Nyob hauv gynecology, ntau yam kev saib xyuas yog siv los kho cov ntshav los ntawm lub tsev menyuam. Tab sis txhua txoj hauv kev no tsis tas yuav ua rau qhov xav tau, yog li lawv pom zoo kom npaj ua haujlwm lossis xwm txheej ceev kom tshem tawm lub tsev menyuam.
Qhov zaus ntawm qhov kev cuam tshuam ntawm kev phais hauv gynecology yog pom hauv 25-40% ntawm cov neeg mob uas muaj hnub nyoog nruab nrab ntawm cov poj niam uas tau pom zoo kom tshem tawm, 40 xyoo. Ntau ntxiv, es tsis txhob siv kev saib xyuas kev kho mob rau uterine fibroids hauv cov poj niam hauv lawv cov plaub caug xyoo, cov kws kho mob tau pom zoo kom tshem tawm ntawm qhov chaw mos, txhawb qhov kev txiav txim siab no los ntawm qhov tseeb tias kev ua haujlwm ntawm kev yug me nyuam twb tau ua tiav thiab lub tsev menyuam tsis xav tau ntxiv lawm. Tab sis thaum twg yog hysterectomy ncaj ncees? Cov kev siv dab tsi, qhov tshwm sim thiab kev kho mob li cas?
Qhia rau kev phais kom tshem tawm lub cev xeeb tub
Kev tshem tawm ntawm lub tsev menyuam (hysterectomy) yog qhia hauv cov xwm txheej hauv qab no:
- Ntau cov fibroids lossis ib leeg leeg uas loj hlob sai thiab los ntshav ntau.
- Fibroids hauv cov poj niam tshaj 50. Txawm hais tias tsis muaj kev nyiam rau malignancy, lawv yooj yim tig mus rau hauv daim ntawv malignant, yog li kev tshem tawm ntawm lub tsev menyuam hauv qhov no yog qhov tsim nyog los tiv thaiv.mob qog noj ntshav. Tab sis feem ntau xws li kev cuam tshuam yog cuam tshuam nrog cov lus hais tom qab vegetative-vascular thiab psycho-emotional disorders, piv txwv li, qhov tshwm sim ntawm post-hysterectomy syndrome.
- Necrosis ntawm fibroid node.
- Cov nodes uas hem tus neeg mob nrog torsion.
- Submucosal nodules cuam tshuam rau myometrium.
- Polyposis thiab kev coj khaub ncaws hnyav hnyav, uas cuam tshuam los ntawm anemia.
- 3-4th theem ntawm endometriosis lossis adenomyosis.
- Malignant neoplasm ntawm lub cev xeeb tub thiab cov appendages, kev kho hluav taws xob tau ua lub luag haujlwm. Feem ntau, rau cov poj niam laus, kev tshem tawm ntawm lub tsev menyuam thiab cov appendages raug pom zoo vim yog mob qog noj ntshav.
- Lub cev prolapse.
- mob plab pelvic uas tsis teb rau lwm yam kev kho mob.
- Kev tawg ntawm lub cev thaum yug menyuam lossis thaum yug menyuam.
- Uncompensated hypotension ntawm lub cev nrog los ntshav hnyav.
- Gender change.
Txawm tias qhov tseeb tias hysterectomy yog suav tias yog txoj hauv kev zoo tshaj plaws, nws tseem nyuaj rau kev siv thiab nrog cov teeb meem tsis tu ncua thaum lub sijhawm thiab tom qab kev cuam tshuam.
Cov teeb meem thaum phais yuav cuam tshuam nrog kev puas tsuaj rau lub qhov quav, zais zis, ureters, hematomas yog tsim nyob rau hauv cheeb tsam parametric, muaj los ntshav hnyav.
Hom thiab txoj kev phais
Txawm tias qhov tshwm sim yeej ib txwm zoo ib yam, kev ua haujlwm tshem tawm lub tsev menyuam tuaj yeem ua taunyob rau hauv ntau txoj kev ntawm ntau theem, nrog rau qhov sib txawv.
Hom kev ua haujlwm nyob ntawm qhov kev cuam tshuam:
- Radical (extirpation of the uterus) cov txheej txheem cuam tshuam nrog kev tshem tawm tag nrho ntawm lub tsev menyuam nrog lub tsev menyuam thiab zes qe menyuam. Sab saum toj ntawm qhov chaw mos thiab cov qog nqaij hlav hauv lub plab kuj raug tshem tawm.
- Tag nrho, thaum lub tsev menyuam thiab lub tsev menyuam raug tshem tawm.
- Supravaginal cuam tshuam nrog kev tshem tawm ntawm lub tsev menyuam, tab sis lub tsev menyuam tseem nyob.
Yog muaj peev xwm cawm tau lub cev xeeb tub thiab zes qe menyuam, tshwj xeeb tshaj yog rau cov poj niam hnub nyoog qis dua 40, ces tus kws kho mob yuav ua tau.
Tsis tas li, txhua qhov haujlwm tau muab faib ua hom raws li lawv cov txheej txheem.
Laparoscopic method
Laparoscopic hysterectomy suav nrog kev siv lub koob yees duab tshwj xeeb uas muab tso rau hauv tus neeg mob lub plab kab noj hniav los ntawm kev phais. Lub cev raug cais tawm siv cov cuab yeej uas tau muab tso rau hauv lub peritoneum los ntawm lwm qhov qhib. Daim duab ntawm lub koob yees duab mus rau lub monitor, thiab tus kws phais tuaj yeem pom txhua yam nws ua. Tus poj niam pw nrog nws ob txhais ceg nce siab thaum lub sijhawm ua haujlwm no.
Txoj kev no yuav siv tsis tau yog tias tus neeg mob lub cev tau poob lawm, nrog kev tsim loj, vim nws yuav tsis tuaj yeem tshem tawm ntawm lub qhov me me hauv lub peritoneum.
Laparotomic method
Cov txheej txheem no yog siv rau kev ua kom dav hauv plab kab noj hniav, nrog rau lub tsev menyuam loj, yog tias cov khoom nruab nrog cev nyob sib ze, lossis yog tias muaj kev cuam tshuam sai.
Qhov noCov txheej txheem muaj xws li ib tug incision los ntawm lub plab mus rau lub pubis. Tag nrho cov cheeb tsam ntawm lub peritoneum thiab lub pelvis tau pom meej meej, kev tshem tawm ntawm qhov chaw mos yog ua tiav. Thaum lub sijhawm ua haujlwm, tus poj niam pw ntawm nws nraub qaum thiab raug tshuaj loog.
Cov txheej txheem no tau pom zoo rau me me benign neoplasms hauv tsev menyuam lossis adnexa.
Kev phais yog ua nyob rau sab sauv ntawm qhov chaw mos, los ntawm qhov uas tus kws phais ua txhua yam ntxiv. Cov txheej txheem no tuaj yeem ua ke nrog kev qhia lub koob yees duab, thiab tom qab ntawd laparoscopy ua tiav. Kev tshem tawm ntawm lub cev yog ua nrog lub cuab yeej tshwj xeeb.
Tab sis koj tsis tuaj yeem siv kev ua haujlwm los ntawm qhov chaw mos hauv qhov xwm txheej no:
- yog lub tsev menyuam loj dhau;
- tus neeg mob kuaj mob qog noj ntshav thiab tsis muaj cov ntaub ntawv tseeb ntawm nws qhov muaj feem ntau;
- yog tias muaj ntau qhov adhesions hauv cheeb tsam pelvic;
- -Caesarean yav dhau los;
- thaum muaj mob lossis kab mob tawm.
YLaser tshem tawm
Laser tshem tawm ntawm lub tsev menyuam yog cov txheej txheem tshiab tshaj plaws, uas tshwj xeeb tshaj yog nrov nrog cov kws kho mob, vim tias nws muaj ntau qhov zoo tsis txaus ntseeg ntawm lwm txoj kev phais:
- txo qis kev pheej hmoo los ntshav, kev ua haujlwm yuav luag tsis muaj ntshav;
- sijhawm rov qab txo qis heev;
- tsis muaj mob loj;
- txo qhov mob thiab tsis xis nyob thaum lub sijhawm rov ua haujlwm;
- yam tsawg kawg ntawm kev tso zis;
- txo qis kev pheej hmoo kis mob;
- tsawg txaus ntshai ntawm caws pliav;
- txo libido tom qab phais tsawg;
- laser tshem tawm mus zoo nrog laparoscopy thiab endoscopy.
Nrog kev pab los ntawm laser scalpel, ntau qhov kev phais tau ua kom tshem tawm lub tsev menyuam. Cov txheej txheem yog ua nyob rau hauv intubation tshuaj loog. Cov cuab yeej tau muab tso rau hauv qhov kev txiav txim siab hauv cheeb tsam umbilical thiab iliac. Lub cev sib cais raug tshem tawm ntawm qhov chaw mos.
Yuav ua li cas npaj rau kev phais?
Kev npaj rau kev npaj ua haujlwm yog los xeem:
- kuaj ntshav biochemical thiab soj ntsuam;
- urinalysis;
- ntshav typing;
- Kev kuaj pom tus kab mob sib kis.
- tus kws kho mob pom zoo kom ua ultrasound;
- lub hauv siab x-ray thiab ECG;
- tshuaj tua kab mob thiab cytological ntawm cov smear coj los ntawm qhov chaw mos;
- colposcopy.
Cov poj niam hauv tsev kho mob tuaj yeem kuaj hysteroscopy, MRI, sigmoidoscopy.
Ib lub lis piam ua ntej kev ua haujlwm, txhawm rau tiv thaiv cov teeb meem xws li thrombosis lossis thromboembolism, tus kws kho mob tau sau cov kws kho mob tshwj xeeb thiab tshuaj noj.
Rau lub hom phiaj tiv thaiv thiab txo qhov hnyav ntawm cov tsos mob ntawm posthysterectomy syndrome, uas feem ntau tshwm sim hauv cov poj niam tom qab tshem tawm ntawm lub tsev menyuam, kev ua haujlwm yog ua rau thawj theem ntawm kev coj khaub ncaws, yog tias lawv tseem nyob.
Ob peb lub lis piam ua ntej kev phaisua cov txheej txheem psychotherapeutic, 5-6 mus ntsib kws kho mob hlwb thiab kws kho mob hlwb, uas yog txhawm rau txo qis kev xav tsis meej, ntshai thiab tsis paub tseeb ua ntej thiab tom qab ua haujlwm. Cov tshuaj ntsuab, tshuaj hormonal thiab sedative kuj tau sau tseg, nws raug pom zoo kom tsis txhob haus luam yeeb thiab haus cawv. Tag nrho cov kev ntsuas no yuav pab txhawb lub sijhawm rov qab los tom qab kev ua haujlwm kom tshem tawm lub cev. Hauv qhov no, kev tshem tawm ntawm tsev menyuam yuav yooj yim dua rau tus poj niam lub siab thiab lub cev.
Lub sijhawm ua haujlwm ntev npaum li cas?
Nws tsis tuaj yeem txiav txim siab lub sijhawm ua haujlwm. Ua ntej tshaj plaws, koj yuav tsum paub tias yuav siv txoj kev twg hauv txhua kis. Nws kuj yog nyob ntawm qhov loj ntawm lub tsev menyuam, muaj cov adhesions thiab lwm yam. Lub sijhawm ua haujlwm nruab nrab yog 1-3 teev.
Kev kho kom rov zoo thiab rov zoo
Tom qab kev phais tshem tawm ntawm lub tsev menyuam, kev saib xyuas ntau yog them rau cov txheej txheem inflammatory, normalization ntawm dej thiab electrolyte tshuav, ntshav muaj pes tsawg leeg, thiab kev sib haum xeeb ntawm tus neeg mob lub hlwb. Kev kho mob tom qab phais plab yog ib hlis thiab ib nrab, tom qab laparoscopy - 2-4 lub lis piam. Kev cuam tshuam ntawm qhov chaw mos muab kev rov zoo tag nrho tom qab ib hlis.
Lub suture tom qab tshem tawm ntawm lub tsev menyuam los ntawm kev phais plab tom qab ib hlis thiab ib nrab. Txhawm rau tiv thaiv kab mob adhesive, tus neeg mob yuav raug muab tshuaj magnetotherapy. Yog tias tsim nyog, tus kws kho mob yuav pom zoo kom siv tshuaj suppositories, txhaj tshuaj lossis ntsiav tshuaj kom tshem tawm qhov tshwm sim loj.phais kev cuam tshuam. Yog tias lub tsev menyuam tau raug tshem tawm, lub sijhawm tom qab phais yuav kav ib hlis thiab ib nrab, rau lub sijhawm no tau tawm kev mob nkeeg.
Kev noj qab haus huv tom qab tshem tawm ntawm lub cev xeeb tub
Nws yog ib qho tseem ceeb uas yuav tsum tau ua raws li kev noj haus tom qab ua haujlwm kom tshem tawm cov kab mob hauv lub cev. Nco ntsoov tshem tawm cov khoom uas ua rau khaus khaus. Cereals, khoom noj siv mis, broths, ceev - tag nrho cov no yuav tsum muaj nyob rau hauv cov poj niam cov zaub mov txhua hnub. Nws tseem ceeb heev kom noj txiv hmab txiv ntoo thiab zaub kom tsis txhob cem quav. Nws yog qhov zoo dua kom tsis suav nrog kas fes, khoom qab zib, tshuaj yej, qhob noom xim kasfes thiab hmoov nplej dawb thaum lub sijhawm kho.
Cov teeb meem tom qab kev phais
Yog tias lub tsev menyuam raug tshem tawm nrog rau ntawm zes qe menyuam, tus poj niam tuaj yeem hnov txhua yam tsos mob ntawm menopause:
- insomnia;
- kub flashes;
- sweating.
Nyob zoo ib tsoom phooj ywg;
Tus mob no hu ua mob menopause. Thaum lub zes qe menyuam tsis raug tshem tawm thaum lub sijhawm ua haujlwm, tsuas yog ib qho ntawm cov tsos mob ntawm menopause - qhov tsis muaj kev coj khaub ncaws.
Cov kws kho mob hais tias kev ua cev qhev ntawm cov poj niam uas tsuas yog qhov chaw mos raug tshem tawm tsuas yog pom tau 5 xyoos tom qab ua haujlwm. Cov neeg mob no feem ntau txhim kho:
- osteoporosis;
- txoov deev tsav;
- kev kub ntxhov;
- Vaginal dryness.
Qhov tshwm sim ntawm kev tshem tawm ntawm tsev menyuam thiab zes qe menyuam hauv thawj ob peb hnub, lis piam, hli yuav ua tau raws li hauv qab no:
- kab mob ntawm daim tawv nqaij ib ncig ntawm seam;
- cystitis;
- tshwm sim ntawm thromboembolism;
- vaginal prolapse;
- urinary incontinence;
- mob tshwm sim los ntawm adhesions lossis los ntshav.
Kuv puas xav tau daim ntaub qhwv tom qab tshem tawm?
Ib daim ntaub qhwv tom qab tshem tawm ntawm tsev menyuam yog qhov yuav tsum tau ua. Thaum tseem hluas, nws yuav tsum tau hnav rau peb lub lis piam, rau cov poj niam tom qab 45 xyoo - tsawg kawg yog 2 lub hlis. Cov ntaub qhwv pab kho qhov txhab sai, txo qhov mob, txhim kho plab hnyuv ua haujlwm, thiab txo qis qhov tshwm sim ntawm hernia. Nws yog ib qho tsim nyog los siv cov ntaub qhwv hauv thawj hnub nkaus xwb thaum nruab hnub, thiab tom qab ntawd tsuas yog thaum taug kev ntev lossis thaum lub cev tawm dag zog.
Tom qab ua haujlwm, qhov chaw ntawm lub plab hnyuv hloov pauv, lub suab thiab elasticity ntawm cov leeg poob. Tag nrho cov no ua rau cem quav, urinary incontinence, deterioration ntawm kev sib deev lub neej, qhov chaw mos prolapse thiab kev loj hlob ntawm adhesions. Hauv qhov no, tsuas yog kev tiv thaiv tuaj yeem pab tau, lossis ua haujlwm Kegel uas yuav pab ntxiv dag zog rau cov leeg nqaij.
Kev sib deev lub neej tom qab phais
Tom qab tshem lub cev xeeb tub tau ob lub hlis, nws yog qhov zoo dua tsis txhob sib deev kom tsis txhob kis kab mob. Kev ua haujlwm tuaj yeem ua rau txo qis hauv kev xav ntawm kev sib deev, thiab tag nrho vim yog qhov kev pheej hmoo ntawm hormonal ntshawv siab, kev loj hlob ntawm neurological, autonomic thiab vascular teeb meem nce.
Txhua tus ntawm lawv, hauv kev sib raug zoo nrog ib leeg, ua rau muaj kev mob hnyav thiab txo kev sib deev. Yeej, kev sib deev lub neej tsis yogtxwv tsis pub, nrog kev pab los ntawm ib tus kws kho mob tshwj xeeb koj tuaj yeem xaiv cov kev tawm dag zog uas yuav pab txhawb kev nkag siab. Kev sab laj nrog kws kho mob yuav pab koj txhim kho koj lub neej kev sib deev.
Puas muaj lub sijhawm tom qab hysterectomy?
Puas coj khaub ncaws tsis tu ncua tom qab kev ua haujlwm tshem tawm cov kab mob hauv lub cev? Lo lus nug no nyiam ntau tus poj niam. Kev khaws cia ntawm kev coj khaub ncaws tuaj yeem ua tau, thiab qhov no yog vim ntau yam. Piv txwv li, ib lub cev tuaj yeem raug tshem tawm thiab lub tsev me nyuam sab laug, thiab tom qab ntawd, nyob rau hauv kev cuam tshuam ntawm kev ua haujlwm ntawm cov appendages, endometrium tseem tsim nyob rau hauv ib cheeb tsam me me, vim li ntawd, tus poj niam tuaj yeem ua nws lub sijhawm mus ntxiv. Tab sis qhov no tsis yog qhov tso tawm ntau ntxiv lawm, tab sis los ntshav tsis txaus thaum cev xeeb tub.
Tom qab tshem lub cev thiab caj dab, kev coj khaub ncaws yuav tsum tsis txhob mus. Yog tias lawv tau pom, qhov no yuav yog qhov tshwm sim ntawm kev loj hlob ntawm pathologies ntawm qhov chaw mos, nyob rau hauv cov xwm txheej zoo li no tsis txhob ncua sijhawm mus ntsib kws kho mob.
Qee zaum cov poj niam yuam kev los ntshav rau lawv lub sijhawm, uas tuaj yeem ua rau muaj kev phom sij. Yog li ntawd, nrog ib qho kev pom, nws yog qhov zoo dua los sab laj tus kws kho mob kom tsis suav nrog kev txhim kho ntawm cov teeb meem.
