Te methylene blue i ngā whakamātautau āhei ki te hapū: he aha tā te chromopertubation e whakaatu ai

Ka hanumi ngā hua rapu mō te methylene blue me te āhei ki te hapū i ngā kerēme rerekē e rua. Ko tētahi, ka taea e tētahi whakamātautau waikano kikorangi i te whare haumanu te whakaatu mēnā e tuwhera ana ngā ngongo kākano. Ko tētahi atu, mā te tango methylene blue ka pai ake te āhei ki te hapū, te kounga o te parāoa, te kounga rānei o ngā hua. Ko te kerēme tuatahi anake e pā ana ki te chromopertubation. Kāore te tuarua i whakamātauria, ā, ehara tērā i tētahi wāhanga o tēnei tukanga. Ko taua wehewehenga te tūāpapa mō ngā kōrero katoa kei raro nei.

He whāiti ake te pātai whai take. Ina kuhuna te waikano kikorangi ki te kōpū i raro i ngā tikanga haumanu, ā, ka kitea te wai e puta ana mā tētahi ngongo, e tuwhera ana taua ngongo i taua wā. Ki te kore e kitea he rerenga, kāore te whakautu i te tino mārama pērā i tōna āhua. Ka whakaatu tētahi whakataurite nō 2021 o ngā horopaki whakamātautau waikano e rua i ngā wāhi e tika ana te whakamāoritanga o ngā kitenga, me ngā wāhi e hapa ana.

Te ariā: he whakamātautau rerenga, ehara i te maimoatanga mō te āhei ki te hapū

He ara whāiti ia ngongo kākano mai i te kōpū ki te kura kākano. Kotahi te āhuatanga o taua ara ka whakamātauria e te chromopertubation: mēnā ka taea e te wai te rere mā roto. Ko te methylene blue te tohu e kitea ai te rerenga, nā te mea ka tino kitea tōna tae hōhonu ki ngā kiko koma.

He ōrite te whakaritenga i ngā horopaki e rua. Ka uru te waikano mā te waha kōpū ki te kōhao kōpū, ā, ka mātakitaki te mātanga haumanu i ngā mahi ka whai ake. Ki te puta te waikano i te pito tawhiti o tētahi ngongo, he tohu tērā e tuwhera ana. Ki te putu te waikano, ā, ka hoki whakamuri te rere, he tohu tērā e āraia ana pea. Ko te whakawhitinga anake e whakaaturia ana e te kitenga, i tētahi ahunga, i tētahi rā.

He tukanga tēnei ka mahia e tētahi mātanga haumanu. Ka mahia te momo whare haumanu i te wā o te hysteroscopy, arā, ka whakamahia he pūrere mātakitaki angiangi hei tiro ki roto i te kōpū. Ka mahia te momo rūma hāparapara i te wā o te laparoscopy, arā, ka whakamahia he pūrere mātakitaki hei tiro ki waho o ngā ngongo me te papatoiake, i te nuinga o te wā i raro i te whakamoenga whānui. Kāore tētahi o ēnei momo e mahia e te tangata ki a ia anō, ā, kāore tētahi e tuku rongoā hei whakarerekē i te āhei ki te hapū. He matū whaiwhai te waikano e rere ana mā roto. He āwhina ngā whakamārama mō te whanonga o te methylene blue hei waikano, ā, ko te pātai motuhake mō te pānui i ngā rangahau methylene blue e whakamārama ana he aha e kore ai tētahi pānga i te taiwhanga e rite ki tētahi maimoatanga haumanu.

Ehara te tuwheratanga i te tohu e pai katoa ana

He ariā kotahi te tuwheratanga, ā, he whānui ake te mahi a te ngongo kākano. Ka tuwhera pea tētahi ngongo, engari kāore e tutuki i a ia tana mahi: ka tūkino pea te pokenga, te endometriosis rānei, i ngā makawe ririki e neke ana i te hua, ahakoa e whānui tonu ana te ara kia puta ai te waikano. Ka pupuri hoki pea ngā kiko nawe kei waho o te ngongo i te kura kākano ki tawhiti, kia kore ai te hua e uru, ahakoa e rere noa ana te waikano. Mā tētahi wāhanga whāiti ka puta tonu pea he rerenga waikano angiangi, engari ka āraia te hua, he nui ake nei.

Nō reira, ka whakautu tētahi kitenga tuwhera i tētahi pātai iti me te tino māia: i whakawhiti te wai i te ngongo. Kāore e whakaū ana kei te pai te kiriuhi o roto, te hopu hua, te papatoiake rānei e karapoti ana. He iti ake anō te pono o tētahi kitenga āraitanga, nā te mea ka taea e ngā āhuatanga rangitahi te aukati i te rere mā tētahi ngongo tuwhera.

Ngā mea i whakatauritea e te rangahau o 2021

Ko ngā raraunga whakataurite tika tino mārama nō tētahi rangahau tuatahi i 2021 mō ngā wāhine 80 kāore e taea te hapū i AIIMS New Delhi, ā, kei te tuhinga e wātea noa ana ngā tikanga me ngā hua katoa. Kua whakaritea kē he hysterolaparoscopy mō ia kaiuru. I whakakorea ngā wāhine kua whakaūngia kētia he āraitanga, kua mōhiotia he hydrosalpinx tō rātou, he pokenga whakapeka rānei kei te papatoiake.

E rua ngā whakamātautau waikano i mahia ki ia wahine, tētahi i muri i tētahi. Tuatahi, he hysteroscopy i te whare haumanu, kāore he whakamoenga: ka kuhuna he waikano kua waimehatia, ā, ka mātakina ia puare ngongo kākano mō te rerenga ka kitea me te mimiti o te tae kikorangi i te kōhao. Kātahi ka mahia he minilaparoscopy i raro i te whakamoenga whānui hei whakamātautau tohutoro: ka rere te waikano mā tētahi ngongo pū tōngāmimi kei roto i te kōpū, ā, ka aromatawaitia ia ngongo kākano mā te putanga waikano ki te papatoiake ka kitea. I tatauria motuhaketia ngā ngongo e rua, nō reira 160 ngā kitenga.

I kitea e te whakamātautau tohutoro e tuwhera ana ngā ngongo 136 o te 160 (85 ōrau). I whakatauria e te whakamātautau whare haumanu e tuwhera ana ngā ngongo 125 (78 ōrau). He pai te ōritetanga, engari kāore i taurite: 119 ngā ngongo i kitea e tuwhera ana e ngā whakamātautau e rua, 18 i kitea e āraia ana e ngā mea e rua, 17 i whakatauria e te whakamātautau whare haumanu e āraia ana engari i kitea e tuwhera ana i te laparoscopy, me te 6 i whakatauria e te whakamātautau whare haumanu e tuwhera ana engari i kitea e āraia ana i te laparoscopy. Ina whakamahia te laparoscopy hei tohutoro, ko te tairongo o te whakamātautau whare haumanu ki te tuwheratanga he 87.5 ōrau, ko te motuhaketanga he 75 ōrau, ko te uara matapae tōrunga he 95.2 ōrau, ko te uara matapae tōraro he 51.4 ōrau, ā, ko te tika whānui he 85.6 ōrau.

Pānuitia aua tau hei kaipānui, kaua hei mātanga tatauranga. I te nuinga o te wā, he tika te whakatau tuwhera a te whakamātautau whare haumanu. Ko te whakatau āraitanga he tata ki te tūponotanga o te whiu moni: tata ki te haurua anake o ngā kitenga āraitanga i te whare haumanu i whakaūngia e te laparoscopy. Ko taua kore taurite te meka kotahi whai take rawa o te tuhinga.

He aha i iti ake ai te pono o tētahi āraitanga e whakapaetia ana

Ko te take tino noa ko te kōpā uaua. Ka kōpā poto pea te kokonga o te kōpū e tīmata ai te ngongo, ka kati ai i tētahi ara tuwhera. E kōrerotia ana i te tuhinga te wai mātao me te mamae kōpā hei take pea ka whakaoho i tēnei. Ka mutu te kōpā, engari he ōrite te āhua o tētahi kitenga i taua wā ki te āraitanga tūturu. Koia e āta tūpato ai te whakamāoritanga o tētahi āraitanga kotahi e tata ana ki te kōpū i tētahi whakamātautau kotahi.

Ka tāpiri hapa anō te tikanga mahi. Mā te tere o te kuhunga ka hoki whakamuri te rere, he rite nei ki te āraitanga, ā, ki te kore e pai te koki tirohanga, kāore pea e kitea he putanga waikano angiangi. Kotahi te mātanga hāparapara mātau i mahi puta noa i te rangahau, nō reira tērā pea he nui ake te rerekētanga i ngā mahi o ia rā.

Ka whai tika mai te pānga ki ngā mahi haumanu. Ko tētahi āraitanga e whakapaetia ana i te whakamātautau waikano whare haumanu he take kia whakaūngia, ehara i te whakatau mate hei tūāpapa kotahi mō ngā mahi ka whai ake. I te nuinga o te wā, ko te whakaū he whakamātautau tohutoro mā te laparoscopy, he aromatawai ngongo kākano kē rānei ka kōwhiria e te tīma āhei ki te hapū, ka whakamāoritia i te taha o te hītori hauora, te mōrea pokenga, me ngā whakaahua hauora. He kaha ake te whakamātautau methylene blue o ngā ngongo kākano ki te whakaū i te tuwheratanga i tōna kaha ki te whakakore i tērā.

Ngā mea kāore e kitea e te rerenga waikano

Ka ine te chromopertubation i te whakawhitinga. He maha ngā āhuatanga whai take ki te āhei ki te hapū kāore i roto i taua tirohanga. Kāore e kitea e te hysteroscope ngā piringa huri noa i te ngongo, arā, ngā tāhei kiko nawe e karapoti ana i te ngongo, nā te mea ko te kōhao me ngā puare ngongo kākano anake ka kitea e taua pūrere. Ka kitea tikatia aua piringa mā te laparoscopy; i tēnei rangahau, i kitea ngā piringa ki ngā wāhine 4 o te 80 i taua wāhanga anake, ā, e whakaatu ana ngā rangahau o mua ka whakapiki ēnei i te tūponotanga o tētahi kitenga rerenga e hē ai te whakapono kei te pai katoa.

Ko te hydrosalpinx, arā, he ngongo kua pupuhi i te wai nā tētahi āraitanga i te pito tawhiti, he āhuatanga anō kāore pea e kitea: i whakakorea ngā take kua mōhiotia kētia, engari i kitea he hydrosalpinx kāore anō kia mōhiotia i te laparoscopy ki ngā wāhine 7 o te 80. Ko te endometriosis, te tūkinotanga o te kiriuhi o roto, me te ngoikore o te hopu hua ngā āhuatanga whakamutunga o te rārangi. Koia ngā aratohu mō te āhei ki te hapū e whakamārama ai i te chromopertubation hei mahi ka mahia ina whai take kē te laparoscopy, pērā i tā te whakaaro o te komiti ASRM mō te aromatawai i te kore āhei ki te hapū. He whai take te horopaki whānui o ngā raraunga haumaru mō te methylene blue ina paunatia tētahi aromatawai hāparapara.

Tōna rerekētanga i ērā atu whakamātautau ngongo

Ka tuku te hysterosalpingography (HSG) i tētahi matū whakataurite e aukati ana i ngā hihi-X mā te waha kōpū, ā, ka whakamahi i ngā whakaahua hihi-X hei whakaatu i te āhua o te kōhao me ngā ngongo. Ka tuhi i te putanga o te matū pērā i te chromopertubation, engari ka tāpiri i te iraruke, kāore e taea te tirotiro i waho o te papatoiake, ā, he raruraru anō te kōpā uaua i te kokonga o te kōpū.

Ka kuhuna e te matawai oro wai tote he wai tote horomata ki te kōhao, ā, ka whakamahia he pūrere i roto i te tara hei whakaputa whakaahua. Ko te matawai wai tote noa he whakamātautau matua mō te kōhao: he tohu te wai i te papatoiake e tuwhera ana tētahi ngongo, neke atu rānei, engari i te nuinga o te wā kāore e taea te tohu ko tēhea. Ka whai te matawai oro whakataurite mā te pahuka, mā ngā mirumiru moroiti rānei, i ia ngongo motuhake, ā, koinei te mea e tata ake ana ki te whakamātautau waikano.

Te haumaru me te horopaki, i roto i ngā kupu māmā

I te rangahau o ngā tūroro 80, i pūrongo ngā kaituhi kāore he raruraru nui, iti rānei, i hua ake i tētahi o ngā whakamātautau waikano. He whakatau māharahara tēnei i roto i tētahi rangahau tuatahi iti, engari kāore e kī ana he kore mōrea: e whakaahua ana ngā pūrongo take whai muri i te chromopertubation i ngā tauhohenga tairongo rawa onge, te methemoglobinemia, te urunga o te waikano ki ngā ia toto, me ngā raruraru pūkahukahu, ā, kāore i pai te tatau i te auautanga o ēnei.

E rua ngā kōrero ka whai mai. Ka tāpiri te momo laparoscopy i ngā mōrea noa o te hāparapara me te whakamoenga, koia ka rāhuitia ai mō ngā take kua whakaritea kētia he tirotiro hāparapara. Ā, kāore tētahi o ēnei e hāngai ki te whakamahinga i te kāinga: kei te tīma haumanu te kawenga mō te kukū, te horomatanga, te wāhi kuhunga, me te noho rite mō ngā ohotata.

Nō reira, he here tō te whakarāpopototanga tōkeke. Ka whakaatu te chromopertubation me te methylene blue mēnā ka whakawhiti te wai i tētahi ngongo i raro i te mātakitakitanga, ā, he nui ake te pono o tētahi kitenga tuwhera i tō tētahi kitenga āraitanga. Kāore e ine i te mahi a te ngongo, kāore e kitea ngā take katoa o te kore āhei ki te hapū kei te papatoiake, ā, kāore e maimoa i tētahi mea. Me pātai te tangata ka tukuna ki a ia tēnei whakamātautau i ngā pātai e toru: ko tēhea horopaki kua whakaritea, ā, he aha ai; ka aha mēnā ka kitea he āraitanga; ā, he aha ngā kitenga tāpiri ka whakarerekē i te mahere.