Kune nzira dzakasiyana dzekudzivirira kubata pamuviri: iyo intrauterine inowedzera Mirena, makondomu, mapiritsi, nezvimwewo, zvino takasarudza kukuudza nezvekuiswa kwe "Mirena" mumuviri. Iyo inonzi infrauterine contraceptive "Mirena" inoshandiswa kushandisa uye kwenguva refu, uye nzira iyi yekudzivirira kubata pamuviri inoshandurwa. Iyo intrauterine chigadziro chinoshamisa chakachengetedza mukadzi kubva pamuviri kwemakore mashanu. Inoshandiswawo mumamiriro ezvinhu ekudarika kwekuenda kumwedzi uye panguva yekugadzirisa remishonga ne estrogen kudzivirira endometrium kubva ku hyperplasia.
Makomborero emuchina we intrauterine:
- Izvi zvinoreva kubata pamuviri zvinoshandiswa uye zvinoshanda chaizvo;
- Zvose zviri nyore mukushanda: "kuisa uye kukangamwa";
- Izvo zvinenge zvisingaiti systemic hormonal effect mumuviri;
- Inotungamirira kukuderera kwehuwandu uye huwandu hwekuenda kwemwedzi kumwedzi;
- Kuwanda kwezvirwere zvinoputika zvemuviri wepachivirira kunoderera.
Zvigaro uye chiito chekudzivirira pamuviri "Mirena".
Mirena chirongwa chekudzivirira chirwere chinonzi intrauterine system, tsvimbo yacho inoratidzika seyimbi yakasimba yakagadzirwa nepurasitiki uye ine hormone levonorgestrel. Kuti urongwa hwacho huve huri nani hunoenderana nechimiro chechibereko, unoitwa muT-shape. Kuti zvive nyore kubviswa kwegadziriro kubva mumuviri, pamucheto wezasi wechepamusoro chikamu chikamu, pane zvidimbu zviviri zvakanamatirwa. Irovonorgestrel hormone iri mune intrauterine inowedzera Mirena ndiyo gestagene yakadzidza zvikuru (semi-natural progesterone), uye inoshandiswa zvinobudirira mune zvakasiyana-siyana zvekudzivirira.
"Mirena", dzakanaka pakudzivirira kubata pamuviri, inodzora kukura kwemweya kwemukati wechibereko chechibereko, uye inodzivirira kufamba kwemuviri muchibereko. Apo levonorgestrel inopinda mumuganda weutterine, inobata mamiriro ekumhara pa endometrium, nokudaro ichidzivirira kupararira kwakawandisa uye kuderedza kushandiswa kwaro kuita. Nokudaro, endometrium haigoni kusvika pakukura kwakakosha, somugumisiro, kubata hakuiti. Levonorgestrel inokurudzira kuwedzerwa kwemavhisikiti emucheka weganda remudzimai, nokudaro kudzivirira chibereko kubva kumunhu kupinda mukati uye nekudaro kukonzera kuberekwa kwewavo. Inogonawo kuonekwa kuti levonorgestrel ine zvigadziriswa zvishoma, izvo zvinozviratidzira mukuderedza kwechirwere muhuwandu husingaperi.
Kubudirira kwemuviri wekudzivirira "Mirena" kunogona kuenzaniswa nekudyiwa kwemukadzi. Kusvika iye zvino, "Mirena" mukubudirira kwayo haisi yakaipisisa kupfuura yakanyatsoshanda mhangura-ine intrauterine spirals uye mishonga yekudzivirira pamuviri.
Zviratidzo zvekushandiswa kwemukati weuterra Mirena ndezvi:
- kunyanya kunonoka kumwedzi kubuda (menorrhagia);
- kudzivirirwa kurwisana ne hyperplasia munguva yekushandura therapy ne estrogens.
- Kubata pamuviri (kuberekwa pamuviri);
Contraindications kune kushandiswa kwe "Mirena" ndei:
- kutarisirwa kana kuumbwa pamuviri;
- kenza yemukati mutezo kana chibereko (kunyunyuta kwaro);
- kusakanganiswa kwechibereko kana chibereko chechirwere, kusanganisira izvo zvinokonzerwa ne fibroids zvinotungamirira mukushandura kweuterine cavity;
- dysplasia yemukativo neatypia;
- chirwere chepamuviri chechikadzi chechikonzero chisingazwisisiki;
- utachiona hwechibereko mushure mokubvisa pamuviri mukati memwedzi mitatu yekupedzisira;
- hutachiona hwemuzasi bwenharaunda;
- zvirwere zvinoputika zvezvikamu zvemuviri
- utachiona hwechirwere;
- hutachiona hwekupedzisira hutachiona hwechibereko;
- zvirwere zvakakomba kana zvipembenene zveropa;
- zvirwere zvinosangana nekuwedzera kwekunzwisiswa kwezvirwere;
- kusagamuchirwa mumwe nomumwe kune zvikamu zveNavy Mirena;
- kenza yebonde.
Shandisa panguva yekuzvitakura uye lactation.
Mune pamuviri, kushandiswa kwetrauterine kuvhura Mirena kunopesana. Asi kana iwe uchinge uchinge wava nepamuviri panguva yekushandiswa kwayo, urongwa hunofanirwa kubviswa nokukurumidza. Nokuti, pane chiitiko chokuti "Mirena" inoramba iri muchibereko panguva yekuzvitakura, kune ngozi yakawanda yekuberekwa nguva isati yakwana kana kutapukira kwepamuviri. Munguva yekurasikirwa, kushandiswa kweMirena kunogoneka - gestagens, iyo inoshandiswa pakuberekera pamuviri, haibatsiri huwandu uye huwandu hwomukaka wechipfuva.
Zvimwe zvikamu zveVSM Mirena
Mumwedzi yekutanga yekutanga mushure mekuiswa kweMirena IUD, zvimwe zvingava nemigumisiro inogona kuonekwa, iyo, semurairo, inopera mukati memwedzi inoverengeka uye haifaniri kuwedzera kurapwa. Imwe yemigumisiro inogona kuitika ndeyekuchinja kumwedzi kwekubuda ropa, izvo zvinoratidza kupindira kwepanyama kune chiito cheMirena spiral. Kazhinji kune nguva dzisina kukwana pakati pekubuda ropa, kuonekwa, kubuda ropa kana kurwadziwa panguva yekuenda kumwedzi, kupera kwakakwana kwemwedzi, kana kutowedzera nguva yekuenda kumwedzi. Isuwo tinoona kuti 12% yevakadzi vakanga vane mavhisi evhavari panguva yekushandisa Mirena.
Paunowedzera ukuru hwe follicles (mazai), dzimwe nguva kupindira mune zvehutano kunodiwa. Nzira yekudzivirira kubata pamuviri pamwe nekushandiswa kwe "Mirena" kune vamwe vakadzi inogona kukonzera ganda rekugadzirisa kwehutano. Kana kuberekwa kwakadaro kusingabatsiri, ipapo pane mukana wekuita ectopic pregnancy. Izwi re "intrauterine" rinonzi "Mirena" rinogona kuva rakakuvadza, nekuda kwekuti kana pairi kushandisa, kune chiitiko chekuitika kwezvirwere zvezvikamu zvemuviri, zvichida kunyange zvakakomba. Mukuwedzera, kushandiswa kweNavy Mirena kunogona kukonzera rusvingo rwechibereko.
Mhedziso yakaratidza kuti mushure mekushandiswa kwemhepo, 1-10% yevakadzi yakakonzerwa: kurwadziwa mumimba, kushaya mutsara, pelvic kana kurwadziwa kumashure, acne, kuonda, kuvhara mvura, kuchengeta musoro, mammary gland, kutya, kusagadzikana kwepfungwa, kuora mwoyo , kugoverwa kweLeucorrhoea kubva kumudzimai, kuputika kwechirwere chemuviri. Pasi pemazana ezana yevakadzi, pane: zvirwere zvebonde, kurasikirwa kwevhudzi kana kukura zvakanyanya, kuderera kwechido chepabonde, ganda rakashata. Uye vakadzi vanopfuura 0.1% vakaonekwa: migraine, urticaria, kuputika kweganda, kubvisa, eczema. Mimwe migumisiro yemigumisiro yakaitikawo panguva dzekushandisa "Mirena" yehomoni inotsiva-shandiswa pamwe pamwe ne estrogens.