Opaleshoni yotereyi, monga kuchotsa chiberekero, ndiyo njira yodalirika yothetsera matenda ena achibadwa. Amachitidwa kuchipatala, ndipo kukhazikitsidwa kwake kumayendetsedwa ndi nthawi yayitali yokonzekera. Ganizirani za opaleshoniyi, mitundu, njira, zovuta ndi zotsatirapo mutachotsa chiberekero.
Kuchotsa chiberekero - zizindikiro za opaleshoni
Matenda a chiberekero - chomwe chimatchedwa ntchito yochotsa chiwalo chogonana. Ikuchitika pokha pa umboni, umene ulipo ambiri. Zina mwazofala kwambiri ndizoyenera kuzizindikira:
- njira zovulaza mu chiberekero;
- kachilombo ka HIV;
- uterine fibroids , mu kukula kwake masabata oposa 12 a mimba;
- kukula kwa chifuwa - pachaka kwa miyezi inayi ya mimba ndi zina;
- necrosis wa nthenda ya myomatous;
- menorrhagia zovuta ndi kuchepa kwa magazi;
- adenomyosis wa madigiri 3-4;
- matenda opweteka aakulu m'mimba yaing'ono;
- Kutaya kwa chiberekero ;
- endometriosis popanda kupititsa patsogolo patatha mankhwala ochiritsa (mankhwala), kupopera.
Njira zochotsera chiberekero
Pochita opaleshoni, njira zosiyanasiyana zochotsa uterine zimagwiritsidwa ntchito. Kusankha kwachindunji kumadalira mtundu wa zolakwira, kukula kwa chikondi cha chiwalo chogonana ndi zida zake. Malingana ndi zotsatira za ultrasound, madokotala amasankha kugwiritsa ntchito izi kapena njira imeneyo. Kawirikawiri, kuchotsedwa kwa chiberekero kukuphatikizidwa ndi kusakanikirana kwa matenda omwe ali pafupi. Malingana ndi kuchuluka kwa ntchitoyi, amasiyanitsa:
- chiwonongeko;
- chiwerengero;
- pangysterectomy;
- zovuta kwambiri.
Kuonjezera apo, malingana ndi njira yopezera kulumikila pa nthawi yopaleshoni, hysterectomy ikhoza kukhala:
- laparotomic - chiberekerocho chimachotsedwa pamtumbo;
- kuchotsa chiberekero ndi njira ya laparoscopic - pogwiritsira ntchito chipangizo chapadera, kupyolera mu mabowo ang'onoang'ono m'mimba;
- Ukazi - kulandira chiberekero chokhudzidwa ndi kudzera mu umuna.
Zosakanikirana za chiberekero cha chiberekero
Mankhwala osokoneza bongo amachitidwa ngati pali kuthekera kosunga chibelekero, gawo ili la chiwalo chogonana silinakhudzidwe. Kuponderezedwa kumachitika pofuna kuchepetsa nthawi yopaleshoni yopatsirana kwambiri. Kwa njira iyi, opaleshoni imagwiritsidwanso ntchito mu endometriosis yamkati, yomwe imafotokozedwa ndi ndondomeko yoyendetsa nkhumba m'mimba yaing'ono. Ndi zoterezi, chiopsezo cha ureter chimawonjezeka. Zisonyezo za mtundu uwu wopaleshoni ndi:
- kusagwiritsidwa ntchito kwa mapulogalamu;
- Kukhalapo kwa chikwama chokwanira cha chiberekero;
- kusalabadira kwazimayi ;
- kukula kwake kwa feteleza sikudutsa kukula kwa fetus pamasabata khumi ndi awiri ;
- Kukhalapo kwa malo opaleshoni okwanira.
Chiwerengero cha hysterectomy
Mankhwalawa amawatcha kuti kutaya chiberekero. Njira ndi imodzi mwa mitundu yofala kwambiri ya hysterectomy. Kupeza ziwalo kumapezeka potsegula m'mimba. Pa opaleshoniyi, chiberekerocho chichotsedwa, ngati palibe chotupa m'khosi, gawo ili latsala. Panthawi imodzimodziyo, ectomy ya mazira ndi mazira amatha. Chithandizo chobwezeretsa pambuyo poyerekeza ndi mankhwala osokoneza bongo amatanthauza kugwiritsa ntchito mahomoni musanayambe kusamba .
Kuchotsa chiberekero ndi mapulogalamu
Kuchita opaleshoni yotereyi kumatsogoleredwa ndi phunziro lapadera. Amatchedwa hysterosalpingography - ndi chiyani, odwala sakuimira, choncho amafunsa dokotalayo. Ndi kafukufukuyu, matendawa akuchitika. Wothandizira wapadera amayamba. Kenako zithunzi zotsatizana za X-ray zimatengedwa.
Ngati kansalu imawoneka m'machubu ndikufalikira ku ziwalo zapafupi ndi matenda, chiberekerocho chichotsedwa. Kufikira ku zithandizi zokhudzana ndi matendawa ndi kudzera mu khoma la m'mimba kapena m'mimba. Chifukwa chakuti odwala okalamba sakulekerera ntchito zambiri, madokotala opaleshoni nthawi zambiri amawasankha. Pankhaniyi, kuchotseratu chiberekero ndi mapulogalamu - ziwalo za kugonana, ma tubes.
Mankhwala osokoneza bongo
Kuchita opaleshoni ya kuchotsa chiberekero cha mtundu umenewu kumachitika ndi kuwonongeka kwakukulu kwa njira yobereka. Amagwiritsira ntchito mankhwalawa chifukwa cha ziphuphu zoopsa za pakhosi laling'ono, ndi metastases ambiri. Opaleshoni imaphatikizapo kuchotsa chiberekero ndi mapiritsi, chiwerengero chachitatu cha vaginayi, mafuta a m'matumbo, maselo am'deralo. Kawirikawiri, mankhwala amtundu uwu amagwiritsidwa ntchito pambuyo pa njira zambiri zovomerezeka. Pambuyo pa opaleshoni yotereyi, mayi amatha kutaya zonse zoberekera, zomwe zimapangitsa kuti mankhwala asinthe.
Kuchotsa chiberekero - nthawi yothandizira
Pambuyo pa opaleshoniyo kuti achotse chiberekero, mkazi ayenera kusungidwa maola 24 aliwonse ogona, mosasamala mtundu wa kupeza (m'mimba kapena m'mimba). Kumapeto kwa nthawi ino, madokotala amaloledwa kuti ayimilire pang'onopang'ono. Izi zimathandiza kuwonjezera matumbo a m'mimba, kuphatikizapo mavuto monga paresis. Ndi kupweteka koopsa, mankhwala ochepetsa mankhwalawa amalembedwa. Pofuna kupewa matenda, njira yothandizira maantibayotiki imachitika.
Mofananamo, antiticoagulants akhoza kulamulidwa. Mankhwalawa amalepheretsa kukula kwa mavuto ngati kutuluka mkati. Ngati kusinthika kumapita mofulumira ndipo sikukhala kovuta mwanjira iliyonse, patatha masiku 8-10, kuchotsedwa kwazithunzi zakunja kumachitika. Pamene opaleshoni imachitidwa ndi njira ya laparoscopic, wodwala amaloledwa kudzuka pambuyo pa maola asanu ndi asanu ndi asanu ndi asanu ndi awiri (6), ndipo kutaya kwake kumachitika kwa masiku 3-5. Chofunika pa nthawi yoyambirira yoperekera ntchito ndi kusunga chakudya - chimbudzi ndi madzi omwe amatha kukhazikitsa chopondapo.
Mavuto pambuyo pa hysterectomy
Zotsatira za kuchotsedwa kwa chiberekero zingakhale chifukwa cha kusagwirizana ndi njira ya opaleshoni, kulephera kutsata ndondomeko zamankhwala. Ngati kumayambiriro kwam'mbuyomu posachedwa, izi zimakhala chifukwa cha zolakwa zachipatala, kenako kumapeto (mu miyezi ingapo) - kulephera kutsatira malamulo ndi madokotala a odwala. Zina mwazovuta, ntchito monga kuchotsedwa kwa chiberekero chokhudza, ndi:
- magazi ;
- mapangidwe a ziŵeto;
- Kuchokera m'magazi a postoperative;
- kuvulala kwa ziwalo zoyandikana panthawi ya opaleshoni - matumbo, chikhodzodzo, ureter;
- thrombophlebitis wa miyendo;
- kuponderezedwa kwa vagina;
- kukhudzidwa kwa chilonda cha postoperative;
- matenda a chikhodzodzo (zotsatira za catheterization yaitali);
- peritonitis (kutupa kwa peritoneum);
- thromboembolism.
Ululu mutachotsa chiberekero
Ululu wa hysterectomy umapezeka makamaka mkati mwa mimba, malo a sutures. Kuti athetse ululu, madokotala amapatsa odwala mankhwala osokoneza bongo nthawi zambiri. Kutalika kwa matenda opweteka ndi otsika. Nthawi zambiri odwala amadandaula za kukhalapo kwa ululu m'masiku 3-4 oyambirira. Pambuyo pa nthawi ino, kuchepa kwachisomo kungapitirire kumalo a kunja kwa sutures, pamene chiberekero cha mimba chimachitidwa mimba.
Kutaya mutatha kuchotsa chiberekero
Mthenda wamagazi, bulauni pambuyo pa hysterectomy ndi yachibadwa. Zitha kuwonetsedwa kwa masiku 14 kuchokera pakangotha opaleshoni. Kukhalapo kwa kupweteka ndi kutaya kuchokera ku njira yobereka pambuyo panthawiyi ziyenera kukhala chifukwa chothandizira azimayi. Zizindikiro zimenezi zingasonyeze zovuta za nthawi yotsatira, yomwe:
- magazi;
- Katemera wodwala m'magazi aang'ono.
Bandage atachotsedwa chiberekero
Mimba mutachotsa chiberekero imafuna chidwi kwambiri. Chifukwa cha kufooka kwa zomangamanga, makina osokoneza mimba, omwe sungapezeke m'mimba ya opaleshoni, amayi amafunika kuvala bandeji. Kawirikawiri, chipangizochi chimalimbikitsa odwala omwe ali ndi mimba yamayi omwe akhala ndi mimba zingapo. Chisankho cha chitsanzocho chiyenera kuchitidwa ndi katswiri. Amavala nsalu tsiku ndi tsiku, amatha kusamba pokhapokha ndikugona usiku.
Madokotala akulangizidwa kuti apange kukonda bandage zopangidwa ndi zakuthupi. Mukagwiritsa ntchito, kusokonezeka sikuyenera kukhalapo. Samalani ndi kuchuluka kwa mankhwala. Madokotala amalankhula za kufunikira kodutsa kuchuluka kwa chilondacho ndi bandage pamwamba ndi pansi pa 1 masentimita (ndi laparotomy yapakatikati). Kuvala kumabala kumbuyo.
Mankhwalawa atachotsa chiberekero
Kodi mankhwala omwe amachotsa chiberekero ndikuchotseratu komanso ngati n'kofunikira kuigwiritsa ntchito akugwiritsidwa ntchito ndi dokotala yemwe akupezekapo. Kawirikawiri, chifukwa chochotsedwa kwa zilondazo ndi chiberekero, zimakhala zofunikira kugwiritsa ntchito njira yamadzimadzi yothamangira thupi. Ndizofunikira kwambiri mankhwala opatsirana pogwiritsa ntchito mahomoni kwa amayi opitirira 50 omwe anachitidwa opaleshoni. Pachifukwa ichi, progestogen ndi estrogen yokonzekera ntchito.
Cholinga cha kuchotsa chiberekero ndi mapulogalamuwa ndi kupezeka kwa nthata zazikulu zedi, wodwalayo amapatsidwa estrogen monotherapy mosalekeza pambuyo pa opaleshoni. Mankhwalawa ndi ovuta, amagwiritsa ntchito mitundu yosiyanasiyana ya mankhwala:
- mapiritsi otsogolera pamlomo - Ovestin, Livial, Proginova;
- Mafuta ndi ma gels omwe amagwiritsa ntchito kunja - Estrogel, Divigel.
Ngati kuchotsa chiberekero kunkachitika chifukwa cha endometriosis, mankhwala ovuta ndi mahomoni, estrogens ndi gestagens zikuchitika. Pankhani iyi, mankhwala monga:
- Kondane;
- Proginova.
Mankhwala opatsirana pogwiritsa ntchito mankhwala osokoneza bongo madokotala amalangizidwa kuti ayambe 1-2 patatha miyezi yotsatira chiberekerocho chitachotsedwa. Kuchiza koteroko kumachepetsa mpata wotenga matenda a mtima, matenda otupa mafupa. Komabe, chisankho cha kufunikira kwa ntchito yake chikutengedwa ndi dokotala yekha. Kutsata kwathunthu ndi kuika kwake ndi ndondomeko zake kumatsimikizira njira yowonongeka mwamsanga.
Moyo pambuyo pa kuchotsedwa kwa chiberekero
Laparoscopic hysterectomy imakhudza moyo wautali m'njira iliyonse, koma imakula bwino kwambiri. Azimayi akuchotsa zizindikiro zomwe zimayambitsidwa ndi matendawa, amakayiwala za kusowa kwa kulera. Odwala ambiri amafotokoza kuwonjezeka kwa libido. Koma nthawi zambiri opaleshoni imachititsa amayi kugwiritsa ntchito mahomoni kwa nthawi yaitali. Kuonjezera apo, pakufunika kuyesedwa kawirikawiri ndi mayeso a amayi. Cholinga chake ndi kuyang'anira chithandizo, osabwereranso, pamene chifukwa chochotseratu chinali chotupa.
Kuchotsa chiberekero - zotsatira za thupi
Mankhwala osokoneza bongo amasonyeza osati ntchito yokha yobereka, komanso thupi lonse. Kuchotsa chiberekero, zotsatira za ntchitoyo zingakhale motere:
- kupanga mapangidwe ammimba m'mimba;
- kupanga kapangidwe kake;
- kusowa kwa khungu kansalu;
- kusamba kwa mimba;
- matenda osokoneza bongo.
Kugonana pambuyo pochotsa chiberekero
Odwala ambiri omwe anachitidwa opaleshoni ali ndi chidwi ndi funso ngati n'zotheka kugonana atachotsedwa chiberekero. Madokotala amavomereza bwino funso ili. Kugonana, monga kale, kumakhala kokondweretsa - malo onse ovuta amasungidwa. Ndi kusunga mazira ochulukirapo akupitiriza kugwira ntchito, kumasula mahomoni ogonana. Komabe, kupweteka, kusokonezeka pa nthawi yogonana sizingatheke.
Zochitika zoterezi ndi zotheka kwa amayi omwe adatulutsidwa pachiberekero (chiwopsezo cha chiberekero) kapena chiwopsezo chachikulu - chiwalo cha abambo ndi chosangalatsa. Komabe, vutoli likhoza kuthetsedwa, potsalira kukhulupirirana ndi kumvetsetsa pakati pa mkazi ndi mnzake. Kumvetsera zofuna za mnzanuyo, mwamuna sangasangalale, koma amaperekanso kwa wokondedwa wake.