Postpartum endometritis imatanthawuza matenda omwe amabwera chifukwa cha amayi obadwa kale. Chifukwa chake, kutukuka kumakhudza chiwalo cha chiberekero, chomwe chingathe kudutsanso minofu yambiri. Tiyeni tikambirane za kuphwanya mwatsatanetsatane, tiyeni titchule zifukwa zake, zizindikiro ndi njira za mankhwala.
Postpartum endometritis - zimayambitsa
Endometritis pambuyo pa kubala kumapangidwira kumalo kumene placenta poyamba inali. Pa nthawi yolekanitsa zitsamba, mitsempha ya magazi imasokonezeka. Chilonda chimapangidwira, chomwe chimayamba kugwira ntchito ya tizilombo toyambitsa matenda. Komabe, satenga kachilomboka nthawi zonse. Kukula kwa matenda kumathandizidwa ndi zinthu zopangitsa, zomwe:
- kuchepetsa kuteteza chitetezo cha m'deralo (kukhalapo kwa matenda aakulu opatsirana ndi opatsirana mu njira yobereka);
- ntchito;
- Kusatsatira malamulo a ukhondo wathanzi nthawi yoberekera.
Kawirikawiri chofunika kuti chitukuko cha postpartum endometritis chikhale chocheperachepera cha kusintha kwa chiberekero, kuchepetsa kutuluka kwa chiberekero. Pankhaniyi, tizilombo toyambitsa matenda timakhala ngati tizilombo toyambitsa matenda zomwe zimayambitsa chisokonezo, zomwe zilipo pang'onopang'ono mu dongosolo la urogenital. Zina mwa izo:
- staphylococcus aureus;
- streptococcus ;
- mavairasi.
Endometritis mutatha gawo la caesarean
Kupanga endometritis pambuyo pa khungu lachitetezo kawirikawiri ndi chifukwa cha opaleshoni yowopsa. Kotero, ndi chokonzekera chokonzekera, mafupipafupi a endometritis sali oposa 5%, ndipo ngati mwadzidzidzi mwadzidzidzi amasiya, 22-80%. Postpartum endometritis, chifukwa cha kansera, kawirikawiri imachitika mwamphamvu kwambiri. Izi zimachokera ku matenda a chifuwa cha chiberekero komanso kufalikira kwa kutupa kupyola mu chiberekero. Chifukwa chake, matenda ena amayamba:
- myometrium - miscular layer damage;
- metrotromboflebit.
Chifukwa cha kutupa, pali kuphwanya njira zowonongeka mu khoma la chiberekero. Izi zingayambidwe ndi zakuthupi. Kuchepetsa ntchito ya mgwirizano ya chiberekero, chifukwa chake kutuluka kwa lochia n'kovuta ndipo kumapangitsa kuti vutoli likhale lovuta. Matendawa amapezeka pa tsiku la 4-5 ndipo akuphatikizapo:
- kutentha kwa thupi 38-39 madigiri;
- chills;
- kuwonjezeka kwa chiwerengero cha matenda a mtima - tachycardia.
Endometritis pambuyo pochotsa mimba
Postpartum endometritis mwa amayi akhoza kuyambitsidwa ndi mimba m'mbuyomo. Mapulogalamu othandizira mazira a uterine amachititsa kuti matendawa atheke. Izi ndizo chifukwa cha vuto lalikulu la gawo la endometrial. Chotsatira chake, mucosa yonse imakhala pangozi yomwe imayamba kugwira ntchito ya tizilombo toyambitsa matenda. Kusagwirizana ndi ukhondo ndi madandaulo azachipatala kumabweretsa chitukuko cha endometritis.
Endometritis atabereka - zizindikiro
Kuti azindikire postpartum endometritis nthawi, mayi aliyense ayenera kudziwa zizindikiro za matendawa. Malinga ndi chithunzithunzi chachipatala, mitundu itatu ya chisokonezo ndi yosiyana, iliyonse yomwe ili ndi zizindikiro zake:
- Fomu ya kuwala. Amayamba masiku 5-12. Pa nthawi yomweyi, motsutsana ndi moyo wabwino, kutentha kwa thupi kumafika madigiri 38-39. Mkhalidwe wa thanzi sumavutika kwambiri. Odwala amafotokoza zowawa m'mimba, zomwe zimatenga masiku 3-7. Pakamwa, madokotala amatha kuwonjezeka pang'ono mu kukula kwa chiberekero. Lochias ndi amagazi m'chilengedwe, ngakhale sabata itatha.
- Maonekedwe aakulu. Matendawa amapangidwa patatha masiku awiri kuchokera pamene mwana wabadwa. Mu 25% ya milandu, endometritis imapangidwa kumbuyo kwa chorioamnionitis pambuyo yobereka zovuta, opaleshoni yotsegula. Ndimawonetsa nthawi yaitali, kusintha kwakukulu sikukuwonedwa ndipo patatha masiku pang'ono, mphamvu zowonongeka zimatha kudziwika. Akazi amakhudzidwa ndi:
- mutu;
- kufooka;
- ululu m'mimba pamunsi;
- chisokonezo chagona;
- kutentha ndi madigiri 39.
- Fomu ya shabby. Iyamba pa 3-4 masiku. Kutentha kwa thupi sikudutsa madigiri 38. Odwala ambiri, lochia ndi bulauni woyamba, koma amapita ku saccharum. Kupweteka kwa chiberekero kumapitirira masiku 3-5. Malinga ndi chiyambi cha mankhwalawa, kutentha kumachitika masiku asanu ndi limodzi.
Zowonjezera mu endometrium
Kutchula zizindikiro zazikulu za postpartum endometritis, ziyenera kunenedwa kuti mawonekedwe ochotsedwa ndi owoneka angapangidwe mosayembekezereka kwa mkaziyo. Komabe, postpartum endometritis nthawi zonse imawonetseredwa mwa kusintha kusintha kwa umuna. Pambuyo pa kubadwa kwa mwana, chiberekero cha uterine chimasulidwa, ndipo mayi amatha lochia . Kawirikawiri amakhala ndi minofu yofiira, ndi yunifolomu, yopanda phokoso ndi fungo losasangalatsa. Ndi chitukuko cha njira yotupa, chithunzichi chimasintha kwathunthu.
Pamene postpartum oyambirira endometritis ikuyamba, lochia kawirikawiri amapeza malawi a brownish. Akayesedwa, zosafunika za pus zimatha kupezeka. Kuwonekera kumatsekedwa kwa magazi, omwe amapangidwa chifukwa cha kutuluka kovuta. Pang'onopang'ono, kutuluka kwayamba kumatenga fungo losasangalatsa. Izi zimafuna thandizo lachipatala. Pofufuza mkazi ali pa mpando wa amayi, adokotala amachepetsa kuchepetsa chiberekero.
Kuzindikira za postpartum endometritis
Kuti apeze matenda ovuta a postpartum endometritis, katswiri wamagetsi akudziwa amayenera kufufuzidwa kokha ndi magalasi. Kawirikawiri, kusintha kumakhudza kachilombo ka HIV. Kuwonjezera apo, n'zotheka kukayikira kuphwanya ku bimanual kuyesa chiwalo chogonana kupyolera mu khoma la m'mimba. Kutulukira kwa "postpartum endometritis" kumapangidwira pa zotsatira za mayeso a laboratori:
- kuyesa magazi;
- kukonza;
- Bakiteriya chikhalidwe cha kutaya kwa chiberekero (chimakhazikitsa mtundu wa tizilombo toyambitsa matenda);
- Ultrasound ya pelvis yaing'ono;
- zosawerengeka.
Endometritis - zotsatira
Ngati palibe mankhwala abwino, osagwirizana ndi malamulo a zachipatala, pali chiopsezo cha mavuto. Zikatero, njira yotupa imakhala yofala ndipo imadutsa ziwalo zozungulira. Pachifukwa ichi, madokotala amalemba zovuta zotsatirazi za postpartum endometritis:
- pelvioperitonitis - kutupa kwa peritoneal serous nembanemba wa chiuno chisa;
- peritonitis - kutupa kwa peritoneum;
- thrombophlebitis - njira yotupa yomwe imakhudza mitsempha yamagazi m'mimba yaing'ono;
- kupuma kwapakhosi - purulent kuganizira, kukhala ndi makoma ake;
- sepsis.
Postpartum endometritis - mankhwala
Chithandizo cha postpartum endometritis chimayamba ndi kukhazikitsidwa kwa mtundu wa tizilombo toyambitsa matenda ndi chifukwa chomwe chinayambitsa matendawa. Chifukwa cha mankhwalawa ndi antibacterial ndi anti-inflammatory drugs. Mofananamo, perekani mankhwala owonjezera chitetezo cha thupi. Kuti mukhale ndi bwino kutuluka kwa lochia, gwiritsani ntchito antispasmodics. Maphunzirowa amasankhidwa payekha, kulingalira za kuchuluka kwa kuphwanya ndi kuuma kwa zizindikiro zake.
Endometritis - mankhwala, mankhwala
Maantibayotiki a endometrium amalembedwa kuganizira za kuyamwitsa nthawi zonse. Amagwiritsa ntchito penicillin ndi cephalosporins . Pakati pa mankhwalawa ndi koyenera kugawa:
- Chithunzi;
- Ceftriaxone;
- Ofloxacin;
- Cefotaxime .
Kawirikawiri amaika regimen pamodzi, ndi nthawi imodzi yomwe imayendera metronidazole ndi antibiotics a gulu la lincomycin. Mankhwalawa samagwiritsidwa ntchito poyamwitsa, pamene akulowetsa mkaka. Ngati ndi kotheka, mayiyo amasiya nthawi yoyamwitsa. Kuchiza ndi mankhwala oletsa antibacterial kumamitsidwa 24-48 maola pambuyo pa kukonzanso kwa chipatala.
Pamene endometritis imayamba chifukwa cha kukhalapo kwa ziphuphu mu chiberekero pambuyo pobaya, kuchipatala kumachitidwa. Zikuphatikizapo:
- chotsumphura;
- chithunzithunzi;
- kusamba kwa chiberekero cha uterine ndi antyeptics utakhazikika (furacilin, dioxin 1%).
Kusamba kumalimbikitsa kuchepetsa kuyamwa kwa mankhwala owonongeka ndi mankhwala oopsa. Kuwonjezera apo, njirayi imachepetsa kuchuluka kwa purulent kutaya, kumapanga njira ya lochia. Kuponderezedwa kumachitika patatha masiku 4-5, ndikupereka zakuthupi ndi pambuyo pa masiku 6-7 ndi gawo lachisokonezo. Mkazi nthawiyi ali m'chipatala.
Physiotherapy ndi endometrium
Pamene matendawa ndi endometritis, njira za physiotherapeutic chikhalidwe zimathandiza kuchepetsa maphunzirowo. Zina mwazofala kwambiri:
- Njira yothandizana nayo ya Nemuk - ikuphatikizapo kugwiritsa ntchito mafunde omwe ali otsika ndi apakati omwe amachitidwa kupyolera mwa magetsi 4;
- mitsinje yochepa yafupipafupi - yogwiritsidwa ntchito pofuna kukonzanso msanga;
- kuwombera thupi - kumakhala ndi zotsatira zabwino zowonongeka.
Prophylaxis ya postpartum endometritis
Kuchotsa matendawa, endometritis, kupewa kuyenera kuyambira pa nthawi yokonzekera mimba. Madokotala akulangizidwa kukonzekera pasadakhale kuti izi zichitike. Kupewa kwa endometritis kumaphatikizapo kutsata njira monga:
- Kuzindikira ndi chithandizo cha matenda akuluakulu a njira yobereka asanayambe kutenga pakati;
- Kulembetsa kwa panthaŵi yake kwa mimba;
- kuyendera dokotala nthawi zonse;
- Kusamalidwa bwino kwa ntchito - kutenga zovomerezeka za kubereka kudzera mwa kubadwa kwachibadwidwe, kuyerekezera kubadwa kwapadera, kupereka mankhwala opha tizilombo pambuyo pochita opaleshoni kuti asatenge matenda.