Puerperal wela: mea, lalau mai, symptoms a me ka hana hiʻona

Ma ka puke kaulana ma Jerome K. Jerome "Three Men i loko o ka Hawaii" pūʻulu aʻu i loaʻa ma nā mea a pau, 'Aʻohe wai iaʻu, mai puerperal kuni. He aha ka mea? E mākou nana i loko o kēia 'atikala.

A pae o ka mai ke kumu ma ka mea hoʻohaumia, hapai wahine i hānau ua kapaia postpartum sepsis, a me ka mea, e olelo aku i loko o nā lā kahiko, puerperal kuni (kuni).

kekahi mau 'ike

Puerperal wela originated i loko o ka Middle Ages. Kekahi o ka mea i ho'ākāka 'ia mua o ka hihia o keia maʻi, Hippocrates. Prior i ka puka o ka mua maternity haukapila i loko o ka XVII kenekulia, na hihia o ka maʻiʻaʻai puerperal kuni, he epidemiological ma ka ano.

Ma ka waena o ka XIX kenekulia Hunakalia obstetrician Ignats Zemmelveys i ka helu o nā mea mahuʻi e pili ana i na kumu o puerperal mai kuni. He kuhikuhi mua mai i ka pono e hoʻohana antiseptic pāʻoihana ma haawi. Eia naʻe, i ko lakou laha ana i loko o obstetrics lilo ana wale nō i loko o ka hopena o XIX kenekulia.

Wahi a ka 'ikepili helu, i keia la wale 0.2-0.3% o nā hihia o obstetric complications ana ma ka sepsis, i hana ku e aku i ka backdrop o endometritis i loko o 90% o ka hapai wahine.

Puerperal wela haawiia i loko o ka Classics buke, pinepine i ho'ākāka 'ia e like me ka mea pepehi a me ka maʻi hiki. Ke hoʻohana i ke kālā no lapaau aseptic, antiseptic, antibiotic hoʻohana hiki aku ai i ka mea i kia-partum sepsis anaʻia.

Nā 'ano o ka postpartum maʻiʻaʻai nā:

• Endometritis - li nui o ka uterus.
• Ke discrepancy ma waena o ka crotch ulana i ka pauku malalo iho.
• Ke discrepancy ma waena o ka ulana ma hope cesarean pauku.
• Mastitis.

Puerperal kuni: 'ehaʻeha ka

He aha nō nā kumu o ka postpartum kuni?

• E like me ka rula, o ka maʻiʻaʻai ma pathogenic Luna o ka wahine meaola ia lŘlŘ i hoʻokoe '-kaʻaeʻana me antiseptics i hānau.
• Ka loa, he pono ole maʻiʻaʻai mea he "haukapila" ke kanana nei o koʻohune, wehewehe aku ma ka mahuahua ia'ku i ka lāʻau.
• Aie i ka mea hoʻonāwaliwali maoli nō o ka e hoʻonele, kena ae la ia e stress i hānau, kino o ka wahine o ka hiki haʻalele kona mau opportunistic flora a me ka mea maʻiʻaʻai.

About pathogens

Puerperal sepsis pathogens i:

• bacteroides;
• Proteus;
• Staphylococcus aureus;
• gonococcus;
• E. coli;
• Klebsiella;
• haemolytic streptococci;
• peptostreptokokki a no laila, ma luna o.

Akā, o ka papa, i kaʻuku lele i loko o puerperal kuni. Kēia mea,ʻaʻole he pathogen, e ka inoa o kekahi o ka malu o ke kala a pau, a me ka maʻi i mea e hana ai.

Loa pinepine, puerperal sepsis - he polymicrobial maʻiʻaʻai, kena ae la ma kekahi mau? Ueo o pathogens.

Kekahi kumu anal o microorganisms i:

• vaginal waimaka, uterine cervix, a me ka perineum.
• placental ciia i loko o ka uterine lua.

Maʻiʻaʻai ana ia lŘlŘ ma ka leka pepa, ma ka hui 'ana me kaʻeha' ilikaiʻino lima a me unsterile kani. A laila, i ka laha ana o pathogens i wahi ma ka lymph a me ke koko moku.

kamepiula kumumea

'Ākena Makaʻu no ka hanana o puerperal sepsis:

• huʻi a me ka maʻi hoʻoʻino maʻi o na wahine - ekstragenital'nye e like me cystitis a me ka pyelonephritis, a me gynecological, e laʻa me endometritis, colpitis a me ka vulvitis;
• hoʻohana ana i invasive ano o prenatal haʻawina;
• kauoha fetal ECG;
• anaʻoki lāʻau lapaʻau? iaea o cervical insufficiency a me ka isthmus;
• pinepine vaginal noi noiʻi i loko o obstetrics;
• uterine kahe ana ke koko.
• kakahiaka hookuuia ana o ka wai;
• obstetric hoʻokō 'ia' ana e like me ka hoohuli ana fetal dilatation ma ka hoʻohana 'ana i forceps.

Primiparous puerperal wela e hoʻomōhala ana i oi pinepine ma mua me ka puana ka nahunahu hanau.

symptoms

1-2 lā ma hope o ka hānau e hōʻike symptoms o puerperal sepsis:

• kuni a me ka ole;
• tachycardia;
• mau malaise a me nā symptoms o intoxication;
• makewai, kahe o ka ikaika loa ka makemake;
• eha ma ka ili o ka opu, aʻaʻole pono ma ka lalo;
• kūpono ', a me impurities pus hookuuia (lochia) mai o ka hānau Canal, i kekahi manawa, ma kahi ee kekahi koho;
• ka wā mastitis piha cessation a me ka ho'ēmiʻana o ka lactation.

Kaawale mai puerperal ke kuni, ma laila nō nā maʻi puʻuwai.

Mua, li nui 'aʻole i ana ma kela aoao o ka tribal eha. A laila, ke kaumaha ma muli o ka lesion, loaʻa nō kekahi 'hoike ana mai o kaʻohana kuni:

• puerperal ulcers - lesions me greyish lalo, me ka pehu ana, a congested kihi, a i aia ma ka cervix, vaginal pa, perineum;
• puerperal coleitis - he li nui o ka vaginal mucosa.

Ma o ka laha ana o li nui hui ke kiʻekiʻe symptoms o ka maʻi.

• Dysmenorrhea hitting ka mucousʻili lahilahi o ka uterus;
• kiko'î a luku parauterine puluniu;
• adnexitis, a me li nui o ka uterus;
• pelvioperitonit - hoʻolilo i ka pelvic peritoneum;
• metrotromboflebit - li nui o na aa koko o ka uterus;
• thrombophlebitis - li nui o na aa koko o na pelvis, a malaloʻaoʻao.

No ka mea kolu o ke kahua o ka maʻi ua wehewehe aku ma symptoms o generalized sepsis a me ka mau symptoms o peritonitis. E like me ka weheia puerperal kuni?

lapaʻau '

I kaʻike, o "puerperal kuni," ua kau ma luna o ke kumu o ka loaʻa lapaʻau symptoms ma hope o pelvic ninaninau a me ke koko hōʻike.

lapaʻau

Lapaʻau puerperal sepsis ia me ka oolea o ka maʻi. Main mau mea:

• Ua haawiia i ke pā lonoaʻili i ka antibiotic o antibiotic hanaia. Ka lāʻau 'ua hoakaka ia hana maʻalahi me breastfeeding, ma ka loa hoopii, e ai ana ua papani iho la i.
• Immunostimulatory ai '(antistaphylococcal immunoglobulin, T-activin, hōʻike wai koko transfusions, ka lawelawe ana toxoid).
• Infusion Inc Ua koi 'ia no ka hoopau ana a me ka hou ana o kaʻawahia wai-paakai kaulike ('ākilikai pāʻoihana gemodez, nā polokina a me reopoligljukin).
• I hoonoho ia e antihistamines ( "Suprastin", "Tavegil").
• Ua hōʻike i ka hoike o proteolytic nā'ūhū (trypsin).

Ma generalized sepsis palapala lawelawe glucocorticoids a me ka lāʻau anabolic hormones.

Paha Noho a me ka physiotherapy:

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

Local lapaau o ke kumu o ka maʻiʻaʻai.

• holoi ulcers paʻakai koloriside a me ka hydrogen peroxide, no ka nui eha - truncation kihi me sutures;
• ma endometritis, i ka wa a ka uterus ua hoopanee koko, e lawe aku oe ke keiki i koe a vocal nana o ka uterine lua.

Ma peritonitis, 'o ia hoʻi, ma ka loa hoopii, he hysterectomy ua hana - ana o ka uterus me appendages.

Outlook

I ka hope o ka maʻi i loko o ka nōhie maʻiʻaʻai hilinaʻi nui ma luna o na mea he nui aʻe:

• ka manawa ia lapaʻau i hoʻomaka ', a me ka'ōnaehana paleʻea nenoaia loa makuwahine;

• ke degere o ka maʻi-ma o na la koʻohune.

Inā ka li nui kaʻina ua kaupalena 'wale i ke hooeha hoi hoola ana, e like me ka rula, i paʻa', a me ka hopena. I sepsis generalized palapala make ihoiho 65%.

Kāohi

I mea e pale aku puerperal kuni e malama pono i ka hahai ana:

• sanitation o ka huʻi a me ka maʻi hoʻoʻino extragenital a me gynecological maʻi;
• i hānau ālai 'discontinuities wahine'āpana'aʻaʻa;
• ke kanana 'adherence i aseptic a me ka antiseptic rula.

meʻe o ka buke, paha na symptoms o keia mai i kapa i loaʻa ma nā mea a pau mai, koe wale no ka puerperal kuni. E hoʻokaʻaʻike ola!