Cov txheej txheem sab hauv ntawm lub cev xeeb tub yog npog nrog endometrium. Endometritis yog txheej txheem inflammatory ntawm cov txheej txheem no. Ntau tus poj niam ntsib qhov no pathology. Nws tuaj yeem ua rau muaj kev cuam tshuam los ntawm kev tshawb nrhiav hauv lub cev, kev rho menyuam, tab sis feem ntau endometritis yog kuaj pom tom qab yug menyuam.
Lub luag haujlwm ntawm endometrium yog tsim los ntawm qee yam mob rau kev txuas lub qe menyuam hauv plab mus rau lub tsev menyuam. Los ntawm cov hlab ntsha ntawm endometrium, tus me nyuam hauv plab tau txais oxygen. Yog li ntawd, nws yog ib qho tseem ceeb heev uas cov txheej txheem no rov zoo dua yam tsis muaj qhov tshwm sim tom qab yug menyuam.
endometritis yog dab tsi?
Endometritis tom qab yug me nyuam tsis zoo cuam tshuam rau kev xeeb tub tom qab, vim hais tias rau lub cev xeeb tub ntawm tus menyuam nws tseem ceeb heev uas cov mucous puv puv.
Thaum lub caij coj khaub ncaws, endometrium hloov, ua rau muaj kev pom zoo rau cev xeeb tub. Yog tias cev xeeb tub tsis tshwm sim, cov txheej txheem endometrial raug tso tawm (tso tawm nrog kev coj khaub ncaws), tawm mustsuas yog cov txheej txheem loj hlob. Tom qab qhov kawg ntawm kev coj khaub ncaws, lub hlwb ntawm cov kab mob pib sib faib, thiab lub endometrium rov npaj tau lub qe fertilized.
Yog tias tom qab yug menyuam lub cev xeeb tub ua rau mob, ces tag nrho cov txheej txheem uas tshwm sim hauv nws raug ua txhaum. Ib tug poj niam tuaj yeem tsim ntau yam teeb meem hauv kev sim xeeb tom ntej.
Yog tias peb tig mus rau kev txheeb cais, endometritis tshwm sim hauv 2-4% ntawm cov poj niam hauv kev ua haujlwm, thiab tom qab kev phais mob, qhov kev pheej hmoo ntawm kev tsim kab mob ntau dua - 10-20%.
Etiology ntawm qhov tshwm sim
Tom qab yug me nyuam, kab noj hniav hauv plab yog qhov qhib los ntshav. Epithelial hlwb rov qab txheej txheej ntawm qhov chaw mos tom qab li ib hlis thiab ib nrab. Txog thaum ntawd, qhov kev pheej hmoo ntawm kev kis kab mob siab heev. Cov kab mob ua rau ntawm cov txheej txheem inflammatory yog tas li tam sim no nyob rau hauv lub cev ntawm ib tug poj niam, tab sis lawv pib active multiply nyob rau hauv tej yam kev mob. Kev yug me nyuam tsuas yog cov xwm txheej nyob rau hauv uas cov kab mob pathogenic ua haujlwm.
Qhov ua rau endometritis tom qab yug menyuam txawv, tab sis feem ntau cov kws kho mob paub qhov txawv hauv qab no:
- Txuag poj niam tiv thaiv kab mob. Lub lim tiam dhau los ntawm cev xeeb tub thiab qee lub sijhawm tom qab yug menyuam, tus poj niam txoj kev tiv thaiv tsis yog qhov zoo tshaj plaws, yog li ntawd, nws nyuaj rau lub cev los tawm tsam tus kabmob ntawm nws tus kheej. Kev txhim kho qib dhau los ntawm kev tiv thaiv kab mob yuav siv sijhawm ob peb hnub - txij li 5 txog 10, nyob ntawm txoj kev xa khoom.
- Kev phais mob hauv lub cev xeeb tub. Ntxiv nrog rau qhov tseeb tias kev tiv thaiv raug txo qis, qhov kev phais phais yog raug tus kab mob thawj zaug. Tom qabKev phais, lub tsev menyuam cog lus zuj zus, uas txhais tau hais tias kev ntxuav tus kheej yuav luag tsis yooj yim sua, uas ua rau muaj kev pheej hmoo ntawm kev tsim endometritis ntawm lub tsev menyuam tom qab yug menyuam.
Tseem pab txhawb rau txoj kev loj hlob ntawm pathology:
- mob foci ntawm kab mob hauv lub cev.
- Cov txheej txheem mob ntawm cov kabmob hauv nruab nrog cev.
- Cov kab mob endocrine thiab cov kab mob metabolic.
- Kev raug mob rau endometrium, uas yog provoked los ntawm kev siv lub sij hawm ntev ntawm kev siv cov tshuaj intrauterine contraceptives, nchuav menyuam, rho menyuam los yog kuaj xyuas curettage ua ntej cev xeeb tub.
- Teeb meem thaum muaj menyuam. Polyhydramnios, kev hem thawj ntawm nchuav menyuam, exacerbation ntawm cov kab mob ntev, isthmic-cervical insufficiency, mob mob, placenta previa - tag nrho cov no yuav muab impetus rau txoj kev loj hlob ntawm endometritis tom qab yug me nyuam. Tsis tas li ntawd, kev kuaj mob hnyav, nrog rau kev ua kom lub ncauj tsev menyuam, tuaj yeem ua rau tus mob no.
- Teeb meem thaum yug menyuam. Kev ua haujlwm ntev, lub sijhawm tsis muaj dej ntev, tsis muaj ntshav ntau, kev sib cais ntawm cov placenta thiab tom qab yug menyuam, thiab lwm yam.
- Ntawm tus me nyuam muaj tus kab mob hauv lub cev.
- nyuaj rau lub sijhawm tom qab yug menyuam. Qhov ua rau endometritis tom qab yug me nyuam tuaj yeem dag ua txhaum txoj cai ntawm kev tu cev tom qab yug me nyuam, pw tsaug zog ntev, tsis muaj kev cuam tshuam ntawm lub cev xeeb tub.
Kuv yuav tsum hais tias txhua tus yam ntxwv tsis tuaj yeem ua rau endometritis, tab sis nyob rau hauv lawv tag nrho, qhov yuav tshwm sim ntawm tus kab mob nce.
Cov tsos mob ntawm tus mob endometritis tom qab
Nyob hauv poj niam lub cev, endometritis tom qab yug me nyuam tuaj yeem tshwm sim hauv daim ntawv mob hnyav lossis mob ntev. Daim duab kho mob txawv nyob ntawm seb hom kab mob. Mob endometritis tom qab yug me nyuam yog nrog cov tsos mob tshwm sim, uas tso cai rau kev kuaj mob raws sij hawm thiab kho cov txheej txheem pathological. Nyob rau hauv daim ntawv ntev, cov tsos mob yog qhov muag plooj thiab mob me. Feem ntau cov poj niam tsis muab qhov tseem ceeb rau cov tsos mob no, sau nws tawm rau lub sijhawm tom qab yug menyuam, yog li ncua sijhawm mus ntsib kws kho mob gynecologist. Kev tsis saib xyuas zoo li no tuaj yeem ua rau muaj kev cuam tshuam tsis zoo.
Ntxiv rau, cov cim qhia ntawm endometritis tom qab yug menyuam ncaj qha nyob ntawm qhov mob hnyav.
Nrog kev mob me me, cov tsos mob pib tshwm sim thawj lub lim tiam tom qab yug me nyuam.
Hauv qhov no, endometritis tom qab yug menyuam yuav muaj cov tsos mob hauv qab no:
- nce lub cev kub;
- tachycardia;
- nce qhov loj ntawm lub tsev menyuam, mob hauv qhov chaw ntawm cov qog ntshav;
- ncig pom;
- qee zaum cov kua dej nkag mus rau hauv kab noj hniav ntawm lub cev xeeb tub.
Tus kab mob hnyav pib tshwm sim hauv thawj 2-3 hnub tom qab yug me nyuam. Feem ntau, cov kab mob hnyav tau pom tom qab yug me nyuam los yog ua haujlwm nyuaj.
Hauv qhov no, endometritis tom qab yug menyuam yuav muaj cov tsos mob hauv qab no:
- purulent-resorptive fever;
- mob hauv tsev menyuam;
- pus in lochia;
- tso tawm ntawm tsev menyuam mus rau pyometra;
- ntshav ntshav.
Tsis tas li ntawd, cov tsos mob ntawm endometritis hauv cov poj niam tom qab yug menyuam tau tshwm sim nyob rau hauv kev tsis zoo ntawm tus mob:
- tsis muaj zog;
- mob taub hau;
- poob qab los;
- insomnia;
- mob plab plab.
Endometritis tom qab phais
Cov tsos mob thiab kev kho mob ntawm endometritis tom qab yug me nyuam nyob ntawm hom kev yug menyuam. Kev phais tshem tawm ntawm tus menyuam yog nrog rau qhov xwm txheej uas tsis tshwm sim thaum yug menyuam:
- Txhawm rau tshem tawm tus menyuam, cov phab ntsa ntawm lub tsev menyuam raug txiav, uas ua kom yooj yim rau txoj hauv kev ntawm cov kab mob sib kis mus rau lub tsev menyuam mucosa. Tsis tas li ntawd, yog hais tias lub suture kis tau tus kab mob, tus kab mob yuav kis tau mus rau lwm cov khaubncaws sab nraud povtseg ntawm lub cev xeeb tub, yog li ntawd lub chav kawm ntawm endometritis tom qab cesarean yog heev hnyav.
- Cov khoom siv suture siv los ntawm cov kws kho mob tuaj yeem tsis lees paub los ntawm tus poj niam lub cev, thiab lub xub ntiag ntawm suture impairs uterine contractions, uas ua rau lub fact tias lochia lingers nyob rau hauv lub kab noj hniav thiab ua ib tug yug me nyuam rau cov kab mob.
- Tom qab kev phais mob, tus poj niam muaj glucocorticosteroid deficiency, uas txo qis kev tiv thaiv kab mob. Tsis tas li ntawd, ib tug poj niam synthesizes histamine nyob rau hauv ntau qhov ntau, ua rau muaj kev tsis sib haum xeeb hauv lub cev, uas tseem ua rau lub cev tsis muaj peev xwm tiv thaiv kab mob.
Ib tug poj niam muaj kev pheej hmoo ntawm kev tsim endometritis nrog txhua txoj hauv kev ntawm kev yug menyuam, tab sis tom qab kev phais nws qhov siab tshaj plaws:
- Lub cev ua rau muaj kev cuam tshuam ntau dua vim kev ua haujlwm tsawgtiv thaiv rog.
- Ib tug poj niam muaj cov kab mob uas tau yuam cov kws kho mob ua ntu zus - ntshav qab zib, teeb meem raum, mob metabolic thiab lwm yam.
- Nyob hauv kev yug me nyuam, tus poj niam poob ntshav ntau.
- YPolyhydramnios.
- Kev tsis saib xyuas cov kab mob septic thiab tshuaj tua kab mob los ntawm cov neeg ua haujlwm kho mob thaum lub sijhawm phais thiab tom qab phais.
mob endometritis
Raws li twb tau hais lawm, cov tsos mob thiab kev kho mob ntawm endometritis hauv cov poj niam tom qab yug menyuam yog nyob ntawm daim ntawv ntawm pathology.
Nyob rau hauv mob endometritis, ib tug poj niam yws txog cov tsos mob hauv qab no:
- kub heev - mus txog 39 degrees;
- mob hauv plab plab, uas tuaj yeem tawg mus rau lub plab;
- ntshav-purulent, serous lossis serous-purulent paug;
- kev qaug zog thiab qaug zog.
Nws yog ib qho tseem ceeb heev uas yuav tsum tau xyuam xim rau qhov tso tawm. Feem ntau, tom qab yug menyuam, pom pom tuaj yeem pom tau ob peb hnub, tom qab ntawd lawv cov lej maj mam txo qis, lawv ua xim av lossis daj. Txog ntawm lub lim tiam thib yim, txhua qhov tso tawm tag nrho nres. Mob endometritis yog nrog los ntawm cov paug tawm, thiab thaum muaj cov kua paug, lawv tuaj yeem tig ntsuab.
YChronic endometritis
mob endometritis tom qab yug menyuam nrog:
- tsis poob kub;
- uterine los ntshav;
- tso tawm uas muaj ntxhiab tsw;
- mob thaum tso quav.
ntsuas ntsuas
Kev kho mob ntawm endometritis tom qab yug me nyuam yuav tsum pib tom qab kuaj pom zoo:
- Nug tus neeg mob txog cov tsos mob thiab kev tsis txaus siab, nrog rau kev sau cov ntaub ntawv hais txog kev kis kab mob yav dhau los.
- Kev kuaj dav dav - ntsuas pulse, kub thiab ntshav siab, nrog rau palpation ntawm lub tsev menyuam.
- Kev kuaj lub ncauj tsev menyuam hauv lub rooj zaum gynecological.
- Palpation ntawm lub tsev menyuam txhawm rau txiav txim siab nws qhov loj thiab qib ntawm qhov mob.
- Ultrasound ntawm lub tsev menyuam - muab cov ntaub ntawv hais txog qhov muaj cov ntaub so ntswg thiab cov ntshav txhaws hauv lub cev xeeb tub, thiab tseem qhia nws qhov loj me.
- Kev kuaj ntshav - ntshav, smear, kab mob kab mob.
Txoj Cai Kev Kho Mob
Kev kho mob tom qab yug me nyuam tuaj yeem yog kev saib xyuas lossis phais.
Yog tias tus poj niam tseem tsis tau tawm hauv tsev kho mob maternity tawm thaum lub sijhawm pib muaj tus kabmob, nws raug xa mus rau chav haujlwm tshwj xeeb uas cov poj niam uas tau ntsib qee yam teebmeem tomqab yug menyuam. Yog tias tus poj niam pom cov tsos mob ntawm endometritis twb nyob hauv tsev, nws yuav tsum tau mus pw hauv tsev kho mob hauv gynecology department.
Kev kho mob tseem ceeb ntawm cov kab mob yog kev siv tshuaj tua kab mob. Nws yuav tsum raug coj mus rau hauv tus account tias tus poj niam pub niam mis rau tus menyuam. Yog tus neeg mob qhov mob hnyav heev, yuav tsum tau muab kev pub niam mis ntxiv.
Ntxiv rau kev kho tshuaj tua kab mob, lwm yam tshuaj tau sau tseg:
- Kho kom txhim khoKev cog lus ntawm lub tsev menyuam tau muab tshuaj oxytocin tom qab kev taw qhia ntawm "No-shpa". Nyob rau tib lub sijhawm, kev tawm ntawm uterine secretions txhim kho, thaj tsam ntawm qhov txhab ntawm qhov txhab raug txo, thiab cov khoom lwj yog absorbed rau hauv cov ntshav. Tsis tas li ntawd, txhawm rau txhim kho kev cog lus ntawm qhov chaw mos, lub tshuab cua txias tuaj yeem siv rau lub tsev menyuam.
- Immunocorrective tshuaj - "Kipferon", "Viferon", human immunoglobulin. Yog hais tias tus neeg mob tus kab mob kis zuj zus mus, cov tshuaj tiv thaiv kab mob tau muab tshuaj.
- Symptomatic therapy - painkillers.
Nyob rau hauv daim ntawv mob ntawm tus kab mob, kev kho mob yog raws li nram no:
- kev huv huv huv;
- remove synechia;
- kho hormonal aimed ntawm stabilizing hormonal theem.
Physiotherapy pab kom txo tau cov kab mob:
- Nemeck cuam tshuam kev kho tam sim no - qis thiab nruab nrab zaus siv plaub electrodes.
- Pulsed low-frequency tam sim no - tshuaj rau kev kho mob thaum ntxov.
- Acupuncture - simulates kev ua haujlwm ntawm lub cev tiv thaiv kab mob.
Hais txog kev kho mob radical, hauv qhov mob hnyav tau sau tseg:
- hysteroscopy;
- vacuum-aspiration;
- ntxuav cov kab noj hniav ntawm qhov chaw mos nrog tshuaj tua kab mob.
Cov txheej txheem zoo li no tsis tau ua nyob rau hauv cov xwm txheej hauv qab no:
- septic shock;
- suture tsis ua hauj lwm tom qab phais;
- puv-inflammatory txheej txheem sab nraum lub cev xeeb tub;
- pelvioperitonitis lossis peritonitis.
Kev kho mob nrog pej xeem tshuaj
Yuav ua li cas endometritis kho tom qab yug menyuam los ntawm txoj kev tsis yog ib txwm? Rau kev kho mob ntawm tus kab mob, cov poj niam raug txhawb kom douche nrog tshuaj ntsuab decoctions.
Piv txwv:
- oak bark;
- marshmallow cag;
- cuff.
Cov txheej txheem no txo qhov mob zoo. Txhawm rau npaj cov tshuaj, koj yuav tsum noj tag nrho cov tshuaj ntsuab nyob rau hauv sib npaug zos proportions, grind thiab sib tov kom huv si. Ib tablespoon ntawm sau yuav tsum tau nchuav nrog ib khob ntawm boiling dej, muab tso rau ntawm hluav taws thiab boil tshaj tsawg tshav kub rau 15 feeb. Tom qab ntawd hais, lim thiab siv raws li qhov xav tau.
Kev mob hauv lub tsev menyuam txo qis kev sib xyaw ntawm turpentine, paj marshmallow thiab lard, uas yog siv rau hauv plab plab.
Uterine o yog kho tau zoo los ntawm elm bark, decoction ntawm uas tau npaj zoo ib yam li daim ntawv qhia saum toj no.
Cov kab mob endometritis tom qab yug me nyuam, raws li cov neeg mob, tau kho zoo nrog cov khoom hauv qab no:
- YBirch nplooj, cuff nplooj, blueberries, geranium paj, tansy, violet, chamomile, oak bark.
- Ntsuab roob roob hauv paus, calendula, plantain, yarrow, thyme, noog cherry txiv hmab txiv ntoo, agrimony.
Cov khoom xyaw rau decoctions yuav tsum tau noj hauv qhov sib npaug, thiab tom qab ntawd ntxiv ib khob dej npau rau ib tablespoon ntawm kev sau. Khaws decoction rauqis cua sov rau 15 feeb, ces lim thiab siv li douche los yog da dej.
Muaj feem cuam tshuam
Yog tias tsis muaj kev kho mob raws sijhawm ntawm endometritis, metritis tshwm sim. Metroendometritis yog ib qho mob ntawm cov txheej txheem basal ntawm endometrium thiab cov myometrium uas nyob ib sab.
Tus kab mob nyuaj no tau muab faib ua peb theem:
- Tsuas yog cov islets endometrial thiab sheath cuam tshuam. Cov txheej txheem reactive inflammatory yog pom nyob rau hauv cov leeg nqaij txheej ntawm lub tsev menyuam - cov hlab ntsha nthuav, cov ntaub so ntswg swell, thiab me me cell infiltration tshwm sim.
- Ntxiv rau qhov saum toj no, cov txheej sib sib zog nqus tau cuam tshuam.
- Kab mob kis tau los ntawm parametrium thiab perimetry, pelvioperitonitis tshwm sim.
Daim ntawv mob metroendometritis yuav luag ib txwm ua rau muaj menyuam tsis taus.
Nrog rau daim ntawv ncua ntev ntawm pathology, salpingitis thiab oophoritis tuaj yeem txhim kho - cov txheej txheem inflammatory kis mus rau cov hlab ntsha thiab zes qe menyuam.
Ntxiv rau, cov kab mob txaus ntshai hauv qab no tuaj yeem ua rau muaj teeb meem ntawm endometritis:
- thrombophlebitis yog cov txheej txheem inflammatory uas cuam tshuam cov hlab ntsha hauv cheeb tsam pelvic;
- pelvic abscess - ib qho mob purulent tsom uas muaj nws cov phab ntsa;
- sepsis.
ntsuas kev tiv thaiv
Txhawm rau txo qhov kev pheej hmoo ntawm kev tsim cov kab mob endometritis tom qab yug me nyuam, koj yuav tsum ua raws li cov hauv qab no:
- Npaj thiab npaj rau cev xeeb tub. Ib tug poj niam ua ntej pibcev xeeb tub yuav tsum txheeb xyuas thiab kho txhua yam kab mob gynecological.
- Ncua sij hawm sau npe ntawm lub tsev kho mob antenatal. Lub sijhawm pom zoo - mus txog 12 lub lis piam.
- Kev tshuaj xyuas tsis tu ncua los ntawm tus kws kho menyuam yaus-gynecologist. Nyob rau lub 1st trimester, qhov no yuav tsum tau ua ib hlis ib zaug, nyob rau hauv lub thib ob peb lub hlis twg - ib zaug txhua 2 lub lis piam, nyob rau hauv lub peb hlis ntuj 3 - ib zaug ib lub lim tiam.
- Ua raws li cov cai ntawm kev noj zaub mov noj. Kev noj zaub mov ntawm tus poj niam cev xeeb tub yuav tsum muaj cov carbohydrates thiab cov rog thiab txaus hauv cov zaub mov muaj protein. Nws raug pom zoo kom tsis suav cov rog, kib, qab zib thiab cov hmoov txhuv nplej siab, noj ntau cov khoom noj siv mis, nqaij thiab legumes.
- Kev kho lub cev rau cov poj niam cev xeeb tub. Kev ua si ntawm lub cev me yog qhia - taug kev, ncab, ua pa ua pa. Koj yuav tsum ua li ib nrab teev ib hnub.
Tsis muaj qhov tseem ceeb me me hauv kev tiv thaiv kab mob endometritis tom qab yug me nyuam yog qhov tseeb:
- Kev qhia thiab contraindications rau qhov chaw mos los yog kev phais yuav tsum raug soj ntsuam.
- Kev kuaj ntshav rau cov nqaij mos thiab kev ncaj ncees.
- Kev tswj cov tshuaj tua kab mob rau lub sijhawm ntev tsis muaj dej, nrog rau kev ua haujlwm caesarean.
Raws li qhov kev cia siab ntawm postpartum endometritis, hom mob me thiab nruab nrab ntawm tus kab mob nrog rau txoj hauv kev muaj peev xwm los kho qhov kawg hauv kev rov qab los thiab kev khaws cia tag nrho ntawm kev ua me nyuam. Nyob rau hauv daim ntawv loj decompensated, muaj teeb meem tshwm sim - septic mob,poob ntawm lub cev xeeb tub thiab txawm tuag. Yog vim li ntawd cov kws kho mob xav kom cov niam uas muaj kev cia siab yuav tsum ua tib zoo saib xyuas lawv txoj kev noj qab haus huv ob qho tib si ua ntej thiab tom qab yug me nyuam. Kev npaj kom raug rau cev xeeb tub, nws muaj peev xwm tswj tau, ua raws li tag nrho cov cai thaum lub sij hawm yug me nyuam, nrog rau kev tiv thaiv tom qab yug me nyuam ntawm endometritis - cov no yog cov kev ceev faj tseem ceeb uas yuav txo tau txoj kev pheej hmoo ntawm kev tsim endometritis thiab tso cai rau ib tug poj niam kom txaus siab rau nws niam.
