Tus kab mob ua rau tuberculosis yog Koch's bacillus. Ib zaug hauv lub cev, nws yuav nyob twj ywm tsis ua haujlwm rau qee lub sijhawm. Nyob rau tib lub sijhawm, cov tsos mob tsis tshwj xeeb tshwm sim hauv daim ntawv ntawm kev qaug zog thiab qaug zog. Feem ntau lawv raug ntaus nqi rau kev ua haujlwm ntau dhau thiab tsis them nyiaj rau lawv. Cov poj niam kawm txog qhov muaj tus kab mob thaum thawj qhov teeb meem nrog kev xeeb tub tshwm sim. Qhov no yog li cas uterine tuberculosis manifests nws tus kheej. Thawj cov tsos mob thiab cov tsos mob ntawm tus kab mob yuav tau tham nyob rau hauv hnub no tsab xov xwm.
daim ntawv pov thawj kho mob
YUterine tuberculosis yog ib yam kab mob sib kis. Nws cuam tshuam feem ntau ntawm cov mucous membrane thiab myometrium. Nyob rau hauv tsawg zaus, cov txheej txheem pathological txuas mus rau lub ncauj tsev menyuam. Nws muaj ntau hom kev khiav: subacute, mob thiab ntev. Nws feem ntau lees paub tias kev xeeb tub yog suav tias yog qhov yuav tsum tau ua ntawm tus kab mob. txaus ntshaikab mob rau fetus. Vim yog adhesions, lub cev hloov pauv, uas tuaj yeem ua rau muaj kev cuam tshuam ntawm kev loj hlob ntawm tus menyuam hauv plab.
YKev faib tawm ntawm pathology
Los ntawm qhov xwm txheej, uterine tuberculosis tuaj yeem ua rau subacute, mob thiab ntev. Daim ntawv mob ntawm tus kab mob no tau kuaj pom tsis tshua muaj thiab, raws li txoj cai, nrog rau kev sib ntxiv ntawm cov kab mob thib ob. Hauv 15-17% ntawm cov neeg mob, subacute tuberculosis tau pom, thaum cov txheej txheem inflammatory tsis ua haujlwm. Tus kab mob sib txawv ntawm tus kab mob no feem ntau tshwm sim.
Kuj paub qhov txawv ntawm Koch tus pas nrig hauv qhov chaw mos. Piv txwv li, hauv thawj 2 xyoos, tus kab mob no feem ntau ua haujlwm. Cov theem ntawm kev zam txim tuaj yeem kav li ntawm 2 mus rau 4 xyoos, tom qab ntawd cov ntawv tsis muaj zog tshwm sim. Cov theem kawg tseem hu ua qhov tshwm sim ntawm tus kab mob. Yog tias thawj 4 xyoos txij li lub sijhawm kis tus kabmob, cov tsos mob ntawm tus kabmob uterine tuberculosis tau tshwm sim ntau dua, tom qab ntawd muaj qhov exacerbation. Thaum zoo li no tshwm sim tom qab thawj 4 xyoo, peb tab tom tham txog kev rov qab los.
Cais, nws yog ib qho tsim nyog los txiav txim siab qhov kev faib tawm raws li qhov chaw ntawm cov txheej txheem pathological. Tuberculosis ntawm uterine appendages tshwm sim hauv 70% ntawm cov neeg mob. Qhov no yog vim lub fact tias cov hlab ntsha fallopian tau txais kev noj haus los ntawm ob txoj hlab ntsha - lub tsev menyuam thiab zes qe menyuam. Lawv, nyob rau hauv lem, muaj ib tug dav network. Cov ntshav ntws hauv cov hlab ntsha no qeeb txaus, uas tso cai rau Koch lub lo rau hauv cov ntaub so ntswg pub los ntawm cov hlab ntsha me me.
Tuberculosis ntawm lub cev ntawm lub tsev menyuam raug kaw hauv 20% ntawm cov neeg mob. Tus kab mob tuaj yeem cuam tshuam tsuas yog thaj tsam ntawm lub plhaub sab hauv ntawm lub cev, tag nrhoendometrium thiab txawm kis mus rau cov leeg nqaij. Kev mob ntawm lwm yam kab mob (cev tsev menyuam, zes qe menyuam, qhov chaw mos) tsis tshua muaj.
Nyob ntawm daim duab histological ntawm pathological foci, tus kab mob tuaj yeem yog:
- Ntawm nrog kev hloov pauv tau zoo. Cov ntsiab lus hauv kev ua kom pom tseeb ntawm qhov mob yog tas li loj hlob thiab sib faib. Yog li ntawd, tus yam ntxwv tubercles los yog lupomas tshwm rau ntawm mucosa.
- Subacute. Cells tsis tsuas yog nquag faib, tab sis kuj zais cov kua dej inflammatory - exudate.
- Cas. Cov ntaub so ntswg tuag zoo li cov curd dawb.
- Tiav. Lub foci ntawm qhov mob yog impregnated nrog calcium ntsev thiab yog tus kheej txwv los ntawm cov tshuaj ntsiav.
Kev txiav txim siab ntawm tus kab mob pab xaiv txoj kev kho thiab tiv thaiv kev txhim kho ntawm cov teeb meem.
Qhov laj thawj tseem ceeb
Tuberculosis yog ib qho kab mob thib ob. Cov kab mob nkag mus rau hauv tsev menyuam los ntawm lwm cov foci, uas tuaj yeem ua rau lub ntsws thiab cov hnyuv. uterine tuberculosis kis tau li cas? Koch lub wand kis mus rau saum huab cua. Ntau tus neeg muaj kev tiv thaiv kab mob, tab sis 10% ntawm lub ntiaj teb cov pej xeem muaj sia nyob tus kab mob.
Lub tsev menyuam yog thaj chaw rau cov teeb meem thiab rov pib dua ntawm cov txheej txheem pathological. Thaum xub thawj, Koch's stick tsis qhia txog kev ua haujlwm vim kev ua haujlwm ntawm lub cev tiv thaiv kab mob, endocrine thiab mob plawv. Txawm li cas los xij, thaum kev tiv thaiv tsis muaj zog, nws kis tau sai sai thoob plaws hauv lub cev los ntawm cov ntshav thiab lymph.
Ntawm cov kev pheej hmoo, cov kws kho mob txheeb xyuas cov xwm txheej hauv qab no:
- kab mob chronic;
- kev cuam tshuam kev phais ntawm lub cev ntawm lub cev xeeb tub;
- kev ua haujlwm tsis zoo;
- kev nyuaj siab;
- hormonal hloov.
Thaum ob peb yam sib xyaw ua ke, qhov tshwm sim ntawm tus kab mob nce ntau zaus.
daim duab kho mob dav dav
Feem ntau, tsis muaj cov tsos mob tshwm sim ntawm tus kab mob uterine tuberculosis. Ib tug poj niam yuav yws yws ntawm qhov tsis muaj zog, ua npaws mus rau qib subfebrile, tawm hws ntau dhau. Nrog kev hloov pauv tseem ceeb hauv uterine mucosa, amenorrhea tshwm sim. Nov yog ib qho mob uas tsis muaj poj niam cev xeeb tub.
Tuberculosis yog tus cwj pwm los ntawm lub sijhawm ntev thiab acyclic uterine los ntshav. Kev xeeb tub feem ntau tshwm sim tom qab yug menyuam thawj zaug lossis lwm qhov kev rho menyuam. Txawm li cas los xij, nws yog thawj. Nws qhov laj thawj tseem ceeb yog kev cuam tshuam ntawm cov hlab ntsha fallopian.
Nyob rau hauv cov ntaub ntawv ntawm ib qho kev mob siab heev, deformation ntawm uterine kab noj hniav yog soj ntsuam tiv thaiv keeb kwm ntawm adhesions, synechia los yog fibrosis. Lub cev tuaj yeem sau nrog curdled neoplasms.
Qhov hnyav ntawm cov tsos mob ntawm tus kab mob uterine tuberculosis nyob ntawm seb tus poj niam noj qab haus huv, lwm yam thiab theem ntawm tus kab mob. Nyob rau hauv tag nrho, muaj peb ntawm lawv: subacute, mob thiab ntev. Txhua tus ntawm lawv yuav tau tham ntau yam hauv qab no.
Kab mob mob hnyav
Pathology yog tshwm sim los ntawm qhov mob hnyav hauv plab plab. Tsis tas li ntawd, muaj qhov kub thiab txias nce ntxiv.
Mob mob thaumtuberculosis ntawm lub tsev menyuam tuaj yeem ua rau hnyav heev uas cov kws kho mob tsis tas yuav ua qhov kev kuaj mob kom raug. Feem ntau, kab mob appendicitis, ectopic cev xeeb tub, los yog zes qe menyuam apoplexy yog xav tias, thiab kev phais yog muab. Yog hais tias thaum lub sij hawm phais kev cuam tshuam qhov tuag ntawm cov seem ntawm lub tsev menyuam raug kuaj pom, lawv raug tshem tawm thiab xa mus kuaj histological. Txwv tsis pub, tuberculosis yuav tsis kuaj tau ntev.
Subacute variant of tus kab mob
Thawj cov tsos mob ntawm tus kab mob uterine tuberculosis tshwm sim raws li qhov mob saum lub pubis. Nws yog txuam nrog cov txheej txheem inflammatory. Tsis tas li ntawd, nws yuav nyuaj rau cov hnyuv thiab lwm yam kabmob ntawm lub plab me me kom cog lus vim muaj coob tus adhesions thiab caws pliav.
Qhov kub feem ntau yog khaws cia ntawm cov nqi subfebrile lossis nyob rau hauv qhov qub. General tsis muaj zog thiab tsis qab los noj mov ceeb toom tus poj niam. Txawm li cas los xij, ntau tus tsuas tsis pom cov tsos mob thawj zaug thiab cov tsos mob ntawm tus kab mob uterine tuberculosis, yog li lawv tsis mus ntsib kws kho mob.
txheej txheem mob ntev
Nyob rau hauv tus kab mob no, ib tug poj niam feem ntau tsis mob dab tsi. Kev qaug zog me ntsis thiab kub taub hau yog tshwm sim los ntawm kev ntxhov siab tsis tu ncua thiab kev ua siab ntev ntawm lub neej. Tsuas yog qhov ua tsis tau tiav los xeeb menyuam tuaj yeem ua rau koj mus ntsib kws kho mob thiab kuaj xyuas. Feem ntau qhov teeb meem yog ua ntej los ntawm ntau qhov kev rho menyuam lossis txawm tias muaj menyuam.
Tus kab mob ntawm kev xeeb tub yog qhov yooj yim heev. Vim lub peculiarities ntawm lub zos ncig, Koch's wand thawj zaug nkag mus rau hauv cov hlab ntsha, provoking o. Nws ua rau constriction ntawm oviducts. Yog li ntawd, ovumtuaj yeem nkag mus rau hauv uterine kab noj hniav thiab txuas. Kev xeeb tub kuj tsis tshwm sim yog tias tus kab mob ua rau ib nrab lossis ua tiav kev kis kab mob, caws pliav ntawm kab noj hniav.
Cervical tuberculosis yog suav tias yog ib qho teeb meem ntawm qhov mob ntawm lub cev. Tus kab mob no tshwm sim hauv cov poj niam laus. Nws tsis muaj cov tsos mob tshwj xeeb, tab sis raug kuaj pom thaum lub sij hawm kuaj colposcopy.
Txoj kev kuaj mob
Kev kuaj mob ntawm tus kab mob no nyuaj heev vim tsis muaj kev paub txog cov pej xeem txog thawj cov tsos mob thiab cov tsos mob ntawm tus kab mob uterine tuberculosis hauv cov poj niam. Tsis tas li ntawd, nws tsis tshua pom los ntawm qhov chaw mos kab lis kev cai.
Nws tuaj yeem xav tias muaj mob tsuas yog tom qab kev soj ntsuam ntev ntawm tus neeg mob noj qab haus huv, kawm txog nws keeb kwm thiab kev sib cuag. Cov kev ntsuas ntsuas thiab kuaj hauv qab no kuj tseem pab:
- kuaj ntawm lub rooj zaum gynecological;
- X-ray lossis CT ntawm lub ntsws;
- tuberculin test;
- hysterosalpingography;
- kuaj mob curettage ntawm endometrium;
- laparoscopy.
Tom qab tau txais cov txiaj ntsig ntawm kev tshuaj ntsuam xyuas, yuav tsum tau sab laj nrog tus kws kho mob TB.
Kev Tiv Thaiv Kev Tiv Thaiv
Uterine tuberculosis yog kho nyob rau hauv ib lub dispensary tshwj xeeb. Qhov no yog ib yam kab mob es insidious. Koch's wand withstands cov teebmeem ntawm ntau yam tshuaj. Yog li ntawd, txoj kev kho nyuaj yog xaiv los rhuav tshem nws.nrog kev siv ntau yam tshuaj tib lub sijhawm. Feem ntau qhov kev nyiam yog muab rau "Isoniazid", "Streptomycin", "Rifampicin" thiab "Ethambutol". Yog tias cov tshuaj tau teev tseg tsis tau txais txiaj ntsig, cov tshuaj tiam tshiab (Kanamycin, Ofloxacin, Amikacin) raug tshuaj.
Kev khomob yog ua los siv tsawg kawg peb yam tshuaj muaj npe. Nws lub sijhawm yuav txawv ntawm 6 lub hlis mus rau 2 xyoos. Nws tag nrho yog nyob ntawm qhov hnyav ntawm pathology, muaj teeb meem kev noj qab haus huv thiab lub xeev ntawm lub cev tiv thaiv kab mob.
Tau qhov cuam tshuam tsis zoo ntawm kev kho mob rau lub siab, hepatoprotectors thiab vitamin complexes tau ntxiv. Nyob rau hauv cov ntaub ntawv ntawm kev coj khaub ncaws tsis xwm yeem, kev pab ntawm cov tshuaj hormonal yuav tsum tau. Txhawm rau tshem tawm cov adhesions thiab nti uas tawm tsam keeb kwm ntawm tuberculosis hauv tsev menyuam thiab zes qe menyuam, cov tshuaj absorbable tau raug sau tseg.
txhawm rau txheeb xyuas cov txiaj ntsig ntawm kev kho tsis tu ncua, lub caij so spa yog qhov tseem ceeb, qhov twg, nyob ntawm qhov kev kuaj pom thawj zaug, cov kws tshaj lij xaiv cov txheej txheem kho lub cev.
Surgery
Yog tias kev kho mob tsis zoo tsis muab qhov xav tau, qhov chaw mob lossis cov kab mob purulent, adhesions tshwm sim nyob rau hauv lub tsev menyuam kab noj hniav, kev phais yog qhia. Kev ua haujlwm tuaj yeem ua tau ob txoj hauv kev:
- tag nrho hysterectomy;
- kev tshem tawm ntawm thaj chaw cuam tshuam nrog kev khaws cia ntawm lub cev.
Lub tshuab ua haujlwm kuj tuaj yeem sib txawv. Hauv txhua kis, tus kws kho mob txiav txim siab qhov ntimkev cuam tshuam. Hauv kev xyaum kho mob niaj hnub no, siv cov kev xaiv hauv qab no rau kev tshem tawm cov kab mob:
- qhov muag tsis pom kev phais. Nws cov kev pab yog siv nyob rau hauv cov ntaub ntawv ntawm nws kim heev kev puas tsuaj rau lub cev, thaum ib tug zoo txheej txheem cej luam yuav tsum tau los txheeb xyuas cov cheeb tsam pathological. Ua raws li kev tshuaj loog.
- Laparoscopy. Qhov no yog cov txheej txheem minimally invasive, thaum lub sij hawm tus kws kho mob ua ob peb punctures ntawm daim tawv nqaij nyob rau hauv lub cheeb tsam. Los ntawm lawv, nws qhia cov cuab yeej rau kev ua haujlwm tom ntej thiab kev sojntsuam video. Cov duab los ntawm tom kawg yog tsis tu ncua pub rau lub computer saib. Yog li, tus kws kho mob tuaj yeem saib xyuas nws txoj haujlwm tas li. Tom qab tshem tawm ntawm thaj chaw pathological, hnav khaub ncaws tsis muaj menyuam yog siv rau qhov punctures. Kev rov qab los tom qab laparoscopy yog nrawm thiab qhov kev pheej hmoo ntawm cov teeb meem tsawg tsawg.
- Kev cuam tshuam Endoscopic. Nws qhia txog kev siv lub hysteroscope nrog lub koob yees duab. Cov txheej txheem yog ua rau cov kab mob me me ntawm endometrium, rau lub hom phiaj ntawm kev kuaj mob curettage lossis kom tsis txhob los ntshav.
Kev tshem tawm ntawm lub tsev menyuam tuaj yeem ua tiav lossis ib nrab. Yog hais tias tus poj niam tseem tsis tau yug los thiab tab tom npaj cev xeeb tub yav tom ntej, tus kws kho mob sim khaws lub cev xeeb tub.
Muaj Teeb Meem
Kev kho tsis raws sij hawm ntawm uterine tuberculosis feem ntau ua rau muaj teeb meem. Ntawm lawv, feem ntau yog cov hauv qab no:
- ntshav;
- kis tus kab mob mus rau hauv nruab nrog cev;
- tsim ntawm abscesses hauv siab kab noj hniav;
- tsim ntawm fistulas thiab adhesions;
- kev hloov tus kab mob mus rau qhov chaw mos tuberculosis.
Kev kho tus kab mob yog ib txoj haujlwm ntev thiab nyuaj. Txawm li cas los xij, kev rov zoo tag nrho tsis tas li tshwm sim. Feem ntau Koch's wand yog insensitive rau tshuaj tua kab mob. Raws li qhov tshwm sim, cov kab mob hauv lub cev xeeb tub poob tag nrho lawv lub peev xwm yug menyuam.
Thaum muaj teeb meem zoo li no, tsuas yog ob peb tus tuaj yeem sim ua tus niam. Yog li ntawd, koj yuav tsum sab laj nrog kws kho mob yog tias koj xav tias uterine tuberculosis. Kev ua xyem xyav tuaj yeem cawm tus poj niam txoj sia.
Tuberculosis feem ntau tshwm sim lig dhau lawm. Yog li ntawd, cov kws kho mob qhia kom ua fluorography ib xyoos ib zaug thiab mus ntsib kws kho mob gynecologist rau kev tiv thaiv.
Txoj Kev Tiv Thaiv
Yuav kom tsis txhob muaj kab mob hauv tsev menyuam, koj yuav tsum tsis txhob sib cuag nrog cov neeg mob, tsis txhob siv lawv cov khoom siv tu cev. Ntxiv rau, txhawm rau tiv thaiv, cov kws kho mob qhia kom ua raws li cov lus pom zoo hauv qab no:
- noj kom raug thiab tag nrho, noj cov vitamin complexes.
- Nws yog qhov yuav tsum tau ua raws li kev tswj hwm kev ua haujlwm thiab so. Yim teev pw tsaug zog txhua hnub yog pab tau.
- kho mob raws sijhawm, tau txhaj tshuaj tiv thaiv kab mob khaub thuas txhua xyoo.
- Nws yog ib qho tseem ceeb kom tswj tau qib siab ntawm kev tiv thaiv. Txog rau qhov kawg no, yuav tsum tau npau taws rau lub cev thiab tso tus cwj pwm phem.
- Txhawm rau zam cov kab mob gynecological uas tsim kom muaj qhov chaw zoo rau kev yug me nyuam ntawm cov kab mob pathogenic, koj yuav tsum mus ntsib kws kho mob txhua xyoo.
- Cov niam txiv yuav tsum saib xyuas lawv tus menyuam cov tshuaj tiv thaiv kom muaj kev tiv thaiv kab mob siab. Tawm tsam tuberculosis, cov tshuaj tiv thaiv yog muab tam sim tom qab tus menyuam yug los, tom qab 7, 12 thiab 17 xyoo. Kev xeem Mantoux yuav tsum ua txhua xyoo.
Uterine tuberculosis yog ib yam kab mob loj heev. Nws yog qhov txaus ntshai vim tias ntev ntev nws tuaj yeem yuav luag asymptomatic. Txawm tias muaj kev tshawb nrhiav kom tau raws sij hawm thiab kev kho mob muaj peev xwm, tus kab mob feem ntau tawm tom qab cov teeb meem tsis zoo. Ntawm lawv, qhov teeb meem feem ntau yog infertility. Relapses tshwm sim hauv txhua tus poj niam thib kaum. Yog tias tus neeg mob khaws lub peev xwm xeeb tub, kev xeeb tub nws tus kheej yog qhov nyuaj heev rau nws. Kev nchuav menyuam feem ntau tshwm sim, kev nchuav menyuam raug kuaj pom, thiab kev yug ntxov ntxov tshwm sim. Yog li ntawd, txawm nyob rau theem ntawm kev xeeb tub, txhua tus poj niam, yam tsis muaj kev zam, yuav tsum tau kuaj xyuas lub cev.
