Umngcipheko ohambelana nomsebenzi oqhelekileyo wokuhlinzwa
I-Asherman's syndrome, ebonakaliswa ngokutshatyalaliswa kwesibeleko, yimeko esoloko ixhamla nenkqubo yokuhlinzwa ngokuqhelekileyo ebizwa ngokuthi i- dilation kunye ne-curettage (iD & C) . I-D & C ingasetyenziselwa ukususa izicubu ezingaphezulu kweyiphi na isizathu, kubandakanywa:
- Ukujongana nokuphuma kwamanzi okungaqhelekanga
- Xa izicubu zigcinwa ngokungavumelekanga njengoko zinokuthi zenzeke kwabasetyhini abane- polycystic ovary syndrome (i-PCOS)
- Ukususa izicubu ezingagxothwanga ngokupheleleyo emva kokushiyeka komzimba, ukuphuphuma kwesisu, okanye ukuhanjiswa
Ukulandela i-D & C, izicubu ze-uterine ngamanye amaxesha zinamathele ndawonye ngokungaqhelekanga kwaye zifake ngokubambisana. I-Fibrosis, ukunyuka kunye nokukhawulwa kwezicubu ezinxibelelwano, kubandakanyeka. Ngokuxhomekeka kubukhulu kunye nobuqili be-scarring, i-Asherman's syndrome ingabangela ukuphuphuma kwesisu , ukungabikho komntwana , intlungu ebangelwa igazi elifihliweyo, kunye nezinye iingxaki ezinzima.
Nangona i-D & C iyona nto ibangela i-Asherman's syndrome, ezinye iimeko zingakhokelela ekubhubhiseni i-uterine, kubandakanywa imisebe ye-pelvic kunye nokusetyenziswa kwezixhobo ze-intrauterine (IUDs).
Iimpawu zeAsherman's Syndrome
I-Asherman's syndrome kaninzi ibangela ukuba kungabikho iimpawu ngaphandle kobunzima bokukhulelwa okanye ukugcina ukukhulelwa. Ukubunjwa kwe-adhesion kunye ne-fibrosis kunciphisa ukuhamba kwegazi kwi-uterus. Xa oku kwenzeka, abanye abafazi banokuba namaxesha okukhanya kakhulu okanye abanakho ixesha (amenorrhea).
Ukuba i-blockages ikhula, inokubangela ukuba ubuhlungu bube buhlungu ngexesha lokuvuthwa okanye ukuya esikhathini.
Ukuxilongwa kwe-Asherman's Syndrome
Umgangatho wegolide wokuxilonga i-Asherman's syndrome yinkqubo ebizwa ngokuba yi-hysteroscopy apho inqanaba elincinci, elikhanyisiweyo lifakwe kwisiswini ukuhlola umlomo wesibeleko kunye nesisu. Oogqirha banokuphinde balayise ii-X-rays, i -ultrasound yangaphakathi , kunye ne-biopsy ukuvavanya ubunzima kunye nobukhulu bokunqanda kunye nokuncedisa inkqubo yokonyango.
Iziphumo zeengozi kunye neziphumo
Umngcipheko we-Asherman's syndrome ngokuqhelekileyo unxulumene nenani le-D & C inkqubo eyenziwa ngumfazi. Ngokomphando, umngcipheko wokunyuka kwama-Asherman ukusuka kwi-14 ekhulwini emva kwe-D & C enye ukuya kwi-32 kwipesenti emva kwe-ezintathu. Ezinye izinto zinokunyusa iingxaki zokuphuhlisa i-Asherman:
- I-D & C emva kokuphazamiseka kokulahlekelwa komzimba (i-30% engozini)
- I-D & C yenza enye kwiiveki ezine emva kokunikezelwa (ingozi ye-25 yepesenti)
Ukuqhekeza nokunyamezela kunokuthintela ukukhulelwa ngokukhawulela ukuhamba kwegazi kunye nokutya kumntwana okhulayo. Ngenxa yoko, abafazi abanamaxholongwane omzimba banama-40% ukuya kuma-80 ekhulwini amathuba okukhulelwa kwesisu kunye nomngcipheko wesine wokuzalwa ngaphambi kokuzalwa. Ukuba iziganeko ezinzima, ukukhwabanisa kunokukhokelela ekukhulelweni okukhulu kwe- ectopic (ukukhulelwa kwe-tubal) .
Ukuphatha i-Asherman's Syndrome
Ukutshatyalaliswa kokutshatyalaliswa kokubambisana kunokuphucula kakhulu imiphumo yokufumana ukukhulelwa okuphumelelayo. Xa kuthethwa oko, inokuba yinkqubo enzima yezobuchule kwaye kufuneka iyenziwe ngokunyamekela ukuthintela ukwakheka kwezikongeza ezongezelelweyo. I-Hysteroscopy iyabandakanyeka. I-Laparoscopy (ebizwa ngokuqhelekileyo njengophando olusisigxina) ingasetyenziselwa kwiimeko ezinzima kakhulu.
Emva kokuhlinzwa, oogqirha abathile baya kuncomela ukubekwa kwebholuni ye-intrauterine ukugcina izicubu zihlangane kunye. I-estrogen yomlomo nayo inokumiselwa ukunceda ukuvuselelwa kwezicubu ze-uterine nokukhuthaza ukuphulukiswa.
> Umthombo:
> Conforti, A .; Alviggi, C; Mollo, A. et al. "Ulawulo lwe-Asherman syndrome: ukuhlaziywa kweencwadi." I-Reprod Biol Endocrinol. 2013; 11:18.