Asherman Syndrome: izimbangela, izimpawu, incazelo, ukuxilongwa kanye nokwelashwa

Nazingane emshadweni - ke ingenye izinkinga ezibaluleke kakhulu emphakathini. Ososayensi baye efakazelwe indima efanayo ngayinye abazali ezingaba akuphumelelanga ekuxazululeni le nkinga. Nokho, ukuthola abantwana ukulethwa kuthiwa yabekwa unina. Yenza le imisebenzi kungaba kuphela abavuthiwe umzimba female. Kule minyaka embalwa sesibonile ukukhula zokuzala izitho izifo ukuthi avuse futhi nenzalo. Ezweni lethu usesikhundleni okuholela endometritis ezingamahlalakhona. Omunye zako kuyinto Asherman Syndrome. Kungakhathaliseki sokukhulelwa kungenzeka yini kulumkhuhlane?

zokugula incazelo

Ngaphansi Asherman Syndrome ibhekisela esimweni sokugembula lapho kwesibeletho kwakhiwa ukuvuvukala. Bona kuholele esinqunyiwe noma ephelele imperforate ingaphakathi layo. Lesi sifo lethiwa ngegama kaJosefa Asherman wezifo zabesifazane. syndrome Okokuqala wachaza ngokuningiliziwe ngo-1894 Genrih Fritch. Esikhathini izincwadi zezokwelapha ezisekelwe ekwazisweni kukhona izihloko eziningana yalesi sifo: ukuvuvukala intrauterine, yoma kuhlasimulise futhi sclerosis we endometrium.

Asherman sika sifo sitholakale umuntu abesifazane kungakhathaliseki ubudala babo futhi isikhundla emphakathini. ukuvuvukala Intrauterine amelela Splice zezinzwa, phakathi lapho solder umzimba udonga futhi abangele ukusonteka yabo. Ngenxa yalokho yenqubo sokugembula eba ezihlukahlukene iziyaluyalu eziholela menstrual ukungasebenzi. Izimpawu ezisemqoka we syndrome ivezwa ngendlela izisu okuvele nenzalo.

Lokho izibalo ku ukusatshalaliswa zesifo? Ngemva curettage kwabesifazane nulliparous ingozi yokuba lesi sifo 25%. Lapho abantu abangewona iphila sokukhulelwa Amathuba kumiswa ukuvuvukala futhi inyuka kuze kube-30% amacala. kwesisu Ngiphakathi nendawo cishe okubeka impilo yowesifazane. Kulokhu, ingozi yesifo ngokulambisa ezingaphezu kuka-7%.

Izizathu eziyinhloko

Kwesibeletho kuyinto isitho eziyize kwemisipha. Ngaphandle-ke imbozwe peritoneum. Ingaphakathi uphahlwe endometrium, esakhiwa izingqimba ezimbili - i-basal futhi zisebenza kahle. Kuye esigabeni umjikelezo wokuya esikhathini futhi ngaphansi kwethonya ubulili-hormone i-endometrium sibhekana nezinguquko eyindilinga. Eduzane isikhathi nge-ovulation, lapho ithuba lokukhulelwa ingane le Osenyangweni, le endometrium sikhula. Amaseli endometrial ikhiqiza asebenzayo izinto eziphila abakhuthele. Emva kokukhulelwa, iqanda lingena kwesibeletho, lapho yenzeka. Xhumana ulwelwesi fetus nge endometrium enempilo - isimo esiyinhloko ukuba akhulelwe yimpumelelo. Uma ekukhulelweni lube khona, ungqimba obusebenzayo is basishulwe, njengoba kufakazelwa nyangazonke. Nge ekuqaleni umjikelezo ngamunye, endometrium ikhula futhi.

Ukuvuvukala - ke amaqhubu noma ukuvuvukala we ungqimba yangaphakathi kwesibeletho ezephula physiology ulwelwesi lwamafinyila. Asherman sika syndrome ngenxa umonakalo noma ukulimala ungqimba basal we endometrium phakathi nezinqubo izifo zabesifazane. Lokhu kungaba nokususa emva isisu, esigabeni cesarean, noma yimuphi omunye ukusebenza. Enye Imbangela evamile zesifo - endometritis. Ukuvuvukala akhiwa isizinda foci eziningi ukuvuvukala e ulwelwesi lwamafinyila kwesibeletho.

Lwasemtholampilo isithombe lesi sifo

Izimpawu zesifo zibangelwa inqubo ingcina futhi umphumela wawo ukusebenza kwesimiso sokuzala. Phakathi kwazo kunabafundi ezivamile:

• disorder kokuya esikhathini (esindayo / ngokwahlukana mafutha, ubuhlungu eqinile);
• kwesisu ;
• wokunciphisa inani kanye nesikhathi menses;
• ukungazali yesibili;
• ukunqwabelana igazi uketshezi kule ingaphakathi lesizalo.

Yini enye inezimpawu ka Asherman Syndrome? Izifo uvame ukuhamba endometriosis obuhlukahlukene zaba namandla kakhulu. I zokugula libhekene ukukhula komntwana ethunjini ungqimba nemisebenzi yokusetshenziswa endometrium awanakufundwa kwesibeletho. Lokhu inhlanganisela nomthelela omubi embonweni amathemba ukuze bayothola ukwelashwa.

Three lamadigri kobukhulu

Banikezwe ukulimala ungqimba basal we endometrium, odokotela basikisela ngezigaba olandelayo Asherman Syndrome:

• omnene (ukuvuvukala hlala akukho ngaphezu kuka-25% of the volume kwesibeletho, wabhubhisa kalula ukulimala mechanical);
• degree isilinganiso (umphetho ashiselwe uvalwe ne lwamafinyila kwesibeletho);
• degree okukhulu (ukuvuvukala aqukethe ogxile kwezicubu sclerosed zezinzwa, ekuvimbeni umlomo kwesibeletho futhi amashubhu umzimba phansi).

ukuzimisela Esifike Ngesikhathi degree of inqubo sokugembula kusheshe ukwelapha Asherman Syndrome.

Ingabe ukukhulelwa kungenzeka?

Izibuyekezo lodokotela abonisa ukuthi ematfuba lokukhulelwa ingane nalesi sifo incike imbangela kanye esiteji. Lapho Asherman Syndrome is iphazamiseke uhlelo zokuzala. Izindonga induku kwesibeletho, abahlukaniswe cross-amapayipi. Ngenxa yalokho, i-embryo ayikwazi ezifakelwa kumuntu. Ngaphezu kwalokho, endometrium ilahlekelwa amandla abo okuphila umlilo aphendule izinguquko estrogen izinkomba. Kancane kancane ukungazali yesibili, futhi nalo, futhi amenorrhea. Ukuvuvukala esifundeni wesibeletho avuse ukucinana kunqanda menses. Ukwephulwa umjikelezo ngokuvamile sibonisa ezifweni ezimbi. Ukukhulelwa kuyindlela yemvelo kuyabongeka lokho, uma hhayi ngesikhathi esifanele belashwa Asherman Syndrome.

kungakhathaliseki IVF kungenzeka? Izibuyekezo lodokotela uqinisekise ukuthi kokukhulelwa kwesibeletho kuwusizo lapho lesi sifo ngendlela efanele usaqala yentuthuko. Isibalo ukuvuvukala ayikwazi ukudlula 25% umthamo kwesibeletho, kufanele isebenze endaweni elilinganiselwe ngalo ingaphakathi.

Akunakwenzeka ukunikeza impendulo eyodwa kuya imibuzo ethunyelwe, ngoba esimweni ngasinye sihlukile. Kuye kobukhulu inqubo sokugembula, kukhona ezahlukeneyo eziningana ukukhulelwa. Ezinye nomame bethwele yizimbangela ezihlobene izinkinga, kanti abanye futhi ephelezelwa yezinkinga eziningi. A indlela yesithathu - isisu nokuguqulwa, yisisu, ukungazali yesibili. Yingakho wonke umuntu wesifazane kufanele banakekele impilo yabo, ibhekane beyohlolwa gqwa ngesikhathi udokotela wezifo zabesifazane, ikhambi ngesikhathi esifanele zonke izifo.

ngihlolwa

izindlela wezinsimbi ngeso lengqondo kwesibeletho zisetshenziselwa ukuxilonga izifo. Nakanjani udokotela ehlola umlando azoya lesiguli (isibalo sokukhulelwa, ukukhishwa kwezisu, izisu nokunye.). Ultrasound luhlolo ubhekwa ezingabizi kakhulu futhi ngesikhathi esifanayo kancane indlela koda ukuxilongwa izitho okhalo. Asherman Syndrome kungaqinisekiswa ngokuthola ultrasound, kodwa ukuthola imiphumela olunembile, kumele usuphinda izikhathi ezimbalwa ngesikhathi umjikelezo.

Izinga egolide ukuthola ukuvuvukala kubhekwe hysteroscopy. ucwaningo kwesibeletho okunjalo kuhilela ukusetshenziswa idivayisi ekhethekile. Iqondiswa ngokusebenzisa komsele wesibeletho, ukuze isimo umzimba kungahlolwa ngesikhathi sangempela esikrinini sekhompyutha. Hysteroscopy ukunquma kobukhulu inqubo sokugembula, ubungako kanye kwasendaweni ukuvuvukala. iziguli ephelele imiphumela yokuhlolwa kufanele kuhlanganiswe umlando azoya futhi okwazanywa ukuphazanyiswa. Ukwenza ngale ndlela ivumela ukubikezela omuhle Dynamics yokwelapha.

zokwelapha

Lesi sifo okuncane kahle kobukhulu kusabela ukwelashwa. amafomu Advanced yesifo nokukhulelwa akuhambisani. Esimweni esinjalo kuziwa surrogacy wokutakula. Lapho spikes zitholakala ingxenye elilinganiselwe kwesibeletho, kusiza IVF. Nokho, kulesi simo ukuzama ngendima unina bengayi bonke abesifazane kwathiwa unesifo "Asherman Syndrome."

Ukwelashwa kuhilela ukususwa ukuvuvukala at indlela hysteroscopy. Ukusebenza aludingi ukubulawa kwezinzwa okuvamile, kube nezinkinga. Ngokomthetho, lena inqubo kunalokho xaka. Ukususwa kwezimiso ukuvuvukala olwenziwa micro-sikelo ngenxa awokuthi kabusha ukulimala. Esikhathini nasezinkingeni ezilandela ngemva kokuhlinzwa esikhathini esibekwe imithi elwa namagciwane ukuvimbela yezinkinga ezithathelwanayo. ukwelashwa liyadingeka ukwelekelela hormone. Ukusetshenziswa estrogens futhi progestins oboniswa ukufukula endometrial.

ukuba nombono ongafani ngeke

Ezintsha inqubo isifo nokukhulelwa esifike yokwelapha is ebonwe 93% eziguli, nge-avareji -% 78 kuphela. ukwelashwa okufanelekile kwabesifazane ne isifo eziphambili kwenza kube nokwenzeka ukuba akhulelwe ingane 57% amacala. Nokho, ukukhulelwa ophumelele Asherman Syndrome akaqinisekisi ukuzalwa kwengane ngaphandle pathologies. Ubudala iziguli nakho kubhekelwe ku umhlahlo. Ngokwesibonelo, ama-66% eziguli ezingaphansi kweminyaka engu-35 kwatholakala ukuthi syndrome severe ukwazi okukhulelwa. Ngesikhathi ubulili fair engaphezu kwengu-35, lesi sibalo ngokulambisa idlula 24%.

izinyathelo

Kungenzeka yini ukuvimbela Asherman Syndrome? Curettage noma cleaner nenshisekelo - onguchwepheshe izinqubo ezimbili wenza cishe zifa, sithembele kuphela okuhlangenwe nakho kwawo siqu. Izicubu we endometrium ngesikhathi sokukhulelwa elithambile, abalimele kalula kanjalo. Ngenxa yalokho, yimuphi nokususa yokuthola isifo noma yokwelapha ngaso sonke isikhathi sihambisana ukulimala ungqimba basal.

Enye kulezi izinqubo isezingeni izisu isisu wezokwelapha. It libonisa oxytocic ngokusebenzisa izidakamizwa. Nokho, ukuphumelela le ndlela kuyinto% 80 kuphela. Ngo-10% amacala ngemuva isisu wezokwelapha waphawula isifo ulwelwesi okudinga nokususa. Ngakho, ukuze kuvinjelwe Asherman Syndrome ungakwazi, uma ngezizathu zezokwelapha ukukhetha isisu wezokwelapha. Ngakolunye uhlangothi, le nqubo akukuniki 100% isiqinisekiso Chile oqondile.