Ntawm cov teeb meem ntawm cev xeeb tub nyob rau hauv thaum ntxov ua sawv ntawm tubal rho menyuam yog ib qho ntawm feem ntau ua txhaum. Nws tshwm sim hauv 1.5-2% ntawm tag nrho cov cev xeeb tub. Cov theem thaum ntxov yog cov tsis pom muaj cov tsos mob, yog li qhov ua txhaum cai yog kuaj ntawm tsib mus rau vasthib tomqab ntawm qhov hnoog.
PUB cev xeeb tub - vim li cas
Thaum tubular xeeb tub tsim tawm, kev qoj yuam kev yog kev tsis pom nriav. Nrog ectopic implantation ntawm fetal qe, nws tuag nrog lub sij hawm, uas leads mus rau kev tuag ntawm lub fetus yav tom ntej. Feem ntau, cov kab mob pathology yog ib qho tsim nyog ntawm kev cuam tshuam rau kev thauj ntawm ib lub qe fertilized. Qhov txawv ntawm qhov sib txawv ntawm cov tshuaj blastocyst yog tseem ua tau - ntawm ib qho ntawm cov theem ntawm lub plab me nyuam hauv plab, qhov qhia txog nws rau hauv phab ntsa ntawm lub uterine raj pib. Ntawm cov teeb meem tseem ceeb ntawm cov teeb meem no, cov kws kho mob teev cov pawg ntau yam:
1. Anatomical thiab physiological:
- inflammatory kev ua rau hauv nruab nrog cev hauv nruab nrog cev, uas ua txhaum txoj cai ntawm cov hlab: adhesions, constrictions, pockets, kev ua txhaum kev quab yuam kev ua haujlwm;
- kev phais plawv (phom);
- siv cov hlab ntsha tuaj ;
- kev ua haujlwm ntawm cov qaum;
- qog ntawm qhov ntxiv thiab lub tsev menyuam;
2. Hormonal yam:
- ua txhaum ntawm cov kev cai ntawm cov zes qe menyuam vim yog tsis txaus siab ntawm qhov system hypothalamic-pituitary;
- ua txhaum ntawm cov synthesis ntawm prostaglandins;
- siv cov tshuaj hormonal contraceptives;
3. Ua kom muaj roj ntsha ntxiv ntawm cov plab me me - ceev cov khoom sib txuas ntawm trophoblastoglyco- thiab proteolytic enzymes, uas ua rau cov txheej txheem implantation.
4. Lwm yam:
- endometriosis ;
- qhov kev xeeb menyuam ntawm lub tsev menyuam;
- anomalies nyob rau hauv txoj kev loj hlob ntawm cov hlab ntaws;
- tsis zoo phev;
- kev ntxhov siab thiab kev puas siab puas ntsws.
Kev xeeb menyuam hauv plab - cov tsos mob
Rau ib lub sij hawm ntev, pathology tsis ua rau nws tus kheej muaj kev xav, yog li ntawd tubal cev xeeb tub, cov cim qhia ntawm uas yog qhia hauv qab no, feem ntau pom nyob rau ntawm theem rho menyuam - thim ntawm lub plab hnyuv qe. Ntawm cov tsos mob uas qhia tau tias ua txhaum cai:
- ntshav tawm ntawm qhov chaw mos, mob qhov mob nyob rau sab nraud ntawm tus yeeb yam;
- txo qis ntawm theem hCG hauv cov ntshav;
- hloov hauv kev kuaj ntawm cev xeeb tub (thawj qhov zoo, ces tsis pom zoo).
Lub sij hawm ntawm kev cuam tshuam ntawm ectopic cev xeeb tub
Kev tu ncua ntawm ectopic cev xeeb tub nyob rau hauv cov nqe lus thaum ntxov yog vim lub cev tsis ntim cov qe me mus rau hauv lub neej hauv cov kab noj hniav ntawm lub raj. Muaj ib qho kev rho menyuam tawm ntau zaus ntawm 5-6 lub lim tiam, hnub kawg yog xam tias yog 10 lub as thiv. Tshaj tawm lub sij hawm no yog fraught nrog ntau cov teeb meem uas cuam tshuam rau kev noj qab haus huv ntawm cov poj niam:
- hnyav sab hauv;
- rupture ntawm lub uterine raj;
- infertility nyob rau hauv lub neej yav tom ntej.
Yuav ua li cas yog ib tug trumpet rho menyuam?
Cov cim qhia ntawm kev ua txhaum ntawm ectopic cev xeeb tub tshwm ntau dua ntawm 4-8 lub lim tiam. Thaum zoo li no tus poj niam kawm txog kev ua txhaum. Kev cuam tshuam ntawm ectopic cev xeeb tub feem ntau tshwm sim raws li ib tug tub rho menyuam. Vim hais tias ntawm kev nce peristalsis ntawm cov hlab plawv, lub plab hauv plab yog exfoliated thiab raug rho tawm mus rau hauv lub uterine kab noj hniav. Yeeb tshuaj tua menyuam yog los ntawm kev los ntshav, yog li nws yog ib qho yooj yim kom paub.
Qee zaum, cov kev poob cev qhev tshwm sim nyob rau hauv cov lus qhia rov qab - hauv cov kab noj hniav ntawm qhov ncauj. Hauv qhov no, muaj ob qho kev xaiv rau kev tsim kho ntawm qhov teeb meem:
- tuag ntawm plab hnyuv qe;
- implantation nyob rau hauv ib qho ntawm cov plab hnyuv siab los yog cov ntsiab lus ntawm lub plab zog nrog ntxiv kev loj hlob ntawm cev xeeb tub (muaj tsawg kawg).
Tub cev menyuam yaus - cov tsos mob
Tubal menyuam yaus nrog txoj hnyuv ectopic yog ib qho tshwm sim heev. Hauv qhov no, tus neeg mob tus mob thiab daim duab saibxyuas yog nyob ntawm qhov siab ntawm ntshav poob. Ntawm cov lus tsis txaus siab tseem ceeb los ntawm cov poj niam uas muaj ectopic cev xeeb tub, nws yog qhov yuav tsum tau paub qhov txawv:
- Mob hauv plab hauv plab. Cov kev mob nkeeg lub sij hawm ntsig yog ua los ntawm cov hlab ntsha tawg thiab sau nrog ntshav. Feem ntau nws muaj qhov irradiation ntawm qhov mob ntawm thaj tsam ntawm lub qhov quav los yog puab tais. Kab mob siab ntev qhia tau hais tias yog ib qho kev hemorrhage rau hauv cov kab noj hniav ntawm lub qhov ncauj.
- Tshem tawm ntshav tawm ntawm qhov chaw mos. Lawv cov tsos yog nrog kev thim qhov kev hloov kho qhov qis thiab kev puas tsuaj rau cov hlab ntsha. Lub ntim ntawm cov ntshav uas siv ntshav tas lawm yog me me, vim tias nws lub ntsiab ntim tawm ntawm lub lumen ntawm cov hlab ntaws mus rau hauv lub plab.
- Ua tshwm sim ntawm cov cim ntawm latent los ntshav:
- mob hauv lub plab mog nrog irradiation hauv hypochondrium, interscapular thaj tsam;
- tsis muaj zog;
- kiv taub hau;
- xeev siab;
- tsaus muag;
- nce lub plawv dhia;
- txo cov ntshav siab.
Qhov mob ntawm tubal abortion tshwm tawm dheev, tawm tsam, muaj ib tug cramping ua cim (tubal thiab rho menyuam). Thaum lub sij hawm nres, lub siab ntawm kev pov thawj ntawm kev puas siab, kev xav tsis thoob, kev mob ntawm cov tsos mob ntawm cov peritoneum, uas muaj qhov sib txawv ntawm qhov sib txawv, tuaj yeem sau tseg. Nrog kev kuaj mob ntawm tus neeg mob, nws pom tau tias lub tsev menyuam tau loj hlob thiab mos. Nyob rau hauv cheeb tsam hauv cheeb tsam, muaj kev tsim muaj txwv nyob rau hauv kev khiav yog palpated, nyob rau hauv sib xws resembling mov paj.
Tubal rho menyuam yuav tsum sib txawv nrog lwm cov kab mob gynecological thiab kab mob pelvic kab mob. Rau qhov no, ultrasound yog ua tau, ntawm qhov uas nws muaj peev xwm kom meej meej txiav txim qhov chaw ntawm lub plab ntim qe nyob rau hauv lub raj. Nyob rau tib lub sij hawm, tus kws kho mob teev qhov loj me ntawm lub plab me me thiab txiav txim seb puas yuav mus kho lossis phais.
Ua tiav tub luam rho menyuam
Cov tsos mob ntawm tubal rho menyuam, qhia saum toj no, tom qab tawm ntawm tus me nyuam hauv plab tawm khiav tawm. Txawm li cas los, dhau sij hawm, cov tsos mob ntawm cov tsos mob zoo sib xws. Qhov no tshwm sim thaum tsis muaj kev rho menyuam tawm - qhov kev ntiab tawm ntawm cov qe los ntawm cov yeeb nkab nres ntawm ib theem twg. Nyob ib ncig ntawm nws tshwm sim thaum lub sij hawm txhaws ntawm cov ntshav, uas tsim ib capsule, tej zaum zoo li nyob ib sab mus rau peritoneum. Nyob rau hauv xws li mob, phais yog tsim nyog.
PUB cev xeeb - ua haujlwm
Tshaj li cas ntawm kev phais yog thaum lub tub ntxhais hluas rho menyuam nyob ntawm theem ntawm cov kab mob pathological thiab cov qib kev koom tes ntawm lwm cov plab hnyuv siab raum. Kev phais yog ua los ntawm laparotomy lossis laparoscopy. Kev nkag xyuas yog txiav txim los ntawm tus neeg mob tus mob: nrog rau ib qho hemorrhage rau hauv plab kab noj hniav, siv lub laparotomy - kev nkag los ntawm phab ntsa sab nrauv. Nws kuj yog siv rau cov lus qhia ua ke. Lwm cov teeb meem, laparoscopy tau ua tiav.
Yeeb yam xeeb tub - nyob rau hauv uas mob tshem tawm cov raj?
Cov yeeb nkab rho menyuam, nws txoj kev khomob tshwjxeeb yog phais, tsis tas yuav xaus nrog salpingectomy. Lub ntsiab lus tseem ceeb rau kev tshem tawm ntawm cov yeeb nkab yog nws qhov tawg. Txawm li cas los xij, tub menyuam tub qaum yuav tsis tuaj yeem ua raws li qhov teeb meem no. Ntawm lwm cov cim qhia txog qhov kev tshem tawm ntawm txoj hlab raj:
- zog ncab ntawm nws cov phab ntsa (2/3 ntawm lub cev yog cuam tshuam);
- muaj ib qho kev mob qub ectopic;
- rov qab ectopic cev xeeb tub hauv tib lub raj;
- ib tug ntau ntawm adhesions nyob rau hauv lub plab kab noj hniav.
Tub menyuam qaub ncaug nrog rau kev xeeb menyuam ectopic - qhov tshwm sim
Tubal menyuam yaus nrog txoj hnyuv ectopic muaj peev xwm ua rau cov hauv qab no:
- rov qab plab (stalled) tubal cev xeeb tub - xaus nrog rho menyuam lossis kev loj hlob ntawm hydrosalpinx (kua dej nyob hauv lub raj);
- kev loj hlob ntawm cev xeeb tub hauv lub zes qe menyuam lossis kab mob plab (tsis tshua muaj).