Varicocele mu achinyamata: Zoyambitsa, chithandizo, zotsatira

mitsempha Varicose wa chingwe spermatic crimp - mmodzi wa pathologies ambiri mwa anthu. varicocele matenda pachimake pa zaka 14-15. Ambiri zaka 15-30 - ndizo m'badwo pamene chosayenerera limapezeka nthawi zambiri. Ambiri matenda m'zimene othamanga ndi anthu ankagwira ntchito thupi. Choncho, tingakhulupirire amanena kuti akulu katundu amagwira ntchito yofunika kwambiri mu mitsempha ya chingwe spermatic.

kudwala kuli ndi phindu kwambiri pa ntchito wamwamuna ubereki. Ndipo poganizira kuti varicocele zowawa mpaka 30% ya anthu wamwamuna, kufunika vuto zimaonekera.

Kodi varicocele?

Spermatic chingwe zikuphatikizapo mwa zinthu zina ndi pampiniform venous plexus. Ndi izi ndipo anadabwa varicocele lapansi. Mitsempha ya chingwe spermatic ndi pathologically anasintha, kukhala dilated ndi tortuous.

Zachitikiranji zimenezi? Matendawa amapezeka chifukwa kuphwanya outflow venous, chifukwa magazi amasonkhana mu plexus venous motsatizana ndi deforming khoma chotengera.

The etiology wa varicocele

Zotengera za thupi dongosolo la wosakoma vena cava, zili ndi mavavu wapadera, chifukwa magazi umayenda kuchokera pansi pa iwo. Popanda anatengera izi, ambiri a magazi chabe sibwenzi anafika mtima; Komabe, pamaso pa chipangizo valavu bwino kwambiri kuteteza stagnation magazi ndi retrograde (chammbuyo) zoyenda ake.

Chinthu chachikulu chomwe varicocele mu achinyamata - kulephera mavavu testicular mtsempha. Mwachibadwa, magazi akulowa ku plexus pampiniform mu mtsempha aimpso kapena mwachindunji mu otsika vena cava yokha pa mitsempha testicular. Kuti ndi vuto mlingo lomaliza kuli nthambi ndi ndi chifukwa chachikulu cha matenda.

Valvular insufficiency kungakhale chachikulu (chifukwa cha kuvutika kobadwa nako testicular mtsempha, kufooka minofu kapena wosanjikiza otsiriza minofu connective dysplasia) ndi sekondale (akuwuka chifukwa cha kuchuluka kwa dongosolo mavuto wosakoma vena cava kapena m'mitsempha aimpso). Zimayambitsa yachiwiri vavu insufficiency ndi onse njira pathological kuti compress ndi spermatic chingwe, testicular, mtsempha aimpso kapena mwachindunji wosakoma vena cava, limapangitsa magazi pa iwo outflow :. Neoplasm m'mimba chophukacho, adhesions, etc. Lang'anani, amalenga ina imene magazi kumayamba stagnate mu mtsempha wa chingwe spermatic.

gulu la varicocele

WHO akuonetsa gulu zotsatirazi matendawa:

1. Vienna pampiniform plexus bwino osati chimafotokozera kukhudza komanso zowoneka noticeable. Dzira makwinya.
2. Mtsempha akhoza palpated, ngakhale wosaoneka.
3. Zabwino Valsalva kuzemba. Onani kapena palpate mtsempha amati chitsanzo n'zosatheka.

Komabe, mu dziko lathu kwambiri amagwiritsidwa ntchito gulu Yu. F. Isakova. Iye, komanso amene m'mbuyomu, chimasiyanitsa masiteji atatu, ngakhale zovuta matenda akusonyeza kuti iwowo. Izo zikuwoneka motere:

1. Vienna wosaonekayo, ndi sanalemberetu ndi kukhudza. Amaganiziridwa varicocele n'chotheka mwa Valsalva kuzemba.
2. Vienna bwino palpable, koma zosaoneka.
3. Mitsempha ndi zooneka ndi palpable. Kusinthidwa dzira.

Mwa njira! Valsalva mchitidwe imagwiridwa motere. Opirira kuimirira akufunsidwa kutsokomola. Chifukwa, kuthamanga mu zonse m'mimba likutuluka, ndi mtsempha plexus pampiniform pathupi. Nthawi zambiri, kwa kuyerekeza anati nyemba ndi ikuchitika mu malo supine. Pankhaniyi, mayeso adzakhala negative.

chithunzi matenda

Kawirikawiri varicocele mu achinyamata sikuchita zomverera aliyense zotengera malingaliridwe. Kawirikawiri, odwala ena amadandaula Ndikumva chisoni kapena kupweteka kwa scrotum pambuyo thupi. Komabe, zizindikiro zimenezi ayenera kusonyezedwa kusamala, chifukwa nthawi zambiri iwo ndi zizindikiro loyamba la kutupa kwa machende ndi zipolopolo awo (orchitis ndi orchiepididymitis).

The varicocele oopsa?

Machende amuna - malo mapangidwe maselo umuna, maselo nyongolosi, feteleza dzira. Matupi amenewa ali ofunika kwambiri ku mawu a chotenga mbali mu ntchito ubereki.

Varicocele chifukwa kuchulukana mu plexus venous ndalama zambiri magazi chifukwa nyamuka m'deralo kutentha lomwe lili ndi ingafooketse spermatogenesis. Komanso, mu varicocele chatsitsa kotunga zimakhala ndi mpweya ndi maselo testicular amapezeka hypoxia; akusokoneza magazi testis chotchinga, zomwe zingachititse mbadwo wa chitetezo, spermicides (popeza zazindikirika ndi chitetezo cha m'thupi monga nthumwi ankhanza). Varicocele nthawi zambiri limodzi ndi disruptions mahomoni kuti anapotoza pa ndondomeko ya spermatogenesis.

Machende amuna ndi ankaganizira kwambiri njira zonse izi, kotero aliyense wa iwo mosavuta kusokoneza mapangidwe umuna ndi umuna.

Tikumbukenso Komabe, udindo wa varicocele mu mapangidwe osabereka akadali akuphunziridwa. Osati aliyense amene amakhulupirira kuti njira pamwamba zakuya za pathogenesis wa varicocele mu achinyamata. Choncho udindo wa mitsempha varicose wa chingwe spermatic mu osabereka wamwamuna amakhalabe penapake yovutayi.

Kodi kuchita?

The zambiri matenda varicocele mu achinyamata. Chithandizo, motero, imagwiridwa mu unyamata. Ndi, monga mukudziwa, ndi za mitundu iwiri: ndiwofatsa komanso opaleshoni. Ngati ife kulankhula za varicoceles mu achinyamata, msonga yoyamba athanso kulamulidwa kunja. chithandizo ndiwofatsa za matenda kulibe. Koma chiwerengero cha ntchito ntchito yochotsa odwala matenda ichi ndi chachikulu.

Mitundu ya zikunena mphuno varicocele

zonse ntchito pa machende akhoza kugawidwa mu magulu angapo:

1. Zopangira alowererepo, zochokera excision ya mitsempha spermatic. Panopa, salinso ntchito, chifukwa ntchito yawo 90% ya milandu manja testicular unkachitika.

2. Ntchito akukonzekera dzira nyengo ya inguinal ngalande kapena minofu aponeurosis. Tsopano si ntchito, monga limodzi ndi testicular manja (20-70% milandu).

3. resection gawo scrotum ndi mazira akunja latching. Varicocele Kuyambiranso amapezeka 100% milandu Komabe, ntchito ili ndi inefficient ndipo osati panopa ntchito.

4. Ligation testicular mtsempha pamwamba pa crease inguinal. mtundu wa ntchito kumayambitsa kutha kwa otaya retrograde magazi ndi kupereka zing'onozing'ono kuchuluka kumwa. Komabe, kafukufuku wasonyeza kuti varicocele si nthawi zonse kudziletsa kudwala. matenda wenewu chizindikiro cha kulankhula za vuto, chifukwa mu oopsa venous. Pankhaniyi, ntchito mwina zimawonjezera vutoli.

5. Ntchito kulenga anastomoses mtima. Kwenikweni awo kwagona kuti venous Reflux anakhalabe, koma ndi kukonza anastomosis resets kuchuluka owonjezera magazi ndi mitsempha amachepetsa.

Panopa, chithandizo cha varicocele mu achinyamata opareshoni - si nthawi yaikulu kusokonezedwa ndi kutsegula zonse m'mimba. Pali mankhwala asang'ambe.

Opaleshoni wa mini-kupeza

Ntchito ambiri kuchitira varicocele - Marmara. Iye anachita pansi mankhwala oletsa ululu pamalopo. The groin, ku mbali kumene anayamba pathological ndondomeko anachita ang'ambe thupilo 2-3 cm. Kuchokera mwayi uwu kuligaŵa zinthu spermatic chingwe, allocated Vienna, overtighten ligature ndi intersects. chilonda ndi sutured mu zigawo.

Motere ku malongosoledwe a ntchito si recessed, komanso kuchitidwa pa outpatient maziko. Sutures amachotsedwa pa tsiku la 8.

Postoperatively, mlungu woyamba zofunika fixation scrotum (zimatheka ndi kuvala mitengo ikuluikulu). Mu mwezi 1 ayenera kupewa kugonana.

Laparoscopic zodula

Njira ina ndi zotsatira zabwino zodzikongoletsera. Kudzera puncture mpanda m'mimba mwa zida wapadera olekanitsidwa testicular mtsempha, klipiruyut ndi intersect iwo.

Poyerekeza ndi opaleshoni lotseguka, njira imeneyi angapo ubwino:

1. Short postoperative nyengo chifukwa sitili pafupifupi mabala pambuyo opaleshoni anachita ndi puncture ndi sanadulidwe.
2. Palibe chiopsezo chophukacho postoperative.
3. A zabwino zodzikongoletsera kwenikweni.
4. Pang'ono mwayi mavuto postoperative.

endovascular flebosklerozirovanie

Njira imeneyi ndi zina opaleshoni. Kwenikweni ake kwagona kuti mu mtsempha testicular wothandizila matenda umayamba, chimalimbikitsa aumirira mapangidwe ndi kuchotsa magazi mwa mtsempha. Iwo anachita pokhapokha ngati palibe chifukwa choganizira yachiwiri vavu insufficiency ndi venous oopsa.

Chinthu chachikulu kumvetsa odwala varicocele, - nthawi ya ntchito n'kofunika. Iwo imatsimikizirika kuti chithandizo mwamsanga kwambiri kuchepetsa kufala kwa matenda a spermatogenesis ndi mapangidwe osabereka.