I-endometritis engapheli kubantu abadala

Iyini i-endometritis engapheli

I-endometritis engapheli ukuvuvukala okungapheli kwe-endometrium (ulwelwesi lwesibeletho). Ukuvuvukala okungapheli kungaphazamisa ukufakwa okuvamile kombungu kanye nokuthuthukiswa kwawo okulandelayo. Ngaphezu kwalokho, ukuvuvukala okuqhubekayo kuqeda umzimba, kungabangela izinkinga ezinkulu.

Ukuhlonza i-endometritis engapheli ngokuvamile kwenziwa ngokuhlolwa kwe-microscopic noma i-histological. Isampula ye-endometrium itholakala ku-biopsy noma ngesikhathi senqubo ye-hysteroscopy. Ngaphansi kwe-microscope, isampula ye-endometrium ingangcoliswa futhi ihlaziywe ukuba khona kwamangqamuzana omzimba okuvuvukala okungapheli aziwa ngokuthi amaseli e-plasma. Isampula ye-endometrial egcwele amaseli e-plasma ibonisa i-endometritis engapheli. Amasiko avela esithweni sangasese sowesifazane noma emlonyeni wesibeletho akusona inkomba ethembekile ye-endometritis engapheli.

Ngaphambi kokuba siqonde ukuvuvukala okungapheli kanye nendima yako ebalulekile empilweni yokuzala, kufanele siqale siqonde ukuthi kuyini ukuvuvukala. Ngokwemvelo yako, ukuvuvukala kuwumzamo wokuzivikela ezifweni, ezintweni ezicasulayo, nokulungisa amangqamuzana alimele. Ukuvuvukala kuyingxenye yokuzivikela komzimba.

Ekuqaleni, ukuvuvukala kunenzuzo. Isibonelo, lapho umzimba wakho uzama ukulwa nokutheleleka okubangelwa amagciwane noma amagciwane. Kodwa-ke, ngezinye izikhathi ukuvuvukala kungabangela ukulimala kwezicubu uma kuba okungapheli. Ingagcinwa ngisho nangemva kokuba imbangela yasekuqaleni isinyamalele. Kulesi simo, ukuvuvukala kungaba yingozi.

Ukuvuvukala kungaba kubi noma kungapheli.

Ukuvuvukala okunamandla. Iqala ngokuzumayo, kungazelelwe futhi ngokushesha iba nzima. Izimpawu nezimpawu zikhona izinsuku ezimbalwa kuphela, kodwa kwezinye zingahlala isikhathi eside.

Kunezibonakaliso ezi-5 eziyinhloko nezimpawu zokuvuvukala okukhulu:

• ubuhlungu - amakhemikhali akhululwa avuselela ukuphela kwezinzwa, okubangela ubuhlungu;
• ubomvu - ukwanda kwegazi endaweni ethintekile kubangela ukubomvu;
• ukushisa - ukwanda kwegazi endaweni ethintekile nakho kuholela ekufudumaleni kwendawo;
• i-edema - kubangelwa ukuvuza koketshezi emithanjeni yegazi yendawo;
• ukungasebenzi.

Ukuvuvukala okunamandla ngokuvamile kulula ukukubona nokwelapha.

Ukuvuvukala okungapheli. Ukuvuvukala okungapheli kusho inqubo ende ehlala izinyanga noma ngisho neminyaka. Lokhu kungase kube ngenxa yokwehluleka ukuqeda okwakubangela ukuvuvukala okunamandla (amagciwane aphikelelayo, angacindezelwa kahle), ukucasuka okungamahlalakhona okungapheli okungapheli, noma lapho isimiso somzimba sokuzivikela ezifweni sihlasela izicubu ezinempilo, sizenza amagciwane ayingozi.

Ukuvuvukala okungapheli kungase kube nzima ukukuhlonza futhi ukwelashwa okuphumelelayo akutholakali ngaso sonke isikhathi.

Ukuvuvukala kuba into eyaziwa kahle enomthelela ekungasebenzi kahle kokuzala, okuhlanganisa izimbangela ezimbalwa ezijwayelekile zokungazali njengesifo sokuvuvukala kwezitho zangasese, i-polycystic ovary syndrome, ukukhuluphala, i-endometriosis, nokulahlekelwa ukukhulelwa okuphindelelayo. Muva nje, ukuvuvukala okungapheli kwe-uterine mucosa kuye kwaba nesithakazelo esikhethekile. Lokhu kubizwa nge-endometritis engapheli.

Izimbangela ze-endometritis engapheli kubantu abadala

Ulwelwesi lwesibeletho lunesibopho sokuthuthukisa ikhono le-embryo lokutshala. Ukukhiqizwa kwe-estrogen ne-progesterone ngamaqanda kubangela izinguquko kulwelwesi lwesibeletho oludingekayo ukuze kufakwe. Izinguquko ezenzeka ku-mucosa yesibeletho ziyinkimbinkimbi kakhulu futhi aziqondi kahle. Ezinye izifundo zikhombe ukuvuvukala okungapheli kwabesifazane abanezimila ezihlulekile. Kukholelwa futhi ukuthi ukuvuvukala kolwelwesi lwesibeletho kungandisa ingozi yokuphuphuma kwesisu.

Kunezimbangela eziningana ze-endometritis futhi iningi lazo lihlotshaniswa nokutheleleka okubangelwa yi-pathogenic noma izitshalo ezingosomathuba. Umlomo wesibeletho, noma imbobo esibelethweni sowesifazane ehlanganisa imbobo yesibeletho nembotshana yangasese, ngokuvamile ivalwa ngamafinyila futhi ivimbela amagciwane ukuba afudukele emgodini we-endometrial. Ama-catheter for intrauterine insemination noma ukudlulisa umbungu adlula i-cervical pylorus futhi angabangela ukutheleleka. Uma isiguli siphuphunyelwa yisisu, umlomo wesibeletho ungase unwebe ukuze uvumele ukukhishwa kwezicubu zombungu oshonile, kodwa ukutheleleka kwamagciwane ngomzila okhuphukayo kungenzeka. Izinsalela ze-placenta kanye nolwelwesi ngemva kokukhulelwa nazo zihlotshaniswa nokutheleleka.

Ngokuvamile, i-endometritis ibangelwa ukutheleleka. Kungaba i-chlamydia, i-gonorrhea, isifo sofuba, noma inhlanganisela yamagciwane avamile esithweni sangasese. Ukuvuvukala kungenzeka kakhulu ngemva kokuphuphunyelwa kwesisu noma ukubeletha, kodwa futhi akuvamile ngemva kokusikwa isikhathi eside noma ukuhlinzwa. Ingozi yokuthuthukisa i-endometritis iphezulu ngemva kokuhlinzwa kwe-pelvic, okwenziwa ngomlomo wesibeletho. Lezi zinqubo zihlanganisa:

• ukuvuvukala kanye nokukhishwa kwesisu ngesikhathi sokukhulelwa;
• i-endometrial biopsy;
• i-hysteroscopy;
• ukufakwa kwe-intrauterine device (IUD);
• ukubeletha (kaningi ngemva kokuhlinzwa kunokubeletha ngesitho sangasese sowesifazane).

I-Endometritis ingenzeka ngesikhathi esifanayo nezinye izifo ze-pelvic.

Izimpawu ze-endometritis engapheli kubantu abadala

Ngaphandle kokweqisa, kungase kungabi nazimpawu. Ngesikhathi sokukhula, izimpawu ezingase zibe khona zingafaka:

• ukuqunjelwa;
• ukopha okungavamile noma ukukhishwa kwesitho sangasese sowesifazane;
• ukungakhululeki ngokunyakaza kwamathumbu (kuhlanganise nokuqunjelwa);
• umkhuhlane ophezulu;
• ukungakhululeki okuvamile, ukukhathazeka, noma ukuzizwa ungaphilile;
• ubuhlungu esiswini esingaphansi noma okhalweni (ubuhlungu esibelethweni).

Ukwelashwa kwe-endometritis engapheli kubantu abadala

Ukwelashwa kuhlanganisa ukususa umthombo wokutheleleka (izinsalela ze-placenta, iqanda le-fetus, ama-hematomas, amakhoyili) okulandelwa inkambo emfushane yama-antibiotics. Kwezinye izimo, "ubufakazi bokwelapha" besibili be-endometrial biopsy kwenziwa ngemva kokuqedwa kwenkambo yemithi elwa namagciwane ukuze kuqinisekiswe i-endometrium evamile. Ukusetshenziswa kwama-antibiotic anamandla kuvame ukusetshenziswa ngaphambi nje kokudluliswa kombungu kuzivumelwano ze-IVF ukuze kukhishwe noma iyiphi i-endometritis encane ngesikhathi sokufakelwa.

Diagnostics

Kukhona ukuhlolwa kwegazi okuyizimpawu ezivamile ezingaqondile zokuvuvukala. Enye yezimpawu ibizwa nge-erythrocyte sedimentation rate (eyaziwa nangokuthi i-ESR). I-ESR ayiwusizo kakhulu ekutadisheni abesifazane abaneminyaka yobudala yokuzala, njengoba ithintwa amazinga e-estrogen.

Olunye umaka olubizwa nge-C-reactive protein noma i-CRP alizimele kumazinga ehomoni, ngakho-ke luyinkomba ethembeke kakhulu yokuvuvukala kwabesifazane. Izinga eliphezulu kakhulu le-CRP (>10) ngokuvamile liyinkomba yokutheleleka okunamandla. Amazinga aphakeme ngokusesilinganisweni angase abe uphawu lokuvuvukala okungapheli okusezingeni eliphansi.

Ulwelwesi lwesibeletho lungabonwa ngokuqondile ngokufaka isibonakude se-fiber optic emgodini wesibeletho. Lokhu kubizwa ngokuthi i-hysteroscopy. Ngezinye izikhathi le ndlela ingasetshenziswa ukuxilonga i-endometritis engapheli. Isibonelo, ukuba khona kwama-micropolyps kuyinkomba ethembekile ye-endometritis engapheli.

I-Hysteroscopy ingasetshenziswa futhi ukuthola isampula noma i-biopsy yolwelwesi lwesibeletho, engabukwa ngesibonakhulu. Olwelweni lwesibeletho, uhlobo olulodwa lwengqamuzana elimhlophe legazi oluwuphawu lokuvuvukala okungapheli amangqamuzana “e-plasma”. Amaseli e-plasma angabonakala ngokubheka ucezu lwesibeletho ngaphansi kwesibonakhulu. Nokho, ngenxa yokuba khona kwamanye amangqamuzana abukeka ngendlela efanayo, akulula ngaso sonke isikhathi ukunquma ukuba khona kwenani elingavamile lamaseli e-plasma. Amaseli e-plasma anomaka endaweni yawo ebizwa ngokuthi i-CD138. Isampula yezicubu ze-endometrial zingangcoliswa ukuze ihlukanise i-CD138. Lena indlela ethembeke kakhudlwana yokuxilonga i-endometritis engapheli.

Ukwelashwa kwesimanje

Uma imbangela ethile yokuvuvukala ingabonakala, ukwelashwa kwembangela kufanele kuholele ekuxazululeni ukuvuvukala okuhambisanayo. Isibonelo, uma ukutheleleka kwebhaktheriya kutholakala, ukwelashwa ngama-antibiotic kungazanywa. Ucwaningo lwakamuva lubonise ukwanda kwamazinga okukhulelwa nokuzalwa lapho abesifazane abanamazinga e-CRP aphakeme kancane bethola i-aspirin yedosi ephansi ngaphambi kokuba bakhulelwe. Nokho, akukho ngcono okwabonwa kwabesifazane abakhuluphele. Ocwaningweni lwezilwane, kuphinde kwatholakala ukuthi ukuchayeka ku-platelet rich plasma (PRP) kucindezela ukukhiqizwa kwamaprotheni athile akhiqizwa olwelweni lwesibeletho ngenxa yokuvuvukala.

Ingabe ukwelashwa ngama-antibiotic e-endometritis engapheli kusebenza ngempela? Ukubuyekezwa kwakamuva kwezifundo ezimbalwa ezibheka ukwelapha i-endometritis engapheli ngama-antibiotics kutholwe ukuthi abesifazane ababenobufakazi bekhambi (ukuhlolwa kabusha kwe-biopsy kwabonisa ukuvuvukala kwakusobala) babenethuba eliphindwe ka-6 lokukhulelwa okuqhubekayo noma ukuzalwa okuphilayo uma kuqhathaniswa nabesifazane abane-endometritis engapheli. engelashwanga.

Ukuvimbela i-endometritis engapheli kubantu abadala ekhaya

Kubalulekile ukunakekela impilo yakho ngokuvakashela udokotela wezifo zabesifazane minyaka yonke. I-Endometritis ingabangelwa izifo ezithathelwana ngocansi (izifo ezithathelwana ngocansi). Ukuvimbela i-endometritis kuma-STIs:

• ukwelapha izifo ezithathelwana ngocansi ngesikhathi esifanele;
• qinisekisa ukuthi abalingani bocansi belashelwa izifo zocansi;
• Zijwayeze imikhuba yocansi ephephile, njengokusebenzisa amakhondomu.

Abesifazane abahlinzwe ngokuhlinzwa banganikezwa ama-antibiotics ngaphambi kwenqubo yokuvimbela izifo.

Imibuzo nezimpendulo ezidumile

Uphendule imibuzo mayelana ne-endometritis engapheli udokotela wezifo zabesifazane, PhD Mikhail Gavrilov.