Ukusebenza okunjalo, njengokususwa kwesibeletho, kuyindlela ephezulu yokunyanga izifo ezithile zentsholongwane. Iqhutyelwa esibhedlele, kwaye ukuphunyezwa kwayo kulandelwa lixesha elide lokulungiselela. Cinga ngongenelelo olungenelelo, iintlobo, iindlela, iingxaki kunye nemiphumo emva kokususwa kwesibeletho.
Ukususwa kwesibindi - izibonakaliso zokuhlinzwa
I-hysterectomy yesibindi-into ebizwa ngokuba ngumsebenzi ukususa isitho somzimba wesini. Kuqhutyelwa kuphela kubungqina, apho kukho ezininzi. Phakathi kwezona ziqhelekileyo kubalulekile ukuphawula:
- iinkqubo ezinobungozi kwisibeleko;
- i-oncology yomlomo wesibeleko;
- i-uterine fibroids , ngobunzima obukhulu kuneveki ezili-12 zokukhulelwa;
- Ukukhula ngokukhawuleza kwe-tumor - ngonyaka ngeenyanga ezine zokukhulelwa kunye nokunye;
- i-necrosis ye-node ye-myomatous;
- i-menorrhagia ilukhuni kunye negazi;
- i-adenomyosis ye- 3-4 degrees;
- izifo zentlungu ezingapheliyo kwi-pelvis encinci;
- ukuguquka kwesisu ;
- i-endometriosis ngaphandle kokuphucula emva kwonyango olulondolozayo (unyango), ukutshiza.
Izindlela zokususa isibeleko
Xa senze ukungenelela kwongxamiseko, iindlela ezahlukeneyo zokususa i-uterine zisetyenziswa. Ukukhethwa kwenkalo ethile kuxhomekeke kuhlobo lokuphulwa, ubukhulu bomdla welilo lomzimba kunye nezixhobo zalo. Ngokusekelwe kwiziphumo ze-ultrasound, oogqirha banquma ukusebenzisa le nto. Ngokuqhelekileyo, ukususwa kwesibeleko kudibaniswa nokuxilongwa kwamancuba athile. Ngokuxhomekeke kumthamo wokusebenza, bahlula:
- i-subtotal;
- lilonke;
- pangysterectomy;
- kakhulu.
Ukongezelela, kuxhomekeke kwindlela yokufikelela kwilungu lokubeletha ngexesha lotyando, i-hysterectomy ingaba:
- i-laparotomic - i-uterus isuswe ngokukhutshwa kwesisu;
- ukususwa kwesibeletho ngendlela ye-laparoscopic - usebenzisa isisombululo esikhethekileyo, ngokusebenzisa izimbobo ezincinci kwindonga yesisu;
- ubulili - ukufikelela kwi-uterus echaphazelekayo kungenxa yesini.
I-hytereticomy ye-subtotal ye-uterus
I-hytereticomy esezantsi iyenziwa xa kukho ithuba lokugcina umlomo wesibeleko, le nxalenye yelungu lomzimba ayichaphazelekayo. Ukunyanzeliswa kwenziwa ukwenzela ukunciphisa ixesha lokungenelela ngoncedo olusisigxina. Kule ndlela, utyando lusetyenziswa kwakhona kwi-endometriosis ye-pelvic, echazwe yinkqubo yokuhamba kwintsimbi. Ngaloo ntsholongwane, umngcipheko wokonakalisa umonakalo ukwanda. Izibonakaliso zolu hlobo lophulo lokungenelela zi:
- ukungabikho kwemfuyo yee-appendages;
- Ubukho bokuhamba ngokwaneleyo kwesibeleko;
- ukushiywa kwesini ;
- ubukhulu be-neoplasm abugqithisi ubungakanani be-fetus kwiiveki ezi-12 zesisu;
- kubakho kwintsimi efanelekileyo yokuphanda.
Iyonke i-hysterectomy
Olu hlobo lonyango oluphandwayo lubizwa ngokuba lukhutshwa kwesibeleko. Le ndlela enye yeyona ndlela ixhaphakileyo ye-hysterectomy. Ukufikelela kwiqumrhu kufumaneka ngokuvula isisu esiswini. Kulo msebenzi, isisu sisuswa, ngokungabikho kwesilonda entanyeni, le nxalenye ishiywe. Ngexesha elifanayo, i-ectomy yamathambo kunye nama-ovari ayenziwa. Ukunyangwa kokubuyisela emva kokuphela kwe-hysterectomy kubandakanya ukusetyenziswa kwamahomoni ngaphambi kokuba kuqalwe ukuphuma kwesisu .
Ukususwa kwesibindi kunye nezixhobo
Ukwenza uphando olunzulu luphambi kovavanyo olukhethekileyo. Kubizwa ngokuba yi-hysterosalpingography - yintoni na, izigulane azimeli, ngoko zicela ugqirha. Ngolu vavanyo, ukuxilongwa kwezigulane ze-fallopian zenziwa. I-arhente ekhethekileyo eyahlukileyo iyaziswa. Emva koko kukho uchungechunge lwezithombe ze-X-ray.
Ukuba inkqubo yomhlaza ifunyenwe kwiibhubhu kwaye isasazeka kwizitho ezisondeleyo kunye nezicubu, isisu sisuswa. Ukufikelela kwiziko elichaphazelekayo ngodonga lwesisu okanye kwangaphakathi kwindonga yesisu. Ngenxa yokuba izigulane ezisebekhulile azinyamezeli imisebenzi enkulu, oogqirha badla ngokukhetha uhlobo lwesini. Kule meko, usususile ngokupheleleyo isibeleko kunye nezixhobo - izigulane zesini, iibhubhu.
Hysterectomy
Ugqirha lokususwa kwesibeletho salolu hlobo luqhutyelwa ngumonakalo omkhulu kwinkqubo yokuzala. Basebenzisa kuyo izilonda ezibi zeeplavis, ezininzi zeemastastas. Ukusebenza kuquka ukukhutshwa kwesisu kunye neefowendages, isithathu esiphezulu sezesini, amanqatha e-pelvic, i-lymph node zesithili. Ngokuqhelekileyo, olu hlobo lonyango lusetyenziswa emva kweendlela ezininzi ezinokuzimela. Emva kokunyangwa okunjalo, umfazi ulahlekelwa ngokupheleleyo inkqubo yokuzala, efuna i-hormone yonyango yokutshintshwa.
Ukususwa kwesibeletho - ixesha lokuhamba emva
Emva komsebenzi ukususa isibeleko, umfazi kufuneka agcinwe ubuncinane kwiiyure eziyi-24 iiyure zokulala, kungakhathaliseki uhlobo lokufikelela (isisu okanye isisu). Ekupheleni kweli xesha, oogqirha bavunyelwe ukuba bavuke baze bahambe. Oku kunceda ukwandisa intestinal peristalsis, ngaphandle kweengxaki ezifana neparresis. Ngobuhlungu obunzima, amayeza enjenge-analgesic anqunywe. Ukuthintela usulelo, uphando lweyeza-antibiotics.
Ngokufanayo, i- anticoagulants ingaqulunqwa . Ezi zi yobisi zikhusela ukuphuhliswa kwezi ngxaki ezinjengegazi langaphakathi. Ukuba ukuhlaziywa kwakhona kudlula ngokukhawuleza kwaye kungabi nzima nakweyiphi na indlela, emva kweentsuku eziyi-8-10, ukususwa kwee-outer seams kwenziwa. Xa usebenzo lwenziwe nge-laparoscopic ndlela, isigulane sivunyelwe ukuba siphakame emva kweeyure ezingama-5-6, kwaye ukukhutshwa kuqhutyelwa iintsuku ezingama-3-5. Ukunyanzeliswa kwithuba lokugqibela emva kokusebenza emva kokugcinwa kwexesha emva kokusebenza emva kokutya okuyiyo yokugcinwa kwesidlo sokutya kunye nokutya okusetyenjini ukuseka isitulo.
Iingxaki emva kwe-hysterectomy
Iingxaki emva kokususwa kwesibeleko kungenxa yokungahambisani nokusetyenziswa kotyando, ukungaphumeleli ukuthobela iingcebiso zonyango. Ukuba kwithuba lokugqibela emva kokusebenza oku kudla ngokuba yimpembelelo yonyango, emva kwexesha elide (ezinyangeni ezimbalwa) - ukungaphumeleli ukuthobela imiyalelo kunye nemiyalelo yoogqirha ngabaguli. Phakathi kweengxaki eziqhelekileyo, imisebenzi efana nokususwa kwesibindi esithintekayo, kukuba:
- ukuphuma kwangaphakathi ;
- ukwakheka kweehematomas;
- ukuphuma kwi-suture emva kokusebenza;
- ukulimala kwizitho ezikufuphi ngexesha lotyando - amathumbu, isisu, izibilini;
- i-thrombophlebitis yemilenze;
- ukutshatyalaliswa kwesini;
- ukuxhaswa kwesilonda emva kokusebenza;
- usulelo lwe-bladder (umphumo wenkcitha ezithatha ixesha elide);
- i-peritonitis (ukuvuvukala kwe-peritoneum);
- thromboembolism.
Ubuhlungu emva kokususwa kwesibeleko
Ubuhlungu emva kwe-hysterectomy ekwalapha ngokubanzi ngaphakathi kwesisu, indawo ye-sutures. Ukumisa ukuhlaselwa kwentlungu, oogqirha bahlala banika izigulane ezingenalo i-analcotic analgesics. Ubungakanani be-syndrome yesifo buphantsi. Ngokuqhelekileyo izigulana zikhalaza ngobukho beentlungu kwiintsuku zokuqala ezingu-3-4. Emva kwesi sihlandlo, ukunyuka kwesisa kungaqhubeka kwimimandla ye-suture yangaphandle, xa ukufikelela kwisibeleko kwenziwa ngesisu.
Ukukhutshwa emva kokususwa kwesibeleko
Ukukhutshwa kwamanzi, kumdaka emva kwe-hysterectomy eqhelekileyo. Ziyakwazi ukugcinwa iintsuku ezili-14 ukusuka kwithuba lokungenelela kokungena. Ubungqina bokuba buhlungu kunye nokukhutshwa kwindlela yokuzala emva kwesi sihlandlo kufuneka sibe sisizathu sokunxibelelana nomntwana wesifo somzimba. Ezi zibonakaliso zingabonisa iingxaki zexesha lokuhamba emva, phakathi kwazo:
- kuphuma;
- inkqubo yokusuleleka kwi-pelvis encinci.
Ibhanji emva kokususwa kwesibeleko
Isisu emva kokususwa kwesibeleko sidinga ingqalelo ekhethekileyo kuyo. Ngenxa yobuthakathaka bezakhiwo ze-muscular, isicindezelo esiswini, esingenakunqandwa kwisisu esiswini sokuhlinzwa, abafazi kufuneka bembathe i-bandage. Ngokuqhelekileyo, esi sixhobo sincoma izigulane ezineeminyaka engama-menopausal ubudala. Ukukhethwa komzekelo kufanele kwenziwe yinkwenkwezi. Bembatha i-bandage yemihla ngemihla, besusa kuphela ngexesha lokugeza kwaye ngaphambi kobusuku bokulala.
Oogqirha bayacetyiswa ukuba banikele ngokukhethekileyo kwi-bandage eyenziwe ngezinto eziphathekayo. Xa uyisebenzisa, kakubi ukuba akukho. Ukuqwalasela ububanzi bomkhiqizo. Oogqirha bathetha malunga nesidingo sokudlula ububanzi besiqabana kunye ne-bandage ngaphezulu kwaye ngaphantsi ubuncinane be-1 cm (kunye ne-laparotomy esezantsi). Ukugqoka kubangela ukulala emva.
Iziyobisi emva kokususwa kwesibeleko
Ziziphi iimichiza ezithatha emva kokususwa kwesibeleko kwaye nokuba kuyimfuneko ukuyisebenzisa iyagqitywa ngugqirha oya kwiindawo. Ngokuqhelekileyo, ngenxa yokususwa kweengqungquthela ngesisu, kuyafuneka ukuba isebenzise i-hormonal indlela yokumisela umzimba. Kubaluleke kakhulu ukwelashwa kwe-hormone yonyango endaweni yabasetyhini abangaphezu kweminyaka engama-50 abaye bahlinzwa. Kule meko, isilungiselelo se-progestogen kunye ne-estrogen sisetyenzisiweyo.
Xa isisusa sokukhutshwa kwesibeleko kunye neefowendishini kubakho ubukhulu beendoda ezininzi ze-myomatous, isigulane sinikezwa i-estrogen monotherapy eqhubekayo emva kokuhlinzwa. Unyango luyinkimbinkimbi, luquka ukusetyenziswa kweendlela ezahlukeneyo zamachiza:
- amaphilisi olawulo lomlomo - Ovestin, Livial, Proginova;
- ioli kunye nama-gel ukusetyenziswa kwangaphandle - i-Estrogel, i-Divigel.
Ukuba ukususwa kwesibeletho kwenziwa ngenxa ye-endometriosis, unyango olunzima kunye namahomoni, i-estrogens kunye ne-gestagens eyenziwa. Kule meko, iziyobisi ezifana nale:
- Klyane;
- Proginova.
Ulwaphulo lwezityalo kunye noogqirha bonyango baqulunqwa ukuba baqale iinyanga ezi-1-2 emva kokususwa kwesibeleko. Ukunyanga okunjalo kunciphisa amathuba okuphuhlisa izifo zengqondo, i-osteoporosis. Nangona kunjalo, isigqibo malunga nesidingo sokusetyenziswa kwayo sithathwa kuphela ngugqirha. Ukuthotyelwa ngokupheleleyo ngokuqeshwa kwakhe kunye neencomo kuqinisekisa inkqubo yokubuyisela ngokukhawuleza.
Ubomi emva kokususwa kwesibeleko
I-laparoscopic hysterectomy ayithinteli ixesha elide nangayiphi na indlela, kodwa liphucula kakhulu umgangatho walo. Abasetyhini belahla iimpawu ezibangelwa sisi sifo, bayalibala ngokupheleleyo ngesidingo sokukhulelwa. Iigulane ezininzi zibika ukwanda kwe-libido. Kodwa ngokuphindaphindiweyo usebenze ukuba abesifazane basebenzise ama-hormone ixesha elide. Ukongezelela, kukho imfuneko yokuvavanya ngezikhathi kunye nokuhlolwa kwamakhwenkwezi. Injongo kukubeka iliso unyango, akukho kubuya kwakhona, xa isisusa sokususwa sisisifo.
Ukususwa kwe-uterus - iziphumo zomzimba
I-Hysterectomy ayibonakali nje kumsebenzi weenkqubo zokuzala, kodwa nakwimzimbeni yonke. Emva kokususwa kwesisu, imiphumo yomsebenzi ingaba ngale ndlela:
- ukubunjwa kokubambelela kwisigxina esiswini;
- ukubunjwa kwesibalo se-keloid;
- ukuphazamiseka kwesikhumba kwindawo yomgca;
- ukuphuma kwesisu;
- izifo zengxaki.
Isondo emva kokususwa kwesibeleko
Izigulane ezininzi ezenza utyando zinomdla kumbuzo wokuba unako ukulala ngesondo emva kokususwa kwesibeleko. Oogqirha basabela ngokufanelekileyo kulo mbuzo. Ukwabelana ngesondo, njengangaphambili, kuya kuba mnandi - zonke iinkalo ezibuhlungu zigcinwa. Ngokulondolozwa kwamaqanda aqhubeka nokusebenza, ukukhulula ama-hormone esondo. Nangona kunjalo, intlungu, ukuphazamiseka ngexesha lokwebelana ngesondo akunakuphelelwa.
Izinto ezinjalo ziyakwenzeka kubasetyhini abaye baphuthukiswa kwintsholongwane (isiqhekeza esiswini) okanye i-hysterectomy enkulu - inxalenye yelungu lesiswini. Nangona kunjalo, le ngxaki inokupheliswa, ngexabiso lokuthembela kunye nokuqonda phakathi komfazi kunye neqabane lakhe. Ukuphulaphula iimfuno zomlingane, indoda ayikwazi ukuzonwabisa kuphela, kodwa iphinde iyithumele kwisithandwa sayo.