Asherman si syndrome: akpata, mgbaàmà, nkọwa, na ịgwọ

Childlessness na nwunye - ọ bụ otu n'ime ihe ndị kasị mkpa na-elekọta mmadụ nsogbu. Ọkà mmụta sayensị pụtara otu ọrụ nke onye ọ bụla nke nwere nne na nna nke ọma idozi a nke. Otú ọ dị, ịmụ nwa na nnyefe na-bunyere site na nne. Igosi ndị a aga-eme nwere ike isi na-eto nwanyi ahu. Ke akpatre afọ ole na ole ka anyị hụrụ uto nke omumu akụkụ ọrịa na akpasu na infertility. Na mba anyị enyene a na-eduga itie ke ala ala endometritis. Onye nke ya ngosipụta bụ Asherman si syndrome. Ma ime bụ omume na ọrịa a?

daa ọrịa Description

N'okpuru Asherman si syndrome na-ezo aka a-enweghị nchịkwa na ọnọdụ nke akpanwa kpụrụ adhesions. Ha na-eduga na ele mmadụ anya n'ihu ma ọ bụ zuru ezu imperforate ya oghere. The ọrịa nwetara aha ya site na aha Joseph Asherman ọkachamara n'ọrịa ụmụ nwanyị. First syndrome kọwara n'ụzọ zuru ezu na 1894 Genrih Fritch. Na ahụ ike na e ji amụ e nwere ọtụtụ utu aha ndị a na ọrịa: intrauterine adhesions, traumatic atrophy na sclerosis nke endometrium.

Asherman si syndrome na-chọpụtara na ndị inyom n'agbanyeghị afọ ndụ ha na-elekọta mmadụ ọnọdụ. Intrauterine adhesions anọchi anya connective splice, n'etiti nke a solder ahụ mgbidi na-eme ka ha deformation. N'ihi nke-enweghị nchịkwa na usoro amalite a dịgasị iche iche nke ọrịa na-eduga ịhụ nsọ dysfunction. Isi mgbaàmà nke ọrịa na-owụt ke n'ụdị n'amaghi ime na infertility.

Na ọnụ ọgụgụ na nkesa nke ọrịa? Mgbe curettage na nulliparous inyom ihe ize ndụ nke na-emepe emepe na syndrome bụ 25%. Mgbe ndị na-abụghị viable ime puru nke guzobere adhesions na-abawanye ruo 30% nke ikpe. Iche ime ọpụpụ fọrọ nke nta egwu a nwaanyị ahụ ike. Na nke a, ihe ize ndụ nke ọrịa sonso karịa 7%.

Isi ihe mere

The bụ akpanwa a oghere muscular ngwa. N'èzí ọ na-kpuchie site peritoneum. The n'ime dị lined na endometrium, nke mejupụtara abụọ n'ígwé - na basal na ọtọ. Dabere na-adọ nke ịhụ nsọ okirikiri na n'okpuru nduzi nke mmekọahụ homonụ na endometrium dabara cyclic mgbanwe. Nso ka oge nke ovulation, mgbe ohere nke tụụrụ ime a nwa kasị elu, na endometrium na esi. The endometrial mkpụrụ ndụ bụ ifịk mmepụta nke biologically ifịk bekee. Mgbe njiko spam nwoke na akwa ọ abatakwa akpanwa, ebe nkunye. Kpọtụrụ nwa ebu n'afọ na membranes na a ike endometrium - bụ isi ọnọdụ nke ọma tụụrụ ime ya. Ọ bụrụ na njikọta spam ya emebeghị, ọtọ oyi akwa a efopụ, dị ka ọ pụtara ìhè site kwa ọnwa. Na mmalite nke ọ bụla okirikiri, endometrium ọkọride ọzọ.

Adhesions - ya outgrowths ma ọ bụ adhesions nke esịtidem oyi akwa nke akpanwa na-emebi physiology nke mucous akpụkpọ ahụ. Asherman si syndrome amalite n'ihi mmebi ma ọ bụ mmerụ na basal oyi akwa nke endometrium n'oge gynecological usoro. Nke a pụrụ ịbụ a scraping mgbe ete ime, cesarean ngalaba, ma ọ bụ ihe ọ bụla ọzọ ọrụ. Ọzọ ihe na-akpatakarị ọrịa - endometritis. Adhesions ii na ndabere nke ọtụtụ foci nke mbufụt na mucous akpụkpọ ahụ nke akpanwa.

The adakarị foto nke syndrome

Mgbaàmà nke ọrịa na-kpatara nyagide usoro na ihe ndị ọ na-arụ ọrụ nke omumu usoro. Otu n'ime ha bụ ndị kasị bụ:

• ịhụ nsọ aghara (arọ / dabere nkewa, a siri ike mgbu);
• ime ọpụpụ ;
• mbenata ọnụ ọgụgụ na oge nke menses;
• sekọndrị infertility;
• ìgwè ọbara secretions na eriri akpa nwa oghere.

Olee ihe ọzọ nwere mgbaàmà nke Asherman si syndrome? Ọrịa na-esokwa endometriosis mgbanwe ogo. The daa ọrịa e ji ectopic uto nke ọtọ oyi akwa nke endometrium n'ofè akporo akpanwa. Nke a Nchikota-ezighị ezi mmetụta na-ele ihe anya na atụmanya maka ọgwụgwọ.

Atọ degrees nke ogo

Nyere mmebi nke basal oyi akwa nke endometrium, ndị dọkịta na-atụ aro ndị na-esonụ nhazi ọkwa nke Asherman si syndrome:

• nwayọọ (adhesions ogide ọ dịghị ihe karịrị 25% nke olu nke akpanwa, mfe ebibi site n'ibu mmebi);
• nkezi ogo (onuete welded tightly na mucous nke akpanwa);
• oké ogo (adhesions iso predominantly nke sclerosed connective anụ ahụ, igbochi ọnụ nke akpanwa na akpa na ala ahu).

Bịara n'Ezi Oge mkpebi siri ike nke na ogo nke enweghị nchịkwa usoro nwere ike ngwa ngwa gwọọ Asherman si syndrome.

Bụ afọ ime na o kwere omume?

Nyocha nke dọkịta na-egosi na ihe gbasara nke puru nke tụụrụ ime a na nwa na ọrịa a na-adabere na ihe kpatara ihe na ogbo. Mgbe Asherman si syndrome na-kpọrọ emetụta omumu usoro. Mgbidi akpanwa osisi, agbajikwa cross-ọkpọkọ. N'ihi ya, ẹmbrayo enweghị ike tinyere. Ke adianade do, endometrium tụfuru ya ike na ime mgbanwe estrogen egosi. Nke nta nke nta na-emepe emepe abụọ infertility, na ya, na amenorrhea. Adhesions na cervical region akpasu mkpọchi na-egbu oge nke menses. Mebiri okirikiri n'ozuzu na-egosi a oké ọrịa. Pregnancy bụ a eke ụzọ na-anara, ma ọ bụrụ na ọ bụghị adọ gwọrọ Asherman si syndrome.

ma IVF bụ omume? Nyocha nke dọkịta na-egosi na na vitro Fertilization bụ uru mgbe ọrịa bụ na n'oge ogbo nke development. The ọnụ ọgụgụ nke adhesions nwere ike gafere 25% of olu nke akpanwa, ha ga-metụtara nanị akụkụ ụfọdụ na a mmachi ebe nke uji eze.

Ọ gaghị ekwe omume na-enye a otu azịza nke ajụjụ osụk, n'ihi na nke ọ bụla bụ dị iche iche. Dabere na ogo nke enweghị nchịkwa usoro, e nwere ọtụtụ variants nke ime. Ụfọdụ ụmụ nwaanyị na-ebu ihe na-akpata nsogbu, ebe ndị ọzọ na-esonyere ọtụtụ nsogbu. A atọ nhọrọ - n'amaghi-ete ime, ime ọpụpụ, sekọndrị infertility. Ọ bụ ya mere nwaanyị ọ bụla ga-anya mgbe ha ike, na-ata oge ele ahụ na ọkachamara n'ọrịa ụmụ nwanyị, na-adọ na-agwọ ọrịa nile.

Medical ule

instrumental ụzọ anya nke uche akpanwa na-eji ịchọpụta ọrịa. Hụ na dọkịta na-enyocha onye ọrịa ahụ obstetric akụkọ ihe mere eme (nọmba nke ime, ime, miscarriages na otú pụta.). Ultrasound nnyocha na-atụle ga ndị kasị oké ọnụ ma n'otu oge minimally invasive usoro nke nchoputa nke pelvic akụkụ. Asherman si syndrome nwere ike na-egosi na ultrasound, kama inweta ezi results, ị ga na-ekpeghachi usoro a ugboro ole na ole n'oge okirikiri.

The gold ọkọlọtọ n'ihi na nchọpụta nke adhesions atụle hysteroscopy. Dị otú ahụ akpanwa research-agụnye iji ihe a pụrụ iche na ngwaọrụ. Ọ na-ndinọ site cervical kanaal, nke mere na ahụ ọnọdụ nwere ike enyocha na ozugbo na a na kọmputa na ihuenyo. Hysteroscopy chọpụta ogo-enweghị nchịkwa na usoro, size na orunótu nke adhesions. ọrịa zuru ezu nnyocha pụta ga-achọkwa na obstetric akụkọ ihe mere eme na gara aga mgbalị na ọgwụgwọ. Ndị dị otú ahụ na obibia na-enye ohere ịkọ mma Ọnọdụ ọgwụ.

therapies

The ọrịa dị nwayọọ na agafeghị oke ogo anabata nke ọma ọgwụgwọ. Advanced iche nke ọrịa na ime chere. N'ọnọdụ dị otú ahụ na-abịakwute nnapụta surrogacy. Mgbe spikes na-emi odude a mmachi òkè nke akpanwa, na-enyere IVF. Otú ọ dị, na nke a ka na-agbalị na ọrụ nke nne nwere ike ọ bụghị ụmụ nwaanyị niile na a nchoputa nke "Asherman si syndrome."

Ọgwụgwọ-agụnye mwepụ nke adhesions na a usoro nke hysteroscopy. Ọrụ na-achọ ọ general ná Nkụnwụ Ahụ, ọ dịghị nsogbu. Nyochawa, nke a bụ a kama mgbagwoju anya na usoro. Mwepụ nke adhesions ekenịmde Micro-mkpa n'ihi na elu puru nke re-mmerụ. Na postoperative oge kenyere ọgwụ nje iji gbochie na-efe efe nsogbu. Aṅụ ọgwụ a chọrọ ka ịgbakwunye hormone. The ojiji nke estrogens na progestins gosiri na-akpali endometrial ibu.

ele ihe anya

Nwayọọ ọrịa usoro na-adọ ime nke ọgwụ a hụrụ na 93% nke ọrịa, na nkezi - na 78%. Ọgwụgwọ kwesịrị ekwesị nke ndị inyom na elu ọrịa na-eme ka o kwe omume na-atụrụ ime a na nwa na 57% nke ikpe. Otú ọ dị, ihe ịga nke ọma ime na Asherman si syndrome anaghị ekwe nkwa ido ọmụmụ nke a na nwa na-enweghị pathologies. Age nke ọrịa na-sonye na akaụntụ na amụma. Ka ihe atụ, 66% nke ọrịa tọrọ karịrị afọ 35 chọpụtara na a syndrome nke oké ike na-atụrụ ime. Na ndị ngosi mmekọahụ karịrị afọ 35, nke a na ọnụ ọgụgụ sonso karịa 24%.

mgbochi

Ọ ga-ekwe omume iji gbochie Asherman si syndrome? Curettage ma ọ bụ agụụ ọchịchọ - abụọ na usoro ọkachamara anamde fọrọ nke nta blindly, ịdabere naanị na ha onwe ha na ahụmahụ. Anụ ahụ nke endometrium n'oge ime adụ, n'ụzọ dị nnọọ mfe merụrụ ahụ. N'ihi ya, ọ bụla na-achọpụta ọrịa ma ọ bụ ọgwụgwọ scraping esokarị site unan na basal oyi akwa.

Onye ọzọ na ndị a na usoro bụ na ime ọgwụ ite ime. Ọ na-egosi ihe oxytocic site n'iji ọgwụ ọjọọ eme. Otú ọ dị, ịdị irè nke usoro a bụ naanị 80%. Na 10% nke ikpe mgbe ọgwụ na-ete ime hụrụ oria nke membranes na-achọ scraping. N'ihi ya, iji gbochie Asherman si syndrome nwere ike, ma ọ bụrụ na maka ọgwụ mere ịhọrọ ọgwụ ite ime. N'aka nke ọzọ, a na usoro adịghị enye a 100% ekwe nkwa nke a mma N'ihi.