Puerperal fever: akpata, mgbaàmà na ọgwụgwọ atụmatụ

Ke ọwọrọetop n'akwụkwọ site na Jerome K. Jerome "ikom atọ a Boat" agwa m na niile, iche site puerperal fever. Gịnị ka ọ bụ? Ka anyị tụlee ihe n'isiokwu a.

A ìgwè nke ọrịa ndị ofufe, ụmụ nwaanyị dị ime n'oge na-amụ nwa na-akpọ ọbara sepsis, ma ọ bụ ka ha na-asị na ochie ụbọchị, puerperal fever (fever).

ozi izugbe

Puerperal fever sitere na Middle Ages. Otu n'ime ihe mbụ kọwara a bụrụ na nke a na ọrịa, Hippocrates. Tupu oghere nke mbụ onodu ụlọ ọgwụ na na Asaa na narị afọ, okwu ikpe nke ibute ọrịa puerperal fever bu epidemiological ke uwa.

Ke n'etiti ndị XIX narị afọ Hungarian obstetrician Ignats Zemmelveys mere a ọnụ ọgụgụ nke echiche banyere ndị na-akpata nke puerperal fever. Ọ na mbụ kwuru na ọ dị mkpa iji antiseptik ngwọta na nnyefe. Otú ọ dị, ha nile iji na obstetrics ghọrọ ọdabara naanị na njedebe nke XIX na narị afọ.

Dị ka ọnụ ọgụgụ, taa naanị 0.2-0.3% niile ikpe nke obstetric nsogbu ime na sepsis, aa megide backdrop nke endometritis na 90% nke ime ndị inyom.

Puerperal fever zoro aka na ochie akwụkwọ, mgbe mgbe, kọwara dị ka ize ndụ ma na-enweghị ngwọta ọrịa. The ojiji nke nkà mmụta ọgwụ ọgbara aseptic, antiseptik, ọgwụ nje eji na-eduga ná eziokwu na post-partum sepsis ọma mesoo.

The ụdị ọbara ọrịa na-agụnye:

• Endometritis - mbufụt nke akpanwa.
• The ndiiche n'etiti crotch onuete na-esonụ ngalaba.
• The ndiiche n'etiti onuete mgbe cesarean ngalaba.
• Mastitis.

Puerperal fever: akpatara

Gịnị bụ ndị na-akpata ọbara fever?

• Dị ka a na-achị, ndị ọrịa site pathogenic mmadụ nke nwaanyị organism na-adị mgbe ndị na-abụghị nnabata ya antiseptics n'oge na-amụ nwa.
• Kacha nkịtị ọrịa bụ a "ọgwụ" ụdị nje bacteria, ji ihe mụbara iguzogide ọgwụ.
• N'ihi na-agwụ ike nke ọgụ mere site nchegbu n'oge na-amụ nwa, nwanyi ahu nwere ike rụọ ọrụ ya opportunistic na osisi na-akpata ọrịa.

About pathogens

Puerperal sepsis pathogens bụ:

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

Ma, n'ezie, ọ bụghị a àkpịrị na puerperal fever. Nke a abụghị a pathogen, dị nnọọ aha otu nke shades nke na agba, na ọrịa nwere ihe ọ bụla na-eme.

Ọtụtụ mgbe, puerperal sepsis - a polymicrobial ọrịa mere site ọtụtụ ụdị pathogens.

Nwere obere penetration nke microorganisms bụ:

• mmamiri anya mmiri, eriri akpa nwa cervix, na perineum.
• placental gbaba n'ime eriri akpa nwa oghere.

Ofufe Ọrịa na-emekarị emee site na kọntaktị, na kọntaktị na ọnya n'elu unyi aka na unsterile ngwá. Mgbe ahụ mgbasa nke pathogens na-ewe ebe site na Lymph na ọbara arịa.

ihe ize ndụ ihe

Ihe ize ndụ ihe maka omume nke puerperal sepsis:

• nnukwu na-adịghị ala ala mkpali oria inyom - ekstragenital'nye dị ka cystitis na pyelonephritis, na gynecological, e.g. endometritis, colpitis na vulvitis;
• ojiji nke invasive ụzọ nke prenatal ọmụmụ;
• kpọmkwem nwa ebu n'afọ na ECG;
• itinye ịwa mgbazi nke cervical insufficiency na ala ahụ dị warara;
• Ugboro mmamiri ngwa nnyocha obstetrics;
• eriri akpa nwa ọbara ọgbụgba.
• n'oge orùrù nke mmiri;
• obstetric eduzi arụmọrụ dị ka izere nwa ebu n'afọ na dilatation site na iji forceps.

Primiparous puerperal fever amalite ọtụtụ ugboro karịa ha ugboro ugboro na-amụ nwa.

mgbaàmà

1-2 ụbọchị mgbe amuchara nwa nwere ike na-egosi ihe mgbaàmà nke puerperal sepsis:

• fever na akpata oyi;
• tachycardia;
• general malaise na mgbaàmà ndị ọzọ nke igbu egbu;
• akpịrị ịkpọ nkụ, ọnwụ nke agụụ;
• mgbu gafee elu nke afo, ma ọ bụghị naanị na ala;
• iwe, na adịghị abu ihapu (lochia) si ọmụmụ kanaal, mgbe ụfọdụ, na-anọghị ọ bụla nhọrọ;
• mgbe mastitis zuru cessation ma ọ bụ Mbelata lactation.

E wezụga puerperal fever, e nwere ndị ọzọ ọrịa.

Akpa, mbufụt adịghị agbaghara n'ofè agbụrụ ọnyá. Mgbe ahụ, dabere na lesion, e nwere ihe bụ ngosipụta nke nna nna fever:

• puerperal onya - ọnya na greyish ala, na fụrụ akpụ na congested n'ọnụ, nke na-emi odude na cervix, mmamiri mgbidi, perineum;
• puerperal coleitis - ihe mbufụt nke mmamiri mucosa.

Site mgbasa nke mbufụt iso abụọ mgbaàmà nke ọrịa:

• Dysmenorrhea ọkụkụ mucous akpụkpọ ahụ nke akpanwa;
• parameters egbu parauterine eriri;
• adnexitis, ma ọ bụ mbufụt nke akpanwa;
• pelvioperitonit - imeri pelvic peritoneum;
• metrotromboflebit - mbufụt nke veins nke akpanwa;
• thrombophlebitis - mbufụt nke veins nke pelvis ma na ala na nsọtụ.

N'ihi na nke atọ ogbo nke ọrịa e ji mgbaàmà nke generalized sepsis na izugbe mgbaàmà nke peritonitis. Dị ka e kpughere puerperal fever?

nchọpụta nsogbu

The nchoputa nke "puerperal fever" na-etinye na ndabere nke dị adakarị mgbaàmà mgbe pelvic nnyocha na ọbara ule.

ọgwụgwọ

Ọgwụgwọ puerperal sepsis kenyere na ogo nke ọrịa. Main ebe:

• Nyere uche na ogwu mgbochi nke ọgwụ nje rụrụ. The ọgwụ na-kenyere dakọtara na ara, na oké ikpe, nri na-kwụsịrị.
• Immunostimulatory ọgwụ (antistaphylococcal immunoglobulin, T-activin, gosiri plasma mmịnye, anamde ibọ toxoid).
• Infusion ọgwụ a chọrọ maka mwepụ na mgbake nke na-egbu egbu mmiri nnu itule (alkaline ngwọta gemodez, ndi na-edozi na reopoligljukin).
• Họpụtara Antihistamines ( "Suprastin", "Tavegil").
• Ọ na-egosi iwebata proteolytic enzymes (trypsin).

Na generalized sepsis ụdị ndinọ glucocorticoids na anabolic homonụ.

Ikekwe okodu na physiotherapy:

• akpanwa electrostimulation;
• UHF;
• UV irradiation;
• microwaves;
• ultrasound.

Obodo ọgwụgwọ nke isi iyi nke ọrịa:

• saa Ọnya sodium chloride na hydrogen peroxide, maka nnukwu ọnyá - truncation n'ọnụ na isi agịga Ma do;
• na endometritis, mgbe akpanwa na-egbu oge ọbara, ewepu fọdụrụ Plasenta na instrumental nnyocha nke eriri akpa nwa oghere.

Na peritonitis, ie, n'oké ikpe, a hysterectomy a rụrụ - mwepụ nke akpanwa na ejiji.

ele ihe anya

Pụta nke ọrịa a ọnyà ọrịa na-adabere na ọtụtụ ihe:

• oge mgbe ọgwụgwọ e butere, na dịghịzi usoro ọtụtụ ná ndị nne;

• ogo na-akpata ọrịa bacteria.

Ọ bụrụ na mbufụt usoro a na-bụghị naanị emerụ na-agwọ ọrịa, dị ka a na-achị, zuru ezu na-enweghị nsogbu. Na sepsis generalized ụdị enwe esịmde 65%.

mgbochi

Iji gbochie puerperal fever ga-edebe ndị na-esonụ jikoro:

• idebe nke nnukwu na-adịghị ala ala mkpali extragenital na gynecological ọrịa;
• n'oge na-amụ nwa gbochie discontinuities Genital tract anụ ahụ;
• ịgbasochi ka aseptic na antiseptik iwu.

dike nke akwụkwọ, eleghị anya, ihe mgbaàmà nke ọrịa a maara dị ka nke dị na ọrịa niile, ma e wezụga n'ihi puerperal fever. Nọrọ mma!