Hysterectomy laparoscopic Hanyar: post-dau lokaci, sakamakon sake dubawa. Kau da igiyar ciki fibroids laparoscopically: reviews

A halin yanzu, mun ɓullo da m fasahar da cewa ba da damar ga wani iri-iri gynecological baki tare da kadan rikitarwa, kuma mai low mataki na tagayyara. Laparoscopic hysterectomy ta - daya daga cikinsu.

Laparoscopy matsayin sabon dabara

Laparoscopic tiyata ya kusa ga kan shekaru 20. A wannan lokaci sai ya tabbatar da kanta a matsayin mai minimally cin zali da kuma tasiri Hanyar da kadan post-gudanar da rikitarwa.

Laparoscopic dabaru a gynecology tsiwirwirinsu yawa shahararsa. A baya can, irin wannan hanyar yin gynecological tiyata kananan kundin. Amma a 'yan shekarun nan, a mafi yawan dakunan shan magani da kuma asibitoci, shi ya zama sananne. Daya daga cikin wadannan ayyukan ne don cire igiyar ciki fibroids laparoscopically. Reviews da marasa lafiya nuna cewa akwai wani m maido da aiki iya aiki, da hadarin da rikitarwa da kuma adhesions na kananan da kuma kadan lalacewar da fata ba ganimar da bayyanar mata.

Ga aiki na bukatar kwarewa da sanin ma'aikata. Tsakani da aka bashi garanti a wannan yanayin, kadan rikitarwa. A wasu lokuta, mai hade da laparoscopic da kuma na al'ada da tiyata kawai bukatar ajiye haƙuri ta rayuwa. Wannan gwani za su zabi daidai Hanyar da su bi marasa lafiya a kowane hali daidaiku.

Mutane da yawa asibitoci gudanar da kau da igiyar ciki fibroids laparoscopically. A Moscow, kusan kowane gynecological sashen sanye take da zama dole kayan aiki da kuma yana da masana ga dauke da fitar da wannan magudi. Daga dukan gynecological tiyata 50-60% suna gudanar da laparoscopy.

Babban abũbuwan amfãni daga cikin Hanyar:

• low mataki na rauni;

• sauri dawo da aiki da duk gabobin.

• raguwa daga post-dau zafi.

• kadan adhesions .

• short lokaci na asibiti.

• tsaya a rana kula.

• akan rage sharuddan na tawaya.

• m na postoperative hernias.

• m lokaci domin fi.

• ceton magunguna.

Korau lokacin laparoscopy

Duk wadannan m fannoni a cikin shakka daga tiyata da kuma warkar da mata rufe dukkan disadvantages cewa ne muhimmi a cikin wani laparoscopic tiyata:

• kayan da horo na kwararrun kwararru bukatar gagarumin ciyarwarsu.

• Likita dole mallaka laparoscopic dabaru da kuma na gargajiya tiyata.

• Matsalolin ne a take hakkin da ayyuka na gabobin hade da allura na gas a cikin kogon ciki, amma gyara da kuma gyara da rigakafin wadannan matsalolin za a iya kauce masa.

• Kada sarauta daga yiwuwar inji lalacewar daban-daban gabobin, tsokoki da kuma Tsarin.

Aikace-aikace a Gynecology

A gynecological laparoscopy yi ne mai tartsatsi ne. Bugu da kari ga ganewar asali a tabas lokuta da m ciki, ƙayyade cikin Sanadin rashin haihuwa, laparoscopic hanya da ake amfani a yanayi kamar:

1. Ectopic ciki.

2. A rata na tube.

3. M sterilization.

4. Endometriosis.

5. A m cutar.

6. cututtuka daban-daban na ovarian cysts, sklerokistoz, ovarian apoplexy.

7. yãfẽwa samuwar mahaifa (hysterectomy laparoscopic dabara rage hadarin da postoperative rikitarwa).

8. hyperplastic matakai, ba amenable ga ra'ayin mazan jiya far.

Kwanan gynecologists amfani laparoscopic hysterectomy ko a m siffofin maruran. Wa ɓullo da yawa dabaru don wannan aiki, dangane da girman da mahaifa, ta matsayi da hannu a aiwatar da ke makwabtaka da gabobin. Yadu amfani fibroids wannan aiki a daban-daban localizations.

igiyar ciki fibroids

Igiyar ciki fibroids - benign cuta a cikin wanda a ƙarƙashin rinjayar hormones auku yaduwa na fibrous nama tare da samuwar kullin. Yana lura da wani babban ruwan dare da cutar - game da 25% na dukkan gynecological matsaloli. igiyar ciki fibroids yana da wani tasiri a kan dukan jiki na mata. Myomectomy yana dauke da "zinariya misali" jiyya ga wannan cuta.

Hysterectomy laparoscopically. iri

A lokacin da zabar wani Hanyar daga m magani daga fibroids aka ɗauke shi zuwa lissafi da yawa dalilai: da wuri da kuma size of nodes, aiki, ko asarar m gabobin, da janar yanayin mace. Dangane da igiyar ciki raunuka appendages da dama iri tiyata a kan haihuwa gabobin.

A yi amfani:

- total hysterectomy a lokacin da cire jiki da kuma cervix. subtotal - cikin mahaifa an cire jiki. Idan tare da ya zauna cikin mahaifa, bisa bututu - gistertubektomiya, kuma idan bututu da kuma Yachnik, irin aiki da aka kira gistertubovarioektomiya. Don m ayyukan kamar pangisterektomii - share duk ciki genitalia tare da Lymph nodes ko gland kewaye kyallen takarda daga cikin farji da kuma jera koma oncological tafiyar matakai.

- Lokacin da adadi kaɗan na raka'a kuma don adana haihuwa mata yin ablative tiyata. Daya daga wadannan shine kau subserous igiyar ciki fibroids laparoscopically. Tare da kadan igiyar ciki rauni kwashe enucleation nodes, Ina nufin husking fibrous nama tare da m saving sashin jiki. Bayan wadannan ayyukan, wata mace zai iya samun juna biyu, bayan wani lokaci kuma ba haihuwa.

contraindications

Akwai contraindications for tiyata don cire mahaifa fibroids laparoscopically. Reviews Gynecologists da shawara cewa, a mafi yawan lokuta aiki za a iya za'ayi duk, fãce ga waɗanda mata suka sha wahala daga mai tsanani zuciya da jijiyoyin jini, na numfashi rashin cin nasara, da hernia, da matsaloli tare da jini coagulation tsarin ko marasmus

Dangi contraindications - wani yanayin a cikin abin da aiki shi ne zai yiwu, amma shi buga wasu matsaloli. Su ne:

• muhimmanci furta subcutaneous mai;

• untreated cututtuka.

• adhesions.

• effusion ko gaban ruwa a cikin kogon ciki na fiye da 1 lita.

Amma zamani gynecologists, da ciwon laparoscopic hanya, bayan da kara jarrabawa na wannan cututtuka wajabta hanya na lura, sanitize foci na kamuwa da cuta da kuma gudanar da wani aikin tiyata. A daidai wannan lokaci ku auna nauyi da "ribobi" da "fursunoni" kafin ka ciyar da wani laparoscopic aiki.

Shiri for tiyata

Reviews na matan da suka yi halartar hysterectomy laparoscopically, an san cewa marasa lafiya ne m tare da kawai wani shiri: The aiki yana minti 40, da kuma shirye-shiryen - 2 makonni da kuma more.

A aiki da mace za ta zo bayan da gwaje-gwaje da kuma sakamakon samu za a tsĩrar:

• jini gwaje-gwaje (total, biochemical, jini irin da RH factor, domin hepatitis, syphilis da HIV clotting, tabbatar da dalilin da glucose).

• fitsari gwaje-gwaje - janar da kuma tabbatar da dalilin da sukari.

• smears.

• electrocardiogram.

• x-haskoki.

• duban dan tayi.

• colposcopy.

• dubawa na kwararru: a ilimin, idan ya cancanta, a likitan zuciyar da sauransu.

Kafin aiki ga marasa lafiya da igiyar ciki fibroids bukatar wani raba bincike curettage na zauna cikin mahaifa, kuma ya sami histological sakamakon. Wannan wajibi ne don magance matsalar da adadin tiyata da kuma kawar da hana kara ci gaba da ciwon daji tafiyar matakai.

All Nazarin - a zama dole hanya, da kuma kawai bayan da cikakken bincike na likita za su iya gudanar da kau da mahaifa laparoscopically.

A ranar kafin tiyata da aka ba da shawarar a ci, dole ne ka aske pubic gashi.

Kafin tiyata, da mace cika fitar da wani amsa form don maganin sa barci, kuma dabam domin aiki. Idan dole, samar da kiwon lafiya, ko psychoprophylactic shiri domin tiyata.

aiki Technology

The aiki cire mahaifa laparoscopically yi a lokacin da myomas Girma up to 16 makonni na ciki, wanda ake wuya da zub da jini, halin da m girma ko hadarin m canji. Ko da yake wasu gogaggen kwararru cire gaba daya cikin mahaifa, size of wanda shi ne game da 20 makonni. Amma mafi sau da yawa, ba cikin shekaru da mace, da za'ayi kau da igiyar ciki fibroids laparoscopically barin wani karamin sashi na mahaifa ga haila.

Yi amfani da uku ko hudu huda na ciki bango (a - kusa da cibiya da sauran biyu - a kan kowane gefe) da kuma gudanar trocars. Wannan na'urar bayar da kyamara domin sa idanu haske ko da wani supercharger shigarwa carbon dioxide ko nitrous oxide da kuma kayayyakin aiki.

Bayan kau na dubawa yi laparoscopically igiyar ciki fibroids. Domin wannan jijiya an excised, ligated tasoshin dissected daga cikin mahaifa, kuma farji bango aka cire ta cikin farji ta wajen incisions a vaults. Wannan aiki ne da ake kira laparoscopically taimaka farji myomectomy. Ku ciyar suturing incisions a cikin farji. A daya aiki na iya share mahara nodes ba tare da sake shiga tsakani.

Bayan odalyayut jini ko ruwa, tara a lokacin aiki, dubawa ne da za'ayi sake jikinsu da kuma ganuwar da kogon ciki. Hankali duba ko da bandaged da ligated tasoshin, ko propotevanie jini ko lymphatic ruwa. Kashe gas da kuma nuni da kayayyakin aiki. Sa'an nan stitches ya auku a kan fata da kuma subcutaneous nama a shafin na trocar, da fata ne sutured kwaskwarima sutures.

A tsawon lokaci da aiki yana iya zama daga 15 minutes zuwa 1.5 hours dangane da girma na ciyar da m baki.

Analgesia a irin wadannan ayyuka kamar yadda kau da mahaifa laparoscopically: reviews

Abin da maganin sa barci ne mafi alhẽri? Wannan tambaya ya kamata a warware tare da Likita wani anesthesiologist, ba general yanayin haƙuri, da Manuniya na dakin gwaje-gwaje karatu, da kiyasta girma na ayyukan. A mafi yawan lokuta, da hada endotracheal maganin sa barci. Reviews na mata cewa shi yana da kyau jure, ba tare da wani ciwon kai. Mace farkawa bayan 15-20 minti bayan da wani aiki kamar kau da mahaifa laparoscopically.

A postoperative lokacin da ya dace maganin sa barci take kaiwa zuwa mai kyau sakamakon bayan da baki: da zafi ba dame, akwai kawai qananan rashin jin daɗi, wanda ya wuce ta kwanaki 2. Wani lokaci yana iya zama tashin zuciya, amma shi ke docked "metoclopramide". A ranar farko da ka iya sha kawai ruwa. A yamma, za ka iya riga tashi da tashi. A rana ta biyu za ka iya ci, wanda ba ya ji haushi cikin hanji, kamar porridge, soups, kiwo kayayyakin. A tsantsa ne da za'ayi a rana ta biyu bayan da baki, da kuma rashin lafiya iznin rufe bayan kwanaki 30. Bayan da cewa mace za ta iya amince je aikin, amma tare da ƙuntatawa na nauyi jiki aiki ga wata. Sutures an cire kan postoperative rana 5.

Bayan tiyata, da zai yiwu rikitarwa, wanda su ne rare: wannan rauni trocar ciki gabobin, zubar da jini daga karkashin ligated tasoshi, subcutaneous emphysema. Duk wannan za a iya hana idan tsananin bi kayan aiki aiki da kuma tsayar da duba na kogon ciki a hankali.

effects

Ya kamata a lura da cewa bayan an aiki kamar wani laparoscopic hysterectomy hanya, da effects ayan samu. Farfadowa da na'ura na faruwa bayan makonni 2 na fi. 30 kwanaki bayan da aiki da mace za ta iya tafiya game da harkokin kasuwanci kamar yadda ya saba. Nagari m motsa jiki. Amma wata daya daga bisani, shi ne a ke so zuwa load da na ciki tsokoki, ya dauke kaya masu nauyi a rana.

A farkon zamanin iya samun qananan nagging sha raɗaɗin a ciki. Wannan shi ne al'ada kuma ya kamata wuce a 1-2 kwanaki. Da samuwar adhesions ne zai yiwu, amma bisa ga statistics wannan ya auku sosai da wuya da kuma kawai a cikin kwayoyin predisposition da kwayoyin ko a karkashin bayyana endometriosis.

Kadan sallama daga al'aura fili. Wannan al'ada idan ovaries an kiyaye su. Sun ci gaba da samar da hormones cewa sa wannan dauki.

Lokuta da kumburi tafiyar matakai bayan laparoscopic tiyata ne m, saboda kwayoyin da aka nada nan da nan bayan da baki da kuma ci gaba domin 5 days. A daidai wannan lokaci shi gyara ruwa da kuma electrolyte abun da ke ciki na jini.

Mayar da haihuwa haƙuri kusan nan da nan, amma a wasu lokuta akwai wani karuwa a libido. A mace zai iya rayuwa a jima'i rayuwa bayan wata 1 bayan tiyata. Idan jiki ne adana, za ka iya samun ciki a cikin watanni shida bayan da baki.

A ina zan iya gudanar da wani aiki?

Mutane da yawa asibitoci iya bayar da hysterectomy laparoscopically. A Moscow birni asibitoci da cewa suna sanye take da kayan aiki da kuma samun kwararru da suka sani wannan dabara za su bayar da ku da wadannan ayyuka. Ma'amala farashin da aka amince da halartar likita.

A binciken da za a iya yi a cikin ofishin ko a cikin pre-asibiti zama. Don gudanar da irin wadannan ayyuka yiwu rajista ƙa'ida. A kudin laparoscopic hysterectomy ne game da 45 zuwa 70 da dubu.