Asherman lub syndrome: ua, cov tsos mob, hauj lwm, kev kuaj mob thiab kev kho mob

Childlessness nyob rau hauv kev sib yuav - nws yog ib tug ntawm cov tseem ceeb tshaj plaws kev teeb meem. Zaum tau pov thawj tib yam luag hauj lwm ntawm txhua tus ntawm lub peev xwm niam txiv hai nyob rau hauv kev daws qhov teeb meem no. Txawm li cas los, nyuam thiab tus me nyuam yog mov los ntawm leej niam. Ua cov kev pab raws qib tsuas paub tab poj niam lub cev. Nyob rau hauv qhov kawg ob peb xyoos peb tau pom txoj kev loj hlob ntawm me nyuam lub nruab nrog cov kab mob uas ntxias thiab ntxiv lawm tshob. Nyob rau hauv peb lub teb chaws occupies ib tug uas txoj hauj lwm nyob rau hauv mob endometritis. Ib qho ntawm nws ces yog Asherman lub syndrome. Seb cev xeeb tub yog tau nyob rau hauv tus kab mob no?

pathology hauj lwm

Nyob rau hauv Asherman lub syndrome hais txog ib tug pathological mob nyob rau hauv uas lub tsev me nyuam tsim adhesions. Lawv ua rau ib feem los sis tag nrho imperforate nws kab noj hniav. Tus kab mob tau txais nws lub npe los ntawm lub npe ntawm Yauxej Asherman gynecologist. Thawj syndrome piav nyob rau hauv kom meej nyob rau hauv xyoo 1894 Genrih Fritch. Nyob rau hauv cov kev kho mob cov ntaub ntawv muaj ntau ntau lub npe ntawm tus kab mob no: intrauterine adhesions, puas Atrophy thiab sclerosis ntawm lub endometrium.

Asherman lub syndrome thiaj paub tias yog nyob rau hauv cov poj niam tsis hais lawv lub hnub nyoog thiab kev raws li txoj cai. Intrauterine adhesions sawv cev connective splice, nruab nrab ntawm uas ib tug solder lub cev phab ntsa thiab ua rau lawv deformation. Raws li ib tug tshwm sim ntawm lub pathological kev npaj ntau yam kev mob uas ua rau coj khaub kawg. Lub ntsiab tsos mob ntawm tus syndrome yog qhia nyob rau hauv daim ntawv ntawm cov txawj abortions thiab ntxiv lawm tshob.

Tias tus txheeb cais rau lub tsev ntawm tus kab mob no? Tom qab curettage nyob rau hauv nulliparous cov poj niam txoj kev pheej hmoo ntawm kev tsim lub syndrome yog 25%. Thaum uas tsis yog-zaum cev xeeb tub yuav qhov muaj tseeb ntawm lub tsim ntawm adhesions thiab nce mus txog 30% ntawm cov neeg. Nruab nrab nchuav menyuam yuav luag hawv ib tug poj niam txoj kev noj qab. Nyob rau hauv cov ntaub ntawv no, txoj kev pheej hmoo ntawm tus kab mob NW nyuam qhuav ntau tshaj 7%.

Lub ntsiab yog vim li cas

Lub tsev menyuam yog ib tug hollow npag hloov khoom nruab nrog. Sab nraum nws yog them los ntawm lub peritoneum. Lub sab hauv yog lined nrog endometrium, uas muaj ob khaubncaws sab nraud povtseg - lub basal thiab haumxeeb. Nyob rau lub sij hawm ntawm lub cev ntas thiab nyob rau hauv tus poj niam txiv neej cov tshuaj hormones lub endometrium undergoes cyclic hloov. Los ze zog mus rau lub sij hawm ntawm ovulation, thaum lub sij hawm ntawm conceiving ib tug me nyuam lub feem ntau high, lub endometrium thickens. Lub endometrial hlwb yog ib tug active zus tau tej cov biologically active tshuaj. Tom qab fertilization, lub qe nws nkag mus rau hauv lub tsev me nyuam, qhov chaw uas lub implantation. Hu rau me nyuam hauv plab week nrog ib tug noj qab nyob zoo endometrium - yog qhov tseem ceeb mob rau muaj kev vam meej conception. Yog hais tias fertilization tsis tau tshwm sim, tej txheej yog torn tseg, raws li evidenced los ntawm txhua lub hlis. Nrog rau thaum pib ntawm txhua lub hlis, lub endometrium hlob dua.

Adhesions - nws outgrowths los yog adhesions hauv cov txheej ntawm lub tsev me nyuam uas ua txhaum cov kev physiology ntawm lub qog ua kua membrane. Asherman lub syndrome muaj vim kev puas tsuaj los yog raug mob rau lub basal txheej ntawm cov endometrium thaum lub sij hawm gynecological cov txheej txheem. Qhov no yuav ua tau ib tug scraping tom qab rho menyuam, phais plab seem, los yog lwm yam lag luam. Lwm ntau ua ntawm tus kab mob - endometritis. Adhesions yog tsim nyob rau hauv lub keeb kwm yav dhau heev heev foci ntawm o nyob rau hauv lub qog ua kua membrane ntawm lub tsev menyuam.

Cov soj ntsuam daim duab ntawm lub syndrome

Cov tsos mob ntawm tus kab mob no yog tshwm sim los ntawm nplaum txheej txheem thiab nws cov nyhuv rau lub lag luam ntawm lub tsev me nyuam system. Ntawm lawv yog cov feem ntau yog:

• coj khaub teeb meem (hnyav / ntshiv sib cais, ib tug muaj zog mob);
• nchuav menyuam ;
• txo tus naj npawb thiab ntev ntawm menses;
• theem nrab ntxiv lawm tshob;
• txuam nrog cov ntshav ntswg nyob rau hauv lub uterine kab noj hniav.

Yuav ua li cas lwm tus muaj cov tsos mob ntawm Asherman lub syndrome? Kab Mob feem ntau nrog endometriosis ua heev. Lub pathology yog yus muaj los ntawm ectopic txoj kev loj hlob ntawm tej txheej ntawm cov endometrium tshaj lub Scope ntawm lub tsev menyuam. Qhov no ua ke nrog ntawm tej yam tsis zoo nyob rau hauv cov chaw saib xyuas thiab zeem muag rau kev kho mob.

Peb degrees ntawm heev

Muab qhov kev puas tsuaj rau lub basal txheej ntawm cov endometrium, cov kws kho mob muab cov nram qab no faib tawm Asherman lub syndrome:

• me me (adhesions nyob tsis muaj ntau tshaj li 25% ntawm qhov ntim ntawm lub tsev me nyuam, yooj yim puas los ntawm cov neeg kho tshuab kev puas tsuaj);
• nruab nrab degree (leeg welded nruj nreem nrog lub txheej ntawm lub tsev me nyuam);
• mob loj heev degree (adhesions muaj feem ntau ntawm sclerosed connective ntaub so ntswg, thaiv cov hlab ntawm lub qhov ncauj ntawm lub tsev menyuam thiab cov hlab hauv qab lub cev).

Raws sij hawm kev txiav txim ntawm cov neeg kawm ntawv ntawm pathological txheej txheem yuav sai sai kho Asherman lub syndrome.

Yog cev xeeb tub tau?

Xyuas ntawm cov kws kho mob qhia tias qhov yuav tshwm ntawm conceiving ib tug me nyuam nrog tus kab mob no nyob rau hauv lub ua thiab theem. Thaum Asherman lub syndrome yog tiag cuam tshuam me nyuam system. Cov phab ntsa hauv cov tsev me nyuam pas, tawg tus ntoo khaub lig-kav. Raws li ib tug tshwm sim, lub embryo tsis tau implanted. Nyob rau hauv tas li ntawd, cov endometrium loses nws muaj peev xwm teb rau cov kev hloov nyob rau hauv cov tshuaj no ntsuas. Maj mam tsim theem nrab ntxiv lawm tshob, thiab nrog nws, thiab amenorrhea. Adhesions nyob rau hauv lub tsev me nyuam thaj av ntawd ntxias congestion thiab ncua ntawm menses. Kev ua txhaum voj voog feem ntau qhia ib tug loj heev kab mob. Cev xeeb tub yog ib tug ntuj txoj kev yuav siv tau, yog hais tias tsis raws sij hawm kho Asherman lub syndrome.

seb IVF puas tau? Xyuas ntawm cov kws kho mob kom paub tseeb tias nyob rau hauv vitro fertilization yog pab tau thaum tus kab mob no yog nyob rau ntawm ib thaum ntxov rau theem ntawm kev loj hlob. Tus nab npawb ntawm adhesions yuav tsis pub tshaj 25% ntawm qhov ntim ntawm lub tsev me nyuam, lawv yuav tsum tau laus nyob rau hauv ib tug tsawg cheeb tsam ntawm cov kab noj hniav.

Nws yog tsis yooj yim sua kom muab ib zaug xwb lo lus teb rau cov lus nug xa, vim hais tias txhua rooj plaub yog sib txawv. Nyob rau hauv lub heev ntawm lub pathological txheej txheem, muaj ntau ntau variants ntawm lub cev xeeb tub. Ib txhia poj niam nqa ntawm ua cov teeb meem, thaum lwm tus neeg kuj nrog heev heev teeb meem. Ib tug thib peb xaiv - txawj rho menyuam, nchuav menyuam, theem nrab ntxiv lawm tshob. Uas yog vim li cas txhua txhua tus poj niam yuav tsum saib tom qab lawv noj qab haus huv, yauv periodic kuaj mob nyob rau gynecologist, raws sij hawm kev kho tag nrho cov kab mob.

kev xeem

instrumental txoj kev yuav pom tau lub tsev menyuam yog siv los kuaj tus kab mob no. Yog tsis muaj tsis tus kws kho mob tshuaj xyuas tus neeg mob lub obstetric keeb kwm (tus naj npawb ntawm me nyuam, abortions, ncuav me nyuam tau thiab li ntawd.). Ultrasound xeem yog pom tias yuav ua tau lub feem ntau pheej yig thiab nyob rau tib lub sij hawm tsawg kawg tus qauv ntawm cov mob ntawm pelvic kabmob. Asherman lub syndrome yuav paub tseeb hais tias los ntawm ultrasound, tab sis kom tau muaj tseeb tau, koj yuav tsum rov hais dua cov txheej txheem ib tug ob peb lub sij hawm thaum lub sij hawm lub voj voog.

Cov txheej txheem kub nrhiav kom tau ntawm adhesions xam tau tias yog hysteroscopy. Tej lub tsev me nyuam cov kev tshawb fawb yuav siv ntawm ib tug tshwj xeeb ntaus ntawv. Nws yog tsim los siv los ntawm lub ncauj tsev menyuam kwj dej, yog li ntawd lub cev mob no yuav raug soj ntsuam nyob rau hauv lub sij hawm rau ib tug computer screen. Hysteroscopy los mus txiav txim qhov heev ntawm lub pathological txheej txheem, luaj li cas thiab localization ntawm adhesions. cov neeg mob kom tiav xeem tau yuav tsum tau ua ke nrog obstetric keeb kwm thiab yav dhau los sim nyob rau kev kho mob. Tej mus kom ze tso cai rau kom twv seb zoo puab txoj kev kho.

kev kho mob

Tus kab mob yog me ntsis heev teb zoo rau kev kho mob. Advanced ntaub ntawv ntawm tus kab mob thiab cev xeeb tub yog incompatible. Nyob rau hauv xws li ib tug cov ntaub ntawv los mus rau txoj kev cawm surrogacy. Thaum lub spikes muaj nyob rau ntawm ib tug tsawg feem ntawm lub tsev me nyuam, pab IVF. Txawm li cas los, nyob rau hauv cov ntaub ntawv no mus sim rau lub luag hauj lwm ntawm leej niam tsis tau tag nrho cov poj niam uas muaj tus mob ntawm "Asherman lub syndrome."

Kev kho mob yuav raug muab tshem tawm ntawm adhesions ntawm ib txoj kev hysteroscopy. Lag luam yuav tsum tau tsis muaj tshuaj kom tsaug zog, tsis muaj teeb meem. Technically, qhov no yog ib tug theej nyuab txheej txheem. Kev tshem tawm ntawm adhesions ua micro-txiab vim hais tias ntawm lub high school yuav re-raug mob. Nyob rau hauv lub postoperative lub sij hawm tshuaj tshuaj tua kab mob los mus tiv thaiv cov kab mob. Tshuaj kho yog yuav tsum tau los pab cov hormone. Kev siv cov estrogens thiab progestins qhia mus tsim kho endometrial txoj kev loj hlob.

outlook

Me me kab mob thiab raws sij hawm cev xeeb tub ntawm txoj kev kho yog cai nyob rau hauv 93% ntawm cov neeg mob, nrog ib tug nruab nrab - tsuas yog 78%. Kom kev kho mob ntawm cov poj niam nrog advanced kab mob ua rau nws tau xeeb tub ib tug me nyuam nyob rau hauv 57% ntawm cov neeg. Txawm li cas los, kev vam meej uas cev xeeb tub nrog Asherman lub syndrome tsis tau lees tias tus me nyuam yug ntawm ib tug me nyuam tsis muaj pathologies. Hnub nyoog ntawm tus neeg mob no kuj coj mus rau hauv tus account nyob rau hauv lub forecast. Piv txwv li, 66% ntawm cov neeg mob uas yau dua 35 xyoo thiaj paub hais tias nrog ib tug syndrome mob tau xeeb tub. Nyob rau tim fair nrog txiv neej pw dua 35 xyoo, qhov no daim duab nyuam qhuav tshaj 24%.

tiv thaiv kev ntsuas

Puas yuav ua tau kom tiv thaiv Asherman lub syndrome? Curettage los yog lub tshuab nqus tsev aspiration - ob txheej txheem specialist ua yuav luag blindly, relying tsuas yog nyob rau lawv tus kheej kev. Cov ntaub so ntswg ntawm lub endometrium thaum lub sij hawm cev xeeb tub mos mos, li ntawd, yooj yim raug mob. Raws li ib tug tshwm sim, tej yam kev diagnostic los yog kho scraping yeej ib txwm nrog kev raug mob mus rau lub basal txheej.

Ib tug lwm txoj rau cov txheej txheem yog abortions kho mob rho menyuam. Nws implies ib oxytocic los ntawm kev siv ntawm cov tshuaj. Txawm li cas los, cov hauj lwm zoo ntawm cov qauv no yog tsuas 80%. Nyob rau hauv 10% ntawm cov neeg tom qab kev kho mob rho menyuam cai kab mob ntawm lub week uas yuav tsum tau scraping. Yog li, kom tsis txhob Asherman lub syndrome tau, yog hais tias rau kev kho mob yog vim li cas mus xaiv kev kho mob rho menyuam. Nyob rau lwm cov tes, txoj kev ua no tsis muab ib tug 100% guarantee ntawm ib tug zoo tshwm sim.