Zopangira Tubal Ligation Options, Risks, ndi Njira Zina
Ngati mukuganiza zogwiritsa ntchito makapu anu omangidwa-tubal ligation-muyenera kudziwa chiyani? Kodi njira zosiyana zogwiritsira ntchito ndondomeko ziti ndi njira iti yomwe ingakhale yabwino kwa inu? Kodi zingakhale zoopsa zotani? Nanga ndi njira zina zotani zomwe zingapezeke kuti zitha kuchitika nthawi zonse?
Kukhala ndi Ziphuphu Zanu Kumangidwa
Tubal ligation ndi mawonekedwe osatha a kubereka kapena kulera.
Kupeza matayala anu omangidwa ndi njira ina yonena kuti mwakhala ndi tubal ligation. Ndondomekoyi ingathenso kutchulidwanso kuti kubereka kwa amayi kapena kubereka kosatha.
Ziribe kanthu kuti mawuwa amagwiritsidwa ntchito, opaleshoni ya tubal ligation ndi njira yomwe imatsekera mazira anu owonongeka. Mukatha kusungunuka zida zanu, umuna sungathe kudutsa mumtunda wautali kuti umve dzira-kutanthauza kuti simungathe kutenga mimba.
Njirayi kawirikawiri imalimbikitsidwa kwa amayi achikulire omwe ali otsimikiza kuti safuna kutenga mimba m'tsogolo. Pali mafunso ambiri oyenera kuwasankha posankha kulera , koma kwa amayi omwe atha kukhala ndi ana, tubal ligation ndiwotchuka kwambiri chifukwa chokhala bwino komanso opanda zotsatira zomwe zingachitike ndi njira zothandizira kulera.
Kodi Ziphuphu Zanga Zimamangidwadi?
Kodi matayala anu amatha kumangirizika kwenikweni pamene muli ndi tubal ligation?
Mwina. Pali njira zingapo zomwe adokotala angasindikizire ma tubes kuphatikizapo:
- Kuwakwapula ndi mphete, kukwapula, kapena zizindikiro
- Kudula ndi kusindikiza motsekedwa ndi magetsi (electrocautery)
- Mangani zikhomo zanu, kuzidula, ndiyeno muziziika kapena kuziika pamagetsi
Kusinkhasinkha za momwe mabotolo anu adzasindikizidwira kungamveke zopweteka, koma ndondomeko imachitidwa pansi pa anesthesia kotero simungamve kalikonse.
Zopangira Tubal Ligation Options
Pali njira zingapo zomwe mungasankhe popita ku njira za tubal ligation, ndipo inu ndi dokotala mungakambirane zomwe mungachite bwino. Dokotala wanu angaganizire zinthu monga kulemera kwa thupi lanu komanso ngati mwachita opaleshoni ya m'mimba kale kapena ayi. Zotsatirazi ndizomwe mungachite pochita opaleshoni zosiyanasiyana kuti mukhale ndi matope anu omangirira:
1. Laparoscopy
Kudzola kwa laparoscopic ndi chimodzi mwa njira ziwiri zomwe zimagwiritsidwa ntchito popanga matayala ndipo nthawi zambiri zimakhala pansi pa anesthesia (mumagona mu chipinda chogwiritsira ntchito.) Panthawiyi, kamangidwe kakang'ono kamapangidwira mkati kapena pafupi ndi mimba yanu. chifukwa cha laparoscope (chida chofanana ndi chida cha telescope ndi kuwala) kuti chilowetsedwe. Gasi ya diyaboni imayidwira kuti ikweze mpanda wanu m'mimba kuchokera m'ziwalo zanu, kuti dokotala wanu awonetsetu mazira anu oponyera. Dokotalayo amatha kugwiritsa ntchito chipangizo china kudzera mu laparoscope kuti asindikize mapepala anu (kapena amangiriza mapapu anu kudzera mumakolo ena ang'onoang'ono). Kenaka zochitikazo zatsekedwa. Njira ya tubal laparoscopy imangotenga pafupifupi 30 minutes. Kaŵirikaŵiri pamakhala kuchepa kochepa, ndipo mwinamwake mudzafika kunyumba tsiku lomwelo.
2. Mini-laparotomy
Kachipangizo kamene kamakhala kotsika kwambiri (tubini ligation) ndi njira yowonjezera yambiri yokhala ndi zida zanu. Azimayi ambiri amatha kuchita izi atangobadwa. Pambuyo pa postpartum mini-laparotomy, dokotala wanu amapanga chotsitsa chaching'ono pansi pa batani lanu. Chifukwa chiberekero chanu chikululukitsidwa kuyambira pakukhala ndi pakati, zida zanu zakuda ziri bwino pamwamba pa chiberekero-chomwe chili pansi pa mimba yanu. Miphika yanu yamtunduwu imatulutsidwa mkati kapena kunja kwa incision ndi kutsekedwa, kenaka kubwezeretsanso mmalo, ndipo incision ikugwedezeka kutsekedwa.
3. Laparotomy (Open Tubal Ligation)
Njira yotchedwa laparotomy (yomwe imatchedwanso tubal ligation) imatengedwa ngati opaleshoni yaikulu-kotero siigwiritsidwa ntchito mofanana monga laparoscopy ndi mini-laparotomy. Dokotala wa opaleshoniyo amachititsa kuti zikhale zazikulu kwambiri (pafupifupi mamita awiri kapena asanu m'litali) m'mimba. Miphika yam'tsogolo idzagwedezeka kapena kulowa kunja, kutsekedwa / kusindikizidwa, ndi kubwezeretsanso. Chombocho chidzasinthidwa kutsekedwa. Kutsegula tubal ligation kawirikawiri kumachitidwa kale kapena pambuyo pa mtundu wina wa opaleshoni ya m'mimba yosagwirizana, monga gawo la Kaisara.
4. Culdoscopy ndi Colpotomy
Culdoscopy ndi colpotomy ndi mitundu iwiri yomwe imagwiritsidwa ntchito panthawi yomwe imawodzera kubereka. Kukhala ndi makapu anu omangirizidwa ndi njira yamaliseche kanali njira yamakono. Koma, popeza culdoscopy ndi colpotomy ali ndi mavuto akuluakulu, opaleshoni ya laparoscopic ndiyo njira yowonjezera yowonjezera ma tubes anu. Dokotala wanu angasankhe kupanga culdoscopy kapena colpotomy ngati muli ochepa kwambiri (kapena mukulemera kwambiri) kapena ngati muli ndi chiberekero choyambitsa matenda (chiberekero chopweteka.) Zonsezi ndizochepa zomwe zimagwiritsidwa ntchito mu khoma lakazi-koma zingakhale zovuta kuchita chifukwa mumayenera kukhala ndi lithotomy (miyendo mumaganizo) pamene muli pansi pa anesthesia.
5. Hysterectomy
Mankhwalawa amachititsa kuti chiberekerocho chichotsedwe ndipo chimatengedwa ngati opaleshoni yaikulu. Mankhwala osokoneza bongo sali njira ya tubal ligation. Koma, chiberekero chanu chitachotsedwa, palibe malo oti dzira likhalepo (kotero simungathe kutenga mimba). Mankhwala osakanizidwa amatha kupyolera mu umuna (ubongo wa hysterectomy) kapena mimba (m'mimba ya hysterectomy). M'mbuyomu, ma hysterectomy nthawi zina ankachitidwa ngati chithandizo chamankhwala pamene tubal ligation ankawoneka ngati zifukwa zachipembedzo.
Ubwino Wopeza Matope Anu Kumangidwa
Ngati mwachita opaleshoni kuti matope anu amangirike, mwinamwake mwalandira chithandizo chapadera cha mankhwala. Kafukufuku akusonyeza kuti kukhala ndi tubal ligation kumachepetsa chiopsezo cha khansa ya ovari koma mpaka 30 peresenti. Ngakhale chifukwa chenicheni cha izi sichikudziwika, pali ziphunzitso zikuluzikulu ziwiri za izi:
- Mukakhala ndi ma-tubes omangirira, magazi omwe mumayambitsa mazira anu amasokonezeka. Izi zingasinthe mahomoni anu, omwe amachititsa kuti chiopsezo cha khansa ya ovari isachepetse.
- Kutsekedwa kwa mazira oyenda mwina kungateteze mazira ochuluka kuchokera ku mawonekedwe a chilengedwe omwe angayambe khansa.
Koma phindu lina la tubal ligation ndi kuti kukhala ndi zida zanu zothandizira kungachepetse mwayi wanu wodwala matenda otsekemera a pelvic (PID). Ngakhale kuti pID ingathe kuchepetsedwa, komabe phokoso lamatenda silipereka chitetezo chilichonse ku matenda opatsirana pogonana .
Ngozi za Tubal Ligation
Mofanana ndi njira iliyonse yopaleshoni, tubal ligation ili ndi ngozi. Mavuto angathe kuthetsedwa m'magulu atatu:
- Zowopsa chifukwa cha ndondomeko yeniyeni: Izi zikhoza kuphatikizapo kutsekedwa kosatha kwa ma tubes (zomwe zimabweretsa mimba mwa amayi amodzi mwa amayi 200), kuvulazidwa ndi ziwalo zozungulira zomwe zimayambitsidwa ndi zipangizo zochizira, komanso kuwonjezeka kwa ectopic pregnancy ngati kutenga mimba kumachitika pambuyo tubal ligation.
- Mavuto okhudzana ndi kugwiritsidwa ntchito kwa anesthesia: Mtundu wa anesthesia wogwiritsidwa ntchito umadalira njira ya opaleshoni yosankhidwa. Tubal ligation ingakhoze kuchitidwa ndi mwina conscious sedation (mawonekedwe a anesthesia kumene mkaziyo akugalamuka, koma momasuka ndi otchera) kapena deep sedation (mankhwala amachiritso ambiri amaperekedwa ndipo mkazi wagona.) Anesthesia akhoza kukhala ammudzi, dera (thupi ali ndi njala kuchokera pamtanda pansi,) kapena wamba (kuphatikiza thupi lonse,)
- Mavuto a opaleshoni ambiri: Zoopsa zambiri za opaleshoni zimaphatikizapo matenda ndi magazi.
Zimene muyenera kuyembekezera
Azimayi ambiri amatha kubwerera kuntchito masiku angapo atakhala ndi tubal ligation. Mankhwala opweteka angathandize kuthetsa vuto lililonse. Ndikoyenera kuti amayi azipewa masewera olimbitsa thupi kwa masiku angapo. Kawirikawiri, amayi ambiri amamverera kukonzekera kugonana kachiwiri mkati mwa sabata.
Ambiri mwa amayi amapezanso njirayi popanda mavuto. Mosiyana ndi kuperekera kwa abambo (vasectomy), palibe mayeso omwe amayenera kuti awonetsetse kuti alibe mphamvu.
A tubal ligation siimachepetsa chisangalalo cha kugonana komanso samakhudza chikhalidwe chake. Popeza palibe zikopa kapena ziwalo sizichotsedwa kapena kusintha ndipo mahomoni onse adzapangidwanso, tubal ligation sayenera kusintha kugonana kapena kusokoneza ntchito ya ziwalo zogonana zazimayi.
Ndalama
Ndalama ya nthawi imodzi ya tubal ligation, poyerekeza ndi njira zina zothandizira, zingakupulumutseni mazana madola pakapita nthawi. Mtengo wokhala ndi tubal ligation ukhoza kukhala pakati pa $ 1,000 mpaka $ 3,000, koma ukhoza kukhala wapamwamba ngati muli ndi vuto lililonse. Mayi ayenera kufufuza chithandizo cha inshuwalansi monga momwe chithandizo cha kubereka chimaonekera. Inshuwalansi ya zachipatala ndi zapadera zokhudzana ndi thanzi zingawononge mtengo wa tubal ligation.
Mphamvu
Tubal ligation ndi oposa 99 peresenti ogwira ntchito. Ndalama yaing'ono yolephera imapezeka chifukwa nthawi zina mazira amatha kubwereranso okha. Ngati mimba ikuchitika pambuyo pa tubal ligation, pali 33 peresenti yokhala ectopic pregnancy. Komabe, mlingo wonse wa mimba ndi wochepa kwambiri, kuti mwayi wamayi wokhala ndi pakati pa ectopic mimba ndi wotsikirapo kuposa momwe angaperekere kuti alibe tubal ligation yoyamba.
Tubal Ligation Reversal
Mayi amayenera kuganizira ngati ayi kapena tubal ligation (njira yowonjezera yowonjezera) ndiyo njira yabwino kwambiri kwa iye. Ngakhale ataganizira mosamala, amayi ena omwe ali ndi tubal ligation amatha kudandaula chifukwa cha chisankho chawo. Mzimayi amadzimva chisoni kuti matope ake amangiriridwa ngati:
- Iye ali wamng'ono
- Ali ndi ana ochepa kapena opanda
- Iye anasankha njira iyi osati chifukwa iye ankafuna izo koma chifukwa mnzakeyo ankafuna kuti izo zichitike
- Anaganiza pa tubal ligation chifukwa adakhulupirira kuti idzathetsa mavuto azachuma kapena amaganiza kuti njirayi ingathandize kuthetsa mavuto a ubale
A tubal ligation sayenera kuganiziridwa ngati kanthawi. Nthawi zina kusintha kwa tubal kungathe kuchitika ngati mkazi atasankha kuti akufuna kutenga pakati. Komabe, kusintha kwa tubal ndi njira yayikulu yopaleshoni yomwe siimabweretsa mimba nthawi zonse. Pafupifupi 50 peresenti mpaka 80 peresenti ya amayi omwe ali ndi matayala awo amatha kutenga mimba.
Njira Zowonongeka Zosatha
A tubal ligation ingakhale njira yabwino kwambiri yothetsera kubereka kosatha, ndipambana kwambiri popewera mimba. Zili ndi ubwino wowonjezera wa kuchepetsa chiopsezo chanu cha khansa ya ovari kapena matenda otupa.
Izi zinati, sikuti aliyense akufuna kuchita izi komanso zoopsa (ngakhale zing'onozing'ono) za opaleshoni ndi anesthesia ambiri.
Pali njira zambiri zothandizira kubereka nthawi ngati zili choncho. Palinso njira ziwiri zazikulu zosatha. Chimodzi, ndi vasectomy . Poyerekezera mutu ndi mutu, vasectomy imakhala ndi chiopsezo chachikulu kuposa tubal ligation, koma amuna ena safuna njirayi chifukwa cha zifukwa zingapo.
Kwa amayi, pali njira ina yopanda chithandizo yopanda chithandizo yomwe imatchedwa Kufunika . Ndondomeko yofunika (yomwe imatchedwanso kuperewera kwachitsulo) ndi njira imene zing'onozing'ono zowonjezera zitsulo zimayikidwa kudzera m'chiberekero ndikulowa m'matope kuti azimitse. Njira yowonjezera yakhala ikuzungulira kuyambira 2002, koma sikupezeka paliponse pamene madokotala akufunikira chidziwitso chapadera kuti achite. Kuyambira mu November 2016, Cholinga chimakhala ndi chenjezo lotetezedwa kuti liwonetsetse kuti anthu aphunzitsidwa za ngozi zomwe zingachitike komanso njira zina.
Kuwunikira Kuyerekezera Njira za Tubal Ligation Njira
Silikuwoneka kuti pali kusiyana kwakukulu kwa kapangidwe ka laparoscopy, lapartomy, kapena hysteroscopy ponena za kupambana ngakhale kufunika kobwereza njira kungakhale kwakukulu kwa iwo omwe ali ndi ndondomeko yofunika.
Pansi pa Njira za Tubal Ligation
Pali njira zosiyanasiyana zomwe tubal ligation ingagwirire, ndipo chisankho chabwino kwa inu ndi chofunika kuti mukambirane mosamala ndi dokotala wanu. Njira yabwino idzadalira pazifukwa zambiri, monga ngati muli ndi pakati pano, mwakhala mukuchitidwa opaleshoni ya m'mimba, ngati muli olemera kwambiri, kapena muli ndi chiberekero chosasunthika. Ngakhale kuti tubal ligation ikhoza kukhala ndi phindu lachiwiri, monga chiopsezo chochepa cha khansa ya ovari, pali zina zomwe mungachite kuti mukhale ndi mphamvu zobereka.
> Zotsatira:
> Antoun, L., Smith, P., Gupta, J., ndi T. Clark. Mpata, Chitetezo, ndi Mphamvu ya Kutsegula Kwasakaniza Kwambiri Kuyerekeza ndi Kutsegula kwa Laparoscopic. Journal American Obstetrics ndi Gynecology . 2017 July 27. (Epub patsogolo pa kusindikiza).
> Jokinen, E., Heino, A., Karipohia, T., Gissler, M., ndi R. Hurskainen. Chitetezo ndi Mphamvu za Women Tubal Oyambitsa Madzi ndi Hysteroscopy, Laparascopy, kapena Laparotomy: Register Yochokera Phunziro. BJOG . 2017 May 2. (Epub patsogolo pa kusindikiza).
> Mpunga, M., Murphy, M., ndi S. Tworoger. Tubal Ligation, Hysterectomy ndi Khansa ya Ovarian: A Meta-Analysis. Journal of Ovarian Research . 2012. 5 (1): 13.
> Utsogoleri wa US Food and Drug Administration. Sungani Njira Yowonongeka Kwamuyaya ndi Bayer Healthcare: FDA Chidziwitso - Kusinthika kwa Mabaibulo. 11/15/16. https://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm529241.htm