Obstruction ntawm cov hlab ntsha fallopian, yuav ua li cas? Cov tsos mob thiab kev kho mob

Cov txheej txheem:

Obstruction ntawm cov hlab ntsha fallopian, yuav ua li cas? Cov tsos mob thiab kev kho mob
Obstruction ntawm cov hlab ntsha fallopian, yuav ua li cas? Cov tsos mob thiab kev kho mob
Anonim

Obstruction ntawm cov hlab ntsha fallopian, yuav ua li cas

Txoj hlab ntshav txhaws
Txoj hlab ntshav txhaws

Txawm tias tus poj niam tuaj yeem xeeb tub tau cuam tshuam ncaj qha los ntawm patency ntawm nws txoj hlab ntshav: txawm tias nws tiav lossis ib nrab. Nws kuj tseem ceeb txawm tias ib lossis ob lub raj qhia pom tias muaj kev cuam tshuam.

Ua tiav cov hlab ntsha ua rau lub qe nkag mus rau hauv lub tsev menyuam tsis tau, vim lub lumen kaw. Hauv qhov xwm txheej zoo li no, tus poj niam yuav tsis muaj peev xwm xeeb tub ib txwm muaj. Txawm li cas los xij, cov thev naus laus zis niaj hnub no, uas yog IVF, tuaj yeem pab nws.

Yog hais tias ib tug poj niam muaj qhov tsis tiav patency ntawm cov hlab ntsha fallopian, qhov no txhais tau hais tias lub lumen ntawm lub appendage tsuas yog kaw ib nrab xwb. Lub qe muaj peev xwm nkag mus rau hauv lub tsev menyuam, uas txhais tau hais tias tus poj niam tuaj yeem xeeb menyuam ntawm nws tus kheej. Txawm li cas los xij, txoj hauv kev muaj kev vam meej fertilization hauv cov neeg mob zoo li no tsawg dua li cov neeg sawv cev noj qab haus huv ntawm ib nrab ntawm tib neeg.

Tsis tas li ntawd, kev xav ntuj tuaj yeem tshwm sim thaum tsuas yog ib txoj hlab ntshav tsis tuaj yeem ua tsis tau, thiab qhov thib ob yog qhov ua tau zoo lossis noj qab nyob zoo. Txawm li cas los xij, qhov teeb meem ntawm tubal infertility tseem muaj feem cuam tshuam hauv lub neej niaj hnub no. Kev xeeb tub thawj zaug tau kuaj pom ob qho tib si hauv cov ntxhais hluas thiab cov poj niam hluas thaum muaj hnub nyoog 30 xyoo. Ntxiv mus, feem ntau lawv tsis tau rho menyuam, tsis raug kev phais, lawv tsis muaj kab mob loj hauv lawv cov anamnesis.

Txheeb cais qhia tias kwv yees li 15% ntawm tsev neeg muaj kev xeeb tub. Thiab nyob rau hauv 20-25% ntawm cov neeg mob, qhov kev cuam tshuam ntawm cov hlab ntsha hauv plab ua nws qhov txhaum.

Cov tsos mob ntawm cov hlab ntsha txhaws

Cov tsos mob ntawm obstruction ntawm cov hlab ntsha fallopian
Cov tsos mob ntawm obstruction ntawm cov hlab ntsha fallopian

Kev cuam tshuam ntawm cov hlab ntsha hauv plab tsis ua rau muaj cov tsos mob zoo. Yog li ntawd, ib tug poj niam yuav tsis paub txog nws qhov teeb meem ntev. Nws txoj kev noj qab haus huv tsis cuam tshuam, kev coj khaub ncaws tshwm sim raws sij hawm, tsis muaj kev ua tsis tiav hauv lawv cov cyclicity. Yog li ntawd, raws li tus poj niam, tsis muaj laj thawj rau kev txhawj xeeb txog nws tus kheej txoj kev noj qab haus huv.

Ib qho cim uas yuav qhia tau tias muaj kev cuam tshuam ntawm cov khoom siv yog qhov tsis muaj cev xeeb tub rau lub sijhawm ntev - tag nrho xyoo ntawm kev sib deev tsis muaj kev tiv thaiv. Ntxiv mus, txhawm rau ua tib zoo saib cov tsos mob no, tus poj niam yuav tsum mob siab rau cev xeeb tub thiab tsis muaj cov tshuaj hormonal lossis endocrine pathologies.

Raws li qhov ua rau ua rau muaj kev cuam tshuam ntawm kev cuam tshuam, daim duab kho mob yuav txawv me ntsis.

Thaum cov kab mob nplaum rau tom qab ntawm qhov mob ntawm lub plab hauv plab ua rau cov kav dej txhaws, ib ntus tus poj niam tuaj yeem cuam tshuam los ntawm qhov mob hauv plab plab ntawm qhov mob.

Yog tias qhov thaiv ntawm cov hlab ntsha yog tshwm sim los ntawm kev phais mob hauv plab kab noj hniav (kev phais mob appendicitis, zes qe menyuam tshem tawm, rho menyuam, thiab lwm yam), ces qhov mob yuav rub. Qee zaum lawv mob siab heev thiab cuam tshuam lub neej zoo.

Cov tsos mob qhia tias cov hlab ntsha txhaws tuaj yeem yog qhov mob hnyav uas tshwm sim thaum lub caij cev khaub ncaws tom ntej.

Ntau zaus, txawm tias ultrasound thiab kuaj ntawm lub rooj zaum gynecological tsis qhia qhov teeb meem.

Qee zaum, tawm tsam keeb kwm yav dhau los ntawm kev cuam tshuam ntawm cov hlab ntsha hauv plab, tus poj niam yuav muaj kev mob thaum muaj kev sib deev, nrog kev sib sib zog nqus los yog poob siab, thaum qhov chaw mos stretched.

Yog tubal obstruction yog tshwm sim los ntawm mob o nyob rau hauv lub plab hnyuv plab hnyuv siab raum, ces txawv txav qhov chaw mos uas tshwm tawm tsam keeb kwm ntawm lub sij hawm mob yuav tsis cais.

Yog li, cov tsos mob tseem ceeb uas tuaj yeem qhia qhov cuam tshuam ntawm cov hlab ntsha fallopian yog raws li hauv qab no:

  • Mob thaum lub caij cev khaub ncaws.
  • Kev tsis xis nyob thaum muaj kev sib raug zoo.
  • Tau ib ntus qhov mob ntawm rub lossis mob qhov xwm txheej nrog rau thaj tsam hauv plab plab.
  • Pathological vaginal paug.

Ua rau thaiv cov hlab ntsha txhaws

Ua rau obstruction ntawm cov hlab ntsha fallopian
Ua rau obstruction ntawm cov hlab ntsha fallopian

Muaj ob qho laj thawj ntawm kev cuam tshuam ntawm cov hlab ntsha hauv plab - cov no yog kev ua haujlwm tsis zoo thiab cov organic pathologies ntawm appendages.

Cov kab mob tsis zoo ntawm qhov ua haujlwm muaj xws li cuam tshuam hauv kev cog lus ntawm cov hlab ntsha, lawv cov hypo- lossis hypertonicity, adynamia ntawm cilia thiab villi, thiab kev tsis sib haum xeeb ntawm lawv cov kev txav. Tib lub sijhawm, cov qauv ntawm cov appendages thiab lawv cov histology tseem tsis hloov pauv.

Yam uas ua rau muaj kev ua haujlwm tsis zoo:

  • Hormonal imbalance. Nyob rau tib lub sijhawm, poj niam txiv neej cov tshuaj hormones hauv lub cev ncig tsawg dua li qhov tsim nyog.
  • Kev poob qis hauv lub paj hlwb vim muaj kev ntxhov siab.
  • Cov tshuaj lom neeg lom neeg ntau hauv cov ntshav thiab cov ntaub so ntswg tawm tsam keeb kwm ntawm kev mob ntawm lub tsev menyuam, zes qe menyuam lossis cov hlab ntsha. Cov tshuaj no suav nrog interleukins, prostaglandins, thromboxane A2, thiab lwm yam.

Cov kab mob organic muaj xws li adhesions tsim nyob rau hauv lub plab kab noj hniav, torsion ntawm appendages, lawv clamping los ntawm ntau yam qog, underdevelopment ntawm lub cev.

Yam uas tuaj yeem ua rau muaj kev loj hlob ntawm cov kab mob organic:

  • Cov kab mob ua rau lub plab pelvic, nrog rau cov kab mob sib deev yav dhau los.
  • Qhov muaj tus kab mob ntev, piv txwv li, mycoplasmosis, chlamydia, ureaplasmosis, cytomegalovirus, thiab lwm yam.
  • endometriosis.
  • Kev phais mob ntawm lub tsev menyuam thiab cov khoom siv, lossis lwm yam kabmob uas nyob hauv plab kab noj hniav.
  • Kev kuaj mob lossis cov txheej txheem kho mob uas tau nrog los ntawm kev cuam tshuam cuam tshuam rau hauv lub cev ntawm lub cev xeeb tub.
  • Nyob mes kas.
  • Kev mob tshwm sim los yog rho menyuam.

Yog li, kev cuam tshuam ntawm cov hlab ntsha tuaj yeem yog vim muaj ntau yam sib txawv uas ua haujlwm lossis cov organic.

Cov kab mob twg tuaj yeem ua rau tubal obstruction?

Yuav luag txhua cov kab mob pathogenic muaj peev xwm ua rau mob ntawm qhov chaw mos, uas yav tom ntej tuaj yeem ua rau muaj kev cuam tshuam ntawm cov hlab ntsha hauv plab. Ntawm cov kab mob coccal, adnexitis feem ntau provoked los ntawm staphylococci, streptococci thiab enterococci. Txawm hais tias fungi, kab mob thiab protozoa tuaj yeem ua rau mob ntawm cov hlab ntsha.

Qhov kev pheej hmoo uas tus poj niam yuav muaj kev cuam tshuam ntawm cov hlab ntsha hauv plab tom qab raug mob ntawm cov kab mob los ntawm cov lej hauv qab no:

  • 12% ntawm cov poj niam tsim kev cuam tshuam tom qab ib zaug ntawm qhov mob.
  • 35% ntawm cov poj niam tom qab 2 ntu mob.
  • 75% ntawm cov poj niam tom qab 3 ntu.

Yuav ua li cas cov hlab ntsha tuaj yeem kuaj xyuas qhov patency?

Tarragon
Tarragon

Muaj ntau ntau txoj kev kuaj mob uas tso cai rau koj los tsim kev cuam tshuam ntawm cov hlab ntsha hauv plab, ntawm lawv:

  • Ultrasound ntawm lub plab hnyuv siab raum. Siv cov khoom siv ultrasound, tus kws kho mob yuav tuaj yeem txiav txim siab tus qauv ntawm cov poj niam hauv nruab nrog cev, txheeb xyuas lawv qhov mob, muaj adhesions, qog., hydrosalpinx.
  • USGSG (echohisterosalpingography, hydrosonography). Cov txheej txheem no tau ua ntau yam tib yam li lwm yam kev kuaj mob ultrasound: ib gel yog siv rau hauv plab kab noj hniav thiab kuaj nrog lub scanner. Txawm li cas los xij, ua ntej cov txheej txheem, cov kua qaub tsis muaj kuab tshuaj yog txhaj rau hauv lub ncauj tsev menyuam uas siv lub catheter nyias, qhov kev txav ntawm qhov uas tau tshwm sim ntawm lub monitor. Yog hais tias ib tug poj niam muaj ib feem ntawm cov hlab ntsha fallopian, ces txoj kev no yog uninformative thiab tsis muaj tseeb tshaj HSG.
  • Hysterosalpingography (HSG, metrosalpingography) yog ib qho kev tshawb fawb ntawm lub tsev menyuam thiab cov appendages siv qhov sib piv nruab nrab, tom qab ntawd cov duab X-ray raug coj mus. Nyob rau hauv cov ntaub ntawv ntawm kev ua txhaum ntawm patency ntawm cov hlab ntsha fallopian, kev kuaj mob yuav tsum tau nqa tawm nyob rau hauv lub thib ob ib nrab ntawm kev coj khaub ncaws. Qhov ua tau zoo ntawm txoj kev yog 98%. Cov txheej txheem yog ua los ntawm tus neeg mob sab nraud, lossis hauv tsev kho mob ntawm cov chaw ua haujlwm gynecological. 2 hnub ua ntej yuav tsum tso tseg kev sib raug zoo. Ib lub lis piam ua ntej qhov kev kuaj mob, koj tsis tuaj yeem douche, muab tshuaj rau qhov chaw mos, tshwj tsis yog cov kws kho mob tau sau tseg. Tus neeg sawv cev sib txawv (cardiotrast, urotrast, verografin, triombrast) yog txhaj rau hauv lub tsev menyuam los ntawm lub raj tshwj xeeb, intravaginally. Tom qab ntawd tus kws kho mob yuav siv cov duab ntau uas tso cai rau koj los ntsuas qhov mob ntawm lub tsev menyuam thiab cov hlab ntsha hauv plab. Rau 3 lub hlis tom qab tus txheej txheem, tus poj niam yuav tsum siv kev tiv thaiv kom tsis txhob muaj menyuam. Hysterosalpingography yog ib txoj hauv kev los kuaj xyuas cov hlab ntsha ntawm cov hlab ntsha. Ib qho teeb meem tseem ceeb ntawm txoj kev tshawb no yog tias nws tso cai rau koj los tsim kom muaj kev cuam tshuam hauv cov kav dej, tab sis nws qhov xwm txheej tsis tuaj yeem qhia meej. (Nyeem ntxiv: HSG X-ray ntawm cov hlab ntsha fallopian: qhov zoo thiab qhov tsis zoo).
  • Perturbation los yog "tshuab tawm" ntawm cov hlab ntsha fallopian. Lub sijhawm kawm no, cov roj tau txhaj rau hauv lub tsev menyuam hauv qab lub siab. Nws tuaj yeem yog cua, carbon dioxide, oxygen. Cov txheej txheem yog xyaum tsis mob rau tus neeg mob thiab tsis siv ntau tshaj 5 feeb. Thaum cov roj puv rau hauv cov hlab ntsha, lawv pib cog lus, nws yog cov txheej txheem no uas tau sau tseg los ntawm cov cuab yeej tshwj xeeb. Cov txiaj ntsig tau tshwm sim hauv daim duab. Tus kws kho mob txiav txim siab txog qhov patency ntawm cov hlab ntsha ntawm lub hauv paus ntawm cov ntaub ntawv tau txais, thiab tseem ntsuas qee cov cim qhia tsis ncaj: ib lub suab nrov hauv lub plab kab noj hniav, mob hauv tus neeg mob pob txha.
  • Laparoscopy nrog chromohydrotubation. Txoj kev no belongs rau cov txheej txheem phais me me. Txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau nws tsuas Txoj kev tshawb no tso cai tsis tau tsuas yog txheeb xyuas qhov cuam tshuam ntawm cov hlab ntsha hauv lub cev, tab sis kuj tseem tshem tawm cov kev ua txhaum cai uas twb muaj lawm. Cov txheej txheem yog ua raws li tshuaj loog hauv tsev kho mob. Ob qhov incisions yog ua nyob rau hauv lub plab kab noj hniav los ntawm cov twj paj nruag yog muab tso rau. Lo lus "chromotubation" txhais tau hais tias cov tshuaj tsis muaj menyuam tau nkag mus rau hauv lub tsev menyuam kab noj hniav, uas, yog tias cov hlab ntsha raug thaiv, yuav tsis kis los ntawm lawv. Tom qab laparoscopy, tus poj niam yuav nyob hauv tsev kho mob ob peb hnub raws li kev saib xyuas ntawm cov kws kho mob.
  • Fertiloscopy (transvaginal hydrolaparoscopy). Cov txheej txheem no tsis tshua muaj kev puas tsuaj piv rau laparoscopy, vim cov hlab nkag tsis tau los ntawm lub plab kab noj hniav, tab sis los ntawm qhov chaw mos, ntawm phab ntsa tom qab. uas lawv ua me me incision. Txoj kev tshawb no tuaj yeem ua tiav hauv qhov chaw kho mob sab nraud raws li tshuaj loog hauv zos. Ib qho tshuaj saline yog txhaj los ntawm qhov txiav mus rau hauv lub plab mog kom txo qis thiab ncaj cov hlab ntsha. Kev ntsuas patency yog ua los ntawm kev siv qhov sib piv nruab nrab.

Txhawm rau txiav txim siab seb txoj kev kuaj mob twg yog qhov tseem ceeb hauv qhov xwm txheej tshwj xeeb, yuav tsum muaj kev sab laj kho mob. Tsuas yog tus kws kho mob tuaj yeem xaiv cov txheej txheem tsim nyog, raws li lub xeev kev noj qab haus huv ntawm tus poj niam. Nws yuav tsum raug coj mus rau hauv tus account tias kev phais kev kuaj mob tsis muaj kev phom sij tsawg dua li kev ua haujlwm puv ntoob. Lawv xav tau kev npaj mus ntev, kev qhia txog tshuaj loog, uas txhais tau hais tias lawv muab lub nra hnyav rau lub cev. Yog li ntawd, thaum twg los tau, kev nyiam yuav tsum tau muab rau cov uas tsis yog-invasive txoj kev kuaj: hysterosalpingography los yog hydrosonography. Tsis tas li ntawd, ib tug poj niam yuav tsum xeem dhau cov ntshav thiab zis, ib qho microflora smear.

Teeb meem thiab qhov tshwm sim ntawm kev cuam tshuam ntawm cov hlab ntsha fallopian

Ua tiav ntawm cov hlab ntsha hauv plab ua rau qhov tseeb tias tus poj niam tsis muaj peev xwm xeeb tub ib txwm muaj. Nrog ib feem patency ntawm lub appendages, cev xeeb tub tuaj yeem tshwm sim, tab sis txoj hauv kev ua tiav fertilization ntawm lub qe yog txo qis. Rau tus poj niam lub neej, kev cuam tshuam ntawm cov hlab ntsha hauv lub cev tsis ua rau muaj kev hem thawj, tab sis qhov teeb meem no dhau los ua qhov ua rau tubal infertility ntau zaus.

Lwm qhov kev phom sij uas tos cov poj niam uas muaj kev cuam tshuam ntawm cov hlab ntsha hauv plab yog kev xeeb tub ectopic. Yog li ntawd, ib tug poj niam yuav poob ib los yog ob qho tib si appendages.

Mob hauv cov hlab ntsha hauv plab: yuav ua li cas?

Mob nyob rau hauv cov hlab ntsha fallopian
Mob nyob rau hauv cov hlab ntsha fallopian

Yog tias qhov mob hnyav tshwm sim thaum lub sij hawm o ntawm cov hlab ntsha, ces nws yuav tsum tau siv tshuaj los ntawm pab pawg NSAID, suav nrog:

  • Diclofenac, Dicloberl, thiab lwm yam. Lawv tuaj yeem tsim tawm hauv daim ntawv txhaj tshuaj lossis hauv daim ntawv ntawm qhov quav suppositories.
  • Koj tuaj yeem haus cov tshuaj hauv cov tshuaj ntsiav lossis ntsiav tshuaj. Nws tuaj yeem yog Ketoprofen, Voltaren, Nimesulide, Ibuprofen, Nurofen, Indomethacin, thiab lwm yam.

Koj tuaj yeem tshem tawm qhov mob los ntawm kev noj tshuaj sib xyaw xws li Baralgin lossis Spazmalgon. Nws tuaj yeem siv Paracetamol lossis Analgin ua tshuaj loog.

Thaum mob hnyav ntawm cov hlab ntsha thiab lub tsev menyuam, koj yuav tsum ua raws li qee yam kev noj haus thiab tsis suav nrog cov khoom hauv qab no los ntawm koj cov zaub mov:

  • -cov nqaij haus thiab cov hnyuv ntxwm;
  • Marinades thiab kub txuj lom;
  • khoom noj kaus poom thiab zaub mov sai;
  • Mayonnaise, ketchup thiab mustard;
  • taum;
  • Cocoa and coffee.

Yog tias qhov mob mob ntev, nws txaus kom tsis suav nrog cov nqaij haus luam yeeb, marinades, zaub mov kaus poom thiab ketchup ntawm koj cov zaub mov. Cov tais diav yog qhov zoo tshaj plaws ci los yog boiled. Fry zaub mov yuav tsum tsis txhob ntau tshaj 2 zaug hauv ib lub lis piam.

Nws yog ib qho tseem ceeb kom txhawb koj cov zaub mov nrog cov khoom noj uas muaj cov vitamins txaus. Ua ntej tshaj plaws, qhov no siv rau zaub thiab txiv hmab txiv ntoo. Nws yog qhov tsim nyog los haus cov kua txiv hmab txiv ntoo tshiab, dej qab zib nrog cranberries, rosehip broth, txiv hmab txiv ntoo qhuav compote, tshuaj yej ntsuab. Nco ntsoov suav nrog cov khoom noj uas muaj vitamin C hauv kev noj haus - cov no yog kiwi, currants dub, txiv qaub, txiv kab ntxwv, tswb kua txob, thiab lwm yam.

Txoj kev rau kev kho cov patency ntawm cov hlab ntsha fallopian

Muaj 4 txoj hauv kev los kho qhov patency ntawm cov hlab ntsha fallopian, xav txog lawv kom meej.

Laparoscopy

Laparoscopy
Laparoscopy

Laparoscopy yog ib txoj hauv kev niaj hnub ntawm kev phais mob, uas yog ua los ntawm kev sib tsoo ntawm phab ntsa hauv plab. Cov txheej txheem yog ua los ntawm kev siv cov cuab yeej tshwj xeeb laparoscopic thiab endoscope.

Thaum kev cuam tshuam ntawm txoj hlab ntaws, laparoscopy tsis yog ib txwm ua, tab sis tsuas yog thaum qhov thaiv ntawm lub appendage raug kuaj pom ze ze ntawm zes qe menyuam thiab tsis muaj cov txheej txheem nplaum nplaum.

Tus txheej txheem yuav tsum tau siv tshuaj loog. Ib qho me me ntawm cov roj inert yog txhaj los ntawm cov hlab ntsha mus rau hauv lub plab kab noj hniav kom nce phab ntsa ntawm peritoneum. Roj yog muab los ntawm ib rab koob tshwj xeeb nyias. Tom qab ntawd 3 qhov kev txiav me me tau ua rau ntawm lub neej, uas tus kws kho mob ntxig cov cuab yeej rau hauv tus poj niam lub cev. Nrog lawv cov kev pab, tus kws kho mob thawb thiab tig cov hlab ntsha hauv plab, excised adhesions thiab hydrosalpinx, sews li incisions, yog tias tsim nyog.

Laparoscopic kev ua haujlwm los kho cov hlab ntsha tuaj yeem yog cov hauv qab no:

  • Fimbryolysis - tso tawm cilia ntawm lub raj los ntawm cov nplaum nplaum;
  • Salpingoanastomosis - tshem tawm ntawm qhov puas ntawm cov yeeb nkab nrog nws txoj hlua txuas ntxiv;
  • Salpingostomatoplasty yog kev txiav thiab tsim ntawm qhov tseeb anatomical qhov hauv lub raj los ntawm sab ntawm zes qe menyuam;
  • Salpingolysis - txiav thiab tshem tawm ntawm thaj chaw pathological nyob ib puag ncig cov hlab ntsha fallopian, tshem tawm nws cov kinks thiab curvature.

Cov txheej txheem yog ua los ntawm 7th hnub ntawm kev coj khaub ncaws, tab sis tsis pub dhau 10 hnub ua ntej pib ntawm ovulation. Txawm hais tias, yog tias kev ua haujlwm yuav tsum tau ua thaum muaj xwm txheej ceev, hnub ntawm lub voj voog tsis muaj teeb meem.

Tom qab txheej txheem, tus poj niam nyob hauv tsev kho mob tau 3-5 hnub. Lub seam kho qhov nruab nrab hauv 10-15 hnub. Kev ua haujlwm raug suav tias ua tau zoo, maj mam thiab tsis ua rau cov nqaij noj qab haus huv.

Thaum qhov kev phais ua tiav, ob peb hlis tom qab, tus poj niam yuav sim xeeb tub. Nws yog ib qho tsim nyog yuav tsum nco ntsoov tias laparoscopy tsis yog txoj haujlwm ntawm kev xaiv rau kev cuam tshuam ntawm cov hlab ntsha fallopian. Yog tias cov adhesions nyob rau hauv lub raj, ces nws muaj peev xwm xeeb tub hauv 10% ntawm cov neeg mob. Thaum lawv nyob sab nraum nws, qhov muaj feem ntawm txoj kev xav tau nce mus rau 60%.

Fertiloscopy
Fertiloscopy

Fertiloscopy yog ib qho ntawm cov kev xaiv rau kev phais endoscopic siv tib yam khoom siv rau laparoscopy. Txawm li cas los xij, tsis zoo li laparoscopy, kev nkag mus rau cov hlab ntsha ntawm lub plab yog tau los ntawm qhov posterior fornix ntawm qhov chaw mos. Cov txheej txheem tuaj yeem ua tau raws li kev siv tshuaj loog hauv zos lossis dav dav.

Ib lub tshuab kho qhov muag nyias tau muab tso rau hauv qab ntawm qhov chaw mos, uas tso cai rau koj los tshuaj xyuas kom meej txog lub xeev ntawm lub plab hnyuv siab raum. Yog tias kuaj pom muaj kev cuam tshuam ntawm cov hlab ntsha hauv plab, salpingoscopy yog ua rau ntawm qhov chaw nrog tib lub endoscope. Thaum kawg ntawm cov txheej txheem, qhov endoscope raug tshem tawm, thiab cov kua dej ntws tawm ntawm lub plab khoob los ntawm trocar channel. Tsis tas yuav tsum muaj sutures ntawm qhov chaw txhaj tshuaj. Cov txheej txheem yuav siv li ntawm 20 feeb.

Ib contraindication rau tus txheej txheem yog ib tug ruaj retroflexion ntawm lub tsev menyuam, uas yog, nws posterior curvature.

YHydrotubation

hydrotubation
hydrotubation

Txoj kev kho tubal obstruction yog dhau lawm, thiab cov kws phais tau sim txav deb ntawm nws. Nws boils mus rau kev qhia txog cov tshuaj isotonic ntawm sodium chloride thiab cov tshuaj sib tov nyob rau hauv ib tug tej yam siab rau hauv lub fallopian raj. Cov nyhuv kho yog raws li cov neeg kho tshuab (rupture of adhesions) thiab cov tshuaj muaj txiaj ntsig ntawm cov hlab ntsha hauv cov hlab ntsha los ntawm sab hauv. Cov tshuaj yog siv ob leeg ib leeg thiab ua ke nrog ib leeg.

Cov txheej txheem yog ua nyob rau hauv lub sij hawm intermenstrual. Txhawm rau kom ua tiav qhov txiaj ntsig zoo, 5-6 zaug yuav tsum tau ua, uas tau rov ua dua txhua 1-2-3 hnub rau 1-5 lub caij coj khaub ncaws.

Hydrotubation yog ua ob qho tib si ntawm tus neeg mob sab nraud thiab hauv tsev kho mob. Qee cov kws tshaj lij hais tias kev sib txuas hydrotubation nrog ultrasound, electrophoresis, diathermy, gynecological massage.

Contraindications rau cov txheej txheem:

  • Mob plab ntawm qhov chaw mos;
  • Kev muaj tus txheej txheem kis;
  • Cov kab mob hnyav dhau los.

Recanalization

Recanalization
Recanalization

Txoj kev no yog tsim los tshem tawm me me adhesions nyob rau hauv cov hlab ntsha fallopian. Tsis tas li ntawd, adhesions yuav tsum nyob rau hauv thawj ntu ntawm lub appendage.

Txoj kev ntawm txoj kev: lub catheter nrog lub zais pa ntawm qhov kawg yog muab tso rau hauv kab noj hniav ntawm lub raj los ntawm lub tsev menyuam. Tus kws kho mob maj mam nce lub catheter tob rau hauv lub appendage, yuam cua mus rau hauv lub zais pa. Yog li ntawd, cov yeeb nkab yog straightened thiab nws patency yog normalized. Cov txheej txheem pib thiab txuas ntxiv nyob rau hauv kev tswj tsis tu ncua ntawm cov cuab yeej laparoscopic.

Tom qab kev kho dua tshiab, txhua tus neeg mob tau muab tshuaj tua kab mob hauv lub sijhawm luv luv ntawm 3-5 hnub. Ib chav kawm ntawm kev kho mob los tiv thaiv thiab tiv thaiv adhesion kuj tau qhia.

Recanalization ntawm cov hlab ntsha fallopian tsis yog siv los tshem tawm cov txheej txheem nplaum, vim tias yuav tsis muaj txiaj ntsig los ntawm kev ua haujlwm.

Liab rau thaiv cov hlab ntsha tawg

Hirudotherapy lossis kev kho mob nrog cov kab mob leeches yog siv dav rau kev cuam tshuam ntawm cov hlab ntsha fallopian. Cov qaub ncaug ntawm cov annelids muaj ntau yam tshuaj lom neeg uas pab tshem tawm qhov mob, txhim kho cov ntshav ncig, thiab yaj adhesions.

Thaum lub sijhawm kho mob hirudotherapy, 3-4 leeches tau muab tso rau ntawm lub plab plab, hauv thaj chaw uas lub tsev menyuam nyob. Qee zaum leeches tau muab tso rau hauv qhov chaw mos. Lawv tseem tshuav mus txog thaum lawv tus kheej haus ntshav thiab poob mus. Cov chav kawm ntawm kev kho mob muaj 10-15 zaug ib hnub. Tom qab ob lub lis piam, chav kawm tuaj yeem rov ua dua.

Rau qhov txheej txheem, koj yuav tsum hu rau tus kws tshaj lij. Nws yog txwv tsis pub nkag leeches rau hauv qhov chaw mos ntawm koj tus kheej.

Ua tiav kev cuam tshuam ntawm cov hlab ntsha fallopian: yuav ua li cas?

Ua tiav obstruction ntawm cov hlab ntsha fallopian
Ua tiav obstruction ntawm cov hlab ntsha fallopian

Ua tiav kev cuam tshuam ntawm cov hlab ntsha fallopian yuav raug kho yog tias cov qauv ntawm lub cev tsis raug puas ntsoog, lossis thaum cov adhesions tsuas yog nyob sab nraum lub appendage, tab sis lawv tsis nyob hauv nws cov kab noj hniav. Nws muaj peev xwm pib kev kho mob yog tias tus poj niam tsis muaj cov txheej txheem inflammatory ntawm lub plab mog.

Nws yuav tsis muaj peev xwm tshem tawm cov kev cuam tshuam ntawm cov hlab ntsha hauv cov xwm txheej hauv qab no:

  • Muaj qhov mob ntawm qhov tso zis.
  • Genital TB diagnosed.
  • Tus neeg mob tshaj 35.
  • Kev mob hnyav ntawm cov kab mob ntawm cov kab mob ntawm cov kab mob hauv lub cev feem ntau tshwm sim.
  • Ib tug loj heev hydrosalpinx tau tshawb pom.
  • Ntau qhov adhesions muaj nyob rau hauv lub plab kab noj hniav, uas ua rau lub cev sib txuas nrog ib leeg.
  • Cov adhesions nyob rau hauv cov hlab ntsha.

Nws tsim nyog nkag siab tias txawm tias tom qab kev kho dua tshiab ntawm patency ntawm cov hlab ntsha fallopian, nws tsis tas yuav daws tau qhov teeb meem ntawm kev xeeb tub. Ib qho xwm txheej tseem ceeb yog kev ua haujlwm tag nrho ntawm cov hlab ntsha fallopian kom lawv muaj peev xwm txav lub qe fertilized mus rau hauv lub tsev menyuam. Txwv tsis pub, muaj kev pheej hmoo siab tias tus poj niam yuav muaj ectopic cev xeeb tub. Yog li ntawd, cov kws kho mob ceeb toom lawv cov neeg mob ua ntej tias qhov normalization ntawm patency ntawm cov hlab ntsha fallopian tsis yog ib qho kev lees paub tias lub cev yuav ua haujlwm kom raug thiab tag nrho.

IVF rau thaiv cov hlab ntsha hauv plab

IVF rau obstruction
IVF rau obstruction

Yog tias tus poj niam raug kuaj pom tias muaj kev cuam tshuam ntawm cov hlab ntsha hauv lub cev, ces nws tuaj yeem ua raws li cov txheej txheem hauv vitro fertilization. Txawm li cas los xij, ua ntej koj yuav tsum tau tshem tawm tag nrho cov mob ntev nyob rau hauv cov kab mob ntawm lub cev xeeb tub, kho tag nrho cov kab mob, thiab, yog tias tsim nyog, tshem tawm cov hlab ntsha. Qhov no tej zaum yuav xav tau thaum lub appendages deformed dhau lawm los yog cuam tshuam qhov chaw ntawm lub tsev menyuam, uas ua rau muaj kev pheej hmoo ntawm nchuav menyuam nrog kev xav tau zoo.

Lwm yam qhia rau kev tshem tawm lub raj:

  • Tsis muaj caij nyoog rov kho lawv cov patency.
  • Qhov tsis muaj peev xwm ua tau zoo thiab tshem tawm tag nrho cov txheej txheem inflammatory.

IVF yog ib tug poj niam tsuas yog kev cia siab rau kev xeeb tub thiab kev xeeb tub nrog kev cuam tshuam tag nrho ntawm cov hlab ntsha fallopian. Yog li ntawd, txoj kev yuav tsum tsis txhob tso tseg.

IVF hauv 60% ntawm cov neeg mob tso cai rau koj xeeb menyuam (tus poj niam hnub nyoog txog li 35 xyoos). Thaum cov kev ua haujlwm los tshem tawm cov kev cuam tshuam ntawm cov hlab ntsha hauv lub cev sib npaug sib npaug ntawm qhov muaj feem cuam tshuam txog 40-70% hauv thawj txheej txheem nplaum thiab mus rau 15-20% nyob rau theem siab ntawm tus kab mob. Nrog IVF, qhov kev pheej hmoo ntawm kev xeeb tub ectopic tsis tshaj 2%, thiab tom qab phais nws nce mus txog 30%. Seb qhov kev xav tau ua tiav tom qab hauv vitro fertilization paub tom qab 14 hnub. Thiab qhov ua tau zoo ntawm kev ua haujlwm tuaj yeem raug txiav txim rau qee qhov kawg ntawm lub xyoo.

Pom zoo: