Kuita kwakadaro, sekubviswa kwechibereko, inzira yakanakisisa yekurapa zvimwe zvirwere zvechirwere. Inotungamirirwa muchipatara, uye kushanda kwayo kunotangira nguva yakareba yekugadzirira. Chimbofunga izvi kupindira kwekupindira, maitiro, nzira, zvinokonzerwa nezvinetso nemigumisiro mushure mekubviswa kwechibereko.
Kubviswa kwechibereko - zviratidzo zvekuvhiyiwa
Hysterectomy ye chibereko - izvo zvinonzi chirongwa chokubvisa chikadzi chechikadzi. Inongoitwa chete pamusoro pehupupuriro, iyo pane vakawanda. Pakati pezvinowanikwa zvakajeka zvakakodzera kuziva:
- zvirwere zvinotyisa mukati mechibereko;
- oncology yemukati;
- uterine fibroids , mumasikirwo makuru mavhiki gumi nemaviri ekudzivirira;
- kukurumidza kukurumidza kwechirwere - gore negore kwemwedzi mina yekudzivirira uye nezvimwe;
- necrosis yechipupuriro chemazwi;
- menorrhagia yakaomeswa neanemia;
- adenomyosis ye 3-4 degrees;
- kusingaperi kurwadziwa syndromes mudiki mapfupi;
- kuputika kwechibereko ;
- endometriosis pasina kusimbiswa mushure mekuchengetedza (medamental) therapy, kupora.
Nzira dzokubvisa chibereko
Paunoita kupindira kwekuvhiya, nzira dzakasiyana-siyana dzehutachiona hunoshandiswa dzinoshandiswa. Kusarudzwa kwezvakanakira kunoenderana nerudzi rwekuputsa, huwandu hworudo rwechirwere chepachiviri uye zvikamu zvaro. Kubva pamigumisiro ye ultrasound, vanachiremba vanosarudza kushandisa iyi kana iyo nzira. Kakawanda, kubviswa kwechibereko chinosanganiswa nekukanganiswa kwemasukisi akavakidzana. Zvichienderana nehuwandu hwebasa iri kuitwa, vanosiyanisa:
- subtotal;
- zvizere;
- pangysterectomy;
- radical.
Mukuwedzera, zvichienderana nenzira yekuwana chikwata chokurera panguva yekuvhiyiwa, hysterectomy inogona kuva:
- laparotomic - chibereko chinobviswa kuburikidza nekukanganiswa pamimba;
- kubviswa kwechibereko kuburikidza ne-laparoscopic nzira - achishandisa chinhu chinokosha, kuburikidza nemakomba maduku mudumbu remuviri;
- vaginal - kuwanika kumubereki unobatwa nehutachiwana huri kuburikidza nemukadzi.
Kunyorera hutachiona hwechibereko
Kunze kwehutachiona hunoitwa apo kune mukana wekuchengetedza chibereko chechibereko, chikamu ichi chechirwere chebonde hachina kukanganiswa. Kushandiswa kunoitwa kuitira kuti kuderedze nguva yekupindira kwekupinda muhutachiwana hwehutano husina simba. Munzira iyi, kuvhiyiwa kunoshandiswawo mumagumo endometriosis, inoratidzirwa nehutachiona hutsika muduku duku. Nehutachiona hwakadaro, njodzi yekukuvadza kune ureter inowedzera. Zviratidzo zvekushandura kwakadai ndezvi:
- kusabatwa kwechirwere chezvipfeko;
- kuvapo kwekufamba kwakakwana kwechibereko;
- kusateerera kwevakadzi ;
- hukuru hweeoplasm haupfu nekukura kwema fetus pamasvondo gumi nemaviri ekuberekwa;
- kuvapo kwenzvimbo yakakwana yekuvhiya.
Total hysterectomy
Urwu urwu hwekurapwa hunowanzotumidzwa sekupararira kwechibereko. Nzira iyi ndeimwe yemhando dzakawanda dze hysterectomy. Kuwanika kwechirongwa kunowanikwa nekuzarura mimba yemimba. Muchibvumirano ichi, chibereko chinobviswa, pasina kusuruvara mumutsipa, chikamu ichi chinosara. Panguva imwecheteyo, ectomy ye fallopian tubes uye mazai ovari anoitwa. Kuvandudza kurapwa mushure mokunge uwandu hwehutachiona hunosanganisira kushandiswa kwehomoni kusati kwasvika pakuenda kumwedzi .
Kubviswa kwechibereko nemapendendi
Kuita kurapwa kwakadaro kunotangira nekudzidza kwakakosha. Inonzi se hysterosalpingography - chii ichocho, varwere havarevi, saka vanobvunza chiremba. Nekuongorora uku, kuongororwa kwe fallopian tubes kunoitwa. A special separator agent inotangwa. Zvadaro mutsara wemifananidzo ye-X-ray inotorwa.
Kana chirwere chekenza chikaonekwa mumatope uye chichipararira kune nhengo dziri pedyo nematukisi, chibereko chinobviswa. Kuwanika kune nhengo yakakanganiswa ndeyemudzimai kana anterior mudumbu rusvingo. Nemhaka yekuti varwere vakwegura havabvumiri maitiro makuru, vanachiremba vanovhiya vanowanzosarudza chikadzi. Muchiitiko ichi, zvakabviswa zvachose chibereko uye zvikamu-zvipembenene zvepabonde, tubes.
Radical hysterectomy
Kuvhiya kwekubviswa kwechibereko chemukati uyu kunoitwa nehuwandu hwekuvadza kwehutano hwekubereka. Vanoshandisa kwairi nokuda kwezvipembenene zvinotyisa zvebato duku, rine mitambo yakawanda. Kuvhiya kunosanganisira kubviswa kwechibereko uye zvikamu zvepakati, chetatu chepamusoro chemadzimai, mafuta emuputi, nhengo dzenharaunda dzenharaunda. Kakawanda, rudzi urwu rwekurapa runoshandiswa mushure mekushandisa nzira dzakawanda dzekuchengetedza. Mushure mekurapwa kwakadaro, mukadzi anokanganisa zvachose urongwa hwekubereka, izvo zvinoita kuti hormone ichinje kurapwa.
Kubviswa kwechibereko - postoperative nguva
Mushure mokuvhiya kuti abvise chibereko, mukadzi anofanira kuchengetwa maawa makumi maviri nemaviri ekurara, zvisinei nokuti rudzi rwekuwanika (pamuviri kana mumudzimai). Pakupera kwenguva ino, vanachiremba vanobvumirwa kuti vasimuka uye vaende. Izvi zvinobatsira kuwedzera mumatumbo peristalsis, kusabatanidza zvinetso zvakadai separesis. Nekurwadziwa kwakanyanya, mishonga inonzi analgesic inorayirwa. Kuchengetedza utachiona, imwe nzira yekurapa mabhakitiriya inoitwa.
Mukufananidzira, anticoagulants inogona kurongerwa. Iyi mishonga inodzivirira kukura kwezvinetso zvakadai sekubuda ropa mukati. Kana kuchinja patsva kunofamba nokukurumidza uye hakuve kwakaoma nenzira ipi zvayo, mushure memazuva 8-10, kubviswa kwekunze kwepasi kunoitwa. Apo chirwere ichi chinoitwa ne laparoscopic nzira, murwere anobvumirwa kumuka mushure memaawa mashanu kusvika maawa matanhatu, uye kubudiswa kunoitwa kwemazuva 3-5. Zvinotarisirwa munguva yekutanga postoperative nguva ndeyekuchengetwa kwekudya - chikafu chemashedhi uye chemvura kuti ugadzire chigaro.
Matambudziko mushure mekunyengera
Matambudziko mushure mekubviswa kwechibereko chinokonzerwa nekusawirirana netsika yekuvhiya, kukundikana kutevera mazano ekurapa. Kana iri munguva yekutanga pashure pemazuva ekupedzisira iyi inowanzova mugumisiro wekangororo yezvokurapa, zvino munguva yekupedzisira (mumwedzi mishomanana) - kusakwanisa kutevedzera mitemo uye mirairo yechiremba nevarwere. Pakati pezvinetso zvinowanzoitika, mabasa akadaro sekubviswa kwechibereko chinokanganisa, ndei:
- mukati kubuda ropa ;
- kugadzira hematomas;
- kubuda ropa kubva kune suture inotevera;
- kukuvadzwa kune nhengo dziri pedyo panguva yekuvhiyiwa - mumukumbo, chikwata, ureters;
- thrombophlebitis yemakumbo;
- abaissement of the vagina;
- kudyidzana kwevanga rinokurumidza kushanda;
- hutachiona hwechirwere (chibereko checatheterization refu);
- peritonitis (kuputika kwe peritoneum);
- thromboembolism.
Pain mushure mekubviswa kwechibereko
Pain mushure me hysterectomy inowanikwa munzvimbo zvikuru mumudumbu, nzvimbo ye sutures. Kuvhara kurwisa kunorwa, vanachiremba vanowanzotaurira varwere kwete nharo dzinoratidzika. Nguva yechirwere chirwere chinoderera. Kazhinji varwere vanong'un'una pamusoro pekuvapo kwekutambudzika mukutanga kwemazuva 3-4. Mushure mekunge nguva iyi, kugadzikana kwechigarire kunogona kuramba kuchiri munzvimbo yekunze sutures, apo kuwanika kwechibereki kwakaitwa mumimba.
Kusununguka pashure pokubviswa kwechibereko
Kubuda ropa, kusvibiswa kwemavara mushure mokunge hysterectomy inowanzoitika. Inogona kuchengetwa kwemazuva gumi nemana kubva panguva yekuvhiyiwa. Kuvapo kwekusuruvara uye kubudiswa kubva pamitambo yekuberekwa mushure mekunge nguva iyi inofanira kuva chikonzero chekutaurirana gynecologist. Izvi zviratidzo zvinogona kuratidzira zvinetso zvemazuva ekupedzisira, pakati payo:
- kubuda ropa;
- hutachiona hwehutachiwana mudiki.
Bandage mushure mekubviswa kwechibereko
Dumbu mushure mokubviswa kwechibereko chinoda kunyanya kukoshesa. Nemhaka yekushaya simba kwezvivako zvemuviri, musikana wepamuviri, izvo zvisingadziviriki mumhando yemimba yekuvhiyiwa, vakadzi vanofanira kupfeka bhenji. Kakawanda, chigadzirwa ichi chinokurudzira varwere vane makore anonzi menopausal avo vane huwandu hwekuzvimba. Kusarudzwa kwemuenzaniso kunofanira kuitwa neyanyanzvi. Vanopfeka bhanhire zuva rega rega, vachibvisa bedzi mumvura uye vasati varara usiku.
Vanachiremba vanorayirwa kuti vape zvakanakira bhandeji rakagadzirwa nezvinhu zvepanyama. Paunenge uchishandisa, kusanzwisisika hakufaniri kuvapo. Teerera kutara kwechigadzirwa. Vanachiremba vanotaura pamusoro pekudiwa kwekudarika upamhi hwekuvhara nebandanhi kumusoro uye pasi pehuwandu hwe1 cm (ine laparotomy iri pasi-median). Kupfekedza kunobereka kunama mushure.
Zvinodhaka pashure pokubviswa kwechibereko
Ipi mishonga inofanira kutora mushure mokubviswa kwechibereko uye kana zvakakosha kuzvishandisa inosarudzwa nechiremba anoshanda. Kakawanda, nekuda kwekubviswa kwezvinyorwa nemukaka, zvinenge zvakakodzera kushandisa hutoni nenzira yekusimudzira muviri. Iyo inonyanya kukosha hormone replacement therapy kwavakadzi vanopfuura makore 50 avo vakazovhiyiwa. Muchiitiko ichi, progestogen uye estrogen magadzirira anoshandiswa.
Apo chinokonzera kubviswa kwechiberekero nezvikamu zvekugadzikana ndiko kuvapo kwemazamu makuru akadai, murwere anopiwa chirwere chinoramba chiri cherostro monotherapy mushure mekuvhiyiwa. Kurapa kwakaoma, kunosanganisira kushandiswa kwemhando dzakasiyana dzemishonga:
- mahwendefa emitemo yekugadzirira - Ovestin, Livial, Proginova;
- mafuta nezvinonhuwira zvekushandisa kunze - Estrogel, Divigel.
Kana kubviswa kwechiberekero kwakaitwa nekuda kwe endometriosis, inorapwa yakaoma nemahomoni, estrogens uye gestagens inoitwa. Muchiitiko ichi, zvinodhaka zvakadai se:
- Klyane;
- Proginova.
Chirwere chemugadziro nemishonga inokonzera madhomoni vanachiremba vanorayirwa kutanga 1-2 mwedzi mushure mekubviswa kwechibereko. Utano hwakadaro hunoderedza mukana wekuvandudza zvirwere zvepfungwa, osteoporosis. Zvisinei, sarudzo pamusoro pekudiwa kwekushandisa kwayo inotorwa chete nachiremba. Kuteerera zvizere nekugadzwa kwake uye mazano zvinotsigira kukurumidza kugadzirisa hurongwa.
Upenyu mushure mokubviswa kwechibereko
Laparoscopic hysterectomy haibvumi kurarama kwenguva yakareba chero ipi zvayo, asi inonyanya kukoshesa unhu hwayo. Vakadzi vanobvisa zviratidzo zvinokonzerwa nechirwere, kukanganwa zvachose nezvekudiwa kwekudzivirira pamuviri. Varwere vazhinji vanorondedzera kuwedzera libido. Asi kazhinji kushanda kunokonzera vakadzi kushandisa mahomoni kwenguva refu. Mukuwedzera, kune chido chekuongorora nguva nenguva uye miedzo yegynecological. Chinangwa ndechekucherechedza kurapwa, kusadzoka zvakare, apo chikonzero chekubviswa chaiva chirwere.
Kubviswa kwechibereko - migumisiro yemuviri
Hysterectomy inoratidzirwa kwete chete mubasa rekuberekwa, asiwo mumuviri sewakazara. Mushure mokubviswa kwechibereko, migumisiro yebasa ingave seinotevera:
- kuumbwa kwekubatanidza mumudumbu wepamuviri;
- kuumbwa kwekaroid scar;
- kupera kweganda iri mumumvuri;
- manopause;
- zvinetso zvemagetsi.
Zvepabonde mushure mokubviswa kwechibereko
Varwere vakawanda vakazovhiyiwa vanofarira mubvunzo wekuti kana zvichiita here kuita zvepabonde mushure mokubviswa kwechibereko. Vanachiremba vanopindura zvakanaka mubvunzo uyu. Kuita zvepabonde, sezvakaitika kare, kuchava kunakidza - nzvimbo dzose dzakaoma dzinodzivirirwa. Nekuchengetedzwa kwemaari mavari ivo vanoramba vachiita, kusunungura mahomoni ekurara. Zvisinei, kurwadziwa, kusagadzikana munguva yepabonde hakugoni kubudiswa kunze.
Zvinhu zvakadai zvinokwanisika kuvakadzi vakazobuda kunze kwechibereko (chirwere mukati mechikadzi) kana kukanganisa hutachiona-chikamu chemukadzi chinonyanyisa. Zvisinei, dambudziko iri rinogona kubviswa, pamutengo wekutendwa uye kuwirirana pakati pemukadzi nemudzimai wake. Kuteerera kune zvido zvemukaroorana naye, murume haagoni kungoseka chete, asiwo anoununura kune vaanoda.