Ntau tshaj 60 lab tus poj niam hauv ntiaj teb nyiam cov tshuaj tiv thaiv kab mob hauv lub cev ua ib qho kev tiv thaiv. Cov cuab yeej intrauterine twg zoo dua, lawv tau teeb tsa ntev npaum li cas, cov txheej txheem no puas mob? Cov lus nug no txaus siab rau ntau tus poj niam.
Navy classification
hom kev tiv thaiv kab mob no yog siv los ntawm ntau dua 16% ntawm cov poj niam Lavxias ntawm hnub nyoog yug me nyuam. Txhawm rau kom paub tias cov cuab yeej hauv lub cev zoo npaum li cas, qhov twg yog qhov zoo tshaj plaws tiv thaiv kev xeeb tub, koj yuav tsum paub tias cov kauv twg tuaj yeem yuav ntawm lub khw hauv tsev.
Muaj ntau ntau yam ntawm IUDs:
- tsis yog tshuaj;
- kho mob thawj tiam - "Multiload", "Nova", "Juno Bio";
- tshuaj thib peb - Mirena.
Thawj yog ua los ntawm cov khoom siv hluavtaws nrog ntxiv ntawm barium sulfate. Lawv tuaj nyob rau hauv ntau yam duab: T-puab los yog S-puab. Cov no yog cov khoom siv intrauterine tsis zoo. Kev tshuaj xyuas cov kws kho mob qhiatias lawv tsis tau siv tam sim no vim muaj kev mob tshwm sim tom qab lawv txhaj tshuaj.
Pab pawg thib ob yog sawv cev los ntawm IUDs (cov tshuaj tiv thaiv kab mob hauv lub cev) uas muaj tooj liab, kub, nyiaj. Nyob rau hauv cov ntaub ntawv no, muaj ib tug hlau los yog ib tug ua ke ntawm ob peb ua tau: tus pas nrig yog nyiaj, thiab winding yog tooj liab. Intrauterine khoom siv nrog nyiaj thiab lwm yam hlau tsis corrode, pab tiv thaiv ntau yam kab mob ntawm cov kab mob hauv nruab nrog cev thiab muab tso rau ntev heev - rau 5 xyoos.
Cov tshuaj tiv thaiv uas muaj nyob rau hauv pab pawg thib peb zoo ib yam li cov yav dhau los, tab sis muaj ib lub thawv nrog hluavtaws progestogen, uas tau tso tawm hauv microdoses - txog li 20 mcg txhua hnub. Xws li spirals muab tso rau 7 xyoo. Lawv tsis tsuas yog muaj cov tshuaj tiv thaiv kab mob, tiv thaiv kev sib txuas ntawm lub qe fertilized, tab sis kuj siv los kho ntau yam kab mob: endometriosis, uterine los ntshav thiab thaum lub sij hawm hloov tshuaj hormones nrog estrogen los tiv thaiv endometrial hyperplasia. Xws li coils yog haum rau cov poj niam uas muaj kev ntseeg prejudices, txij li thaum fertilization tsis tshwm sim vim muaj kev hloov nyob rau hauv hormonal tshuav nyiaj li cas nyob rau hauv lub cuam tshuam ntawm tas li tso tawm ntawm progestogens.
Mechanism of action
Txhawm rau txiav txim siab seb IUDs twg yog qhov zoo tshaj plaws, koj yuav tsum paub tias lawv ua haujlwm li cas. Txoj kev tiv thaiv kab mob no ua rau muaj qhov tseeb tias qhov mob tshwj xeeb tshwm sim raws li cov tshuaj tiv thaiv rau lub cev txawv teb chaws: leukocyte.endometrial infiltration, morphological thiab kev ua haujlwm hloov pauv uas tsis yog qhov kev coj khaub ncaws ib txwm muaj thiab qhov kev taw qhia ntawm lub qe fertilized tsis yooj yim sua.
Lub IUD ua rau lub tsev menyuam contractions, tiv thaiv kev loj hlob ntawm endometrium rau qe cog, txhawb peristalsis ntawm cov hlab ntsha, thiab tsis zoo rau cov spermatozoa nrog tooj liab, kub thiab nyiaj ions.
Ib tug yuav tsum tsis txhob xav txog txhua txoj kev xav ntawm kev tiv thaiv kev tiv thaiv raws li kev nthuav dav, cov txheej txheem ntawm kev txiav txim muaj ntau yam.
txiaj ntsig
Yuav kom paub seb yam khoom siv hauv plab yog qhov zoo tshaj plaws, koj yuav tsum paub koj tus kheej nrog cov txiaj ntsig ntawm txhua hom IUD:
- efficiency mus txog 98%;
- siv tau yooj yim;
- yam tsawg kawg kev phiv tshwm sim;
- rov qab muaj menyuam tom qab tshem tawm IUD thaum thawj lub hlis;
- tsis raug kev pub niam mis (tsis haum rau IUDs nrog gestagens);
- pab tau ntev;
- nqi qis;
- tsis xav tau tshuaj txhua hnub thiab saib xyuas kev siv thaum siv cov tshuaj tiv thaiv qhov ncauj.
Flaws
Ntawm qhov tsis txaus yuav tsum tau sau tseg rub qhov mob hauv plab, tshwj xeeb tshaj yog thaum ntxov, hnyav hnyav, muaj kev pheej hmoo ntawm o, tswj tsis tu ncua ntawm cov kav hlau txais xov, txwv rau cov poj niam hluas.
YContraindications
Qhov IUDs twg zoo dua: "Multiload", "Juno Bio", "Nova"? Puas muaj contraindications rau qee hom kauv? Nws yuav tsum raug sau tseg tias rau txhua hom muaj cov txheeb ze thiab tsis muaj contraindications.
Tsis muaj contraindications suav nrog cov txheej txheem mob hnyav, oncological neoplasms ntawm lub ncauj tsev menyuam thiab lub cev ntawm lub tsev menyuam, los ntshav los ntawm qhov chaw mos ntawm qhov tsis meej, qhov xav tias xeeb tub lossis uas twb muaj lawm. Nrog rau cov tsos mob no, kev taw qhia ntawm kauv yog nruj me ntsis txwv tsis pub.
Cov txheeb ze contraindications yog cov tsos mob uas qhov kev taw qhia ntawm IUD tuaj yeem ua tau tom qab kev kuaj xyuas lossis kev kho mob tsim nyog, lossis thaum cov tshuaj tiv thaiv yuav tsis ua rau muaj kev vam meej ntawm cov txheej txheem. Nov yog:
• mob ntev heev thiab rau lub hlis tom qab kev kho mob;
• kab mob sib deev;• cervicitis, vaginitis;
• poj niam hnyav, los ntshav;• endometrial hyperplasia lossis polyps;
• uterine fibroids nrog submucous nodes;
• qee hom endometriosis;
• uterine malformations: underdevelopment, txawv txav qauv;• hloov ntawm lub ncauj tsev menyuam, uas qhov kev taw qhia ntawm IUD yog tsis yooj yim sua;
• ectopic cev xeeb tub rau lub hlis ua ntej kev taw qhia;
• tshem tawm (tus kheej rho tawm) ntawm IUD hauv keeb kwm;
• kis kab mob thiab kis mob tom qab rho menyuam hauv peb lub hlis dhau los;
• yog tias muaj ntau tus neeg koom nrog;
• kab mob somatic: mob ntevmob, incl. tuberculosis; anemia los yog coagulopathy; kab mob rheumatic mob plawv, valvular defects;
• ua xua rau hlau ions;
• Westphal-Wilson-Konovalov kab mob - ib tug kab mob nyob rau hauv uas tooj liab metabolism cuam tshuam;• kho nrog immunosuppressants.
Nyob rau hauv txhua rooj plaub, tom qab qhia meej txog txhua yam tsis zoo thiab kev tshuaj xyuas zoo, tus kws kho mob txiav txim siab txog kev siv IUD. Cov tsev muag tshuaj muag ntau yam khoom siv hauv lub cev. Cov duab ntawm cov pob khoom tau nthuav tawm saum toj no. Lawv tus nqi txawv ntawm 200 txog 10,000 rubles.
Kev tshuaj xyuas ua ntej tso lub kauj
Ua ntej siv txoj kev tiv thaiv kab mob no, koj xav tau kev sab laj tus kheej nrog koj tus kws kho mob gynecologist thiab kuaj yam tsawg kawg nkaus:
- CBC;
- kuaj lub raum ua haujlwm;
- kuaj mob syphilis, kab mob siab B thiab C, kab mob HIV;
- extended colposcopy;
- Ultrasound ntawm lub tsev menyuam thiab appendages.
IUD lub sijhawm
Raws li WHO cov kws tshaj lij, cov kauv tuaj yeem tso rau txhua hnub, tab sis hnub zoo tshaj plaws yog 4-7 hnub ntawm kev coj khaub ncaws. Qhov no yog vim lub fact tias nyob rau lub sij hawm qhia, uterine mucosa yog rov qab los tom qab endometrial rejection, lub ncauj tsev menyuam kwj dej yog ajar, lub xub ntiag ntawm kev coj khaub ncaws yog ib tug txhim khu kev qha cim ntawm tsis muaj cev xeeb tub, thiab cov los ntshav tsawg heev uas tshwm sim tom qab txhaj tshuaj. ua rau tus poj niam tsis xis nyob.
Tom qab induced rho menyuam lossis rho tawm tus kheejIb qho IUD tuaj yeem muab tso rau tam sim lossis hauv 4 hnub yog tias tsis muaj pov thawj los ntshav lossis mob.
Tom qab yug me nyuam (hauv 48 teev), nws tsis pom zoo kom tso cov IUD tam sim ntawd, vim tias muaj feem ntau ntawm kev tshem tawm ntawm lub helix. Lub sijhawm zoo tshaj plaws yog 6 lub lis piam tom qab yug menyuam.
Kev nyuaj siab
Cov teeb meem tshwm sim tau tam sim ntawd thiab tom qab ib ntus tom qab lub cuab yeej hauv lub cev raug teeb tsa. Qhov twg yog qhov zoo dua ntawm qhov tsawg kawg ntawm cov kev mob tshwm sim tsis kaj siab? Feem ntau, tom qab kev taw qhia ntawm kauv, ib qho mob tshwm sim, uas tuaj yeem kav ntev li ib teev. Qhov no tau tshaj tawm hauv kev tshuaj xyuas. Feem ntau, tsis xis nyob yuav ploj tom qab noj tshuaj analgesics. Yog tias qhov mob tsis zoo los ntawm kev noj tshuaj analgesics thiab antispasmodics, tom qab ntawd ultrasound lossis hysteroscopy yog qhov tsim nyog los tsim kom muaj qhov tseeb tso ntawm IUD thiab kuaj pom muaj cov kauv hauv tsev menyuam lossis sab nraud (nrog rau lub tsev menyuam thaum lub sijhawm tso)..
IUD tshem tawm feem ntau pom nyob rau hauv cov poj niam hluas tsis muaj zog vim muaj qhov ua rau lub tsev menyuam muaj zog. Nws tshwm sim feem ntau hauv thawj hnub tom qab kev taw qhia. Tsis tas li ntawd, qhov zaus ntawm qhov teeb meem no nyob ntawm hom kauv: cov tooj liab uas muaj tus kheej raug tshem tawm hauv 6-16% ntawm cov neeg mob, cov uas muaj progestogen - hauv 3-6.5%. Nrog rau hnub nyoog, nce tus naj npawb ntawm kev yug thiab rho menyuam, qhov tshwm sim ntawm qhov teeb meem no txo qis.
Cov kab mob ua npaws yog cov teeb meem uas tau pom hauv 3.8-14.5% ntawm cov neeg mob nrog kev qhia txog IUD ntawm pab pawg thib ob. Ntxiv mus, yog tias mob tshwm sim hauv thawj 3 lub lis piam, ces nws qhov tshwm sim tuaj yeem cuam tshuam nrog kev qhia txog IUD; yog tias tom qab 3 lub hlis, qhov no yog qhov tshiab tshwm simkab mob. Kev tsim ntawm purulent tubovarial tsim yog qhov teeb meem loj tshaj plaws uas tshwm sim. Nws tshwm sim nrog kev siv ntev ntawm cov kauv - ntau dua 6-7 xyoo.
Ntshav tuaj yeem ua tau hauv thawj hnub tom qab kev tswj hwm (2, 1-3, 8% ntawm cov neeg mob) thiab raug tso tseg los ntawm kev teem sijhawm ntawm cov neeg ua haujlwm hemostatic. Yog tias los ntshav txuas ntxiv, nrog rau qhov mob, lossis tshwm sim ntawm lub sijhawm thiab tsis tuaj yeem kho tau, ces lub kauj yuav tsum raug tshem tawm.
Hauv 0.5-2% ntawm cov neeg mob, cev xeeb tub yog ua tau. Qhov no tshwm sim nrog kev tshem tawm tag nrho lossis ib nrab ntawm IUD. Feem ntau, xws li cev xeeb tub yuav xaus rau kev rho menyuam tsis tu ncua, txawm tias tus poj niam xav khaws cia. Thiab cov khoom siv hauv tsev menyuam twg zoo dua rau cov teeb meem, tus kws kho mob gynecologist yuav pab txiav txim siab.
YCov tshuaj tiv thaiv kab mob hauv lub cev
Ntau hom IUDs nug cov lus nug rau tus poj niam: yuav ua li cas kom tsis txhob muaj teeb meem, thiab cov cuab yeej hauv plab twg zoo dua? Kev tshuaj xyuas cov kws kho mob thiab cov neeg mob hais lus pom zoo ntawm tooj liab lossis nyiaj IUDs.
Qhov sib ntxiv ntawm tooj liab thiab nyiaj ua kom txo tau qhov tshwm sim ntawm cov teeb meem los ntawm 2-10 npaug. Nyob rau tib lub sijhawm, qhov ua tau zoo ntawm cov IUDs yog 93.8%. Inert coils muaj qhov ua tau zoo ntawm 91-93%. Cov coils uas muaj tooj liab tam sim no tau txais ntau tshaj plaws vim lawv qhov teeb meem qis thiab kev tiv thaiv kab mob siab.
Hormonal tso system "Mirena" yog cov tshuaj tiv thaiv zoo tshaj plaws thiab suav tias yuav luag lomKev ua kom tsis muaj menyuam, vim nws muaj ntau yam ua los tiv thaiv kev yug menyuam ntawm lub qe, txuas rau lub endometrium, ua kom cov viscosity ntawm cov mucus nyob rau hauv lub tsev me nyuam kwj dej los tiv thaiv cov phev los ntawm lub tsev menyuam.
Peb tau tshuaj xyuas qhov zoo thiab qhov tsis zoo uas cov cuab yeej hauv plab muaj. Qhov twg yog qhov zoo dua los tso? Qhov teeb meem no yuav tsum tau daws ua ke nrog gynecologist. Qhov no txiav txim siab tus nqi uas tus poj niam xav tau, thiab cov lus qhia uas tus kws kho mob nthuav tawm tom qab kuaj.
