ʻO ka endometritis maʻi i nā mākua

He aha ka endometritis mau

ʻO ka endometritis mau ʻO ka ʻeha mau o ka endometrium (ka uhi o ka ʻōpū). Hiki ke hoʻopilikia i ka hoʻomohala maʻamau o ka embryo a me kona ulu ʻana ma hope. Eia kekahi, hoʻopau ka mumū mau i ke kino, hiki ke hoʻonāukiuki i nā pilikia koʻikoʻi.

Hana ʻia ka ʻike ʻana i ka endometritis maʻamau e ka microscopic a i ʻole ka histological examination. Loaʻa kahi laʻana o ka endometrium mai kahi biopsy a i ka wā o kahi kaʻina hana hysteroscopy. Ma lalo o kahi microscope, hiki ke hoʻopaʻa ʻia a nānā ʻia kahi laʻana o ka endometrium no ka loaʻa ʻana o nā pūnaewele hoʻomaʻamaʻa maʻi maʻi i ʻike ʻia ʻo nā cell plasma. ʻO kahi hōʻailona endometrial piha i nā pūnaewele plasma e hōʻike ana i ka endometritis mau. ʻO nā moʻomeheu mai ka ʻōpū a i ʻole ka ʻāʻī ʻaʻole ia he hōʻailona hilinaʻi o ka endometritis mau.

Ma mua o ka hoʻomaopopo ʻana i ka ʻeha mau a me kāna kuleana koʻikoʻi i ke olakino hānau, pono mākou e hoʻomaopopo mua i ke ʻano o ka mumū. Ma kona ʻano maoli, ʻo ka mumū ka hoʻāʻo ʻana o ke kino e pale iā ia iho mai nā maʻi, nā mea hoʻonāukiuki, a me ka hoʻoponopono ʻana i nā cell i poino. ʻO ka mumū kekahi ʻāpana o ka pane ʻana o ke kino.

I ka hoʻomakaʻana, he mea maikaʻi ka mumū. No ka laʻana, ke hoʻāʻo nei kou kino e hakakā i kahi maʻi i hoʻokumu ʻia e ka maʻi bacteria a i ʻole nā ​​maʻi. Eia nō naʻe, i kekahi manawa hiki i ka mumū ke hoʻopōʻino hou i ke kino inā lilo ia i mau. Hiki ke mālama ʻia ma hope o ka nalowale ʻana o ke kumu kumu. I kēia kūlana, hiki ke hōʻeha i ka mumū.

Hiki i ka hū ke ʻeha a i ʻole ka lōʻihi.

ʻūhā nui. Hoʻomaka koke ia, hikiwawe a lilo koke i koʻikoʻi. Loaʻa nā hōʻailona a me nā hōʻailona no nā lā liʻiliʻi, akā i kekahi mau manawa e lōʻihi paha lākou.

Aia he 5 mau hōʻailona nui a me nā hōʻailona o ka ʻeha nui:

• ʻeha - hoʻokuʻu ʻia nā kinikona e hoʻoulu ai i ka hopena o ke aʻalolo, kahi e hōʻeha ai;
• ʻulaʻula - hoʻonui i ke kahe o ke koko i ka wahi i hoʻopilikia ʻia i ka ʻulaʻula;
• wela - hoʻonui i ke kahe o ke koko i ka wahi i hoʻopilikia ʻia e alakaʻi i ka hoʻomehana kūloko;
• ʻO ka edema - ma muli o ka kahe ʻana o ka wai mai nā kīʻaha koko kūloko;
• kūleʻa.

He mea maʻalahi ke ʻike a mālama ʻia ka ʻaʻa nui.

ʻAha mau. ʻO ka maʻi maʻi maʻi he hana lōʻihi e mau ana no nā mahina a i ʻole mau makahiki. Ma muli paha o ka hiki ʻole ke hoʻopau ʻana i ka mea e hoʻoulu ai i ka ʻaʻa nui (mau, hoʻopaʻa maikaʻi ʻole ʻia ka bacteria), kahi ʻeha haʻahaʻa haʻahaʻa e hoʻomau mau ana, a i ʻole ke hoʻouka ʻia e ka ʻōnaehana pale i nā ʻiʻo olakino, me ka manaʻo he mau pathogens.

Hiki ke paʻakikī ke ʻike ʻana i ka maʻi ʻeha maʻamau a ʻaʻole i loaʻa mau ka lāʻau lapaʻau maikaʻi.

Ke lilo nei ka mumū i mea hoʻohui maikaʻi ʻia i ka hana ʻole o ka hānau ʻana, me nā kumu maʻamau o ka infertility e like me ka maʻi pelvic inflammatory, polycystic ovary syndrome, obesity, endometriosis, a me ka nalowale o ka hāpai ʻana. I kēia mau lā, ua hoihoi nui ʻia ka mumū mau o ka mucosa uterine. Kapa ʻia kēia ʻano endometritis maʻi.

ʻO nā kumu o ka endometritis mau i nā mākua

ʻO ke kapa o ka ʻōpū ke kuleana no ka hoʻomohala ʻana i ka hiki o ka embryo ke hoʻokomo. ʻO ka hana ʻana o ka estrogen a me ka progesterone e nā ovaries e hoʻololi i ka ʻili o ka ʻōpū e pono ai no ke kanu ʻana. ʻO nā loli i hana ʻia i ka mucosa uterine he paʻakikī loa a maopopo ʻole. Ua ʻike kekahi mau haʻawina i ka ʻaʻa ʻana i nā wahine me nā implants i hāʻule ʻole. Ua manaʻoʻiʻo ʻia ʻo ka mumū o ka uhi o ka ʻōpū e hoʻonui i ka pilikia o ka hāʻule ʻana.

Nui nā kumu o ka endometritis a ʻo ka hapa nui o ia mau mea e pili ana i kahi maʻi i hoʻokumu ʻia e ka flora pathogenic a i ʻole opportunistic. ʻO ka puʻupaʻa, a i ʻole ka wehe ʻana i loko o ka ʻōpū o ka wahine e hoʻopili ai i ka lua o ka ʻōpū i ka ʻōpū, ua uhi mau ʻia me ka ʻāʻī a pale i ka neʻe ʻana o ka bacteria i loko o ka lua endometrial. ʻO nā catheters no ka insemination intrauterine a i ʻole ka hoʻoili ʻana o ka embryo e kāpae i ka pylorus cervical a hiki ke hoʻoulu i ka maʻi. Inā hāʻule ka mea maʻi, hiki ke hoʻomāhuahua ka ʻāʻī e ʻae i ka hoʻokuʻu ʻana i nā ʻiʻo o ka embryo i make, akā hiki ke maʻi bacteria ma ke ala piʻi. ʻO nā koena o ka placenta a me nā membrane ma hope o ka hāpai ʻana e pili pū me ka maʻi.

Ma keʻano laulā, loaʻa ka endometritis ma muli o kahi maʻi. Hiki paha ke chlamydia, gonorrhea, tuberculosis, a i ʻole hui pū ʻia o nā maʻi bacteria maʻamau. ʻOi aku ka nui o ka ʻeha ma hope o ka hāʻule ʻana a i ʻole ka hānau ʻana, akā ʻaʻole ia he mea maʻamau ma hope o ka hana lōʻihi a i ʻole ka ʻāpana caesarean. ʻOi aku ka nui o ka pilikia o ka hoʻomohala ʻana i ka endometritis ma hope o ke kaʻina pelvic, i hana ʻia ma o ka pūpū. Aia kēia mau kaʻina hana:

• ditation a me ka curettage i ka wā hāpai;
• biopsy endometrial;
• hysteroscopy;
• ka hoʻokomo ʻana i kahi mea intrauterine (IUD);
• ka hānau ʻana (ʻoi aku ka nui ma hope o ka pauku caesarean ma mua o ka hānau ʻana o ka wahine).

Hiki ke loaʻa ka Endometritis i ka manawa like me nā maʻi pelvic ʻē aʻe.

Nā hōʻailona o ka endometritis mau i nā mākua

Ma waho aʻe o kahi exacerbation, ʻaʻohe mau hōʻailona paha. I ka wā o ka exacerbation, hiki i nā hōʻailona ke komo:

• ʻōhūhū;
• ke kahe ʻana o ka vaginal a i ʻole ke kahe ʻana;
• pilikia me ka neʻe ʻana o ka ʻōpū (me ka constipation);
• ke kuni nui;
• ka ʻeha nui, ka hopohopo, a i ʻole ka manaʻo maikaʻi ʻole;
• ʻeha ma ka ʻōpū o lalo a i ʻole pelvis (ʻeha i loko o ka ʻōpū).

Ka mālama ʻana i ka endometritis maʻi i nā pākeke

Hoʻomaʻamaʻa ʻia ka wehe ʻana i ke kumu o ka maʻi (koena o ka placenta, fetal egg, hematomas, coils) a ukali ʻia e kahi papa pōkole o nā lāʻau antibiotic. I kekahi mau hihia, hana ʻia kahi biopsy endometrial "hōʻoia o ka ho'ōla" ma hope o ka pau ʻana o ka hana o nā lāʻau antibiotic e hōʻoia i ka endometrium maʻamau. Hoʻohana pinepine ʻia ka hoʻohana antibiotic empiric ma mua koke o ka hoʻoili ʻana o ka embryo i nā protocol IVF e hoʻoholo i nā endometritis liʻiliʻi i ka manawa o ka implantation.

lapaʻau '

Aia kekahi mau ho'āʻo koko he mau hōʻailona maʻamau ʻole o ka mumū. ʻO kekahi o nā hōʻailona i kapa ʻia ʻo ka erythrocyte sedimentation rate (ʻike pū ʻia ʻo ESR). ʻAʻole maikaʻi loa ka ESR i ke aʻo ʻana i nā wahine o ka makahiki hānau, no ka mea, pili ia i nā pae estrogen.

ʻO kekahi hōʻailona ʻē aʻe i kapa ʻia ʻo C-reactive protein a i ʻole CRP he kūʻokoʻa ia i nā pae hormone, no laila he hōʻailona ʻoi aku ka hilinaʻi o ka mumū i nā wahine. ʻO ka pae CRP kiʻekiʻe loa (>10) he hōʻailona maʻamau ia o kahi maʻi maʻi. ʻO nā pae haʻahaʻa haʻahaʻa paha he hōʻailona ia o ka ʻeha mau loa.

Hiki ke ʻike pono ʻia ka uhi o ka ʻōpū ma ka hoʻokomo ʻana i kahi telescope fiber optic i loko o ka lua o ka ʻōpū. Kapa ʻia kēia he hysteroscopy. I kekahi manawa hiki ke hoʻohana ʻia kēia ʻano hana e ʻike ai i ka endometritis maʻi. No ka laʻana, ʻo ka hiki ʻana o nā micropolyps he hōʻailona hilinaʻi o ka endometritis mau.

Hiki ke hoʻohana ʻia ka Hysteroscopy no ka loaʻa ʻana o kahi laʻana a i ʻole biopsy o ka uhi o ka ʻōpū, hiki ke nānā ʻia ma lalo o kahi microscope. I loko o ka uhi o ka ʻōpū, hoʻokahi ʻano o ke koko keʻokeʻo keʻokeʻo he hōʻailona o ka mumū mau ʻana he "plasma" cell. Hiki ke ʻike ʻia nā cell plasma ma ka nānā ʻana i kahi ʻāpana o ka ʻōpū o ka ʻōpū ma lalo o kahi microscope. Eia nō naʻe, ma muli o ka loaʻa ʻana o nā ʻāpana like ʻole, ʻaʻole maʻalahi ka hoʻoholo ʻana i ka loaʻa ʻana o kahi helu maʻamau o nā cell plasma. Loaʻa i nā cell plasma kahi māka ma ko lākou ʻili i kapa ʻia ʻo CD138. Hiki ke pani ʻia kahi laʻana o ka ʻiʻo endometrial e hoʻokaʻawale iā CD138. He ala hilinaʻi kēia no ka ʻike ʻana i ka endometritis maʻi.

Nā lāʻau lapaʻau hou

Inā hiki ke ʻike ʻia kahi kumu kikoʻī o ka ʻāʻī, ʻo ka mālama ʻana i ke kumu e hopena i ka hoʻonā ʻana o ka mumū pili. No ka laʻana, inā loaʻa kahi maʻi bacteria, hiki ke hoʻāʻo ʻia ka lāʻau antibiotic. Ua hōʻike ʻia kahi noiʻi hou i ka piʻi ʻana o ka hāpai ʻana a me ka nui o ka hānau ʻana i ka wā i loaʻa ai i nā wahine me nā kiʻekiʻe CRP haʻahaʻa haʻahaʻa i ka aspirin haʻahaʻa ma mua o ko lākou hāpai ʻana. Eia naʻe, ʻaʻole i ʻike ʻia ka hoʻomaikaʻi ʻana i nā wahine momona. Ma kahi noiʻi holoholona, ​​ua ʻike pū ʻia ʻo ka ʻike ʻana i ka platelet rich plasma (PRP) e hoʻopau i ka hana ʻana o kekahi mau protein i hana ʻia i loko o ka ʻōpū o ka ʻōpū ma muli o ka mumū.

He hana maoli anei ka lāʻau antibiotic no ka endometritis mau? ʻO kahi loiloi hou o kekahi mau haʻawina e nānā ana i ka mālama ʻana i ka endometritis maʻi me nā lāʻau lapaʻau i ʻike ʻia ʻo nā wahine i loaʻa ka hōʻike o ka hoʻōla (re-biopsy hōʻike ʻia ka mumū) he 6 mau manawa ke loaʻa i ka hāpai ʻana a i ʻole ka hānau hānau ʻana i hoʻohālikelike ʻia me nā wahine me ka endometritis mau. i malama ole ia.

Ka pale ʻana i ka endometritis maʻi i nā pākeke ma ka home

He mea nui e mālama i kou olakino ma ke kipa ʻana i ke kauka maʻi i kēlā me kēia makahiki. Hiki ke hoʻokumu ʻia ka endometritis e nā maʻi STI. No ka pale ʻana i ka endometritis mai STI:

• mālama i nā STI i ka manawa kūpono;
• e hōʻoia i ka mālama ʻia ʻana o nā hoa moe kolohe no nā STI;
• E hoʻomaʻamaʻa i nā hana moe kolohe, e like me ka hoʻohana ʻana i ka condom.

Hiki ke hāʻawi ʻia nā lāʻau antibiotic ma mua o ke kaʻina hana no ka pale ʻana i nā maʻi maʻi.

Nā nīnau a me nā pane kaulana

Ua pane ʻia nā nīnau e pili ana i ka endometritis maʻi gynecologist, PhD Mikhail Gavrilov.