Izindlela ezintsha zokwelashwa kwe-endometriosis - isihloko sesihloko. Lokhu kungaholela ekuthuthukiseni izimpawu ezilandelayo:
- Ukuya esikhathini esibuhlungu (i-dysmenorrhea) - ubuhlungu buvame ukuqala izinsuku ezilodwa ukuya kwezinsuku ngaphambi kokuya esikhathini bese kancane kancane buthaka, nakuba ngezinye izikhathi azipheli ngokuphelele;
- ubuhlungu ngesikhathi sokulala ngokocansi (dyspareunia) kungadlulela emahoreni angu-24;
- umuzwa wokucindezela emgodleni - ngezinye izikhathi kungase kube nokucindezelwa okuphuthumayo noma ubuhlungu ngesikhathi sokuhlukunyezwa;
- ubuhlungu esifundeni se-lumbar bungase buhlanganiswe ne-ingress yegazi emcimbini; ubuhlungu uma uchama;
- Ukungabi nabantwana - abesifazane abangaba ngu-40% abane-endometriosis ubunzima bokuthola ingane.
Nakuba abanye besifazane bangase babonakalise i-endometriosis nhlobo, iningi labo lihlushwa ubuhlungu obukhulu, okuholela ekuwohlokeni okuvamile kwezempilo nokucindezeleka. Isizathu esiqondile se-endometriosis asiyazi, kodwa kunezinkolelo eziningana:
- Ukubuyela esikhathini - ngesikhathi sezinkathi zokuya esikhathini se-endometrium ngokusebenzisa ama-tubespian tubes athola esibelethweni sangena emgodini we-pelvic; uma kuhlongozwe, lezi zingcezu zingaxhunyaniswa nezitho zomzimba;
- izici zofuzo - owesifazane ogama lakhe elisondelene naye ogula nge-endometriosis, lingama-6-9 izikhathi eziningi zokuthuthukisa lesi sifo;
- ukusakaza ngegazi noma isimiso se-lymphatic - le ncazelo ichaza amacala okuthola i-foci ye-endometriosis ezithombeni ezifana namaphaphu ngisho nobuchopho;
- ukuthuthukiswa okungavamile kwezitho zokubeletha - izicubu ze-endometrial zingathuthuka ngaphandle kwebhubhiso lamangqamuzana lesibindi ngesikhathi sokuphazanyiswa kwe-intrauterine ekubunjweni kwezitho zobulili.
Izingozi Zezingozi
Ucwaningo lubonisa ukuthi kungenzeka ubuhlobo bokuthuthukiswa kwalesi sifo ngezici ezinjengokuthi:
- ukuvame ukuhamba esikhathini esiningi;
- ukuqala kokuya esikhathini ukuya eminyakeni engama-13;
- uneminyaka engaphezu kwengu-25;
- ukungabikho kokukhulelwa;
- ukusetshenziswa kuka-300 mg ikhofi ngosuku;
- ukungabi nokusebenza ngokomzimba;
- ukuya esikhathini ngokungavamile;
- ukwamukela izitho zomzimba zomlomo.
Ukuya esikhathini kanye ne-endometriosis
Ngemuva kokuya esikhathini, izinga le-estrogen likhuphuka, kanti ukugqoka kwangaphakathi kwesibeletho (i-endometrium) kuqala ukukhukhumeza, kulungiswe ukwemukelwa kweqanda elikhulelwe. Ngaphambi kokuvuthwa kwegazi (ukukhululwa kweqanda kusuka esibelethweni), izinga le-progesterone landa, elikhuthaza ukwandisa kanye negazi ukugcwalisa izigcawu ze-endometrial. Uma ukukhulelwa kungenzeki, izinga lama-hormone linciphisa. I-endometrium inqatshiwe futhi, kanye ne-ovum e-unfertilized, ivela emgodini we-uterine ngendlela yokuchitheka kwamanzi (ukuya esikhathini). I-endometriosis iphinda ihlanganise igazi, okwamanje, elingenalo i-outlet. Esikhundleni salokho, kwenzeka ukwakheka kwe-cysts enegazi, okungaqeda izicubu ezizungezile. Kungenzeka futhi ukuba bahlukane noma baphuze ngokuphulukiswa okulandelayo nokubunjwa kokunamathela.
Umjikelezo wesisindo
Ukusabalalisa kwe-endometriosis akukwaziwa ngokuqiniseka, njengoba abesifazane abaningi abagulayo bengaboni izimpawu. Kukholelwa ukuthi okungenani u-10% wabo bonke abesifazane besiminyaka yokuzala bahlushwa yi-endometriosis.
Ukuhlonza
I-Endometriosis kufanele isolwe kuwo wonke owesifazane ohlukunyezwayo, okunciphisa izinga lokuphila. Ukuxilongwa kusekelwe ekuhloleni umgodi we-pelvic ngokusebenzisa i-laparoscope (okufakwe emgodini wesisu ngokusebenzisa ukugxila okuncane) noma ngesikhathi sokuhlinzwa kwesisu. Ama-splices amakhulu angenza ukuhlolwa kwe-laparoscopic kungenakwenzeka, ezimweni ezinjalo ngiya ku-MR ukuskena, okwamanje, okungaqiniseki kangako. Ama-cysts aphethwe yi-endometrioid emgodini we-pelvic udokotela angakwazi ukuhlolisisa nge-vaginal examination. Kunezindlela ezimbili eziyinhloko zokwelapha i-endometriosis: ukwelashwa kwezidakamizwa nokuhlinzwa. Noma kunjalo, ukwelashwa kufanele kube ngabanye. Imithi yokwelapha i-endometriosis ihlanganisa: ukuhlanganiswa kokubeletha komlomo okuqukethe i-estrogen ne-progestogen (i-progesterone yokwenziwa). Isikhathi sokwelashwa yisizinyanga ezingu-6-9 zokudla okuqhubekayo. Njengendlela yokukhetha, ukuphathwa okungekho eceleni kwe-progestogen, i-dydrogesterone noma i-medroxy progesterone kungenzeka; i-danazol - i-hormone ye-steroid ene-antiestrogenic ne-antiprogesterone; Izifanekiselo ze-gonadotropin-ukukhulula i-hormone (GnRH) ithinta ingcindezi ye-pituitary futhi ivimbele ukuqala kwe-ovulation; lokhu kungaholela ekwakhiweni kwezimpawu zomama we-menopausal ezifana nokushisa okushisayo nokuphefumula kwamathambo. Ukunciphisa le miphumela emibi, ukushintshwa kwe-hormone kungenzeka; Izidakamizwa ezingekho-steroidal anti-inflammatory (NSAIDs) zisetshenziselwa ukukhulula ubuhlungu; Izibonelo zemithi enjalo yi-mefenamic acid neurooxene. Ukwelashwa kwama-hormonal, okuvimbela ukuvuthwa kwegazi, kuvame ukukhulula ngokuphumelelayo ubuhlungu, kodwa awuphili lesi sifo. Uma kungabikho ukwelashwa, lesi sifo siqhubeka sikhula kuze kube yilapho sekuya esikhathini noma ngaphambi kokukhulelwa, lapho izimpawu zivame ukwehlisa. Isiguli kufanele sikhulume ngokuningiliziwe nodokotela zonke izimpawu bese sakha imithi yokwelashwa.
Ukukhulelwa
Abaningi besifazane bayakwazi ukulawula lesi sifo ngosizo lenye yezindlela zokwelapha. Cishe iziguli ezingama-60% ezine-endometriosis elandelanayo emva kokuhlinzwa ukwelashwa ziyakwazi ukukhulelwa ingane. Amathuba okukhulelwa esiqhingini esinzima sesi sifo sinciphise sibe ngu-35%. Ukuqedwa kwe-endometriosis kunganciphisa ubuhlungu nokuphulukiswa kwe-endometriosis, nokuhlukaniswa kwamafissi kwandisa amathuba okukhulelwa. Kulokhu, ukwelashwa kwama-laser kanye ne-cauterization nge-electrocoagulant kungasetshenziswa. Abesifazane abasha abahlela ukukhulelwa banconywa ukuhlinzeka laparoscopic. Ukususwa kwesibeletho, amashubhu kanye nama-ovari angeke anikezwe abesifazane abangaphezu kuka-40 abaye bafeza umsebenzi wabo wokuzala.