Kuchuluka kwa kuchuluka kwa kusamba kwa msinkhu nthawi zambiri kumakhala chifukwa chothandizira dokotala. Pa nthawi yomweyo, pali kusintha kwa chikhalidwe cha nthawi ya kusamba - nthawi zambiri mwazi umatuluka ndi zitsulo. Kuti athetse vutoli n'zotheka, pogwiritsa ntchito hemostatic kukonzekera pamwezi wambiri.
Zambiri zimayambitsa kusamba
Kusamba kumadzinso kumatchedwa mwezi uliwonse, pamene opitirira 80 ml ya magazi amatulutsidwa (kawirikawiri ndi 50ml). Mkaziyo amasintha nsalu yotchinga nthawi zonse maola 1-1.5. Kutayika kwa maola 100 a magazi pa mlungu uliwonse kumaonedwa ndi madokotala monga mwamphamvu kwambiri mwezi uliwonse, chifukwa chake chingakhale motere:
- Kulephera kwa Hormonal. Kusokonezeka mu thupi la estrogens ndi gestagens nthawi zambiri kumayambitsa kuwonongeka kwa magazi. Kawirikawiri matendawa amachitikira kwa atsikana aang'ono - kuperewera kwapakati pa zaka zapakati pa 1.5-2 kuchokera pa nthawi ya madokotala oyambirira kumaonedwa kuti ndizolowezi. Kusayenerera kawirikawiri kumachitika chifukwa cha kudya kwa mankhwala osokoneza bongo.
- Zambiri za m'chiberekero. Pamene matendawa ali kunja, pamphuno zimapangidwira, zomwe zimapweteka, zimayambitsa msambo.
- Myoma wa chiberekero. Maphunziro a Benin, pamodzi ndi kuwonjezeka kwa mwezi uliwonse.
- Matenda a ziwalo za m'mimba - matenda opatsirana, kutupa thupi: endometriosis, endometritis, colpitis, salpingitis.
- Ndondomeko yokhudzana ndi ubereki. Nthawi zambiri mafupa a mitsempha m'mimba mwazing'ono amachititsa kuti chiwerengero cha endometrium chifalikire chifukwa cha kuchuluka kwa msambo.
- Kugwiritsa ntchito njira za kulera za intrauterine. Mizimu imasokoneza kuchoka kwa endometrium yokana, choncho, mwezi uliwonse umakhala wautali.
- Kuphulika kwa dongosolo la magazi coagulation. Kuperewera kwa njira yoperekera kumabweretsa kuwonjezeka kwa excretion ndi magazi pamwezi.
- Kusokonezeka maganizo , kusokonezeka, zochitika, kusintha kwa nyengo kungakhudzenso chikhalidwe ndi kukula kwa msambo.
Mwezi uliwonse - choti uchite chiyani?
Polimbana ndi zoterezo, amai nthawi zambiri amakhala osokonezeka: chochita ngati miyezi yambiri, momwe angachitire - ambiri samatero. Ndi kulakwitsa kuyembekezera kuti kusamba kudzasintha payekha, ngati kuwonjezeka kwa mphulupulu kumachitika pafupipafupi. Njira yothetsera vutoli ndiyo kukaonana ndi mayi wazinayi ndikufufuza thupi.
Chidziwitso cha "menorrhagia" chikuwonekera pazifukwa zodandaula za mkazi, zizindikiro za kutaya magazi pamwezi uliwonse. Kumayambiriro kwa kafukufuku, dokotala samaphatikizapo matenda omwe amakhala nawo ndi zizindikiro zofanana (ectopic pregnancy). Mkazi wamkazi amafufuzidwa kwa matupi akunja, mbiri yakale ikupangidwa. Ngati pali zokayikitsa za matenda, zotsatirazi ndizo:
- Ultrasound ya ziwalo zamimba ;
- chithunzithunzi;
- chiwopsezo cha chiberekero;
- kupima matenda a endometrium ;
- kuyesa magazi, coagulogram;
- kuyesa magazi kwa oyendetsa.
Kodi mungachepetse bwanji kutaya mwezi uliwonse?
Kulankhula za zomwe zimathandiza popita kumaliseche, madokotala amamvetsera nthawi zonse chifukwa cha kuphwanya. Malingana ndi chomwe chinachititsa kusintha kwa msambo, dongosolo lachipatala limasankhidwa. Nthaŵi zambiri, maziko a mankhwala ndi mankhwala osokoneza bongo. Pochepetsa kuchepa kwa magazi, kuteteza chitukuko cha kuchepa kwa magazi, madokotala amapereka mankhwala apadera a hemostatic nthawi zambiri. Mankhwala ovutawo amagwiritsanso ntchito:
- mankhwala kuti achepetse uterine myometrium;
- zitsulo zopangidwa ndi zitsulo (kupewa kuchepa kwa magazi).
Kudula mankhwala osokoneza chiberekero kwa mwezi uliwonse
Pochepetsa kuchepa kwa mwezi uliwonse ngakhale chisanayambe chifukwa, madokotala amagwiritsa ntchito ndalama zomwe zimapangitsa kuti uterine myometrium imveke. Chifukwa cha kugwiritsira ntchito kwawo, kugwiritsidwa ntchito kwa nsalu za minofu kumakula, zomwe zimapangitsa kuti pakhale kusiyana kofulumira kwa endometrium pakutha msambo. Kudula, mankhwala osokoneza bongo amayamba kugwiritsidwa ntchito pakakhala zovuta komanso zovuta zina m'mabanja ndi m'mimba:
- ndi ntchito yofooka;
- nyengo yoberekera;
- matenda pambuyo pochotsa mimba.
Kusankhidwa kwa mankhwala oterowo kumachitika ndi madokotala okha. Amasonyeza dzina la mankhwala, mlingo, kuchulukana ndi nthawi ya ntchito. Zina mwa mankhwala omwe amagwiritsidwa ntchito kawirikawiri amadziwika:
- Deaminooxytocin;
- Chithandizo;
- Gynestrel;
- Dinoprost.
Kukonzekera chitsulo kumakhala mwezi uliwonse
Mankhwala omwe ali ndi zitsulo amagwiritsidwa ntchito popewera magazi m'thupi. Kutaya magazi kwakukulu kungachititse kuti thupi lichepetse mlingo wa hemoglobin, umene umakhudza moyo wabwino, ntchito za ziwalo ndi machitidwe. Kutopa, kutopa ndizo zizindikiro zazikulu za kusowa kwa magazi kwachitsulo, komwe kumafuna kukonza mankhwala.
Mankhwala ambiri a zitsulo amaperekedwa popanda mankhwala a mankhwala. Kawirikawiri tizilombo toyambitsa matenda timapezeka m'magulu a multivitamin, omwe amagwiritsira ntchito omwe akuchotsa kufunikira kwa kugwiritsa ntchito chitsulo mosiyana. Pakati pa mankhwala omwe ali ndi zokhudzana ndizomwe zili zodziwika:
- Ferretab;
- Sorbifer;
- Chiwonongeko;
- Fenyuls.
Mankhwala osokoneza bongo amwezi uliwonse
Mafilimu omwe amatha msambo kwa nthawi yaitali amathandiza kuchepetsa kuchuluka kwa zobisika. Komabe, pofuna kuchiza matenda, zizindikiro zimayesedwa pakukhazikitsidwa kwa chifukwa china cha mimba. Madokotala amalangiza kuti aziwatenga kwa kanthawi kochepa, kuti asakhudze ntchito ya magazi yogwiritsira ntchito magazi. Perekani mankhwala a haemostatic nthawi zonse poganizira zomwe zinayambitsa matendawa.
Mankhwala osokoneza bongo omwe nthawi zambiri amakhala ndi amuna okhala ndi endometriosis
Endometriosis ndi matenda a umoyo ophatikiza ndi kukula kwa chiberekero cha mkati. Mphunguyi imayamba kuwonjezeka chifukwa cha kukula kwake kwa maselo ake. Chotsatira chake, kumapeto kwa endometriamu kwakula kwambiri. Kuwonjezeka kwa mlingo wamwezi pamtundu uwu ndi chifukwa cha maselo ochuluka a maselo otchedwa endometrial. Kuonjezera apo, endometrium ikhoza kumera ku ziwalo zoyandikana nawo. Zotsatira zake - kukhudzana ndi magazi pambuyo pa kugonana. Powaletsa, sankhani mankhwala a haemostatic kusamba:
- Etamsylate;
- Tranexam;
- Ascorutin;
- Kupititsa patsogolo;
- Exacil.
Mankhwala osokoneza bongo omwe ali ndi GW pamwezi uliwonse
Kubwezeretsa kwa kayendetsedwe ka nthawi yoberekera nthawi zambiri kumaphatikizapo kuphwanya mulingo ndi chikhalidwe cha kusamba. Miyezi yoyamba kuchokera pamene mwana wabadwa, mayiyo amatha miyezi 1-2 ndikudyetsa pakapita mayezi 4-6 pambuyo poyamwitsa. Kufulumira kwa kuchira kumadalira maonekedwe a kubadwa, pambuyo pa nthawi yobereka, kutsata zikhalidwe ndi ndondomeko za madokotala.
Kawirikawiri, chifukwa cha mahomoni osasinthasintha pa nthawi yobereka, amayi amatha mwezi uliwonse komanso ndi GV. Kusankhidwa kwa mankhwala pa nkhaniyi kuyenera kuchitidwa ndi dokotala, chifukwa mankhwala ambiri amaletsedwa kuti abvomereze pamene akuyamwitsa. Mukamaloledwa kugwiritsa ntchito mankhwalawa oterewa pamwezi uliwonse (popanda malamulo amamasulidwa):
- Chiwonongeko;
- Vikasol.
Mankhwala osokoneza bongo omwe ali ndi nthawi zambiri ndi myoma
Kuwonjezeka kwa mwezi kulikonse pamene myoma ili ndi submucosal kapena intermuscular localization. Kuwonjezeka kwanthawi zonse, kuwonjezeka kwa kukula kwake kwa chiwindi kumayambitsa kukula kwa chiberekero. Pa nthawi imodzimodziyo, malo ozungulira mapulaneti amakula, ndipo, pakutha, amawonjezera kuchuluka kwa msambo. Chifukwa cha kukula kwa myoma, mitsempha ya chiberekero imatayika, liwalo limataya kwambiri. Chigwirizano cha uterine chimachepetsanso. Kusintha kumeneku kumabweretsa kuchuluka kwa kuchuluka kwa msambo. Dokotala amatha kugwiritsa ntchito mankhwala osokoneza bongo omwe ali ndi nthawi zambiri.
Pa nthawi yoyamba ya matendawa, mankhwala opatsirana amakhala othandiza kwambiri. Mayi amalembedwa mankhwala osokoneza bongo komanso mankhwala osokoneza bongo omwe amatha mwezi uliwonse. Ena mwa mankhwalawa ndi awa:
- Vikasol;
- Traneksam.
Mankhwala osokoneza bongo omwe ali ndi nthawi yokwanira kumasana ndi kusamba
Nthawi yowonjezereka ikuphatikizidwa ndi kutaya kwa msambo kosagwirizana. Kuchuluka kwa mwezi kumawonjezeka. Chowonadi chimachitika chifukwa cha kusintha kwa mahomoni m'thupi. Kusakanikirana kwa mahomoni opatsirana pogonana omwe amachititsa kuti kusamba ndi kusamba kumachepetse, zomwe zimayambitsa kuwonongeka kwabwino (kusinthasintha maganizo, kuthamanga kwa kutentha, kuwonjezeka kwa magazi).
Mankhwala opanga mahomoni omwe amakhala ndi nthawi yochulukirapo nthawi zambiri amaphatikizidwa ndi haemostatic agents. Awalandire iwo, malinga ndi lamulo la adokotala, kuwona mlingo, kuchuluka kwa nthawi ndi nthawi. Zina mwa mankhwala ogwiritsidwa ntchito ndi amayi:
- Etamsylate;
- aminocaproic asidi.
Wopambana haemostatic mawothandizi
Mankhwala osokoneza bongo omwe amatha mwezi uliwonse ayenera kuuzidwa ndi dokotala. Kufufuza kovuta koyambirira ndi kutsimikizirika molondola chifukwa cha kukhetsa magazi kwakukulu kumafunika. Posankha mankhwala, dokotala amalingalira zinthu zingapo:
- zaka za wodwala;
- kukhalapo kwa matenda aakulu omwe amachititsa kuti azibereka;
- kukhalapo kwa concomitant pathologies.
Mapulogalamu a Hemostatic
Mankhwala ozunguza bongo omwe amatsutsana ndi nthawi yaitali amagwiritsidwa ntchito nthawi zambiri kuposa ena. Izi zimakhala chifukwa chosavuta kugwiritsira ntchito mankhwala osokoneza bongo, kugwiritsa ntchito mankhwala mosavuta, kupezeka kwa mankhwala osokoneza bongo. Zina mwa zomwe zimagwiritsidwa ntchito kwa nthawi yayitali - mapiritsi a Dicinon a hemostatic. Chithandizochi chimagwiritsidwa ntchito poyeretsa magazi (mwazi) wa chiyambi chilichonse.
Zosakaniza zokhazokha ndi etamzilate - chinthu chomwe chimayambitsa mapangidwe a prothrombin. Kuonjezera apo, chinthuchi chimalimbitsa makoma a zombozo, kuchepetsa kuperewera kwawo. Pomwe amatchulidwa kuti amatha msambo, mankhwalawa amatengedwa katatu patsiku pa mapiritsi awiri. Zina mwa zotsutsana ndi kugwiritsa ntchito mankhwala:
- kusautsika;
- thromboembolism;
- khansa ya m'magazi.
Ma pulogalamu ya Hemostatic Traneksam nayenso ankasiya nthawi yolemetsa. Amayambitsa magazi, pamene amapereka mankhwala odana ndi kutupa, anti-allergenic ndi antitumor effect. Tengani iwo molingana ndi dongosolo la adotolo. Zina mwazotsutsanazo:
- hypersensitivity;
- kupweteka kwa mitsempha ndi ziwiya za ubongo;
- impso kulephera;
- kuchepa kwachisawawa;
- kuswa kwa masomphenya a mtundu.
Majekeseni a Hemostatic
Nthaŵi zambiri kumasamba, mankhwala otchedwa hemostatic amagwiritsidwa ntchito ngati jekeseni. Njira yothetsera vutoli imaperekedwa mobwerezabwereza. Mankhwala osokoneza bongo omwe amakhala ndi miyezi yambiri (jekeseni) amasankhidwa molingana ndi kuopsa kwa matendawa komanso kuganizira kukhalapo kwa matenda ndi matenda. Zina mwa njira zomwe zimasiya kuika magazi, zotulutsidwa mu njira, tikhoza kusiyanitsa:
- Vikasol ;
- chithandizo;
- Fibrinogen;
- Tracerol;
- Protamine sulphate;
- Hemofobin.
Makandulo a Haemostatic
Pakati pa antchito omwe amawoneka ngati akusiya magazi, m'pofunikanso kuzindikira phytohemostatic suppositories (FGS). Mankhwalawa amagwiritsidwa ntchito mwakhama pochizira matenda a mitsempha, koma nthawi zambiri madokotala amagwiritsa ntchito mankhwala a hemostatic mu maukwati, ndi nthawi zambiri. Mankhwalawa amangosiya magazi, komanso amalimbitsa zitsulo, osati kupuma. Ikani makandulo malinga ndi mankhwala a dokotala, nthawi zambiri 1 suppository usiku, jekeseni mu anus.