I-Endometritis: izimpawu kanye nokwelapha. Ukukhulelwa ne-IVF ku-endometrium

Esikhathini sokwakhiwa kwama-gynecological pathologies kulabo besifazane abaneminyaka yobudala yokubeletha, ukuvama kwe-endometritis kuyahlukahluka kusuka ku-3% ukuya ku-70%, okubangelwa ukuhlukahluka okukhulu kwenani lokubheka, ukuxakaniswa kokuqinisekiswa komzimba kokuxilongwa, ukungafani kweziguli nezibalo ezihlolisisiwe. Naphezu kokwandiswa kwesisekelo samakhemikhali, i-endometritis, izimpawu kanye nokwelapha okungase kuhluke kakhulu ngokuya kwemibonakaliso yemitholampilo, odokotela abenza izinkinga ezithile ngokuxilongwa kanye nokwelapha kwesifo. Lokhu kuchazwa yizici ze-endometritis ezimweni zanamuhla: ukumelana okwandisiwe kwe-microflora ye-pathogenic izidakamizwa, ukuguqulwa kwesakhiwo se-etiologic yesifo ngokunyuka kwe-flora yegciwane, kanye nezinkathi zokwelashwa eside.

Iyiphi i-endometritis yabesifazane?

I-Endometritis iyisifo se-clinical ne-morphological syndrome esichazwe yizinguquko eziyinkimbinkimbi ekupheleni kwe-endometrium yemvelaphi evuthayo, eyenza ukuphulwa kwekhono "lokuthola" nokuguqulwa kwamathambo. Lesi sifo siholela ekunciphiseni kokuzala kwabantu besifazane, ukungasebenzi kahle kokuya esikhathini, ukungaziphathi kahle, ukuhlukunyezwa kwentombazane, ukungabi namntwana. Ngesikhathi esifanayo, ukusebenza kahle kwe-endometrial therapy akudluli ku-60-68%.

I-endometritis enamandla: izimpawu kanye nokwelashwa

Inqubo eyinhloko yokuvuvukala, engahambi ngaphezu kwesibeletho, ivela ngenxa yokunyuka kwe-agent esebenzayo emngceleni wesibeletho. Ngokuvamile, amabhaktheriya angena ku-endometrium anomonakalo ebuqothweni bokuvimbela isisu - ngesikhathi sokukhipha isisu, ukushaya umzimba wesibindi kanye nentamo yomswakama, ufaka idivayisi yangaphakathi nokunye okungenelela.

Izimpawu ze-endometritis enzima:

• ukunyuka okubukhali kokushisa;
• ukubola, ubuhlungu esiswini esingaphansi;
• ukubonakala kwe-purulent ehlukaniswayo nepheshana.

Izinyathelo zokuhlola:

• iqoqo le-anamnesis (ukungabikho / ukutholakala kwe-intrauterine ukungena, i-necrosis ye-node ye-mucous);
• Ukuhlolwa kwegazi (kwembula isibeletho esikhulisiwe);
• ucwaningo lwe-bacteriology (lusemigqa yezinhlobo ezincane zemifino);
• I-ultrasound yezitho zomzimba;
• i-laparoscopy (yenza kube lula ukuhlola ama-appendages, ngaphandle kwama-pathologies okuhlinzayo);
• i-endometrial biopsy.

Ukwelashwa nokubikezela

I-endometritis enamandla idinga ama-antibiotic. Inqubo yokuvuvukala ithinta uhlaka olungezansi lwe-endometrium ngenxa yokutheleleka ngamagciwane angacacile / aqondile. Imithombo yokuzivikela ye-endometrium ihlobene ngqo nomphumela wamahomoni ocansi, "sebenzisa" ngokubambisana nenani lamaseli anciphisa izinhlayiya eziyingozi. Lapho kuqala ukuya esikhathini, lesi sivinqo sinyamalalala, okwenza ukuba ukutheleleka kwekhanda elimangalisa libe khona. Uhlelo lwezokwelapha luhlanganisa ukwelashwa kwama-antibiotic kanye ne-physiotherapy. I-prognosis iyakhuthaza: nge ukwelashwa okwanele nesikhathi esifanele, ukubuyiswa okugcwele kwenzeka ezinsukwini ezingu-7-10.

I-endometritis engapheli: izimpawu kanye nokwelashwa

I-endometritis engapheli yisifo lapho khona, ngenxa yezilonda ezithathelwanayo eziqhubekayo ze-endometrium, izinguquko zokusebenza eziyisibili zenzeka ukuthi ziphazamise isimo se-receptor kanye nokuguqulwa kwesimo somzimba we-uterine. Ezimweni ezingama-95%, i-ChE iyingqayizivele, ivusa ama-microorganisms, adluliselwa ngocansi, futhi avela emva kokuxhaphazwa kwe-intrauterine. Ezingamaphesenti angu-5, i-ChE iqala ngenxa yokutheleleka nge-lymphogenic, i-hematogenic, yehla endleleni ye-foci e-extragenital. Ukuhlukanisa okungavamile nokuqondile, okubangelwa ama-mycoplasmas, isikhunta, amabhaktheriya, amagciwane, i-endometritis engapheli.

I-endometrite ye-uterus - izidalwa ezithandwayo:

• ukunciphisa umzimba ukuvikela umzimba;
• izimo zokuphila ezingenelisekile, imikhuba emibi, ukungondleki;
• Izifo ezithathelwanayo;
• i-neuroendocrine pathologies, i-hypertension ye-arterial;
• isifo sezinso esivuthayo;
• ukuhluleka kwe-autoimmune, ama-STD, i-anemia, izifo ze-bronchopulmonary;
• izifo zesimiso sesisu sokuzala;
• ukusetshenziswa kwesikhathi eside kwe-intrauterine spirals, kudluliselwa esigabeni sokugcina;
• inamba enkulu yokungenelela kwezinsimbi emgodini we-uterine;
• izinkinga emva kokubeletha / ukukhulelwa kwesimo esithathelwanayo;
• ukutheleleka komlomo wesibeletho / isisu;
• I-radiation therapy endaweni yangasese.

Izimpawu ze-endometritis engapheli:

• ukwephulwa komsebenzi wokuya esikhathini. Ukuba khona kokugxila okuvame ukuvuvukala emgodleni omncane kubangela ukungahambi kahle komjikelezo wokuya esikhathini esikhathini esiyi-50-60% yeziguli - lokhu kubonakala yi-amenorrhea, i-algodismenorei, i-oligomenorrhea. Izikhalazo ezivame ukwedlula zonke futhi zithintana nezindawo zokuxhumana, izinyanga eziqhubekayo, izinhlungu zomzimba eziqhubekayo;
• ubuhlungu besisu, ukuphuma kwamagciwane okungavamile;
• ukuphazanyiswa kokusebenza kwepheshana lamathumbu. Ukukhathazeka ngesikhathi sokuhamba kwamathumba, ukuqothulwa, ukubhubhisa, ukulala, ukwehlisa isifiso;
• izimo ezinjenge-influenza. Umkhuhlane, umkhuhlane, ama-body aches, i-malaise jikelele.

I-endometritis engapheli: izimpawu kanye nokwelashwa, ukuxilongwa

Ukuxilongwa kwe-endometritis engapheli kusekelwe ekuhlaziyweni komlando wesiguli, izimpawu zomtholampilo, ukutadisha komzimba nge-endometrium, eyenziwa ngosuku lwama-7-10 womjikelezo.

Imigomo yokuxilongwa kwe-morphological ye-endometritis engapheli:

• ukuvuvukala okungena ngaphakathi, okwakhiwa kwezakhi ze-lymphoid ezizungeze imithwalo yegazi nezigulane, kaningi kangako. Ekubukeni, i-foci ifana nezintambo futhi zikhona kuzo zonke izingxenye zesendlalelo sokusebenza;
• ukutholakala kwezinto ze-plasma cell cell;
• ukugxila okulinganiselwe kwe-stroma, eyakhiwe inqubo ende yokuvutha, kwezinye izimo, izindawo ezinkulu ezithakazelisayo;
• ukuguqulwa kwama-sclerotic ezindongeni ze-articular arteries ye-tishu ebonakala ngokumelene nesimiso sempawu ezinzima nokugeleza okuqhubekayo kwe-endometritis.

Ukwelashwa kwendabuko

I-standard yegolide ekwelapheni kwe-ChE yindlela yokuhamba ngesinyathelo ehlose ukuqeda izimbangela zokuvuvukala nokuqeda imiphumela yendlela yokuvuvukala, kuhlanganise nokuqedwa kwezicubu ischemia, umonakalo wesibili, ukuvuselelwa kwezinto zokuthola izinto kanye nama-hemodynamics wendawo ye-endometrium. Uhlelo oluyinkimbinkimbi kufanele lube nolungileyo futhi lufanelekile ngokwezomthetho futhi lusekelwe emiphumeleni yokuhlolwa okuphelele.

Izindlela zokwelapha CHE:

1. Ukuqedwa kwe-agent elimazayo noma ukwehla komsebenzi wegciwane. Ukwelashwa kwama-antimicrobial kufanele kuqinisekiswe ukususwa kwezinhlobo eziningi zezilwane ze-pathogenic, kuhlanganise ne-trichomonads, i-chlamydia, i-streptococci, i-gonococci, namagciwane. Kwezinye izimo, odokotela banikeze izifundo eziningana ngokuguqulwa kwamaqembu okwelapha, okukhethwa kukho okuxhomeke emiphumeleni yokuhlolwa kwe-microbiological ye-uterine cavity kanye nesiswini, isiteji senqubo yokuvuvukala kanye nezici zesithombe somtholampilo. Ngokufanayo, ukulungisa ukuzivikela komzimba kwenziwa.

   Izidakamizwa: inhlanganisela ye-nitroimidazoles (i-Metronidazole, i-Ornidazole) ne-fluoroquinolones (i-Ciprofloxacin, i-Ofloxacin, i-Levofloxacin), inhlanganisela yama-penicillin avikelwe ngama-macrolide (i-Spiramycin, i-Roxithromycin). Uma ukutheleleka kwegciwane kukhona, ama-nucleoside analogues asetshenziswa (Valtrex, Acyclovir).

2. Ukuqalwa kwamandla okusebenza okuyi-endometrium nokuqedwa kwemiphumela yezilonda ze-pathological: ukubuyiswa kwemetabolism, umsebenzi kanye ne-hemodynamics yezicubu zokuthola izicubu. Iziguli ezinokuphulwa okucacile komsebenzi wokuzala zibizwa ngokuthi yi-hormone therapy, eyakhelwe ukwandisa amathuba okufakelwa.

   Ukulungiselela: izidakamizwa zemithi (Actovegin)

3. I-Physiotherapy: i-magnetotherapy, i-electropulse therapy.

   I-criteria eyinhloko yokwelashwa okuphumelelayo: ukwehla okuphawulekayo emisebenzini ye-agent esebenzayo, ukusizwa kwezibonakaliso zemitholampilo zesifo, ukubuyiswa kobuciko kanye nesakhiwo se-morphological of the tishu, ukuvuselelwa kokuzala.

Amakhandlela nge-ChE

Amakhandlela ekwelapheni i-endometritis engapheli asetshenziswa njengendlela yokwelashwa yendawo eyengeziwe ukuze azuze ukuphola okusheshayo. Zivimbela ukungcoliswa kwamagciwane ngama-microorganisms eziyingozi emlandweni wokuthatha ama-antibiotics, ungavumeli ukuthuthukiswa kwezimo ezinzima nokulimala kwesibeletho ngama-bacterial agents avela ku-genitalia engezansi.

Iziphi izimo amabhandlela asetshenzisiwe:

• i-endometritis enzima, ehambisana ne-dysbiosis yesisindo;
• ukuvuvukala komlomo wesibeletho / isisu;
• endometritis engapheli;
• ukunamathela emgodleni / emgodleni we-pelvis encane.

Izinhlobo ze-suppositories zangasese:

• kuhlangene. Iqukethe: i-Neomycin (i-aminoglycoside antibiotic), i-Ternidazole (imithi elwa namagciwane), i-Prednisolone (i-agent ye-glucocorticoid), i-Nystatin (izidakamizwa ze-antifungal);
• nge-antiseptic. Amakhandlela ane-betadine (i-agent eline-iodine) kanye ne-chlorhexidine (i-antiseptic);
• nezitshalo zokwelapha. Yiba nokuphumula, ukuphulukisa, i-antimicrobial, umphumela wokulwa nokuvuvukala.

I-suppository yama-vaginal ayikwazi ukubhekwa njengendlela eyinhloko yokwelashwa kwe-CHE. Wabanike kuphela ochwepheshe, ucabange ngesiteji, isithombe somtholampilo kanye nenhlalakahle enhle yowesifazane. Ubude obujwayelekile bokuphathwa ngamakhandlela yizinsuku ezingu-12-14.

I-endometritis ye-postpartum: izimpawu kanye nokwelapha

I-endometritis ye-Postpartum i-inflammation ye-mucosa ye-uterine eyenzeka ngemva kokubeletha. Ezingamaphesenti ama-10-12% inqubo yokuvuvukala idlulela emgqeni wamasipha wesibeletho, okwenza ukuthuthukiswa kwe-endomyometritis. I-PE ikhonjelwa kaningi - ibangelwa izici eziningi: ukusetshenziswa okujwayelekile kwamasu okuhlola okungajwayelekile, ukwanda kwemvamisa yokuhlinzwa ngesikhathi sokubeletha, ukuqoqwa kwemithi emincane yezilwanyana ezincane ezibanjelwa ezibhedlela, ukusetshenziswa kwe-corticosteroids ebonakala ngesenzo sokuzivivinya umzimba. Waba nezinguquko eziqinile kanye nabesifazane abahamba phambili - namuhla abesifazane abanezinhlobonhlobo zokungazalwa, nge-pathologies yangaphandle, ngemuva kokulungiswa kwama-hormonal of miscarriages, okutheleleka ngegciwane, labo abasengozini enkulu yokubhekana nezinkinga ezithathelwanayo, ikakhulukazi.

I-endometritis ngemuva kokubeletha - isifo se-symptomatology

Ngosuku olulandelayo ka-5-10 emva kokubeletha, izinga lokushisa likhuphukela kuma-degree 38-39, i-chill eqinile iqala, ukushaywa kwenyuka kuya kuma-85-100 ukushaya ngomzuzu. Egazini, inani lama-leukocyte nesilinganiso se-sedimentation ye-erythrocyte landa, ubuhlungu be-uterine nokubukeka buhleliwe. I-endometritis enzima "iqala" ngosuku lwesithathu emva kokubeletha. Amacala angu-25% aqala ngemuva kwesigaba sokuqeda noma umsebenzi obanzi. Ubuthakathaka, ubuhlungu bekhanda, ubuhlungu besisu, i-anorexia, i-chills, i-tachycardia, i-fever ephezulu (ngaphezu kwama-degrees angu-39). Ngemuva kwezinsuku ezingu-1-2, izivimbe ze-uterine ziba yi-purulent. I-endometritis ye-postpartum ivame ukuba nzima nge-paresis emathunjini, okuholela ekungeneni kwamagciwane emgodleni we-peritoneal kanye ne-peritonitis.

Ukwelashwa kwe-endometritis ye-postpartum

Ukwelashwa kwe-PE kufanele kube okuphelele, okuhloswe ekuhlaleni kokugxila kokuvuvukala, ukungathathi hlangothi kwe-agent esebenzayo, ukuvuselelwa kokuzivikela komzimba nokuxoshwa kwe-detoxification. Izakhi zokwelapha ziyi-general restorative, antibacterial, ukumnika ukuthelela (ukukhushulwa komzimba), ukusetshenziswa kwezidakamizwa ezinciphisa isisu. Ngezinye izikhathi ukwelashwa okuhlinzekwa kwesibeletho kuboniswa, izinhlobo ezimbi ze-endometritis zidinga ukusetshenziswa kwe-plasmapheresis - ukususwa kwezingxenye ezingavamile ze-plasma yegazi, ama-microbes, amakhemikhali, ama-cryoglobulins. Ukuphumelela kokwelapha kulinganiselwa ezinsukwini ezingu-7, lapho kungekho khona umphumela omuhle, umbuzo wokukhipha isisu uxazululwa.

Ukwelashwa kwe-endometritis ngamakhambi omuntu

Izindlela zomphakathi zokwelapha i-endometritis zisebenza kahle, uma uzisebenzisa emva kokubonisana nodokotela ozokhetha inhlanganisela enhle yamathebhulethi namakhambi omuntu.

1. Ukumnika kwe-ivy. Thatha isipuni samaqabunga ochotshoziwe, uthele ama-milliliters angu-250 amanzi abilayo, uqinise amahora angu-12-14. Letha ukumnika kwamathumba, ususe ekushiseni, ugcizelele imizuzu engu-10-15, ucindezele ngokucophelela. Sebenzisa izikhathi ezintathu ngosuku ngamamitha ayizigidi eziyikhulu. Ukuze ukunambitheka, ungafaka ushukela noma uju. Ukungahambisani nomuntu: ukubekezelelana ngabanye, i-anemia, ukukhulelwa.

2. Amakhambi aqoqiwe. Izitshalo zokwelapha zibhubhisa ukutheleleka, ubuyisele ubuqotho be-mucosa, uyeke inqubo yokuvuvukala:

   • valerian impande, yarrow, mint, heather izimbali, birch amaqabunga, sihlahla sivame ukutholakala amagxolo, amaqabunga amajikijolo;
   • utshani ihansi, ama-valerian impande, amaqabunga e-mint, amagxolo okuvuthwa kwe-buckthorn;
   • utshani rue, imifino tansy, i-licorice izimpande, i-aira.
3. Umhluzi wort St. John's wort. Thatha i-spoonful enkulu yamakhambi, uthele ingilazi yamanzi abilayo, ubeke umlilo, ubilise imizuzu engu-15-20, ugeze. Phuza umhluzi izikhathi ezintathu ngosuku ngamamithalitha angu-50 esiswini esingenalutho.

4. Ukumnika kwe-fern. Amaqabunga e-tablespoon we-fern (ochotshoziwe) aphuza ama-milliliters angu-250 amanzi abilayo, agcizelele imizuzu engu-15-20, idonse. Yidla ama-50-70 millilitres kane ngosuku ngaphambi kokudla. Inkambo yokwelashwa yizinsuku ezingu-14-21.

5. Amathoni anezinyathelo zokulwa namagciwane:

   • ngegalikhi. Ukulwa nokuvuvukala nokutheleleka. Faka ikhasi le-clove likagalikhi, uthathe ezindaweni ezingu-2-3, ugcotshwe ngamafutha omquba, ugoqwe nge-gauze, ufake i-vagin amahora angu-10-12;
   • ngamafutha we-sea buckthorn. Ukusheshisa ukuphulukiswa kwe-mucosal;
   • ne-plantain. Soothe futhi usize ukuphulukiswa kwesibeletho esinamahloni. Geza amaqabunga amasha we-plantain, ugaya, uhlanganise namafutha. Yenza ingxube ehlanganisiwe ibe yi-gauze, ifakwe emaseni amahora angu-10-12.

I-Endometritis ne-endometriosis: yini umehluko?

Naphezu kwamagama afanayo, i-endometriosis ne-endometritis izifo ezihluke ngokuphelele. Ngezici zayo, i-endometriosis ifana ne-neoplasms emangalisa, ayihlosile izinqubo zokuvuvukala kwe-immune etiology ku-endometrium, ihluke kuzo ngemitholampilo kanye nedatha yokuhlola i-laboratory.

Ukungezwani okukhulu

I-Endometriosis - ukwakheka kwama-benign nodes, okufana nokwakhiwa kwe-mucosa ye-uterine. I-tumor ifomu ngemuva kokungajwayelekile kwe-hormone, etholakala endaweni yesigodi - kusukela esibelethweni nakama-ovari ukuya kwesinye nesisu. I-pathogenesis yesifo ayiqondi kahle, odokotela bakholelwa ukuthi i-endometriosis iyisici esimisweni somzimba sokuzivikela. Ngenxa yokuphazamiseka kwamagciwane, i-endometrium is thinned. I-Endometritis iyinqubo yokuvuvukala kwekhanda lesisu lesandulela ngculazi, okuholela ekuphepheni kwe-endometrial hyperplasia.

Isithombe esijwayelekile

Ngesikhathi sokuya esikhathini ne-endometriosis, i-membrane evamile ye-mucous inqatshiwe, negazi ligeleza amaseli e-endometrial aphinde afake ama-tublopian tubes, ahlele futhi aqale ukwahlukanisa, "ukwakha" izicubu ezintsha eziseduze ekulungiselelweni kwe-endometrium. I-node yenziwa - i-endometriosis iyaqhubeka. Ukukhiqizwa kwenqubo ye-pathological kugcizelela isimo: inani lamanothi likhula ekuthuthukisweni kwejometri, ubukhulu be-endometrium buncibilika. Njengoba i-endometritis, ngenxa yokwanda okukhulu okwenyuka kwendwangu yesisu, ukuhamba kwesikhathi sokuya esikhathini kukhishwa. Igobolondo iphethwe futhi ibuyiselwe ezingxenyeni, ngokukhishwa kwamanzi okuvamile.

Izinkinga

I-Endometritis: ukugxila kokuvuvukala kungabandakanyi amathuba okufakelwa okuvamile kombungu ku-endometrium.

I-Endometriosis: i-endometrium ebuthakathaka ilahlekelwa ikhono lokufakela umbungu ngaphakathi futhi ulibambe. Isakazwe nxazonke zendawo ye-pelvic, ama-node asho ukuthi ukulungele ukuthatha "ukuthatha" i-fetus, eholela ekungalingani okuphelele emiphakathini yomzimba.

Ngingakhulelwa yini nge-endometrium?

Phakathi kwabesifazane abane-endometritis, i-97% yilabo besifazane / amantombazane enyaka yokuzala abagcizelela kuphela ukubaluleka kwesifo ngokuphathelene nomthelela walo wokuzala. Ingabe ukukhulelwa kungenzeka nge-endometrium? Izinganekwane, yebo. Ukuzwela kwe-endometrium nemisebenzi yokuzala kubalwa kancane kancane esigabeni sokuqala sesi sifo ngenxa yokutholakala kwezinqubo zokukhokha, ukusebenza okuhambisana ngqo nomsebenzi wezinhlaka ezithathelwanayo, isimo samasosha omzimba, kanye nokwanela komthethonqubo we-hormone.

I-endometritis engapheli ne-IVF

Ngokusho kwe-WHO, imvamisa yemishado engaphelele ezweni lethu inomkhuba ocacile wokukhula, okuholela ekunyuseni kwenani lezinhlelo eziqhubekayo zokusiza ukukhiqiza. Ngeshwa, iphesenti lokufakelwa kwemibungu engasebenzi kahle liphakeme kakhulu - ngokwesilinganiso liyi-50-60%. Esinye sezizathu eziyinhloko zokuhluleka kwezinhlelo ze-IVF yi-pathology ye-endometrium, i-endometritis kuhlanganise. Ukuphikelela okuqhubeka isikhathi eside nokuphindaphindiwe (ukuthola) amagciwane nama-bacteria ku-endometrium kubangela ukukhubazeka okunzima kwesakhiwo somzimba, ukuvimbela ukufakelwa okunempilo nokubekezwa kwemibungu. Ukuhlukumeza ukuguqulwa kwe-cyclic kanye nokwanda (ukuvuselelwa kabusha) kwe-endometrium kunciphisa ubukhulu bokufakelwa okuphumelelayo futhi kunciphisa ukusebenza kwe-IVF yonke.

Izimbangela zokungabi nalutho ku-endometrium:

• umonakalo emsebenzini we-receptor wesibeletho ngokungahambi kahle kwemibono enempilo yesenzo se-hormonal;
• edlula izinga elijwayelekile le-estradiol, elinomphumela omubi emsebenzini womzimba ophuzi ngesikhathi sesigaba sesibili somjikelezo;
• ukuguqulwa kwemikhumbi yokuvuthwa engahlangabezane nokucindezeleka okuqondene nokukhulelwa;
• ukwephula ukugeleza kwegazi okujwayelekile esibelethweni;
• ukuthuthukiswa emgodleni wokubambelela ophazamisa inqubo yokwethulwa kwe-oocyte;
• ukubhujiswa ngokuzenzakalelayo kwe-spermatozoa eboshwe esigodini sesibindi;
• ukuguqulwa kwamathambo wezintambo ngenxa yokufuduka kokutheleleka kwezitho ezingomakhelwane.

Ingozi enkulu kunazo zonke i-ChE, njengoba iqhubeka nesithombe somtholampilo esicacile. E-endometritis enzima, owesifazane ukhathazekile ngezimpawu ezicacile ezenza ukuthi aphendule odokotela. Ngaphezu kwalokho, inqubo enzima, ngokungafani nokugula okungapheli, iyaphendula kangcono ukwelashwa.

Uhlelo lwe-screen pre-IVF

Iziguli ezinehluleka / ukwehluleka kokufakelwa kombungu emlandweni wazo wezokwelapha kumele zilungiselele ukulungiselela (ukulungiselela ukukhulelwa), okubandakanya izinyathelo zokuvimbela, zokuxilonga nezokwelapha. Ngemuva kokulungiswa kwangaphambi kokuvuthwa komzimba, ukusebenza komzamo wokuqala we-IVF ngokumelene nesimo se-endometritis kungama-45-50% ngokwesilinganiso.

Izigaba zokuhlolwa:

• I-ultrasound yesibeletho / i-appendages, ukuhlaziywa kwe-bacteriological ye-aspirate kusuka emgodini wesibindi futhi uhlukaniswe nomlomo wesibeletho;
• Ukuhlolwa kwe-dopplerometric ye-appendages nesibindi ngokuzimisela kokugeleza kwegazi esifundeni sezintambo;
• ukuhlolwa kwesimo somzimba;
• ukuzimisela kwezinga lamahomoni we-pituitary gland, ugqozi we-thyroid; amahomoni ocansi;
• Ukuhlolwa kwezinto eziphathelene nokuziphatha kwe-biopsy kokunganakekelwa kwempilo.

Izici ze-IVF ku-endometrium

1. Ukusekelwa kwama-hormonal kwezinyanga ezingu-3-5. Ukulungiswa kukhethwe ngokucabangela idatha yezivivinyo ze-laboratory kanye nobudala besifazane. Ivumela ukuvuselela ubuzwe be-receptors ye-uterine nemiphumela ye-hormonal:

   • abesifazane abene-endometrium (amamitha ayisishiyagalombili noma ngaphezulu) kanye nokugeleza kwegazi okujwayelekile emithanjeni ye-basal yabekwa iD Dydrogesterone ngaphakathi, 10 mg kabili ngosuku. Inkambo yokwelashwa - izinsuku ezingu-10 (kusukela kumjikelezo wosuku lwangama-16 kuya ku-25);
   • Iziguli ezinomzimba we-endometrium ezinqunyelwe zibekwa i-Femiston emapilisi kanye ngosuku (izifundo ezingu-28) noma ukuziphatha kokwelashwa ngama-hormone (i-Estradiol + Dydrogesterone);
   • abesifazane abanomlando wokuhlanganiswa kokunciphisa ukugeleza kwegazi ezitsheni ngokunciphisa ubukhulu be-endometrium, beka ukwelashwa okuyisimiso sokuzivikela kanye ne-acupuncture.

2. Ukuphulwa okuqinisekisiwe kokugeleza kwegazi kudinga ukwelashwa okufanele ngama-anticoagulants, ama-antiplatelet agents kanye nama-phlebotonic agents.
3. Ngaphambi kwe-pathogenic flora esibelethweni misela izidakamizwa ze-antiviral kanye ne-antibacterial.
4. Ngokungaziphathi kahle ekusebenzeni kwesimiso somzimba sokuzivikela, kwenziwa ukwelashwa kwe-immunomodulatory.
5. Yenza izinqubo ze-physiotherapy ezikhuthaza ukugeleza kwegazi nokwandisa igciwane lesandulela ngculazi.

I-Endometritis, izimpawu kanye nokwelapha okuxhomeke ekutheni isithunzi somtholampilo - isifo esibucayi nesingenangqondo, okuholela ekutheni kungabikho nokukhulelwa kwesisu. Ukuxilongwa okwesikhashana, uhlelo olungelahle lwezokwelapha lungabangela ukuvela kwamafomu ajwayelekile okutheleleka, ngakho-ke izibonakaliso zokuqala ze-alamu kufanele zibonane nodokotela ngokushesha bese ziqala ukwelashwa.