathelwanayo ezingena esibelethweni - isikhunta, amagciwane, amagciwane.1. Imvamisa, i-endometritis yenzeka ngokumelene nesizinda sokuncipha okujwayelekile kokuzivikela komzimba.
Izici eziyingozi zokuthuthukiswa kwe-endometritis:
- ukubeletha okuyinkimbinkimbi;
- noma yikuphi ukungenelela emgodini wesibeletho (i-diagnostic and therapeutic curettage, ukukhipha isisu);
- izifo eziphansi zesitho sangasese;
- izifo ezithathelwana ngocansi (njenge-gonorrhea noma i-chlamydia);
- amanye ama-microorganisms (i-microbacteria ye-tuberculous, i-Escherichia coli, i-diphtheria bacillus, i-mycoplasma, i-streptococci, njll.);
- ukungahambisani nemithetho yenhlanzeko eseduze.
Emithini yesimanje, izinhlobo ezinzima nezingapheli zesifo zihlukaniswa.
I-endometritis eyingozi
Kwenzeka ngokuzumayo, ngokuvamile ngokumelene nesizinda sokungenelela esibelethweni. Ibonakala ngezibonakaliso ezicacile zomtholampilo, phakathi kwazo izimpawu zokudakwa komzimba zivelele.
Izimpawu ze-endometritis engapheli:
- ukwanda okubukhali kwezinga lokushisa;
- Ukugodola;
- izinhlungu zokudonsa ngaphansi kwesisu (ubuhlungu bunganikezwa emhlane ophansi, i-coccyx, isifunda se-inguinal);
- ubuthakathaka jikelele;
- ukulahlekelwa ukudla;
- ukukhishwa kwe-purulent vaginal.
I-endometritis engapheli
Ifomu elingapheli lesifo ngokuvamile alibonakali futhi livame ukwenzeka lapho kungabikho ukwelashwa okwanele kokuvuvukala okunamandla.2.
- Ukusabalala kwe-endometritis engapheli akwaziwa kahle. Ngokusho kwabalobi bethu, kusukela ku-1 kuya ku-70% yeziguli ezingenayo inzalo noma ngemva kwemizamo engaphumeleli yokuqeda ukukhulelwa zitholakala ukuthi zine-endometritis engapheli. I-endometritis engapheli ingathathelwana: amagciwane, amabhaktheriya, izifo ezithathelwana ngocansi, kanye ne-autoimmune. Ngemva kokuqedwa kokukhulelwa, kunoma yikuphi, ukuxilongwa "kwe-endometritis engapheli" kwenziwa, - amanothi U-Anna Dobychyna, udokotela wezifo zabesifazane, udokotela ohlinzayo, iphini likadokotela omkhulu we-CER we-REMEDI Institute of Reproductive Medicine.
Izimpawu ze-endometritis engapheli
- ukuphazamiseka kokuya esikhathini;
- ukukhishwa okuncane okuncane ngaphambi nangemva kokuya esikhathini
- ukuntuleka kokukhulelwa nokuphuphuma kwesisu.
Ekhuluma ngokwelashwa kwe-endometritis, i-obstetrician-gynecologist ibeka izidakamizwa ngokusekelwe imbangela yalesi sifo. Kungaba yi-antibacterial, i-hormonal, i-metabolic therapy, i-physiotherapy noma inhlanganisela yezidakamizwa.
Ubude besikhathi sokwelashwa buncike emlandweni. Uma isiguli singenalo ukungenelela emgodini wesibeletho, ukukhipha isisu, khona-ke umjikelezo owodwa wokuya esikhathini wanele ukwelapha i-endometritis nokubeka ukulungiswa kwe-hormonal efanele.
Endabeni yomlando we-gynecological othwele, ukwelashwa kungathatha izinyanga ezingu-2-3.
1. Imithi ye-endometritis kwabesifazane
Ukwelashwa kwe-antibacterial
Esigabeni sokuqala sokwelashwa kwe-endometritis kwabesifazane, ama-antibiotic abanzi asetshenziswa. Uchwepheshe wethu u-Anna Dobychina uphawula ukuthi ukwelapha ngama-antibiotic ngesikhathi sokukhulelwa kuboniswa kuphela ezimweni zokuqinisekiswa kwelabhorethri ye-microbial pathogen emgodini wesibeletho endaweni ebalulekile yomtholampilo.
Ukwelapha i-endometritis kwabesifazane, udokotela angase anikeze ama-antibiotics abanzi ngokungena kwamaseli aphezulu. Lezi zidakamizwa zihlanganisa i-amoxicillin, i-clindamycin, i-gentamicin, i-ampicillin3. Ukwelashwa kunconywa ukuthi kuqale kusukela ngosuku lokuqala lokuya esikhathini.
Izidakamizwa ze-Antifungal
Ukuvimbela i-candidiasis ngokumelene nesizinda sokusetshenziswa kwama-antibiotics, izidakamizwa ze-antifungal zinqunywe: iNystatin, Levorin, Miconazole, Ketoconazole, Itraconazole, Fluconazole nabanye.
Lapho kukhona ukutheleleka ngegciwane ngemuva kokwelashwa ngama-antibiotic, kusetshenziswa izidakamizwa ze-antiviral kanye ne-immunomodulatory, njenge-Acyclovir, Valciclovir, Viferon, Genferon.
2. Amakhandlela e-endometritis
Ukukhethwa kwe-suppositories yangasese kuncike ezimpawu kanye nohlobo lwe-pathogen. Uma usebenzisa ama-suppositories, izithako ezisebenzayo azingeni emathunjini, kodwa zingena ngqo egazini kusuka ku-vagin, okunciphisa ingozi yokuthuthukisa i-dysbacteriosis nemiphumela emibi esibindi.
Esigabeni esibucayi sesifo, kusetshenziswa ama-suppositories e-antibacterial acindezela ukukhiqizwa kwamagciwane. Ekwelapheni uhlobo olungapheli lwe-endometritis, i-anti-inflammatory, immunostimulating, suppositories ye-antiseptic, njenge-Diclofenac, i-Galavit, i-Terdinan, i-Livarol, i-Lidaza nabanye, iphinde inqunywe.
Uhlu olubanzi lwezidakamizwa ezahlukene zisetshenziselwa ukwelapha ukuvuvukala kwesibeletho. Esigabeni esibucayi sesifo, ama-antibacterial e-systemic asetshenziswa. Ama-suppositories ngokuvamile anqunywa njengokwelashwa kwe-adjuvant.
3. Ukwelashwa kwe-metabolic
Ukwelashwa kwe-Metabolic yisigaba sesibili sokwelashwa, okuhloswe ngaso ukuqeda umonakalo wesibili, okuhlanganisa ukuphazamiseka kwe-metabolic. Kunconywa ukusebenzisa amavithamini, ama-antioxidants, i-hepatoprotectors nama-enzyme (Wobenzym, Phlogenzym).
4. I-Physiotherapy
Ngokusho kwe-obstetrician-gynecologist u-Anna Dobychina, ekwelapheni i-endometritis, amasu we-physiotherapy anethonya elikhulu: odonsa, ama-lasers, nama-ultrasounds. Umsebenzi we-physiotherapy kuleli cala ukuthuthukisa ukugeleza kwegazi kwezitho ze-pelvic, ukuthuthukisa izinqubo zokuvuselelwa kwe-endometrium, kanye nokwandisa ukuzivikela komzimba.4.
5. Ukwelashwa ngama-hormone
Ukwelashwa kwama-hormone kwezinye izimo kusetshenziswa ukugcina nokulungisa ukukhula kwe-endometrium. Njengomthetho, kulokhu, izisu zokuvimbela inzalo ezihlangene zinqunywa, isibonelo, i-Regulon ne-Novinet. Lapho uhlela ukukhulelwa, i-progesterone isetshenziswa.
Ukuvimbela i-endometritis
Ukuze uvimbele i-endometritis kwabesifazane, okokuqala, kuyadingeka ukuhlanganyela ekuvimbeleni izifo ezithathelwana ngocansi: ukunciphisa inani lokuya ocansini, sebenzisa amakhondomu, uthathe ama-swabs njalo ngezifo, futhi uma kwenzeka ukutheleleka, thola ukwelashwa okufika ngesikhathi. Futhi isici esibalulekile ukuvimbela ukukhipha isisu, ngakho udinga ukuthatha indaba yokuvimbela inzalo ngokungathi sína.
- Yiqiniso, ukukhulelwa okungakhuli kunzima kakhulu ukukuvimbela, ngakho-ke, uma lokhu kwenzeka, kuyadingeka ukuba ube ngaphansi kokuqondisa okujwayelekile futhi ulandele zonke izincomo ze-obstetrician-gynecologist. Lokhu kuzonciphisa izingozi esikhathini esizayo,” kuphawula u-Anna Dobychyna.
Imibuzo nezimpendulo ezidumile
Imibuzo ethandwayo mayelana ne-endometritis kwabesifazane iyaphendulwa udokotela ohlinzayo, udokotela wezifo zabesifazane we-European Medical Center u-Oleg Larionov.
Yini ebangela i-endometritis?
I-Endometritis ngemva kokubeletha ivame kakhulu. Kubangelwa i-microflora, ngokuvamile engase ibe sesithweni sangasese, kodwa ingangeni endaweni eyinyumba yomgodi wesibeletho ngesikhathi sokubeletha. Nge-endometritis ye-postporal, kunezinhlungu ezinzima ngaphansi kwesisu, ukukhishwa okugcwele kwe-purulent noma okunegazi okuvela endaweni yangasese, izinga lokushisa lomzimba liyakhuphuka, futhi izinga lokushaya kwenhliziyo liyakhuphuka.
I-Endometritis, engahlotshaniswa nokukhulelwa nokubeletha, ngokuvamile iwumphumela wezifo ezithathelwana ngocansi. Ibangelwa i-chlamydia, i-gonorrhea nezinye izifo. Futhi, imbangela ingase ibe ukungenelela kwezokwelapha, isibonelo, ukufakwa kwedivayisi ye-intrauterine, i-hysteroscopy nge-curettage yesibeletho, ukukhipha isisu.
Kungani i-endometritis iyingozi?
I-endometritis yelashwa isikhathi esingakanani?
Imithombo ye:
- Serebrennikova KG, Babichenko II, Arutyunyan NA New ekuxilongweni nasekwelapheni kwe-endometritis engapheli ekungazali. I-gynecology. 2019; 21(1):14-18. https://cyberleninka.ru/article/n/novoe-v-diagnostike-i-terapii-hronicheskogo-endometrita-pri-besplodii
- I-Plyasunova MP, i-Khlybova SV, i-Chicherina EN Ukuhlolwa okuqhathaniswayo kwemingcele ye-ultrasound kanye ne-Doppler ku-endometritis engapheli. Ukuxilongwa kwe-Ultrasonic nokusebenza. 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. I-endometritis engapheli: i-etiology, umtholampilo, ukuxilongwa, ukwelashwa. I-Russian Bulletin ye-obstetrician-gynecologist. 2013; 13(5):21-27. https://cyberleninka.ru/article/n/hronicheskiy-endometrit-puti-resheniya-problemy-obzor-literatury
- I-Nazarenko TA, i-Dubnitskaya LV Amathuba okwelashwa kwe-enzyme ye-endometritis engapheli ezigulini zeminyaka yokuzala. Izinkinga zokukhiqiza kabusha 2007; 13(6):25-28. https://gynecology.orscience.ru/2079-5831/article/view/27873