Ukuvunguza kwama-hormonal yikhambi elizogcina izinkinga eziningi

Ukuvunguza kwe-hormonal kuyindlela yokukhulelwa. Isetshenziselwa ukuvimbela ukukhulelwa, kodwa ingabuye ibe nomphumela wokwelapha. Ake sicabangele ngokuningiliziwe loluhlobo lwe-intrauterine yokukhulelwa, izinhlobo zalo, indlela yokufaka kanye nezici zokusetshenziswa.

Ingabe wonke ama-spirals ama-hormonal?

Ezinsini zokubeletha, phakathi kwezinqubo zokukhulelwa kwe-intrauterine, kunezinhlobo eziningana zemiklamo. Nokho, akuwona wonke ama-hormonal. I-spiral ngokwayo, ngenxa yesimo sayo, ingavimbela ukuqala kokukhulelwa. Ama-IUDs angama-hormone akuyona nje isivinini somshini samagciwane wesilisa omzimba, kodwa futhi akhipha ingxenye ye-hormonal eqhubekayo. Ngaphansi kwesenzo salesi sici, kunezinguquko zesakhiwo ku-endometrium ye-uterine, ngenxa yokuthi imuphi umklamo awunakwenzeka.

Yiziphi izinhlobo ze-IUDs ezikhona?

Phakathi neminyaka, izinhlobo zeNavy ziye zathuthukiswa. Kulezi zifo zemizimba yesimanje, izizukulwane ezintathu ze-intrauterine zisetshenziswa:

1. Inert (isizukulwane sokuqala). Lezi zindilinga zenziwe ngepulasitiki, echaza izindleko zabo eziphansi. Umthelela wabo wokuvimbela ukukhulelwa utholakala ngokudala isithiyo eqenjini elikhulelwe - alikwazi ukufakwa. Lolu hlobo lwemiklamo engasetshenzisiwe futhi, ngenxa yomphumela omncane, izinga eliphezulu lokuxoshwa (ukuwa kwe-spiral), izinqubo ezivame ukuvuvukala.
2. Izindwangu ezinezinsimbi (isizukulwane sesibili). Ekuqaleni, i-IUD yenziwe ngokuqukethwe kokuthutha. Le nsimbi ine-anti-anion effect - ivimbela inqubo evamile yokufakelwa kweqanda le-fetal. Isisekelo sokuvuthwa yisihlaka sepulasitiki, okusizungeze ucingo oluncane lensimbi. Kamuva baqala ukusebenzisa isiliva negolide njengezinsimbi. Lokhu kwanciphisa ingozi yokuvuvukala esibelethweni, kwandisa ukusebenza kwe-agent kanye nokuphila kwesikhathi salezo zi-IUD.
3. Ama-hormone-aqukethe (isizukulwane sesithathu). I-Progestin-levonorgestrel ikhona ekubunjweni kwalokhu. Isici esivelele salezi zi-IUDs cishe ngu-100% umthelela wokukhulelwa. Ngaphezu kwalokho, la madivaysi ngokuvamile asetshenziselwa izinqubo zokwelapha, ngezifo zesifo somzimba ezibangelwa ukwephulwa kwesizinda se-hormonal.

Ukuvunguza kwe-hormonal - izinkomba

I-spiral intrauterine hormonal efakwe isicelo sesifazane uqobo. Nokho, ingasetshenziswa odokotela, ngezifo ezithile. Ngaphambi kwesicelo, kwenziwa ucwaningo, oluhloswe ekuqedeni izidakamizwa ezibulalayo ohlelweni lokuzala. Phakathi kwezifo nokuphazamiseka lapho kuvunguza khona ama-hormonal, kubalulekile ukuhlukanisa:

• i-endometriosis ;
• ingozi ye- endometrial hyperplasia ;
• i-menorrhagia ;
• i-oophorectomy yamazwe amabili (ukususwa kwama-ovari);
• ukukhishwa esikhathini sokuphuza kakhulu.

Imibala ye-hormone e-endometriosis

Ukuvuthwa kwe-hormonal yokwelashwa kwe-endometriosis kungenziwa kunqunywe ngezwi elizwakalayo, i-lesion enkulu yezingqimba zangaphakathi zesisu. Okuqukethwe ku-analogue ye-progesterone, kususa ngokugcwele ukuthuthukiswa okuqhubekayo nokwanda kwezilonda ezintsha emgodini we-uterine. Lokhu kusiza ukuvimbela ukuthuthukiswa kwezinqubo zokuvuvukala ngokumelene nesizinda se-endometriosis. Uma ukuvunguza kwe-hormone kusetshenziselwa i-endometriosis isikhathi eside, odokotela bavame ukulungisa ukuthambekela okuhle okuzoqhubeka nokuphumula, njengoba kuboniswe yi:

• ukunciphisa emtheni wegazi lokuya esikhathini;
• ukunciphisa ukucindezeleka kokuya esikhathini ;
• ukujikeleza ngokujwayelekile.

Ukuvunguza kwe-hormonal nokuya esikhathini sokuya esikhathini

Ukusetshenziswa kwe-intrauterine nge-hormone injection ingasetshenziselwa ukusetshenziswa futhi ngesikhathi sezinqubo zokumisa. Lesi sikhathi sihambisana nokunciphisa ukuhlanganiswa kwama-hormone ocansi emzimbeni wesifazane. Ukusetshenziswa kwe-spiral kusiza ukulinganisa ukuhlushwa kwe-estrogens ne-progesterone. Nsuku zonke i-IUD inikeza i-20 mg ye-levonorgestrel. Lesi sici sithinta ngokuqondile uhlaka lwangaphakathi lwesibindi, lwandisa isilinganiso se-epithelization yayo. Ngesikhathi esifanayo, ukuvunguza akuphazamisi izigulane zocansi, kodwa kugcwalisa ukungabi khona kwehomoni okwenziwa yibo.

IUD contraindications

Njenganoma yimiphi imithi, ukuvunguza kwe-hormonal kunezinkinga zayo (i-hormonal contraceptive spiral). Ngaphambi kokufakwa kwalo, ukubonisana kanye nokuhlolwa kwesiguli sezifo zomzimba kuyadingeka. Ngokusekelwe emibhalweni yokuhlolwa, udokotela ukhetha ukuthi ingabe idivayisi ye-intrauterine ingafakwa, lokho okushiwo yi-contraindications okulandelayo:

• isikhathi sokukhulelwa noma ukusola;
• izinqubo zezinto eziphilayo zezinhlelo zokuzala, okuyizinto ezizalelwa zona;
• izinqubo ezivuthayo ezivuthayo nezindabuko zesistimu yokuzala;
• ukutholakala kwezifo zocansi;
• ukuphuma egazini lomzimba we-etiology engaziwa.

Lokhu ukwephulwa kuyizingqinamba ngokuphelele. Ngakho-ke ababelethisi bezinkinga zokubeletha bahlukanisa futhi:

• ukuvuvukala nokutheleleka kwezingxenye zokusebenza esikhathini esidlule;
• izikhathi ezibuhlungu;
• ukuhamba esikhathini eside ;
• izinqubo ezingenasisekelo kwi-endometrium;
• ukuthuthukiswa kwesibeletho kanye nemikhuba yaso (i-saddle, ama-two-horned);
• ukukhubazeka komlomo wesibeletho;
• i-anemia kanye nezifo zegazi;
• isisu somsele wesibeletho;
• i-myoma encane;
• ukuxoshwa ngokuzenzekelayo kwe-IUD ku-anamnesis.

IUD - isicelo

I-hormonal contraceptive spiral asiza nje ukuvimbela ukukhulelwa okungadingeki, kodwa futhi ukubuyisela uhlelo lokuzala. Ngenxa ye-hormone eyimfihlo, umsebenzi wesibeletho kanye nemikhiqizo ejwayelekile ijwayelekile. Nsuku zonke i-spiral ifihla into, efana nesakhiwo se-progesterone. Ngaphansi kwesenzo salesi sakhi:

• kuthuthukisa ukubuyiselwa kwe-endometrium ye-uterine;
• umjikelezo wesimiso ujwayelekile;
• nyanga zonke zinciphisa ivolumu kanye nobude bawo.

Intrauterine Kuvunguza - kanjani ukubeka?

Ngaphambi kokusungulwa kwedivaysi ye-intrauterine, lona wesifazane kuyodingeka ahlolwe. Ukuhlolwa okulandelayo kuyimpoqo:

• Ama-smears e-flora wesifazane, i-urethra nesisu somlomo wesibeletho;
• ukuhlolwa kwegazi jikelele;
• I-PCR yezifo zobulili;
• ukuhlaziywa okujwayelekile komchamo;
• I-Ultrasound yezitho zomzimba .

Le nqubo ngokwayo iqhutshwa emathunjini. Ukuguqulwa kwe-algorithm kubonakala kanje:

1. Isiguli sisezihlalo zesisu.
2. Esikhathini sangasese isibuko se-Simpsa sifakiwe, esikhombisa intamo.
3. I-vagina nesifunda somlomo wesibeletho zenza i-antiseptic.
4. Ngosizo lwe-bullet bullet, udokotela wenza isilungiselelo somlomo wesibeletho futhi uyalinganisa ubude besibeletho.
5. Emgodini womlomo wesibeletho, kuqhutshwa umqhubi, ofika emgodini wesibeletho.
6. Ukucindezela i-piston ye-plastiki, phonsa i-spiral ukuze ihlale emahlombe ngaphansi kwesibindi.
7. Umqhubi uyasuswa ngokucophelela, ingxenye yezintambo ezivulela ngaphakathi kwesiswini inqunywe, futhi isiza ukulawula ukutholakala kwe-IUD esibelethweni.

Inqubo yonke ayithathi imizuzu engaphezulu kwemizuzu. Ngemuva kokufakwa, udokotela ekhadini lokuphulukisa iziguli ulungisa isikhathi nosuku, ubonisa uhlobo lwe-spiral, ukwazisa isiguli isikhathi sokusebenza kwayo. Ngemuva kwezinsuku ezingu-10, ukuvakashelwa kokulawula kuhlelelwe. Izinsuku ezingu-14 emva kwenqubo, kunconywa owesifazane:

• ukugwema ukulala ngokocansi;
• Gwema ukuphakamisa izisindo;
• ungathathi okugeza okushisayo;
• ungasebenzisi amathoni wokuhlanzeka.

Ukususwa kwedivayisi ye-intrauterine

Emva kokufakwa kwe-hormone yokuvunguza, owesifazane angakhohlwa ngemithi yokwelapha ngomlomo nangokwemishini isikhathi eside. Isikhathi sokusetshenziswa kwe-IUD sineminyaka engama-5. Nokho, ukususwa kwe-spiral kungenziwa ekuqaleni, uma owesifazane ethatha isinqumo sokukhulelwa ingane. Inqubo yenziwa kungakhathaliseki ukuthi usuku luni lokuya esikhathini. Ngokuvamile, ukukhwabanisa kunqunyelwe izinsuku zokuqala. Emva kokukhipha, uhlelo luhlolwa, ngaphandle kokushiya kwesakhi se-hormonal emgodini we-uterine.

I-hormonal spiral - imiphumela emibi

Isibeletho sivame ukuphendula kabi ngokusungulwa komzimba wezinye izizwe, okuyi-IUD. Ngemuva kokufakwa kwedivayisi ye-intrauterine, imiphumela emibi kwabanye besifazane ivela emahoreni ambalwa. Noma kunjalo, izinkinga zenzeka kaningi, okuwumphumela wenqubo yokufaka uqobo:

• ukuhlukunyezwa komlomo wesibeletho;
• ukuguqulwa komsele womlomo wesibeletho kanye nezicubu zesisu;
• ubuhlungu obukhulu ngokuya esikhathini;
• ukukhathazeka ngesikhathi sokulala;
• ukuxoshwa okuzenzekelayo (ukwehla kwe-IUD);
• ukwephulwa komjikelezo wokuya esikhathini - ukwandisa kokuya esikhathini, isikhathi eside;
• i-adnexitis kanye ne-endometritis ngemuva kokususwa kwe-spiral.

Imibala ye-hormonal - amagama

Ukukhuluma ngokuthi yikuphi ukuvunguza kwe-hormonal kukhona, kufanele kuqashelwe ukuthi wonke la ma-IUD aqukethe i-hormone ekubunjweni. Okuvamile phakathi kwezidakamizwa ezinjalo emakethe yemithi yizo:

• I-Mirena (ukukhiqiza ukukhishwa, i-Germany);
• Levonov (ukukhiqizwa kweLeiras, Finland).

I-spiral yama-hormonal - izinzuzo nezingozi

Ngokuvamile, abesifazane baya ku-gynecologist ngombuzo mayelana nokuthi yini engcono kune-IUD noma amaphilisi e-hormonal asetshenziselwa ukukhulelwa. Kulolu daba, udokotela uthi akukho ndlela enhle, ngakho owesifazane kufanele asebenzise okufanelekayo kuye. Phakathi kwezinzuzo zama-spirals:

• isikhathi eside sokusetshenziswa;
• ukungabi nokuzithiba;
• ukululama okusheshayo komsebenzi wokuzala ngemva kokuhoxisa ukukhishwa;
• ukuqala komphumela ngokushesha ngemva kokufakwa;
• umphumela wokwelapha.

Ukunciphisa amantombazane eNavy ukubhekisela:

• ingozi eyengeziwe yokukhulelwa kwe-ectopic;
• ukulahlekelwa ngokuzenzekelayo kokubeletha;
• ingozi eyengeziwe yokutheleleka ngokocansi;
• ivolumu ekhulayo, isikhathi sokuphuma esikhathini sokuya esikhathini;
• isidingo sokhetho olulodwa.