I-Endometriosis yesibeletho - iyini nokuthi ungayiphatha kanjani?

I-Endometriosis yesibeletho: kuyini ngolimi olufinyelelekayo?

Inkinga ye-endometriosis yesibeletho ibaluleke kakhulu emithini yesimanje. Lokhu kungenxa yokuthi imvamisa yalesi sifo iyanda unyaka nonyaka. Ngokwezibalo, kusukela ku-5 kuya ku-10% yabesifazane abasebasha emhlabeni wonke bahlushwa i-endometriosis. Phakathi kweziguli ezitholwe zinesinyumba, i-endometriosis ivame kakhulu: ku-20-30% yamacala.

endometriosis - lokhu ukusabalala kwe-pathological kwezicubu ze-glandular zesibeletho, okuyinto enhle. Amaseli asanda kwakhiwa afana ngokwakheka nokusebenza kumaseli e-endometrium yesibeletho, kodwa ayakwazi ukuba khona ngaphandle kwayo. Ukukhula (i-heterotopias) okuye kwavela kuhlale kwenzeka izinguquko ze-cyclic, ezifana nalezo zinguquko ezenzeka njalo ngenyanga nge-endometrium esibelethweni. Banamandla okungena ezicutshini ezingomakhelwane ezinempilo futhi bakhe ukunamathela lapho. Ngokuvamile i-endometriosis ihambisana nezinye izifo ze-etiology ye-hormonal, isibonelo, i-uterine fibroids, i-GPE, njll.

I-Endometriosis yisifo se-gynecological, esihambisana nokwakheka kwama-benign nodes anesakhiwo esifanayo nolwelwesi lwangaphakathi lwesibeletho. Lawa ma-node angatholakala kokubili esibelethweni ngokwaso nangaphandle kwesitho. Izinhlayiya ze-endometrium, okuthi njalo ngenyanga zinqatshwe udonga lwangaphakathi lwesibeletho ngesikhathi sokuphuma kwegazi, zingase zingaphumi ngokuphelele. Ngaphansi kwezimo ezithile, ezinye zazo zihlala kumashubhu e-fallopian, kanye nezinye izitho, futhi ziqala ukukhula, okuholela ku-endometriosis. Abesifazane ababhekana nokucindezeleka njalo basengozini yokuthola lesi sifo.

Ngesifo, i-endometrium ikhula lapho kungafanele ibe khona ngokuvamile. Ngaphezu kwalokho, amangqamuzana angaphandle kwesibeletho aqhubeka esebenza ngendlela efanayo nasemgodini wayo, okungukuthi, ukwanda ngesikhathi sokuya esikhathini. Imvamisa, i-endometriosis ithinta ama-ovari, amashubhu e-fallopian, i-ligamentous apparatus yesibeletho, kanye nesinye. Kodwa ngezinye izikhathi i-endometriosis itholakala ngisho nasemaphashini kanye nolwelwesi lwamafinyila lomgodi wamakhala.

Izizathu zokuthuthukiswa kwe-endometriosis

I-Endometriosis ingabizwa ngokuthi isifo esine-etiology engachazwanga. Kuze kube manje, odokotela abakakwazi ukuthola imbangela eqondile yokuvela kwayo. Kunemibono yesayensi kuphela ngale ndaba, kodwa ayikho neyodwa yazo efakazelwe. Kukholelwa ukuthi izici eziyingozi zokuthuthukiswa kwe-endometriosis yizifo ezivame ukuhlushwa ebuntwaneni, ukungalingani kwe-hormonal emzimbeni, ukuvuvukala kwama-ovari. Njengoba kushiwo, i-endometriosis ivame ukuhlotshaniswa ne-uterine fibroids.

Ithiyori ye-retrograde menstruation kuze kube manje ithole impendulo enkulu phakathi kochwepheshe abahilelekile ocwaningweni lwenkinga ye-endometriosis. I-hypothesis ibilisa eqinisweni lokuthi ngesikhathi sokuphuma kwegazi, izinhlayiya ze-uterine mucosa ngokugeleza kwegazi zingena emgodini we-peritoneal kanye namashubhu e-fallopian, zihlale lapho futhi ziqale ukusebenza. Nakuba igazi lokuya esikhathini eliphuma esibelethweni ngesitho sangasese sowesifazane lingena endaweni yangaphandle, igazi elikhiqizwe izinhlayiya ze-endometrial ezithathe izimpande kwezinye izitho aziyitholi indlela yokuphuma. Ngenxa yalokho, ama-microhemorrhages ayenzeka njalo ngenyanga endaweni ye-endometriosis foci, ehlanganisa izinqubo zokuvuvukala.

Eminye imibono egqamisa izimbangela ze-endometriosis yilena elandelayo:

• i-implantation hypothesis. Ibilisa eqinisweni lokuthi izinhlayiya ze-endometrial zifakwe ezicubu zezitho, zifika lapho ngegazi lokuya esikhathini.

• i-metaplastic hypothesis. Kubilisa eqinisweni lokuthi amangqamuzana e-endometrial awagxili ezindaweni ezingavamile kubo, kodwa avuselela izicubu ezinguqukweni ze-pathological (ku-metaplasia).

Kodwa-ke, kuze kube manje ayikho impendulo yombuzo oyinhloko: kungani i-endometriosis ikhula kuphela kwabanye besifazane, hhayi kubo bonke ubulili obuhle. Ngemuva kwakho konke, ukubuyela emuva kokuya esikhathini kubonakala kulowo nalowo kubo.

Ososayensi basikisela ukuthi i-endometriosis ikhula kuphela lapho kukhona lezi zinto ezilandelayo eziyingozi:

• Ukuphazamiseka kwamasosha omzimba emzimbeni.

• Ufuzo ekuthuthukiseni lesi sifo.

• Isakhiwo esithile se-appendages, okuholela egazini eliningi elingena emgodini we-peritoneal ngesikhathi sokuya esikhathini.

• Amazinga aphezulu e-estrogen egazini.

• Ubudala kusuka ku-30 ​​kuya ku-45 iminyaka.

• Ukusetshenziswa ngokweqile kotshwala neziphuzo ezine-caffeine.

• Ukuthatha imithi ethile.

• Ukuphazamiseka kwe-metabolic okuholela ekukhuluphaleni.

• Ukuncipha komjikelezo wokuya esikhathini.

Lapho amasosha omzimba esebenza kahle, aqapha futhi amise zonke izinhlobo zamaseli e-pathological emzimbeni. Izingcezu zezicubu ezingena emgodini we-peritoneal kanye negazi lokuya esikhathini nazo zibhujiswa amasosha omzimba. Babhujiswa ama-lymphocyte nama-macrophages. Lapho amasosha omzimba ehluleka, izinhlayiya ezincane kunazo zonke ze-endometrium zihlala emgodini wesisu futhi ziqala ukugrafti. Ngakho, i-endometriosis iqala.

Ukuhlehliswa kokuhlinzwa esibelethweni kwandisa ingozi yokuthola lesi sifo. Lokhu kufaka phakathi ukwelapha, ukukhipha isisu, ukukhishwa kwe-cauterization yokuguguleka komlomo wesibeletho, njll.

Ngokuqondene nokuthambekela kofuzo ku-endometriosis, isayensi iyazazi izimo lapho emndenini owodwa bonke abameleli besifazane behlushwa yilesi sifo, kuqala ngogogo futhi bagcine nabazukulu.

Naphezu kweqiniso lokuthi kunezinkolelo-mbono eziningi zokuthuthukiswa kwe-endometriosis, akekho kubo ongachaza i-100% ukuthi kungani lesi sifo sisazibonakalisa. Kodwa-ke, kufakazelwa ngokwesayensi ukuthi ingozi yokuthuthukisa i-endometriosis iyanda kulabo besifazane abaye bakhipha isisu. Ukunqanyulwa kokukhulelwa okwenziwayo kuwukucindezeleka komzimba, okuthinta zonke izinhlelo ngaphandle kokukhetha: ukwesaba, i-hormonal, nocansi.

Ngokuvamile, labo besifazane abavame ukuzwa ukucindezeleka ngokomzwelo (ukucindezeleka, ukushaqeka kwezinzwa, ukucindezeleka) bangabhekana ne-endometriosis. Ngokumelene nesizinda sabo, ukuzivikela komzimba kwehluleka, okuvumela amangqamuzana e-endometrial ukuba ahlume kalula kwezinye izitho nezicubu. Njengoba umkhuba we-gynecology ubonisa, labo besifazane imisebenzi yabo yobungcweti ehlotshaniswa nokungezwani kwemizwa eyandayo kungenzeka ukuthi kutholakale ukuthi bane-endometriosis.

Esinye isici esiyingozi ekukhuleni kwalesi sifo ukuhlala endaweni ezungezile engalungile. Ososayensi bathole ukuthi enye yezinto eziyingozi kakhulu ezikhona emoyeni i-dioxin. Ikhishwa ngamanani abalulekile ngamabhizinisi ezimboni. Kufakazelwe ukuthi abesifazane abahlale bephefumula umoya onokuqukethwe okuphezulu kwe-dioxin kungenzeka ukuthi baphathwe yi-endometriosis, ngisho besebancane.

Lezi zici ezilandelayo ze-endogenous ne-exogenous zingandisa ingozi yokuthuthukisa i-endometriosis:

• Ukufakwa kwedivayisi ye-intrauterine.

• Ukuthatha ama-hormonal contraceptive.

• Ukubhema ugwayi.

Izimpawu ze-endometriosis kwabesifazane

Izimpawu ze-endometriosis azenzi isithombe esicacile somtholampilo. Ngakho-ke, kuze kube yilapho owesifazane edlula ukuhlolwa kwekhwalithi ephezulu, ngeke azi ngesifo sakhe. Ngokuvamile, ngisho nokuhlolwa esihlalweni se-gynecological usebenzisa izibuko akuvumeli ukuthi kuhlolwe ukuxilongwa. Ngakho-ke, kufanelekile ukunaka izimpawu ze-endometriosis. Ngaphezu kwalokho, wonke owesifazane ophethwe yilesi sifo uhlala enenhlanganisela yezici eziningana.

Okokuqala, ukungakwazi ukukhulelwa umntwana. Ukungabi nanzalo yilapho owesifazane engakwazi ukukhulelwa ngocansi olungavikelekile unyaka wonke. I-Endometriosis ivimbela iqanda ukuba lingavundiswa yisidoda noma ukuba ligcine ukusebenza kwalo. Ukwanda kwe-pathological kwamangqamuzana e-endometrial kuholela ekuphazamisekeni kwe-hormonal, kuvimbela ukukhiqizwa kwamahomoni adingekayo esikhathini esivamile sokukhulelwa.

Lapho ukunamathela kwe-endometriotic kukhula kuma-appendages, esifundeni somlomo wesibeletho, lokhu kuzoholela ekuhlanganisweni kwezitho nezindonga zazo komunye nomunye. Ngenxa yalokho, ukuvinjelwa kwamashubhu e-fallopian kwakhiwa, okuyimbangela eyinhloko yokungazali kwabesifazane ngokumelene nesizinda se-endometriosis.

Okwesibili, ubuhlungu. Imvelo yobuhlungu kwabesifazane abaphethwe i-endometriosis ihlukile. Ubuhlungu bungase budonse futhi bube buthuntu, bukhona ngokuqhubekayo. Ngezinye izikhathi zibukhali futhi ziyasikwa futhi zenzeka ngaphansi kwesisu ngezikhathi ezithile kuphela.

Njengomthetho, ubuhlungu ngenxa ye-endometriosis abubonakali kangangokuthi owesifazane kufanele abonane nodokotela ngenxa yokuvela kwabo. Ezimweni eziningi, zibhekwa njengezimpawu ze-PMS, noma umphumela wokuzikhandla ngokomzimba.

Ngakho-ke, kubalulekile ukunaka ubuhlungu obungapheli obuvela njalo ngesikhathi socansi, ngesikhathi sokuya esikhathini esilandelayo nalapho uphakamisa izinsimbi.

Okwesithathu, ukopha. Ukubonakala kwamabala ngemva kocansi kungenye yezibonakaliso ze-endometriosis, kungakhathaliseki ukuthi indawo ye-node ikuphi. Lapho ukunamathela sekwakheke endaweni yezitho zesistimu yomchamo noma amathumbu, khona-ke amaconsi egazi azoba khona endle noma emchameni.

Njengomthetho, igazi livela ezinsukwini ezimbalwa ngaphambi kokuqala komjikelezo olandelayo wokuya esikhathini. Ukukhululwa kwayo kuhambisana nobuhlungu. Ngemuva kwezinsuku ezingu-1-3, igazi liyayeka ukuvela, futhi ngemva kwezinsuku ezingu-1-2, owesifazane uqala enye ukuya esikhathini.

Phakathi nokopha kokuya esikhathini, amahlule egazi aphuma esithweni sangasese. Ukubukeka kwabo kufana nezicucu zesibindi esiluhlaza. Ngakho-ke, uma owesifazane ebona lolu hlobo lokukhishwa futhi enezinye izimpawu ze-endometriosis, khona-ke kuyadingeka ukubika inkinga yakhe kudokotela.

Okwesine, ukungahambi kahle kokuya esikhathini. Cishe njalo kungavamile ku-endometriosis.

Owesifazane kufanele aqaphele amaphuzu alandelayo:

• Umjikelezo ushintsha njalo.

• Ukuya esikhathini kungase kungabi khona izinyanga ezimbalwa.

• Ukuya esikhathini kuthatha isikhathi eside futhi kuhambisana nokopha kakhulu.

Ngokuhluleka okunjalo, akufanele ungabaze ukuxhumana nodokotela. Uma kungenjalo, owesifazane ugijima engozini yokuthola izinkinga ezinkulu zempilo. Uma ingelashwa, i-endometriosis ingavusa ukwakheka kwezimila ezinobungozi, ukungazali nokuvuvukala kwezitho zangaphakathi.

Izimpawu zezinhlobo ezahlukene ze-endometriosis

Izimpawu ze-endometriosis kwabesifazane asebekhulile

I-Endometriosis ayiveli kuphela kwabancane, kodwa nakwabesifazane abadala abangaphezu kweminyaka engama-50. Ngaphezu kwalokho, ngemva kokuya esikhathini, ingozi yokuthuthukisa lesi sifo iyanda, okubangelwa ukuntuleka kwe-progesterone emzimbeni.

Izici ezilandelayo zingavusa ukuthuthukiswa kwe-endometriosis ekugugeni:

• Ukukhuluphala;

• Diabetes;

• Izifo ze-thyroid;

• Izifo ezithathelwanayo ezivame ukuhlushwa owesifazane kukho konke ukuphila kwakhe;

• Ukungenelela kokuhlinzwa okuningi, futhi indawo yendawo yakhona ayinandaba.

Izimpawu ze-endometriosis kwabesifazane abangaphezu kweminyaka engama-50 zingabandakanya:

• Isicanucanu;

• Ikhanda;

• Usizi;

• Ngezinye izikhathi ukuhlanza kwenzeka;

• Ukwanda kokucasuka, ukukhala, ukuba nolaka.

Ubuhlungu besisu esingezansi akuvamile ukuthi buphazamise abesifazane asebekhulile.

Izimpawu ze-endometriosis yangaphakathi

Izimpawu ezilandelayo zizobonisa i-endometriosis yangaphakathi:

• Ubuhlungu bendawo ethintekile ku-palpation.

• Izinhlungu ezibukhali ngesikhathi sokuphuma kwegazi, ezitholakala ngaphansi kwesisu.

• Ukwanda kobuhlungu ngesikhathi sokusondelana, ngemva kokuphakamisa izinsimbi.

Uchwepheshe wokuxilonga nge-ultrasound ubona esikrinini amanodi ayisici asodongeni lwesibeletho.

Isithombe sokuhlolwa kwegazi lomtholampilo sibonakala nge-anemia, echazwa ngokuphuma kwegazi njalo.

Izimpawu zokugula ngemva kokuhlinzwa

I-Endometriosis iqala kwabesifazane abahlinzwe ngokuhlinzwa emacaleni angama-20%. Amaseli aqala ukukhula endaweni yesibazi ne-suture.

Izimpawu ezilandelayo zizobonisa lesi sifo:

• Ukubonakala kokuphuma kwegazi okuvela kumthungo;

• Ukukhula kancane kwesibazi;

• Ukuluma emthungo;

• Ukubonakala kokukhula kwama-nodular ngaphansi komthungo;

• Izinhlungu zokudweba ezansi kwesisu.

Uma owesifazane ethola izimpawu ezinjalo kuye, kufanele axhumane nodokotela wezifo zabesifazane futhi ahlolwe. Kwezinye izimo, ukwelashwa kwesiguli kuyadingeka.

I-Endometriosis, i-endometritis kanye ne-uterine fibroids - uyini umehluko?

I-Endometriosis, i-endometritis kanye ne-uterine fibroids yizifo ezihlukene.

I-Endometritis ukuvuvukala kongqimba lwangaphakathi lwesibeletho, olukhula ngokumelene nesizinda sokungena kwama-microorganisms e-pathogenic emgodini wawo. I-Endometritis ibangelwa amagciwane, amabhaktheriya, isikhunta, ama-parasites. I-Endometritis ayithinti ezinye izitho, kuphela isibeletho. Lesi sifo siqala ngokujulile, sihambisana nomkhuhlane, ubuhlungu besisu esingaphansi, ukukhishwa kwesisu. I-endometritis engapheli ifana nezimpawu ze-endometriosis.

I-uterine fibroids iyithumba elibi lemisipha ebushelelezi kanye nongqimba oluxhumayo lwesibeletho. I-Myoma iqala ngokumelene nesizinda sokuphazamiseka kwe-hormonal.

Ingabe i-endometriosis ne-adenomyosis yinto efanayo?

I-Adenomyosis uhlobo lwe-endometriosis. Ku-adenomyosis, i-endometrium ikhula ibe yizicubu zomzimba zesibeletho. Lesi sifo sithinta abesifazane abaneminyaka yobudala yokuzala, futhi ngemva kokuqala kokuya esikhathini sihamba sodwa. I-Adenomyosis ingabizwa ngokuthi i-endometriosis yangaphakathi. Kungenzeka ukuthi lezi pathologies ezimbili zizohlanganiswa nomunye nomunye.

Kungani i-endometriosis yesibeletho iyingozi?

I-Endometriosis yesibeletho iyingozi ngezinkinga zayo, kufaka phakathi:

• Ukwakheka kwama-ovarian cysts azogcwala igazi lokuya esikhathini.

• Ukungazali, ukuphuphuma kwesisu (ukukhulelwa okungabanjwanga, ukukhulelwa kwesisu).

• Ukuphazamiseka kwezinzwa ngenxa yokucindezelwa kweziqu zezinzwa yi-endometrium ekhule ngokweqile.

• I-anemia, ehlanganisa ubuthakathaka, ukucasuka, ukwanda kokukhathala nokunye ukubonakaliswa okungalungile.

• I-Foci ye-endometriosis ingawohloka ibe izimila ezimbi. Nakuba lokhu kungenzeki ngaphezu kwe-3% yamacala, nokho, ingozi enjalo ikhona.

Ngaphezu kwalokho, i-syndrome yobuhlungu obungapheli ehlukumeza owesifazane ithinta inhlalakahle yakhe futhi yenza izinga lokuphila libe libi kakhulu. Ngakho-ke, i-endometriosis yisifo esingaphansi kokwelashwa okuphoqelekile.

Ingabe isisu singalimaza nge-endometriosis?

Isisu singaba buhlungu nge-endometriosis. Futhi ngezinye izikhathi ubuhlungu bukhulu kakhulu. Njengoba kushiwo ngenhla, ubuhlungu buyaqina ngemva kokulala, ngesikhathi sokusondelana, ngemva kokuzikhandla ngokomzimba, lapho uphakamisa izinsimbi.

Ubuhlungu be-pelvic kwenzeka ku-16-24% wabo bonke abesifazane. Ingase ibe nohlamvu olusahlukanisiwe, noma ingaba nokwasendaweni okucacile. Ngokuvamile ubuhlungu buyaqina ngaphambi kokuqala kokuya esikhathini okulandelayo, kodwa kungase kube khona ngokuqhubekayo.

Cishe u-60% wabesifazane abane-endometriosis bathi banezikhathi ezibuhlungu. Ubuhlungu bunamandla amakhulu ezinsukwini ezi-2 zokuqala kusukela ekuqaleni kokuya esikhathini.

Ukuxilongwa kwe-endometriosis

Ukuxilongwa kwe-endometriosis kuqala ngokuvakashela udokotela. Udokotela ulalela izikhalazo zesiguli futhi uqoqa i-anamnesis. Bese kuthi owesifazane ahlolwe esihlalweni se-gynecological. Ngesikhathi sokuhlolwa, kungenzeka ukuthola isibeletho esikhulisiwe, futhi sizoba sikhulu, sisondele esikhathini esilandelayo. Isibeletho siyindilinga. Uma ukunamathela kwesibeletho sekuvele kwakhiwe, khona-ke ukuhamba kwayo kuzoba nomkhawulo. Kungenzeka ukuthola ama-nodules ngamanye, kuyilapho izindonga zesitho zizoba ne-bumpy futhi engalingani.

Ukucacisa ukuxilongwa, ukuhlolwa okulandelayo kungadingeka:

1. Ukuhlolwa kwe-Ultrasound yezitho ze-pelvic. Izimpawu ezilandelayo zibonisa i-endometriosis:

   • Ukwakheka kwe-anechogenic kuze kufike ku-6 mm ububanzi;

   • Ukuba khona kwendawo yokwanda kwe-echogenicity;

   • Ukwandiswa kwesibeletho ngosayizi;

   • Ukuba khona kwemigodi nge-liquid;

   • Ukuba khona kwama-node anamafomu afiphele, afana ne-oval (ngesimo se-nodular sesifo), esifinyelela ku-6 mm ububanzi;

   • Ukuba khona kwe-saccular formations kufika ku-15 mm ububanzi, uma lesi sifo sinefomu eligxile.

2. I-Hysteroscopy yesibeletho. Izimpawu ezilandelayo zibonisa i-endometriosis:

   • Ukuba khona kwezimbobo ngendlela yamachashazi e-burgundy avelele ngokumelene nesizinda se-mucosa ye-uterine ephaphathekile;

   • Umgodi wesibeletho owandisiwe;

   • Ungqimba oluyisisekelo lwesibeletho lune-contour yokukhululeka efana nekama elinamazinyo.

3. I-Metrosalpingography. Ucwaningo kufanele lwenziwe ngokushesha ngemva kokuphothulwa kokuya esikhathini okulandelayo. Izimpawu ze-endometriosis:

   • Isibeletho esinwetshiwe;

   • Indawo ye-ejenti yokuqhathanisa ngaphandle kwayo.

4. I-MRI. Lolu cwaningo lunolwazi ngama-90%. Kodwa ngenxa yezindleko eziphakeme, i-tomography ayivamile ukwenziwa.

5. I-Colposcopy. Udokotela uhlola umlomo wesibeletho esebenzisa i-binoculars kanye ne-light fixture.

6. Ukuhlonza izimpawu ze-endometriosis egazini. Izimpawu ezingaqondile zesifo ukwanda kwe-CA-125 ne-PP-12. Kufanele kucatshangelwe ukuthi ukugxuma kwe-protein-125 akubonwa kuphela ngemuva kwe-endometriosis, kodwa futhi lapho kukhona ama-neoplasms ayingozi ama-ovari, nge-uterine fibromyoma, ngokuvuvukala, kanye nasekukhulelweni kokuqala. Uma owesifazane ene-endometriosis, khona-ke i-CA-125 izophakanyiswa ngesikhathi sokuya esikhathini kanye nesigaba sesibili somjikelezo.

Ukwelashwa kwe-endometriosis yesibeletho

Ukwelashwa okuyinkimbinkimbi kuphela kwe-endometriosis kuzofeza umphumela omuhle.

Ngokutholakala ngesikhathi kwalesi sifo, akhona wonke amathuba okusikhipha ngaphandle kokubandakanya udokotela ohlinzayo ekwelapheni. Uma kwenzeka owesifazane engazinaki izimpawu zesifo futhi engayi kudokotela wezifo zabesifazane, lokhu kuzoholela eqinisweni lokuthi njalo ngenyanga kuzovela i-foci entsha ye-endometriosis emzimbeni wakhe, i-cystic cavities izoqala ukwakha, izicubu zizoba nesibazi, ukunamathela. izokwakha. Konke lokhu kuzoholela ekuvinjweni kwama-appendages kanye nokungazali.

Umuthi wanamuhla ubheka izindlela eziningana zokwelapha i-endometriosis:

• Ukusebenza. Odokotela bazama ukuphendukela ekungeneleleni ngokuhlinzwa kuyaqabukela, lapho ukwelashwa ngezidakamizwa kunganikezanga umphumela omuhle. Iqiniso liwukuthi ngemva kokuhlinzwa, ithuba lokukhulelwa kwengane kowesifazane liyoba liphansi. Nakuba intuthuko yakamuva kwezokwelapha kanye nokwethulwa kwama-laparoscopes ekusebenzeni kokuhlinzwa kwenza kube nokwenzeka ukufeza ukungenelela ngokuhlukumezeka okuncane emzimbeni. Ngakho-ke, amathuba okukhulelwa okulandelayo asekhona.

• Ukulungiswa kwezokwelapha. Ukuthatha imithi ekwelapheni i-endometriosis kungenye yezindlela eziphumelela kakhulu zokwelapha. Owesifazane unqunyelwe ama-hormone asiza ukujwayeza ukusebenza kwama-ovari futhi avimbele ukwakheka kwe-foci ye-endometriosis.

Izidakamizwa ezisetshenziselwa ukwelapha lesi sifo zinendlela efanayo yokuvimbela inzalo ye-hormonal yomlomo evela eqenjini le-Decapeptyl ne-Danazol. Ukwelashwa kowesifazane kuzoba isikhathi eside, njengomthetho, akukhawulelwe ezinyangeni ezimbalwa.

Ukunciphisa ubuhlungu obukhulu, isiguli sinqunyelwe ama-painkillers.

Kuze kube sekuqaleni kwawo-80s, izidakamizwa zokuvimbela inzalo zazisetshenziselwa ukwelapha i-endometriosis, eyayisebenza njengenye indlela yokuhlinzwa. Banqunyelwe isikhathi esiyizinyanga eziyisithupha kuya onyakeni, ithebhulethi eyi-1 ngosuku. Khona-ke umthamo wanda waba amaphilisi ama-2, okugwema ukuthuthukiswa ukopha. Ngemva kokuqedwa kokulungiswa okunjalo kwezokwelapha, amathuba okukhulelwa kwengane ayengama-40-50%.

Ukwelashwa

• Ama-Antiprogestin - ingenye yezidakamizwa eziphumelela kakhulu ekwelapheni i-endometriosis. Isenzo saso sihloselwe ukucindezela ukukhiqizwa kwe-gonadotropins, okubangela ukumiswa komjikelezo wokuya esikhathini. Ngemva kokuyeka umuthi, ukuya esikhathini kuyaqala futhi. Ngesikhathi sokwelashwa, ama-ovari awakhiqizi i-estradiol, okuholela ekuqothulweni kwe-endometriosis foci.

  Phakathi kwalezi zenzakalo ezimbi:

  • Ukuzuza kwesisindo;

  • Ukunciphisa ubukhulu bezindlala ze-mammary;

  • ukuvuvukala;

  • Ukuthambekela kokucindezeleka;

  • Ukukhula ngokweqile kwezinwele ebusweni nasemzimbeni.

• GnRH agonists - cindezela umsebenzi we-hypothalamic-pituitary system, okuholela ekwehleni kokukhiqizwa kwe-gonadotropins, bese kuthinta ukugcinwa kwama-ovari. Ngenxa yalokho, i-endometriosis foci iyafa.

  Imiphumela emibi yokwelashwa ngama-GnRH agonists yile:

  • Ukwephulwa kwe-metabolism yamathambo okungenzeka kube nokuvuselelwa kwamathambo;

  • Ukunqamuka kokuya esikhathini eside, okungase kuqhubeke ngisho nangemva kokuqedwa kwezidakamizwa kuleli qembu, okudinga ukuqokwa kwe-hormone replacement therapy.

• Izivimbela-nzalo zomlomo ezihlanganisiwe (COCs). Ucwaningo lwezokwelapha luye lwathola ukuthi luqeda ukubonakaliswa kwe-endometriosis, kodwa alunawo umthelela ezinkambisweni ze-metabolic, lucindezela ukukhiqizwa kwe-estradiol ngama-ovari.

Ukwelashwa kokuhlinzwa kwe-endometriosis

Ukwelashwa kokuhlinzwa kwe-endometriosis kuqinisekisa ukususwa kwe-foci yayo, kodwa akukhiphi ukuphindaphinda kwesifo. Ngokuvamile, abesifazane abanale pathology kufanele bangenele ukungenelela okuningana. Ingozi yokuphindaphinda ihluka phakathi kuka-15-45%, okuncike kakhulu ezingeni lokusabalala kwe-endometriosis emzimbeni wonke, kanye nendawo yenqubo ye-pathological. Kuthinta ukuthi kungenzeka yini ukuphindeka futhi nokuthi ukungenelela kokuqala kwakukhulu kangakanani.

I-Laparoscopy iyindinganiso yegolide yokuhlinzwa yesimanje yokwelapha i-endometriosis. Ngosizo lwe-laparoscope efakwe emgodini wesisu, kungenzeka ukususa ngisho ne-foci encane kakhulu ye-pathological, ukususa ama-cysts nokunamathela, ukusika imigudu yezinzwa ezibangela ukubonakala kobuhlungu obuqhubekayo. Kuyaqapheleka ukuthi ama-cysts acasulwa yi-endometriosis kufanele asuswe. Uma kungenjalo, ingozi yokuphinda isifo ihlale iphezulu.

Ukuzilapha kwe-endometriosis akwamukelekile. Amaqhinga okwelapha kufanele anqunywe udokotela.

Uma i-endometriosis inzima, khona-ke kuyadingeka ukususa isitho esithintekile. Lokhu kungenzeka futhi ngokusebenzisa i-laparoscope.

Odokotela babheka ukuthi owesifazane welashwe i-endometriosis uma engakhathazwa izinhlungu futhi engazange abuyele emuva eminyakeni emi-5 ngemuva kokwelashwa.

Uma i-endometriosis itholakala kowesifazane oneminyaka yobudala, khona-ke odokotela benza konke okusemandleni abo ukuze balondoloze umsebenzi wakhe wokuzala. Kumele kuqashelwe ukuthi izinga lokuhlinzwa kwesimanje liphakeme kakhulu futhi livumela abesifazane abaneminyaka engu-20-36 ku-60% amacala ukuba bakhuthazele futhi babelethe ingane enempilo.

Ukusetshenziswa kwama-endoscopes ngesikhathi sokuhlinzwa kukuvumela ukuthi ususe ngisho ne-foci encane kakhulu ye-endometriosis. Ukwelashwa okwengeziwe kwe-hormonal kwenza kube nokwenzeka ukugwema ukuphindaphinda kwesifo. Uma i-endometriosis iholela ekungazali, khona-ke ukwelashwa kwe-endoscopic cishe kuwukuphela kwethuba owesifazane analo lokuba ngumama ophumelelayo.

I-Endometriosis yisifo esinezinkinga eziyingozi. Ngakho-ke, kubaluleke kakhulu ukuxilonga nokwelapha ngesikhathi esifanele. Ukusetshenziswa okuyinkimbinkimbi kwabo bonke ubuchwepheshe besimanje bokungenelela kokuhlinzwa: inhlanganisela ye-cryocoagulation, ukususwa kwe-laser, i-electrocoagulation kwenza kube nokwenzeka ukwenza lo msebenzi ngamathuba amaningi okuphothula ngempumelelo.

Indlela ephumelela kunazo zonke yokwelapha i-endometriosis ibhekwa njenge-laparoscopy (yebo, ngokwehluleka kokwelashwa okulondolozayo) ngokwelashwa okwengeziwe kwe-hormonal. Ukusetshenziswa kwe-GTRG ngemva kokuhlinzwa kwandisa ukusebenza kwayo ngo-50%.

Imuphi udokotela owelapha i-endometriosis?

I-Endometriosis iphathwa yi-obstetrician-gynecologist.