Pakati pematambudziko ekudzivirira pamuviri wekutanga kwekubvisa pamuviri kubvisa pamuviri ndechimwe chekuputsika kazhinji. Inowanikwa mu 1.5-2% yevose vanozvitakura. Matanho ekutanga anoonekwa nekusavapo kwezviratidzo, saka kutyora kunowanikwa kune imwe yevhiki yechishanu kusvika kwechitanhatu yekubata.
Pipe pamuviri - zvikonzero
Kana kubata pamuviri kubereka, kupererwa kwepamuviri hakugoneki. Ne ectopic implantation ye fetal egg, inofa nenguva, iyo inotungamirira kurufu rwemangwana rekuzvarwa. Muzviitiko zvakawanda, hutachiona hunovapo semugumisiro wekuvhiringidzwa kwekutakura kwezai rinogadzirwa. Pane zvakasiyana-siyana zvinonzi basa rakawandisa reblastocyst zvinogonawo - pane imwe nzvimbo ye fetal egg egg, kuiswa kwayo mumadziro eUterine tube inotanga. Pakati pezvikonzero zvinokonzera chirwere ichi, vanachiremba vanocherechedza maverengeka ezvikonzero:
1. Anatomical uye muviri:
- kuvhiringidza zvirongwa mukati memhengo dzomukati dzomukati, izvo zvinopesana nehutano hwemashupu: kusungirira, zvinyorwa, zvigaro, kuputsa kwechibvumirano chebvumirano;
- kuporesa sterilization (piping);
- kushandisa intrauterine midzi ;
- kushanda pamakumbo edzimba;
- matumbo ezvinyorwa uye chibereko;
2. Hormonal factors:
- kukanganisa kwekugadzirisa kwemasvosve nekuda kwekusaenzana kwe hypothalamic-pituitary system;
- kukanganisa kwehupano hwe prostaglandin;
- kushandiswa kwemakemikari emuviri;
3. Kuwedzerwa kwebasa rezvemhuka ye fetal egg - kukurumidza kufambiswa kwetrophoblastoglyco- uye proteolytic enzymes, iyo inoita kuti zvirongwa zvivepo.
4. Zvimwe zvinhu:
- endometriosis ;
- kuberekwa kusakanganiswa kwechibereko;
- anomalies mukubudirira kwe fallopian tubes;
- unhu husina kunaka hwehuta;
- mamiriro ezvinhu anokonzera uye kushungurudzika mupfungwa.
Pipe pamuviri - zviratidzo
Kwemazuva mazhinji, chirwere hachizviiti chaiyo, saka kubata pamuviri, zviratidzo zvaro zvinoratidzwa pasi apa, zvinowanzowanikwa pakubvisa pamuviri - kurambwa kwe fetus egg. Pakati pezviratidzo zvinoratidza kukanganisa kunogona kuitika:
- kubuda ropa kubva mumudzimai, kurwadziwa kwenguva nenguva kune rumwe rutivi rwekudhonza;
- kuderera muhuwandu hweHCG muropa;
- kuchinja mumugumisiro wekudzivirira pamuviri (kutanga zvakanaka, uye kwete).
Nguva yekuvhara kwe ectopic pamuviri
Kukanganiswa kweEctopic pregnancy mukutanga kwekutanga kunokonzerwa nokusakwanisa kweiyo fetal kuupenyu huri mukati mechipfuva che tube. Pane kubvisa pamuviri kanowanzoitwa pavhiki 5-6, musi wekupedzisira unofungidzirwa kuva vhiki yegumi. Kuwedzerwa nguva iyi kunozara nematambudziko akawanda anokanganisa hutano hwevakadzi:
- rinorema mukati kumabuda ropa;
- kuputika kweuterine tube;
- kusabereka mune ramangwana.
Chii chinonzi kubvisa pamuviri kwehwamanda?
Zviratidzo zvekuputsa ectopic pamuviri zvinowanzoonekwa kakawanda pavhiki 4-8. Panguva dzakadaro mukadzi anodzidza nezvekuputsa. Kukanganiswa kwe ectopic pamuviri kanowanzoitika sekubvisa pamuviri kubvisa. Nemhaka yekuwedzera peristalsis ye fallopian tubes, iyo fetal egg inodzingwa uye yakadzingwa mukati mumiriri. Pipe kubvisa pamuviri kunosangana neropa, saka zviri nyore kuziva.
Mune zvimwe zviitiko, kutapwa kunowanikwa kune zvakasiyana-siyana-kupinda mujinga re peritoneum. Muchiitiko ichi, pane zvingasarudzwa zviviri zvekugadzirisa mamiriro acho ezvinhu:
- kufa kwe fetal egg;
- kuiswa mune chimwe chezvikamu kana zvikamu zvemuviri wepamuviri nekuwedzera kwekuita kwekuita pamuviri (pane zvakanyanya kusingadi).
Tubal kupererwa kwepamuviri - zviratidzo
Tubal kuputika kwechisimba ne ectopic pamuviri inowanzoitika. Muchiitiko ichi, chirwere chemurwere uye kliniki yemufananidzo inobva mukukura kweropa kurasikirwa. Pakati pezvisununguko zvikuru zvakaitwa nevakadzi vane ectopic pamuviri, zvakakosha kusiyanisa:
- Kusuruvara mucheche pasi. Periodic cramping pain is caused by contractions of fallopian tube and filling it with blood. Kazhinji kune irradiation yekutambudzika mukati memharaunda kana kugomera. Nguva dzose marwadzo anorwadza anoratidza kuti zvinogona kuitika mumuviri we peritoneum.
- Kubuda ropa kunobva kumadzimai echikadzi. Kuonekwa kwavo kunobatanidza nekurambwa kweendometrium yakashandurwa uye kukuvara kumidziyo yeropa. Izwi reropa rakanyanyisa ridiki, sezvo ivhu rayo guru rinodururwa kuburikidza ne lumen ye fallopian tubes kusvika mudumbu.
- Chiitiko chezviratidzo zvekubuda ropa panguva inotevera:
- marwadzo mucheche pasi nejekisheni mu hypochondrium, nzvimbo interscapular;
- kushaya simba;
- chizoro;
- nausea;
- kukanganisika;
- kuwedzera kwenhamba yemwoyo;
- kuderedza ropa.
Kutambudzika kwekubvisa pamuviri kwebhabhu kunowanzoerekana kwaitika, kurwiswa, kuva nehutsika huno (tubal uye kubvisa pamuviri). Panguva yekurwiswa, manzwiro okusagadzikana kwekuziva, kutyisidzira matambudziko, zviratidzo zvekutsamwa kwe peritoneum, iyo ine dhigirii yakasiyana, inogona kunyorwa. Nekuongororwa kwebhuku remurwere, zvinowanikwa kuti chibereko chinowedzera uye chiri nyore. Mune nzvimbo dzinowanikwa, mapurisa anenge asingakwanisi kuenderera mberi anowedzera, akafanana nemafuta.
Tubal pamuviri inofanira kuve yakasiyana nemamwe zvirwere zvinogona kuitika zvechirwere uye zvirwere zvepelvic. Nokuda kweizvi, ultrasound inoshandiswa, iyo inogona kujekesa nzvimbo ye fetal yai mu tube. Panguva imwecheteyo, chiremba anoisa uswa hwema fetal egg uye anosarudza kana achienderera mberi kurapwa kana kuvhiyiwa.
Kukwana kubvisa pamuviri kubvisa pamuviri
Zviratidzo zvekubvisa pamuviri kubvisa pamuviri, zvinoratidzwa pamusoro, mushure mekubuda kwe fetal egg outward inoparara. Zvisinei, nekufamba kwenguva, kuonekwa kwezviratidzo zvakafanana. Izvi zvinoitika kana kusabvisa pamuviri kusakwana - kubviswa kwemazai kubva pombi inomira kune imwe nzvimbo. Pasi pake inounganidza nguva yakawanda yeropa, iyo inoumba capsule, dzimwe nguva iri pedyo pedyo ne peritoneum. Mumamiriro ezvinhu akadaro, kuvhiyiwa kunodiwa.
Pipe pamuviri - opera
Kuvhiya kwakanyanya sei kunoitwa mukati mekubvisa pamuviri kubvisa kubva padanho rehutachiona hwehutano uye chiyero chekubatanidzwa kwevamwe nhengo dzepelvic. Kuvhiya kunoitwa neparparotomy kana laparoscopy. Kuwana kunotaridzirwa nemamiriro ezvinhu emurairo: nehupachipa mukati memumvuri wemimba, laparotomy inoshandiswa - kuwanika kuburikidza nekunze kwemuviri kumadziro. Iyo inoshandiswa zvakare kune mazita ekubatanidzwa. Mune dzimwe nguva, laparoscopy inoitwa.
Pipe pamuviri - mune zviitiko zvakabvisa tube?
Pipe kubvisa pamuviri, uyo mushonga unongorapwa chete, haugumi nguva dzose ne salpingectomy. Chiratidzo chikuru chekubviswa kwepombi ndiko kuparara kwayo. Kunyange zvakadaro, kutapukisa kwepabhu kunogona kusafambidzana nechinetso chakadaro. Pakati pezvimwe zviratidzo zvekubviswa kwe fallopian tube:
- kusimba kwaro rusvingo (2/3 yemuviri kunogadziriswa);
- kuvapo kwekare yeEctopic pregnancy;
- anodzokorora ectopic pamuviri mune imwe tube;
- nhamba yakawandisa yekubatanidza mumudumbu wepamuviri.
Tubal kuputika kwechisimba ne ectopic pamuviri - zvibereko
Tubal kuputika kwepabonde ne ectopic pamuviri kunogona kuita kuti zvinotevera:
- regressing (stalled) tubal pamuviri - inoguma nokubvisa pamuviri kana kukura kwe hydrosalpinx (fluid accumulation in the tube);
- kukura kwekuita pamuviri muchivako kana mumimba cavity (kazhinji).