I-postpartum endometritis ibhekisela kwizifo zesifo esiyintlungu esisisiphumo sokuzalwa kwangaphambili. Ngalo, ukuvuvukala kukuphazamisa umlenze we-mucous we-uterus, ongaphinda uwele uhla lwe-muscle. Masiqwalasele ukuphulwa ngokubanzi, masiqambe igama, izibonakaliso kunye nezindlela zonyango.
I-postpartum endometritis - izizathu
I-Endometritis emva kokubeleka ibunjwe kwindawo apho iplascenta ikhona ngaphambili. Ngexesha lokuhlukana kokutshatyalaliswa, imithwalo yegazi ixinzeleleke. Ubunxeba obunobumba luyakheka, obangelwa yinto eyenziwa yizilwanyana ezincinci ze-pathogenic. Nangona kunjalo, ayifumaneki njalo. Ukuphuhliswa kwentsholongwane kuququzelelwe yimibandela echukumisayo, apho:
- ukunciphisa ukukhuselwa komzimba wendawo (ubukho beenkqubo ezingenasiphelo kunye nokusuleleka kwindlela yokuzala);
- msebenzi ogqithisiweyo;
- ukungagcinwa kwemimiselo yococeko olusenyongweni ngexesha lokugqibela.
Ngokuqhelekileyo imfuneko yokuphuhliswa kwe-endometritis yangemva kwe-postpartum kukunciphisa inkqubo ye-involution (ukubuyisela) kwesibeleko, ukulibaziseka kwe-lop-hews. Kule meko, ii-microorganisms ezichaphazelekayo zenza njengama-pathogens abangela ukuphazamiseka, ezikhoyo kwinani elincinane kwi-urrogenital system. Phakathi kwazo:
- staphylococcus aureus;
- streptococcus ;
- kwiintsholongwane.
I-Endometritis emva kwecesarean section
Ukuphuhlisa i-endometritis emva kokuba i-cearean idla ngokubakho ngenxa yokuhlinzwa ngokukhawuleza. Ngoko, kunye nokucwangciswa okucwangcisiweyo, ukuphindaphinda kwe-endometritis akudluli kwi-5%, kwaye xa kwenzeka unxunguphako, i-22-80%. I-postpartum endometritis, ngenxa ye-caesarean, ngokuqhelekileyo ivela ngesimo esibi. Oku kungenxa yokusuleleka kwe-incision kwi-uterus kunye nokusabalalisa ngokukhawuleza kokuvuvukala ngaphaya komlenze we-mucous. Ngenxa yoko, ezinye izifo zikhula:
- i-myometrium - umonakalo womgca we-muscular;
- metrotromboflebit.
Ngenxa yenkqubo yokuvuvukala, kukho ukuphulwa kweenkqubo zokuvuselela kwindonga edibeneyo yesisu. Oku kungabangelwa yimpahla ye-suture. Ukunciphisa umsebenzi wekhontrakthi webele, ngenxa yokuba ukuphuma kwe-lochia kunzima kwaye kwandisa imeko. Esi sifo senziwa ngomhla we-4-5 kwaye sihamba kunye:
- lokushisa komzimba 38-39 degrees;
- ukuphosa;
- ukwanda kwenani lezintso zomzimba - tachycardia.
Endometritis emva kokukhipha isisu
I-postpartum endometritis kubasetyhini inokubangela ukukhipha isisu ngexesha elidlulileyo. Ukungenelela kwee-instrumental ezichaphazela isithwathwa se-uterine kwandisa amathuba okuba le ngxaki iphuhlise. Oku kubangelwa utyhafu olunzima lwendawo yokugcina i-endometrial. Ngenxa yoko, yonke i-mucosa iba yindawo enxeba enokuthi ithinteke kwizenzo ze-microorganisms ze-pathogenic. Ukungathobeli ukuhlanjululwa nococeko kunye neengcebiso zonyango kukhokelela ekuphuhlisweni kwe-endometritis.
I-Endometritis emva kokubeletha - iimpawu
Ukuze ufumane i-postometum endomitritis ngexesha, wonke umama kufuneka azi izibonakaliso zesi sifo. Ngokuxhomekeke kwimifanekiso yekliniki, iintlobo ezintathu zokuphazamiseka ziyahlukana, ngasinye sineziganeko zayo:
- Ifowuni yokukhanya. Iyakhula iintsuku ezi-5-12. Ngelo xesha, ngokumalunga nemvelaphi yentlalo-jikelele, izinga lokushisa lomzimba liphakama kuma-38-39 degrees. Umbuso wezempilo awukhathazi kakhulu. Izigulane zibika ukukhathazeka kwisibeletho, ezihlala iintsuku ezi-3-7. Xa i-palpation, oogqirha banokunyuka okwenyuka ubukhulu besisu. I-Lochias igazini kwindalo, kwaneveki emva kokuqala.
- Ifom enkulu. Esi sifo senziwa kwiintsuku ezingama-2-4 emva kokuzalwa komntwana. Kwi-25% yamatyala, i-endometritis yenziwe kwimvelaphi ye-chorioamnionitis emva kokuhanjiswa okulukhuni, ukungenelela okutyathwayo. Ngokuqwalasela ixesha elide, ukulungelelanisa, ukuphuculwa okufanelekileyo akuqwalaselwa kwaye emva kweentsuku ezimbalwa, izinto ezinokuthi zingabonakali. Abafazi banenkxalabo malunga:
- intloko;
- buthathaka;
- intlungu kwisisu esezantsi;
- ukuphazamiseka kokulala;
- iqondo lokushisa ngama-39 degrees.
- Ifom shabby. Uqala ngeentsuku eziyi-3-4. Ubushushu bomzimba abugqithisi ama-38 degrees. Kwizigulane ezininzi, i-lochia ibontshisi yokuqala, kodwa ke iya kwi-saccharum. Ukukhathazeka kwesibeleko kuqhubeka iintsuku ezingama-3-5. Ngokuchasene nemvelaphi yonyango, iqondo lokushisa liqheleke emva kweentsuku ezingama-5-10.
Iziqhamo kwi-endometrium
Ukubizela iimpawu eziphambili ze-endometritis yangemva kwe-postpartum, kufuneka kuthathelwe ukuba iifomu ezipholileyo kunye ezikhanyayo zenzeke ngokungafunekiyo kumfazi ngokwakhe. Nangona kunjalo, i-endometritis ye-postpartum ihlala ibonakaliswa ngokutshintsha ukukhulelwa kwesisu. Emva kokuzalwa komntwana, umtya wesisu ususwe, kwaye umama ulungisa i- lochia . Ngokuqhelekileyo bane-hue ebomvu, bafana, bengenamacangco kunye nephunga elimnandi. Ngokuphuhliswa kwenkqubo yokuvuvukala, umfanekiso uguqulwa ngokupheleleyo.
Xa i-endometritis yangaphambili ye-postpartum ikhula, i-lochia ifumana i-hue. Xa zihlolwe, ukungcola kwe-pus kungafumaneka. Ukubonakala kwegazi, ezibunjwa ngenxa yokuphuma kanzima. Kancinci, ukukhutshwa kokuqala kuqalisa iphunga elimnandi. Le meko idinga ukungenelela kwezonyango. Xa uhlolisisa ibhinqa kwisihlalo somzimba, ugqirha ugxininisa ukubuyiswa kwesisu.
Ukuxilongwa kwe-endometritis ye-postpartum
Ukufumanisa i-endometritis ehamba phambili yokuhamba, i-gynecologist enamava kufuneka ihlolwe kuphela ngezibuko. Kwiimeko ezininzi, utshintsho luchaphazela umlomo wesibeleko. Ukongezelela, kunokwenzeka ukukrokreka ukuphulwa kwimeko yokuhlola ibimanual yesitho somzimba ngesalathisi sangasemva kwesisu. Ukuxilongwa "kwe-endometritis yokuhamba emva kwenyanga" kwenziwa ngesiseko seziphumo zeemvavanyo zelabhoratri:
- vavanyo lwegazi;
- urinalysis;
- inkcubeko ye-bhakteria yokukhutshwa kwi-uterus (isungula uhlobo lwe-pathogen);
- I-Ultrasound ye-pelvis encinci;
- hysteroscopy.
I-Endometritis - iziphumo
Xa kungabikho unyango olufanelekileyo, ukungathobeli imimiselo yonyango, kukho umngcipheko weengxaki. Kwiimeko ezinjalo, inkqubo yokuvuvukala iyaba yanda kwaye idlulela kumaziko angummelwane. Kule meko, oogqirha babhala iingxaki ezilandelayo ze-endometritis yokuhamba emva:
- i-pelvioperitonitis - ukuvuvukala kwimbumba ye-peritoneal serous ye-pelvic cavity;
- i-peritonitis - ukuvuvukala kwe-peritoneum;
- i-thrombophlebitis-inkqubo yokuvuvukala echaphazela imithwalo yegazi kwi-pelvis encinci;
- Iphofu le-pelvic - ingqwalaselo ye-purulent, eneendonga zayo;
- sepsis.
I-postpartum endometritis - unyango
Unyango lwe-endometritis emva kwe-postpartum luqala ngokusekwa kohlobo lwe-pathogen kunye nesizathu esibangela isifo. Isiseko sonyango i-antibacterial and anti-inflammatory drugs. Ngokufanayo, misela izidakamizwa ukwandisa ukhuseleko lomzimba. Ukuphucula ukuphuma kwe-lochia, sebenzisa i-antispasmodics. Ikhosi ikhethwe ngabanye, ingqalelo iqondo lokuphulwa kunye nokuqina kwempawu zayo.
I-Endometritis - unyango, iziyobisi
I-antibiotics ye-endometrium imiselwe ukuba ithathe ingqalelo ngokunyamezela ukuncelisa. Ukusetyenziswa kwamapenicillin kunye ne- cephalosporins . Phakathi kwala mayeza kuyimfuneko yokwabiwa:
- Cefuroxime;
- Ceftriaxone;
- Ofloxacin;
- Cefotaxime .
Ngokuqhelekileyo bakhethe i-regimen edibeneyo, kunye nokulawulwa ngokufanayo kwe-metronidazole kunye ne-antibiotics yeqela le-lincomycin. Ezi zokugqibela azizisetyenziselwa ukuncelisa, njengoko zingena kumbisi. Ukuba kuyimfuneko, le ntokazi iyayeka ixesha lokuncelisa. Unyango olwenziwe ngamachiza olwaphulo-mthetho luye lwayeka ii-24-48 iiyure emva kokuphuculwa kweklinikhi.
Xa i-endometritis ibangelwa ubukho beethambo kwi-uterine cavity emva kokutshatyalaliswa, unyango olwenziwa ngonyango lwenziwa. Iquka:
- ukucima ukucima;
- hysteroscopy;
- ukuhlamba i-uterine cavity kunye ne-antiseptics ecolile (furacilin, dioxin 1%).
Ukuhlamba kunconywa ukunciphisa ukuxutywa kwemveliso yokuceka kunye namayeza anobuthi. Ukongezelela, le nkqubo inciphisa kakhulu umlinganiselo wokukhutshwa kwegazi, iphucula inkqubo ye-lochia. Ukunyanzelisa kwenziwa emva kweentsuku ezi-4 ukuya ku-5, kunye nokuhanjiswa kwendalo kunye emva kweentsuku ezingama-6-7 kunye necandelo lesareari. Ibhinqa ngeli xesha lisesibhedlele.
I-Physiotherapy ne-endometrium
Xa isifo sisifo se-endometritis, iinkqubo zendalo ye-physiotherapeutic zinceda ukunciphisa ikhosi. Phakathi kwezona ziqhelekileyo:
- Ukuchithwa kwamanyathelo okwangoku okwenziwe ngeNemuk - kuquka ukusetyenziswa kwamasebe aphantsi kunye nee-medium frequencies ezenziwa nge-4 electrodes;
- Iimitha zamanzi eziphantsi kwexesha eliphantsi-ezisetyenziselwa ukuvuselelwa kwangaphambili;
- i-acupuncture - inefuthe elifanelekileyo lokuzikhumbuza.
I-Prophylaxis ye-endometritis ye-postpartum
Ukukhuphela isifo, i-endometritis, inqanda kufuneka iqale kwisigaba sokucwangcisa ukukhulelwa. Ogqirha bayacetyiswa ukuba balungiselele kwangaphambili kule nkqubo. Ukuthintela i-endometritis kubandakanya ukuthotyelwa kwamanyathelo anjenge:
- ukufumanisa kunye nokunyangwa kwezifo ezingapheliyo kwinkqubo yokuzala ngaphambi kokuba ukhulelwe;
- ukubhaliswa ngexesha elifanelekileyo lokukhulelwa;
- tyelela rhoqo ugqirha;
- Ukulawulwa kakuhle kobasebenzi - ukuthatha ingqinisiso ekuzalweni kokuzalwa ngokweemvelo zokuzalwa, ukuhlola ukuzalwa emva kokuzalwa, ukulawula i-antibiotics emva kokuhlinzwa okuthintela ukhuseleko.