Puerperal fivha: zvinokonzera, zviratidzo uye kurapwa mamiriro

In yakakurumbira bhuku rakanyorwa Jerome K. Jerome "Men Three ari Boat" hunhu Ndakawana ose, kunze puerperal fivha. Chii? Ngationgororei munyaya ino.

Boka zvirwere zvinokonzerwa netsvina, vakadzi vane pamuviri pakusununguka inonzi postpartum sepsis, kana sezvo vachiti pamazuva akare, puerperal fivha (fivhiri).

Vhuṱanzi

Puerperal nefivha yakatanga kuMiddle Ages. Mumwe wekutanga akarondedzera nyaya chirwere ichi, Hippocrates. Asati Panovhurwa wokutanga maternity muchipatara vari XVII remakore, zviitiko chirwere puerperal fivha vakanga epidemiological zvakasikwa.

In pakati Hungarian obstetrician XIX remakore Ignats Zemmelveys akaita uwandu zvekungofungira pamusoro zvinokonzera puerperal nefivhiri. Akatanga akanongedza kudiwa kushandisa akambozvishandisa kuuraya utachiona mhinduro pa pakukurukura. Zvisinei, avo kushandiswa kwakapararira Obstetrics vakava zvinoshanda chete pamagumo XIX remakore.

Maererano nenhamba, nhasi chete 0.2-0.3% vose nyaya obstetric yematambudziko rwakavapo sepsis, kuitika pamusoro colour ose endometritis muna 90% yevakadzi pamuviri.

Puerperal fivha anotaurwa Classics mabhuku, kazhinji se chirwere ngozi uye chisingarapiki. Kushandiswa mushonga aseptic ano, akambozvishandisa kuuraya utachiona, mushonga kushandisa inoenda chokuti post-partum sepsis vakabudirira kurapwa.

The Mhando postpartum chirwere dzinosanganisira:

• Endometritis - kuzvimba dumbu.
• Kuenderana pakati crotch musono zvinotevera chikamu.
• Kuenderana pakati musono pashure cesarean chikamu.
• Mastitis.

Puerperal fivha: Zvinokonzera

Ndezvipi zvinokonzera postpartum fivha?

• Kazhinji, utachiona kubudikidza pathogenic vaishandira munhukadzi muviri kunoitika apo asiri zvaidiwa antiseptics pakusununguka.
• The inonyanya chirwere ari "chipatara" utachiona, hune ichazivikanwa noku yakawedzerwa kuramba mishonga.
• Nokuda kwakaderera kutapata kunokonzerwa kushushikana pakusununguka, muviri mumwe mukadzi anogona Activate ayo mikana kasvisto pachako uye mhaka hweHIV.

About utachiona

Puerperal sepsis utachiona vari:

• bacteroides;
• Proteus;
• Anonzi Staphylococcus aureus;
• gonococcus;
• E. coli;
• Klebsiella;
• haemolytic streptococci;
• peptostreptokokki uye zvichingodaro.

Asi, chokwadi, kwete nhata mu puerperal fivha. Iyi haisi utachiona hwakakura, chete zita rimwe noruvara ruvara, uye hosha haina kuita.

Kakawanda, puerperal sepsis - a polymicrobial chirwere kunokonzerwa akawanda mhando utachiona.

Pamwe kupinda zvigare zviri:

• kusangana nekutsi kwemukadzi misodzi, uterine cervix, uye perineum.
• placental mapazi kupinda uterine mhango.

Chirwere kazhinji kunoitika kuonana, neVadzidzi ronda pamusoro maoko tsvina uye unsterile zviridzwa. Zvino kupararira utachiona kunoitika kuburikidza node uye ropa midziyo.

zvinokonzera njodzi

Njodzi zvikonzero nokuti panowanikwa puerperal sepsis:

• chenjera uye chisingaperi anogumbura zvirwere pavakadzi - ekstragenital'nye zvakadai cystitis uye pyelonephritis, uye gynecological, semuenzaniso endometritis, colpitis uye vulvitis;
• Kushandiswa invasive nzira pamuviri zveBhaibheri;
• yakananga fetus ECG;
• kushandisa kuvhiya nokururamiswa remuromo insufficiency uye rokuPacific;
• kakawanda kusangana nekutsi kwemukadzi Chikumbiro kutsvakurudza Obstetrics;
• uterine ropa.
• mangwanani okuyerera mvura;
• obstetric anoitisa kwacho sezvo wekushanduka fetus dilatation nokushandisa forceps.

Primiparous puerperal fivha hwapedyo kakawanda kupfuura zvichimurova yokusununguka.

zviratidzo

Mazuva 1-2 pashure pokuberekwa anogona kuratidza zviratidzo puerperal sepsis:

• nefivhiri uye chills;
• tachycardia;
• vakawanda zvakawanda zvive nezvimwe zviratidzo kudhaka;
• nyota, kurasikirwa havi;
• marwadzo mhiri pemvura mudumbu, uye kwete chete nechepasi;
• tsamwisa, pamwe nouipi pus zvinoyerera (lochia) kubva pakuberekwa canal, dzimwe nguva ndisipo chero Kusarudzwa;
• kana mastitis kumbomira kwakakwana kana zvinoderedza kuti lactation.

Kunze puerperal fivha, pane zvimwe zvirwere.

Chokutanga, kuzvimba haaratidzi mhiri maronda dzemadzinza. Zvadaro, zvichienderana lesion, pane kuratidzwa chaiwo yemadzitateguru nefivhiri:

• puerperal nemaronda - maronda pamwe greyish pasi, pamwe kuzvimba uye congested micheto, izvo riri pamusoro cervix, rusvingo kusangana nekutsi kwemukadzi, perineum;
• puerperal coleitis - ane kuzvimba kusangana nekutsi kwemukadzi mucosa.

By kupararira kuzvimba abatane yedzimwe zviratidzo chirwere:

• Dysmenorrhea achirova mucous Kamudzira of dumbu;
• parameters achirova parauterine faibha;
• adnexitis, kana kuzvimba dumbu;
• pelvioperitonit - kukunda pelvic peritoneum;
• metrotromboflebit - kuzvimba mutsinga ari dumbu;
• thrombophlebitis - kuzvimba mutsinga ari chiuno uye ezasi migumo.

Nokuti wechitatu pavaipfuura chirwere kunoratidzwa zviratidzo generalized sepsis uye mukuru zviratidzo peritonitis. Rinotaurwa puerperal fivha?

Diagnostics

The chirwere kuti "puerperal nefivhiri" anoiswa pachishandiswa iripo zvekuchipatara zviratidzo mushure pelvic kuongororwa uye bvunzo ropa.

mabatiro

Treatment puerperal sepsis basa pamwe kwokuomerwa chirwere. Main nzvimbo:

• Vakapiwa aikanganiswa mushonga kuti mushonga rinoitwa. The mushonga wacho ushandiswe inowirirana achiyamwa, muna Muzviitiko zvakaipisisa, dzichifura anomiswa.
• Immunostimulatory zvinodhaka (antistaphylococcal immunoglobulin, T-activin, kuratidzwa yeplasma kuwedzerwa, vachiita toxoid).
• Aizomupa kurapa runodiwa kuti kubviswa uye kuzoita chepfu mvura-munyu mwero (alkaline zvinogadzirisa gemodez, mapuroteni uye reopoligljukin).
• Akagadzwa antihistamines ( "Suprastin", "Tavegil").
• Kunoratidza pakatanga proteolytic makemikari (trypsin).

In generalized sepsis fomu achiita glucocorticoids uye anabolic mahormone.

Zvichida kupedza uye physiotherapy:

• dumbu electrostimulation;
• UHF;
• UV irradiation;
• microwaves;
• Ultrasound.

Local kunaka kunobva chirwere:

• Washing maronda yavaibvisa chloride uye hydrogen peroxide, nokuti mavanga guru - truncation mativi pamwe sutures;
• panguva endometritis, kana dumbu iri kunonoka ropa, anobvisa vasara placenta uye richishanda rokuongorora yacho uterine mhango.

In peritonitis, kureva, muna Muzviitiko zvakaipisisa, chibereko rinoitwa - nokubviswa dumbu pamwe zvinoshandiswa.

mataridzikiro

Zvaizobuda chirwere ari Generic chirwere inotsamira zvinhu zvakawanda:

• nguva apo kurapwa yakatangwa, uye zvirwere vanaamai vakawanda;

• mwero utachiona hunokonzera zvirwere.

Kana kuzvimba kwacho kuri shoma chete kuti muchikuvadza kuporesa, sezvinoita ushe, kwakakwana uye pasina nemigumisiro. In sepsis generalized chimiro kufa rinosvika 65%.

dziviriro

Kuitira kudzivisa puerperal fivha vanofanira kuchengeta zvinotevera matanho:

• kutsvinda kuti chenjera uye chisingaperi anogumbura extragenital uye gynecological zvirwere;
• pakusununguka kudzivisa discontinuities yokubereka turakiti tishu;
• kunyatsotevedza aseptic uye akambozvishandisa kuuraya utachiona mitemo.

gamba bhuku, zvimwe zviratidzo chirwere ichi kuzivikanwa pana zvirwere zvose, kunze puerperal fivha. Stay utano!