Nelaktatsionny purulent mastitis: Zizindikiro ndi Chithandizo

Purulent mastitis - ovuta kwambiri ndi zosasangalatsa matenda akazi. Zoipitsitsa mtundu - nelaktatsionnomu purulent mastitis - ife adzamvetsera kwambiri masiku ano, chifukwa umoyo wa amayi - chikhalidwe chachikulu thanzi ndi kulemera kwa mtundu.

Mbiri ya kafukufuku

Kuyambira kale mkazi osowa zapita chidziwitso cha akamanena za matenda, amene kale otchedwa mastitis, ndipo anadzatchedwa mastitis. Ndipo n'zosadabwitsa, popeza anati kudwala, lomwe ndi yaikulu matenda kutupa mu bere, koma chopezera kuchuluka yogwira, nthaŵi zambiri kwachititsa purulent chotupa makamaka glandular thupi m'mawere ndi minofu ozungulira, ndiyeno sepsis ku uwu generalization la ndondomeko opatsirana.

subtleties ziwerengero

Mu mastitis ano akhoza kugawidwa mu mkaka wa m'mawere, pamene England mammary ndi kupanga mkaka (zambiri purulent mastitis yoyamwitsa), ndipo nelaktatsionny, zomwe tikufuna kulankhula za lero. Monga ziwerengero wa zaka zapitazi, mu 90-95% ya malipoti a mastitis Kutacha nyengo ya postpartum, nelaktatsionnym monga mastitis, amene si kugwirizana ndi pakati komanso pobereka, kuvutika avareji za 5% ya akazi.

magulu zaka

Bwinobwino chitukuko nelaktatsionnogo mastitis zimakhudza akazi pakati pa 15 ndi 60 zakubadwa. Mu malire awa zaka mawonekedwe mastitis, monga kuyenera mkaka wa m'mawere, kumaonekera osati nkhanza, ndi mavuto septic pafupifupi konse zimachitika. Mosiyana ndi akazi, odwala mu nthawi zaka anati, tiyenera kuphunzira azikhala ndi mastitis kwa zaka zambiri, chifukwa nthawi zambiri amakhala aakulu relapsing mawonekedwe. Komabe nelaktatsionny mastitis zingakhudze osati akazi komanso amuna, ndi ana a amuna ndi akazi.

etiology

Nelaktatsionny purulent mastitis alibe mogwirizana ndi mkaka wa m'mawere, amapezeka ndi kawirikawiri ndipo nthawi zambiri anapangitsa chisokonezo chapansipansi m'thupi ndi kuchepa kwa anayankha zimakumana wothandizila opatsirana. Kawirikawiri anasonyeza wosakwatira kapena awiri kumbali mwapang'onopang'ono kutupa zopangitsa za mammary.

Lofotokoza zifukwa

Ndi momwemo chinachitika kuti ambiri nelaktatsionny purulent mastitis kuyambika thupi wamkazi ndi akusokoneza m'thupi kapena yafupika ayankhe zimakumana wothandizila opatsirana. Childs, nthaŵi ali motere:

1. akuluakulu wotsikirapo esitirojeni msinkhu, pamene nthawi yomweyo yimitsira yofunika kwambiri chitetezo cha m'thupi, kumaonekera postklimakterii nthawi.

2. Unamwali wachinyamata ndi mlingo wake wosakhazikika m'thupi nawonso kukhala nkhawa kwambiri kwa kupanga thupi, amene amalenga nthaka yachonde pa chitukuko cha matenda amenewa osafunika. Komanso, Dziwani kuti nelaktatsionny mastitis zimakhudza atsikana komanso anyamata akamakula.

3. Kuyenera kudziŵika milandu pambuyo matenda mabala anachita pa ntchito chifuwa, mwachitsanzo, pambuyo kuika analili kuchotsa kapena zophuka fibrocystic, zoopsa bere limodzi ndi psinjika a minofu yake.

4. Ngakhale kwambiri maso khungu zoopsa za chifuwa kapena nipple chingathandize malowedwe matenda ndi chitukuko cha mastitis nelaktatsionnogo.

mitundu ya matenda

takambirana matenda zambiri kumachitika m'njira ziwiri - pachimake ndi aakulu. Pachimake nelaktatsionny mastitis popanda mankhwala yake m'chipatala ndi mankhwala okwanira a bluetongue (infiltrative) mawonekedwe mwamsanga ndithu ndipo ndi mwakachete kuti mkazi akhoza lidzasinthidwa purulent nelaktatsionny mastitis ndi aakulu zedi pamene palibe hospitalization kuchita zosatheka, ndi generalization kwa ndondomekoyi patsalanso nkhani masiku angapo mwinanso maola.

pathogenesis

Pankhaniyi nelaktatsionnogo mastitis tizilombo toyambitsa matenda ambiri umalowa mu England mammary kudzera kuwonongeka alipo khungu, amene amayamba ndi mwina choipa mwangozi, kapena matenthedwe opweteka, mwachitsanzo, ntchito heaters kapena amayaka inadvertent, ndipo nthawi zina chifukwa chifuwa pustules yaing'ono alipo pa khungu . Ndiye mabakiteriya kuwonongeka woyamba subcutaneous wosanjikiza mafuta ndi mafuta kapisozi a chifuwa, ndiyeno kuukira wachiwiri glandular minofu.

Kodi akazi zochepa kuthana ndi aakulu nelaktatsionnym mastitis, zomwe kawirikawiri kuyambika pachimake mastitis kumanzere undertreated, kupeza zizindikiro loyamba kusintha mu kulingalira kwa discontinuation mankhwala zotchulidwa ndi mankhwala. Zikatero, ndi zisadzachitikenso a mastitis amakhala nthaŵi zonse akazi, ukugwira pa kulephera m'thupi pang'ono, pambuyo hypothermia, nkhawa, kapena pamene ambiri chifooke chitetezo cha mthupi.

Nelaktatsionny purulent mastitis. zizindikiro

Kumayambiriro kwa pachimake nelaktatsionnogo mastitis - mu siteji serous, pamene nsalu zimakhudzira thoracic England sequentially impregnated ndi madzimadzi serous, ndipo mwachangu kulowa maselo oyera - mkazi m'pamene zikamera pa ululu bere, sipangakhalenso palpated dziko ting'onoting'ono basi ndi omveka bwino mu umodzi kapena zambiri magawo. Thupi kutentha kuchuluka kwa 37-38 oz., Ndi zina mpaka 39. Komanso, mu nthawi iyi, mkazi akhoza nkhawa anasonyeza kufooka ambiri. Nthawi zina kwambiri, zosiyana amapezeka siteji serous chitukuko ndi isanayambike kuchira lachibadwa, komanso kwambiri ndi angayambe kumbuyo siteji serous kusalola.

Chinthu infiltrative mu akhudzidwa mammary England chisindikizo anapanga chowawa popanda omveka bwino amatchedwa adzalowerera. Pankhaniyi, khungu pa adzalowerera chofuna sichitsata, edema m'dera lino palibe, ndi kutentha m'dera akhalabe mwa uthunthu yachibadwa. Thupi kutentha ndi kuchuluka, chifukwa yogwira mankhwala bakiteriya kulowa magazi foci lactostasis zowonongeka kudzera ducts ya bere. Nkofunikira kuti mkazi adathawira kuchipatala chifukwa mamologist, gynecologist kapena dokotala ndi maonekedwe zizindikiro woyamba, popanda kuyembekezera kupita patsogolo ndi kusintha mu purulent mawonekedwe. The catarrhal siteji mastitis amaliona bwino kwambiri ndipo alibe zikuphatikizapo mavuto aakulu, monga mmene nelaktatsionnogo purulent mastitis.

Pankhani ya kusowa chithandizo chokwanira cha masiku 5 pambuyo kusalola sitepe amapita ku mwatsatane chiwonongeko, i.e. chiwonongeko. Kutupa amakhala purulent, ndi mammary England akukhala kwathunthu kufanana chinkhupule ankawaviika kudzera mafinya.

Chinthu zowononga zimene imatchedwanso pachimake purulent mastitis, akazi ambiri chatsitsa chifukwa poizoni ku cholinga cha purulent kutupa mosalekeza zimalowa magazi. kutentha thupi akuchulukirachulukira ndipo nthawi zambiri mu nyengo ya 38-40 oz., ndi kukula ndi zizindikiro zosonyeza kuledzera. Itamva ndi ukuwonjezeka mammary England kukula, izo zimakhala mantha. Khungu pa malo a chiwonongeko amakhala wofiira, mitsempha subcutaneous dilate. Ndi kukula ululu zimafalikira kuti armpit, komanso ngati lymph mfundo dera m'malo mofulumira amene amasamalira matenda. Wodwala akukhala osati kugona ndi chakudya.

mitundu

Nelaktatsionny purulent mastitis, zithunzi zimene angathe kuona akalozera zachipatala, amafuna njira aluso matenda.

The mitundu zotsatirazi kuti:

1. abscessed Mastitis, amene amakhala mu izo wathuyo mammary England abscesses wambirimbiri - a cavities kuti ndizodzazidwa ndi mafinya. Kawirikawiri pamene m'dera kusalola akhoza palpated olimbikitsa kapena kumva pansi zala wothwanima ndi akufufuza mpata madzimadzi - chizindikiro kusinthasintha zabwino (mu 99% milandu).

2. Mastitis infiltrative abscessed. Wake ndi aakulu kuposa amene wapitawu. Wandiweyani adzalowerera tichipeza ambiri abscesses yaing'ono zamitundu osiyana kwambiri ndi mosiyanasiyana, kotero ndi kwabwino kusinthasintha chizindikiro mu% 5 kokha odwala. kusalola kuyambira zambiri osati quadrants chifuwa oposa awiri.

3. Mastitis abscess. Pankhaniyi, chifuwa wakulitsidwa ndipo anasonyeza kwathunthu kutupa. Khungu ya m'mawere akhudzidwa wofiira kwambiri (ndi zina bluish-wofiira), pano, ndi nsonga zamabele Imatithandiza. Palpation a prostate zedi chowawa kusinthasintha zabwino chizindikiro. Mu oposa theka la odwala purulent chotupa chimafikira quadrants osachepera atatu.

4. gangrenous mastitis nthawi limodzi ndi chotupa Mitsempha ndi thrombosis yogwira. Popeza magazi yachibadwa kuwonjezera bere kumakhala kovuta, kukhala necrosis. Choncho chitsulo kwambiri kuchuluka, pamwamba pake, pali zambiri minofu necrosis, thovu amene anadzazidwa sanies khungu amakhala bluish-wofiirira. Kutupa chimakwirira bere lonse. Nthawi imeneyi, chikhalidwe cha odwala ndi lolemera kwambiri, maganizo amakhala osokonezeka, tachycardia ukuwonjezeka motsutsa likhale kutsitsa magazi. magazi anapanga bwinobwino sepsis. Kumene, pa siteji iyi ya chiopsezo ku moyo wa wodwalayo amakhala lalikulu kwambiri.

mankhwala ntchito

Ngati matenda "nelaktatsionny purulent mastitis", chithandizo wake ndi kugwira ntchito ndi ndiwofatsa.

Direct chosonyeza kuti alowererepo opaleshoni mitundu yonse yoipa ya matenda-yotupa ndondomeko, purulent-catarrhal mastitis, zizindikiro amene tafotokozazi.

Ngati kumene mankhwala kwa masiku awiri palibe kusintha kwambiri nthawi adzaweruzidwa pamaso pa purulent ndondomeko mu bere, ndilo umboni yosavuta kwa alowererepo opaleshoni, amene amapangidwa yekha chilengedwe chipatala zambiri pansi onse mtsempha ochititsa dzanzi.

ovuta ntchito

Pa ntchito imene abscess lidzatsegulidwa mosamala kuyeretsa onse minofu sanali yotheka ndi excised ndi kuchotsedwa. Choncho kwathunthu inathetsedwa suppurative mastitis. ntchito Nthawi zambiri mosavuta analekerera ndi akazi. Pambuyo phukusi la England mammary chofunika kukhazikitsa bere kuti adzagwa kusamba chilonda, osaleka mabakiteriya ngakhale mwayi yaing'ono yambitsa. Kukapanda kuleka chilonda lavage imagwiridwa 5 mpaka 12 masiku womwe kukwaniritsa wabwino wonse udindo mtima ndipo mofulumira a Ulimbo wosambitsa madzi, mafinya ndi tinthu necrotic.

Therapy pambuyo opaleshoni

Komanso pambuyo opaleshoni ikuchitika mankhwala mankhwala omwe cholinga chake ndi kuonetsetsa kuti posachedwapa ndi bwino kuthetsa poizoni ndi kukonza kuyan'anila kuti apanga pa maziko a ndondomeko purulent. mankhwala chofunika amapatsidwa (intramuscularly kapena m'nsinga). Kawirikawiri izi cephalosporin kukonzekera Ine, II, kapena nkhani ya kujowina matenda sekondale - III-IV m'badwo.

Nelaktatsionny suppurative mastitis: chithandizo popanda opaleshoni.

chithandizo ndiwofatsa zimatheka pamene chikhalidwe ambiri wodwala amakhalabe ndi zogwira mtima, matenda kumatenga zosaposa masiku atatu, kutentha thupi si upambana 37,5 g., zizindikiro Local a purulent kutupa ndi ululu mu ziyerekezo kwa kusalola zolimbitsa, kusalola si zimadziŵika koposa wina nusu ya bere, ndi kusanthula ambiri magazi kumanga chithunzi cha mwapang'onopang'ono kutupa.

Nthawi zambiri akazi pitani kuchipatala mu magawo koyamba mastitis - serous kapena infiltrative, ngati n'kotheka, ndipo imathandiza ndiwofatsa chithandizo. Mu malo oyamba, amasonyeza makonzedwe a mpumulo wa m'mawere akhudzidwa, umene akazi kusamuka layamba, kuvala lotayirira nsalu kamisolo kapena bandeji, mungathe kugwiritsa kuthandiza chifuwa mtima, koma compress izo, kuti imfayo kupitirira kwa ndondomekoyi. Chifukwa cha kukhudzana ndi wothandizila opatsirana chofunika amapatsidwa mankhwala ( "Cephalexin" "Cefixime" "Levofloxacin") Nthawi zambiri kuperekedwa intramuscularly pa mlingo si choposa sredneterapevticheskih. Kuwonjezera mankhwala kuchepetsa kutupa ndi kutupa, desensitization za thupi ikuchitika ndi mankhwala mibadwo yomaliza, kuti amadzetsa tulo mu mtima ndi kuchepetsa mavuto.

Kuwonjezera pa "zida zankhondo lolemera" yotithandiza chitetezo cha thupi anaika B mavitamini ndi vitamini C. mu chochitika kuti mgwirizano wa ndondomeko yotupa sizikupanga akubwera, tsiku anawonjezera kuti ultrasound mankhwala ndi UHF, amenenso amalimbikitsa chikalata othamanga wa kusalola ndi kubwezeretsa zachilengedwe njira mu England mammary.

Dzisamalire, kudziwa matenda sioneka ngati nelaktatsionny purulent mastitis. Chithandizo kungakhale ayi kovuta, mukayamba pa magawo oyambirira. Ine ndikukhumba inu thanzi!