åŠåš äžçµ¶åŸã®åŠåš ã®å¯èœæ§
èšäºäžã§
- äžçµ¶åŸã«åŠåš ããã®ã¯ç°¡åã§ããïŒ
- åŠåš äžçµ¶ããŠããã©ã®ãããæ©ãåŠåš ã§ããŸããïŒ
- åŠåš äžçµ¶åŸã«äœãåé¡ãæ±ããŠããŸããïŒ
- éå»ã®äžçµ¶ã¯åŠåš ããã®ãé£ããããŸããïŒ
- å±éºå åã¯äœã§ããïŒ
- äžçµ¶åŸã«åŠåš ãã
- åŠåš äžçµ¶åŸã«åŠåš ããŠãããã©ããã確èªããæ¹æ³
- åŠåš äžçµ¶åŸã®èµ€ã¡ããã®ããã®èšç»äžã«ç¥ã£ãŠããã¹ãããš
åŠåš ããããšã¯å®¶æã«å€ãã®å¹žããããããããšãã§ããŸãã æã ãåŠåš ãäžçµ¶/æµç£ã«è³ããšãã幞çŠã¯çåœã§ãã ããããããã¯ããªããåžžã«èµ€ã¡ããã®ããã«åã³èšç»ãç«ãŠãããšãã§ããã®ã§ããªããèœã¡èŸŒãã§ããçç±ã§ã¯ãªãã¯ãã§ãã
äžçµ¶åŸã«åŠåš ããã®ã¯ç°¡åã§ããïŒ
æåµããã»ã¹ã¯äœå ã§ç¶ç¶ãããããäžçµ¶ã¯å人ã®åèèœã«åœ±é¿ãäžããŸããã ããã¯ãäžçµ¶åŸã«åŠåš ããã女æ§ã¯æè¡çã«åŠåš ããå¯èœæ§ãããããšãæå³ããŸãã ããããªãããéæ³ãªäžçµ¶ã¯èè±ãè žãžã®å€å·ã®ãããªå䜵çãèµ·ããåŸåããããããã¯çæ®åšç³»ã®é·æçãªæå·ã«ã€ãªããå¯èœæ§ããããŸãã ãããã®å䜵çã¯äž»ã«å€ç§å»ãçç·ŽããŠããªããããŸãã¯åŠçœ®ãå®è¡ããã®ã«å¿ èŠãªéå ·ãæ¬ ããŠããããã«äž»ã«çºçããŸãã
åŠåš äžçµ¶ããŠããã©ã®ãããæ©ãåŠåš ã§ããŸããïŒ
åŠåš äžçµ¶åŸã«åŠåš ããææãå¿é ã§ããïŒ
åŠåš äžçµ¶ããã©ããããã®æéåŠåš ããããšãã§ãããã¯ãè€æ°ã®èŠå ã«ãã£ãŠç°ãªããŸãã æåµã¯èªç¶çŸè±¡ã§ãã äžçµ¶åŸã®æåµã®éåžžã®ãµã€ã¯ã«ãåéãããšããã«ãããªãã¯åã³åŠåš ããå¯èœæ§ããããŸãã çµå£é¿åŠæ³ã䜿çšããããšããªãå Žåã¯ãäžçµ¶åŸããã«åŠåš ããå¯èœæ§ããããŸãã ããªãã¯ãŸã åºè¡ããŠãããšãã§ããåŠåš äžçµ¶åŸ7-10æ¥ä»¥å ã«åŠåš ããããšãã§ããŸãã ããã«åŠåš ããããšã¯å¯èœã§ãããäœãããèªèº«ãçŽãå¿ èŠãããã®ã§ãå§ãã§ããŸããã
ããã¯ããªããåã³èµ€ãåãè©Šãããšã«æ±ºããåã«ããªããæäœ3ã¶æåŸ ã€ããšããå§ãããŸãã ããã¯ãæ¯åäž¡æ¹ã®å®å šãšå¥åº·ã確ä¿ããããã§ãã ããªãã®äœã¯ãŸãå€å·ããå埩ããæéãå¿ èŠã«ãªããŸãã ããªãã®äœãééããæ é€ã®åªå€±ãšäžè¶³ã¯å埩ããã®ã«æéãå¿ èŠã«ãªãã§ãããã ããªãã®å»è ã¯æµç£ã®åçºã®ããã®å»åŠçåå ãæé€ããããã«å°æ°ã®èª¿æ»ãšåºçåã®ã±ã¢ãå§ããŸãã
ããªããå€ç§çäžçµ¶ãŸãã¯D&CïŒæ¡åŒµããã³æ»ç¬ïŒæè¡ãåããå Žåãããªãã®å¥åº·ç®¡çéæ¥å»ã¯ããªãã«åå®®ã修埩ããããšãå¯èœã«ããããã«å°ãªããšã1ãµæåŸ ã€ããšãå§ããŸãã ããªãã®äžçµ¶ã2åŠæãŸãã¯3åŠæã«ãã£ããªãã°ãããªãã®å»è ã¯ããé·ãåŸ ã€ããšãå§ããŸããããã§äœã¯ããäŒãŸããŠããããŠåã®æ¬ é¥ãçŽãããã«åçãããŸãã ããªãã¯æ¬¡ã®åŠåš ã§ç¥çµç®¡ã®æ¬ é¥ã®å¯èœæ§ãæžããããã«èé žã®ãããªãµããªã¡ã³ããæ¶è²»ããããã«ææ¡ããããããããŸããã å»åŠçå䜵çããªãå Žåã¯ãäžçµ¶åŸã®åŠåš ã¯éåžžå®å šã§ãã
åŠåš äžçµ¶åŸã«äœãåé¡ãæ±ããŠããŸããïŒ
æµç£ã¯éåžžã«ã¹ãã¬ã¹ããããå¯èœæ§ããããŸãã åœãèœãšãããšãã眪ã¯ããªãã®å¹žçŠãç ç²ã«ããå¯èœæ§ããããŸãã å€ãã®å¥³æ§ã¯è€æ°ã®åŠåš äžçµ¶ãçµéšãã絶æçã«æããŸãã ããªãã®åŠåš äžçµ¶ãçç·Žããå€ç§å»ã«ãã£ãŠåæ³çã«è¡ãããå Žåãããã¯æµç£ã®ããã«æ±ãããŸãã ããªãã¯åŠåš ã®æºåãã§ããŠãããšãã¯ãã€ã§ãããªããåŠåš ããåé¡ãæã£ãŠã¯ãããŸããã ãããã解éãéæ³ã«è¡ãããå ŽåããŸãã¯èšç·ŽãåããŠããªãå»åž«ãå©ç£åž«ããŸãã¯äžæœãªæ¡ä»¶ã§è¡ãããå Žåã¯ãåã³åŠåš ããå¯èœæ§ãäœããªããŸãã ææãç¢çåããŸãã¯äžå®å šãªåŠåš äžçµ¶ãªã©ã®å䜵çãããå¯èœæ§ãããããã®çµæã女æ§ã«é倧ãªå¥åº·äžã®ãªã¹ã¯ãçããåŠåš ããå¯èœæ§ãåã³äœäžããŸãã
äžåŠçã®åé¡ã¯ä»¥äžã®å Žåã«èµ·ãããŸãïŒ
- åŠåš ã¯çµäºããŸããããåŠåš ã®æ®éªžã¯å®å šã«ã¯é€å»ãããŠããããææãç¢çåããã³å䜵çã®å±éºæ§ãé«ãŸã£ãŠããŸãã
- å Žåã«ãã£ãŠã¯ãïŒæ¡åŒµãšæ»ç¬ïŒD&Cæé ãæ£ãã泚ææ·±ãè¡ãããªããšãæž æäžã«åå®®ãæå·ããå¯èœæ§ãé«ããªããŸãã
- æ²»çããªããšè¡åŸã«çºçããå¯èœæ§ãããææçã§ãã骚ç€å ççæ§çŸæ£ïŒPIDïŒã¯ãåµç®¡ã®åšå²ãŸãã¯å éšã§éå¡ãåŒãèµ·ãããåå®®å€ã§åå®®å€ã«çºçããå¯èœæ§ããããŸãã
- åå®®ã®å åŽãŸãã¯åå®®é žéšã®é ç¹ïŒåå®®ã®éå£éšïŒã«ç¢çãããå¯èœæ§ããããŸãã ããªããããªãã®æéãæ¬ å ŽãããããŸãã¯åŠçœ®ã®åŸã«è»œãæéããããªãã°ãããã¯ç¢çåã®ãããããããŸããã ããªãã®å»è ã¯ãåå®®é¡æ€æ»ãããªãã¡ãã®ãããªåŸŽåã確ãããããã«å°ããã«ã¡ã©ãåå®®é žéšãéã£ãŠåå®®ãŸã§ééããæé ãéããŠç¢çåã«ã€ããŠãã¹ããããããããŸããã å»è ã¯ç¢çåããçµç¹ãåæã«ä¿®åŸ©ããããšããããŸãã åå®®ã®ç°åžžãªç¢çåã¯ãDïŒCææäžã®æ»ç¬ã«ããåå®®ã®æŠéã«ãã£ãŠåŒãèµ·ããããããšããããŸãã åºç¯å²ã®ç¢çåã®å Žåãããã¯äžåŠã«ã€ãªãããããããŸããã ãã㯠'Asherman's syndrome'ãšåŒã°ããŠããŸãã çè«çã«ã¯ãManual Vacuum Aspirationã¯ãããèœãšããé¢äžããªãããããã®ãªã¹ã¯ãæé€ããŸãã åæ§ã«ãåžåŒäžçµ¶/åžåŒæ»ç¬ã¯ç¢çåã®ãªã¹ã¯ã軜æžããŸãã ãã ããçè«ããµããŒãããããã®åºç¯ãªç 究ã¯ãããŸããã
- ããªããè€æ°ã®åŠåš äžçµ¶ã®ç æŽãæã£ãŠãããªãã°ãããªãã¯é žéšã®æ¡å€§ãåŠçœ®ã®éã«ãããããšãåå ã§ãããããããªãé žéšã®åŒ±ããæã€ãããããŸããã ããã¯ãåå®®é žéšãéããç¶æ ã«ä¿ã€ããã«æ°ã¹ãããã§æ²»çããããšããããŸãã
ä¿è·ãããŠããªãã»ãã¯ã¹ãé »ç¹ã«è¡ã£ãåŸã§ããåŠåš äžçµ¶ãã1幎以å ã«åŠåš ããã®ãé£ãããšæããå Žåã¯ãå»åž«ã®æ瀺ããæ€æ»ãåããããäžåŠæ²»çã®å°é家ã«çžè«ããŠãã ããã
åŠåš äžçµ¶åŸã®åŠåš
äžçµ¶ã¯å€å·æ§ã§çã¿ã䌎ãçµéšã«ãªãããšããããŸãã ããããªãããåŠåš äžçµ¶åŸã®åŠåš ã¯åŠåš äžçµ¶åŸ7ã10æ¥ã§å¯èœã§ãã ããªãããŸã åºè¡ããŠãããšãã§ããããã¯èµ·ãããããããŸããã åŠåš ã®ç¶ç¶ãçµäºã«ã€ããŠã®å¿é ã¯ãããŸããã
èšç»åŠåš ãŸãã¯åéåŠåš
ã»ãšãã©ã®å¥³æ§ã¯ããäžçµ¶åŸã«åŠåš ããããšã¯ã§ããŸããããšããå ±éã®æžå¿µãæ±ããŠããŸãã å®æçãªäžçµ¶ãé©åã«è¡ãããŠããåºççã®åé¡ã¯çããŸããã ããªããäžçµ¶åŸã«åŠåš ããããšããŠãããªããããªãã¯äžçµ¶åŸããã«åŠåš ã§ããã¯ãã§ãã ãã ããåå®®ã®æ²»çãå¯èœã«ããèé žãªã©ã®å¿ èŠãªãµããªã¡ã³ããæåããŠäœãå¥åº·ã§å®å šãªåŠåš ã®ããã«æºåãããããã«ããŠãäœãæŽããããã«å°ãªããšã3ã¶æåŸ ã€ããšããå§ãããŸãã ããªãã¯å¥ã®æµç£ãçµéšãããšããèŠçãä¹ãè¶ããããªããããããŸããã
3.æãŸãªãåŠåš
æãŸãªãåŠåš ã¯ãäž¡æ¹ã®ããŒãããŒã«ãšã£ãŠå¿çå€å·ãè² ãå¯èœæ§ããããŸãã ããªãã¯äžçµ¶åŸããã«èµ€ã¡ãããç£ãããšãèšç»ããŠããªããããããã身äœçæ²»çã確å®ã«ããããã«åŠåš ãé ããã粟ç¥çå€å·ããã®å埩ãåŸ ã€ããšãæãã§ãããã åŠåš äžçµ¶ãèšç»å€ã§ã家æãå§ããæºåãã§ããŠããªãå Žåã¯ãããã«å¥ã®åŠåš ã«æè¬ããããšã¯ã§ããŸããã
åŠåš ããå±éºãããå Žåã¯ãåºçé²æ¢çãè¬ããããšããå§ãããŸãã ããã¯çµäºåŸ1é±é以å ã«éå§ããå¿ èŠããããŸãã ããªãã¯ã³ã³ããŒã ããã«ã泚å°ãé¿åŠããããªã©ã®é¿åŠè¬ã䜿çšããããšãã§ãããããŠä¿è·ãããŠããªãæ§ã®å Žåã«ã¯ãç·æ¥é¿åŠè¬ãæçšããããšæããããããŸããã ãã®ãããªç¶æ³ã®äžã§ããªãã®å»è ã®æèŠããšãã®ãæåã§ãã
éå»ã®äžçµ¶ã¯åŠåš ããã®ãé£ããããŸããïŒ
äžçµ¶ãŸãã¯ç¹°ãè¿ãã®äžçµ¶ãå°æ¥ã®åŠåš ã劚ãããšããååãªèšŒæ ã¯ãããŸããã ããªããåŠåš ããäºå®ã§ãããªãã®åå®®ãåŠåš ããæºåãã§ããŠãããªãã°ãããªãã¯å¿é ããããšã¯äœããããŸããã
家æãå§ããæºåãã§ããŠããªãå Žåããå»åŠçãªçç±ã§äžçµ¶ãããå Žåãããå Žåã¯ãäžçµ¶ããããšãéžæããã«ããã«ãããŸãã åŠåš äžçµ¶åŸã¯äºé²æªçœ®ãšèšç»ãå¿ èŠã«ãªããŸãã ã«ããã«ã¯ãã質åã«æ©ãã§ããŸãã éå»ã®äžçµ¶ã¯åŠåš ã®å¯èœæ§ã«åœ±é¿ããŸããïŒ
- å»åŠåéã®é²æ©ã«äŒŽããäžçµ¶ã¯å®å šãªåŠçœ®ã§ãã å°é家ã«ããé©åãªå»çèŠå¶ã®äžã§è¡ãããäžçµ¶ã¯ãå°æ¥ã®åºççã«åœ±é¿ãäžããŸããã ãšãŠãå®å šãªæé ã§ãã ãã®åé¡ã¯ãåµç®¡ãåµå·£ãåå®®å èãªã©ã®çæ®åšç³»èåšãžã®ææäžã«ææãæå·ãããããã«ãæªçãªå»åž«ã«ãã£ãŠäžæ£ã«ãŸãã¯èª€ã£ãŠè¡ãããå Žåã«ã®ã¿çºçããŸãã
- ç¹°ãè¿ãè¡ãããå Žåãäžçµ¶ã¯åå®®é žéšã®æ¡åŒµã䌎ããŸãã ããã¯ãåå®®é žéšã衰匱ãããææå°æ©ã®äžçµ¶ãããããæ©æã®æ¡åŒµãããããå¯èœæ§ããããŸãã ãã®äžãäžçµ¶ã®éã«åå®®ã®æŽæµãå«ãè€æ°ã®D&Cæé ã¯ãåå®®ã®å åŽãŸãã¯åå®®é žéšã®äžéšã®ç¢çåã«ã€ãªããå¯èœæ§ããããŸãã ããã€ãã®ã±ãŒã¹ã§ã¯ãåå®®é žéšãéããŠèå ã®èå ãå®å šã«ä¿ã€ããã«ã¹ããããäœãããŸãã
- äžçµ¶çŽåŸã«åŠåš ããããšã¯å»åŠçãªäžçµ¶ã®ç¶æ³ã«ãããŸããè¬ã®ããã«åå®®ã¯åŒ±ãŸããŸãããããŠãããã¯èå ãæŒãåºãããã«åçž®ãèªçºããããšãã§ããŸãã ããã¯éå°ãªåºè¡ã䌎ããŸãã å€ç§çæµç£ã®å Žåã«ã¯ãåžåŒæåºã®åŸã«D&Cãè¡ãããŸãã ããã¯å¥³æ§ãšåœŒå¥³ã®åå®®ã®å¥åº·ã«å€§ããªè² æ ããããã®ã§ãäžçµ¶åŸã«åŸ ã€ããã«å°ãªããšã3ã¶æåŸ ã€ã®ãçæ³çã§ãã çããèš±ããªããïŒ
- åŠåš ãéããªãèšç»ããªãå Žåã¯ãé¿åŠãŸãã¯ä¿è·ã䜿çšããããšãéèŠã§ãã åŠåš äžçµ¶åŸéããªãæãŸãªãäºå®å€ã®åŠåš ãåãéåœã«ã€ãªããå¯èœæ§ããããŸãã ããªãã¯åŠåš ããããã«å¿ççã«ãããŠç²Ÿç¥çã«æºåãããªããã°ãªããªãã§ãããã
- åå®®ãæ²»ãã®ãåŸ ã£ãŠããŠããèµ€ã¡ãããèšç»ããåã«å»åž«ã«çžè«ããŠãã ããã åå®®ã®å¥åº·ç¶æ ããã§ãã¯ããåŠåš ã«é©ããŠãããã©ãããå€æããããã«ãããã€ãã®æ€æ»ã蚺æãå§ãããããããããŸããã
- ããªããèµ€ã¡ãããç£ãæºåãã§ããŠãããšããåŠåš ã®å¯èœæ§ãé«ããããã«æ§äº€ã«é »ç¹ã«ãµããŠãã ããã ããã¯ããªããããæ©ãåŠåš ããã®ãå©ããã§ãããã
å±éºå åã¯äœã§ããïŒ
å°éçã«æ²»çãããå ŽåãåŠåš äžçµ¶ã¯å±éºå åãããããããšã¯ãªãã女æ§ãéåžžã®åŠåš ãããããšãå¯èœã«ããã¯ãã§ãã æã ãããã¯äžçµ¶åŸã«åŠåš åé¡ãåŒãèµ·ãããããããŸããã ãããã¯é©åãªæ³šæãšäºé²æªçœ®ããšãããšã«ãã£ãŠåŠçããããšãã§ããŸãã
äžçµ¶åŸã«åŠåš ãã
åŠåš äžçµ¶åŸã«åŠåš ããæ¹æ³ã¯æ¬¡ã®ãšããã§ãã
- åŠåš äžçµ¶åŸã®å®å šãªåŠåš ã確ä¿ããããã«å»åž«ãšè©±ãããšããå§ãããŸãã
- éæ³ãªäžçµ¶ã¯å°æ¥ã®çæ®èœåãå±éºã«ãããå¯èœæ§ããããŸãã åå®®é žéšãžã®æå·ãåå®®ãå°æ¥ã®å°é£ãªã©ã®äžç¢ºå®ãªãªã¹ã¯ãåé¿ããããã«ãå°éã®å©Šäººç§å»ã«çžè«ããŠãã ããã
- å¥åº·çãªã©ã€ãã¹ã¿ã€ã«ãç¶æããå«ç ã飲é ããããã«ãã§ã€ã³æåéãæžãããŸãã æé©ãªã¬ãã«ã®ãã£ãããã¹ã¯å¥åº·ãªåŠåš ã«ã€ãªãããŸãã
- 掻åçãªæ§ç掻ã¯åŠåš ã®ããªãã®ãã£ã³ã¹ãå¢ããããšãã§ããŸãã
- æåµæã远跡ããæåµäžã«é »ç¹ã«ã»ãã¯ã¹ãããã ããªãã¯ããªããããªãã®ã¹ããŒããã©ã³äžã§æåµãã©ãã«ãŒã¢ããªã远跡ãŸãã¯ããŠã³ããŒãããã®ãå©ããããã«æåµããããè³Œå ¥ããããšãã§ããŸãã
- æ§äº€åŸãåºã®äžã«æã眮ããŠè¶³ãšè °ãäžãã粟åãåµåã«éããã®ãå©ããŸãã
åŠåš äžçµ¶åŸã«åŠåš ããŠãããã©ããã確èªããæ¹æ³
ç°¡åãªåŠåš ãããã¯åŠåš ã®å€æã«åœ¹ç«ã¡ãŸãã åŠåš äžçµ¶çŽåŸã«æ€æ»ãåãããšããŠããåŠåš ããŠããªããŠãçŽ1ã¶æéã¯éœæ§ã®çµæã瀺ãããšããããŸãã åŠåš ããŠãããšæãããå Žåã¯ãåŠåš ãããæ€æ»ãåãã1é±éåŸã«æ€æ»ãç¹°ãè¿ããŠç¢ºèªããŠãã ããã
åŠåš äžçµ¶åŸã®èµ€ã¡ããã®ããã®èšç»äžã«ç¥ã£ãŠããã¹ãããš
ããªããåŠåš ããããšããŠãããªããããªãã¯åããšããœãŒããç¹°ãè¿ãããªãããšã確å®ã«ããããã«ããã€ãã®äºé²çããšãã¹ãã§ã
- ããªãã®å©Šäººç§å»ãŸãã¯äžåŠæ²»çã®å°é家ãšè©³çŽ°ãªè°è«ãããŠãã ããã å®å šãªåŠåš ãåŠçããããã«ããªãã®çæ®ã·ã¹ãã ãšããªãã®èäœçããã³ç²Ÿç¥çãªæºåç¶æ ããã§ãã¯ããããã«ããã€ãã®ãã¹ããè¡ãããšããå§ããããããããŸããã
- è€æ°ã®äžçµ¶ã¯ããªãã®åå®®é žéšã匱ããããšããããŸãã ããã¯æé·ããŠããèµ€ã¡ãããå®å šã«ä¿ã€ããã«ã¹ãããã§ããªãã®å»è ã«ãã£ãŠåºå®ããããšãã§ããŸãã ããªãã¯ãŸãããªãã®ã«ãŒãã³ã«Kegelã®ç·Žç¿ãå«ããããšã«ãã£ãŠããªãã®éªšç€åºçã匷åããããšãã§ããŸãã
- ããªããæè¿äžçµ¶ãããå Žåã¯ãããªãã®äœãçããã次ã®åŠåš ã«åããããã«ããŠãã ããã äžçµ¶åŸããã«åŠåš ãããããšããã©ãŠãããå埩ããŠããäœã«ã¹ãã¬ã¹ãåŒãèµ·ããå¯èœæ§ããããŸãã çãŸããã°ããã®åäŸã®åªå€±ã¯ãŸããããªããããŸãã«ãæ©ãåŠåš ãããã®çµæãšããŠèå ã®å¥åº·çãªçºéã«ã圱é¿ãäžãããªãã°ãäžå®ã«ã€ãªããå¯èœæ§ãããå¿çç圱é¿ãäžããå¯èœæ§ããããŸãã
- åŠåš ã®æºåãã§ããŠããªãå Žåã¯ãé¿åŠè¬ã䜿çšããŠããããšã確èªããŠãã ããã
- ããªãã¯ãå€ãã®ãã«ã¢ã³ã®å€åãäžå®å®ãªææãããã³æµç£åŸã®æ°åå€åã«å¯ŸåŠããã®ãšåãããã«ãèµ€ã¡ãããç£ãããã«ç²Ÿç¥çã«æºåããå¿ èŠããããŸãã
- è©ŠããåŸã«åŠåš ã§ããªãå Žåã¯ãè£å©åŠåš ãæ€èšããŠãã ããã äœå€å粟ãäœå€å粟ã®ãããªéžæè¢ã«ã€ããŠäžåŠæ²»çã®å°é家ã«çžè«ããŠãã ããã
åŠåš äžçµ¶ã¯å¿ ãããåŠåš ããã¯ãäžå¯èœã§ããããšãæå³ããããã§ã¯ãããŸããã ãããã¯ã®ã¿ããŒçãªæ§è³ªã®ããã«ãå€ãã®äººã ã¯äžçµ¶ã«ã€ããŠã®ããŸããŸãªäºå®ã«æ°ã¥ããŠããŸããã èªå®ããã蚺çæã§è¡ãããéãããããã¯å®å šã«å®å šã§ãããæ¯èŠªã®å¥åº·ã«åœ±é¿ãäžããŸããã