Varicocele mu kuyaruka: Zvinokonzera, kurapwa, migumisiro

Varicose mutsinga of spermatic tambo crimp - mumwe rakajairika pathologies muvarume. varicocele chirwere yeGomo nemakore 14-15. Vakawanda 15-30 Makore - ndicho nemakore apo abnormality kunoitika kakawanda. Ruzhinji chirwere ichi kuonekwa vatambi uye vanhu vaiita basa rakaoma. Naizvozvo, tinogona kutaura nechivimbo kuti tsandanyama mutoro unokosha muchinangwa mutsinga ari spermatic tambo.

zvokurwara Izvi zvinonyatsooneka kwakabatsira makono pamuviri ushande. Uye kufunga kuti varicocele atambure kusvika 30% ngakuite vakawanda, kukurumidzira dambudziko kunova pachena.

Chii chinonzi varicocele?

Spermatic tambo zvinosanganisira pakati pezvimwe zvinhu uye pampiniform venous plexus. Ndicho ichi uye vakashamiswa varicocele. The mutsinga of spermatic tambo iri pathologically achinja, kuva dilated uye chakakombama.

Nei izvi zvichiitika? The chirwere kunoitika nokuda kutyora venous water drainage, zvichiguma ropa rinoungana iri venous plexus, Munotatamura uye deforming ngarava rusvingo.

The etiology pamusoro varicocele

Midziyo vechigaro ezvinhu muduku vena cava, takashongedzerwa chaizvo mavharuvhu, nokuti ropa runoyerera kubva pasi pamusoro pavo. Pasina kwadzakabva ichi, vakawanda ropa nyore haana kwasvika mwoyo; Zvisinei, kuvapo vharuvhu mudziyo zvinobudirira kwazvo kudzivisa kurega kunotanga ropa uye retrograde (nechekumashure) ayo inofamba.

The chikuru chinokonzera varicocele mu kuyaruka - kukundikana mavharuvhu testicular tsinga. Kazhinji, ropa anopinda kubva pampiniform plexus mu renal tsinga kana zvakananga kupinda muduku vena cava pachayo iri testicular mutsinga. Kuti ndiro dambudziko rokupedzisira pachiyero mavharuvhu uye ndiwo kukonzera chirwere.

Valvular insufficiency kunogona kuva yokutanga (somugumisiro vachiberekwa abnormalities testicular tsinga, tsandanyama simba kana rokupedzisira rukoko kuti connective zvinyama dysplasia) uye yechipiri (yomuka somugumisiro kuwedzera hurongwa kwokudzvinyirira kwomunhu akaderera vena cava kana renal tsinga). Zvinokonzera dzisiri vharuvhu insufficiency muri pathological zvose pezvakaitwa kuti dzvinya spermatic tambo, testicular, renal tsinga kana zvakananga akaderera vena cava, zvichiita kuti zviomere ropa pamusoro pavo water drainage :. Neoplasm abdominal heniya, adhesions, etc. Zvisinei, pave mamiriro ezvinhu apo ropa kunotangira stagnate muropa nhumbi spermatic tambo.

kupatsanura pakati varicocele

WHO rinokurudzira zvinotevera kupatsanura chirwere:

1. Vienna pampiniform plexus kwete chete zvakanaka kunorondedzerwa akagunzva asiwo nemaziso kuchioneka. Zai rakawunyana.
2. Tsinga inogona palpated, kunyange zvazvo asingaoneki.
3. Positive Valsalva rinoshamisa. Ona kana palpate imwe tsinga hunonzi mharidzo hazvibviri.

Zvisinei, munyika yedu kupfuura inowanzoshandiswa kupatsanura Yu. F. Isakova. Iye, uyewo yaimbovapo kusiyana muzvikamu zvitatu, kunyange zvazvo kwokuomerwa hosha kunoratidzwa nekwekupedzesera. Zvinoita sezvinotevera:

1. Vienna asingaoneki, havasi pakutsvaga ikabatwa. Vanofungidzirwa varicocele zvinogoneka chete Valsalva rinoshamisa.
2. Vienna ndiro tsime palpable, asi asingaoneki.
3. Mutsinga uye chinooneka uye palpable. Modified zai.

Zviya! Valsalva rinoshamisa rinoitwa sezvinotevera. Patient akamiswa ukakumbirwa kukosora. Somugumisiro, kwokudzvinyirira iri abdominal mhango rinobuda, uye tsinga plexus pampiniform kuzvimba. Kazhinji, nokuti kuenzanisa akati mharidzo uye rinoitwa munyika supine chinzvimbo. Panyaya iyi, muedzo achava asina kunaka.

zvekuchipatara mufananidzo

Kazhinji varicocele mu kuyaruka kunoitika pasina kuzviitira nezvekufadza. Kashoma, vamwe varwere vanotsutsumwa pamusoro kunzwa waziya kana kurwadziwa scrotum pashure muviri. Zvisinei, Zviratidzo izvi vanofanira kubatwa nokungwarira, nekuti kazhinji ndivo zviratidzo kuzvimba manhu uye anoshongwa dzavo (orchitis uye orchiepididymitis) rokutanga.

The varicocele ngozi?

Manhu nevanhu - nzvimbo paumbwe dzisingaoneki masero, masero nembeu, kuberekesa zai. Miviri Ava zvikuru panyaya dzavo nekupinda rokubereka ushande.

Varicocele nokuda kuzara ari venous plexus pamusoro yakawanda ropa nokuda omunzvimbo tembiricha simuka, ine tigume spermatogenesis. Uyezve, muna varicocele kuipa nerubatsiro nyama pamwe okisijeni uye masero testicular kunoitika hypoxia; kwakakanganiswa ropa-testis mhinganidzo, izvo zvingaita kuti rudzi antibodies, spermicides (zvinonzwisiswa panoonekwa zvirwere sevamiriri utsinye nekuti). Varicocele kunowanzoguma hormone disruptions kuti ave simba zvakaipa pamusoro nedanho spermatogenesis.

Manhu mune vanhu nehanya chaizvo azvaiitwa zvose, saka chero wavo anogona kuvhiringa nyore paumbwe dzisingaoneki uye dzisingaoneki.

Zvinofanira, tinofanira kucherechedzwa Zvisinei, kuti basa varicocele pakugadzirwa mwana ichiri kuitwa kudzidzwa. Havasi vose vanodavira kuti pamusoro zvigadziriswe akashandurwa kuti pathogenesis kuti varicocele mu kuyaruka. Naizvozvo basa varicose mutsinga zviri spermatic tambo iri hono kushaya mbereko anoramba zvishoma nharo.

Zvokuita?

The anowanzodanwa chirwere varicocele mu kuyaruka. Treatment ukuwo, rinoitwa mu kuyaruka. Zvinoita, sezvamunoziva, riri nezvezvikwata zviviri: kuchinja uye zvomusejari. Kana isu nezvazvo varicoceles vari kuyaruka, wokutanga pfungwa anogona pakarepo vacharairwa panze. Kuchinja mabatiro chirwere ichi haako. Asi nhamba remapazi zvinoshandiswa kubvisa varwere chirwere ichi yakakura.

Mhando zvomusejari kupindira mune varicocele

akavhiyiwa All pamusoro manhu inogona kupatsanurwa muzvikwata akawanda:

1. Nzira Kupindira, inobva excision ari spermatic mutsinga. Pari, havachaoni kushandiswa, nekuti pashure kushanda kwavo muna 90% kuti zviitiko testicular atrophy yaiitwa.

2. Operations kugadzirira zai kuti zvinhu zviri inguinal Canal kana tsandanyama aponeurosis. Zvino haana kushandiswa, sezvo achiperekedzwa testicular atrophy (20-70% nyaya).

3. resection mugove scrotum pamwe dzokunze nemazai latching. Varicocele kuitazve kunoitika Zvisinei, muna 100% nyaya, oparesheni iyi va neudhadha uye hausi kushandiswa.

4. Ligation testicular tsinga pamusoro inguinal crease. Izvi mhando kushanda kunotungamirira kumira ropa kuyerera retrograde uye anopa duku kubva muzana wava kusvutazve. Zvisinei, ongororo dzakaratidza kuti varicocele haisi nguva kuzvidzora zvokurwara. chirwere ichi chinogona chete kuva chiratidzo kutaura ane dambudziko, zvichiguma venous neBP. Panyaya iyi, nokushanda anogona kuwedzera zvinhu.

5. Operations kusika vascular anastomoses. Chaizvoizvo yavo iri pakuti venous reflux anodzokororwa, asi paakasika munhu anastomosis resets zvakawandisa huwandu ropa uye mutsinga kunodzikira.

Panguva ino, dambudziko varicocele mu kuyaruka oparesheni - hazvina rakakura dzevamhan'ari pakuvhurwa abdominal mhango nguva dzose. Pane zvishoma invasive kurapa.

Surgery of Mini-kuwana

The inonyanya kushanda kubata varicocele - Marmara. Akaita pasi zvomunharaunda yokutindivadza. The groin, kubva kurutivi apo dzakabudirira pathological muitiro akaita incision 2-3 cm. Kubva ichi mapindiro dissected zvinhu spermatic tambo, dzinounzwa Vienna, overtighten ligature uye intersects. The ronda sutured mu akaturikidzana.

Sezvinotevera kubva tsananguro hwokushanda haina recessed, uye unogona kunyange kuitwa pamusoro outpatient hwaro. Sutures vanobviswa pazuva rechi8 zuva.

Postoperatively, muvhiki yokutanga inokosha Kuda kutamba scrotum ari (kubudirira nokupfeka hunde dzacho). Mumwedzi 1st vanofanira kudzivisa kuita zvepabonde.

Laparoscopic rakanga

Chimwe nzira nezvakanaka zvizorwa kushanda. Kuburikidza ponji iri abdominal rusvingo pachishandiswa anokosha zvishandiso dzoga testicular tsinga, klipiruyut uye piringisha navo.

Zvichienzaniswa rakavhurika kuvhiyiwa, nzira iyi dzakawanda zvakwakanakira:

1. Pfupi postoperative nguva nokuda kusavapo maronda pashure pokuvhiyiwa kuteererwa ponji uye kwete akacheka kutopedza.
2. No mukana postoperative heniya.
3. A yakanaka zvizorwa kushanda.
4. Zvishomanana mukana postoperative yematambudziko.

endovascular flebosklerozirovanie

Nzira iyi ndiyo imwe nzira kune kuvhiyiwa. Chaizvoizvo Its iri yokuti mune testicular tsinga chinonzi sclerosing mumiriri kutaurwa, inosimudzira clot inotungamirwa uye kugumiswa ropa riyerere kubudikidza tsinga. It rinoitwa chete kana pasina chikonzero kutora yechipiri vharuvhu insufficiency uye venous neBP.

Chinhu chikuru kunzwisisa varwere varicocele, - nguva remapazi kunokosha. Zvinonzi zvakaratidza kuti mangwanani kurapwa yekudyidzana kunoderedza ngozi kusagadzikana spermatogenesis uye paumbwe mbereko.