Nelaktatsionny purulent mastitis: Zviratidzo neMarapirwo

Purulent mastitis - chinonetsa uye kusingafadzi vakadzi chirwere. The vakaipisisa ayo siyana - nelaktatsionnomu purulent mastitis - isu vacharipa vainyatsotarisirwa nhasi, nekuti vakadzi utano - mukuru ezvinhu kuti utano uye kubudirira rwacho.

History kutsvakurudza

Sezvo makarekare mukadzi chisingawanzowaniki akapfuura ruzivo musimboti chirwere, izvo kare anonzi mastitis, uye gare gare akazozivikanwa mastitis. Hazvishamisi, sezvo akati zvokurwara, inova hombe kutapuriranwa kuzvimba ari pazamu, asi achiri achirapa kushingaira kuwanda kunowanzoguma purulent lesion chaizvoizvo glandular muviri zamu uye dzakapoteredza rinenge uye ipapo sepsis kubva -this zvavo nezvirwere kwacho.

subtleties nhamba

In mastitis ano unogona kukamurwa lactation, kana mammary shwanu ndiyo kugadzirwa mukaka (kazhinji purulent mastitis achiyamwa), uye nelaktatsionny, izvo tinoda kutaura nhasi. Sezvo nhamba wekupedzisira emakore, muna 90-95% kubva yakashuma zviitiko mastitis nayo yakatanga muna postpartum nguva, nelaktatsionnym sezvo mastitis, iyo isina chokuita nepamuviri uye pakusununguka, vanotambura avhareji vanenge 5% yevakadzi.

zera Categories

Kazhinji budiriro nelaktatsionnogo mastitis inotambudza vakadzi pakati 15 uye 60 makore. In izvi zera nemiganhu chimiro iyi mastitis, kusiyana lactation anoratidza pacharo kwete nesimba, uye septic yematambudziko anenge kumbobvira kuitika. Kusiyana vakadzi, varwere akati zera nguva, tinofanira kudzidza kuti vagare mastitis kwemakore akawanda, nokuti kazhinji inova chirwere relapsing fomu. Zvisinei nelaktatsionny mastitis kunogona kukanganisa kwete chete nevakadzi asi varume, uye vana vose varume navakadzi.

etiology

Nelaktatsionny purulent mastitis haana chokuita lactation, kunoitika panongova kashoma uye kazhinji kunokonzerwa nenyonganyonga iri hormone pakanyorwa uye kuderera kwesimba romuviri rinodzivirira mukupindura noutachiona nevamiririri. Kazhinji akaratidza single- kana kaviri madziro mberi kuzvimba mammary mumasero.

nezvechiratidzo zvikonzero

It kuitira zvakaitika kuti vakawanda nelaktatsionny purulent mastitis hwapedyo kana munhukadzi muviri kwakakanganiswa hormone kana kuderedzwa zvirwere mukupindura noutachiona nevamiririri. Kazhinji, zvakadai nguva ndeinotevera:

1. Kwakakura akaderedza inonzi estrogen pamwero, panguva iyoyo inokosha kudzvinyirira iri masoja kudzivirira, hworatidza pacharo postklimakterii kumwedzi.

2. kuyaruka kuyaruka aine kusagadzikana kwemakemikari omuviri pamwero riri ava mupfungwa simba yokuva muviri, izvo zvinoitawo kuti yakaorera pasi nokuda kukura zvirwere vasingadiwi. Uyezve, zvinokosha kuziva kuti nelaktatsionny mastitis inobata kwete chete vasikana asiwo vakomana pakuyaruka.

3. Zvinofanira kucherechedzwa nyaya pashure chirwere Maronda anoitwa pachipfuva kushandiswa Somuenzaniso, pashure Ndokunyengetererai kudyara kubviswa kana fibrocystic growths, kunotevera zamu, achiperekedzwa compression kuti nyama dzawo.

4. Kunyange usingaonekwi ziso ganda kunotevera kuti zamu kana munyatso anogona kugarwa ari kupinda chirwere uye kukura nelaktatsionnogo mastitis.

marudzi chirwere

zvatakurukura chirwere kazhinji inoitika zviviri siyana - chakasimba uye chisingaperi. Chenjera nelaktatsionny mastitis pasina nenguva kurapwa muchipatara uye pokugara kurapa pakati bluetongue (infiltrative) chimiro nokukurumidza zvikuru uye tichishandisa chinyararire kuti mukadzi anogona kushandurwa kuva purulent nelaktatsionny mastitis nounzenza zvikuru apo pasina muchipatara kuita vasingachakwanisi, uye kuti kungotaurawo acho ichingova nyaya mazuva kana kunyange maawa.

pathogenesis

Kana nelaktatsionnogo mastitis utachiona yemanyorero zvinopfuura mammary shwanu Via huripo kukuvadza ganda, izvo zvinokonzerwa kana netsaona, kana chafariz inokuvadza, semuenzaniso, vachishandisa Heaters kana vanhuwo kutsva, uye dzimwe nguva nemhaka zamu duku pustules huripo pamusoro ganda . Ipapo utachiona wokutanga kukuvara subcutaneous mafuta rukoko uye mafuta Kamudzira pamusoro zamu, uye ipapo kurwiswa wechipiri glandular tishu.

Apo vakadzi zvishoma kugadzirisa chisingaperi nelaktatsionnym mastitis, izvo kazhinji anovandudza apo rikwanise mastitis akasiya undertreated, kuwana zviratidzo kuvandudzika rokutanga pfungwa nokuda discontinuation Chiremba zvinodhaka uye maitirwe ezvinhu. Muzviitiko zvakadaro, dzokororo ine mastitis inova kuramba shamwari vakadzi, kuratidza pacharwo kuchangotanga hormone kukundikana, pashure hypothermia, kushushikana, kana apo mukuru kwakaderera muviri dzokuzvidzivirira.

Nelaktatsionny purulent mastitis. zviratidzo

Pakutanga rikwanise nelaktatsionnogo mastitis - mune serous danho, kana jira zvinovhiringidzika thoracal shwanu sequentially akaiswa mushonga wokuuraya serous fluid uye kushingaira kupinda chena ropa masero - mukadzi chinoratidza chidzoke panguva kurwadziwa nechityu, iyo inogona palpated nekuumbanidzwa nyika pachena miganhu mune rimwe kana kupfuura mugove. tembiricha muviri yakawedzera kusvika 37-38 oz., uye mune zvimwe zviitiko kusvikira 39. Uyezve, iyi, mumwe mukadzi anogona kufunga akaratidza talk simba. In zvikuru zvisingawanzoitiki zviitiko, pakatarisana kunoitika serous kukura rwakazara uye kutanga vaingoerekana kupora, asi yekudyidzana vangangotaura kuva shure serous infiltration rwakazara.

The infiltrative danho iri njodzi mammary shwanu chisimbiso vakaumba zvinorwadza pasina pachena miganhu kunotaurwa nda. Panyaya iyi, ganda pamusoro zvomoto nda haruzvitsvakiri, edema munharaunda iyi asipo, uye tembiricha yeko inoramba mukati inowanzotorwa siyana. tembiricha muviri rwuchiwanzwa, nokuda vanoshingaira kwemabhakitiriya zvigadzirwa vachipinda ropa kubva tagovera foci lactostasis kuburikidza ducts yacho zamu. Zvinokosha kuti mukadzi akatsvaka kurapwa kuti mamologist, gayinakorojisiti kana chiremba pamwe pakuonekwa wokutanga zviratidzo, pasina akamirira avo mberi uye kuchinja mune purulent fomu. The catarrhal Danho mastitis ikarapwa zvakanaka zvikuru uye asingauyi kunotoreva kwazvo matambudziko, sezvakaitwa nelaktatsionnogo purulent mastitis.

Kana vasina pokugara pakurapa 5 mazuva pashure infiltration danho anoenda ambomira kuparadzwa, i.e. kuparadzwa. Kuzvimba anova purulent, uye mammary shwanu anova zvizere zvakafanana chipanje, akanyatisa kuburikidza ne pus.

Rokuparadza danho, iyo inonziwo rikwanise purulent mastitis, mukuru vakadzi kuipa nekuti zvinokachidza kubva ainyanya kuti purulent kuzvimba ichi- zvokudya kupinda ropa. tembiricha muviri inoramba ichiwedzera uye kazhinji munguva 38-40 oz., uye pamwe richikura uye zvakajairika zviratidzo kudhaka. Akarova nokuda mammary shwanu kuwedzera kukura, zvinova nerongo. The ganda pamusoro munharaunda yokuparadza inova tsvuku, subcutaneous mutsinga dilate. With kuwedzera marwadzo kupararira kune hapwa, uyewo remunharaunda node nodes asi vakakurumidza muzvirongwa rwarisa muitiro. Murwere anova asina kurara uye zvokudya.

mhando

Nelaktatsionny purulent mastitis, mapikicha izvo zvinogona kuonekwa zvokurapa Directories, kunoda hwakakwana nzira iri kuongorora chirwere.

Zvinotevera akasiyana nayo:

1. abscessed Mastitis, iyo inozivikanwa munyika kuti njodzi mammary shwanu abscesses yakawanda - kubva in kuti vakafufutirwa pus. Kazhinji apo ari infiltration nzvimbo inogona palpated kunyoroveswa kana kunzwa pasi minwe ikapenya pamwe inoda kufunga Urume - akanaka chiratidzo nokufamba (muna 99% nyaya).

2. Mastitis infiltrative abscessed. Wake zvikuru kupfuura neyakapfuura. Gobvu nda ine zvakawanda duku abscesses siyana chaizvo hukuru uye zvitarisiko, ndizvo zvakanaka chiratidzo nokufamba muna 5 chete% wevarwere. kazhinji infiltration kwakadaro kunotora haana zamu quadrants anopfuura maviri.

3. Mastitis pute. Panyaya iyi, chityu yakawedzera uye akaratidza zvachose zvimba. Ganda njodzi zamu dzvuku kwazvo (uye pano neapo rinokwanisa kucheneruka-tsvuku), nerongo, pamwe inverted minyatso. Palpation kweprostate iri kunorwadza zvikuru nokufamba zvakanaka chiratidzo. In kupfuura hafu varwere purulent lesion kunosvika quadrants dzinenge nhatu.

4. gangrenous mastitis inowanzopiwa kubatana lesion midziyo ropa uye kushingaira thrombosis. Sezvo chakaipa ropa wedzerai chityu zvisisakwanisiki, kutanga necrosis. Saka dare dzinokwanisa ikawanda, pamusoro wayo pechiso, pane yakawanda zvinyama necrosis, matema izvo zvinogutswa sanies ganda anova rinokwanisa kucheneruka-pepuru. Kuzvimba anofukidza yose zamu. Munguva iyi, mamiriro ezvinhu varwere zvikuru rinorema, pfungwa yava yakanyongana, tachycardia kunowedzera pamusoro colour kuti BP. Ropa akaumba Kunyatsoona sepsis. Chokwadi, panguva ino pakaoma kuti upenyu murwere anova zvikuru guru.

kushanda kurapa

Kana chirwere "nelaktatsionny purulent mastitis", kurapwa kwayo kunogona kushanda uye kuchinja.

Direct chiratidzo nokuti kuvhiya kupindira vose dzinoparadza siyana zvakawanda zvinotapukira-kushoma, purulent-catarrhal mastitis, zviratidzo zvakanga zvataurwa pamusoro apa.

In Kana apo mishonga kwemazuva maviri hapana kuvandudzika chinokosha Kazhinji kutongwa pamusoro pamberi purulent kwacho mazamu, ndoupiko unonyanya zvakananga chiratidzo nokuda kuvhiya kupindira, iyo anogadzirwa chete muchipatara ezvinhu, kazhinji pasi kakawanda intravenous yokutindivadza.

subtleties remapazi

Munguva oparesheni pute kuzarurwa nokungwarira kuchenesa kunze zvose non-zvimwe zvinyama zviri excised uye kubviswa. Saka chose zvachose suppurative mastitis. The oparesheni Kazhinji nyore akashivirira vakadzi. Mushure Kupindira pamusoro mammary shwanu kunodiwa yokugadza drains the kuti kuchadonha kugeza ronda uye kwete kupa utachiona kunyange mukana duku kuti Activate. Donhwe muchikuvadza lavage rinoitwa mazuva 5 kusvika 12, izvo unoenderana kuwana uchitikurudzira murwere chinzvimbo zvakanaka uye kunyangarika geza mvura fibrin, pus uye necrotic inoramba.

Therapy pashure pokuvhiyiwa

Uyewo avhiyiwa rinoitwa zvinodhaka kurapa iyo ndehwokuti nechokwadi kuti nekukurumidza uye kwazvo kubvisa tsvina uye kururamisa kutyorwa kuti zvave pamusoro pakanyorwa purulent kwacho. Raida mishonga vanotumirwa (intramuscularly kana nomutsinga). Kazhinji ichi cephalosporin kugadzirira I, II, kana iri nyaya pakubatana chirwere yechipiri - III-IV chizvarwa.

Nelaktatsionny suppurative mastitis: kurapwa pasina kuvhiyiwa.

Kuchinja mabatiro zvinogoneka chete kana murwere talk ezvinhu anoramba nekaupenyu dzinogutsa, chirwere chinogara hakuna kupfuura mazuva matatu, tembiricha muviri haasi kupfuudza 37.5 g., Zviratidzo Local pamusoro purulent kuzvimba hapana marwadzo ari fungidziro ane mwero infiltration, infiltration hakusi detectable kupfuura imwe quadrant of zamu, uye mukuru kuongorora ropa asingadi kuvaka mufananidzo mberi kuzvimba.

Kakawanda vakadzi kutsvaka rubatsiro rwezveutano mu kwokutanga nzendo mastitis - serous kana infiltrative, pazvinobvira, uye kunobatsira chaizvo kuchinja kurapwa. Pakutanga, inoreva urongwa mamwe ane zamu, uhwo vakadzi vanokurudzirwa kufamba sekwaserera, vanopfeka kusunungura jira bhurezha kana bhandeji, iyo unogona dzika rutsigiro murwere muchipfuva, asi asingaiti tsonyera izvozvo, kuti arege kutsamwisa kuchiita kwacho. Nechinangwa yokuwana zvinotapuriranwa yomuchipatara hunodiwa vanotumirwa mishonga ( "Cephalexin" "Cefixime" "Levofloxacin") kazhinji kupiwa intramuscularly mune mishonga isingadariki sredneterapevticheskih. Kuwedzera nemishonga, kuderedza kuzvimba uye kuzvimba, desensitization muviri rinoitwa pamwe antihistamines okupedzisira zvizvarwa, kwete kuti nehope ari murwere uye kuderedza marwadzo.

Kuwedzera "inorema atirari" kuti vabatsire muviri dzokuzvidzivirira gadzai B mavhitaminzi uye vhitamini C. Pane chiitiko kuti regression pakati kushoma hakuiti kuuya, zuva akawedzera Ultrasound kurapa uye UHF, izvo rinokurudzira kunokurumidza chisarudzo pamusoro infiltration uye kudzorerwa rwokuzvarwa pezvakaitwa ari mammary shwanu.

Zvichengetedze, vachiziva ichi achinyengera chirwere chakafanana nelaktatsionny purulent mastitis. Kunokwanisa haungoerekani akaoma, kana ukatanga nayo Pandakangowana nzendo. Ndinoshuva kuti utano!