BEMORLAR TOMONIDAN BERILGAN BAHOLASH MA’LUMOTLARI ASOSIDA CHANOQ A’ZOLARI PROLAPSINI JARROHLIK YO‘LI BILAN DAVOLASHNING UZOQ MUDDATLI NATIJALARI TAHLILI
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chanoq a’zolari prolapsi, jarrohlik davolash, uzoq muddatli natijalar, POP-Q, hayot sifati, seksual funksiya, stressli siydik tuta olmaslik, prolaps retsidivi##article.abstract##
Maqsad: Chanoq a’zolari prolapsi (ChAP) bo‘lgan bemorlarda jarrohlik davolashning uzoq muddatli natijalarini baholash, davolash samaradorligiga ta’sir etuvchi omillarni aniqlash hamda bemorlarning hayot sifati va seksual funksiyasidagi o‘zgarishlarni o‘rganish.
Material va metodlar: Tadqiqotga chanoq a’zolari prolapsi bo‘yicha jarrohlik davolash o‘tkazilgan 58 nafar ayol kiritildi. Bemorlar operatsiyadan keyin 1 yildan 3 yilgacha bo‘lgan muddatda kuzatildi. Anatomik samaradorlik POP-Q (Pelvic Organ Prolapse Quantification) tizimi yordamida baholandi. Hayot sifati va chanoq tubi funksiyasidagi o‘zgarishlar PFDI-20 va PFIQ-7 savolnomalari asosida o‘rganildi. Jinsiy faol bemorlarda seksual funksiya PISQ-12 (Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire) yordamida baholandi. Jarrohlik usullari bemorning o‘z to‘qimalaridan foydalanilgan rekonstruktiv operatsiyalar (n=33) va sintetik endoprotezlar qo‘llanilgan operatsiyalar (n=25) guruhlariga ajratildi.
Natijalar: Kuzatuv davrida aksariyat bemorlarda chanoq a’zolarining anatomik holati va klinik simptomlarida sezilarli yaxshilanish kuzatildi. Operatsiyadan keyin chanoq sohasidagi bosim hissi, og‘irlik va noqulaylik sezgilari kamaydi, hayot sifati ko‘rsatkichlari yaxshilandi. Shu bilan birga, ayrim bemorlarda prolaps retsidivi, de novo stressli siydik tuta olmaslik, surunkali chanoq og‘rig‘i sindromi va seksual disfunksiya qayd etildi. Seksual faol bemorlarning bir qismida jinsiy hayot sifati yaxshilangan bo‘lsa, ayrim hollarda disparuniya, jinsiy qoniqishning pasayishi va intim munosabatlar sifatining yomonlashuvi kuzatildi. Mazkur asoratlar bemorlarning davolash natijalaridan qoniqish darajasiga salbiy ta’sir ko‘rsatdi.
Xulosa: Chanoq a’zolari prolapsini jarrohlik yo‘li bilan davolash anatomik va funksional natijalarni yaxshilashda samarali usul hisoblanadi. Biroq kasallik retsidivi, de novo stressli siydik tuta olmaslik, surunkali chanoq og‘rig‘i va seksual disfunksiyalar bemorlarning hayot sifati hamda davolash natijalaridan qoniqishiga salbiy ta’sir etuvchi asosiy omillar bo‘lib qolmoqda. Jarrohlik davolash samaradorligini baholashda anatomik natijalar bilan bir qatorda hayot sifati, seksual salomatlik va bemorlarning subyektiv baholarini ham inobatga olish zarur.
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