Ovarian cev xeeb tub: ua rau pathology, tsos mob, kuaj mob, ultrasound nrog yees duab, kev kho mob tsim nyog thiab qhov tshwm sim tshwm sim

2024 Tus sau: Priscilla Miln | [email protected]. Kawg hloov kho: 2024-02-18 01:45

Cov poj niam niaj hnub no feem ntau paub txog lub tswv yim ntawm "ectopic cev xeeb tub", tab sis tsis yog txhua tus paub tias nws tuaj yeem txhim kho qhov twg, nws cov tsos mob dab tsi thiab qhov tshwm sim tshwm sim. Hauv tsab xov xwm, peb yuav txiav txim siab seb qhov cev xeeb tub ntawm zes qe menyuam yog dab tsi, nws cov cim qhia thiab kev kho mob.

Definition

Ovarian cev xeeb tub yog ib qho fertilization uas tshwm sim nyob rau lub sij hawm thaum lub qe tseem tsis tau muaj sij hawm tawm hauv lub follicle tseem ceeb. Nyob rau hauv cov ntaub ntawv no, nws txuas mus rau lub zes qe menyuam yam tsis tau tawm hauv kab noj hniav ntawm lub fallopian raj thiab tsis nkag mus rau hauv lub tsev menyuam. Muaj ob hom kev xeeb tub ntawm zes qe menyuam:

1. Intrafollicular - thaum fertilization tshwm sim hauv follicle.
2. Epiophoral - yog tias lub qe fertilized txuas rau ntawm lub zes qe menyuam. Daim duab ntawm lub zes qe menyuam cev xeeb tub qhia qhov chaw ntawm kev sib txuas ntawm zes qe menyuam.

Ob hom kev xeeb tub ectopic yog qhov txaus ntshai rau lub neej thiab kev noj qab haus huv ntawm poj niam.

Kev tshwm sim

BFeem ntau, kev xeeb tub ectopic tshwm sim tsis muaj laj thawj, txawm li cas los xij, cov kws tshaj lij txheeb xyuas cov hauv qab no uas tuaj yeem ua rau lub qe tsis raug:

1. Ib tug poj niam yav dhau los lossis tam sim no keeb kwm ntawm kev kis kab mob uas cuam tshuam rau lub cev xeeb tub.
2. Kev ua haujlwm ntawm lub tsev menyuam lossis appendages.
3. Tau los lossis muaj kev cuam tshuam ntawm cov hlab ntsha fallopian.
4. Hormonal ntshawv siab.
5. Kev muaj cov kab mob benign lossis malignant neoplasms nyob rau hauv lub tsev menyuam lossis cov hlab ntshav.
6. Kev tsis txaus ntseeg hauv kev loj hlob ntawm cov kab mob hauv nruab nrog cev.
7. Kev mob caj ces.

Tsis tas li ntawd, xws li pathology tuaj yeem pom yog tias tus poj niam tau txais kev kho tsis raug rau kev xeeb tub.

Symptoms

Kev cev xeeb tub ntawm zes qe menyuam tuaj yeem tshwm sim nrog cov tsos mob hauv qab no:

1. kuaj cev xeeb tub zoo.



2. Mob thaum nias hauv cheeb tsam iliac los ntawm sab ntawm lub qe cog, uas nce nrog cov hnub nyoog gestational.
3. Mob plab plab uas tawm mus rau qhov quav thiab coccyx. Nws tshwm sim sai sai thiab ua rau tus poj niam hloov txoj hauj lwm ntawm lub cev.

Ntxiv rau, nrog rau kev xeeb tub, tag nrho cov tsos mob ntawm lub tsev menyuam tau raug sau tseg - ncua kev coj khaub ncaws, xeev siab, ntuav, o thiab mob ntawm lub mis. Nws yog mob nyob rau hauv ib qho chaw txawv txawv uas yuav tsum ceeb toom rau ib tug poj niam thiab ua ib qho laj thawj rau kev hu rau gynecologist. NtawmKev mob hnyav ntawm cov tsos mob ntawm zes qe menyuam cev xeeb tub, yuav tsum tau mus pw hauv tsev kho mob sai, vim lawv yuav qhia tau tias muaj qhov sib tsoo ntawm zes qe menyuam.

Diagnosis

Kev txiav txim siab ntawm zes qe menyuam ectopic cev xeeb tub yuav tsum muaj kev qhia dav:

1. Kev xam phaj thiab tshuaj xyuas, thaum tus poj niam cov tsos mob tau qhia meej.
2. Ultrasound ntawm lub zes qe menyuam cev xeeb tub tuaj yeem pab ua qhov kev kuaj mob kom raug. Hmoov tsis zoo, txoj kev no tsis yog 100% lav. Qhov no yog vim lub fact tias lub fetal qe zoo ib yam li ib tug cystic tsim.
3. Txhawm rau tiv thaiv lub cyst los ntawm kev hloov mus ua lub zes qe menyuam, kev kuaj mob laparoscopy tau raug sau tseg - kev ua haujlwm tsis tshua muaj kev cuam tshuam ua haujlwm siv laparoscope.

Tsis tas li, ntshav tau muab rau hCG thiab kuaj cov zis dav dav. Txawm tias muaj tseeb hais tias thaum lub sij hawm ultrasound ntawm lub zes qe menyuam cev xeeb tub, ib daim duab uas muab tawm tam sim ntawd, nws yuav zoo li ib tug cyst los yog lwm yam neoplasm. Tus kws kho mob pom zoo kom nce qib ntawm hCG cov tshuaj hormones hauv cov ntshav thiab muaj qhov ncua sij hawm ntawm kev coj khaub ncaws, nrog rau cov yam ntxwv mob thaum nias ntawm lub plab los ntawm sab uas lub qe fetal txuas.

Kev kho mob

Hmoov tsis zoo, nrog rau cov kab mob no, tsuas yog kev phais tshem tawm ntawm qhov teeb meem yog qhia. Txoj kev tshem tawm yog xaiv raws li cov hauv qab no:

• poj niam xav kom muaj menyuam yav tom ntej;
• size ntawm ovum;
• xeev ntawm zes qe menyuam (tag nrho lossis tawg).

Feem ntau tsis yogQhib kab noj hniav phais ua laparoscopy:

• lub cuab yeej tau ntxig los ntawm kev txiav me me rau hauv lub plab kab noj hniav;
• kev txiav yog ua rau ntawm zes qe menyuam;
• lub hnab gestational raug tshem tawm;
• Cov cuab yeej raug tshem tawm thiab muab tso rau.

Feem ntau, cov haujlwm zoo li no tau ua tiav thiab kev ua haujlwm ntawm lub cev tau khaws cia. Kev zam tsuas yog thaum cov tsos mob ntawm zes qe menyuam cev xeeb tub tau pom lig dhau lawm thiab lub qe fetal nce mus rau qhov loj. Hauv qhov no, lub zes qe menyuam tawg, uas yog qhov qhia txog kev tshem tawm. Lub cev xeeb tub ntawm zes qe menyuam, zoo li lwm yam kev xeeb tub ectopic, tsis tuaj yeem suav hais tias yog ib qho xwm txheej - nws yog ib qho pathology uas yuav tsum tau muaj kev phais sai.

Npaj rau kev phais

Txawm hais tias qhov kev phais laparoscopic tsawg dua, tus poj niam tseem yuav tsum tau kawm qee yam, uas suav nrog cov ntsiab lus hauv qab no:

• pub tso zis thiab ntshav;



• ua tus electrocardiogram;
• ultrasound;
• kev sab laj ntawm tus kws kho mob dav dav, gynecologist thiab anesthesiologist.

Yog tias tsim nyog ua haujlwm xwm txheej ceev, laparoscopy hloov los ntawm kev cuam tshuam plab.

Post-operative period

Lub sijhawm tom qab laparoscopy lossis kev cuam tshuam hauv plab yog qhov tseem ceeb heev rau kev kho kom zoo ntawm cov kabmob sab hauv. Lub sijhawm postoperative muaj xws li noj cov tshuaj hauv qab no:

• painkillers;
• tshuaj tua kab mob tiv thaiv kab mob;
• tshuaj tiv thaiv kab mob kom txo tau qhov mob.

Lub sijhawm tso tawm tom qab laparoscopy yog tom qab 3-4 hnub ntawm kev mus pw hauv tsev kho mob, thiab tom qab qhib kev phais yog li ob lub lis piam. Lub sijhawm no, cov kws kho mob saib xyuas tus poj niam tus mob thiab kho cov sutures.

Ntxiv rau, tom qab ua haujlwm, nws yog ib qho tseem ceeb uas yuav tsum tau saib xyuas qib hCG, vim tias lub qe fetal yuav tsis raug tshem tawm tag nrho. Tom qab ntawd nws tuaj yeem loj hlob mus rau hauv cov qog. Feem ntau, qib hCG txo qis los ntawm 50% rau 2-3 hnub tom qab kev phais.

Rehab

Ectopic cev xeeb tub yog ib qho nyuaj pathology uas yuav tsum muaj lub sijhawm rov qab los ntev, tshwj xeeb tshaj yog tias tus poj niam tab tom npaj cev xeeb tub yav tom ntej. Nrog rau kev noj cov tshuaj tom qab kev ua haujlwm, tus neeg mob yuav tsum saib xyuas nws cov zaub mov: thawj hnub tsuas yog tso cai rau dej, hnub thib ob haus yogurts tau tso cai, hnub thib peb tuaj yeem hloov mus rau cov zaub mov yooj yim digestible - cereals., broth, boiled nqaij thiab ntses, crackers.

Rau lub cev rov qab sai, cov kev kho mob hauv qab no tuaj yeem pom:

• magnetotherapy;
• electrophoresis;
• kho mob ultrasound;
• muag da dej;
• paraffin therapy.

Nyob rau lub sijhawm ob peb lub lis piam tom qab kev ua haujlwm, txhua yam kev ua si lub cev, txawm tias qhov tsis tseem ceeb tshaj plaws, raug txwv tag nrho. Kev nqa qhov hnyav yog txwv nruj.

Kev rov pib dua ntawm kev sib deev tsuas yog tso cai ib hlis tom qab phais laparoscopic thiab 3 lub hlis tom qab phais plab. Nyob rau tib lub sijhawm, tus poj niam yuav tsum tau tiv thaiv cov tshuaj tiv thaiv ntawm qhov ncauj, uas yuav tsis tsuas yog tiv thaiv kev xeeb tub, tab sis kuj pab kho cov tshuaj hormonal. Kev siv tshuaj tiv thaiv yuav tsum tau siv rau 6-9 lub hlis tom qab kev phais. Tsuas yog tom qab lub sijhawm no lub cev xeeb tub tshiab tuaj yeem ua tau. Kuj tseem muaj feem kis tau tus kab mob hauv lub sijhawm tom qab phais tas li, yog li kws kho mob qhia kom siv cov hnab looj tes rau txhua qhov kev sib deev.

Txoj kev rov qab los ntawm kev coj khaub ncaws

Kev tshuaj xyuas ntawm zes qe menyuam cev xeeb tub qhia tias thawj zaug kev coj khaub ncaws tom qab kev phais ib txwm tshwm sim tom qab 28-40 hnub. Yog tias kev coj khaub ncaws pib ntxov, ces peb tuaj yeem tham txog zes qe menyuam, uterine lossis tubal los ntshav, thiab yog tias tom qab ntawd, tom qab ntawd hais txog kev mob hormonal lossis muaj teeb meem.

Rau cov poj niam uas tau cev xeeb tub ectopic, nws yog ib qho tseem ceeb heev uas yuav tsum ua tib zoo npaj cov kab mob tom ntej ntawm tus menyuam, vim tias qhov kev pheej hmoo ntawm kev rov qab los yog siab. Kev xyaum qhia tau hais tias lub sijhawm zoo tshaj plaws rau qhov no yog lub sijhawm 1 xyoos tom qab ua haujlwm.

Muaj Teeb Meem

Nws nyuaj rau xav txog tej yam cev xeeb tub uas yuav dhau mus yam tsis muaj qhov tshwm sim. Kev xeeb tub ntawm zes qe menyuam, nyob ntawm qhov hnyav, muaj cov teeb meem hauv qab no:

1. Rupture ntawm zes qe menyuam. Hauv qhov xwm txheej no, kev tshem tawm tag nrho ntawm lub cev yog qhia.
2. poob ntshav txausmus rau hauv lub plab kab noj hniav, uas nrog lub rupture ntawm lub zes qe menyuam. Tib lub sijhawm, tus poj niam hnov mob hnyav, ntshav siab cuam tshuam.
3. Kev loj hlob ntawm kev xeeb tub vim tsis muaj ib qho ntawm zes qe menyuam.

Nyob tsis tshua muaj, kev tuag los ntawm kev poob ntshav loj yog ua tau.

Cov tsos mob ntawm zes qe menyuam rupture

Cov tsos mob ntawm lub cev xeeb tub ntawm zes qe menyuam tau nce ntxiv thaum nws los txog rau kev ua txhaum ntawm kev ncaj ncees ntawm zes qe menyuam:

1. Mob hauv plab plab, uas tshwm sim vim khaus ntawm lub plab kab noj hniav. Cov kev xav tsis zoo tshwm sim hauv thaj tsam ntawm lub zes qe menyuam cuam tshuam thiab maj mam kis thoob plaws hauv plab. Lawv nyob ruaj khov thiab muaj zog heev.



2. qaug zog thiab tsis nco qab tsim tawm tsam keeb kwm ntawm oxygen deficiency vim ntshav poob loj.
3. Nquag yaug kom tso quav thiab cov quav xoob qhia tias khaus ntawm phab ntsa ntawm qhov quav, nchuav ntshav rau hauv.
4. Qav thiab ntuav tshwm sim vim qhov tsis zoo ntawm qhov tsis muaj oxygen ntawm lub paj hlwb.
5. Hemorrhagic shock yog ib yam mob uas tus poj niam hnov hws txias, ua tsis taus pa, pos huab ntawm nws lub siab, daj ntseg ntawm daim tawv nqaij, apathy. Nyob rau tib lub sijhawm, muaj qhov txo qis hauv cov ntshav siab mus txog qhov tseem ceeb. Tus mob no tshwm sim vim poob ntshav loj thiab ua rau muaj kev hem thawj rau lub neej.

Yog tias pom cov tsos mob no, nws yuav tsum tau hu rau lub tsheb thauj neeg mob sai li sai tau thiab coj tus poj niam mus rau tsev kho mob, qhov chaw ua haujlwm yuav tsum tau ua sai sai los ntxuav lub plab thiabtshem tawm ntawm zes qe menyuam txawv txav.

Puas muaj peev xwm muaj menyuam nrog cev xeeb tub

Lub cev nkaus xwb uas tus menyuam hauv plab tuaj yeem txhim kho yog lub tsev menyuam. Kev sib txuas ntawm cov qe menyuam hauv plab mus rau lub zes qe menyuam, cov hlab ntsha thiab lwm qhov chaw tsis tau npaj rau qhov no yog pathology. Cov qauv ntawm zes qe menyuam tsis tau yoog kom ncab nrog tus menyuam hauv plab, ua rau lub cev tawg.

Hnub no, tsis muaj txoj hauv kev uas yuav pab cov poj niam cev xeeb tub ectopic. Tus mob no yog pathological thiab ua rau muaj kev hem thawj rau tus poj niam lub neej.

Kev Tiv Thaiv

Hmoov tsis zoo, kev tiv thaiv kev xeeb tub ectopic tsuas yog ua tau thaum tsis muaj kev sib raug zoo. Txawm li cas los xij, koj tuaj yeem txo qhov txaus ntshai yog tias koj ua raws li cov lus pom zoo los ntawm kws kho mob gynecologist:

1. Txij thaum koj pib sib deev, koj yuav tsum tau mus ntsib kws kho mob poj niam niaj hnub txhawm rau kuaj kev tiv thaiv, txawm tias tsis muaj kev tsis txaus siab.



2. Khaws daim ntawv qhia hnub ntawm kev coj khaub ncaws, thiab yog tias lawv sib txawv, nrog tus kws kho mob tshwj xeeb.
3. Kho tau raws sijhawm thiab kho tau txhua yam kab mob ntawm cov kab mob kev ua me nyuam. Nrog rau kev mob me me, nrog rau cov kab mob sib kis.
4. Pib npaj cev xeeb tub nrog kev kuaj xyuas los ntawm gynecologist.
5. Tiv thaiv lossis kho cov kab mob urinary raws sijhawm.
6. Tsis txhob rho menyuam tawm siv cov tshuaj tiv thaiv niaj hnub notiv thaiv kev xeeb tub tsis xav tau. Lawv pab txhawb txoj kev loj hlob ntawm adhesions uas tiv thaiv lub embryo los ntawm kev sib txuas ntawm qhov chaw, vim tias nws txuas rau hauv zes qe menyuam, hlab ntsha, ncauj tsev menyuam, thiab plab kab noj hniav.

Ntxiv rau, raws li kev tiv thaiv, nws raug nquahu kom tswj lub neej noj qab haus huv, nrog rau tag nrho kev haus luam yeeb thiab haus dej cawv.