Puerperal zazzabi: haddasawa, cututtuka da kuma magani siffofin

A cikin sanannen littafinsa nan ta Jerome K. Jerome "Three Men a wani jirgin ruwa da" halin da na samu a duk, baicin puerperal zazzabi. Mene ne wannan? Bari mu bincika a cikin wannan labarin.

A rukuni na cututtuka da samu, mata masu juna biyu lokacin haihuwa da ake kira zubar sepsis, ko kamar yadda suka faɗa, a cikin tsohon kwana, puerperal zazzabi (zazzabi).

janar bayanai

Puerperal zazzabi samo asali a tsakiyar zamanai. Daya daga cikin na farko da aka bayyana wani hali na wannan cuta, Hippocrates. Kafin bude na farko na haihuwa a asibiti a cikin XVII karni, lokuta na kamuwa da cuta puerperal zazzabi sun ANNOBA a yanayi.

A tsakiyar karni XIX Hungarian obstetrician Ignats Zemmelveys sanya da dama zaton game da Sanadin puerperal zazzabi. Ya farko ya nuna bukatar yin amfani da maganin antiseptik mafita a bayarwa. Duk da haka, su tartsatsi amfani a cutukan ya zama m kawai a karshen XIX karni.

Bisa kididdigar da, a yau kawai 0.2-0.3% na duk lokuta na obstetric rikitarwa faruwa a sepsis, abin da ke faruwa a kan backdrop na endometritis a 90% na mata masu juna biyu.

Puerperal zazzabi ake magana a kai a cikin litattafansu littattafai, sau da yawa aka bayyana a matsayin mai hadarin gaske da kuma m cuta. A amfani da zamani magani aseptic, antiseptic, kwayoyin amfani take kaiwa zuwa da cewa post-partum sepsis nasarar bi da.

The iri zubar kamuwa da cuta sun hada da:

• Endometritis - kumburi daga cikin mahaifa.
• Hilafa tsakanin crotch kabu to da wadannan sashe.
• Hilafa tsakanin kabu bayan cesarean sashe.
• Mastitis.

Puerperal zazzabi: Sanadin

Mene ne Sanadin zubar zazzabi?

• Matsayin mai mulkin, da kamuwa da cuta ta pathogenic jamiái na mace kwayoyin faruwa a lokacin da ba yarda da magunguna iri iri a lokacin haihuwa.
• Mafi na kowa kamuwa da cuta shi ne "asibiti" damuwa da kwayoyin cuta, halin da ya karu da juriya ga magunguna.
• Saboda da weakening na rigakafi ya sa ta danniya a lokacin haihuwa, mace ta jiki iya kunna da kansa opportunistic Flora da dalilin kamuwa da cuta.

game da pathogens

Puerperal sepsis pathogens ne:

• bacteroides.
• Proteus.
• Staphylococcus aureus.
• gonococcus.
• E. coli.
• Klebsiella.
• haemolytic streptococci.
• peptostreptokokki da sauransu.

Amma, ba shakka, ba gwanjo a puerperal zazzabi. Wannan ba wani pathogen, kawai da sunan daya daga cikin inuwõwi na launi, da kuma cutar da kõme ba su yi.

Mafi sau da yawa, puerperal sepsis - a polymicrobial kamuwa da cuta sa da yawa daga jinsunan pathogens.

Sunny shigar azzakari cikin farji na microorganisms ne:

• farji hawaye, igiyar ciki cervix, kuma perineum.
• placental zone a cikin igiyar ciki rami.

Kamuwa yakan auku da lamba, a lamba tare da rauni surface datti hannuwansu da unsterile kida. Sa'an nan da baza pathogens faruwa ta hanyar da Lymph da jini.

hadarin dalilai

Hadarin dalilai ga abin da ya faru na puerperal sepsis:

• m kuma na kullum kumburi cututtuka na mata - ekstragenital'nye kamar cystitis da pyelonephritis, kuma gynecological, msl endometritis, colpitis da vulvitis.
• amfani da masu cin zali hanyoyin da prenatal nazarin.
• kai tsaye fetal ECG.
• da ake ji m gyara daga mahaifa insufficiency da Isthmus.
• m farji aikace-aikace bincike a cikin cutukan.
• igiyar ciki na jini.
• farkon sallama na ruwa.
• obstetric kade ayyukan kamar juya fetal dilatation ta yin amfani da forceps.

Primiparous puerperal zazzabi tasowa mafi akai-akai fiye da tare da maimaita haihuwa.

cututtuka

1-2 kwanaki bayan haihuwa iya nuna bayyanar cututtuka na puerperal sepsis:

• zazzabi da kuma jin sanyi.
• tachycardia.
• janar malaise da kuma sauran cututtuka na maye.
• ƙishirwa, asarar ci.
• zafi a fadin surface na ciki, da kuma ba kawai a kasa;
• m, tare da impurities ruɓaɓɓen jini sallama (lochia) daga haihuwa canal, wani lokacin ba a nan wani zabin.
• lokacin da mastitis cikakken lõkacin fatara ko rage lactation.

Baya puerperal zazzabi, akwai sauran magunguna.

Da farko, da ciwon kumburi ba ya mika hayin tribal raunuka. Sa'an nan, dangane da rauni, akwai musamman manifestations na kakanninmu zazzabi:

• puerperal ulcers - raunuka tare da greyish kasa, tare da kumbura, kuma cunkoson ababen hawa gefuna, wanda aka located a kan cervix, ta farji bango, perineum.
• puerperal coleitis - wani kumburi daga cikin farji mucosa.

By yaduwar ciwon kumburi shiga sakandare bayyanar cututtuka da cutar:

• Dysmenorrhea bugawa da mucous membrane na mahaifa;
• sigogi karin parauterine fiber.
• adnexitis, ko kumburi cikin mahaifa.
• pelvioperitonit - kayar da pelvic peritoneum.
• metrotromboflebit - kumburi daga cikin jijiyoyinmu daga cikin mahaifa.
• thrombophlebitis - kumburi daga cikin jijiyoyinmu daga cikin kafafuwa da kuma ƙananan extremities.

Domin da uku mataki na cutar halin bayyanar cututtuka na jimlace sepsis da kuma janar bayyanar cututtuka na peritonitis. Kamar yadda aka saukar puerperal zazzabi?

bincikowa da

A ganewar asali da "puerperal zazzabi" aka sanya a kan tushen da samuwa na asibiti cututtuka bayan pelvic jarrabawa da kuma jini gwajin.

magani

Jiyya puerperal sepsis sanya tare da tsananin cutar. Main yankunan:

• Ganin ji na ƙwarai to kwayoyin na kwayoyin yi. Da miyagun ƙwayoyi An wajabta jituwa tare da nono, a mai tsanani lokuta, ciyar da aka tsaya.
• Immunostimulatory kwayoyi (antistaphylococcal immunoglobulin, T-activin, nuna jini transfusions, da gudanarwa toxoid).
• Jiko far ake bukata domin kau da dawo da mai guba ruwa-gishiri balance (alkaline mafita gemodez, sunadaran da reopoligljukin).
• Nada ta antihistamines ( "Suprastin", "Tavegil").
• Yana nuna gabatarwar proteolytic enzymes (trypsin).

A jimlace sepsis form gudanar glucocorticoids da anabolic ji ba gani.

Zai yiwu jawabin da physiotherapy:

• mahaifa electrostimulation.
• UHF.
• UV sakawa a iska mai guba.
• microwaves.
• duban dan tayi.

Local magani daga tushen kamuwa da cuta:

• wanka ulcers sodium chloride, kuma hydrogen peroxide, domin manyan raunuka - truncation gefuna da sutures.
• a endometritis, a lokacin da ya zauna cikin mahaifa an jinkirta jini, ta kawar da sauran mahaifa da instrumental dubawa na igiyar ciki rami.

A peritonitis, watau, a cikin mai tsanani lokuta, a hysterectomy aka yi - kau da mahaifa da appendages.

Outlook

A sakamakon cutar a wani Generic kamuwa dogara a kan da yawa dalilai:

• lokacin da magani da aka qaddamar, da kuma tsarin na rigakafi mafi uwãyenku.

• da mataki na cuta-haddasa kwayoyin.

Idan kumburi tsari ne iyakance kawai don rauni warkar, kamar yadda mai mulkin, da cikakken kuma ba tare da sakamakon. A sepsis jimlace form mace-mace ta kai 65%.

rigakafin

Domin ya hana puerperal zazzabi ya kamata tsayar da wadannan matakan:

• dubagari na m kuma na kullum kumburi extragenital kuma gynecological cututtuka.
• a lokacin haihuwa da hana discontinuities al'aura fili nama.
• m riko ga aseptic da antiseptic dokoki.

gwarzo na littafin, mai yiwuwa bayyanar cututtuka da wannan cuta da aka sani da samu a duk cututtuka, fãce puerperal zazzabi. Zauna lafiya!