I-non-lactic purulent mastitis: iimpawu kunye nonyango

I-mastitis enobugqwetha isifo esibi kakhulu nesingathandekiyo sabasetyhini. Iyona nto ibaluleke kakhulu kwiifom zayo ayiyi-lactational purulent mastitis - siya kuhlawula ingqalelo ngokukhethekileyo namhlanje, njengoko impilo yowesifazane yimeko esemgangathweni yempilo kunye nokuchuma kwesizwe.

Imbali yophando

Ukususela kwixesha elidlulileyo, umfazi onqabileyo wayedlulisa ulwazi lwesimo sesifo eso, okwakusemva kwangoko kwakubizwa ngokuba ngumongikazi, kwaye kamva saziwa ngokuba yi-mastitis. Ewe, kwaye akumangalisi, ekubeni le ntsholongwane, eyinkqubo enkulu yokusuleleka kunye nokuvuvukala kwi-grey gland, kunye nokuba nekhono lokusasazeka ngokuqhelekileyo, ngokuqhelekileyo kukhokelela kwisilonda esiswini se-glandular body of breast and tissue tissues, kwaye ke Ukuzaliswa kwenkqubo yokusuleleka.

Ubuqhetseba beenkcukacha

Kwimihla yamhlanje, i-mastitis ihlukaniswe yaba yi-lactation, xa iimveliso zobisi ziveliswa kwi-mammary gland (isoloko esondla ngokusondeza i-mastitis), kunye nokungaxelwanga, esingathanda ukuthetha ngawo namhlanje. Ngokwezibalo zamashumi adlulileyo, kwi-90-95% yeziganeko ezibhalisiweyo ze-mastitis zaphuhliswa ngexesha lexesha lokugqibela, kanti i-mastitis engeyiyo yokuhlamba, engahambelani nokukhulelwa nokuzala, inokuchaphazela ama-5% amabhinqa ngokulinganayo.

Iindidi zonyaka

Ngokuqhelekileyo abasetyhini abaneminyaka eyi-15 ukuya kweyama-60 ubudala bavezwa ekuphuhlisweni kwe-mastitis engeyona i-lactational. Ngalolu hlobo lobudala, le fom ye-mastitis, ngokungafani nendawo yokutya, ayibonakali ngokukhawuleza, kwaye iingxaki ze-septic ayifumanekanga. Ngokuchasene nale nto, abafazi abagulayo kwixesha elidlulileyo, kufuneka bafunde ukuhlala kunye ne-mastitis iminyaka emininzi, kuba ihlala iphenduka ifom ephindaphindiweyo. Nangona kunjalo, i-non-lactational mastitis inokuchaphazela abafazi kuphela, kodwa kunye namadoda, kunye neentsana zesini.

Etiology

Ukungabikho kwamathambo okungaxelwanga kwamathambo akungaxhamli kunye ne-lactation, kwenzeka ngokungafaneki kwaye kudla ngokuba ngenxa yokuphulwa kwemvelaphi ye-hormonal kunye nokunciphisa ukuphendula kwe-immune kumayeza atshayayo. Njengomthetho, kubonakaliswa ngokunyuka komzimba omnye okanye ezimbini ukuvuvukala kwamathambo.

Ukuchaza izizathu

Kwenzeka njalo ukuba i-mastitis engapheliyo i-mastitis iqhubekile xa i-hormonal imvelaphi emzimbeni wesibini okanye ukuphendula komzimba kumagciwane okusulelayo. Ngokuqhelekileyo amaxesha alandelayo anokubhekiswa kula maxesha:

1. Ukunyuka okukhulu kumgangatho we-estrogens, kwaye ngexesha elifanayo ukuxothwa okukhuselekileyo kokukhuselana nomzimba, kubonakalisa ngexesha lexesha emva kokuphuma kwesisu.

2. Ixesha lokutshatyalaliswa komntwana osemva kunye nesimo sakhe semimoya esingaqinisekanga sinokubangela uxinzelelo olunzulu kumzimba owenzayo, odala umhlaba ocebileyo ukuphuhliswa kwesifo esingafunekiyo. Ukongezelela, kufuneka kuqatshelwe ukuba ukungabikho kwe-lactational mastitis akuchaphazeli kuphela amantombazana, kodwa kunye namakhwenkwe ngexesha lokufikisa.

3. Akunakwenzeka ukuba ungabhekiseli kwiimeko zokusuleleka kwezilonda emva kwemisebenzi eyenziwa kwi-grey gland, umzekelo, emva kokufakela ukutsalwa okanye ukususwa kweentlobo ze-fibro-cystic, kunye neengxaki zesifuba, ezazihamba kunye nokucima izicubu zakhe.

4. Nangona iliso elibonakalayo elingabonakaliyo kwesikhumba seengcambu zamathambo okanye iinkophe zinokufaka isandla ekungeneni kwintsholongwane kunye nophuhliso lwe-mastitis engeyona i-lactational.

Iifom zesifo

Isifo esizicingayo ngokuqhelekileyo senzeke ngeendlela ezimbini - ezinzima kwaye ezingapheliyo. I-mastitis engeyona i-lactational efanelekileyo ngaphandle kwexesha elifanelekileyo kwisibhedlele kwaye unyango olwaneleyo kwi-catarrhal (ukungenelela) kwifomu ngokukhawuleza kwaye ngokungaqondakaliyo ukuba umfazi angatshintshwa abe ngumzimba ongenamacabisi ongenamathambo kunye nenkqubo enzima kakhulu, xa kungenakukwazi ukulawula ukulaliswa esibhedlele, nangaphambi kokuveliswa kwenkqubo Kusele iintsuku kuphela, okanye iiyure.

Pathogenesis

Kwimeko ye-mastitis engeyona i-lactational, ama-agent adluliselayo angena emlonyeni wezilonda zesikhumba ezibangelwa ngengozi yengozi okanye ngomonakalo oshisayo, umzekelo, xa usebenzisa i-hoter okanye i-burn accident, ngamanye amaxesha ngenxa yeepustules ezincinci esikhumbeni sebele . Emva koko iibhaktheriya ziwonakalisa okokuqala i-capsule yamanqatha kunye namanqatha amancinci, kwaye kwakhona iphinde ihlasele izicubu ezinobulunga.

Ngaphantsi kwexesha, abafazi bafanele bajongane nesifo esingapheliyo sesifo se-mastitis, esivame ukukhula xa kushiywe imastitis engaqhelekanga, ukufumana iimpawu zokuqala zokuphuculwa kwiingxabano zokuyeka unyango olunqunywe ngugqirha kunye neenkqubo. Kwiimeko ezinjalo, ukuphindaphinda kwe-mastitis kuya kuba ngumfazi ohlala ehlala njalo, ebonisa ukusilela kwe-hormonal encinci, emva koxinzelelo, ukuxinezeleka, okanye ukukhubazeka ngokubanzi kwamalungu omzimba.

I-non-lactic purulent mastitis. Iimpawu

Ekuqaleni kokuphuhliswa kwe-mastitis engeyona i-lactational - kwisigaba se-serous, xa izicubu ze-thoracic gland zihlala zigcwele i-serous fluid kwaye i-leukocyte ingena kuyo ngokuthe ngqo-loo ntokazi ibonisa ukuba kwenzeka intlungu kwi-mammary gland apho indawo enomda onemizila ecacileyo inokuthi ibe neyodwa Okanye i-lobes eziliqela. Iqondo lokushisa lomzimba liphakanyiselwa kuma-37-38 amagremu, kwaye kwezinye iimeko ukuya kwi-39. Ukongeza, ngeli xesha, umfazi unokuphazamiseka ngumntu obuthathaka obuthathaka. Kwiimeko ezinqabileyo kakhulu, kukho ukuphuhliswa okuqhubekayo kwesigaba se-serous kunye nokuqala kokuhlaziywa ngokukhawuleza, kodwa ngokuphindaphindiweyo emva kwesigaba se-serous of infiltration.

Kwinqanaba elincinci kwi-mammary gland echaphazelekayo i-compaction ibuhlungu iyakhiwa ngaphandle kwemida ecacileyo ebizwa ngokuba yi-infiltrate. Ngaphezu koko, isikhumba ngaphezu kwe-infiltrated sitshisa konke, akukho i-edema kule ndawo, kwaye ukushisa kwendawo kuhlala kusemgangathweni. Ubushushu bomzimba buhlala buphakanyisiwe, obangelwa ukungena ngokusebenzayo kwimveliso yebhaktheriya kwigazi elivela kwi-foci ye-lactostasis ngedaka elonakalisiweyo le-mammary gland. Kubaluleke kakhulu ukuba ibhinqa lifune uncedo lwezonyango kwi-mammalogist, gynecologist okanye ugqirha ukuba iimpawu zokuqala zivele, ngaphandle kokulinda ukuqhubela phambili kunye nokuguqulwa kwimo epheleleyo. Kwinqanaba le-catarrhal, i-mastitis iyaphathwa ngokuphumelelayo kakhulu kwaye ayikho inkxalabo enzima, njengokuba kunjalo kwimeko yokungabikho kwe-lactative purstent mastitis.

Xa kungabikho unyango olwaneleyo, emva kweentsuku ezingama-5, isigaba sokungena singena kwisigaba sokutshatyalaliswa, oko kukuthi, intshabalalo. Inkqubo yokuvuvukala iya kuba yinto ehlambulukileyo, kwaye i- mammary gland iyajika ibe yinto epheleleyo yesiponji, igxinwe ngokugqithisa.

Kwinqanaba elibhubhisayo, eyaziwa ngokuba yi-mastitis ephosakeleyo, imeko ephezulu yowesifazane ihla kakhulu, njengoko i-toxins esuka ekugxilweni kwe- purulent inflammation iqhubeka ingena egazini. Ukushisa komzimba kuyaqhubeka ukwandisa kwaye ngokuqhelekileyo ngeli xesha li-38-40 grams, kunye kunye nayo impawu eziqhelekileyo zokuxhatshazwa nazo zanda. Ingqungquthela yamathambo echaphazelekayo ikhula ngobukhulu, iyanzeka. Ulusu ngaphezu kwendawo yokutshatyalaliswa luba lubomvu, iintlanzana ezingaphantsi kwamanzi zikhulu. Njengoko intlungu ikhula, isasazeka kwingingqi ye-armpit, njengoko i-lymph nodes zengingqi zibandakanyeka kwinkqubo yokusuleleka ngokukhawuleza. Isigulane asifumani ukulala nokutya.

Iintlobo

I-non-lactic purstent mastitis, umfanekiso onokubonwa kwiincwadi zeenkcukacha zonyango, idinga indlela efanelekileyo yokwenza ukuxilongwa.

Ezi zilandelayo zilandelayo:

1. Ukugqithwa kwe-mastitis, ebonakaliswa kukuba ininzi yamabhunqa yenziwe kwiindawo ezincinci zengxube ezithintekayo ezizaliswe ngumbhobho. Ngokuqhelekileyo, ngexesha elifanayo, ukunciphisa kunokwenziwa kwintsipho yokungena okanye kungayivalelwa phantsi kweminwe echithwayo ngexesha le-palpation-uphawu oluhle lokutshintshwa (kwii-99% zamatyala).

2. Ubumbele be-infestrative-abscessing. Ubonakaliswe ngolu hlobo oludlulileyo kunalowo odlulileyo. Ukunyuka okunamandla kunamalungu amancinci amancinci ahlukeneyo kunye nobujamo obuninzi, ngoko ke uphawu lokutshintshwa kwezinto luphephile kuphela kwi-5% yezigulane. Iingcambu ezifana nokungena kwangaphakathi azikho ngaphezu kwama-quadrants amabini.

3. I-mastitis iphlegmonous. Kule meko, i-grey gland igxininise kwaye ichongiwe. Ikhumba lebele elichaphazelekayo libomvu ngokucacileyo (kwaye ngamanye amaxesha lubomvu obomvu), ngexesha, nge ingxowa ebuyisiwe. Ukubethelwa kwe-gland kuyabuhlungu kakhulu, uphawu lokutshintshana luyinto entle. Ngaphezulu kwesiqingatha sezigulane, iilon purulent isasazeka ngaphezu kwama-quadrants amathathu.

4. I-mastitis gangrenous, njengomthetho, ihamba kunye nokutshatyalaliswa kwemithambo yegazi kunye nokwakhiwa kwe-thrombus esebenzayo. Njengoko igalelo legazi eliqhelekileyo lebele lingenakwenzeka, i-necrosis yayo iyaqhubeka. Ngelo xesha, i-gland yanda kakhulu, kukho indawo ye-necrostis yinyama ebusweni bayo, i-blisters ezaliswe yisipilisi, isikhumba siyaba bluish-purplish. Ukuvuvukala kugubungela yonke intle. Ngeli xesha, imeko yezigulane zinzima kakhulu, ingqondo iyadideka, i-tachycardia iyanda ngokusuka kwimvelaphi yokunciphisa uxinzelelo lwegazi. Iprogram ehlukeneyo ye-sepsis yenziwa egazini. Ewe, kweli nqanaba, umngcipheko wobomi bomguli uba phezulu kakhulu.

U kunyango

Ukuba "i-nonc lactic purulent mastitis" ifunyaniswa, unyango lwayo lunokuba lusebenza okanye luyalondoloze.

Isalathiso esicacileyo sokungenelela ngongxamnye nazo zonke iindlela eziwonakalisayo zenkqubo echaphazela ukutshatyalaliswa, i-purulent-catarrhal mastitis, imiqondiso echazwe ngasentla.

Kwimeko apho iyeza lonyango lingaphuculwa ngokukodwa phakathi kweentsuku ezimbini, ngokuqhelekileyo kukho inqubo ehlanjululwayo kwi-mammary gland, eyona nto iboniswe ngokuthe ngqo kwindlela yokungenelela eyenziwa kuphela kwisibhedlele, ngokuqhelekileyo phantsi kwe-anesthhesia eqhelekileyo.

Ubuqili bokusebenza

Ngethuba lokusebenza, i-abscess ivuliwe ngokucophelela, ihlambuluke, zonke izicubu ezingenakulungeleka zidibene kwaye zisuswe. Ngaloo ndlela i-purulent mastitis isuswe ngokupheleleyo. Ukusebenza, njengomthetho, kulula ukunyamezelwa ngabasetyhini. Emva kokungenelela kwi-grey gland, kufuneka kufakwe iimfomfayile ukuze kuqhutywe isilonda kwaye anganiki i-bacteria ithuba elincinane lokusebenza. Ukunkcenkceshela kwelinxeba kwenziwa kwimihla yesi-5 ukuya kwi-12, ehambelana nesigulane esiphumelele imeko epheleleyo kunye nokunyamalaka kwe-fibrin, pus necrosis ukusuka kumanzi okuhlamba.

Unyango olusemva

Emva kokusebenza, unyango lweziyobisi luqhutyelwa, olujoliswe ekususeni ngokukhawuleza kwaye kunokuba lube nefuthe ngokugqithiseleyo emzimbeni kwaye lukulungiselele ezo ziintlupheko eziye zaphuhliswa ngokwemvelaphi yenkqubo. I-antibiotics kufuneka imiselwe (i-intramuscularly or intravenously). Ngokuqhelekileyo, ezi zilungiselelwe uchungechunge lwe-cephalosporin I, II okanye, xa kwenzeka isifo sesibini-III-IV.

I-noncctic purulent mastitis: unyango ngaphandle kokuhlinzwa.

Unyango olukhuselekileyo lunokwenzeka kuphela xa imeko yesigulane isalokhu iyanelisekile, isifo asihlali ngaphezu kweentsuku ezintathu, ukushisa komzimba akudluli kwi-37.5 gr., Akukho zibonakaliso zendawo zengqungquthela yokuqhaqhazela, intlungu ekubonakalweni kokungenelela iyamodareyitha, ukungena kungenanto ngaphezulu I-quadrant yebele, kunye nokuhlalutya ngokubanzi kwegazi umfanekiso wesibalo sokuqhubela phambili asikhuli.

Ngokuqhelekileyo, abafazi bafuna uncedo lwezonyango kwiinqanaba zokuqala ze-mastitis-serous or infiltrative, apho kukho unyango olulondolozayo kwaye lunempumelelo. Okokuqala kwaye okokuqala, kuthetha ukubonelela ukuphumla kwesifuba esichaphazelekayo, apho kucetyiswa ukuba abesetyhini bahambise ngaphantsi, bembethe i-bra band okanye i-bandage, enokukwazi ukuxhasa isifuba sesigulane, kodwa ungayifaki ukukhusela ukuqhubela phambili kwenkqubo. Ukuze kuphembelele ama-anti-infectious agents, i-antibiotics ("i-Cephalexin", "Cefixim", "Levofloxacin") imiselwe, zidla ngokulawulwa nge-intramuscularly, kwii-dose ezingadlulanga i-mediotherapy dose. Ukongeza kwii-antibiotics, ukwenzela ukunciphisa ukuvuvukala nokuvuvukala, ukuxhatshazwa komzimba kunye nama-antihistamines ezizukulwana zokugqibela kuqhutywe ukukhusela ukubangela isibindi kwisigulane nokunciphisa iziphumo zecala.

Ukongeza kwi "artillery enzima," iivithamini B kunye nevithamini C zinqunywe ukuba zivuselele ukukhusela komzimba. Xa kwenzeka ukuba uphuculo oluphambeneyo lwenkqubo yokuvuvukala aluyi kukulinda, emva kokuphuma kwe-ultrasound yonyango kunye ne-UHF yonyango, eyakhuthaza isisombululo esiphuthumayo sokungena ngaphakathi kunye nokubuyiselwa kwemvelo Iinkqubo kwi-grey gland.

Ziqaphele, khumbula esi sifo esichukumisayo, njengento engeyiyo i-lactating purulent mastitis. Unyango luya kuba yinto enzima, ukuba uyayifaka kwiinqanaba zokuqala. Impilo kuwe!