Kuchita Opaleshoni Kaŵirikaŵiri Yopeza 'Matope Akumangiriridwa'
Mayi-laparotomy (omwe amadziwikanso ngati kamphanga kakang'ono) ndi imodzi mwa njira zitatu zomwe zimagwiritsa ntchito tubal ligation . Mitundu iyi yopangira opaleshoni yopaleshoni nthawi zambiri imatchedwa "kukhala ndi zida zanu zomangidwa." Njira zina zimaphatikizapo laparotomy ndi laparoscopy .
Kapepala kakang'ono ndi mawonekedwe ochepa a laparotomy. Zimaphatikizapo kutengeka kochepa ndipo zimachitika panthawi yomwe akubereka.
Laparotomy, mosiyana, imagwira nthawi iliyonse ndipo imafuna kutengeka kwakukulu chifukwa ziphuphu zazing'ono sizingatheke.
Njira yachitatu, laparoscopy, ndi njira yopaleshoni yopangira opaleshoni yomwe imagwiritsidwa ntchito kudzera mu khoma la m'mimba kupyolera mu kapangidwe kake. Ndi njira yowonongeka yochepa yomwe ingathe kuchitidwa panthawi yopuma.
Kuyerekezera Mini-Laparotomy ndi Laparoscopy
Kapepala kakang'ono kamakhala kachitidwe kaŵirikaŵiri kamene kamadziwika kuti ndi kotetezeka komanso koyenela kuteteza mimba yam'mbuyo mtsogolo mwa kuletsa mazira a mkazi kuti asakumane ndi mazira ake omwe amamera.
Zimapindulitsa kangapo pa laparoscopy chifukwa zimafuna zipangizo zochepa zochepa, luso losachita, ndipo likhoza kuchitidwa kuchipatala mwamsanga mutangobereka kapena musanamasulidwe. Kawirikawiri, imachitidwa mkati mwa maola 48 akubeleka.
Zovuta zochokera pa galimoto yazing'ono zimakhala zochepa kwambiri kuposa za laparoscopy, koma, muzochitika zonsezi, sizikhala zochepa. Ngati izo zimachitika, zimakonda kugwirizanitsidwa ndi mimba yokha osati njira.
Momwe Mini-Laparotomy Imagwirira Ntchito
Madokotala ambiri opaleshoni amakonda kupanga tubal ligation patangotha kubadwa kumene.
Izi ndi chifukwa chakuti muli kale m'chipatala, ndipo khoma lanu la m'mimba limasuka. Kuwonjezera apo, mimba imatulutsa chiberekero chapamwamba pafupi ndi batani pamimba kumene makinawo angapangidwe. Izi zimapangitsa kuti mukhale ovuta kuzipata zamatope.
Kwa laparotomy, mudzapatsidwa ngati anesthesia wamba kapena wachigawo (omwe amawoneka ngati epidural). Kuchita opaleshoni kudzachitidwa motere:
- Dokotala wa opaleshoniyo amapanga chitsulo chochepa koma chooneka pansi pa umbilicus.
- Miphika yam'tsogolo idzachotsedwa ndi kutuluka mu incision.
- Miphikayi idzabwezeretsedwanso mmalo mwake ndipo chitsulocho chimatsekedwa ndi zikhomo.
Amayi ambiri amachira masiku angapo kapena kutalika ngati mankhwalawa ndi aakulu. Mavuto siwowonjezereka koma angaphatikize matenda (mkati ndi malo osokoneza) komanso kulekanitsa mavayala omangidwa.
Kuopsa kwa Mimba Kutengera Mini-Laparotomy
Zomwe zimakhala zovuta kuti munthu akhale ndi pathupi pambuyo pa tubal ligation ndi 1.2 / 1,000 m'nthawi yoyamba mpaka zaka ziwiri ndi 7.5 / 1,000 kupitirira zaka zisanu ndi ziwiri mpaka 12, kotero zimatengedwa njira zothandiza zowonetsera. Ngakhale kuti vutoli liri lochepa, mayi akhoza kutenga mimba pambuyo pa laparotomy ngati zotsatirazi zikuchitika:
- Kuchita opaleshoni kumalephera kutsekera njira imodzi kapena ziwiri zonsezi.
- Mipira yamakono imakula mmbuyo palimodzi.
- Kubwezeretsa kumapezeka, kumapanga mapangidwe atsopano omwe amalola dzira ndi umuna kukumana.
- Mkaziyo anali atakhala ndi pakati pamene opaleshoniyo inkachitika.
Kutenga mimba pambuyo pa laparotomy kumawonjezera chiopsezo cha ectopic mimba, chikhalidwe chimene mwanayo amakula kunja kwa chiberekero (chomwe chimapezeka makamaka mu khola lamagulu).
Ectopic pregnancy ndi matenda aakulu ndipo, ngati osasamalidwa, amatha kutaya phokoso lamkati, kutuluka m'magazi, kusokonezeka, ngakhale imfa. Zizindikiro zimaphatikizapo kuchepa kwa msambo, magazi a m'mimba, kupweteka kwa mutu, kupweteka kwa m'mimba, ndi ululu wamimba kapena ululu wamimba.
Eptpatic ectopic pregnancy imaonedwa ngati yowopsa mwachipatala yomwe ikusowa kusamalidwa mwamsanga.
> Zotsatira:
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> Moss C, Isley MM. "Kutsekemera: Kubwereza ndi Kukonzanso." Zipatala za Amuna ndi Amayi a ku North America . 2015; 42 (4): 713-24. lembani: 10.1016 / j.ogc.2015.07.003.
> Patil E, Jensen JT. Sinthani pa Zomwe Mungasankhe Pakati pa Akazi. Malingaliro amasiku ano mu Obstetrics ndi Gynecology. 201527 (6): 465-470; lembani: 10.1097 / GCO.0000000000000213