Ukusebenza okunjalo, njengokususwa kwesibeletho, kuyindlela ejwayelekile yokwelapha izifo ezithile zesifo somzimba. Iqhutshwa esibhedlela, futhi ukuqaliswa kwayo kulandelwa isigaba eside sokulungiselela. Cabanga ngalokhu kungenelela, izinhlobo, izindlela, izinkinga ezingenzeka kanye nemiphumela ngemuva kokususwa kwesibeletho.
Ukususwa kwesibeletho - izinkomba zokuhlinzwa
I-Hysterectomy yesibeletho - okuthiwa umsebenzi wokukhipha isitho sobulili besifazane. Kuqhutshwa kuphela ebufakazini, okungabaningi. Phakathi kokuvamile kubalulekile ukuphawula:
- izinqubo ezimbi embelethweni;
- i-oncology yomlomo wesibeletho;
- i-fibroids yama-uterine , ngamasayizi amakhulu amasonto angama-12 okukhulelwa;
- ukukhula okusheshayo kwesisu - ngonyaka ngezinyanga ezingu-4 zokukhulelwa nokuningi;
- i-necrosis ye-node ye-myomatous;
- i-menorrhagia eyinkimbinkimbi yegazi legazi;
- i-adenomyosis ye- 3-4 degrees;
- ama-syndromes ubuhlungu obungapheli emphethweni omncane;
- ukuphefumula kwesibeletho ;
- i-endometriosis ngaphandle kokuthuthukiswa ngemuva kokuthola ukwelashwa okunamandla (okudakamizwa), ukuhlunga.
Izindlela zokususa isibeletho
Lapho kwenziwa ukungenelela okuhlinzekwa, izindlela ezihlukahlukene zokususwa kwe-uterine ziyasetshenziswa. Ukuzikhethela okwehlukile kuxhomeke kuhlobo lokuphulwa, ubukhulu besithandwa segciwane lesandulela ngculazi kanye nezinto zalo zokusebenza. Ngokusekelwe emiphumeleni ye-ultrasound, odokotela banquma ukusebenzisa lokhu noma leyo nqubo. Ngokuvamile, ukususwa kwesibeletho kuhlangene nokuziqhenya kwezicubu eziseduze. Kuye ngomsindo wokusebenza okwenziwe, bahlukanisa:
- i-subtotal;
- inani;
- i-pangysterectomy;
- kakhulu.
Ngaphezu kwalokho, kuye ngokuthi indlela yokufinyelela kwilungu lokubeletha ngesikhathi sokuhlinzwa, i-hysterectomy ingaba:
- i-laparotomic - isibeletho sisuswa ngokushaywa kwesisu;
- ukususwa kwesibeletho ngendlela ye-laparoscopic - usebenzisa idivayisi ekhethekile, ngokusebenzisa izimbobo ezincane edongeni lomzimba;
- ubulili - ukufinyelela kwesibindi esithintekayo kungenxa yesifazane.
I-hyptotal hysterectomy yesibeletho
I-hyterectomy e-subtotal yenziwa lapho kungenzeka khona ukulondoloza umlomo wesibeletho, le ngxenye yesitho sobulili ayithintekile. Ukuxhaphazwa kwenziwa ukuze kuncishiswe isikhathi sokungenelela kokuhlinzwa emzimbeni omkhulu we-pathology extragenital. Kule ndlela, ukuhlinzwa kubuye kusetshenziswe ku-endometriosis ye-pelvic, evezwe yinqubo yenkampani ku-pelvis encane. Ngama-pathologies anjalo, ingozi yokulimala ku-ureter iyanda. Izinkomba zalolu hlobo lokungenelela kokuhlinzwa yizi:
- ukungabikho kwe-pathology ye-appendages;
- Ukuba khona kokuhamba okwanele kwesibeletho;
- ukwehluleka kwesifazane ;
- ubukhulu be-neoplasm abudluli ubukhulu be-fetus emavikini angu-12 wokubeletha;
- ukutholakala kwensimu yokuhlinzeka eyanele.
Ingqikithi ye-hysterectomy
Lolu hlobo lwezokwelapha oluvame ukubizwa ngokuthi ukukhipha kwesibeletho. Le ndlela ingenye yezinhlobo ezivame kakhulu ze-hysterectomy. Ukufinyelela esithombeni kuyatholakala ngokuvula isikhumba esiswini. Kulo msebenzi, lesi sizalo sisuswe, uma kungekho isifo esikhwameni, le ngxenye ishiywe. Ngesikhathi esifanayo, i-ectomy ye-tublopian tubes nama-ovaries yenziwa. Ukwelashwa okubuyisela emuva ngemuva kwe-hysterectomy ephelele kuhilela ukusebenzisa amahomoni ngaphambi kokuqala kokuya esikhathini .
Ukususwa kwesibeletho nge-appendages
Ukwenza ukuhlinzwa okunjalo okuphambili kulandelwa isifundo esikhethekile. Ibizwa ngokuthi i-hysterosalpingography-ukuthi yini, iziguli azimele, ngakho zibuza udokotela. Ngalolu cwaningo, ukuxilongwa kwezigubhu ze-fallopian kwenziwa. I-agent ehlukile yokuphambene isethulwa. Khona-ke uchungechunge lwezithombe ze-X-ray lithathwa.
Uma inqubo yomdlavuza itholakele kumatayipi futhi isakaze ezithombeni nasezikhungweni eziseduzane, lesi sizalo sisusiwe. Ukufinyelela esithombeni esithintekile kungenxa yodonga lwesisu noma yangaphakathi kwesisu. Ngenxa yokuthi iziguli asebekhulile azibekezeleli imisebenzi enkulu, odokotela abahlinzayo ngokuvamile bakhetha uhlobo lwesisu. Kulesi simo, ususwe ngokuphelele lesi sibeletho nezinsimbi - izigulane zobulili, amashubhu.
Hysterectomy enamandla
Ukwelashwa kokususwa kwesibeletho salolu hlobo kwenziwa ngomonakalo omkhulu ohlelweni lokuzala. Basebenzisa kuwo izicubu ezimbi ze-pelvis encane, nge-metastases eminingi. Ukusebenza kuhilela ukususwa kwesibeletho kanye nezinsimbi zomzimba, ingxenye yesithathu yesifazane, amafutha omzimba, ama-lymph node zesifunda. Ngokuvamile, lolu hlobo lwezokwelapha lusetshenziswa ngemuva kwezinqubo eziningi ezizenzekelayo. Ngemuva kokwelashwa okunjalo, owesifazane ulahlekelwa ngokuphelele uhlelo lokuzala, oludinga ukwelashwa kwe-hormone.
Ukususwa kwesibeletho - isikhathi se-postoperative
Ngemuva kokuhlinzwa ukukhipha isisu, owesifazane kufanele agcinwe okungenani amahora angu-24 wokulala, kungakhathaliseki uhlobo lokufinyelela (kwesisu noma kwesisu). Ekupheleni kwalesi sikhathi, odokotela bavunyelwe ukuvuka kancane bese behamba. Lokhu kusiza ukwandisa ama-intestinal peristalsis, kungafaki izinkinga ezifana ne-paresis. Ngesifo esibi kakhulu, imithi ye-analgesic imisiwe. Ukuvimbela ukutheleleka, ukwelashwa kwe-antibiotic kwenziwa.
Ngokufanayo, ama- anticoagulants angabekwa. Lezi zidakamizwa zivimbela ukuthuthukiswa kwezinkinga ezifana nokuphuma kwangaphakathi. Uma ukuvuselelwa kudlula ngokushesha futhi kungabi nzima kunoma iyiphi indlela, emva kwezinsuku ezingu-8-10, ukususwa kwezingxenye zangaphandle kwenziwa. Uma ukusebenza kwenziwa nge-laparoscopic indlela, isiguli sivunyelwe ukuvuka emva kwamahora angu-5-6, futhi ukukhishwa kwenziwa izinsuku ezingu-3-5. Okuphoqelekile esikhathini sokuqala ngemuva kokusebenza ngemuva kokugubha ukudla okuyisidlo nokudla okuketshezi ukusekela isitulo.
Izinkinga emva kwe-hysterectomy
Izinkinga emva kokususwa kwesibeletho kungenxa yokungahambisani nenqubo yokuhlinzwa, ukwehluleka ukuhambisana nezincomo zezokwelapha. Uma kusenesikhathi sokuqala emva kwesikhathi sokusebenza lokhu ngokuvamile kuba umphumela wephutha lezokwelapha, ngasekupheleni kwesikhathi (ezinyangeni ezimbalwa) - ukwehluleka ukuhambisana nemigomo nemiyalelo odokotela ngeziguli. Phakathi kwezimo ezinzima, imisebenzi efana nokususwa kwesibeletho esithintekile, yilezi:
- ukuphuma kwangaphakathi ;
- ukwakheka kwe-hematomas;
- ukuphuma kwe-suture postoperative;
- ukulimala ezithombeni eziseduze ngesikhathi sokuhlinzwa - amathumbu, isambiso, izibilini;
- i-thrombophlebitis yemilenze;
- ukuxoshwa kwesisindo;
- ukuxhaswa kwesilonda esilandelayo;
- ukutheleleka kwesinye isisu (umphumela wokugaya isikhathi eside);
- i-peritonitis (ukuvuvukala kwe-peritoneum);
- i-thromboembolism.
Ubuhlungu ngemva kokususwa kwesibeletho
Ubuhlungu ngemva kokudla kwe-hysterectomy kutholakala ikakhulukazi ngaphakathi kwesisu, indawo ye-sutures. Ukumisa ukuhlaselwa ubuhlungu, odokotela bavame ukunikeza iziguli hhayi izidakamizwa ze-narcotic. Ubude be-syndrome yobuhlungu buphansi. Ngokuvamile iziguli zikhononda ngokutholakala nobuhlungu ezinsukwini ezingu-3-4 zokuqala. Ngemuva kwalesi sikhathi, ukwehlisa isisa kungase kuqhubekele endaweni ye-sutures yangaphandle, uma ukufinyelela kwesibeletho kwenziwa ngesisu.
Ukukhishwa ngemuva kokususwa kwesibeletho
Ukulahla okwesibhakabhaka, okubomvu ngemuva kwe-hysterectomy kuvamile. Ziyakwazi ukugcinwa izinsuku ezingu-14 kusukela ngesikhathi sokungenelela kokuhlinzwa. Ukutholakala kwesifo sokuqothula nokukhishwa kwindlela yokuzala emva kwalesi sikhathi kufanele kube isizathu sokuxhumana nomjozi wezifo zomzimba. Lezi zibalo zingase zibonise izinkinga zenkathi yokuthunyelwa kwesikhathi, phakathi kwazo:
- ukuphuma kwegazi;
- inqubo esithathelwanayo ku-pelvis encane.
Ikhansela ngemuva kokususwa kwesibeletho
Isisu ngemva kokususwa kwesibeletho sidinga ukunakwa okukhethekile. Ngenxa yokwehla kwesakhiwo se-muscular, umshini wesisu, ongenakugwenywa ngendlela yokuhlinzwa kwesisu, abesifazane kufanele bagqoke ibhande. Ngokuvamile, le divayisi iphakamisa iziguli ezine-menopausal ubudala eziye zakhulelwa eziningana. Ukukhethwa kwesibonelo kufanele kwenziwe ngumchwepheshe. Bembatha i-bandage nsuku zonke, bephumula kuphela ngesikhathi sokugeza futhi ngaphambi kokulala ubusuku.
Odokotela bayelulekwa ukuba banikeze okwenziwe ngebhanji elenziwe ngezinto zemvelo. Uma usebenzisa, ukungabikho kahle kufanele kube khona. Naka ububanzi bomkhiqizo. Odokotela bakhuluma ngesidingo sokudlulela ububanzi besiqephu nge-bandage ngenhla nangaphansi kwe-1 cm engaphansi (nge-laparotomy ephansi). Ukugqoka kuveza ukulala ngemuva.
Izidakamizwa emva kokususwa kwesibeletho
Imiphi imithi okufanele isithathe ngemuva kokususwa kwesibeletho nokuthi ngabe kuyadingeka yini ukuyisebenzisa inqunywa udokotela oya khona. Ngokuvamile, ngenxa yokususwa kwezingqungquthela ngesisu, kubalulekile ukuthi usebenzise izindlela ze-hormonal ukusimamisa umzimba. Kuyinto edingekayo ikakhulukazi i-hormone replacement therapy kubantu besifazane abangaphezu kweminyaka engama-50 abahlinzwa. Kulokhu, kusetshenziselwa amalungiselelo ase-progestogen ne-estrogen.
Uma imbangela yokususwa kwesibeletho nge-appendages yukuba khona kwezingqimba ezinkulu ze-myomatous, isiguli sinikezwa i-estrogen monotherapy eqhubekayo ngemva kokuhlinzwa. Ukwelashwa kuyinkimbinkimbi, kuhilela ukusebenzisa izinhlobo ezahlukene zemithi:
- amaphilisi okuphatha ngomlomo - Ovestin, Livial, Proginova;
- amafutha kanye nama-gel okusetshenziswa kwangaphandle - i-Estrogel, i-Divigel.
Uma ukususwa kwesibeletho kwenziwa ngenxa ye-endometriosis, ukwelashwa okuyinkimbinkimbi namahomoni, ama-estrogens nama-gestagens ayenziwa. Kulesi simo, izidakamizwa ezifana nalezi:
- IKlyane;
- I-Proginova.
Ukwelapha okufakelwa izidakamizwa ngezidakamizwa ze-hormonal odokotela bayelulekwa ukuba baqale izinyanga ezingu-1-2 ngemuva kokususwa kwesibeletho. Ukwelashwa okunjalo kunciphisa amathuba okuthuthukisa izifo zenhliziyo, isifo sofuba. Noma kunjalo, isinqumo ngesidingo sokusetshenziswa kwayo sithathwa kuphela ngudokotela. Ukuhambisana ngokugcwele nama-aphoyintimenti akhe nezincomo kuqinisekisa inqubo yokutakula ngokushesha.
Ukuphila ngemva kokususwa kwesibeletho
I-hysterectomy ye-laparoscopic ayithinteki isikhathi eside kunoma iyiphi indlela, kodwa ikhulisa kakhulu izinga layo. Abesifazane beqeda izimpawu ezibangelwa yisifo, bakhohlwe ngokuphelele ngesidingo sokukhulelwa. Iziguli eziningi zibika ukwanda kwe-libido. Kodwa ngokuvamile ukuhlinzwa kwenza abesifazane basebenzise ama-hormone isikhathi eside. Ngaphezu kwalokho, kunesidingo sokuhlolwa ngezikhathi kanye nokuhlolwa kwegazi. Inhloso ukuqapha ukwelashwa, ukuphindaphindiwe, uma imbangela yokususwa kwaba yisisu.
Ukususwa kwesibeletho - imiphumela yomzimba
I-Hysterectomy ayibonakali nje kuphela emsebenzini wezinhlelo zokuzala, kodwa nasemzimbeni wonke. Ngemva kokususwa kwesibeletho, imiphumela yomsebenzi ingaba kanje:
- ukwakheka kokunamathela emgodini wesisu;
- ukwakheka kocingo lwe-keloid;
- ukubopha isikhumba endaweni yomcibisholo;
- ukusa esikhathini;
- ukuphazamiseka kwemizimba.
Ukuya ocansini emva kokususwa kwesibeletho
Iziguli eziningi ezenziwa ukuhlinzwa zinesithakazelo embuzweni wokuthi kungenzeka yini ukuthi ucansi ngemuva kokususwa kwesibeletho. Odokotela basabela kahle kulo mbuzo. Ukulala ngokocansi, njengangaphambili, kuzojabulisa - zonke izindawo ezibucayi zigcinwa. Ngokulondolozwa kwama-ovaries bayaqhubeka nokusebenza, bekhipha ama-hormone ezocansi. Kodwa-ke, ubuhlungu, ukungakhululeki ngesikhathi socansi ngeke kukhishwe.
Izinto ezinjalo zingenzeka kubantu besifazane ababeletha isisu (ukonakala kwesifazane) noma i-hysterectomy enkulu - ingxenye yecala lesiswini ihlelwe. Noma kunjalo, le nkinga ingaqedwa, ngenxa yokuthembela nokuqonda phakathi komuntu nomlingani wakhe. Ukulalela izifiso zomlingani, indoda ayijabuli nje kuphela, kodwa iphinde iyihambise kumthandekayo wakhe.