I-endometritis ye-Postpartum ibhekisela kulawo magciwane esibelethweni esiwumphumela wabantwana bokuzalwa. Ngalo, ukuvuvukala kuphazamisa ulwelwesi lwamangqamuzana esibelethweni, olungaphinde luwele uhlaka lwesisipha. Ake sicabangele ukwephula ngokuningiliziwe, ake sithi izimbangela zayo, izimpawu nezindlela zokwelapha.
I-endometritis ye-postpartum - imbangela
I-endometritis ngemuva kokubeletha kwakha endaweni lapho i-placenta ikhona ngaphambili. Ngesikhathi sokuhlukaniswa kwe-afterburn, imithwalo yegazi ihlukumezekile. Kukhona isilonda esilonda, esithinta isenzo samagciwane ezincane ze-pathogenic. Kodwa-ke, akutholaki njalo igciwane. Ukuthuthukiswa kwe-pathology kuhlinzekwa yizinto ezibangela ukuthi:
- ukunciphisa ukuzivikela komzimba wangaphakathi (ukutholakala kwezinqubo ezingavamile zokuvuvukala nokutheleleka ohlelweni lokuzala);
- umsebenzi ophuthumayo;
- ukungahambisani nemithetho yokuhlanzeka okujulile esikhathini sokuhamba kwesikhathi.
Ngokuvamile okudingekayo ekuthuthukiseni i-postpartum endometritis ukunciphisa inqubo ye-involution (ukutakula) kwesibeletho, ukubambezeleka kwe-lop-hews. Kulokhu, ama-microorganisms angenayo amathuba njengama-pathogens abangela ukuphazanyiswa, okukhona esincane esesimisweni se-urogenital. Phakathi kwabo:
- i-staphylococcus aureus;
- streptococcus ;
- amagciwane.
I-Endometritis ngemuva kwesigaba se-caesarean
Ukwakhiwa kwe-endometritis emva kwe-cearean kuvame ukuhlinzwa ngokuphuthumayo. Ngakho-ke, ngokulondolozwa okuhleliwe, imvamisa ye-endometritis ayidluli ku-5%, futhi uma kwenzeka isimo esiphuthumayo siphume, u-22-80%. I-endometritis ye-postpartum, ngenxa ye-caesarean, ivame ukuvela ngesimo esibi. Lokhu kubangelwa ukutheleleka kwe-incision esibelethweni nokusabalala okusheshayo kokuvuvukala ngaphandle kwebhubhiso elimangalisa. Ngenxa yalokho, ezinye izifo zikhula:
- i-myometrium - umonakalo we-muscular layer;
- i-metrotromboflebit.
Ngenxa yenqubo yokuvuvukala, kukhona ukwephulwa kwezinqubo zokuvuselela odongeni oluhlanganisiwe lwesibeletho. Lokhu kungabangelwa izinto ze-suture. Ukunciphisa umsebenzi we-contractile wesibeletho, ngenxa yokuthi ukuphuma kwe-lochia kunzima futhi kwandisa isimo. Lesi sifo senziwa ngosuku lwesi-4 kuya ku-5 futhi sihambisana nalokhu:
- ukushisa komzimba 38-39 degrees;
- izikhukhula;
- ukwanda kwenani lezinhliziyo zokuvimbela inhliziyo - tachycardia.
I-Endometritis ngemuva kokukhipha isisu
I-endometritis ye-Postpartum yabesifazane ingabangela ukukhipha isisu esikhathini esidlule. Ukungenelela kwe-instrumental okuphazamisa uketshezi lwe-uterine kwandisa amathuba okuba le disorder ithuthuke. Lokhu kubangelwa ukuhlukunyezwa okukhulu kwesendlalelo se-endometri. Ngenxa yalokho, yonke i-mucosa iba yindawo enobungozi obangelwa isenzo samagciwane ezincane ze-pathogenic. Ukungahambisani nokuphakanyiswa kwezinhlanzeko nezokudokotela kuholela ekuthuthukiseni i-endometritis.
I-endometritis ngemuva kokubeletha - izimpawu
Ukuze uthole ukuthi i-endometritis ye-postpartum ngokuhamba kwesikhathi, wonke umama kufanele azi izimpawu zalesi sifo. Kuye ngesitholampilo esibhedlela, izinhlobo ezintathu zokuphazamiseka ziyahlukahluka, ngayinye yazo inezici zayo:
- Ifomu elikhanyayo. Iqala izinsuku ezingu-5-12. Ngesikhathi esifanayo, ngokumelene nesimo senhlalakahle jikelele, izinga lokushisa lomzimba likhuphukela kuma-38-39 degrees. Isimo sempilo asihlupheki kakhulu. Iziguli zibika ukukhathazeka esibelethweni, okugcina izinsuku ezingu-3-7. Ngenkathi i-palpation, odokotela bathi ukunyuka okuncane kwesayizi kwesibeletho. I-Lochias inamandla emvelo, ngisho nesonto ngemuva kokuqala.
- Ifomu elinamandla. Lesi sifo senziwa ezinsukwini ezingu-2-4 emva kokuzalwa komntwana. Ezimweni ezingu-25%, i-endometritis yenziwa ngemuva kwe-chorioamnionitis ngemuva kokulethwa okunzima, ukungenelela kokuhlinzwa. Ngokubonwa isikhathi eside, okunamandla, ukuthuthukiswa okulungile akubhekwa futhi emva kwezinsuku ezimbalwa, izintambo ezimbi zingacaciswa. Abesifazane bakhathazekile ngalokhu:
- ikhanda;
- ubuthakathaka;
- ubuhlungu esiswini esingaphansi;
- ukuphazamiseka kokulala;
- izinga lokushisa lingama-degrees angu-39.
- Ifomu le-Shabby. Iqala ngezinsuku ezingu-3-4. Ukushisa komzimba akudluli ama-38 degrees. Ezigulini eziningi, i-lochia iyinhlamba yokuqala, kodwa iya kwi-saccharum. Ukukhathazeka kwesibeletho kuqhubeka izinsuku ezingu-3-5. Ngokumelene nesizinda semithi yokwelashwa, izinga lokushisa livamile ngemva kwezinsuku ezingu-5-10.
Izithako ku-endometrium
Ukubiza izibonakaliso eziyinhloko ze-endpartritis ye-postpartum, kufanele kuthiwe ukuthi amafomu akhiphekile futhi alula angabonakala engacabangi nakowesifazane ngokwakhe. Kodwa-ke, i-endometritis ye-postpartum ibonakala njalo ngokushintsha ukukhishwa kwesisu. Ngemuva kokuzalwa kwengane, igumbi le-uterine lisuliwe, futhi umama ulungisa lochia . Ngokuvamile bane-hue ebomvu, ayifanelana, ngaphandle kwama-clots kanye nephunga elimnandi. Ngokuthuthukiswa kwenqubo yokuvuvukala, isithombe sishintsha ngokuphelele.
Lapho i-endometritis yasekuqaleni kokubeletha iqala, i-lochia ngokuvamile izuza i-brownish hue. Uma zihlolwa, ukungcola kwe-pus kungatholakala. Ama-clots avela egazi, akhiwa ngenxa yokuphuma okulukhuni. Kancane kancane, ukuphuma kwecala kuqala ukuthatha iphunga elimnandi. Isimo sidinga ukungenelela kwezokwelapha. Lapho ehlola owesifazane esihlalweni somzimba wegciwane, udokotela uyaxilonga ekunciphiseni ukuvuselelwa kwesibeletho.
Ukuxilongwa kwe-endometritis ye-postpartum
Ukuze uhlolisise i-endometritis e-postpartum ephawulekayo, i-gynecologist enolwazi kufanele ihlolwe kuphela ngezibuko. Ezimweni eziningi, izinguquko zithinta umlomo wesibeletho. Ngaphezu kwalokho, kungenzeka ukusola ukwephulwa kokuhlolwa kwe-bimanual kwesitho sofuba ngokusebenzisa udonga lwangaphakathi lwesisu. Ukuxilongwa kwe-"endotum endometritis" kwenziwa ngesisekelo semiphumela yokuhlola i-laboratory:
- ukuhlolwa kwegazi;
- ukuguqulwa kwamanzi;
- isiko lesibhaktheriya sokukhulelwa esibelethweni (sakha uhlobo lwe-pathogen);
- I-ultrasound ye-pelvis encane;
- i-hysteroscopy.
I-Endometritis - imiphumela
Uma kungekho ukwelashwa okufanele, ukungahambisani nemigomo yezokwelapha, kunengozi yezinkinga. Ezimweni ezinjalo, inqubo yokuvuvukala iba yanda futhi idlula ezitho ezingomakhelwane. Kulokhu, odokotela babhala izinkinga ezilandelayo ze-postpartum endometritis:
- i-pelvioperitonitis - ukuvuvukala kwendwangu ye-peritoneal serous yesigxobo se-pelvic;
- i-peritonitis - ukuvuvukala kwe-peritoneum;
- i-thrombophlebitis - inqubo yokuvuvukala ethinta imithwalo yegazi ku-pelvis encane;
- I-abscess ye-pelvic - ukugxila kwe-purulent, enezindonga zayo;
- i-sepsis.
I-endometritis ye-postpartum - ukwelashwa
Ukwelashwa kwe-postpartum endometritis kuqala ngokusungulwa kohlobo lwe-pathogen kanye nesisusa esabangela lesi sifo. Isisekelo sokwelashwa yizidakamizwa zokulwa namagciwane nokulwa nokuvuvukala. Ngokufanayo, misela izidakamizwa ukwandisa izivikelo zomzimba. Ukuze uthuthukise ukuphuma kwe-lochia, sebenzisa ama-antispasmodics. Inkambo ikhethwe ngabanye, kucatshangelwa izinga lokuphulwa nokuqina kwezibonakaliso zalo.
I-Endometritis - ukwelashwa, izidakamizwa
Ama-antibiotics we-endometrium anqunywe acabangela ukubeletha okuqhubekayo. Ama-penicillin ase-Semisynthetic ne- cephalosporin asetshenziswa . Phakathi kwemithi enjalo kuyadingeka ukwabela:
- I-Cefuroxime;
- Ceftriaxone;
- I-Ofloxacin;
- I-Cefotaxime .
Ngokuvamile ukhethe irejista elihlangene, kanye nokuphathwa okufanayo ngesikhathi se-metronidazole nemithi elwa namagciwane eqembu le-lincomycin. Lezi zinsuku azisetshenziselwa ukubeletha, njengoba zingena ebisi. Uma kunesidingo, lo wesifazane uyeka isikhathi sokuncelisa. Ukwelashwa ngezidakamizwa zokulwa namagciwane kunqanyelwe amahora angu-24-48 ngemuva kokuthuthukiswa komtholampilo.
Lapho i-endometritis ibangelwa ukutholakala kwezicubu emgodini we-uterine ngemva kokukhipha, ukwelashwa okuhlinzekwayo kwenziwa. Ihlanganisa:
- i-aspuum aspiration;
- i-hysteroscopy;
- ukuhlanza kwesiguli se-uterine nama-antiseptics asehlile (i-furacilin, i-dioxin engu-1%).
Ukuhlanza kunconywa ukunciphisa ukumiswa kwemikhiqizo yokudiliza kanye nama-toxic compounds. Ngaphezu kwalokho, le nqubo iyancipha kakhulu inani lokukhishwa kwegazi, ithuthukisa inqubo ye-lochia. Ukukhwabanisa kwenziwa emva kwezinsuku ezingu-4-5, ngokulethwa kwemvelo nasemuva kwezinsuku ezingu-6-7 nge-cearean. Owesifazane ngalesi sikhathi usebhedlela.
I-Physiotherapy ne-endometrium
Uma lesi sifo singukuthi i-endometritis, izinqubo zesimo se-physiotherapeutic zisiza ekunciphiseni inkambo. Phakathi kokuvamile:
- Ukuphazamiseka kwamanje kwamanje ngeNemuk - kuhilela ukusetshenziswa kwemifudlana yamazinga aphansi namaphakathi aqhutshwa nge-4 electrodes;
- Amagundane ashukumisayo of imvamisa ephansi - esetshenziselwa ukuvuselelwa ekuqaleni;
- ukukhishwa kwesikhumba - kunomphumela omuhle we-immunostimulating.
I-prophylaxis ye-endometritis ye-postpartum
Ukukhipha lesi sifo, i-endometritis, ukuvimbela kufanele kuqale esigabeni sokuhlela sokukhulelwa. Odokotela bayelulekwa ukuba balungiselele kusengaphambili kule nqubo ephethe. Ukuvimbela i-endometritis kuhilela ukuhambisana nezinyathelo ezifana nalezi:
- ukutholakala kanye nokwelashwa kwezifo ezingapheli zesistimu yokuzala ngaphambi kokukhulelwa;
- ukubhaliswa ngesikhathi esifanele sokukhulelwa;
- ukuvakashelwa njalo kudokotela;
- ukuphathwa okunengqondo kwemisebenzi - ukuthatha ukuphikisana nokubeletha ngokubeletha kwezindawo zemvelo, ukuhlola ukuzalwa kokubeletha okuhlukanisiwe, ukulawula ama-antibiotics emva kokuhlinzwa okweqile ukuvimbela ukutheleleka.