Emva kokugqiba umsebenzi onoxanduva lokuphelisa ukukhulelwa, umfazi udlala umdla kumgqirha: indlela yokukhupha isisu, ziphi iindlela ezikhoyo. Masiqwalasele ngokucacileyo le nkqubo, iindlela zokuqhuba, iimiphumo ezikhoyo kunye neengxaki.
Ukukhupha isisu - iindidi
Ngaphambi kokuphazamiseka kokukhulelwa , oogqirha baqhuba intetho ngesigulane malunga nemiphumo emibi yokuphathwa. Abaninzi emva kokukhipha isisu banzima ukukhulelwe. Emva kokuba wenze isigqibo sokugqibela, intombazana kufuneka idibane kunye neentlanganiso zentsebenziswano yabasetyhini, apho unokufumana ulwazi malunga neendlela ezikhoyo zokukhupha imisebenzi kunye nexesha lokuphunyezwa kwazo.
Ngokwenkqubo yesisu, iindlela ezininzi zokukhupha isisu zisetyenziswa. Xa ukhetha ugqirha othile, zikhokelwa ngethuba lokukhulelwa, iminyaka yesigulane, ngokuqwalasela ubukho bokukhulelwa kwangaphambili. Phakathi kweendlela ezikhoyo:
- ukukhipha isisu - kubandakanya ukuthatha iziyobisi ezibangelwa ukufa kwesibindi kunye nokuxoshwa kwisigxina se-uterine;
- Ukukhupha isisu (isifiso sokuphumula) - kuqhutywa ngoncedo lwesitye esikhethekileyo, umgaqo ofana nokucoca umbane;
- ukukhupha isisu (ukutsalwa) - umtya we-uterine uhlambulukileyo ngezixhobo ezizodwa.
Iipilisi zokukhupha
Xa isisu sisisu sisenziwa, iziyobisi ezisetyenziselwa ukuxhaphaza zibangelwa ukufa kweqanda lomntwana, eliphuma ngalo. Inkqubo eyenziwa kuphela ngamagama amancinci, kunye namanani amancinci amancinci. Ukuthetha malunga nendlela ukukhupha isisu kuyenzeka ngayo, kufuneka kuthiwe ukuphumelela kwayo ngu-98%. Yenziwa kumaziko ezonyango, phantsi kolawulo loogqirha. Kwisigaba sokuqala, bacetyiswa ukuba uphuze isilwanyana esibangela ukufa kombungu, emva koko isilwanyana sithumela umbungu (iMifepreston kunye neMisoprostol).
Ukukhipha isisu
Ukukhupha i-aspiration, igama lesibili lokukhupha isisu, kuyindlela yokuphazamisa ukuphazamiseka kwesisu. Iphethwe ngamagama amancinci. Umsebenzi awuhlali ngaphezu kwemizuzu eyi-10. Ngoncedo lwe-aspirator ekhethekileyo ngesipoti, oogqirha basebenzisa ukutsalwa kweqanda lomntwana kwi-uterine cavity. Yenziwe ngokudala i-vacuum. Ngenxa yokungabikho koxinano oluqinileyo phakathi kombindi kunye nodonga lwe-uterine, i-detachment ilula. Ukungahleleki kwile ndlela yinkqubo yokukhutshwa okungaphelelanga kwezicubu ze-fetal ezivela kwisigodlo se-uterine. Ngenxa yoko, kukho umngcipheko wokusuleleka kwesisu.
Ukukhipha isisu
Olu hlobo lokukhipha isisu luyasetyenziswa kumaxesha asemva, xa umbungu ungakwazi ukushiya isigxina se-uterine ngokuzimela (ngenxa yobukhulu bayo). Ukusebenza kwenziwa ngokusebenzisa i-anesthetics. Ukuthetha ngendlela olu hlobo lokukhipha isisu lwenzeka ngayo, oogqirha baqwalasela izigulane ukufana kwazo kunye nokusebenza ngokuqhelekileyo kwinkqubo yokuzala. Emva kokufakela izibuko zomzimba, yenza ukwandiswa komlomo wesibeleko. Ukuba nokufikelela kwisigxina se-uterine, i-curette isetyenziselwa ukutshatyalaliswa ngokupheleleyo - ukususwa kweqanda lomntwana kunye ne-endometrium.
Ukukhipha isisu - ukunikezelwa kwempahla
Ukuthetha malunga nendlela ukukhipha isisu kwenzeka ngayo emva kwexesha elidlulileyo, oogqirha bakhankanya ukungabikho komsebenzi wokwenza umyalelo ngesifiso somfazi okhulelweyo. Ukuze kuqhutywe olo hlobo, izizathu ezifanelekileyo ziyimfuneko. Ukukhethwa kweendlela zokwenza oko kuxhomekeke kwimeko yowesifazane, ubukho okanye ukungabikho kwezifo ezingapheliyo. Ukungabikho kokuphikisana, isisombululo esisodwa (i-hypertonic sodium chlorine) ifakwe kwi-amniotic fluid ngomlomo wesibeleko, obangela ukufa komntwana. Isinyathelo esilandelayo egazini lomfazi okhulelweyo lijojowe ngezidakamizwa ezandisa ukontrakthi lwe-uterine.
Ukuphazamiseka kokukhulelwa ngamayeza omntu
Ukukhupha isisu ekhaya kuyingozi, inkqubo yokusongela ubomi. Izindlela ezifana nokuhlamba okufudumele kunye nefayard powder, ukutyelela ibhagi, ukuphakamisa izisindo, kunokuchaphazela impilo yabasetyhini. Ezi zinto zenza ukuba kuqhutywe igazi kwizitho zeplavic. Uxinzelelo olwandayo ngaphakathi kweempahla zentsimbi encinci, ecatshulwa yimivalo ye-uterine, ngenxa yoko umbungu uphulukiswa ngaphandle.
Kufuneka kuthathelwe ingqalelo ukuba izixhobo zokukhupha zisetyenziselwa ukuba zihlale zikhokelela kwisiphumo se-100%. Ngenxa yoko, kukho umngcipheko wokusuleleka usuleleko - iindawo zomzimba weesibindi eziseleyo kwisibilini se-uterine ziqala ukuqhuma. Le meko idinga ukungenelela kwezonyango, ukucoca i-uterine cavity. Ukongezelela, kukho umngcipheko wokuphuluka kwamagciwane xa usebenzisa i-abortifacients and ways. Ukungabikho kolondolozo olufanelekileyo lwegazi kunokukhokelela ekufeni.
Izimpawu zokukhipha isisu
Ukukhipha isisu esifutshane kudla ngokuphindaphindiweyo kwisicelo somfazi ngokwakhe. Nangona kunjalo, kukho kwakhona okubizwa ngokuba yimpawu zokukhipha isisu. Zahlukaniswe zonyango kunye noluntu. Iyokuqala iquka izifo ezingahambelani nobomi bentsholongwane - kukho ukuphazamiseka komntwana, umntwana uzalwa eneempazamo kunye nezibi. Ukukhipha isisu kunokumiselwa imishanguzo, xa leyo nkqubo yokukhulelwa ayifanelekanga kwimizimba yomfazi-isisu kwi-pelvis encinci, ukutshatyalaliswa kwangaphambilini.
Izizathu zentlalo zisetyenziselwa ukubhekisela kwezi zizathu ezifunekayo, zombini kwimpilo kamama, kunye neemeko zobomi bakhe - iintsapho ezingasebenzi, ubukho bezifo zofuzo kwi-genus. Kwiimeko ezinjalo, ikhomishoni yezokwelapha inquma ukukhipha isisu. Kule meko, umnqweno wesifazane ngokwawo uphathwa. Uluhlu lwezibonakaliso zokukhipha isisu ngenxa yezizathu zentlalo luhluke kumazwe ahlukeneyo, kwaye ichazwa ngokulandelelana kweSebe lezeMpilo.
Ukuphazamiseka kokukhulelwa ngenxa yeemeko zonyango
Ukuphazamiseka kokukhulelwa ngophulo olungagqibekanga lwenziwa kunye nezizathu zonyango. Ezi zinto ziboniswe kumaphepha aqhelekileyo yoLawulo loMphathiswa wezeMpilo. Ukuba ibhinqa inokukhubazeka okanye ayikwazi ukuthwala umntwana, umhla wokusebenza uyatyunjwa. Ukukhethwa kwendlela kuxhomekeke kubude bentshukumo, ubukho beepathologies ezihambelanayo. Phakathi kweendlela eziqhelekileyo zonyango zokuphazamiseka kokukhulelwa zi:
- kwisigaba esisebenzayo sesifo sofuba;
- rubella - uxhumane nesigulane ukuya kwiiveki ezili-12 zokukhulelwa, ukungabi nokhuseleko;
- izicubu ze-pelvic, unyango olubandakanya ukusebenzisa i-X-ray;
- isifo sikashukela esinesimo esinzima (kunye nomonakalo wenzalo);
- leukemia;
- ukuphazamiseka kwengqondo;
- utywala;
- i-meningitis, i-encephalitis;
- ukuhluthwa ngesimo esithile sokubanjelwa ngokukhawuleza;
- i ntliziyo;
- isilonda sesisu ngegazi;
- i-hepatitis kunye ne-cirrhosis;
- glomerulonephritis.
Ukuphazamiseka kokukhulelwa ngokwemiqondiso yoluntu
Ngaphambi kobu bungqina, ukuphazamiseka kokukhulelwa ngamapilisi kwenziwa esibhedlele. Uludwe lweenkalo zentlalo lungahluka, kwaye luxhomekeke kwilizwe elihlala kulo wesifazane okhulelweyo. Ngoko kumazwe e-CIS, izibonakaliso eziphambili zoluntu zokukhipha isisu zi:
- ukukhubazeka komyeni (1,2 iqela);
- ukufa komntu ofumana ukutya ngexesha lokukhulelwa;
- ukuhlala komfazi okhulelweyo okanye iqabane lakhe kwiindawo zokulahla inkululeko, isigqibo somgwebo ngokunyanzeliswa kwamalungelo omzali;
- umtshato ngexesha lokukhulelwa kwangoku;
- ubukho bemeko;
- ukungabi nendlu;
- Ingeniso yentsapho ephantsi (ngaphantsi kwezinga lokuhlala).
Ukukhipha isisu - ixesha elide
Akunjalo ngaso sonke isikhathi, ukuba kukho umnqweno wesifazane okhulelwe, ukukhipha isisu kungenziwa - ixesha lo msebenzi lichongiwe. Ukungabikho kwezibonakaliso zonyango, amanyathelo okukhipha isisu avunyelwe ukufikelela kwiiveki ezili-12. Ukukhupha isisu kuthathwa njengento yokuqala. Ingaba oogqirha banako kwaye kamva - iiveki ezi-12 ukuya ku-22, xa kukho iyeza. Kuxhomekeke kwixesha lokunyuka, indlela yokunyangwa kwongenelelo yonyulwa. Ukuthetha ngendlela yokukhipha isisu kuyenziwa ngexesha elifutshane, oogqirha banqula unyango kunye nokukhishwa kwesisu.
Ukukhupha isisu
Xa ibhinqa inqwenela ukuphelisa ukukhulelwa ekuqaleni, oogqirha basebenzisa isisu sokukhupha isisu, ngokwemiqathango yokufikelela kwiiveki ezingama-5 zesigxina. Oogqirha banokuxilonga ukukhulelwa nge-ultrasound kwiiveki ezi-3. Ukuba ukrokrela ukukhulelwa okungathandekiyo, kufuneka uqhagamshelane nomzimba wakho wezilwanyana. Ukungabikho kocwangco, ukungenelela kwezinto ze-hardware kuyinzuzo yokukhipha isisu, iimiphumo zazo ezingenakunzima kwimpilo.
Ukukhulelwa-isisu kuya kufikelela kwiiveki ezi-7 . Unobungakanani obukhulu ngaphezu kwelapha ngentla, kodwa kukho iingozi zengxakeko kwiindonga ze-uterine. Ngokuqhelekileyo, ixesha elifutshane, ukufunyanwa kungasetyenziswa njengendlela yokulawula i-medabort. Ukususwa ngokupheleleyo kweengxowanxu zezicubu zamathumbu kubangela ukuphuhliswa kweengxaki zesimo esivuthayo nesasasazekayo.
Ukukhipha isisu ngasekupheleni kwexesha
Ukuthetha malunga nendlela yokwenza isisu kwiinqanaba zokuqala, siyaqaphela ukuba kunokwenzeka kwii-2-3 trimesters. Ukuphazamiseka kokukhulelwa ngokwexesha elidlulileyo kunokwenzeka kuphela ngenxa yezizathu zonyango. Inkqubo ngokwayo ifana nokuzalwa - ukuvuselelwa kwenkqubo yokuzalwa kwenziwa kwakhona. Ukuba kukho isidingo sokukhutshwa ngokukhawuleza komntwana, i-caesarean (ayinqabile) ingasetyenziswa. Ekusebenziseni ukusetyenziswa kokusetyenziswa kwesigxina okanye isisombululo sesisombululo sesicombululo esisodwa (ngokusebenzisa udonga lwesisu okanye intamo ye-uterine).
Ngaphambi kokukhipha isisu, i-catheter ekhethekileyo ifakwe kwingxangxamo yentamo, emva koko i-fetal bladder ifinyelelwe kwaye ihlulwe, isisombululo se hypertonic. Ukubalwa kwamanzi afunekayo kuyenziwa ngokuqwalasela ixesha lokugaya - 6 ml ngeveki e-1. Esikhundleni sesisombululo se-hypertonic sodium chloride, i-glucose isetyenziselwa isisombululo se-20%. Emva koko, izidakamizwa ezivusa izicatshulwa ze-uterine ziyaziswa.
Ukukhipha isisu - iingxaki
Iingxaki emva kokukhipha isisu zenzeka iintsuku ezimbalwa emva kokuphathwa. Ziyakwazi ukudibanisa, zombini ukuphunyezwa okungalunganga kokukhishwa kwe-algorithm, kunye nekhosi yokuphucula. Phakathi kweengxaki ezinzima zokukhupha isisu:
- ukuphuma kwegazi;
- ukuguqulwa kwodonga lwe-uterine;
- ikhefu elingaphelelanga;
- iinkqubo ezivuthayo kwinkqubo yokuzala.
Iziphumo zokukhipha isisu
Akukho hlobo olukhuselekileyo lokukhipha isisu. Ngelo xesha, akukho xho mekeke kwimiphumo yendlela ukukhipha isisu kwenziwa ngayo. Kwakungenakukhuseleka ukubiza isisu sokukhupha isisu, nemiphumo engayikhathaza emva kweenyanga okanye iminyaka embalwa. Ngokuqhelekileyo, kuba nomlando wokukhipha isisu, abafazi benza izikhalazo malunga nokuphulwa komjikelezo wokuya esikhathini: ukuhlala kwintlanganiso kulahlekile, ukutshintsha kwevolumu. Ukuhluleka kweHormon kubakho rhoqo, kungakhathaliseki ukuba ibhinqa likhutshwa njani. Ikwaphula ngokukhawuleza izigulane zisebenza. Ukungasebenzi kwabo kubangela ezinye izifo kunye nokuphazamiseka:
- endometriosis;
- myoma ;
- i-endometrial hyperplasia;
- polycystic;
- iinkqubo ze-oncological kwinkqubo yokuzala;
- ukuphulwa komsebenzi wokuzala (ukungabikho kwengqondo);
- ubuthathaka bezixhobo ze-muscular of the cervix;
- Ukwakhiwa kwezikhonkwane kwiindonga ze-uterine (emva kokutshiza).