I-endometrium yimbumbulu yangaphakathi yesibeletho. Inyanga ngayinye, i-endometrium iyaqina futhi ivuselele ngokwayo, ilungiselela ukukhulelwa.
Uma ukukhulelwa kungenzeki, i-endometrium ihamba ngenqubo eyaziwa ngokuthi ukuya esikhathini .
Uma ukukhulelwa kwenzeka, i- embryo ifaka ku-endometrium.
Izimo ezihilela i-endometrium futhi zingathinta ukuzala kwakho:
- Endometrium encane kakhulu noma encane kakhulu
- Isici se-Luteal defect
- I-Endometriosis
- I-polyps ye-Endometrial
- Adenomyosis
- I-Asherman's Syndrome ( ukunamathela kwe-uterine )
- Ukutheleleka ngegciwane
- Umdlavuza we-Endometrial
Ngayinye yalezi zimo nomthelela wazo ekuzaleni kuzoxoxwa ngezansi ngezansi.
Indlela i-Endometrium isebenza ngayo
Isibeletho sakhiwa izingxenye ezintathu: i-serosa, i-myometrium, ne-endometrium.
I-serosa yisikhumba sangaphandle sesibeletho. Ibeka amanzi amanzi ukuvimbela ukungezwani phakathi kwesibeletho nezitho eziseduze.
I- myometrium yi-layer ye-uterine ephakathi. Lona ungqimba obukhulu kakhulu lwesibeletho. I-myometrium yenziwe ngezicubu ezinesisindo esibucayi.
Ngesikhathi sokukhulelwa, i-myometrium iyaqhubeka ukuze ikwazi ukubhekela umntwana okhulayo. Ngesikhathi sokubeletha, izinhlangothi ze-myometrium zisiza ekubelethweni kwengane.
I- endometrium yenza i-lining yangaphakathi yesibeletho. Kuyinto yokugqoka okuyi-mucosal kanye nezinguquko ekubunjeni kulo lonke umjikelezo wokuya esikhathini.
I-endometrium ngokwayo yenziwe ngezigaba ezintathu:
- I-basal stratum, eyaziwa nangokuthi ungqimba lwe-basal. Lona ungqimba olujulile lwe-endometrili oluhlala ngokumelene ne-myometrium yesibeletho. Ayishintshi kakhulu kulo lonke umjikelezo. Cabanga ngokuthi yisisekelo lapho izingxenye eziguqukayo ze-endometrium zikhula khona.
- I-stratum spongiosum: lokhu kungqimba lwe-spongy intermediate ye-endometrium. Lokhu kuguqulwa kushintsho phakathi nomjikelezo wesimiso.
- I-stratum compactum: lokhu kungqimba lwangaphandle lwe-endometrium, futhi libuye lenze izinguquko. I-thinner ne-compact xaxa uma kuqhathaniswa nezinye izendlalelo ze-endometrial.
I-stratum spongiosum ne-stratum compactum izendlalelo ezishintsha ngokuphawulekayo kulo lonke umjikelezo wokuya esikhathini. Ngokubili, lezi zigaba ezimbili ziyaziwa njenge-stratum functionalis noma ungqimba osebenzayo.
Uhlaka olusebenzayo lwe-endometrium luhamba ngezinyathelo ezintathu eziyinhloko umjikelezo ngamunye:
Isigaba esiphezulu: yilokhu lapho i-endometrium ikhula khona, ilungiselela isibeletho sombungu.
Lesi sigaba siqala ngosuku lokuqala lokuya esikhathini futhi siyaqhubeka kuze kube yilapho kuqhutshwa i- ovulation .
I-hormone estrogen ibalulekile ekwakheni i-endometrium enempilo. Uma amazinga e-estrogen ephansi kakhulu noma ephakeme kakhulu, angabangela i-endometrium encane kakhulu noma eningi kakhulu.
I-endometrium iphinda ihlukumezwe ngalesi sikhathi nge-artery eqondile neyomoya. Lezi zitho zomzimba zinikeza ukugeleza kwegazi okubalulekile ku-endometrium.
Isigaba se-secretory : yilokho lapho i-endometrium iqala ukusungula izakhi ezibalulekile kanye nezikhukhula.
I-progesterone yi-hormone ebalulekile yalesi sigaba.
Lesi sigaba siqala ngemva kokuvuthwa kwegazi futhi siyaqhubeka kuze kube sekupheleni.
Izigulane ze-endometrium zihlanganisa amaprotheni, lipids, ne-glycogen. Lokhu kuyadingeka ukondla umbungu. Futhi zivimbela i-endometrium ukuthi ingaphuli.
Uma i-embryo izifaka emdongeni we-endometrium, i-placenta eqhubekayo izoqala ukufihla i -hormone ye-chorionic ye-gonadotropic (hCG) yomuntu .
Le hormone yokukhulelwa yabe isayine i -corpus luteum (kuma-ovari) ukuqhubeka nokukhiqiza i-progesterone, egcina i-endometrium.
Uma i-embryo ingangeni ngaphakathi kwe-endometrium, i-corpus luteum izoqala ukuphuka, okuholela ekunciphiseni amazinga we-progesterone ye-hormone.
Lapho i-progesterone yehla, izigulane ze-endometrium zizoyeka ukufihla izikhukhula ezazilondoloza.
Futhi, ngokuxoshwa kwe-progesterone, imishanguzo yokuvunguza eyayihlinzeka i-endometrium ngegazi iqala ukukhazamiseka.
Lokhu kuholela ekuqhekekeni kwengqimba yokusebenza ye-endometrium.
Ekugcineni, i-endometrium ixoshwa esibelethweni ngokuya esikhathini, futhi umjikelezo uqala kabusha.
Ubukhulu
Uma uphethwe ukwelashwa kwesibeletho , udokotela wakho wokuzala angase abhekisele ekugcineni kwe-endometrium yakho njengobuncane noma obukhulu kakhulu.
Ukuqina kwe-endometrium kunqunywa nge-ultrasound yangasese. Akukho ukuvumelanisa okucacile ngalokho "okuncane kakhulu" noma "okunamandla kakhulu." Wonke udokotela unemiqondo ehlukile ngale ndaba.
Lokho esikwaziyo ukuthi ukuthi kunomzimba omncane kakhulu noma we-endometrium (kungakhathaliseki ukuthi kusho ukuthini) kunganciphisa izingqinamba zokukhulelwa okuphumelelayo. Ucwaningo luye lwabona ukuthi lungathinta ukufakelwa kombungu noma ukwandisa izinkinga zokukhulelwa kwesisu.
I-endometrium encane ingaba isibonakaliso sokunciphisa inzalo ngokujwayelekile. Impendulo embi ye-ovarian ihlotshaniswa ne-endometrium encane.
Okunye okubalulekile ukwazi, ukusetshenziselwa ngokuphindaphindiwe komuthi wokuzala I-Clomid iyaziwa ngokuthinta ubukhulu be-endometrial.
Ukusetshenziswa kwamaphilisi okulawula ukubeletha isikhathi eside kusolwa ukuthi kubangela okwesikhashana i-endometrium encane.
I-Luteal Phase Defect
Isigaba esilandelayo sokujikeleza kokuya esikhathini siqala ngemuva kokuvuthwa kwegazi futhi siqala ekuqaleni kokuya esikhathini.
Njengoba kukhulunywe ngenhla, ngesikhathi sesigaba sokuqapha, i-progesterone ye-hormone idlala indima ebalulekile ekusunguleni i-endometrium ibe yimithonjeni nezinto eziyimfihlo ezibalulekile. Lezi zombili zisekela i-endometrium futhi zakha indawo enempilo yombungu.
I-luteal phase defect iyimbangela engabangela ukungabi nalutho . Kuyenzeka lapho amazinga e-progesterone engekho okwanele noma enganakeki isikhathi eside ukuze kugcinwe i-endometrium futhi ilungiselelwe ukufakwa kombungu.
Ngesinye isikhathi, i-luteal phase defects (LPD) yatholakala nge-biopsy ye-endometrial. Lokhu kusenziwa ngezinye izikhathi.
Ngokuvamile, iziphambeko zesigaba se-luteal zingatholakala ngezinga le-blood testing progesterone. Uma amazinga aphezulu kakhulu ngokwanele noma engagcini isikhathi eside, lokhu kungabonisa ukungabi nesigaba se-luteal.
Ezinye izibonakaliso ezibonakalayo ze-luteal phase defect zi ...
- ukuqaphela emva kokuvuthwa kodwa ngaphambi kokuya esikhathini
- isigaba esincane esifundeni (ezinsukwini ezingaphansi kwezinsuku ezingu-12 kuya kwezingu-14) eshadini lokushisa lomzimba osisekelo
Abesifazane abashisa izinga lokushisa lomzimba wabo bangase babone le ndlela engavamile ngaphambi kokuba babone ukuthi banenkinga yokuzala. Lokhu kungenye yezinzuzo eziningi ze- charting .
I-Endometriosis
I-Endometriosis yisimo lapho i-endometrium itholakale khona ngaphandle kwegumbi lomkhuhlane. Yimbangela evamile yokungabi nabantwana.
Nakuba i-endometriosis ngokuyinhloko ichazwa yizicubu ze-endometrial ezikhulayo ezindaweni ezingalungile, zingathinta futhi imvelo yemvelo, i-endometrium ngokwayo, nokuvunguza.
Ezinye izifundo zithole umthelela omubi ekufakweni kombungu kwabesifazane abane-endometriosis, kanti abanye abatholanga lokhu.
I-Endometrial noma i-Uterine Polyps
I-polymer ye-endometrial iyinqwaba ye-endometrium. Zivame ukungabi nomdlavuza futhi ezinobuthi, kodwa hhayi njalo.
Ukuba khona kwepolitiki ye-endometriki kungabangela ukungasebenzi, kodwa kungenjalo.
Uma unzima ukukhulelwa, udokotela wakho angase asikisele ukususwa kwe-polyp. Lokhu kungakwenza ukwazi ukukhulelwa ngaphandle kwemithi yokwelapha eyengeziwe.
Adenomyosis
I-Adenomyosis yilapho i-endometrium ikhula ibe yi-myometrium (ungqimba lwemisipha yesisu). Kungabangela izikhathi ezibuhlungu, ezinzima.
I-Adenomyosis ngezinye izikhathi ibizwa ngokuthi "i-endermriosis ye-uterine." Yivame kakhulu kumama angama-menopausal, kodwa ingabonakala nakwabesifazane ekupheleni kweminyaka engama-30 no-40.
Izindlela zokwelashwa eziyinhloko ze-adenomyosis ziye zaba ukuphela kwe-endometrial ablation (okubandakanya ukubhujiswa kwe-endometrium) noma i-hysterectomy (okuyinto ukususwa kwesibeletho.) Akekho kulezi zokwelapha ezifanele uma usafuna ukuba nezingane.
Kwabesifazane abafuna ukuba nezingane, kunezinye izinketho:
- Ukwakhiwa okukhethiwe (okubhekiswe kuphela esifundeni se-adenomyosis hhayi yonke i-endometrium)
- Ukwelashwa kwama- Hormonal ne- GnRH agonists (njengoLupron)
- Inhlanganisela yokwelashwa kwe-hormonal and kuhlinzwa
I-Asherman's Syndrome
I-Asherman's syndrome yilapho ukunamathela kwe-intrauterine kufaka ngaphakathi kwesibeletho. Lezi zicubu ezibomvu ezikhula ngamashidi ngaphakathi kwesibeletho.
Kungabangelwa ukuxilongwa okuphindaphindiwe kanye nama-curettages (i-D & Cs), ukutheleleka kwe-pelvic , isigaba se-Caesarea, kanye nokuhlinzwa okubelethwayo. Ngezinye izikhathi, imbangela yayo ayifakazi.
I-Asherman's syndrome ingabangela ukukhathazeka ngokukhulelwa futhi iphindwe ngokuphindaphindiwe.
Ingaphathwa ngesikhathi se-hysteroscopy, inqubo yokuthi kokubili ivumela kokubili ukuxilongwa nokususwa kwezicubu ezibomvu.
Ukutheleleka nge-Viral ye-Endometrium
Ukutheleleka kwesandulela ngculaza okutholakala endometrium kungabangela ukungabi nalutho nokulahlekelwa okukhulelwa njalo. Nakuba lokhu kusengumqondo futhi ezinyathelweni zokuqala zocwaningo, kungachaza ezinye izimo zokungabonakali "okungabonakali".
Ucwaningo oluthile kodwa olusenokwenzeka ukuthi luye lwathola ukuxhumana okukhona phakathi kwegciwane le-herpes HHV-6A kanye nokungasebenzi.
Lapho abantu abaningi becabanga nge-herpes, bacabanga ngesifo esithathelwana ngocansi herpes simplex virus 2, noma i-HSV-2. Nokho, i-herpes simplex iyindlela eyodwa kuphela yegciwane.
Umndeni we-herpes wamagciwane nawo unesibopho sezinkukhu, i-mononucleosis, nesifo esivamile sebandayo.
I-HHV-6 isolwa ukuthi idluliselwa nge-saliva futhi iyaziwa kakhulu ngokubangela ukuqhuma kwengane evamile ye-viral, roseola, ezinganeni.
Njengawo amanye amagciwane we-herpes, ngisho nangemva kokudlula kokuqala kokutheleleka, igciwane lihlala limile emzimbeni. Abacwaningi abasolwa ngokuthi i-HHV-6 bangase bahlotshaniswe nezinye izindaba zezempilo, ngaphesheya kwezingxube zezingane.
Ucwaningo lwase-Italy lwabesifazane abangama-30 abangenalutho kanye nezilawuli ezingu-36 (owayesele abeletha okungenani ingane eyodwa) wabheka ukuthi i-HHV-6A ingahle ihlotshaniswe no-infertility.
Bonke abesifazane abasesifundweni babe ne-biopsies ye-endometrial.
Abacwaningi bathola ukuthi kulaba besifazane abangenalutho, amaphesenti angu-43 abe nobufakazi bofuzo lweHHV-6A emasampheni abo okuphela kwe-endometrium.
Kodwa-ke, akekho kulaba besifazane eqenjini elilawulayo (elivundile) elinemikhawulo ye-DNA ye-HHV-6A ema-biopsies.
Izifundo ezinkulu kufanele zenziwe, futhi aziwa ukuthi ukwelashwa okuphumelela kakhulu kungaba ngowesifazane abane-viral HHV-6A.
Amanye amathuba okucwaninga esikhathini esizayo angase aphenye afaka imishanguzo ye-anti-virus noma imithi yokwelashwa (okuhloswe ukunciphisa isifo somzimba womzimba emzimbeni, okungase kuphazamise ukufakelwa kombungu noma ukuhlasela umbungu ngaphambi kokuthi kukhule ube ngumntwana.)
I-Cancer Endometrial
Umdlavuza we-Endometrial ngezinye izikhathi uyaziwa nangokuthi umdlavuza wesibeletho. Ngenxa yokuthi kubangela ukuphuma kwegazi okungavamile, lolu hlobo lomdlavuza luvame ukutholakala ngokushesha. Ukuxilongwa kwangaphambili kungenza ukwelashwa okulondoloza ukuzala.
Ingaphansi kuka-5% yamagciwane e-endometrial ayenzeka kwabesifazane abangaphansi kweminyaka engu-40, ngakho-ke ukulondeka kokuzala akuvami ukukhathazeka. Noma kunjalo, kungenzeka kubafazi bokukhula kweminyaka.
Ukwelashwa komdlavuza we-endometrial kungabangela ukungasebenzi uma ukwelashwa okunonya kuyadingeka. Ukuxilongwa kokuqala kubalulekile.
Futhi, kubalulekile ukutshela udokotela wakho ukuthi awuqedanga ngokuba nezingane ngaphambi kokuba kuxoxwe ngakho.
Kunezindlela zokulondoloza ukuzala uma ukuxilongwa kusenesikhathi. Isibonelo, ukwelashwa kwama-hormonal (esikhundleni sokwelashwa okuhlinzekwayo) umdlavuza we-endometrial kungcono ukulondoloza ukuzala.
Njengoba ukwelashwa okungaqondakali, ukwelashwa komdlavuza we-post-endometrial kungaba nezinkinga nge-endometrium encane. Lokhu kungalimaza kakhulu izinga lokufakelwa komzimba futhi kwandise amathuba okukhulelwa kwesisu.
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