Hoʻopuka i ka maʻi maʻi

I kēlā me kēia makahiki, ʻoi aku ka mālama ʻana i ka maʻi diabetes. ʻAe kēia iā ʻoe e pale pale i nā hoʻopiʻi vascular a hoʻolōʻihi i ka manawa o ko lākou helehelena. No laila, no nā wahine me ka maʻi maʻi, e hoʻonui ka lōʻihi o ka wā hānau.

Hiki i ka maʻi maʻi ke paʻakikī i kahi koho koho kūpono.

I ka manawa like, pono nā wahine a me ka maʻi diabetes i ka hoʻolālā ʻana o ka hapai maʻi. Hiki iā ʻoe ke hoʻomaka e hānō inā ua pili loa ke kō o ke kō koko kōpili iā ʻoe ma kahi maʻamau, ʻo ia hoʻi, ua loaʻa i ka uku diabetes maʻi maikaʻi.

ʻO kahi ʻōpō ʻole ʻole i hoʻolālā ʻia me ka maʻi hānai e hoʻoweliweli i nā hoʻopiʻi koʻikoʻi no ka wahine a me kāna mau hanauna e hiki mai ana. ʻO ke kumu kēia o ka hihia o ke kuhi ma ka maʻi diabetes he mea nui loa. Hāʻawi ʻia ʻo ia i ka nānā nui e nā kauka a me kā lākou mau maʻi me ka maʻi diabetes.

ʻO ke koho ʻana i ke ala e koho ai ʻoi aku ka paʻakikī Hoʻoholo ʻia kēia pilikia ma kēlā me kēia wahine. Inā e loaʻa iā ia i ka maʻi maʻi, a laila e kū hou mai nā nuances hou aʻe. Ma kēiaʻatikala o kēia lā, e aʻo ʻoe i nā mea āpau āu e pono ai, a pū me kāu kauka, e hoʻoholo i ka maʻi hoʻomanawanui no ka maʻi diabetes.

ʻO ka mea aʻe i wehewehe wale nō i nā ʻano hoʻokūkū hou o nā kūlike. He kūpono ia no nā wahine me ka maʻi maʻi, e pili ana i kā lākou hōʻike pilikino. ʻAʻole mākou e kūkākūkā i ka ʻano o ka koukau ʻana, ka hana moe kolohe, hana like ʻole a me nā ʻano hana ʻē aʻe pono ʻole.

Loaʻa i nā hana contraceptive no nā wahine me ka maʻi maʻi

He aha ka helu?

• 1 - ke hoʻohana ʻia o ke ʻano hana;
• 2 - i nā hihia he nui nā contraindications e hoʻohana i ka hana;
• 3 - ʻaʻole i aʻo ʻia ka hoʻohana ʻana o ke ʻano, akā inā nā hanana ʻē aʻe kahi kūpono ʻole o ka hoʻohana ʻana ia mea;
• 4 - ua hoʻohālikelike maoli ʻia ka hoʻohana ʻana o ke ʻano.

Nā Hoʻolālā:

• COCs - nā pēpē mana hoʻomalu i hānau ʻia e loaʻa ana nā hormones mai ka haʻahaʻa o ka estrogens a me nā progestins;
• POC - nā pā kīpeke hana nona ka progestogen wale nō;
• Cu-IUD - kahi ʻāpana intrauterine e loaʻa ana i ke keleawe;
• ʻO LNG-IUD kahi mea intrauterine e loaʻa ana i ka levonorgestrel (Mirena).

Ke koho ʻana i kahi ala kumu hoʻomākiʻikuʻi no ka maʻi maʻi maʻi maʻi

ʻO ke kumu o nā ʻike: nā kulekele lapaʻau "Algorithms no ka mālama olakino kūikawā no nā maʻi me ka maʻi mellitus" i hoʻoponopono ʻia e II. Dedova, M.V. Shestakova, 6th edition, 2013.

Inā he wahine maʻi maʻi maʻi mau contraindications no ka hapai, a laila e noʻonoʻo i ka hana ʻana ma muli o ka hiki ʻana ke hoʻolimalima. ʻO ka mea like inā ʻoe "i hoʻoponopono i kāu hana hana."

Hoʻohui ʻia nā mea hoʻohālikelike waha

ʻO nā ʻōpū ʻōpala i hoʻohālikelike i nā waha (COC) nā pihi mana hoʻomalu i loaʻa i ʻelua mauʻano o nā hormones: estrogens a me progestins. ʻO Estrogen e like me kahi mahele o ka lāʻau hānau hānau e hoʻopiha i ka hemahema o ka estradiol, ke kūlohelohe kūlohelohe i kālai ʻia i loko o ke kino. Pēlā, hoʻomalu ʻia ka mālama ʻana o ka pōʻaiā. A hāʻawi ka progestin (progestogen) i ka hopena maoli o ka COC.

Ma mua o ka lawe ʻana i nā mea hoʻohālike hormonal, e nīnau aku i kāu kauka a hele i ka nānā ʻana hemostasiological. ʻO kēia nā hoʻāʻo koko no ka hana platelet, AT III, mea VII a me nā mea ʻē aʻe. Inā hewa kēia mau hoʻokolohua maikaʻi ʻole - ʻaʻole kūpono kēia ʻano hoʻohālikelike iā ʻoe, no ka mea, he nui ka piʻi ʻana o ka thrombosis venous.

I kēia manawa, kaulana nui nā contraceptive wahaʻai a puni ka honua, i waena hoʻi o nā wāhine i loaʻa i ka maʻi maʻi. Nā kumu:

• Mālama pono nā COC i ka wā i makemake ʻole ai ka wahine;
• ua ae like loa lakou e ka wahine;
• ma hope o ka hoʻopaʻa ʻana i ka paila, hāpai ka hapanui o nā wahine i loko o ka mahina 1-12 mahina;
• ʻOi aku ka maʻalahi o nā paila ma mua o ka hoʻopili ʻana i kahi manakia, hana i nā injections, etc.
• kēia ala o ka contraception i loaʻa he hopena therapeutic a me prophylactic hopena.

Nā maʻi hoʻohālikelike i ka hoʻohana ʻana o nā ʻākeke waha i hui pū ʻia i ka wahine me ka maʻi maʻi.

• ʻaʻole e koi ʻia ka maʻi diabetes, i.e., ua kū ka nui o ke kōpaʻa koko;
• huki koko ma luna o 160/100 mm RT. st .;
• ua haki ʻia ka ʻōnaehana hemostatic (ka hoʻokaʻeha kaumaha a ʻoi hoʻi ka nui o ke koko);
• ua ulu mua ka hopena maʻi vascular maʻi o ka maʻi maʻamau - proliferative retinopathy (2 mau kumu), nephropathy maʻi ma ke ʻano o microalbuminuria;
• nele i ka mea hoʻomanawanui i ka ʻike pono ʻole.

ʻO nā hoʻohālikelike me ka estrogen intake ma ke ʻano o ka hui pūnāwai waha.

• mahuahua o ka mahuahua o ke koko a me ka pani ʻana o nā moku koko (e hana i nā hōʻike a nānā!
• ua ulia ʻia ka maʻi cerebrovascular, migraine;
• nā maʻi pūpū (hepatitis, Rotor, Dabin-Johnson, nā sindrom Gilbert, cirrhosis, nā maʻi ʻē aʻe e hui pū ʻia e ka palaleka o ke ake);
• ka huhū ʻana mai ke aʻa o ka genital tract, nā kumu kumu i ʻike ʻole ʻia;
• nā maʻi maʻi hormon-hilinaʻi.

ʻO nā mea i hoʻonui nui i ka hopena o ka hopena estrogen:

• ulaula
• maʻalahi hypertension arertial;
• makahiki 35 makahiki;
• nā kau ma luna o ka pae kiʻekiʻe 2;
• hoʻoilina hema ʻole i nā maʻi cardiovascular, i.e., ua loaʻa nā maʻi o ka coronary heart disease a i ʻole ka weliweli i loko o ka ʻohana, ʻoi aku ma mua o 50 makahiki;
• lactation (umauma).

No nā wahine me ka maʻi maʻi, hoʻolaʻa haʻahaʻa a me nā micro-dosis hoʻohui i nā kūmole waha.

ʻO COC haʻahaʻa haʻahaʻa - aia ka liʻiliʻi ma mua o 35 μg o ka māhele estrogen. E pili ana kēia:

• monophasic: "Marvelon", "Femoden", "Regulon", "Belara", "Jeanine", "Yarina", "Chloe";
• ʻekolu kolu: "Tri-Regol", "Three-Merci", "Trikvilar", "Milan".

Nā COrod Microdosed - loaʻa 20 mcg a i ʻole ka liʻiliʻi o ka māhele estrogen. Hoʻopili ʻia kēia me ka hoʻomākaukau ʻana monophasic "Lindinet", "Logest", "Novinet", "Mercilon", "Mirell", "Jacks" a me nā mea ʻē aʻe.

No nā wahine me ka maʻi maʻi, he milestone hou i loko o ka hoʻohālikelike ʻana i ka hoʻomohala ʻana o KOK, ka mea e loaʻa ai ka estradiol valerate a me ka dienogest, me kahi papa hana hoʻonaninani ("Klayra").

Hoʻopili i nā maʻi hoʻohālikelike waha a pau i nā kiʻekiʻe o ka triglyceride i ke koko. Akā he mea kūpono ʻole kēia no ka poʻe wahine i loaʻa iā hypertriglyceridemia ma mua o ka lawe ʻana i nā pōpoki. Inā wahine ka dyslipidemia moderate (pākuhi i ka momona metabolism), a laila palekana palekana COCs. Akā i ka wā o kā lākou hoʻokau kai, pono ʻoe e mālama pinepine i kahi hoʻokahe koko no ka triglycerides.

ʻO ke apo hormonal hāmeʻa NovaRing

ʻO ke ala o ka hopena o ka hoʻokolohua o nā testosterone aila no ka mea, ke kumu no ka nui o nā kumu. Mālama ʻia ka paʻa ʻana o nā hormones i loko o ke koko. ʻAʻole ʻike ʻia nā mea ola i ka pau mua ma ke ake, me ke komo ʻole ʻana o nā papa. No laila, i ka wā e hoʻohana ai i nā contraceptives vaginal, hiki ke hōʻemi ʻia ka nui o ka lā no kēlā me kēia lā.

ʻO ke apo hormonaliali NovaRing he contraceptive i ke ʻano o ke aniani hōʻailona, ​​he 54 mm ka lōʻihi a me ka 4 mm ka palena ma ka ʻaoʻao ʻāpana. Mai ia manawa, 15 micrograms o ethinyl estradiol a me 120 micrograms o etonogestrel e hoʻokuʻu ana i loko o ka pū i kēlā me kēia lā, he metabolite kūpono o ka desogestrel.

Hoʻokomo kūʻokoʻa kahi wahine i kahi apo contraceptive i loko o ke kaʻi, me ka ʻole o ke komo ʻana i nā limahana lapaʻau. Pono e kāhiko ʻia no nā lā 21, a laila hoʻomaha i ka hoʻomaha no 7 mau lā. ʻO kēia ala o ka contraception ka hopena liʻiliʻi loa i ka metabolism o nā huapalapala a me nā momona, e like me ka microdosed gabungan kūmole wahaʻelima.

Hoʻomaopopo iki ka mole hormonal hāpau o NovaRing no ka hoʻohana ʻana i nā wahine e hoʻohui i ka maʻi diabetes me ka momona, hoʻokiʻekiʻe ʻia i ka triglycerides i loko o ke koko a i ʻole ka hana ʻana i ka puʻuwai. Wahi a nā noiʻi haole, ʻaʻole e loli ka ʻōnaehana olakino maʻi mai kēia.

Maikaʻi ia ma ʻaneʻi e hoʻomanaʻo i nā wahine me ka momona a me / a o ke koko koko koko nui paha ma muli o ka maʻi maʻi maʻi kūmole i ka candidal vulvovaginitis. ʻO ke kumu kēia inā he uhai ʻoe, a laila ʻo ka hopena paha ʻaʻole ia he hopena o ka hoʻohana ʻana o ka maʻi laʻa o NovaRing vaginal, akā ua ala mai nā kumu ʻē aʻe.

Intacauterine contraceptives

Hoʻohana ʻia nā mea hoʻohālikelike Intrauterine e 20% o nā wahine me ka maʻi maʻi. Ma muli o kēia koho kūpono o ka contraception ʻokoʻa a paʻa i ka manawa like me ka pale ʻana i ka wā makemake ʻole. ʻOluʻolu loa nā wahine ʻaʻole pono lākou e nānā pono i kēlā me kēia lā, e like me ka wā e lawe ai i nā paila hānau.

Loaʻa nā pono hou o nā contraceptives intrauterine no ka maʻi maʻi:

• ʻaʻole lākou e hoʻoluhi i ka pālea a me ka momona momona;
• mai hoʻonui i ka hopena o nā koka koko a me ka pōkole o nā kīʻaha koko.

ʻO nā hemahema o kēia ʻano ʻokoʻa.

• Hoʻopau pinepine nā wahine i nā hōʻekekeke kāne kāne (hyperpolymenorrhea a me dysmenorrhea)
• mahuahua i ka ulu ʻana o ka ʻōpū ectopic
• ʻoi aku ka nui o nā maʻi o nā maʻi pelvic i ka maʻi maʻamau, ʻoiai inā me ka maʻi ʻaʻomaʻi ʻoi mau ke koko koko.

ʻAʻole ʻōlelo nā wāhine hānau i hāʻawi ʻia e hoʻohana i nā hana hoʻohālikelike intrauterine.

No laila, ua ʻike ʻoe i nā kumu nā koho i ke ʻano hoʻokahi a i ʻole ke ʻano o ka mea hoʻohālikelike no ka maʻi maʻi. Hiki i kahi wahine o ka hua hānau ke koho i kahi koho kūpono nona iho, e maopopo pono e hana me ke kauka. Ma ka manawa like, e mākaukau e hoʻāʻo ʻoe i nā ʻano 'ana aʻe a hiki i ka manawa e hoʻoholo ai ʻo wai ka mea e pili loa iā ʻoe.