Nyob rau dab tsi hnub ntawm lub voj voog, ua rau lub tsev me nyuam hysteroscopy?

Rau hnub tim, hysteroscopy yog ib tug ntawm cov tseem ceeb tshaj plaws qhov chaw nyob rau hauv lub diagnostic kev ntsuam xyuas Gynecology. Qhov no endoscopic txoj kev tau ua yuav tsum tau nyob rau hauv lub gynecological departments. Muaj coob tus neeg xav: dab tsi hnub ntawm lub voj voog tsis hysteroscopy?

Hysteroscopy - ib tug kev soj ntsuam ntawm lub uterine kab noj hniav tshwj xeeb kho qhov muag system. Thaum lub diagnostic hysteroscopy coj kev soj ntsuam ntawm lub uterine kab noj hniav. Thaum muaj me me phais haujlwm nyob rau hauv yuam cai ntawm lub endometrium. Rau cov saib xyuas los yog phais kho mob yog ib tug conservative tswj hysteroscopy. Lub rov tshwm sim ntawm tshiab li rau hysteroscopy pub saib tsis tau tsuas yog lub tsev me nyuam, tab sis kuj rau kev ntsuam xyuas qhov mob ntawm lub paum epithelium, ncauj tsev menyuam kwj dej, ncauj tsev me nyuam thiab lwm tus. Mikrogisteroskopy nrog ua x 150 x60 thiab cia mus kawm ntawv hauv tus qauv ntawm lub hlwb thiab lawv nuclei thiab cytoplasm.

Nyob rau dab tsi hnub ntawm lub voj voog yog ib qho zoo ua hysteroscopy, nws yuav tsum tau piav rau hauv qab no.

Yuav ua li cas ua kuv?

Feem ntau cov paub optical systems Hamou kuv thiab Hamou II. 4 thawj ua kom x1, x20, x60 thiab x 150, lub thib ob x20 (rau panoramic hysteroscopy) thiab x80 (rau mikrogisteroskopii thiab phais tiv thaiv microtools 1-3 hli).

Rau mikrogisteroskopii txaus mus kov lub cheeb tsam ntawm lub distal kawg ntawm txoj kev tshawb unit.

Thaum cov kev sib cuag hysteroscopy nyob rau hauv lub xub ntiag ntawm thaj av ntog endometrial 6-8 hli nyob rau hauv txoj kab uas hla, li ntawd, ib tug xav paub ntau tshaj daim duab ntawm lub hysteroscope pheej kis mus rau hauv lub uterine kab noj hniav.

Txawm ntau ntshiab, kaj duab yuav tsum tau nyob rau hauv ib tug saj zawg zog fibrogisteroskop, muaj tsawg heev kev puas tsuaj rau lub uterine phab ntsa.

Lwm novelty - Operating hysteroresectoscopy, tus siab heev tshuab nyuaj Hopkins'a, nws yuav ua rau electrosurgical cov txheej txheem nyob rau hauv lub uterine kab noj hniav.

Yuav ua li cas yog lub chaw ua hauj lwm hysteroscopy? Nyob rau dab tsi hnub ua voj? Nyob rau qhov no - nyob rau hauv.

Chaw ua hauj lwm hysteroscopy yog tsis ntau nyob rau hauv Russia. Nyob rau hauv kev nws yog nqa tawm nyob rau hauv txawv teb chaws cov chaw kho mob. Qhov no kev soj ntsuam ntawm lub tsev me nyuam siv ib tug nyias raj-hysteroscope. Nqa tawm tsis muaj tshwj xeeb tshuaj loog nyob rau hauv tus kws khomob lub chaw ua hauj lwm. Nws yuav tsum tau lub tsev me nyuam dilatation.

Txawv ntawm lub niaj zaus uas tsis koom nrog kev kho mob cov txheej txheem.

Hysteroscopy yog muab faib, nyob ntawm seb lub tuav lub sij hawm nyob rau hauv lub pre-operative los yog post-operative, thaum muaj xwm ceev los yog npaj. Tej zaum zoo tshaj txoj kev ua no ua ke nrog laparoscopy.

Thaum ua hauj lwm nrog lub TV systems yog preferable siv ib tug txias lub teeb qhov chaw. Tam sim no ntau Xenon teeb ntawm 150 mus rau 300 watts.

E ₂ yog CO pub gisteroinsuflyatorami. Insufflating roj tso cai rau txhaj koob tshuaj thiab tswj lub siab thiab roj txaus tus nqi.

Introduction ntawm cov kua xov xwm los ntawm txoj kev ntawm huab cua twj. Kho cov pub kua tshwm sim txiav, tej zaum nws yuav discontinuous thiab tas mus li.

Endoscopic chav yog nruab nrog niaj hnub TV systems uas siav yuav tsum endoscopic phais.

Hnav thiab me me-sized koob yees duab hau cov duab rau tus saib hais tias tso cai rau koj mus archive cov kev tshwm sim ntawm hysteroscopic kev tshawb fawb thiab tom qab ntawd muab piv rau kev soj ntsuam. Siv rau kev ua qauv qhia thiab kev kawm.

Nrog lub advent ntawm TV ua hauj lwm hysteroscopy tus kws kho mob tau mus txog ib tug tshiab npaum li, ib tug neeg gynecologist muab tshem tawm los ntawm lub qhov chaw mos txoj kab txiav tus poj niam, qhov muag sab yog txo los ntawm ob peb lub sij hawm, uas tswj qhov kev siv ntawm intrauterine manipulation. Nyob rau dab tsi hnub ntawm lub voj voog menstruatsionnogo ua hysteroscopy, nws yog ib yam uas tseem ceeb heev.

Feem ntau cov kev siv ntawm ib tug laser thaum lub sij hawm intrauterine hauj lwm. Nyob rau hauv no laser kho qhov muag fibers yog nkag tau rau hauv cov kab noj hniav los ntawm ib tug khiav hauj lwm channel nyob rau hauv kev sib cuag nrog lub dissecting nto nqa tshem tawm partitions kev puas tsuaj ntawm cov endometrium.

Mus nqa tawm hysteroscopy cov kws kho mob ncab lub tsev me nyuam, uas tso cai rau zoo xyuas nws phab ntsa. Tensile yuav siv tau ib tug roj los yog kua. Carbon dioxide, siab molecular nyhav thiab tsis muaj molecular yuag nruab nrab (saline, mannitol, muaj menyuam tsis taus dej) yog tsis tu ncua thov kom distention. Feem ntau cov tseem ceeb tshaj, qhov ib puag ncig muaj ib tug zoo kev soj ntsuam yog txaus los mus nce lub intrauterine siab thiab tus menyuam tsis tau tshwm sim los qhov tshwm sim ntawm ib tug kab mob txheej txheem. Yog li ntawd nws yog ib qho tseem ceeb, nyob rau dab tsi hnub ntawm lub voj voog ua hysteroscopy.

Tsis indications rau hysteroscopy

By tsis muaj xws li polyps ntawm lub endometrium, ntxiv lawm tshob, xav tias endometrial cancer thiab ncauj tsev me nyuam, vesico-uterine fistula thiab xav tias nws nyob rau residues cov ntaub so ntswg pob txha ntawm lub fetus, lub xub ntiag ntawm ib tug txawv teb chaws lub cev, perforation ntawm lub tsev me nyuam phab ntsa, lub cev ntas, nrog endometriosis, tshe qhov chaw nyob qhov twg cov contraceptive endometrial, uterine fibroids, tshe qhov xwm ntawm uterine kho raws, xav tias intrauterine adhesions, hu rau los ntshav, endometrial hyperplasia, metro-thiab menorrhagia.

Los ntawm no pov thawj nyob, ua tsev menyuam hysteroscopy rau dab tsi hnub ntawm lub voj voog.

txheeb ze indications

• Post-operative tej yam kev mob.
• Tom qab hydatidiform tias.
• Nyob rau hauv tus menyuam nchuav.
• Tom qab lawm kev kho mob los tswj.

Contraindications

Hysteroscopy yog ua rau cov neeg mob uas mob thiab subacute o ntawm lub qhov chaw mos kabmob, nrog hnyav uterine los ntshav, cev xeeb tub cov poj niam, cov poj niam uas lub tsev me nyuam stenosis, ncauj tsev menyuam mob khees xawj.

Nyob rau dab tsi hnub ntawm lub voj voog tsis hysteroscopy rau ntau yam kab mob?

Nyob rau hauv lub yeej xaiv thiab lub sij hawm ntawm txoj kev tshawb. Yog hais tias ib tug poj niam yog xav tias adenomyosis los yog submucousmyoma, kev tshawb fawb yog ua rau lub thib rau-cuaj hnub ntawm lub cev ntas. Yuav kom txiav txim seb qhov functionality ntawm cov endometrium, xws li hyperplasia los yog ntxiv lawm tshob, hysteroscopy ua thaum lub sij hawm thib ob theem ntawm lub voj voog.

Txheej txheem kev tshawb

5% tshuaj ntawm iodine dej caw los yog "Yodonatom" kho ncej puab thiab txheej genitals. lub ncauj tsev menyuam yog raug thiab cov cawv yog kho siv paum tsom iav. Relegates rau pem hauv ntej di ncauj ntawm lub ncauj tsev menyuam, lub tsev me nyuam thiab probed noj peb caug nws ntev raws cov kev sojntsuam. Successively expanders Geger lub tsev me nyuam kwj dej pib los ntawm cov kab noj hniav los xyuas kom meej free flow ntawm cov kua hauv lub tsev me nyuam. Ceev ceev cov ntshav tshem tawm tiav qhov kom. Hysteroscope koom nrog ib tug menyuam tsis taus kua mov system thiab lub teeb qhov chaw, thiab ces los ntawm lub ncauj tsev menyuam kwj dej nws yog nkag tau rau hauv lub uterine kab noj hniav. Yuav pib, nws yog nqa tawm ib tug general txheej txheem cej luam, mloog yog twv rau cov duab thiab loj ntawm lub tsev me nyuam, lub endometrium (vascular txawv, coloring, thickness, folding), lub nyem ntawm nws cov phab ntsa, tus mob thiab nyob rau ntawm lub qhov ncauj ntawm txoj hlab qe menyuam. TEB tsev me nyuam, ncauj tsev me nyuam, isthmic sib cais thiab sidewalls mus saib kev qhia kev ntxiv hysteroscope. Cov kev kho nqi lus yog nqa tawm nyob rau hauv ib tug clockwise kev taw qhia.

Cov poj niam feem ntau xav li cas hnub ntawm lub cev ntas ua hysteroscopy. Hais txog nws - hauv qab no.

Nyob rau hauv expanding ncauj tsev menyuam kwj dej thaum fibrogisteroskopii tsis tsim nyog, txij thaum lub workpiece fibrogisteroskopa diagnostic txoj kab uas hla ntawm 3.6 millimeter. Tsiv mus ua hauj lwm ib feem ntawm lub uterine kab noj hniav apparatus yog nqa tawm los ntawm kev sib hloov ntawm distal hysteroscope.

rau kev ua hauj lwm

Phais hauj lwm nyob rau hauv lub uterine kab noj hniav yog desirably nqa tawm nyob rau hauv thawj theem ntawm lub voj voog thaum lub endometrium yog nyias txaus, nws yuav tsis tiv thaiv kom txhob soj ntsuam.

Operations muaj thaum lub sij hawm hysteroscopy:

• hysteroscopic endometrial ablation;
• polypectomy;
• cryosurgery;
• hysteroscopic kom tsis muaj menyuam;
• myomectomy;
• Uterine septum resection;
• tshem tawm ntawm txawv teb chaws lub cev thiab IUD;
• intrauterine adhesions phais;
• tshem remnants ntawm cov pob txha tawg tsam;
• catheter raj.

Cov neeg mob uas underwent diagnostic hysteroscopy tsis yuav tsum tau tshwj xeeb kev saib xyuas. Uterotoniki thiab painkillers tsa tsis tshua muaj heev. Nyob rau hauv cov ntaub ntawv ntawm kev nrhiav ib tug neeg mob uas muaj feem yuav tshwm sim ntawm lub taub dej khawb teeb meem tsa tshuaj tua kab mob. Nyob rau dab tsi hnub ntawm lub voj voog, koj yuav ua li cas ib tug hysteroscopy, peb piav qhia txog tom qab nyob rau hauv tsab xov xwm.

Pom zoo tom qab phais hysteroscopy

Tshuaj tua kab mob prophylactically muab tom qab phais hysteroscopy ( "Gentamycin" intramuscularly 80 mg ib hnub ob zaug). Tshuaj tua kab mob ua ke nrog metronidazole formulations ( "Trichopolum" 1 tab. 3 lub sij hawm ib hnub twg).

Nyob rau hauv thawj hnub tom qab hysteroscopy cai los ntawm qhov chaw mos huam spotting hereinafter yog haujlwm. Yuav kom accelerate uterine contractions teev "oxytocin" 1 ml / m ib hnub ob zaug thiab hemostatic "Vikasol" los yog "Dicynonum" ntawm rooj 1. 3 lub sij hawm ib hnub twg.

Rau qhov mob nyem tom qab phais tsa uas tsis yog-narcotic analgesics, "Analgin", "Baralgin", "maksigan".

Qhov zoo ntawm cov hysteroscopy

1. Nyob rau hauv no txoj kev, qhov kev xeem yuav tau tsim kom muaj qhov xwm ntawm endometrial pathology.

2. Qhov no yog qhov method enabling kev soj ntsuam ntawm lub ncauj tsev menyuam, lub tsev me nyuam thiab isthmic department.

3. Hloov laparotomy nkag tau mus rau hysteroscopic uterine.

4. Tso cai rau cov lag luam ua visually saib xyuas.

5. Qhov no yog ib tug yooj yim, tsawg-tej yam thiab mas tuav txoj kev.

6. Ib qho yooj yim mus nqa cov neeg mob.

7. Nyob hauv lub tsev kho mob yog txo.

Nyob rau dab tsi hnub ntawm lub voj voog tsis hysteroscopy npaj?

Nws yog nyob ntawm seb koj npaj rau hysteroscopy. Yog hais tias npaj, txhua yam yuav yog nyob ntawm seb muaj sia yam ntxwv ntawm cov poj niam. Feem ntau cov feem ntau ntau yog cov follicular theem ntawm lub cev ntas thaum lub endometrium yog cia li pib mus rov qab los ntawm cov rejection. Nws yog nyias nyob rau hauv lub sij hawm no, yog li cov kab noj hniav ntawm lub tsev menyuam yog yooj yim pom. Yog li ntawd hysteroscopy feem ntau ua rau 7-9 hnub los ntawm qhov pib ntawm poj niam.

Nyob rau dab tsi hnub ntawm lub voj voog ua hysteroscopy thaum muaj xwm ceev?

Thaum muaj xwm ceev version ntawm hysteroscopy tsis hnub voj voog. Tab sis lub hli tuav tus nqi yog considerably txo, li ntawd, nws yog zoo dua rau refrain los ntawm txoj kev tshawb no thaum lub sij hawm lub sij hawm no.