Urinary tract infections mumadzimai ane pamuviri akakamurwa kuva mapoka matatu:
• bhakteriuria - kuvapo kwebhakitiriya mumugwagwa wemuguta;
• zvipembenene zvezvikamu zviduku zveurinary tract (cystitis, urethritis);
• hutachiona hwepamusoro pekuvhenekera (pyelonephritis).
Vakadzi vanotambura nepelelonephritis kanomwe kakawanda kakawanda kupfuura varume, uye vanorwara mumakore avo ekubereka. Sei? Chimwe chikamu chemhosva ndeyezvinhu zvakasikwa zvemuviri wevakadzi: kuvapo kwemufupi uye yakareba urethra kuvhura pachikumbaridzo chemukadzi (kureva kukwanisa kukuru kwehutachiwana). Mukuwedzera, panguva yechipiri yekuenda kumwedzi uye panguva yose yekugumira, kuchinja kwemuviri kunoitika mumugine excretory system yevakadzi, izvo zvinoderedza kusagadzikana kwezvirwere.
Yakawanikwa kuti njodzi yekugadzira urinhi inotakura zvirwere inopfuura vakadzi vakawanda:
• kutanga kuberekwa pazera remakore 28-30;
• vatauriri vakawanda;
• avo vakanga vaine zvirwere izvi kare;
• varwere vane chirwere cheshuga mellitus;
• kuva nehutachiona husina kuchena kana kushungurudzwa kwebasa remutsotsi.
Sezvaunoziva, mutoro mukuru unonyoreswa paitsvo panguva yekuzvitakura - kushanda kwavo kunoitika nekuoma kukuru. Vanofanira kubvisa kubva mumuviri zvibereko zvekuora nekutsinhanisa kwete chete kumukadzi pachake, asiwo zvekurera kwake mwana. Zvisinei, pasina kutarisa, hutumbi hwepanyama pachahwo hunoita kuti pave nekushandura muitsvo uye vanobata nebasa racho. Mumazuva ekupedzisira ekudzivirira mumuginho, pangave nezviito zveprotini - ichi ndicho chiratidzo chekutanga pamusoro pezvinoitika kune gestosis.
Asymptomatic bacteriuria
Inowanikwa nerubatsiro rwekutsvaga kwemuviri mugore re2-7% revakadzi vane pamuviri, kunyange zvazvo kwete kuchipatara kuratidzwa (saka iro izwi rokuti "asymptomatic"). Kuongororwa kunoreva kuti kune hurumende inoramba ichishandiswa mumakirini. Pasinei nokushayikwa kwechirwere chemakiriniki, kubatwa kwechirwere chinonzi bacteriuria panguva yekudzivirira kazhinji (muna 20-30% yemhosva) kunokonzera kukura kwe cystitis uye pyelonephritis uye kunoda kurapwa kwakananga.
Acute cystitis
Urwu hutachiona hwehutachiona panguva yekuzvitakura hausi zvakaoma kuona mumararamiro ezvirwere zvakanyanya: kukurumidza, kunorwadza kunyorera. Mune mabhuku anozivikanwa zvino iko kudhindisa mazano akawanda akasiyana-siyana pamusoro pekugadzirisa dambudziko iri. Kuchenesa kupisa kwekuita, hongu, iwe unogona. Asi izvi hazvigone kuitwa, kunyanya pamuviri! Izvo zvisina kutorwa zvakajeka cystitis zvinongopfuurira zviri muhupenyu husingaperi. Mukuwedzera, sekufanana neyeymptomatic bacteriuria, ne cystitis, zvinokwanisika kukwira chirwere kune itsvo uye kukura pyelonephritis.
Acute pyelonephritis
Muchikamu chinotapukira-chinokonzera kukuvadza kunoparadza, mhuka dzomukati dzeimpso uye ndiro-uye-pelvic system inoshandiswa. Chiitiko chakakomba zvikuru chepamuviri (munguva ino chirwere chinonzi gestational pyelonephritis). Inogona kufambira mberi kusvika pakuchengetwa kweurosepsis uye inotungamirira kukuzvarwa kusati kwapera.
Inowanikwa mumapurisa anopfuura 12% evakadzi vane pamuviri (kazhinji mumatangwe ekutanga). Muchiitiko ichi, kune dambudziko rakaipa pamutambo wekuzvitora pachayo uye zvakananga pamwana - kazhinji inowirirana ne gestosis, inokonzera kubvisa pamuviri pakarepo, kukura kwe fetal hypotrophy, kusagadzikana kwekushaya chimiro.
Zvinokonzera uye zvirwere
Basa rinogadziriswa mukuvandudzwa kwehutachiona hwehutachiona muvakadzi vane pamuviri inotambidzwa nemapoka maviri ezvimwe zvinhu - kutomical uye hormonal. Kutanga nevhiki yechinomwe, inonzi hydroureter yemuviri inoumbwa - kuwedzera kwe calyx uye pelvic system uye ureter. Nokudaro, muviri unoyera kuenderana nekuwedzera mumvura inotenderera. Nhamba ye ureter inokwanisa kusvika 200 ml, iyo inokonzera kukanganisa kwekubuda kwemuti, kusachengetwa kwayo mumushure, i.e. mamiriro ezvinhu akanaka nokuda kwekubuda kwebhakteriuria.
Icho chibereko chinowedzera zvishoma nezvishoma, zvichichinja chimiro chechivharo nekuda kwekudzikisa kwayo nekunyunyisa. Iyo inotarisa nzvimbo yakasununguka uye inhengo yevakadzi, uyewo gluco-zuria (shuga mumuguta) inowanikwa mumadzimai ane pamuviri, inobatsira kutapukirwa kwemuti muto uye kupararira kwehutachiona nenzira yakakwira. Kuwedzera kwemaitiro e estrogen kunokonzera kuderera kwevhiri rezvenyeredzi, izvo zvinogona kuita kuti kutyorwa kwekuvhenekera kuve.
Zvose izvi zvinoitika panguva yekuzvitakura zvinotanga pane imwe nguva yevhiki masere uye kusvika pakuguma kwemavhiki masere makumi maviri nemasere, kuchengetedza zviratidzo zvayo kune imwe vhiki 2-3 mushure mokuberekwa. Pakutanga kwehafu yechipiri yepamuviri, kukanganisa kwemuviri wemuguta kunogona kuitika nekuda kwekumanikidzwa kwevechiremba nechokuwedzera uye kuchinjwa chibereko chekuita. Kunyanyisa ureter kunogonawo kubudisa varicose inoderedzwa, yakasviba uye shomanana yakasununguka mavheini. Aya mazviri anotsanangura zviitiko zvinotyisa zve pyelonephritis.
Mutungamiri anokonzera chirwere chekuvhenekera mumadzimai maviri ane pamuviri uye asingasviki ndeyeE E. coli (80-90% emhosva), asi panogona kunge kune mamwe mabhakitiriya eGam-negative seProteus neKlebsiella. Mabhakitiriya e-Gram-positive haana kunyanya kufanana. Madzimai panguva yekuzvitakura, chirwere chinoputika mukati maitsvo chinogona kukonzerwa nefungi ye genus Candida. Chimwe chinhu chinokosha pakuitika kwe pyelonephritis inowedzerwawo ne mycoplasma, ureaplasma, trichomonads, uye mu20% yevarwere masangano ezvinyorwa zvitsva anowanikwa.
Endotoxins yeEscherichia coli yakakonzera chirwere chetsitsi pelvis, kapule yeputsvo uye mavara ezvisikwa zvinoshandiswa. Utachiona hunokonzerwa ne prostate hunoratidzwa nenzira inoramba ichidzoka, kuumbwa kwebwe uye zvinyorwa zvezasi zvemasero machena mumuguta nekuda kwekuparadzwa kwavo ne enzymes ye microorganisms. Chikoro che gestational pyelonephritis chinokonzerwa nemafuta-gramu-yakaoma zvikuru, uye kushamiswa kwebhakitiriya uye septicemia.
Ko pyelonephritis inoratidzwa sei?
Chirwere chemakirini chechirwere chinotungamirirwa zvakananga nenzira yehutachiona. Kana iyi iri nzira inotyisa (ine ropa), zviratidzo zvinowanzoonekwa zvechirwere zvinopinda. Kana iyi inzira yeurogenital (kuburikidza nemuguta), ipapo zviratidzo zvekugara zvichapfuura. Kuratidzwa kweAacute Pelphonephritis kunowanzoitika mazuva mashomanana mushure mekuwedzera kwekugara kwenguva refu kana kuonekwa kweimwe zvirwere zvakanyanya (furunculosis, mastitis, nezvimwewo). Ndokusaka chirwere ichi hachikwanise kuongororwa pakarepo. Pane kuwedzera kusinganzwisisiki nekushisa, chills, kuteverwa nekukurumidza kuputika, musoro wemusoro, kurwadziwa kwakanyanya mumusana wezasi, kazhinji pane kurudyi. Zviitiko zvakafanana zvinoratidzwa nechitatu chezviratidzo: chills, dysuric phenomena, kurwadziwa munharaunda ye lumbar. Zvinorwadza zvinowedzera kuwedzera, uye imwe neimwe inokura mukupisa, tinogona kutaura pamusoro pekuonekwa kwezvitsva zvitsva muhutsvo. Kushungurudzika nekushungurudza, kurutsa, aches kumativi ose mumuviri. Yakatsanangurwa tachycardia, dyspnea. Nekuderera kweropa, kukanganiswa kwebhakitiriya kunogona kutanga.
Kurapa kweAacute pyelonephritis
Inogara iri yakaoma, yakareba (vhiki 4-8), munhu mumwe nomumwe. Panojekesa kurapwa kwemishonga kunofanirwa kufungisisa nguva yekudzivirira, kuoma uye nguva yehutachiona, kuongorora kwehutano hwehuso hwechipi uye chiropa, kushivirira kwezvinodhaka zvemishonga pamwe nekukwanisa kushanduka mumukaka. Muchikamu chakaoma chechirwere, mubhedha wezororo inenge mazuva 4-6. Kana fivha yapfuura, kushandiswa kwebasa rinoshanda rinokurudzirwa kuitira kuti uvandudze kuputika kwemuti.
Kushandiswa kwepasito therapy: 2-3 nguva pazuva, mabhe--bowhi kwemaminitsi 4-5; kurara bedzi kune rumwe rutivi, kune rumwe rutivi rwetsvo yakaremara. Chikafu chinokonzerwa nemugadziri wemunyu hachidiwi. Kana pasina dema, inwa zvakawanda, kusvika 2 litres pazuva. Yakakurudzirwa cranberry juice, tsvete tiyi, infusions yeparsley, horsetail, cowberry - plant diuretics uye antiseptics. Kune mishonga yakagadzirwa yakagadzirirwa (kunyanya kanefrononi), iyo inoshandiswa kugadziriswa inokosha zvikuru mukurapa kwepelelonephritis nezvimwe zvirwere zvehutano.
Munguva pfupi yapfuura, kugadzirwa kwemishonga kanefronsi yekambani yeGermany "Bionorica AG" yakashandiswa zvakasimba, ine dambudziko rakawanda rezviito. Pakati pavo - antiseptic, anti-inflammatory, spasmolytic, antibacterial, diuretic. Kanefron inoshandiswa kurapa gestational pyelonephritis mukutanga kwekuita pamuviri. Nekubatsira kwayo, kuwedzera kwekugara kwenguva refu pyelonephritis, kurapwa kweurolithiasis, kudzivirira kwezvinetso zvepamuviri, izvo zvinosanganisira kukanganisa kwehutano hwehuno hwetsvo. Kanefron yakakodzera panguva yekurapa maantibhoti panguva yekurapa kwekusagadzikana kwezvirwere zvemugodhi uye nekushandisa kwenguva refu mushure mekutanga kurapwa nemishonga inorwisa mabhakitiriya. Kwakange kusina migumisiro yechirwere.
Migumisiro yezvirwere zvakatapurirwa
Panguva yekuzvitakura uye nzira yekuzvidzivirira pachayo, vakadzi vanotambura nepelelonephritis vane zvimwe zvavanoita. 6% yevakadzi vane chirwere chisingaperi chisingarashiki, 25% vane njodzi yekuberekwa vasati vasvika, 44-80% vakagadziriswa toxicosis yevakadzi vane pamuviri. Kuberekwa nekukura kwekuberekwa kunoenderana nekukura kukuru kwekushaya simba kwekushaya simba, kuoma kwehutachiona hwehutachiona.
Kuberekwa vana kazhinji kune zviratidzo zvakawanda zvehutachiwana hunowanikwa muUtero. Saka hutano hwetsvo muamai hwakakosha mukukurudzira mafungiro ekugadziriswa mumwana (asina kukwana zvakakura mumapfupa evanhu, urinary system dysembryogenesis). Fetal fetal hypoxia, hypotrophy, inowanzosangana, uye kunyatsochenjerera kwe fetus kunokosha.
Mumaawa ekupedzisira, 22-33% yevakadzi vakabata gestational pyelonephritis vanoita zvirwere zvepatulent-septic. Pazuva rechina, rechigumi nemapfumbamwe nemapfumbamwe mushure mekuberekwa, pyelonephritis inogona kuipa. Mumakumi maviri ematatu mushure mekuberekwa, renal basa rinogona kuramba rakaderedzwa.
Pamusoro pekudzivirira uye kukanganiswa kwekuvhenekera mukati mekubata pamuviri
1. Kugadzirira pamuviri. Kunyatsotarisa, kunyatsotarisa, kunyanya kana munguva yakapfuura mukadzi aine zvikamu zvekuvhenekera zvirwere. Chiremba achakuudza izvo zviongorori zvaunoda kuti upfuure kune vose vakaroorana vasati vatanga mwana.
2. Chirairo chepakutanga chezvipembenene zvose mumuviri.
3. Mukadzi ane pamuviri anofanira kunyora nekliniki yemukadzi nekukurumidza uye munguva yose yekuzvitakura inotevera mazano ose echiremba wake, kutora miedzo munguva uye kutora zvimwe zviedzo. Kudzivirirwa kubva kunotonhora!