Asherman kuti chirwere: zvinokonzera, zviratidzo, description, kuongorora chirwere uye kurapwa

Childlessness muwanano - ndiyo imwe inokosha nezvinetso zvamagariro. Masayendisiti nekusimba chete basa nechimwe zvaigona vabereki kundikana kugadzirisa nyaya iyi. Zvisinei, vana uye kukurukura neni amai. Kuita mabasa aya anogona chete uchikura hadzi muviri. Mumakore mashoma apfuura takaona kukura nhengo dzokubereka nadzo zvirwere kuti vanotsamwisa uye kushaya mbereko. In nyika yedu ane nzvimbo aitungamirira chinzvimbo mune chirwere endometritis. Mumwe kuratidzwa aro Asherman kuti syndrome. Kana pamuviri zvinogoneka mune chirwere ichi?

zvokurwara Description

Under Asherman kuti chirwere kunoreva mamiriro pathological umo dumbu akaumba adhesions. Hunozoita kuti haasaruri kana zvakakwana imperforate mhango kwayo. The chirwere akawana zita raro nezita Joseph Asherman gayinakorojisiti. First chirwere zvakajeka muna 1894 Genrih Fritch. In mabhuku ezvokurapa pane okuremekedza wandei chirwere ichi: intrauterine adhesions, dzechimwe atrophy uye kuoma dzimwe nhengo dzomuviri womunhu endometrium.

Asherman kuti chirwere kunokwanisa kuonekwa mune vakadzi pasinei nezera ravo uye chinzvimbo. Intrauterine adhesions inomiririra connective splice, pakati uyo solder muviri rusvingo uye kukonzera deformation yavo. Somugumisiro pakati pathological muitiro hwapedyo zvakasiyana siyana zvirwere kuti kukonzera yekutevera dysfunction. The chikuru Zviratidzo zviri chirwere akataurwa muchimiro kwatangwa pamuviri uye kushaya mbereko.

Kuti nhamba iri kuparadzira chirwere? Pashure curettage vakadzi nulliparous ngozi Pakukurukura chirwere ndiyo 25%. Apo non-zvimwe pamuviri ndingangokuvara paumbwe adhesions uye inowedzera 30% nyaya. Kwazvakarerekera kupfupfudzika vanenge angavatsugudusa utano hwemukadzi. Panyaya iyi, pangozi chirwere haawanzotauri anopfuura 7%.

The zvikonzero

The dumbu riri pamhango tsandanyama nenyere. Kunze zviri nokufukidzwa peritoneum. The nechomukati mudungwe pamwe endometrium randinogara maviri akaturikidzana - the basal uye dzichipfekeka. Zvichienderana chokutambudzika kumwedzi uye vakadhakwa dzepabonde Makemikari ari endometrium kaviri cyclic kuchinja. Pedyo panguva ovulation, kana mukana yokubereka mwana Wokumusorosoro, vari endometrium richikora. The endometrial masero ane inoshingaira kugadzirwa pakugadzira vanoshingaira zvinhu. Mushure fertilization, zai inopinda muchibereko chemusikana, apo muchibereko. Contact fetus membranes ane endometrium utano - Nde zvimiso vabudirire pamuviri. Kana pakusangana kumboitika, iyo yaishandiswa rukoko yakabvaruka kure, sezvinoratidzwa pamwedzi. With pakutanga nomumwe kutenderera, ari endometrium inokura zvakare.

Adhesions - nayo outgrowths kana adhesions ari womukati rukoko pamusoro dumbu kuti mukaputsa physiology ari mucous membrane. Asherman kuti chirwere hwapedyo nokuda kukuvara kana kukuvara kuti basal rukoko pamusoro endometrium panguva gynecological dzokuvhiya. Izvi zvinogona kuva tichibvisa pashure pamuviri, cesarean chikamu, kana mumwe oparesheni. Chimwe chikonzero zvinowanzovapo chirwere - endometritis. Adhesions vari akaumba pamusoro pakanyorwa dzakawanda foci pakati kuzvimba ari mucous Kamudzira yacho dumbu.

The kunotoda Mufananidzo urwere

Zviratidzo zviri chirwere zvinokonzerwa namira muitiro uye rawo kushanda dzokubereka nadzo. Pakati pavo pane Zvinonyanyozivikanwa:

• kumwedzi nyonganyonga (rinorema / dzakaonda kuparadzana, kurwadziwa simba);
• kusvodza ;
• kuderedza uye paanowedzera varikutsika;
• kushaya mbereko yechipiri;
• kuunganidza ropa secretions vari uterine mhango.

Chiizve ane zviratidzo Asherman kuti chirwere? Chirwere chinowanzoguma endometriosis siyana zvakaoma. The zvokurwara kunoratidzwa ectopic ikure dzichipfekeka rukoko pamusoro endometrium mhiri yezvinoreva dumbu. Kubatana uku inokanganisa maonerwo uye tarisiro kurapwa.

madhigirii Matatu nekuomarara

Kupiwa kuvadza basal rukoko ari endometrium, vanachiremba vanoti zvinotevera kupatsanura pakati Asherman kuti urwere:

• nyoro (adhesions kugara hapana anopfuura 25% of Vhoriyamu dumbu, nyore nyore yakaparadzwa zvokuimba kukuvadzwa);
• avhareji dhigirii (musono welded zvakasimba pamwe mucous ari dumbu);
• zvakakomba dhigirii (adhesions Zvinosanganisira runonyanya pamusoro sclerosed connective zvinyama, ichivharira muromo dumbu uye sepombi pasi muviri).

Panguva Chaiyo Kutsunga mwero pathological muitiro unogona kukurumidza kurapa Asherman kuti syndrome.

Ko pamuviri zvinobvira?

Reviews kuvarapi anoratidza kuti mukana yokubereka mwana nechirwere ichi kunobva chikonzero uye pachikuva. Apo Asherman kuti chirwere ari kukanganiswa dzokubereka nadzo. Madziro dumbu rutanda, nokuputswa muchinjikwa pombi. Somugumisiro, embryo haigoni kwomwoyo. Mukuwedzera, endometrium anorasikirwa kukwanisa kwayo kupindura nokuchinja inonzi estrogen zviratidzo. Zvishoma nezvishoma kutanga kushaya mbereko chesekondari, uye pamwechete nayo, uye amenorrhea. Adhesions ari remuromo nharaunda vanotsamwisa kuzara uye kunonoka kuti varikutsika. Kutyora kutenderera Kazhinji rinoratidza wakaomarara chirwere. Pamuviri wechisikigo nzira unogamuchirwa, kana kwete nenguva arapwa Asherman kuti syndrome.

kana IVF kunobvira? Reviews kuvarapi asimbise kuti ezvokunambira kunze kwomuviri waamai muchangosangana inobatsira kana hosha yava vachiri padanho kukura. Kuwanda adhesions havagoni pfuura 25% of Vhoriyamu dumbu, vanofanirwa vemunyika zvishoma nzvimbo mhango.

Hazvibviri kupa mhinduro chete dzemibvunzo vakabvuma, nekuti chimwe nechimwe yakasiyana. Zvichienderana kwokuomerwa ari pathological muitiro, pane dzakasiyana siyana pamusoro pamuviri. Vamwe vakadzi akatakura pamusoro zvinokonzera ukama matambudziko, apo vamwe pamwe vakawanda matambudziko. A pfungwa yechitatu - vaingoerekana pamuviri, zvinoguma nokupfupfudzika, kushaya mbereko yechipiri. Ndokusaka mukadzi wose anofanira kutarisa pashure utano hwavo, vanosangana nguva nenguva uchiongororwa panguva gayinakorojisiti, nenguva mushonga zvirwere zvose.

Medical ongororo

Nzira paku kuona dumbu anoshandiswa rokuongorora chirwere. Chokwadi chiremba anoongorora nhoroondo obstetric murwere (nhamba pamuviri, pamuviri, kupfupfudzika nezvakadaro.). Ultrassom ongororo ichaongororwa kuti kupfuura kutengeka uye panguva imwecheteyo zvishoma invasive nzira nechirwere ose pelvic nhengo. Asherman kuti chirwere unogona kuva kwechokwadi Ultrasound, asi kuti vawane zvibereko zvakarurama, unofanira kudzokorora nzira kakati panguva kutenderera.

Mureza zvendarama kuziva miedzo adhesions vaiona hysteroscopy. tsvakurudzo dumbu kwakadaro kunosanganisira kushandisa zano rinokosha. It chinotarisirwa kuburikidza remuromo canal, zvokuti muviri ezvinhu anogona kuongororwa nenguva chaiyo pakombiyuta. Hysteroscopy kuona kukomba ari pathological muitiro, ukuru uye localization pakati adhesions. Varwere kwakakwana kuongororwa zvabuda anofanira kubatanidzwa obstetric nhoroondo uye yapfuura kuedza pa kurapwa. nzira kwakadaro kunoita kuti kufanotaura zvakanaka simba kurapa.

kurapwa

The chirwere munyoro kuti zvive nomwero nekuomarara ikarumbidzwa zvakanaka kurapwa. Advanced siyana chirwere uye pamuviri haawirirani. Pakadaro anouya kuzonunura surrogacy. Kana yakatesvera panyanga dzacho dziri shoma mugove dumbu, kunobatsira IVF. Zvisinei, muchiitiko ichi kuedza pamusoro basa amai asingagoni vakadzi vose vane chirwere kuti "Asherman kuti syndrome."

Treatment kunosanganisira Kubviswa adhesions pane nzira hysteroscopy. Operation kunoda hapana mukuru yokutindivadza, hapana matambudziko. Zvazviri, izvi nani yakaoma muitiro. Kubviswa adhesions vakapfuudzira Micro-chigero nokuti mukuru mukana kunenge kukuvara. Mugore postoperative nguva waakaudzwa mishonga kudzivisa zvirwere matambudziko. Drug kurapa kunodiwa kutsivira kemikari. Kushandiswa estrogens uye progestins kuratidzwa kuti ude endometrial kukura.

mataridzikiro

Munyoro chirwere kwacho uye nenguva pamuviri of ARV kuchengetwa 93% wevarwere, neavhareji - 78 chete%. Kurapwa vakadzi vane yemhando chirwere runoita kuti pamuviri mwana muna 57% nyaya. Zvisinei, vakabudirira pamuviri pamwe Asherman kwakaita chirwere hakuvimbisi kuzvarwa mwana pasina pathologies. Age of varwere kuripowo kufungwa iri kushurudzira. Somuenzaniso, 66% wevarwere makore vaduku pane 35 nechirwere chirwere chakakomba kukwanisa pamuviri. Panguva akanaka bonde kwemakore 35, nhamba iyi haawanzotauri kukasapfuura 24%.

matanho

Zvinoita kudzivirira Asherman kuti chirwere? Curettage kana Vacuum chido - maviri maitiro nyanzvi anoita anenge tinongoita, kuvimba chete pachavo ruzivo. Zvinyama of endometrium panguva pamuviri munyoro, saka zviri nyore kukuvara. Somugumisiro, chero chirwere kana kuti yokurapwa tichibvisa nguva dzose achiperekedzwa kukuvara basal rukoko.

Rinogona kutsiva maitirwo izvi uri pamuviri dzokurapa pamuviri. Kunoreva kuva oxytocic nokushandisa zvinodhaka. Zvisinei, kubudirira nzira iri 80 chete%. Muna 10% nyaya pashure yezvokurapa pamuviri vakachengeta hweHIV membranes inoda tichibvisa. Saka, kudzivisa Asherman kuti chirwere unogona, kana nokuda kwezvikonzero zvokurapa kusarudza marapirwo pamuviri. Ukuwo, nzira iyi haripi 100% kuvimbisa zvakanaka mugumisiro.