Bacterial vaginosis - chirwere chemuviri wemakadzi, chinokonzerwa nekukura kwakasimba kwevanaerobic mabhakitiriya (mycoplasmas, peptococci, gardnerell). Izvo zvinokonzera kupora hazvipo. Vaginosis inoratidzwa nekubudiswa kwenguva refu uye yakawanda, umo maitiro ezvinyorwa zvepathogenic (trichomonads, gonococci) zvisingawanikwi. Kukura kwemasimba makuru (kukura) kwemafuta akasiyana-siyana kunobatanidza nekurasikirwa kwemazuva ose ectoctoccler inowanikwa mumadzimai emakirini, ichiita basa rekudzivirira kunopesana nekupinda kwezvirwere zvepachigoni kubva kunze. Izvi zvinoumba ivhu rakaorera rekuvandudzika nekufambira mberi kwezvirwere zvisingaperi zvepachivhiri zvinoputira.
Bacterial vaginosis: zvinokonzera
Zvirwere zvepamuviri zvechirwere ndezvevanaerobic bacteria (Mycoplasma hominis, Mobiluncus spp, Gardnerella vaginalis). Ne bacterial vaginosis, kukanda kwavo kunokwira nemitemo yakasiyana-siyana yepamusoro, iyo iyo vanhu vemu lactobacilli inopera, iyo yakawanda ye lactic acid uye acidity yemudzimai uri mukati inoderera. Bacterial vaginosis inonzi multitifactorial syndrome iyo iyo inotungamirira inobatanidzwa kunokanganisa kwemadzimai echikadzi microflora iyo inovapo semugumisiro wekuvhiringidza kwezvinhu zvinogadzirisa uye zvisingazivikanwi zvechirwere ichi:
- endocrine disorders, asingashandisi antibacterial therapy;
- kuchinja munharaunda yekudzivirira;
- Zvirwere zvinogadzirisa / zvinotapukira zvezvikadzi zvenhengo dzechikadzi zvekuvhiringidza kwakabva;
- kugara achitsvaga mazai ionizing;
- kushandiswa kwemishonga yekudzivirira (spermicide, intrauterine, muromo);
- frequent douching;
- kuongororwa kwepfungwa / kupindira;
- dysbacteriosis yemukumbo, zvinodhaka zvinokonzerwa nemagetsi.
Bhakitiriya vaginosis inoparidzirwa sei
Bacterial vaginosis inowanzoonekwa kune zvirwere zvepabonde. Zvinhu zviviri zvinosimbisa izvi. Ikokutanga ndeyekuwanda kwekudzokazve pakati pevakadzi vanoporesa avo vanoita zvepabonde vasina kubatwa. Nechirwere chechipiri-yakanyorwa yezvirwere zvevakadzi vane utano hwakanaka mushure mekubatana nevarume, kuongorora kunoratidza kuti kune vanaerobic mabhakitiriya.
Bacterial vaginosis muvarume
Muvanhu, chirwere ichi chinowanikwa kazhinji kupfuura vakadzi. Kazhinji kazhinji vana vanaerobic mabhakitiriya vari voga musangano nemarudzi akasiyana eabteroid. Izvo zvinopisa zvinokonzera uterthra yekare, kliniki yemifananidzo yemurume bhakitiriya vaginosis inogadzirwa, isina zviratidzo zvakakomba, uye dzimwe nguva yakareba serous-mucous discharge inoonekwa. Nechepfungwa, kufambiswa kwezvinetso (pyelonephritis, epididymitis, cystitis, gardnerelleous prostatitis) zvinogoneka, asi mukuita izvo zvisinganyanyi kukosha (1-2%). Varume vanotambura neAymymomatic / asymptomatic forms of the disease serve as sources of infection for women.
Zviratidzo zveBacterial vaginosis kuvakadzi
Kushandiswa kwezvirwere zvebhakitiriya vaginosis hazvina humwe hunhu hunoratidza, chiratidzo chaicho chaicho chiripo kuvapo kwekuwanda kwechikadzi, iyo ine furo inofadza yehove dzinotyisa. Pachigamba chekutanga ivo vane gorosi kana kuti vhena, nechinangwa chokufambira mberi vanowana yellow-green hue uye vanowedzera. Zviratidzo zvekuputika (hyperemia, puffiness) hazvipo, panguva yekuongororwa kwechikadzi kunoratidzira zvirwere zvemuviri wechibereki uter - cervicitis , kudengenyeka, kukonzera maitiro. 50% yevarwere vane hanya nekutengesa munzvimbo yekunze kwemajini, marwadzo mu perineum, zvinetso zvekugunzva, kubuda kwenguva refu.
Degrees of bacterial vaginosis
- Anogadziriswa. Inozivikanwa nekusavapo kwakakwana kwe lactobacillary microflora mu "normal" epithelial cells mumashoko ari pasi pekutsvakurudza. Mamiriro acho haatauri kune avo vanorwara, zvisinei nokuti zvinoratidza kuvepo kwevanaerobic mabhakitiriya ari kuparadzira niche isina chinhu uye inotevera kuumbwa kwe vaginosis.
- Inopiwa chikwereti. Iyo inoratidzika nekuderera kukuru kwe lactobacilli, kuonekwa kwemasero anokosha pakusangana nemamiriro ekurudzira leukocytosis.
- Decompensated. Chirwere chinoratidzirwa chinonzi bacterial vaginosis: kune zviratidzo zvechirwere uye bhakitiriya maruva anomiririrwa nevanaerobes, hapana lactobacilli.
Kuongorora zviyero
Chinhu chinokosha pakukosha kwekuongororwa kwebhakitiriya vaginosis kunopiwa maitiro ekuongorora maitiro ekudzidza - aminotest nemhinduro ye potassium hydroxide (10%) uye pH-metry. Kana uchitarisa glycogen yepine epithelium panguva ye lactobacillus metabolism, lactic acid inoumbwa. Kana iyo inogadziriswa, lactobacillus rufu inowanikwa uye pH inopinda muarakine reaction vector, iyo inoita kuti kuwedzere kwakanyanya kwevanaerobes. A positive amine test ndiyo kuonekwa kwekunhuwa kwehove "yakaora" munguva yekubatanidza sarudzo ye potassium hydroxide uye vagina yakasiyana.
Clinical uye microbiological zviratidzo, pamusana pokuti kuongororwa kwebhakitiriya vaginosis kunoitwa sei:
- yakawanda inokonzerwa nekubuda kwepabonde nekunhuhwirira kwakashata;
- positive amine test;
- kuwedzera mune pH yevakadzi vekuvharidzira kune yakakwirira kupfuura 4.5;
- Kuvapo kweboka guru revakadzikadzi epitheliocytes; "Makemikisi makuru" (anaerobes);
- kukwana kusavapo / kuderera kukuru kwe lactobacilli;
- kuwanikwa kusingaoneki / kusasipo kwepolynucleated leukocytes;
- kuvapo kwehuwandu hweFusobacterium spp, Bacteroides spp, Gardnerella vaginalis.
Bacterial vaginosis, kurapwa
Kubudirira kwehutano hweBV kunotsanangura nguva yakakodzera uye yakarurama kuongororwa, kukwana uye kugadziriswa kwepatigenetically kururamisirwa, chinangwa chekugadzirisa zvakare chimiro chechikadzi chechikadzi, kurambidza kubereka kwezvirwere zvisingaenzaniswi nehutachiona. Kusvika iye zvino, kurapwa kweBV kunoramba iri basa rakakomba, iro rinokonzerwa nehuwandu hwekushandisa zvinodhaka nekudzoka kazhinji kwechirwere.
Complex two-stage pathogenetic uye etiotropic therapy
Kubviswa kwezvirwere zvebhakitiriya vaginosis
Zvinodhaka zvinoshandiswa - mishonga inopesana nevanaerobic zvinhu zvemukadzi wechidiki microflora. Kubudirira kwavo kwekliniki kunosvika 87-95%. Mukufanana, systemic prophylaxis yemukati candidiasis inoitwa. Zvakanakisisa zvinoguma mukurapa kweBV vaiva Metronidazole (Trichopol, Metrogil), iyo inhengo yeboka remishonga inorwisa mabhakitiriya ine ringimidazole. Inopinda mu microbial cell, inosungirirana kuDNA, inovhara nucleic acid musanganiswa. Metronidazol shiroko inoshandiswa mumitemo yakasiyana-siyana yemishonga, asi kazhinji inokonzera kumira kwemaitiro - dyspeptic kusagadzikana, utachiona, utsi hwemagetsi mumuromo. Nzira inofanirwa yekugadzirisa ndeyevakadzi.
Kuti vawane kurapwa munzvimbo, vanachiremba vanowanzoshandisa Clindamycin. Iyo mishonga inobata basa rakasimba rebabhabacterial, neutralizing mapuroteni mukati me microbial cell. Zvinokwanisika kuisa muromo nemuromo weClindamycin. Nhengo yechirwere: kukura kwembiriso-yakafanana nefungi, zvinokonzerwa nemagetsi.
Kudzorerwa kwevakadzikadzi biocenosis
Iyo inoitwa kunze kwekushandiswa kwemuzinda we eubiotics - Bifidumbacterin, Acilacta, Lactobacterin. Iyi mishonga inokurudzira kukura kwechimiro chechikadzi yebroctollora, inobatsira kuderedza nhamba yekudzoka kwebhakitiriya vaginosis nokuwedzera hudziviriro hwemadzimai.
Zvirongwa zvekubudirira kwemishonga:
- Dynamics yemakiriniki zviratidzo zvechirwere;
- kuparara kwe subjective sensations;
- kugadzikana kwezviratidzo zve laboratory.
Uhu hwehutano hunofungidzirwa mazuva gumi nemaviri shure kwekupedzwa kwechikoro. Zvinokurudzirwa kushandisa nzira dzekudzivirira kubata pamuviri panguva yose yekurapa.
Kugadzirira kurapwa kwebhakitiriya vaginosis:
- Lactagel (gel). Inowanzoita pH yemukadzi, inodzokorora microflora yemasikirwo, ichiita zvakanaka mamiriro ekukura kwe microflora ine utano. Inobatsira kubvisa zvinyorwa zvakawanda, kunhuhwirira kwakashata, kusagadzikana;
- Femilex (vaginal suppositories). Maererano nemichina yekuita, Femilex yakafanana neLactagel. Muna 5-10% yematambudziko, inogona kukuvadza kunetseka kwakanyanya mumudzimai. Contraindications: thrush, pamuviri, lactation;
- Vaginorm-G (mahwendefa emadzimai). Inoderedza pH yemukadzi, inhibits kukura kwebhakitiriya inokuvadza, inogadzirisa zvirwere zvechikadzi zvepanyama. Izvo zvakanaka zvinoregererwa, mumatambudziko akasiyana-siyana inogona kukuvadza kubvarura / kupisa mumudzimai, kuwedzera kukwirira kwezvinyorwa zvemukati. Contraindicated ne mbiri ye thrush;
- Acylact (vaginal suppositories). Iine lactobacilli inorarama, iyo inokonzera vanaerobic mabhakitiriya, zvichibatsira kudzorera hutachiwana hwekuzvidzivirira. Zvinorambidzwa kushandiswa pakutsvaga;
- Clindamycin (vaginal cream). Antibacterial agent yekushandiswa kwemashoko. Anokurumidza kuparadza mabhakitiriya anokuvadza, anowanzoita zvirwere zvepachikadzi. Zvimwe zvinokonzerwa nemusoro: kuora musoro, chizuru, thrush, kurwadziwa mumimba, kukanganiswa kwekudya;
- Bifidumbacterin (vaginal suppositories). Inodzokorora kuenzana kwe microflora yemukadzi, inoparadza vanaerobic zvipenyu;
- Trichopolum (mahwendefa emukadzi). Inogadzirisa hurumende yakawanda, inoderedza kuwanda kwezvakavanzika, inopedza kunhuhwirira kunofadza, kunodzosera maruva akazara emukadzi. Contraindications: kubata, chiropa kusakundikana. Chikamu kuitika: kazhinji kunyorera, kushungurudza, kuoma muromo, candidiasis (thrush).
Bhakitiriya vaginosis inobata sei mishonga yevanhu?
Pamberi pekutanga kwechirwere chekurapa, zvinokurudzirwa kutaurirana nachiremba kuti urege kunetseka nemigumisiro. Nekodzero yakakodzera, kushandiswa kwevanhu vanoita mapeji kunobatsira kubvisa zviratidzo zvisingafadzi uye kudzorera utano hwakanaka hwemakirini emadzimai.
Mhinduro yekugadzirisa:
- tora maruva emamomile mishonga uye gose fuzz (imwe puniji yepuni), turai litari yemvura inodzika, tsanidza maminitsi 30-40, shandisai fomu inodziya;
- tora zvakakwana zvakaenzana midzi yeAngellica, badana, chicory, dandelion, calendula herhi, mashizha amai namai vokurera, thyme. Geza, sangana, sanisa mikoko miviri yepuniko yekusanganiswa, inwa neawa imwe yemvura inwaya, kusimbisa maawa 10-12, shandisa fomu inotonhora;
- Ipuniki yegoroki rakapwanyika ye oki kuti iite nema 250 milliliteri emvura yakachena, kutora mumvura yekushambidza kwemvura kwemaminitsi gumi nemaminitsi gumi nemashanu, kusimbisa maawa 3-4. Usati wanyatsonyoroveswa, kunotonhorera uye kunetseka;
- tora kikapu chekiziro chibereko, svetera pamoto unoenzanisa kwemaminitsi makumi maviri nemakumi maviri nemashanu, kunotonhora, kunaya. Shandisa kuchenesa mukadzi.
Bhabhu rinotapira:
- soak 250 gm oak bark mumvura inotonhorera, siya kwemaawa maviri, funganisa musanganiswa wiraya, wedzera kubhati yakagadzirwa kare. Kurapa nzira inopedza kuvhiringidza, kunokurudzira kurapa kweonda;
- pamwe chete mashizha emashizha, mashizha oat, juniper majikiti, chamomile, oak bark. Birai kwemaminitsi makumi matatu nemakumi mana nemasere ekupisa, wedzera muto kune bhati rakagadzirwa. Mushonga une antimicrobial, antiviral, antifungal action.
Bacterial vaginosis pamuviri
Kuita zvechisimba kwemadzimai ekudzivirira pamuviri kune chirevo chekuda kwehutachiona hwehutachiona hwehutachiona uye hupombwe huri mumamai. Pane ukama hwakananga pakati pekuoma kwebhakteria vaginosis uye nzira yakaoma yekuzvitakura. Bacterial vaginosis inogona kutungamirira kumapfupa akasiyana-siyana, kusununguka nguva isati yasvika, kudengenyeka kusina nguva kweamniotic fluid, endometritis, chorioamnionitis (utachiona hwemuviri). Kuberekwa kunopesana nemamiriro ehutachiona hwehutachiona kazhinji kunowanzoomeswa nekusawirirana kwekukura kwekuberekwa - kunonoka kwekuwedzera kwemukati, kutadza kwemwoyo yematambudziko, hypoxia.
Therapy yeBacterial vaginosis muvakadzi vane pamuviri
Iyo huru yekurapa kwekurapa - kushandiswa kwemishonga yemasikirwo kana emunharaunda iyo ine antianaerobic effect:
- Clindamycin. Ipai imwe yenzira dzekurapa kwemishonga: krisita Invavaginally kamwe kamwe pazuva kwemazuva matanhatu, mapiritsi emudzimai 100 mg mukati-katikati kamwe kamwe pazuva kwemazuva matatu;
- Hexicon. Iyo inoshandiswa mumhando yemakandulo, kudzorera microflora ine utano hwemadzimai, inodzivirira kuwedzera kwezvirwere zvinopfuudza uye zvinoputira mu postpartum period;
- Metronidazole. Usasarudza mumatatu ekutanga ekudzivirira nekuda kwekukanganisa kunogona kuitika pamucheche, nzira yekurapa Metronidazole inoitwa mushure memasvondo makumi maviri. Paunenge uri nepamuviri, zvinokurudzirwa kushandisa mushonga mune mavara emakandulo. Nzira yemakirini yekurapa neBV haisi yakaipisisa kupfuura kunyora mumuromo, uye mune dzimwe mamiriro ezvinhu kunyange inoipfuura. Nekushandiswa kwemashizha, chinhu chinoshanda chinopinda zvakananga mumasumbu ezvirwere zvechirwere ichi - izvi zvinobvisa kushandiswa kwemagadzirirwo emakemikari ane utano, kunoderedza mikana yekukanganisa kwakaipa;
- Limafucine. Iyo inoratidzirwa nechisimba chiito chemukati, inoshanda pakurwisana neanaerobic microflora, haina kuipa zvakanyanya fetus.
Ndinogona here kutora bhakitiriya vaginosis? Iwe unogona, kuvapo kwehutachiwana hwehutachiwana hakubvumi. Asi hazvina kukodzera kuisa utano hwako pachako uye hutano hwemangwana revana. Nechinetso cheBV, 10-35% yevakadzi vachiri pakurongwa kwekuita pamuviri. Zvinosuruvarisa, zviratidzo zvakasvibiswa zvinotungamirira kune chokwadi chekuti chirwere chinowanikwa zvakajeka pangozi. Bacterial vaginosis inofanira kubviswa asati abata pamuviri - izvi zvichabatsira kudzivisa zvinetso zvakakomba panguva yekubereka uye kubereka.
Kudzivirirwa kwekudzoka uye kuitika kwebhakitiriya vaginosis:
- kunyoresa chikafu, kuchengetedza kushanda zvakanaka kwemukati;
- kunyorerwa kwakakwana kwezvinodhaka zvinopesana nemabhakitiriya;
- kuchena kwakachena kune nhengo dzebereki dzomukati;
- kushandiswa kwezvidziviriro zvepabonde panguva yekubatana pabonde nemurume asina kudzidza.
Bacterial vaginosis inowanzobatwa nehutachiona hwehupenyu hwemadzimai, hunoda kurapa kwakakwana uye kwakakwana. Kusava nekurapa kwakakodzera kunobatsira pakugadziriswa, kubuda kwezvirwere zvekuberekwa, kuwedzera kwezvinetso panguva yekuzvitakura nekuberekwa. Gynecologists vanokurudzira kana zviratidzo zvisinganzwisisiki (kusununguka kusina kujairika, kuchenesa / kupisa, kurwadziwa mukati memimba pasi) kuoneka, kuongororwa zvakakwana uye, kana zvichidiwa, nzira yekurapa inotora mazuva 12-14.