Laparoscopy kwa mimba Ectopic: mbali ya ntchito, zotsatira za

M'nkhaniyi, timapereka inu timudziwe bwino mimba laparoscopic ectopic, lomwe limapezeka nthawi zambiri za 5%. Mwatsoka, kupulumutsa mwana ankalephera, kuthetsedwa kale za miyeso chojambulidwa, mwayi ndi kusunga zokhudzana kapena moyo ngakhale mkazi. Ngati mwakumana ndi zizindikiro za mimba, muyenera yomweyo kupita gynecologist lapansi. Mwamsanga kuchita ultrasound, liwiro ndi kosavuta mukhoza tichotse zotsatira zosasangalatsa. Komanso, ultrasound kumathandiza kudziwa malo a implantation wa linagwira lapansi. Ngati ultrasound anapeza kuti mimba ectopic, m'pofunika kanthu mwamsanga (usokoneze). Mu njira zimene tingachite? ndi laparoscopy chubu ndi mimba ectopic chiyani? Mafunso onse awa mupeza yankho m'nkhani ino.

mimba ectopic

Choyamba tidzamva mmene umuna zimachitika. Izi maphatikizidwe wa gametes awiri (umuna ndi umakakumana) mu chubu mazira. Pambuyo ndondomeko izi kale ukala dzira chimachititsanso mu chiberekero, ndipo zaikidwa pakhoma. Ichi ndi chitsanzo cha mimba wabwinobwino, lomwe limapezeka mu nthawi makumi asanu ndi anayi mphambu zisanu kuchokera zana. Nthawi zina, dzira ndi anapitiriza mu chubu mazira ndi kumanga kulikonse kunja uterine patsekeke. Kodi umawonongeka akhoza atathana:

• mazira chubu;
• mu zonse m'mimba;
• mu n'kuwasanganiza lapansi.

Izi misplacement ukala linagwira akutchedwa mimba ectopic. Kupulumutsa mwana Pankhaniyi sachiza, dokotala chofunika kuti asankhe ndondomeko ya kuchotsa ake. Laparoscopy kwa mimba Ectopic - ndi njira wotchuka kwambiri ndi wofatsa mankhwala. Ngati nthawi kuchitapo kanthu, ndiye pambuyo opaleshoni patapita kanthawi mukhoza kuyamba akukonzekera kubadwa kwa mwana.

Ectopic kapena Tubala mimba - ndi kudwala, imene dzira ndi anapatsa kunja chiberekero. Dziwani kuti posachedwapa chiwerengero cha milandu ikukula.

ndi matenda hule kudwala chiyani? Zikuphatikizapo zotsatirazi:

• matenda opatsirana a chiberekero;
• odwala zokhudzana;
• matenda kapena njira yotupa zikuchitika mu chikhodzodzo mkodzo;
• kobadwa nako nthenda Kapangidwe ka mipope;
• opareshoni, anasamukira ku Ukalawu;
• mahomoni kulephera;
• pafupipafupi mimba;
• pamaso helix (njira za kulera);
• yaitali Inde mankhwala kukonzekera m'thupi;
• maliseche endometriosis;
• chotupa chiberekero ndi zina zotero.

Laparoscopy chubu ndi mimba ectopic kuti akufotokozera mu Ukalawu, lofunika. The kale ndi matenda a kudwala izi ndi kuchita opaleshoni, wamkulu Mwina apulumuke zokhudzana ndi. Komanso, muyenera kupeza chifukwa ndi kumwa mankhwala kupewa zisadzachitikenso.

Mitundu ya mimba ectopic

Munthu angathe tchulani gulu zotsatirazi mimba ectopic (pa malo kukonza linagwira)

• chitoliro;
• yamchiberekero;
• m'mimba;
• khomo lachiberekero.

Yoyamba ndi ambiri (98% a milandu onse). Pamene chitoliro yolusa mimba ectopic amapezeka mmodzi wa mucosa wa Ukalawu. Choncho n'zotheka kugawanitsa mawonekedwe tubular wina subspecies angapo (chifukwa malo mu mazira chubu):

• ampullar;
• isthmic;
• interstitial;
• fimbrial.

The ena mitundu atatu awa n'zochepa kwambiri. Pamene yamchiberekero mimba ectopic amapezeka kuphatikiza mu M'mimbamo wa follicle, pamene m'mimba - mu zonse m'mimba, khomo lachiberekero - mu khomo pachibelekeropo.

zochiritsira

nthawi zofunika kwambiri kudziwa kumene kuli mimba ectopic. Izi zidzathandiza zizindikiro ake. Choyamba, mkazi angaone ngati kupweteka, mwina iye adzapereka m'chiuno. Ngati panthawi imeneyi sakuona dokotala, ululu posachedwapa pachimake. Sikuti kutenga ululu mankhwala, monga izi zikhoza kusokoneza matenda a mimba ectopic. Monga mkazi akhoza kumva wamphamvu kufooka, chizungulire komanso nseru.

Samalani Kugawilidwa kwanthaka, iwo akhoza kukhala mtundu wamagazi, amasonyeza magazi mkati chifukwa kuwonongeka kwa zokhudzana ndi. Ngati mimba mayeso ndi kwabwino ndipo inu mungazindikire zizindikiro zimenezi, onetsetsani kupita gynecologist lapansi. Chonde dziwani kuti imfa ya chikumbumtima - komanso ndi chizindikiro cha matenda.

dokotala ayenera ndikutume kwa ultrasound mayeso chifukwa cha zomwe adzapezeka malo implantation wa linagwira lapansi. Atalandira zotsatira za gynecologist ndi n'kukulemberani chithandizo. Njira kuchotsa mimba ectopic:

• laparotomy (kugwira ntchito phukusi, imene imakhudza kutsegula khoma m'mimba, kuchotsa Ndisanaumbidwe ndi chitoliro kapena n'kuwasanganiza);
• laparoscopy (mimba ectopic ndi njira yabwino kwambiri ndi zochepa oopsa, pa ntchito amapanga okha puncture zing'onozing'ono);
• mankhwala.

Tsopano tiyeni tikambirane pang'ono za njira iliyonse.

Laparotomy - kuchotsa linagwira ntchito, zomwe zingachititse kuchotsa chubu kapena n'kuwasanganiza. Njira imeneyi anali kale, pamaso pa Kubwera kwa laparoscopy. Komabe, m'madera ena zipatala ndi kuchita lero. Izi zikhoza kukhala milandu zotsatirazi:

• Sakupezeka zofunika ano zipangizo;
• palibe katswiri amene angathe kuchita opaleshoni laparoscopy;
• ndi mwakayakaya ya mkazi, kusokoneza moyo wake.

Laparotomy imachitika mu njira zingapo:

• milking;
• tubotomiya;
• tubektomiya.

Yoyamba njira zimathandiza kuteteza odulidwa mazira chubu. Linagwira ndi extruded, n'zotheka, ngati ili pafupi kuchoka kwa chubu. Pambuyo opaleshoni mkazi akhoza kutenga mimba.

Tubotomiya kumafuna ang'ambe thupilo kapena kuchotsa chubu pamodzi ndi dzira yoopsa. Pogwiritsa ntchito njira imeneyi, ngati inu kuchotsa dzira simungathe ndi extrusion. Mwina kubwereza mimba akazi pambuyo opaleshoni amakhalabe, koma kwambiri yafupika.

Tubektomiya - kuchotsa kwa mazira chubu, ndi n'kuwasanganiza ngati n'koyenera. Kumene, amayi apakati mwachidziwikire mwina koma kupulumutsa moyo wake angathe. Monga ulamuliro, njira iyi agwiritsa ntchito chabe pa umphawi wadzaoneni pamene masekondi kulengeseka.

Ife tifike ku njira zambiri panopa otchuka opaleshoni imeneyi - laparoscopy ndi mimba ectopic. Iwo chochepa zoopsa ndi wofatsa. Njira pansipa ife adzalipira nthawi zambiri.

Njira lomaliza - mankhwala. Dziwani kuti madokotala sakhulupirira kuti ankaona opaleshoni. Njira ntchito kawirikawiri ndi nthawi yochepa kwambiri. Kwenikweni umenewu chagona kumayambiriro "Methotrexate" mankhwala wakupha Ndisanaumbidwe linagawanika. Zikuoneka kuti mimba pambuyo mankhwala wopambana pafupifupi osati yafupika kuyerekeza ndi zimene kale.

laparoscopy

Monga tanena kale, laparoscopy ndi mimba ectopic - ndi njira yabwino mankhwala. Pomwepo tisaiwale kuti si zoopsa. Laparoscopy kumathandiza kwambiri popanda kumva ululu uliwonse kuchotsa mimba ectopic, kuti ndi amene akufotokozera kunja chiberekero. Mkazi pa opaleshoni akhoza Simumva kuwawa kulikonse kapena kusamva, monga timachitira pogonekedwa ndi mankhwala ambiri.

The dokotala akufuna kupanga ang'ambe thupilo yaing'ono zonse m'mimba ndi kuyambitsa chida chapadera chimene inu mukhoza kuchotsa Ndisanaumbidwe kwa chubu mazira. Ntchito lonse umalamulidwa ndi makina ultrasound.

Pamene wakhala bwino, mwana laparoscopy mimba ectopic simungathe kupulumuka. Koma mu nthawi kuchita opaleshoni kumathandiza kupulumutsa moyo ndi thanzi la mkazi. Pa kukayikitsa woyamba wa mimba ectopic kupita kwa dokotala. Liwiro adzatengedwa chithandizo cha mimba ectopic, m'pamenenso mkazi m'tsogolo ana.

Kale pa ntchito, adokotala wasankha kusunga chubu kapena ayi. Zonsezi kumatengera zifukwa zingapo. chubu mazira ndi anapitiriza ngati:

• yochepa mimba;
• salpinx zambiri anakhudzidwa.

Ngati ziwiri zinthu izi zofunika zimapezeka, dokotala akupanga ang'ambe thupilo yaing'ono kuchotsa sac gestational. Pambuyo ntchito ngati mkazi akupeza bwino ndipo amasunga thanzi lanu ubereki. Apo ayi (ngati linagwira mwachilungamo lalikulu ndi mwamphamvu maganizo mazira chubu) dokotala mukuganiza kuti kuchotsa gawo kapena onse chitoliro lapansi.

Apanso ine kuyandikira tcheru chanu chakuti m'mbuyomo mufunafuna thandizo kuchokera gynecologist ndi mwayi kwambiri kusunga thanzi lawo ubereki. Khalani tcheru ndipo mverani zizindikiro thupi lanu. Kuti adzimvera chigawo ichi, ine ndikufuna kuti asonyeze ubwino wa opaleshoni ano amatchedwa laparoscopy:

• Small kukha mwazi;
• mofulumira kuchira pambuyo ntchito;
• osowa postoperative zosokonezeka;
• palibe zipsera.

Mu ntchito iyi, pali ubwino:

• Izo zidzachitika mwachinyengo laparoscopy zonse m'mimba kwa magazi (magazi chifukwa cha mapangidwe adhesions, comaliza, nayenso, kungachititse kuti kubwereza kwa mimba ectopic);
• Pambuyo pa opaleshoni, dokotalayo akhoza kuwunika boma la chitoliro chachiwiri ndi zokhudzana;
• zotheka reconstructive alowererepo (colliotomy, kubwezeretsa mipope patency).

Mwamsanga nkhani ya laparoscopy, mpata zambiri pathupi mwana wathanzi m'tsogolo.

yopulumutsa chitoliro

Laparoscopy kwa mimba ectopic ndi kuteteza chitoliro ndi ikuchitika pansi malamulo: gestational yaing'ono chubu si kuonongeka. Nthawi zina, dokotala sangathe kusiya chitoliro, cifukwa chifukwa zisadzachitikenso matenda, monga sadzakhalanso kugwira ntchito yake mwachindunji.

Laparoscopy ndi mimba ectopic ndi kuteteza chitoliro ndi zotheka ndi chithandizo yake kuchipatala. Mverani chizindikiro thupi lanu. Development wa mimba ectopic ndi zoopsa kuti mpanda wa mazira chubu Tambasula ndi kuwonjezeka linagwira. Chifukwa, iwo alibe kuima ndi kung'ambika. Pa nthawi imeneyi n'kofunika kuti kokhazikika chitoliro, ndi moyo wa mkazi.

Ngati mukumva zizindikiro woyamba wa mimba ectopic, funsani munthu gynecologist. Kupeza Vuto izo yafupika mfundo zingapo:

• kusonkhanitsa magazi zofufuza hCG;
• ultrasound.

Ngati ectopic pregnancy mayeso, ngakhale unachitikira m'nyumba zawo, ndidzakuwonetsa chifukwa positive. Komabe, ultrasound ndi wapezeka ndi linagwira mu uterine patsekeke. Pankhaniyi, Akufunika kupita matenda laparoscopic. Ngati inu muiwale kuchita ichi, mwayi wa kupulumuka wa chitoliro ndi kuteteza uchembere wabwino ndi lalikulu kwambiri.

kuchotsa chubu

Opaleshoni laparoscopic ectopic pregnancy ndi kuchotsa chubu n'kofunika kwambiri zina. Pa iwo mudzaphunzirira gawo ili nkhaniyo.

Ntchito palokha ndi otetezeka kwathunthu ndi kusintha mofulumira nthawi losiyana akazi pambuyo. Ndi pogonekedwa ndi mankhwala ambiri. Kukhazikitsa ake ayenera kuchita atatu puncture (m'mimba si centimeter kuposa wina) kwa laparoscope ndi laparoscopic machubu. wachiwiri chofunika kusonyeza chithunzi chimene chili chofunika kuti aone akuluakulu a boma.

Laparoscopy ali mitundu iwiri:

• tubotomiya (cha zimene talankhulazi pamwamba, dokotalayo amadula chubu mazira ndi kuchotsa dzira, kusunga chitoliro ntchito);
• tubektomiya (kuchotsa mazira chubu).

Laparoscopy chiberekero pa mimba ectopic ndi kuchotsa chubu chofunika zochitika mwadzidzidzi, ndi kulemedwa kwambiri (ngati kuti chubu mazira amanyamula chiopsezo kuposa kuchotsa ake). Sungani n'zotheka mu chochitika palibe kusintha structural, mwinamwake ndi osathandiza, oopsa.

Choncho tubektomiya kuchita ngati:

• ndi inasinthiratu mu chubu mazira;
• mimba ectopic ndi implantation abwerezedwa chitoliro chomwecho monga kale pambuyo tubotomii;
• adhesions mu mafupa a chiuno ndi.

Mu sitepe mezosalpinks excised ndi isthmic kulekanitsidwa. Salpinx kuchotsedwa pamodzi ndi dzira yoopsa. Unikani boma la "pakati" chitoliro anayendera amathandiza ena. Tafufuza dokotalayo chiganizo: mukhoza kusiya chubu mtima kapena ndi bwino kuchotsa.

Kusunga uchembere wabwino ndi kuthekera kutenga mimba ndi kubereka mwana wathanzi ayenera musazengereze pa ulendo gynecologist lapansi. mankhwala panthawi yake ndiponso mankhwala - ndicho chinsinsi tsogolo lanu likhale losangalala.

kuchira

Choncho laparoscopy - ndi kuchotsa mimba ectopic, amene, ngati mankhwala yake ndi modekha. Takambirana kale anatsindika ubwino wa ntchito imeneyi. Mmodzi wa iwo - kuchira mwamsanga akazi pambuyo laparoscopy. Kuchotsa mimba ectopic mothandizidwa ndi njira imeneyi chagona pa kuboola mabowo kakang'ono oyamba a zipangizo zapadera. Mu nkhani imeneyi, sutures amachotsedwa pa tsiku lachisanu kapena lachisanu ndi chiwiri pambuyo opaleshoni, pakalibe kutupa.

Ayamikira wa madokotala mu nthawi postoperative:

• chithandizo cha zilonda ndi ayodini masabata awiri;
• masabata awiri okha kutenga mimvumbi;
• usadye wochuluka ndi zokometsera;
• kugonana n'chotheka pambuyo pa kukonzedwanso kwa kuzungulira kusamba;
• mimba akukonzekera kukambidwa ndi dokotala (mtengo mwezi kudikira 1 mpaka 4).

magazi

M'chigawo chino, tikambirana magazi pambuyo mimba laparoscopic ectopic. akazi ambiri omwe anali opaleshoni, anaona kuti patapita masiku 20-30 magazi lotseguka. Anaimba mlandu pa mbali zotsatira za mankhwala akuchipatala. Mmunsimu muli chitsanzo cha mndandanda wa mankhwala konzanso;

• kashiamu kolorayidi;
• "Metrogil";
• "Aktovegin";
• "TSikloferon";
• "AGT";
• "Diclofenac";
• "Gluconate CA";
• "Voebenzim";
• "Rotramitsin";
• "Viferon".

The njira ya mankhwala ayenera anayamba nthawi yomweyo pambuyo opaleshoni, ntchito mankhwala amenewo, amene anaika dokotala nawo. Musanatsegule magazi mwina kuundana magazi, ichi ndi zabwinobwino pambuyo laparoscopy. Tsegulani magazi - palibe kanthu ngati mwezi.

kusankha

Zoonera pambuyo laparoscopic ectopic pregnancy nkhani za mwezi akubwera. Mwamsanga pambuyo opaleshoni, musati mantha ngati kusankha adzakhala "kudzoza" khalidwe. Ngati zoonera anaonekera kale kuposa masiku 25-30 pambuyo opaleshoni, izo zikusonyeza magazi uterine. Onetsetsani kuti dokotala.

Komanso, musati kuvula kudzacheza kwa gynecologist ngati palibe kumaliseche kuposa mwezi umodzi pambuyo opaleshoni ya. Zimenezi zikusonyeza kuti mkhutu m'thupi bwino ndi ofuna kudutsa njira yapadera mankhwala.

Ngati pali matenda m'thupi, amasulidwe adzakhala ndi chinthu chosangalatsa fungo. Iwo amafanana kugwirizana phala. Onetsetsani kuti kudutsa kuona ndi mankhwala.

Mwezi pambuyo opaleshoni

Mwezi ndi mimba laparoscopic ectopic kufika pasanafike masiku sate pambuyo ntchito. Musadandaule ngati mukuona magazi kuundana.

Amenorrhea zikusonyeza kulephera m'thupi pambuyo opaleshoni. Kulankhula kwa dokotala. Iye ayenera kutumiza inu mayesero kutsimikiza kapena kutsutsa mfundo imeneyi. Ngati zolakwika aliyense mwakale ali yomweyo anatumiza kwa upo kuti gynecologist lapansi.

Mimba pambuyo laparoscopy

Mimba pambuyo mimba laparoscopic ectopic n'zotheka. Chonde dziwani kuti pamafunika kukaonana pa nkhani imeneyi ndi gynecologist lapansi. Ngati palibe contraindications, mukhoza kuyamba kukonzekera kukhala pakati pa mwezi wamawa.

Ndi bwino kuganizira mfundo yakuti kuti kuteteza zisadzachitikenso mimba ectopic ayenera kukayezetsa kufufuza zonse ndi kudziwa chifukwa cha pakuwonekera kwake. Pambuyo akudzizindikiritsa ndi kukonza mavuto, mukhoza bwinobwino kupanga chimodzi zambiri amayesetsa mwana pathupi.

The mimba nthawi yaitali pambuyo laparoscopy, mimba ectopic sangathe kuyenda kwa nthawi yaitali. Pankhaniyi, akazi ndi thandizo la ndondomeko lidzawagwiritsenso. Nkofunika amatchula kuti njira imeneyi akhoza kutenga mimba ngakhale anthu asungwana ndi amayi amene ali ndi uterine chubu chinatha pa ntchito.

Reviews

Laparoscopy mimba ectopic ndi ndemanga zabwino kwambiri. Ndipotu, njira imeneyi amakhala ndi konzanso mofulumira ndi luso kukhalabe uchembere wabwino. Komanso, dokotala pa opaleshoni akhoza kuthetsa adakali mavuto ena amene kupewedwa Mayi woyembekezera. Zikuphatikizapo kung'ambika wa adhesions kapena Tubala patency kubwezeretsedwa.