Nzira yakanakisisa ndeyokutarisa gynecologist uyo achapa chirongwa chekudzivirira pamuviri kubva pane kuongororwa uye kuongorora kuonekwa. Kana nokuda kwechikonzero chero chipi zvacho hazvibviri kuonana neyanyanzvi pakusarudzwa kwemakemikari emuviri, iwe unogona kuzviita iwe pachako. Mutemo mukuru wekusarudzwa: hutano hwekuenda kumwedzi, kuratidza maitiro ehomoni. Kubuda kwemwedzi kwenguva refu uye kwenguva refu kunoratidzira basa rakajeka reestrogen, duku uye shoma-pane basa re gestagens. Zvirongwa zvekusarudza kwakakwana kwekudzivirira kubata pamuviri: utano hwakanaka, hapana kubuda kwemazuva, kuparara kweMDC.
Kubata pamuviri kune vanoputa
Estrogen-ine chinyorwa chekudzivirira uye kusvuta - pfungwa dzinopesana. Chirwere chinotapukira chinodhaka mukati mawo pachacho chinokuvadza muviri wemukadzi, uye pamwe chete nekushandiswa kweprogestin + estrogen) kubata kwepabonde, kukanganiswa kweikicine kunokwira kazhinji.
Ngozi nemigumisiro:
- ropa coagulability inowedzera;
- pane vasospasm yenguva pfupi;
- kushamba kweropa kuburikidza nemakumbo nemidziyo yeropa kwakaoma;
- ngozi yekuvhara ropa inowedzera, iyo inotungamirira kumaraparction infarction, atherosclerosis, chirwere.
Kubvisa pamuviri mapiritsi ekuputa vakadzi havafanire kuva nesradiol valerate, ethinyl estradiol, estradiol hemihydrate. Vanogona kutora chirongwa chekudzivirira pamuviri pasina estrogen ("mini-drank"): Charozetta, Microlut, Laktineth, Eksluton. Nhamba yePearl "mini-saws" iri 0.5-4. Iyi mishonga inochengetedza zvakavimbika pamusana pemubereki asingatarisirwi uye inova nemwero munyoro pamuviri, asi huri kutonyanya kudzora mhepo, iyo inotungamirira kumagumo anogara nokusingaperi mukati mekubuda ropa. "Mini-second" inokurudzirwa kutorwa nguva dzose mupiritsi zuva kubva pazuva rokutanga rokubuda kumwedzi. Nzira dzekudzivirira nadzo: mahomoni anosimudza, kushandiswa kwehomoni, kwete-hormonal drug Benatex .
Kubata pamuviri kune nulliparous
Nokuda kwevasikana vasiri vana uye vechidiki vanoita zvepabonde, mazuva ano pamwe chete nemishonga yekudzivirira pamuviri zvakanaka. Dzinosanganisira progestagen uye ethinyl estradiol, dzinonyatsoshanda pakudzivirira kubata pamuviri nemhando dzakasiyana-siyana dzekurapa - kuderedza zviratidzo zve PMS, kurwadziwa kwemanheru, kutonga kumwedzi. Muvechiri kuyaruka vanogara vachitora mishonga yekudzivirira pamwe chete, kuratidzwa kweDysmenorrhea kunonyangarika, izwi rekurasikirwa kweropa pakuenda kumwedzi kunoderera, uye kutaridzika kwehomoni kunodzorerwa.
Zviratidzo zvepabonde kune vasikana:
- Nhamba dzakaderera dzeCOC: Lindineth-30, Regulon, Belara , Janine ;
- Microdosed COC: Lindineth-20, Clayra, Jess.
Gynecologists havatauri kuisa endometrial kuvhiringidza kuvakadzi nekuda kwengozi yakakura yezvinetso: kuvhiringidza (chibereko, chibereko chechirwere, zvipembenene), kukanganisa mumuviri wemukati, kuwedzerwa kweuropa uterine, kuponda kwe endometrium, iyo yakazara nekusavhiringidzika pamatanho akasiyana-siyana ekudzivirira, kuberekwa. Kuvana vasikana nevechiri kuyaruka zvinonyanya kukosha kushandisa nzira dzakachengeteka dzokudzivirira: kwete-hormonal suppositories yeBenatex , makondomu, hormonal contraceptive piritsi .
Kubata pamuviri pashure pokubvisa pamuviri uye kupererwa pamuviri
Kunyatsosarudzwa nekudzivirira pamuviri pashure pokunge kubvisa pamuviri kana kubvisa pamuviri kune chikamu chinokosha - kunobatsira kuisa chimiro chemahomoni, kunodzivirira kuitika kwezvokuvhiringidza zvirwere mumakumbo edzimba, kunodzivirira kudengenyeka kwechirwere, kunodzivirira kupera kwemagetsi, kunoderedza kuoma kwekubuda ropa. Mushure mokubvisa pamuviri wezvokurapa, mucosa wechibereko chekuberekwa inokuvadzwa, kubata pamuviri kunowanikwa zvakanyatsopesana, asi kukwanisa kubata kunodzokorora kare musi we8-12, naizvozvo, kusarudzwa kwemapiritsi emuromo kunonzwika zvine musoro.
Kubata pamuviri shure kwekubvisa pamuviri uye kupererwa pamuviri
Kusanganiswa kwepabonde. Zvinosanganisira kuderedza masero eesrogen uye mazuva ano progestogens. Yakaratidza kugamuchirwa pazuva 1-2 zuva mushure mokubvisa pamuviri. Deredza kuderera kwemavara, kuderedza kusimba kwezvipembenene zveUterine, kudzora kutonhora kwemuviri, kudzivirira kuputika kwezvikamu zvepachiviri, kuderedza kuwanda kwematambudziko ekutanga:
- monophasic (Regulon, Yarina, Lindineth-30, Belara);
- katatu (Triziston, Trinovium, Trikvilar).
Gestagennye pamuviri ("mini-drank"): Charozetta, Microlut, Laktineth, Eksluton. Zvinopesana mukubudirira kwakanaka kwekudzivirira pamuviri, usingawedzere ropa, haufaniri kuwedzera njodzi yeprombosi, usashandise zvinoshanda zvepachiropa.
Kubata pamuviri mushure mekuita pamuviri uye chikamu chepakati
Hormonal contraceptives yerudzi rwemazuva ano ruchivimbisa 99% kudzivirirwa pakubata pamuviri usina kukodzera, asi 1% inosara apo mishonga inogadzirirwa pakutora mishonga. Kubata pamuviri pahutachiwana, fetus haina kukuvadza, vanachiremba havana ruzivo rwechokwadi pamusoro pehukama huripo pakati pekushandisa kwekudzivirira uye kusagadzikana mucheche, kana mukadzi achitora mapiritsi asati anopfuura 1 mwedzi yekuzvitakura. Kutanga kubva pavhiki yechitanhatu, fetus inotanga kugadzira chirongwa chepabonde, inofunga nezvemaitiro ehomoni, saka kutora mishonga yemimba yeboka iri kunogona kukonzera kushushikana kwebasa mumwana. Mushure mekudzidza nezvekudzivirirwa kwemukadzi, unofanirwa kutarisa gynecologist uyo acharatidza nzira yakanakisisa yekugadzirisa dambudziko racho.
Nzira dzokudzivirira kubata pamuviri mushure mokuberekwa nekudzivirira:
Spermicides (Benatex, Pharmatex, Contraceptin). Inoshandiswa paunodzokerazve kune zvepabonde pamusana pemamiriro ekudzikisa kana kusanganiswa nedzimwe nzira dzekudzivirirwa. Kuvimbika kwenzira yacho ndeye 90-92%, chirongwa chekubata pamuviri chinoitika mushure memaminitsi mashanu kubva mushure mekutonga, kunopera maawa 2-6.
Gestagennye mishonga yekudzivirira mishonga (Charozetta, Microlut, Laktionet, Eksluton). Kugadzirira kweboka iri kunotora mavhiki 6-6.5 mushure mokuberekwa. Nekushandisa nekugara kwakakwana kweminini-mapiritsi, hutano hwavo hwekuberekwa hunosvika 97-98%.
Akabatanidzwa OK . Kubvuma kwegestagen estrogens kunogona kuitika chete kana kunwisa kunorega, nokuti estrogen ine simba rakaipa pahuhu / huwandu hwomukaka wechipfuva, inoderedza nguva yeactation. Matafura anofanira kutorwa pane imwe purogiramu, pasina kumira. Kuvimba kwepabonde kweCOC ndeye 99-100%.
Kubata pamuviri mushure mechikamu chechiesarea kwakafanana nekudzivirirwa mushure mokuberekwa kwezvisikwa, musiyano ndewe - mapiritsi anofanira kutanga kutora masvondo 8-9 mushure mokuberekwa.
Kubata pamuviri kune mishonga yevaricose uye ma cysts ovarian
Varicose chirwere hachirevi kunopesana zvakakwana kumashandisirwo emakemikari ekudzivirira kubata pamuviri, zvisinei, progestins inowanikwa mukugadzirira kwegestagens uye estrogen inogona kukuvadza kuvhara ropa uye mamiriro emidziyo yakaipa. Kuti usabvisa ngozi yehutachiona hwehutachiona - yakadzika yehutachiona, inokurudzirwa kuti kana chirwere chepachiviri chemuviri chinoramba chichitorwa, ona phlebologist. Kuonekwa kwekudzimara kwemagumisiro ekumusoro, kurwadziwa, kusagadzikana, kunetseka kunotangira kumbotora mahwendefa ehomoni - chiitiko chekurumidza kurapwa kune nyanzvi.
Hormonal contraceptive mu cyst ovarian ye functional genesis inoshandiswa senzira inokosha yekurapa. Cysts yenguva pfupi (inoshanda) inowanika kuvakadzi vezera rekubereka, pamwe nehutano hwakasarudzwa hunogadziriswa, mushure memwedzi 2-3. Ne makumbo asina kukanganiswa, mapato maviri uye gumbo rekuzvidzivirira mumuromo anoratidzirwa anoratidzwa pamwe chete neacupuncture uye vitamini therapy.
Kubata pamuviri pakunwisa
Kubata pamuviri kwekutarisira uye uterine myoma
Kusanganiswa kwemakwenzi ekurapa kwemuviri nekuda kwekutarisira ndiyo nzira inoshandiswa yekudzivirira kubata pamuviri. Madzimai anotora COC kwenguva yakareba, mamiriro acho ezvinhu anovandudza zvakanyanya, kushamba kwemwedzi kunogadzikana, kusuruvara kwezvinyama zvinyuchi zvinonyangarika, uye kuwedzera kunowedzera muhuwandu hwekutarisira kunoitika. Zvinoshandiswa nezvinodhaka: monophasic COC (Lindineth-20, Yarina , Janine , Regulon ), COC nemabasa anonzi androgenic (Jeanine, Jess).
ICHI neUterine myoma - chiremera chinorwara che myometrium, kuronga hormonal background, iyo inobatsira kuderedza kuderedza kuwedzera / kushandiswa kwemichina ye fibroids. Zvinodhaka: Jeanine, Regulon, Lindineth-20/30.
Kubata pamuviri mune endometriosis
Monophasic pamwe chete yekudzivirira pamuviri mu endometriosis inobatsira pakurapa myometrium uye endometrium, kubudirira kwehutano hwechirwere nemishonga yeboka iri 57-59%. Zvinodhaka: Jeanine , Regulon , Yarina .