txheem
Epididymitis yog ib qho mob inflammatory ntawm ib qho kev tsim tshwj xeeb uas zoo li lub raj nqaim nyob rau saum toj thiab tom qab lub noob qes thiab ua haujlwm txhawb nqa thiab ua kom cov spermatozoa - lub epididymis (epididymis).
Feem ntau cov kab mob epididymitis hauv cov txiv neej hnub nyoog 19 - 35 xyoo. Pathology ntawm lub hnub nyoog no yog ib qho ua rau mus pw hauv tsev kho mob. Tsawg tsawg zaus, tus kab mob no tau sau tseg hauv cov neeg laus, thiab epididymitis yuav luag tsis tshwm sim hauv cov menyuam yaus.
Hom thiab ua rau epididymitis
Tus kab mob tuaj yeem muaj ntau yam ua rau, ob qho tib si kis tau (vim cov kab mob tshwm sim ntawm cov kab mob, kab mob, fungi), thiab tsis kis kab mob. Cov kab mob epididymitis feem ntau yog. Nws ntseeg tau tias hauv cov tub ntxhais hluas (15 - 35 xyoo), tus kab mob feem ntau tshwm sim los ntawm kev sib deev kis kab mob (STIs), xws li chlamydia, gonorrhea, thiab lwm yam. Hauv cov neeg laus thiab menyuam yaus, qhov teeb meem cuam tshuam nrog cov kab mob uas feem ntau ua rau. kab mob ntawm cov urinary system (piv txwv li, enterobacteria). Qhov ua rau ntawm epididymitis tuaj yeem yog cov kab mob tshwj xeeb, xws li tuberculosis (tuberculous epididymitis), thiab lwm yam.
Qee lub sij hawm tus kab mob pathogenic (tsis tu ncua nyob rau hauv lub cev, tab sis tsis ib txwm ua rau muaj kab mob) fungus ntawm genus Candida dhau los ua tus neeg sawv cev ntawm pathology, ces lawv hais txog candidal epididymitis. Hauv qhov no, kev siv tshuaj tua kab mob tsis zoo, txo qis hauv kev tiv thaiv kab mob, tuaj yeem ua rau muaj kev loj hlob ntawm tus kab mob.
Tej zaum qhov tshwm sim ntawm cov txheej txheem pathological hauv epididymis tawm tsam keeb kwm yav dhau los ntawm: • kab mob qog ("mob") - o ntawm cov qog parotid; • angina; • mob khaub thuas; • mob ntsws o; • tshwj xeeb tshaj yog cov kab mob uas nyob ze - urethritis (inflammatory pathology ntawm cov kwj dej tso zis), vesiculitis (seminal vesicles), prostatitis (prostate caj pas), thiab lwm yam.
Qee lub sij hawm tus kab mob kuj nkag mus rau hauv lub appendage los ntawm qee qhov kev ua haujlwm: endoscopy, catheterization, bougienage ntawm cov urethra (ib txoj kev kuaj mob ua los ntawm kev qhia tshwj xeeb ntsuas - bougie).
Piv txwv li, tsis kis kab mob epididymitis tuaj yeem tshwm sim: • thaum kho nrog tshuaj xws li Amiodarone rau arrhythmias; • tom qab ua kom tsis muaj menyuam los ntawm kev tshem tawm/ligation ntawm vas deferens (vim cov spermatozoa txuam nrog unresorbed) – granulomatous epididymitis.
Muaj qhov mob hnyav (lub sijhawm ntawm tus kab mob tsis pub dhau 6 lub lis piam) thiab mob epididymitis, uas yog tus cwj pwm los ntawm qhov tshwm sim ntawm ob qho tib si appendages, feem ntau tshwm sim nrog cov kab mob tuberculous, syphilis (ntev ntev tshaj li rau lub hlis).
Nyob ntawm qhov hnyav ntawm qhov tshwm sim, mob me, nruab nrab thiab loj epididymitis yog qhov txawv.
Risk yam
Txij li thaum epididymitis feem ntau yog qhov tshwm sim ntawm STIs, qhov tseem ceeb ntawm kev pheej hmoo rau kev loj hlob ntawm pathology yog kev sib deev tsis muaj kev tiv thaiv. Lwm lub sij hawm provocative: • raug mob ntawm lub plab mog, perineum, scrotum, nrog rau kev phais (adenomectomy, thiab lwm yam); • anomalies nyob rau hauv txoj kev loj hlob ntawm urogenital system; • Cov kab mob ntawm cov kab mob urinary (cov qog, prostate hyperplasia, thiab lwm yam); • Cov kev phais tsis ntev los no ntawm cov kab mob tso zis; • kho mob manipulations - hluav taws xob stimulation (thaum multidirectional contractions ntawm lub vas deferens tshwm sim, uas yuav provoke "sucking" ntawm microbes los ntawm lub urethra), infusion ntawm tshuaj mus rau hauv lub urethra, catheterization, massages, thiab lwm yam.; • prostate hyperplasia; • hemorrhoids; • nqa qhov hnyav, kev ntxhov siab ntawm lub cev; • nquag coitus cuam tshuam, erections tsis muaj kev sib deev; • txo qis hauv lub cev tiv thaiv los ntawm kev mob hnyav (mob ntshav qab zib, AIDS, thiab lwm yam), hypothermia, overheating, thiab lwm yam.
Cov tsos mob ntawm epididymitis
Qhov pib ntawm tus kab mob manifests nws tus kheej raws li cov tsos mob hnyav, uas, nyob rau hauv tsis muaj kev kho mob txaus, zoo li yuav phem dua. Nrog epididymitis, tej zaum yuav muaj: • mob npub ntawm ib sab ntawm lub scrotum / nyob rau hauv lub noob qes nrog irradiation mus rau puab tais, sacrum, perineum, sab nraub qaum; • mob heev nyob rau hauv cov cheeb tsam cuam tshuam; • mob plab; • liab, kub hauv cheeb tsam ntawm lub scrotum; • o / nce qhov loj, induration ntawm appendage; • qog zoo li tsim nyob rau hauv lub scrotum; • txias thiab kub taub hau (txog 39 degrees); • Kev noj qab haus huv tsis zoo (tsis muaj zog, tsis qab los noj mov, mob taub hau); • nce inguinal lymph nodes; • mob thaum tso zis, tso zis; • tso zis ntau ntxiv, sai sai; • mob thaum sib deev thiab ejaculation; • pom cov ntshav hauv cov phev; • tso zis tawm ntawm noov.
Ib qho kev kuaj mob tshwj xeeb yog tias qhov siab ntawm scrotal tuaj yeem ua rau cov tsos mob zoo (zoo Pren's kos npe).
Nyob rau hauv lub sijhawm ntev ntawm tus kab mob, cov cim qhia ntawm qhov teeb meem yuav tsis tshua muaj suab, tab sis qhov mob thiab qhov loj ntawm lub scrotum, thiab feem ntau kuj tso zis ntau zaus.
Tseem ceeb! Mob hnyav nyob rau hauv cov noob qes yog ib qho qhia rau kev kho mob tam sim!
Txoj kev kuaj mob thiab kuaj pom tus kab mob
Thawj qhov kev kuaj mob hauv kev kuaj mob yog tus kws kho mob qhov kev kuaj xyuas ntawm qhov cuam tshuam ntawm cov noob qes, cov qog nqaij hlav hauv puab tais. Yog tias xav tias epididymitis vim yog prostate o, kev kuaj lub qhov quav yog ua.
Tsis tas li ntawd, txoj kev kuaj tau raug siv: • smear los ntawm lub urethra rau kev soj ntsuam microscopic thiab cais cov kab mob ua rau tus kab mob STIs; • PCR diagnostics (nrhiav cov kab mob los ntawm polymerase saw cov tshuaj tiv thaiv); • soj ntsuam thiab biochemical tsom xam ntshav; • urinalysis (general, "3-khob test" nrog rau cov zis sib law liag hauv 3 khob, kev kawm kab lis kev cai, thiab lwm yam); • tsom xam cov kua dej seminal.
Instrumental diagnostics suav nrog cov hauv qab no: • Ultrasound ntawm lub scrotum los txiav txim qhov txhab, theem ntawm o, qog cov txheej txheem, kev soj ntsuam ntawm cov ntshav khiav ceev (Doppler kawm); • nuclear scanning, nyob rau hauv uas ib tug me me ntawm ib tug xov tooj cua tshuaj yog txhaj thiab cov ntshav txaus nyob rau hauv lub noob qes raug soj ntsuam siv cov khoom tshwj xeeb (tso kev kuaj mob epididymitis, testicular torsion); • cystourethroscopy – kev taw qhia los ntawm lub urethra ntawm ib qho khoom siv kho qhov muag, ib lub cystoscope, los tshuaj xyuas qhov chaw sab hauv ntawm lub cev.
Kev suav tomography thiab magnetic resonance imaging tsis tshua siv.
Kev kho mob ntawm epididymitis
Kev kho mob ntawm epididymitis yog nqa tawm nruj me ntsis raws li kev saib xyuas ntawm tus kws kho mob tshwj xeeb - urologist. Tom qab kev kuaj mob, kev txheeb xyuas cov kab mob, ntev ntev, mus txog ib hlis lossis ntau dua, cov txheej txheem ntawm kev kho tshuaj tua kab mob tau raug sau tseg.
Cov kev npaj tau raug xaiv los ua tus account rhiab heev ntawm cov kab mob pathogenic microorganisms, yog tias hom kab mob tsis tuaj yeem tsim, tom qab ntawd siv cov tshuaj tua kab mob dav dav. Cov tshuaj tseem ceeb ntawm kev xaiv rau epididymitis, tshwj xeeb tshaj yog nyob rau hauv lub xub ntiag ntawm lwm yam pathologies los ntawm urogenital system thiab cov tub ntxhais hluas, yog cov tshuaj tua kab mob ntawm fluoroquinolone pawg. Tetracyclines, penicillins, macrolides, cephalosporins, sulfa tshuaj kuj raug sau tseg. Nyob rau hauv ib qho xwm txheej uas tus kab mob tshwm sim los ntawm tus kab mob STI, yuav tsum muaj kev kho mob ib txhij los ntawm tus neeg mob tus khub sib deev.
Tsis tas li ntawd, txhawm rau txo cov txheej txheem inflammatory thiab txo qhov mob, tus kws kho mob pom zoo kom cov tshuaj uas tsis yog-steroidal anti-inflammatory (xws li indomethacin, nimesil, diclofenac, thiab lwm yam), nrog rau qhov mob hnyav, novocaine blockade ntawm cov phev qaum yog ua. Tej zaum yuav raug pom zoo ntxiv: • noj cov vitamins; • physiotherapy; • enzymatic, absorbable (lidase) thiab lwm yam kev npaj.
Nrog rau qhov mob me me, tsis tas yuav mus pw hauv tsev kho mob, tab sis yog tias qhov mob hnyav zuj zus (kub nce siab tshaj 39 degrees, kev ua rau qaug cawv, kev nce ntxiv hauv cov appendage), tus neeg mob raug xa mus rau tsev kho mob. Yog tias tsis muaj kev cuam tshuam, yuav tsum muaj tshuaj tua kab mob sib txawv. Yog hais tias tus kab mob tsis tu ncua, tshwj xeeb tshaj yog nrog ob sab lesions, muaj ib tug tsis ntseeg ntawm tuberculous xwm ntawm lub pathology. Nyob rau hauv cov xwm txheej zoo li no, kev sab laj nrog tus kws kho mob phthisiourologist thiab, raws li kev pom zoo ntawm kev kuaj mob, kev teem caij ntawm cov tshuaj tiv thaiv kab mob tshwj xeeb.
Kev kho mob ntawm daim ntawv mob yog nqa tawm hauv txoj kev zoo sib xws, tab sis siv sijhawm ntev dua.
Ntxiv nrog rau kev noj tshuaj, tus neeg mob yuav tsum ua raws li cov cai hauv qab no: • saib xyuas lub txaj; • muab ib qho chaw siab ntawm lub scrotum, piv txwv li, los ntawm txoj kev ntawm ib txoj phuam twisted rau hauv ib tug menyuam; • Tsis suav nrog kev nqa hnyav; • nruj me ntsis soj ntsuam kev sib deev so; • Tsis suav cov khoom noj ntsim, rog; • xyuas kom muaj dej txaus; • siv cov compresses txias / dej khov rau lub scrotum kom txo tau qhov mob; • Hnav ib qho suspensorium – ib daim ntaub qhwv tshwj xeeb uas txhawb nqa lub scrotum, uas ua kom cov scrotum seem, tiv thaiv kom tsis txhob co thaum taug kev; • hnav cov ris tsho nruj nruj, lub cev ua luam dej (yuav siv tau kom txog thaum cov tsos mob ploj mus).
Raws li qhov xwm txheej zoo dua, kev ua kom lub cev tsis zoo yog tso cai: taug kev, khiav, tshwj tsis yog caij tsheb kauj vab. Nws yog ib qho tseem ceeb kom tsis txhob muaj kev tsis haum rau hauv cheeb tsam thiab hauv zos hypothermia thaum lub sij hawm kho thiab thaum kawg.
Tom qab ua tiav cov txheej txheem tshuaj tua kab mob, tom qab li 3 lub lis piam, koj yuav tsum sab laj nrog kws kho mob kom rov kuaj dua ( tso zis, ejaculate) txhawm rau txhawm rau paub meej tias kev tshem tawm tag nrho ntawm tus kab mob.
Cov tshuaj ib txwm siv tau tsuas yog siv los ua ib qho ntxiv rau chav kho mob tseem ceeb thiab tsuas yog tom qab kev tso cai los ntawm tus kws kho mob tuaj koom. Ib txwm kho mob nrog epididymitis pom zoo siv decoctions los ntawm: • lingonberry nplooj, tansy paj, horsetail; • nplooj nettle, mint, linden paj thiab lwm yam tshuaj ntsuab npaj.
Nrog rau kev txhim kho ntawm cov teeb meem xws li purulent abscess, kev phais qhib ntawm suppuration yog ua. Hauv qhov xwm txheej hnyav, nws yuav tsum tau tshem tawm ib feem lossis tag nrho cov cuam tshuam appendage. Tsis tas li ntawd, kev ua haujlwm yog siv rau: • kho lub cev tsis zoo uas ua rau muaj kev loj hlob ntawm epididymitis; • nyob rau hauv cov ntaub ntawv uas xav tias testicular torsion / txuas (hydatids) ntawm lub epididymis; • nyob rau qee qhov xwm txheej uas muaj tus kab mob ntsws (tuberculous epididymitis).
Teeb meem
Raws li txoj cai, epididymitis tau kho zoo nrog cov tshuaj tua kab mob. Txawm li cas los xij, yog tias tsis muaj kev kho mob txaus, cov teeb meem hauv qab no tuaj yeem tshwm sim: • kev hloov ntawm cov kab mob pathology mus rau ib qho mob ntev; • tshwm sim ntawm ob sab lesion; • orchiepididymitis – kis tau tus txheej txheem inflammatory mus rau lub noob qes; • testicular abscess (purulent, txwv o ntawm cov ntaub so ntswg ntawm lub cev); • kev loj hlob ntawm adhesions ntawm cov noob qes thiab scrotum; • testicular infarction (cov ntaub so ntswg necrosis) los ntawm cov ntshav tsis txaus; • atrophy (txo qis hauv volumetric qhov ntev, ua raws li kev ua txhaum ntawm cov phev ntau lawm thiab txo qis hauv testosterone ntau lawm) ntawm cov noob qes; • tsim ntawm fistulas (qhov nqaim pathological kwj dej nrog purulent tawm) nyob rau hauv lub scrotum; • Kev muaj menyuam tsis taus yog qhov tshwm sim ntawm ob qho tib si txo qis hauv cov phev tsim tawm thiab tsim cov teeb meem rau qhov kev vam meej ntawm qhov kawg.
Kev tiv thaiv ntawm epididymitis
Cov kev ntsuas tseem ceeb los tiv thaiv kab mob epididymitis muaj xws li: • kev noj qab nyob zoo; • kev sib deev nyab xeeb; • kom lub neej sib deev; • Kev kuaj xyuas kom raws sij hawm thiab tshem tawm cov kab mob urinary uas rov tshwm sim dua; • tiv thaiv kev raug mob rau cov noob qes (hnav cov khoom tiv thaiv thaum xyaum ua kis las); • ua raws li cov cai ntawm kev nyiam huv ntawm tus kheej; • tsis suav nrog overheating, hypothermia; • Kev tiv thaiv/kev kho kom txaus ntawm cov kab mob sib kis (xws li txhaj tshuaj tiv thaiv kab mob qog), thiab lwm yam.