Imfiva Puerperal: izimbangela, izimpawu kanye nezici ukwelashwa

Okukhulunywa ngaye encwadini edume nge UJerome K. Jerome "Three Men in a Boat" uhlamvu ngithole nhlobo, ngaphandle imfiva puerperal. Kuyini lokhu? Ake sihlole kulesi sihloko.

Iqembu izifo okubangelwa ukungcola, abesifazane abakhulelwe ngesikhathi sokubeletha libizwa kwangemva kokubeletha sepsis, noma njengoba besho ezinsukwini ubudala, imfiva puerperal (imfiva).

ulwazi olujwayelekile

imfiva Puerperal eladabuka Ephakathi. Omunye wabantu bokuqala echazwe icala yalesi sifo, uHippocrates. Ngaphambi kuvulwa lokuqala esibhedlela womama ekhulwini XVII, amacala ukutheleleka imfiva puerperal babe epidemiological ngokwemvelo.

Ngo phakathi obelethisayo Hungarian XIX leminyaka Ignats Zemmelveys wenza eziningi ezizathwini ngezimbangela zokuziphendukela imfiva puerperal. Waqale wabonisa isidingo ukusebenzisa izixazululo isinqandakuvunda ngesikhathi kwezidingo. Nokho, ukusetshenziswa kwabo chithi saka zokubelethisa baba osebenzayo kuphela ekupheleni XIX leminyaka.

Ngokwezibalo,% namuhla kuphela 0.2-0.3 kuzo zonke izimo yezinkinga azoya zenzeka sepsis, okwenzeka ngaphansi kwesimo endometritis e-90% abesifazane abakhulelwe.

imfiva Puerperal kubhekiselwe kuyo zabuna izincwadi, ngokuvamile kuchazwa ngokuthi isifo esiyingozi futhi ezingelapheki. Ukusetshenziswa imithi aseptic, isinqandakuvunda, ukusetshenziswa yesimanje-antibiotic kuholela yokuthi post-partum sepsis iphathwa ngempumelelo.

Imihlobo ukutheleleka kwangemva kokubeletha zihlanganisa:

• Endometritis - ukuvuvukala kwesibeletho.
• I iphutha phakathi kwaso, maqondana lekuhlanganeni ukuxhuma esigabeni esilandelayo.
• I iphutha phakathi kwaso, maqondana lekuhlanganeni emva kwesigaba cesarean.
• Mastitis.

imfiva Puerperal: Izimbangela

Ziyini izimbangela ka kwangemva kokubeletha imfiva?

• Njengomthetho, ukutheleleka nge-ejenti pathogenic umzimba besifazane kwenzeka uma non-ukuhambisana antiseptics bokubeletha.
• Lesifo ezivamile kuyinto "esibhedlela" zama-bacterium, libhekene i ukumelana lenyuka emithini.
• Ngenxa buthakathaka amasosha omzimba kubangelwa ukucindezeleka ngesikhathi sokubeletha, isidumbu sowesifazane kusebenze siqu flora zayo ngentuba kanye imbangela ukutheleleka.

mayelana Amagciwane

Puerperal sepsis Amagciwane yilezi:

• bacteroides;
• Proteus;
• Staphylococcus aureus;
• gonococcus;
• E. coli;
• Klebsiella;
• streptococci haemolytic;
• peptostreptokokki nokunye.

Kodwa-ke, hhayi zigcwele imfiva puerperal. Lena akuyona lwegciwane, nje igama omunye shades of umbala, futhi lesi sifo akuhlangene.

Ngokuvamile, sepsis puerperal - igciwane polymicrobial kubangelwa Kunezinhlobo eziningi Amagciwane.

Ngokwengxenye Ukungena nezilwanyana ezincane yilezi:

• izinyembezi lwesitho sangasese sowesifazane, lesizalo wesibeletho, kanye perineum.
• esinomhlapho zone phakathi komgodi lesizalo.

Ukutheleleka ngokuvamile kwenzeka ngokuthintana, nabo isilonda ebusweni izandla ezingcolile futhi amathuluzi anamagciwane. Khona-ke ukusabalala kwamagciwane kwenteka ngekutsi bafundzi lymph kanye igazi emithanjeni yakhe.

engcupheni

Izinto eziyingozi ezingabangela i okuvela sepsis puerperal:

• izifo oyingozi futhi ezingalapheki sokuvuvukala abesifazane - ekstragenital'nye ezifana cystitis kanye pyelonephritis, futhi izifo zabesifazane, isb endometritis, colpitis futhi vulvitis;
• ukusebenzisa izindlela koda izifundo kokubeletha;
• oqondile ECG fetus;
• isicelo ukulungiswa kuhlinzwa ka esingamahlalakhona wesibeletho kulesi siqephu sezwe;
• njalo lwesitho sangasese sowesifazane ucwaningo isicelo e zokubelethisa;
• lesizalo ukopha.
• osenyameni ekuseni yamanzi;
• azoya Umqhubi imisebenzi ezifana nokuvula dilatation fetus ngokusebenzisa esebenzisa.

Primiparous imfiva puerperal eba kanengi ukudlula nokuzala okuphindaphindiwe.

izimpawu

Ezingu-1-2 ngemuva lokuzalwa kungase ekhombisa izimpawu zokungenwa sepsis puerperal:

• imfiva kanye Ukugodola;
• tachycardia;
• ukucobeka jikelele kanye nezinye izimpawu zokudakwa;
• ukoma, ukungakuthandi ukudla;
• ubuhlungu yonkana kobuso esiswini, futhi hhayi nje ezansi;
• oluhlambalazayo ukungcola ubomvu osenyameni (lochia) kusukela emgudwini wokuzala, ngezinye izikhathi lingekho iyiphi Ukukhetha;
• lapho mastitis ukumisa okuphelele noma ukuncishiswa lactation.

Ngaphandle imfiva puerperal, kukhona nezinye izifo.

Okokuqala, ukuvuvukala akavele ngale amanxeba zamaKhosi. Khona-ke, kuncike lesion, lapho zenzo ziwukubonakaliswa ezithile imfiva yokhokho:

• izilonda puerperal - izilonda nge phansi greyish, ne imiphetho ukuvuvukala eminyene, okuyinto zitholakala wesibeletho, udonga lwesitho sangasese sowesifazane, perineum;
• coleitis puerperal - yisishiso mucosa lwesitho sangasese sowesifazane.

Ngu ukusabalala ukuvuvukala ukujoyina izimpawu yesibili isifo:

• Dysmenorrhea ukushaya ulwelwesi lwamafinyila kwesibeletho;
• Amapharamitha abatelekile parauterine fibre;
• adnexitis, noma ukuvuvukala kwesibeletho;
• pelvioperitonit - anqobe peritoneum okhalo;
• metrotromboflebit - ukuvuvukala ngemithambo kwesibeletho;
• thrombophlebitis - ukuvuvukala ngemithambo ukhalo futhi emikhawulweni aphansi.

Ukuze esigabeni sesithathu lesi sifo libhekene izimpawu of sepsis generalized futhi izimpawu jikelele peritonitis. Njengoba kwembulwe imfiva puerperal?

ukuhlola

Sitholakele "imfiva puerperal" ibekwe ngesisekelo izimpawu etholakalayo emitholampilo sekuhloliwe okhalo futhi ukuhlolwa igazi.

ukwelashwa

Ukwelashwa sepsis puerperal babelwe kanzima lesi sifo. izindawo Main:

• Banikezwe luvelo-antibiotic ka-antibiotic wenziwa. Umuthi ezinqunyiwe iyahambisana ibele, ezimweni ezimbi kakhulu, yokudla imisiwe.
• izidakamizwa Immunostimulatory (immunoglobulin antistaphylococcal, T-activin, kuboniswa ukumpontshelwa plasma, esasikhipha toxoid).
• yokwelapha ukumnika liyadingeka ukuze kususwe kanye nokuvulwa anobuthi amanzi-usawoti ibhalansi (izixazululo ane-alikhali gemodez, amaprotheni reopoligljukin).
• Aqokwe antihistamine ( "Suprastin", "Tavegil").
• Ibonisa ukwethulwa enzyme proteolytic (trypsin).

Ngo sepsis generalized ifomu iqondiswa glucocorticoids futhi hormone Anabolic.

Mhlawumbe kokuchitha futhi Physiotherapy:

• electrostimulation kwesibeletho;
• UHF;
• UV ngemisebe;
• ama-microwave;
• ultrasound.

ukuphathwa endawo umthombo ukutheleleka:

• ukuwasha izilonda sodium chloride futhi i-hydrogen peroxide, amanxeba ezinkulu - akhronimi imiphetho nge sutures;
• ngesikhathi endometritis, lapho kwesibeletho imisiwe igazi, kususa placenta ezisele nokuhlolwa wezinsimbi we umgodi lesizalo.

Ngo peritonitis, okungukuthi, ezimweni ezimbi kakhulu, a hysterectomy wenziwa - ukususwa kwesibeletho kanye ezihlobene.

ukuba nombono ongafani ngeke

Umphumela lesi sifo igciwane ejwayelekile kuxhomeke ezicini eziningi:

• isikhathi lapho ukwelashwa seluqaliwe, futhi izivikeli mzimba, iningi lonina;

• degree of amagciwane adala izifo.

Uma inqubo ukuvuvukala kukhawulwe kuphela esilondeni sokuphulukiswa, njengoba umthetho, ephelele futhi ngaphandle kwemiphumela. Ngo sepsis generalized ifomu ngokwempilo yangenyama ifinyelela 65%.

zokuvimbela

Ukuze uvimbele imfiva puerperal kufanele bagcine izinyathelo ezilandelayo:

• ukukhucululwa kwendle ka oyingozi futhi ezingalapheki extragenital ukuvuvukala futhi izifo gynecological;
• ngesikhathi sokubeletha ukuvimbela unokungaxhumani zangasese ipheshana izicubu;
• ukwenza ngokuvumelana neminye imithetho aseptic kanye isinqandakuvunda.

iqhawe le ncwadi, cishe izimpawu zalesi sifo ezaziwa ngokuthi kwakutholakala cishe kuyo yonke izifo, ngaphandle imfiva puerperal. Hlala uphilile!