Varicocele ku olufikisayo: Oonobangela, unyango, iziphumo

ngemithambo Varicose ye intambo spermatic crimp - enye ezimbi ixhaphakileyo ebantwini. Incopho varicocele diagnostic kwiminyaka eyi 14-15. Kwiminyaka 15-30 jikelele - yiloo ubudala xa ukungaqheleki kwenzeka amaninzi. Uninzi lwesi sifo sibonakala leembaleki kunye nabantu abathatha inxaxheba yezandla. Ngoko ke, sinako bathi umthwalo dystrophy lidlala indima ebalulekileyo ngemithambo ze intambo spermatic.

Le ezisemthethweni zoxilongo-mthetho lubanesiphumo ebalulekileyo umsebenzi oyindoda okuzala. Kwaye ucinga ukuba varicocele ubunzima ukuya kwi-30% yabantu eyindoda, ukungxamiseka ingxaki ibonakale.

Yintoni varicocele?

Intambo Spermatic ibandakanya, phakathi kwezinye izinto kunye plexus pampiniform lwemithambo. Yile kwaye ukumangaliswa yiloo varicocele. Le mithambo ye intambo spermatic sele pathologically itshintshiwe, baba inimba-jiko.

Kutheni le nto isenzeka? Isifo kwenzeka ngenxa waphula nencindi lwemithambo, kubangela igazi oluhlala kwi plexus lwemithambo, kukunaba kwaye deforming udonga inqanawa.

I-umyalezo we varicocele

Izikhephe ukubayinxalenye inkqubo le Vena cava kunguhata, baxhotyiswa kwezivalo ezikhethekileyo, kuba igazi aqukuqela ukusuka ezantsi ukuya phezulu phezu kwazo. Ngaphandle kolu adaptation, uninzi igazi umane alifikeleli intliziyo; Nangona kunjalo, phambi kokuba icebo vana ngempumelelo kakhulu kuthintela kokoma igazi kunye retrograde (umva) isindululo yayo.

Oyena nobangela varicocele in abafikisayo - ukusilela mbobo wamatyhalarha umthambo. Ngokuqhelekileyo, igazi lingena ukusuka plexus pampiniform kwi ndlela kwezintso okanye ngqo Vena cava ngokwayo enasilela kwi mithambo wamatyhalarha. Yiloo nto ke ingxaki kwinqanaba lokugqibela kwemithambo kwaye esona sizathu sokuba esi sifo.

Valvular insufficiency inokuba ephambili (ngenxa ukungaqheleki iziphene umthambo wamatyhalarha, buthathaka kwezihlunu okanye umaleko yokugqibela ka nokuqina inyama dysplasia) kunye aphakamileyo (ngenxa ngenxa yokwandisa inkqubo yengcinezelo cava Vena kunguhata okanye Kusenjalo sezintso). Ubangelwa ivelufa insufficiency zasesekondari zonke iinkqubo zophendlo lwezifo ukuba compress intambo, wamatyhalarha, iphuma kwezintso okanye ngqo spermatic ukuya Vena cava kunguhata, kwenza kube nzima ukuba igazi kuzo lokuphuma :. Neoplasm Ithemba esiswini, azikhuli, njl Ngenye indlela, kudala imeko apho luqala igazi angaxingi kwimikhumbi yegazi lika intambo spermatic.

ngezigaba varicocele

NGUBANI icebisa ulwahlulohlulo zilandelayo sifo:

1. Vienna pampiniform plexus zichazwe kakuhle nje kuphela kwebala kodwa abangaboni azikaqapheleki. Iqanda ukushwabana.
2. Emthanjeni zibe iviwe, nangona ezingabonakaliyo.
3. Valsalva kushenxa Positive. Bona okanye palpate emthanjeni kuthiwa isampuli akunakwenzeka.

Noko ke, kweli lizwe lethu ezininzi eziqhele ukusetyenziswa Ukuhlelwa Yu. F. Isakova. Yena, kwakunye kowangaphambili, iyayahlula izigaba ezithathu, nangona ubungqongqo sifo kubonisiwe ukuze reverse. Kubonakala ngolu hlobo lulandelayo:

1. Vienna ongabonakaliyo, hayi zigqitywa kwebala. varicocele okusolwayo kunokwenzeka kuphela Valsalva kushenxa.
2. EVienna kakuhle uvalo, kodwa ezingabonakaliyo.
3. Emithanjeni nebonakalayo kunye uvalo. iqanda Kulungiswe.

By the way! Valsalva zenzeke lwenziwa ngolu hlobo. Nomonde babemile bacelwa ukuba isikhohlela. Ngenxa yoko, uxinzelelo kwi kwisisu liyaphuma, kwaye pampiniform vein plexus adumbe. Amaxesha amaninzi, zokuthelekisa isampuli Wathi kwaye lwenziwa kwindawo lisalele. Kulo mzekelo, uvavanyo luya kuba mibi.

picture clinical

Ngokuqhelekileyo varicocele e olufikisayo kwenzeka ngaphandle ukushukumisa ezikhathazayo. Ayifane, ezinye izigulane ezikhala imvakalelo ubunzinyana okanye intlungu samatyhalarha emva umthambo. Nangona kunjalo, ezi mpawu kufuneka aphathwe ngokuqaphela, ngenxa yokuba kaninzi yokuba Iimpawu zokuqala ukudumba amasende kunye Amaqokobhe zabo (orchitis kunye orchiepididymitis).

Le varicocele eyingozi?

Amasende ezingabantu - indawo apho ukuyilwa amadlozi, iiseli intsholongwane, ukuchumisa iqanda. zibaluleke kakhulu ngokwayamene nokuthatha inxaxheba kwabo umsebenzi ekuzaleni La maqumrhu.

Varicocele ngenxa nokumfixana plexus lwemithambo oluninzi igazi ngenxa lobushushu nokunyuka lwasekuhlaleni, nto leyo iba nefuthe elibi spermatogenesis. Ngaphezu koko, ngo varicocele kuguga kunikezelo izicwili mpilo kunye neeseli wamatyhalarha kwenzeka hypoxia; kuphazanyiswe igazi-iba lityhalarha isithintelo, oko kunokubangela kwisizukulwana omzimba, spermicides (ngenxa yokuba ziqondeka amajoni omzimba njengoko arhente ezinobutshaba). Varicocele kudla kunye ukuphazamiseka kwamadlala ukuba nempembelelo embi kwinkqubo spermatogenesis.

Amasende e amadoda ethe kakhulu kuyo yonke le nkqubo, ngoko nayiphi na kubo ngokulula uphazamise ukuyilwa isidoda amadlozi.

Kufuneka kuqatshelwe ke, ukuba indima varicocele ekubunjweni ukungachumi nangoku efundwayo. Asingabo bonke abakholwayo ukuba iindlela ngasentla engunobangela Pathogenesis of varicocele in elivisayo. Ngoko ke indima imithambo varicose ye intambo spermatic kwi ubudlolo inkunzi kuhlala ngandlel 'impikiswano.

Yintoni ukwenza ntoni?

Eyona ngokuqhelekileyo sifo varicocele in elivisayo. Unyango, ngokulandelelana, kuyenziwa elivisayo. Ngoko ke, njengokuba usazi, kuvela iindidi ezimbini: emithethweni futhi yotyando. Ukuba sithetha varicoceles e olufikisayo, ingongoma wokuqala ngoko nangoko kwaba njalo. unyango Conservative kwesi sifo ayikho. Kodwa ke inani imisebenzi ezisetyenziswayo lokuphelisa izigulane kwesi sifo mkhulu.

Iintlobo kongenelelo zoqhaqho in varicocele

Yonke imisebenzi phezu amasende zingahlulwa zibe ngamaqela ezininzi:

1. yokungenelela Surgical, ngokusekelwe Ukusikwa yegazi spermatic. Okwangoku, akusekho ezisetyenzisiweyo, kuba emva kokuba isicelo wabo 90% amatyala yoma wamatyhalarha uyalandelwa.

2. Imisebenzi ukulungisa iqanda iziqalelo ze inguinal lomsele okanye izihlunu aponeurosis. Ngoku ayisetyenziswa na, njengoko kukhatshwe yoma wamatyhalarha (20-70% amatyala).

3. resection inxenye isingxobo samatyhalarha kunye amaqanda latching engaphandle. Varicocele Uphephe kwenzeka ke, ngo-100% yamatyala, lo msebenzi ayisebenziseki kwaye ayisetyenziselwa okwangoku.

4. tubal ndlela wamatyhalarha ngaphezu ndezela inguinal. Olu hlobo lomsebenzi kukhokelela ekuyekeni ukuhamba kwegazi retrograde kwaye unika incinane ipesenti likakade. Noko ke, uphando lubonisa ukuba varicocele akusoloko self-ngezifo. Esi sifo kuphela iliphawu ethetha ingxaki, leyo lwegazi lwemithambo. Kulo mzekelo, umsebenzi inokuba mandundu le meko.

5. Imisebenzi ukudala anastomoses nemithambo. umongo yabo ixhomekeke yokuba reflux lwemithambo igcinwa, kodwa ngokudala anastomosis licwangcisa kwakhona isixa ezingaphezu igazi ngemithambo ucutho.

Okwangoku, unyango lwe varicocele in abafikisayo msebenzi - akusoloko ukuphazamisana olubanzi kunye yokuvulwa kwisisu. Zininzi iintlobo zonyango kancinane wesibeleko esigqibeleleyo.

Utyando le mini-ufikelelo

Umsebenzi eqhelekileyo ukunyanga varicocele - Marmara. Yena wenziwa phantsi Ukubulawa yasekuhlaleni. Le ubudoda, zathabathela kwiphiko apho inkqubo iphuhlisiwe zophendlo lwezifo eyenziwa liqatywe 2-3 cm. Ukususela kulo ukufikelela dissected izinto intambo spermatic, kwabelwa Vienna, ligature ukuyiqinisa kunye yekhampasi. Inxeba sutured ngokwemaleko.

Ngolu hlobo lulandelayo ukusuka inkcazo sebenziso alwenziwanga ingontsi, kwaye nokuba izakwenziwa qho kwesibhedlele. Sutures zisuswa ngomhla 8.

Postoperatively, kwiveki yokuqala nitrogen ebalulekileyo isingxobo samatyhalarha (kuphunyezwa ngokunxiba umboko). Kwinyanga 1 kufuneka bakuphephe umsebenzi ngesondo.

clip laparoscopy

Enye indlela ukususela elungileyo izithambiso. Ngokusebenzisa i okuhlatywa ngokusebenzisa izixhobo ezikhethekileyo bodwa wamatyhalarha umthambo, klipiruyut kwaye phambana nabo eludongeni esiswini.

Xa kuthelekiswa utyando evulekileyo, le ndlela zinezibonelelo ezininzi:

1. Mfutshane ixesha postoperative ngenxa yokungabikho phantse epheleleyo amanxeba emva kotyando ezenziwa zokuhlatywa yaye ndingakunqumli.
2. Akukho ingozi Ithemba postoperative.
3. A isiphumo izithambiso olungileyo.
4. ithuba okuncinane yobunzima postoperative.

flebosklerozirovanie endovascular

Le ndlela enye indlela uqhaqho. kubume bayo siyifumana yokuba ndlela wamatyhalarha arhente sclerosing yaziswa, nto leyo ekhuthaza ukusekwa ihlwili kunye nokupheliswa yokumpompoza kwegazi ngokusebenzisa Kwangale. Oku kwenziwa kuphela ukuba akukho sizathu sokuba iqalise ivelufa insufficiency lesibini kunye noxinzelelo lwegazi lwemithambo.

Eyona nto ibalulekileyo ukuze baqonde izigulane varicocele, - ixesha imisebenzi ibalulekile. Oku kubonakaliswa ukuba unyango kwangoko kunciphisa kakhulu umngcipheko ukuphazamiseka yokuba spermatogenesis kunye nokusekwa ukungachumi.