Pessary thaum cev xeeb tub: qhia, teeb tsa, tshuaj xyuas
Pessary thaum cev xeeb tub: qhia, teeb tsa, tshuaj xyuas
Anonim

Kev cev xeeb tub yog ib qho tseem ceeb thiab kev zoo siab hauv poj niam lub neej. Tab sis qee zaum lub sijhawm no tuaj yeem cuam tshuam los ntawm kev yug ntxov ntxov. Ib qho ntawm qhov ua rau tus mob no yog qhov ua tsis tiav ntawm lub ncauj tsev menyuam. Qhov no txhais tau hais tias tseem muaj ntau lub sijhawm ua ntej yug menyuam, tab sis lub ncauj tsev menyuam pib mos thiab qhib, uas tuaj yeem ua rau yug tsis tau sijhawm. Yav dhau los, nrog rau kev kuaj mob zoo li no, tus menyuam tsis tuaj yeem muaj sia nyob, tab sis niaj hnub no, tus poj niam tau muab tso rau hauv ib lub cuab yeej uas yuav txo qhov kev pheej hmoo ntawm kev yug ntxov ntxov kom tsawg.

pessary yog dab tsi

Cov cuab yeej siv los tiv thaiv kev yug ntxov ntxov yog hu ua pessary lossis uterine nplhaib. Lub pessary thaum cev xeeb tub yog ib qho cuab yeej ua los ntawm silicone lossis yas uas tau hnav ntawm lub ncauj tsev menyuam, txhawb nqa qee yam hauv nruab nrog cev, suav nrog tsev menyuam, qhov quav thiab zais zis. Thaum siv, cov ntaub so ntswg sab hauv tsis raug mob, raws li cov khoom tsim los nrog cov npoo zoo kawg nkaus thiab tsis muaj menyuam ua tiav. Haum rau ib tus neeg rov siv dua. Ib qho pessary thaum cev xeeb tub yog qhov pib ntawm lub nplhaib, lub tais, nceb lossis oval, tab sis qhov yuav tsum tau ua ua ntej yog lub qhov nruab nrab rau lub caj dab nws tus kheej. Hauv qee cov qauv, muaj qhov ntxiv ntawm cov npoo rau kev tso tawm ntawm qhov chaw mos.

Yuav siv hom twg, thaum teem sijhawm, tus kws kho mob tuaj koom yuav txiav txim siab tom qab kuaj.

Type of pessary

Obstetric pessaries
Obstetric pessaries

Muaj peb hom obstetric pessaries thaum cev xeeb tub, nyob ntawm qhov ntsuas ntawm lub ncauj tsev menyuam thiab qhov chaw mos:

  • 1st view. Siv rau cov poj niam thaum cev xeeb tub thawj zaug thiab thib ob. Txoj kab uas hla ntawm lub ncauj tsev menyuam yuav tsum tsis pub tshaj 30 mm, thiab qhov ntev ntawm lub sab sauv peb ntawm qhov chaw mos yuav tsum tsis pub tshaj 65 mm.
  • 2nd look. Ib qho cuab yeej ntawm hom no feem ntau yog ntsia rau cov poj niam thaum lawv cev xeeb tub thib ob lossis thib peb. Qhov ntev ntawm lub ncauj tsev menyuam nyob rau hauv cov ntaub ntawv no yuav tsum tsis txhob ntau tshaj 30 mm, hos qhov ntev ntawm lub Upper thib peb ntawm qhov chaw mos yuav tsum tsis txhob ntau tshaj 75 mm.
  • 3rd view. Nws yog ntsia rau hauv rooj plaub thaum lub thib peb ntawm qhov chaw mos yog ntau tshaj 76 hli, thiab txoj kab uas hla ntawm lub ncauj tsev menyuam yog ntau tshaj 30 hli. Yeej, hom no yog muab rau cov poj niam uas muaj ntau yam cev xeeb tub.

Indications rau kev tso chaw pessary

Mounted pessary
Mounted pessary

Pessary thaum cev xeeb tub raug pom zoo rau cov poj niam hauv cov xwm txheej hauv qab no:

  • Isthmic-cervical insufficiency (ICI). Hauv qhov no, lub ncauj tsev menyuam, rau qee yam, tsis tuaj yeem tiv nrog lub luag haujlwm muab rau nws thiab pib qhib hauv qab qhov hnyav.fetus lossis amniotic kua, uas tuaj yeem ua rau yug ntxov ntxov lossis muaj kab mob hauv dej.
  • nrog lub ncauj tsev menyuam luv.
  • Kev tiv thaiv CCI.
  • Thaum tus poj niam twb yug ntxov ntxov lossis nchuav menyuam lawm.
  • Qee lub sijhawm kev teeb tsa ntawm pessary thaum cev xeeb tub yog ua nyob rau hauv cov xwm txheej uas qhov kev kho mob ntawm isthmic-cervical insufficiency tsis ua tiav. Tsis tas li ntawd, tus pessary tuaj yeem ua tus tiv thaiv rau kev sib txawv ntawm stitches tom qab lawv tau thov rau lub ncauj tsev menyuam.
  • Muaj cev xeeb tub.

Contraindications rau kev txhim kho lub cuab yeej

Tab sis muaj cov xwm txheej uas nws txwv tsis pub tso pessary thaum cev xeeb tub.

Cov no suav nrog:

  • ntshav los yog ntshav tawm;
  • cov txheej txheem inflammatory ntawm lub ncauj tsev menyuam lossis qhov chaw mos (qhov no, kev siv cov cuab yeej ua tau tom qab tshem tawm qhov mob);
  • xav tias nchuav menyuam;
  • mob hnyav fetal malformations;
  • kab mob ntawm tus poj niam uas cev xeeb tub yog contraindication;
  • qhia qib siab ntawm CCI;
  • kev ua txhaum ntawm kev ncaj ncees ntawm lub hnab amniotic.

Pessary installation txoj cai

Gynecological lub rooj zaum
Gynecological lub rooj zaum

Kev teeb tsa ntawm pessary thaum cev xeeb tub, raws li txoj cai, tshwm sim tom qab 24-26 lub lis piam, tab sis raws li cov lus qhia, nws tuaj yeem siv tom qab lub lim tiam 13th.

Ua ntej kev tswj hwm, nws yog ib qho tsim nyog yuav tsum tau noj cov tshuaj smears rau cov kab mob thiab kev hloov pauv pathological hauv microflora ntawm qhov chaw mos thiab kho kom zoo. Qhov kev npaj no tseem ceeb heev, vim tias thaum twgcev xeeb tub, ntau tus poj niam muaj thrush.

Ntau tus neeg ntshai ntawm cov txheej txheem no thiab xav tias nws mob thaum lub sijhawm teeb tsa ntawm pessary thaum cev xeeb tub. Feem ntau cov kws kho mob sib cav hais tias qhov kev taw qhia ntawm cov cuab yeej tsis yog ib txoj kev mob, nws tsuas tuaj yeem ua rau me ntsis tsis xis nyob. Nws tag nrho yog nyob ntawm qib ntawm rhiab heev ntawm lub tsev menyuam thiab lub tsev menyuam. Muaj tsawg zaus, siv tshuaj loog hauv zos. Cov txheej txheem tau ua thaum lub sijhawm teem sijhawm nrog koj tus kws kho mob.

  • Ib ob peb hnub ua ntej kev teeb tsa, nws raug nquahu kom siv cov tshuaj tua kab mob hauv qhov chaw mos los ntxuav cov microflora ntawm ntau yam kab mob.
  • Kwv yees li ib nrab teev ua ntej tus txheej txheem, nws raug nquahu kom noj cov tshuaj antispasmodic los tiv thaiv uterine contractions nyob rau hauv teb rau kev kho mob manipulations.
  • Tom qab ntawd tus kws kho mob xaiv qhov zoo tshaj plaws thiab hom khoom siv rau tus neeg mob, vim tias cov txheej txheem ntxig yog nyob ntawm qhov no.

Hnub no, hom ntau tshaj plaws yog:

  • Pessary Juno
    Pessary Juno

    Y Plastic "Juno" (ua hauv Belarus). Nws tsuas muaj peb qhov ntau thiab tsawg, muaj kev ua haujlwm siab. Tab sis thaum nws hloov chaw, tus poj niam yuav raug mob. Hauv qhov no, nws raug nquahu kom mus ntsib kws kho mob sai li sai tau.

  • Pessary Arabin
    Pessary Arabin

    "Pessary of Dr. Arabin" (ua hauv lub teb chaws Yelemees). Nws muaj qhov zoo li lub tais. Tsis mob ntxig, tsis ua rau khaus thiab tsis xis nyob thaum hnav. Pessary Arabin thaum cev xeeb tub muaj 13 qhov ntau thiab tsawg, uas ua rau nws nyuaj rau yuavqhov loj me rau tus kheej. Ua ntej yuav khoom, nws raug nquahu kom sab laj nrog kws kho mob kom pab. Nws tsim nyog sau cia tias qee zaum silicone tuaj yeem lo rau cov ntaub so ntswg, ua rau mob thiab tsis xis nyob.

YYuav ua li cas muab pessary thaum cev xeeb tub?

  • Koj yuav tsum tso koj lub zais zis ua ntej tus txheej txheem.
  • Ib tug poj niam zaum ntawm lub rooj zaum gynecological, tus kws kho mob ntxuav qhov chaw mos thiab cov pessary nws tus kheej.
  • Cov pessary, yav tas los lubricated nrog roj av jelly lossis glycerin, maj mam muab tso rau hauv qhov chaw mos nrog lub hauv paus dav.
  • Tom qab ntawd lub cuab yeej tig tig kom qhov nqaim nyob rau hauv cov pob txha pubic ntawm lub plab, thiab qhov dav yog qhov tob hauv qhov chaw mos.

Yog siv ib puag ncig pessary, tus kws kho mob, tau hnov lub ncauj tsev menyuam, ua tib zoo muab lub nplhaib rau nws.

Cov txheej txheem tag nrho yuav siv sijhawm tsis pub dhau 20-30 feeb, tom qab ntawd tus poj niam yuav tsum tau saib xyuas qee lub sijhawm. Yog tsis muaj dab tsi thab nws, nws raug tso cai mus tsev.

Thaum txhim kho lub pessary, kev txawj ntawm tus kws kho mob yog qhov tseem ceeb heev, vim tias kev ntxig thiab kev teeb tsa tsis raug tuaj yeem ua rau tus menyuam mos thiab leej niam zoo heev.

Cov lus qhia tom qab kev taw qhia

ntxhais ntawm qhov rais
ntxhais ntawm qhov rais

Tom qab txhim kho pessary thaum cev xeeb tub, poj niam lub neej zoo dua qub, vim qee qhov kev txwv ntawm kev ua lub cev raug tshem tawm. Txawm li cas los xij, nws yuav tsum ua raws li qee txoj cai:

  • A categorical txwv tsis pub muaj kev sib deev.
  • Tsis suav nrog kev ua lub cev, tshwj xeeb tshaj yog qaij thiab squats.
  • Txhua2-3 lub lis piam mus kuaj kab mob.
  • Koj ua tsis tau dej hauv pas dej, qhib dej.
  • Raws li txoj cai, tus kws kho mob tau sau ntawv qhia qhov chaw mos suppositories rau tag nrho lub sijhawm ntawm kev siv pessary txhawm rau tshem tawm qhov chaw mos.
  • Tsis txhob sim kho lossis tshem lub cuab yeej koj tus kheej. Yog tias koj muaj kev tsis xis nyob, nrhiav kev kho mob tam sim.

Yuav muaj teeb meem tom qab pessary ntxig

Kev siv pessary tsis suav nrog cov kev mob tshwm sim, vim tias lub cev tuaj yeem cuam tshuam txawv rau lub cev txawv teb chaws. Cov teeb meem tshwm sim muaj xws li:

  • Kev xaiv. Yog tias koj pom qhov nce ntawm lawv tus lej, tsis txhob ntshai tam sim ntawd. Qee qhov nce hauv cov xim dawb yog ib txwm teb tag nrho ntawm lub cev mus rau kev qhia txog cov khoom txawv teb chaws. Koj yuav tsum sab laj nrog kws kho mob tam sim yog tias muaj ntshav lossis ntshav tawm; yellowish los yog ntsuab (tej zaum yuav qhia tau hais tias muaj kab mob); pob tshab, kua nrog cov ntxhiab tsw qab me ntsis (qhov tshwm sim ntawm kev ua txhaum kev ncaj ncees ntawm lub hnab amniotic).
  • Kev txhim kho ntawm qhov mob, mob plab. Qee zaum, thaum lub pessary hloov chaw, colpitis tuaj yeem tshwm sim - qhov mob ntawm qhov chaw mos mucosa. Hauv qhov no, qhov mob hauv plab thiab khaus khaus, zoo li thrush, tuaj yeem hnov. Hauv qhov no, yuav tsum pib kho sai li sai tau.

Tshem tawm pessary

Yog tias cev xeeb tub yog ib txwm, kev tshem tawm cov cuab yeej tshwm sim tom qab 38 lub lis piam gestation, thaum tus me nyuam pib txiav txim siab tag nrho. Cov txheej txheem yog ua los ntawm gynecologist nruj me ntsis hauv lub tsev kho mob. Tshem tawm cov pessary sai heev thiab feem ntau tsis mob. Tom qab ntawd, kev huv ntawm tus kwj dej yug yog ua.

Yog vim li cas rau kev tshem tawm ntxov ntawm lub cuab yeej.

Nws tshwm sim tias koj yuav tsum tshem cov pessary sai sai hauv cov xwm txheej hauv qab no:

  • yog kev ua haujlwm tau pib;
  • yog cov kua dej amniotic tawg;
  • nrog cov kua dej amniotic;
  • yog xav tau kev xa khoom ceev;
  • yog pom muaj kab mob inflammatory ntawm tus poj niam hauv nruab nrog cev ntawm leej niam.

Efficiency

Pessary thaum kuaj cev xeeb tub feem ntau yog qhov zoo. Ntau tus poj niam nco txog nws txoj kev ua tau zoo, tsis mob ntawm kev tswj hwm. Raws li txoj cai, pessary tsis tshua muaj kev hloov pauv lossis ua rau mob. Tsis zoo li kev phais suturing, kev teeb tsa ntawm cov cuab yeej no tsis tas yuav siv tshuaj loog thiab tsis tshua muaj mob.

Zoo kawg

Poj niam cev xeeb tub
Poj niam cev xeeb tub

Summarizing, nws tsim nyog sau cia tias tom qab tshem cov pessary thaum cev xeeb tub, kev yug menyuam tsis tas yuav tshwm sim nyob rau hnub tom ntej. Ntau tus poj niam nqa tus menyuam mus txog 40 lub lis piam, thiab qee tus yug tau ob peb hnub tom qab tshem tawm.

Nws yog ib qho tseem ceeb heev uas cov cuab yeej raug teeb tsa los ntawm tus kws kho mob uas tsim nyog koj tuaj yeem ntseeg tau. Nws txoj kev ua tau zoo thiab qhov tsis muaj cov kev mob tshwm sim yuav nyob ntawm nws qhov kev ua thiab kev xaiv kom raug ntawm qhov loj thiab hom pessary.

Kev yug me nyuam tom qab tshem lub cuab yeej tsis txawv ntawm qhov qub.

Cov niam txiv yuav tsum nco ntsoov tias txhawm rau ua tiavcev xeeb tub ib pessary yuav tsis txaus. Nws yog ib qho tsim nyog yuav tsum ua raws li tag nrho cov lus pom zoo ntawm tus kws kho mob thiab ua cov kev ntsuam xyuas tsim nyog raws sij hawm.

Pom zoo: