Nyob rau hauv tsab xov xwm peb yuav xav txog xws li ib tug pathology raws li ib tug everted uterus.
Nov yog lub cev xeeb tub ntawm poj niam. Nws yog nyob rau hauv qis dua pelvis. Thaum nws qhov tshwm sim tshwm sim, qhov no qhia tau hais tias qee txheej ntawm lub cev ib nrab lossis tag nrho protrudes dhau ntawm lub plab me me. Xws li tus kab mob no tau kuaj pom tsis tshua muaj, tab sis muaj ntau cov cim qhia los ntawm kev txiav txim siab pathology. Thiab kev kho mob yuav tsum tau pib tam sim ntawd thiab tsuas yog los ntawm tus kws kho mob gynecologist uas ntseeg siab, tsim nyog.
Basic concept
Uterine eversion yog ib qho mob hnyav thiab ua rau muaj kev phom sij rau lub neej uas tshwm sim hauv ib kis ntawm 400,000 yug. Inversion ntawm lub tsev menyuam yog hu ua kev nyuaj siab ntawm lub tsev menyuam ntawm lub tsev menyuam los ntawm ib sab ntawm lub plab thiab lub hauv siab mus rau sab hauv kom txog rau thaum tag nrho lub tsev menyuam yog everted los ntawm lub tsev me nyuam nrog cov mucous membrane sab nraud. Hauv qhov no, lub tsev menyuam tau nqis mus rau hauv qhov chaw mos, thiab qhov tob tob yog tsim nyob rau hauv lub plab kab noj hniav, uas yog lined nrog serous txheej. Cov hlab ntsha hauv plab, lub tsev menyuam ligaments thiab zes qe menyuam tau kos rau hauv nws.
Invertedlub tsev menyuam tuaj yeem tshwm sim thaum cov pab pawg ntawm cov ntaub so ntswg thiab cov leeg uas txhawb nqa lub plab pelvic tsis muaj zog. Nyob rau hauv cov ntaub ntawv ntawm sagging ntawm cov kabmob no, lub Upper ib feem ntawm lub tsev menyuam prolapses. Ib tug poj niam yuav ntsib ob qho tib si ntawm lub tsev menyuam mus rau sab sauv ntawm qhov chaw mos (qhov no yog suav tias yog thawj qib ntawm tus kab mob), thiab lub tsev menyuam prolapse txog 10 cm, uas yuav ua rau nws poob tawm ntawm lub cev..
Feem ntau, uterine inversion yog txuam nrog kev ua haujlwm tsis raug, nws yog qhov txaus ntshai rau tus poj niam thiab yuav tsum tau tshem tawm tam sim.
Ua rau kab mob
Lub tsev menyuam rov qab tuaj yeem tshwm sim los ntawm:
- atony, thaum tsis muaj cov leeg nruj ntawm lub cev tom qab yug menyuam, tshwj xeeb tshaj yog tshwm sim thaum hnoos, txham, siab ntawm lub plab;
- ntxov rub txoj hlab ntaws thaum cev xeeb tub tseem tsis tau sib cais;
- kev coj tus cwj pwm tsis zoo los ntawm tus kws kho mob ua haujlwm, thaum lub cev xeeb tub tau nias rau ntawm lub tsev menyuam kom cais cov placenta;
- tshem tawm cov polyps lossis fibroids nrog riam luv.
Cov yam ntxwv ntawm kev ua neej nyob kuj tau txiav txim siab:
- txhaj xeeb ntawm lub plab mus rau hauv qab ntawm lub tsev menyuam;
- muaj ib tug loj myomatous node nyob rau hauv lub cheeb tsam ntawm nws qab.
Symptoms
Symptomatology ntawm everted cervix tshwm:
- ntshav tawm ntawm qhov chaw mos liab ci nrog cov ntshav txhaws.
- pallor ntawm daim tawv nqaij thiab mucous daim nyias nyias, tus neeg mob qhia hws txias;
- ntse mob mob hauv plab plab, sacrum.
- tso tseg tsis nco qab;
- poob ntshav siab nrog NW nyuam qhuav pom pom;
- muaj cov mucus liab tsim hauv qhov chaw mos.
Cov kev tshwm sim no yuav tsum tsis txhob hnov qab.
Shapes
Rau lub tsev menyuam rov qab tuaj yeem ua rau nws lub xeev so, nrog rau ib txhij nce siab hauv thaj tsam hauv plab. Qhov no yog hu ua spontaneous eversion. Kev kub ntxhov tshwm sim thaum ntxov ntawm txoj hlab ntaws thiab qhov hnyav ntawm lub tsev menyuam.
Qhov txawv ntawm qhov ua tiav thiab tsis tiav eversion:
- Nrog kev ua tsis tiav, qhov nyiaj ntawm lub tsev menyuam tsis hla qhov txwv ntawm sab hauv os.
- Thaum puv, lub tsev menyuam thiab qhov chaw mos tig tawm sab nraud, sab nraud ntawm qhov chaw mos. Nyob ntawm lub sijhawm tshwm sim, tus kab mob yog tus cwj pwm mob hnyav lossis mob ntev. Thawj daim ntawv tshwm sim thaum yug me nyuam los yog tam sim ntawd tom qab lawv, qhov thib ob loj hlob maj mam, aggravates ob peb hnub tom qab yug me nyuam.
Yav dhau lub tsev menyuam tom qab yug menyuam
Uterine inversion tshwm sim thaum lub cev nqaij daim tawv ntawm lub plab hnyuv siab raum tsis muaj zog thiab kev yug me nyuam raug mob. Feem ntau, qhov no yog qhov ua rau tawg. Thrush kuj tuaj yeem ua rau qhov no, txij li thaum nyob rau hauv tus kab mob no, cov leeg nqaij yog corroded, uas ua rau lawv nyias thiab tsis muaj zog, yog li lawv tus kheej tuaj yeem tsim kua muag thaum yug menyuam. Cov chaw tawg qee zaum nyuaj rau kev xaws, thiab cov caws pliav kho tsis zoo thiab siv sijhawm ntev.
Qee zaum, obstetric forceps yog siv thaum yug me nyuam, uas kujyooj yim raug mob cov ntaub so ntswg tsis muaj zog.
Txhawm rau tswj lawv hauv daim ntawv elastic, poj niam lub cev xav tau estrogens. Nrog rau hnub nyoog, qib ntawm cov tshuaj hormones ntawm cov hluas txo, uas ua rau ib tug poob ntawm yav tas los elasticity, cov ntaub so ntswg ua nyias, tsuas yog lub sij hawm no, cov poj niam feem ntau ntsib teeb meem ntawm uterine prolapse.
Lub tsev menyuam puas tuaj yeem hloov pauv sab nraud ntawm kev ua haujlwm?
Kev mob sab nraud ntawm kev yug menyuam
Qhov xwm txheej tsis zoo li no tuaj yeem tshwm sim thiab tsis yog hauv kev yug menyuam xwb. Ib tug poj niam uas muaj keeb kwm ntawm ib tug xov tooj ntawm gynecological teeb meem yuav ntsib ib tug zoo xws li pathology. Qhov no tseem tuaj yeem tshwm sim tom qab kev tawm dag zog lub cev hnyav, uas yog qhov txaus ntshai heev, nws tuaj yeem ua rau los ntshav hnyav thiab lub xeev poob siab. Nws yuav tsum tau maj mam mus tsev kho mob kom sai li sai tau.
Nyob rau hauv qhov muaj cov qog ntawm lub tsev me nyuam, lub cev eversion kuj ua tau. Hauv qhov no, cov tsos mob ntawm tus mob no yuav maj mam nce ntxiv, tus poj niam nws tus kheej yuav tsis pom qhov tshwm sim, thiab, feem ntau, nws yuav nrhiav kev pab kho mob tsuas yog tom qab ob peb hnub.
Txawm li cas los xij, tus poj niam tau pw hauv tsev kho mob. Nws txoj kev kho mob yuav nyob ntawm nws lub hnub nyoog, thaum lub sij hawm lub tsev menyuam nyob rau hauv lub xeev everted. Nyob rau hauv cov ntaub ntawv ntawm tiav prolapse ntawm lub cev, nws yog qhwv nyob rau hauv ib tug sterile bandage.
Diagnosis
Kev kuaj mob ntawm lub ncauj tsev menyuam qhov ncauj tsuas tuaj yeem ua los ntawm tus kws kho mob gynecologist. Ua ntej tshaj plaws, tus neeg mob tau nug: thaum twg thiab qhov tso tawm zoo li cas, lawv lub ntim yog dab tsi, puas muaj qhov mob tshwm sim?hauv plab plab, seb puas muaj kev phais lossis kev ua haujlwm.
Ntxiv mus, obstetric thiab gynecological ntaub ntawv yog sau: tej kab mob gynecological raug kev txom nyem thaum ntxov, cev xeeb tub, hom kev yug me nyuam, lub peculiarity thiab tshwm sim ntawm kev yug me nyuam, thaum kawg ntawm cev xeeb tub.
Tus kws kho mob tshuaj xyuas tus poj niam, ntsuas nws cov ntshav siab, mem tes, hnov nws lub plab thiab lub tsev menyuam. Nrog rau kev kuaj sab nraud, tus kws kho mob txiav txim siab qhov loj ntawm lub cev, cov duab thiab qhov nro. Tom ntej no, kev ntsuam xyuas yog nqa tawm ntawm lub rooj zaum tshwj xeeb. Tus kws kho mob, ntxig ib txhais tes rau hauv qhov chaw mos, palpates lub tsev menyuam nws tus kheej, nws ligaments thiab zes qe menyuam, thiab tuav lwm txhais tes ntawm tus neeg mob lub plab. Tsis tas li, txhawm rau txiav txim siab cov duab tseeb, tus kws kho mob tshuaj xyuas lub ncauj tsev menyuam hauv daim iav tshwj xeeb kho mob.
Kev kho mob
Muaj ib txoj hauv kev rau kev tshem tawm cov kab mob, uas yog, rov qab lub cev mus rau nws qhov chaw. Tus kws kho mob nias nrog nws txhais tes rau hauv qab ntawm lub tsev menyuam, rov qab los. Yog tias qhov no tshwm sim thaum yug menyuam, nws thawj zaug manually cais cov placenta ntawm nws cov phab ntsa. Cov kws kho mob xav txog txoj kev no txaus ntshai vim tias muaj kev poob siab thiab kis kab mob. Feem ntau siv kev saib xyuas kev kho mob ntawm uterine inversion, uas yog siv:
- Cholinomimetics uas ua rau lub ncauj tsev menyuam kom tsis txhob cog lus.
- Cov tshuaj tua kab mob yog siv los tiv thaiv kev loj hlob ntawm cov kab mob, lawv ntxuav lub uterine kab noj hniav.
- Aqueous thiab colloidal daws kom ntshav siab yog sivintravenously.
Thaum phais kho mob, colpohysterotomy tau ua, thaum qhov kev phais tau ua rau sab nraub qaum ntawm qhov chaw mos thiab lub tsev menyuam, nws tau teem rau hauv qhov chaw, ces qhov tsis xws luag yog sutured. Txoj kev no yog siv yog tias phau ntawv txo qis tsis tuaj yeem ua tau. Yog tias ntau tshaj 24 teev dhau los txij thaum lub tsev menyuam prolapse, ces nws raug tshem tawm. Tom qab ua tiav kev txo qis ntawm lub tsev menyuam, tamponade yuav tsum tau muab tshuaj, broad-spectrum antibacterial tshuaj, thiab cov kab noj hniav yog kho nrog tshuaj tua kab mob. Tom qab tus neeg mob, lub tshuab cua txias thiab hnyav hnyav yog muab tso rau ntawm lub plab mog. Nws yog ib qho tsim nyog los txwv kev txav ntawm tus neeg mob hauv thawj teev tom qab ua tiav, nws txoj haujlwm yuav tsum nruj nruj, nws ob txhais ceg yuav tsum tau tsa me ntsis.
Kev phom sij ntawm tus menyuam hauv plab yog dab tsi?
Muaj teeb meem thiab qhov tshwm sim
Hauv kev kho mob, lawv ntsib cov teeb meem hauv qab no:
- endometritis - o ntawm cov mucous txheej ntawm lub tsev menyuam;
- peritonitis;
- sepsis, uas cov kab mob nkag mus rau hauv cov hlab ntsha;
- necrosis ntawm lub tsev menyuam, piv txwv li, kev tuag ntawm nws ntu tshwm sim;
- hemorrhagic shock;
- kev txhim kho los ntshav;
- faus.
Kev tiv thaiv yuav tsum tau coj los tiv thaiv qhov no.
Kev Tiv Thaiv
Txhawm rau tiv thaiv lub tsev menyuam hauv tus poj niam, koj yuav tsum:
- Npaj thiab npaj rau cev xeeb tub, kuaj xyuas thiab kho cov kab mob ntev ntev. Yog ibmuaj kev ua haujlwm ntawm lub tsev menyuam, tom qab ntawd nws yog qhov zoo dua los ncua kev npaj xeeb tub rau ob xyoos.
- Ncua sijhawm rau kev xeeb tub ntawm lub tsev kho mob antenatal.
- Mus ntsib koj tus kws kho mob OB/GYN tsis tu ncua, tsawg kawg ib hlis ib zaug.
- Noj zaub mov kom zoo thiab sib luag, cov poj niam cev xeeb tub tau qhia kom tso cov zaub mov rog, kub thiab ntsim, tsis txhob noj cov kaus poom.
- Nyob zoo.
- Noj cov vitamins thiab tshuaj sedative yog tias koj tus kws kho mob pom zoo.
- Tau haus luam yeeb, cawv thiab tshuaj yeeb.
- Tshwj tsis pub dhau lub cev thiab kev xav-kev ntxhov siab.
Pom zoo kom muaj kev pheej hmoo ntawm uterine prolapse thaum yug menyuam:
- tshem tawm txoj hlua rub;
- zam lub zog ntawm lub tsev menyuam;
- siv tau cov txheej txheem Krede-Lazarevich kom raug;
- noj tshuaj kom txo cov leeg nqaij ntawm lub tsev menyuam;
- Ua ultrasound ntawm lub plab hnyuv siab raum kom kuaj tau raws sijhawm thiab kho cov neoplasms, polyps thiab myomatous nodes.
Peb saib seb nws txhais li cas - lub ncauj tsev menyuam puas lawm.
