I-bacterium vaginosis - pathology ye-ecosystem ecosystem, echukunyiswa ngumsebenzi okhulayo we-bacterial anaerobic (i-mycoplasmas, peptococci, gardnerell). Inkqubo yokuvuvukala ayikho. I-Vaginosis ibonakaliswe ukukhutshwa okude kunye nokukhulula, apho i-microorganisms (i-trichomonads, i-gonococci) ayitholakali. Ukukhula okuphezulu (ukukhula) kwintlanta edibeneyo kuhambelana nokulahleka kwe-lactobacilli eqhelekileyo kwi-microflora ye-vaginal, ukwenza umsebenzi wesithintelo sokukhusela ngokungena kwamagciwane okuphuma ngaphandle. Oku kudala umhlaba ocebileyo wokuphuhliswa nokuqhubela phambili kwezifo ezingapheliyo zeplavic.
I-bacterium vaginosis: izizathu
Izifo eziphambili zesifo ziyi-bacterial anaerobic (Mycoplasma hominis, Mobiluncus spp, Gardnerella vaginalis). Nge-bacterial vaginosis, ukugxininiswa kwabo kuphakanyiswa yimithetho emininzi yemigangatho, apho i-lactobacilli iyancipha, inani le-lactic acid kunye ne-acidity ye-vaginal content liyehla. I-bacterium vaginosis yimizimba ye-multifactorial syndrome apho inxaxheba ehamba phambili ibelwa ukuphazanyiswa kwe-microflora yangasese eyenzeka ngenxa yempembelelo yezinto ezingapheliyo nezingenangqiqo zesifo:
- iingxaki ze-endocrine, unyango olungaphelelanga lwe-antibacterial;
- utshintsho kwiimeko zokuzikhusela;
- Iziganeko ezidibeneyo / ezidluliselweyo kwizitho zomzimba zesini zesisu esivuthayo;
- ukutyhila ngokukhawuleza kwimisebe ye-ionizing;
- ukusetyenziswa kwezicwangciso zokukhulelwa (ukukhulelwa kwe-spermicide, intrauterine, ngomlomo);
- rhoqo;
- ukuxilongwa / ukunyangwa kwamanyathelo;
- i-dysbacteriosis yamathumbu, izidakamizwa ezithintekayo.
I-bacterial vaginosis isasazwa njani
I-bacterium vaginosis ngokuqhelekileyo ibangelwa zizifo ezithathelwana ngesondo. Iimbakala ezimbini ziqinisekisa le nyaniso. Iyokuqala ipesenteji ephakamileyo yokubuyela kwakhona phakathi kwabasetyhini abaphilisayo abalingani bezesondo abazange baphathwe. Iziganeko zesibini ezibhaliweyo zezifo zabasetyhini abasempilweni emva kokubambisana namadoda, ukuhlalutya okubonisa ubukho be-bacterial anaerobic.
I-bacterium vaginosis kumadoda
Kubantu, isifo sifumaneka kangangoko kuninzi kubafazi. Uninzi lwama-bacterial anaerobic luhlala luhlangene kunye neentlobo ezahlukeneyo ze-bacteroides. Inkqubo yokuvuvukala ichaphazela i-urethra yangaphakathi, umfanekiso wekliniki wesibindi se-vaginosis vaginosis isilisiwe, ngaphandle kwempawu ezinzima, kwaye ngamanye amaxesha ukugqithiswa kwe-serous-mucous discharge. Ukufunda, ukuphuhliswa kweengxaki (i-pyelonephritis, epididymitis, cystitis, gardnerelleous prostatitis) inokwenzeka, kodwa ngokwenza izinto ziqabile kakhulu (1-2%). Amadoda aphethwe yi-asymptomatic / asymptomatic fomu zesifo asebenza njengemithombo yesifo kwabasetyhini.
Iimpawu zebhakterial vaginosis kwabasetyhini
Ukubonakaliswa kweklinikhi ye-bacterial vaginosis ayinayo iimpawu eziphawulekayo, uphawu olubonakalayo kuphela kubangelwa ukungcola kwe-vaginal, enomfutho ongathandekiyo weentlanzi ezinqabileyo. Kwinqanaba lokuqala banamabala amhlophe okanye abamhlophe, kunye nenkqubo yokukhetha eqhubekayo bafumana i-hue eluhlaza okomhlaza kwaye baninzi kakhulu. Ukubonakaliswa kokuvuvukala (i-hyperemia, ukukhukhuma) ayikho, ngexesha lovavanyo lwama-gynecological lubonisa i-pathologies ye-cervix uteri- cervicitis , ukukhukhula kwamanzi, ukubunjwa kwamathambo. I-50% yezigulane zixhala malunga nokubethelwa kwiindawo zangaphandle, intlungu kwi-perineum, iingxaki zokungcungcutheka, ukuhamba kwexesha.
Iziganga ze-bacterial vaginosis
- Ukuhlawulwa. Efanelwe ukungafi ngokupheleleyo kwe-lactobacillary microflora kwiiseli "eziqhelekileyo" ze-epithelial kwizinto eziphantsi kophando. Le meko ayibhekiseli kumathambo, nangona ibonisa ukuba kungenzeka ukuba i-anaerobic ibhaktheriya ikhupha i-niche engenanto kunye nokubunjwa kwe-vaginosis.
- Inkxaso-mali. Ibonakala ngokunyuka okukhulu kwi-lactobacilli, ukubonakala kweeseli eziphambili ngokusuka kwimvelaphi ye-leukocytosis enobubele.
- Ukuhlawuliswa. Iiklinikhi zibonakalisa i-bacterial vaginosis: kukho ukubonakaliswa kwesi sifo kunye ne-britteria flora emele ama-anaerobes, akukho lactobacilli.
Amanyathelo okuchonga
Ixabiso eliphambili ekuxilongweni kwe-bacterial vaginosis linikezelwa kwiindlela zokuhlola iziphumo -sitshintsha ngesisombululo se-potassium hydroxide (10%) kunye ne-pH-metry. Xa uhlaziya i-glycogen ye-vagin epithelium ngexesha le-lactobacillus metabolism, i-lactic acid yenziwe. Ukuba le nkqubo ichithwa, ukufa kwe-lactobacillus kwenzeka kwaye i-pH iyaphambukela kwi-alkaline reaction vector, ekhokelela ekunyuseni okukrakra kwi-anaerobes. Ukuhlolwa kwe-amine ebonakalayo kukubonakala kwintlanzi ye "intlanzi" edibeneyo ngexesha lokuxuba isisombululo se-potassium hydroxyde kunye nesondo elihlukileyo.
Izibonakaliso zezonyango kunye ne-microbiological, ngenxa yesifo sokuxilongwa kwe-bacterial vaginosis:
- ininzi egciniweyo yamanzi kunye nephunga elimnandi;
- vavanyo lwe-amine;
- ukwanda kwiph ye-secretion ye-vaginal iphezulu kune-4.5;
- Ubukho be-association enkulu ye-epitheliocytes yama-vaginal; "Iiseli eziphambili" (anaerobes);
- ukungabikho ngokupheleleyo / ukwehla okukhulu kwi-lactobacilli;
- ukungabonakali / ukungabikho kwe-leukocyte ye-polynucleated;
- ubukho be-Fusobacterium spp, iBacteroides spp, i-Gardnerella vaginalis.
I-bacterium vaginosis, unyango
Impatho ephumelelayo ye-BV ixhomekeke kwi-diagnostic ngexesha elifanelekileyo nelilochanekileyo, unyango olwaneleyo nolulungeleleneyo, olwenzelwe ukuhlaziya kwakhona i-microflora ye-vaginal yangasese, ukuyeka ukuveliswa kwezinto ezincinci ezingaqhelekanga kwi-microcenosis. Okwangoku, unyango lwe-BV luhlala luyinkqubo enzima, obangelwa ukusetyenziswa okuphantsi kweziyobisi kunye nokuphindaphindiweyo kwesi sifo.
Inkomfa yesibini ye-pathogenetic kunye ne-etiotropic
Ukupheliswa kwezilwanyana ezinobomi be-bacterial vaginosis
Iziyobisi ezikhethiweyo - amayeza ngokumelene nama-anaerobic e-microphone. Ukusebenza kwabo klinikhi kufinyelela kuma-87-95%. Ngendlela efanayo, inkqubo yeprophylaxis ye-candidiasis yamanzi isenziwa. Iziphumo eziphambili kwonyango lwe-BV yi-Metronidazole (Trichopol, i-Metrogil), eyinxalenye yeqela le-antibiotics ene-ring imidazole. Ingena kwi-cell cell, ibophezela kwi-DNA, ibimbela i-nucleic acid component. I-Metronidazol shiroko isetyenziselwa kwiinkqubo ezahlukeneyo zonyango, kodwa ngokuqhelekileyo ibangela ukuba abantu baxhomekeke kwicala - ukungabikho komzimba, ukungabikho komzimba, ukunambitha kwentsimbi emlonyeni. Indlela ekhethiweyo yokulawulwa ngumfazi.
Ukuze unyango lwendawo, oogqirha basebenzisa iiClindamycin. Isilwanyana sinomsebenzi onamandla wokulwa ne-antibacterial, ukuthobela iprotein ye-protein kwi-cell cell. Kuyakwazi ukuzisa isicelo somlomo kunye nomlomo weClindamycin. Isiphumo esisezantsi: ukukhula kweefungum efana nesinambu, ukuphendula ngokuthe tye.
Ukubuyiselwa kwe-biocenosis yamanzi
Yenziwa ngenxa yokusetyenziswa kwendawo ye-eubiotics - iBifidumbacterin, Acilacta, iLactobacterin. Ezi zi yobisi zikhuthaza ukukhula kwe-lactoflora yesisu, ukufaka isandla ekunciphiseni inani le-bacteria vaginosis ngokunyusa iimpawu zokukhusela zesini.
Iimpawu zokusebenza ngonyango:
- ukuguqulwa kweempawu zeklinikhi zesifo;
- ukunyamalala kweemvakalelo eziphantsi;
- ukuzinzisa kwama-laboratory indicators.
Umgangatho wonyango uqikelelwa kwiintsuku ezili-10 ukuya ku-14 emva kokugqitywa kwekhosi. Kunconywa ukuba isebenzise iindlela zokuthintela ukukhulelwa kwemithi ngexesha lokunyanga.
Ukulungiselela unyango lwe-bacterial vaginosis:
- I-Lactagel (i-gel). I-Normalizes i-pH yesini, ibuyisela i-microflora yemvelo, idale izimo ezintle zokukhula kwe-microflora enempilo. Unceda ukususa imfihlelo emininzi, ukuvumba komnandi;
- I-Femilex (i-vaginal suppositories). Ngokwendlela yokusebenza, i-Femilex ifana neLactagel. Kwi-5-10% yamatyala, inokukhuphaza kakhulu ukutshitshisa kwisini. Ukuchasana: ukukhupha, ukukhulelwa, i-lactation;
- I-Vaginorm-G (iipilisi zangasese). Iyanciphisa i-pH yesini, ikhubaza ukukhula kweebhaktheriya eziyingozi, ivuselela iziqhamo eziqhelekileyo zamanzi. Ukunyamezela kakuhle, kwiimeko ezikhethekileyo kunokususa ukutshisa / ukutshisa kwisini, ukwandisa ubungakanani beemfihlo zokugcina. Ukungqinelana kunye nembali ye-thrush;
- I-acylact (i-vaginal suppositories). Iqukethe i-lactobacilli ephilayo, echitha ama-bacterial anaerobic, ekuncediseni ukubuyisela umzimba wendalo. Akuvumelekile ukusebenzisa i-thrush;
- I-Clindamycin (ukhilimu wesisu). I-antibacterial agent for usepial usetyenziso. Ngokukhawuleza kubhubhisa iibhaktheriya ezinobungozi, ngokuqhelekileyo zivelisa izityalo eziqhelekileyo zamanzi. Imiphumo emibi: intloko, isisu, i-thrush, intlungu yesisu, ukuphazamiseka kwesisu;
- I-Bifidumbacterin (i-suppositories yama-vaginal). Ukuhlaziya kwakhona ukulingana kwe-microflora yesini, kubhubhisa i-anaerobic eziphilayo;
- I-Trichopolum (iipilisi zamanzi). Iphucula imeko ejwayelekile, iyanciphisa inani lemfihlo, ikhuphe iphunga elimnandi, libuyise iiflethi eziqhelekileyo zesini. Ukungqinelana: ukukhulelwa, ukuhluleka kwesibindi. Umphumo osisigxina: ukucima rhoqo, isisongomso, umlomo owomileyo, i-candidiasis (thrush).
I-bacterial vaginosis iyiphatha njani imichiza yabantu?
Ngaphambi kokuqala kwekhosi, kucetyiswa ukuba udibane nogqirha ukuze ugweme iingxaki kunye nemiphumo emibi. Ngendlela efanelekileyo, ukusebenzisa iindlela zokupheka kwabantu kunceda ukususa iimpawu ezingathandekiyo nokubuyisela i-microflora ye-vaginal ephilileyo.
Isisombululo sokwabelana:
- uthathe iinduli ze-chamomile yeyeza kunye ne-fose ye-fuzz (i-tablespoon eyodwa), uthele iithayitha yamanzi abilayo, ugxininise imizuzu engama-30-40, usetyenzise kwifom efudumeleyo;
- uthathe ubungakanani obulinganayo kwingcambu ye-angelica, i-badana, i-chicory, i-dandelion, i-calendula itsha, amaqabunga omama kunye nomama wesibini, i-thyme. Ukuxuba, ukuxuba, ukulinganisa iipunipoli ezimbini zokuqokelela, ukuphuza iithayitha zamanzi abilayo, ugxininise iiyure eziyi-10-12, usebenzise kwifom efudumeleyo;
- I-tablespoon ye-bark echotshoziweyo ye-oki ukuzalela kunye nama-milliliters angama-250 wamanzi acocekileyo, ukuthabatha amanzi ngamanzi emizuzu eyi-10-15, ukugxininisa ama-3-4 iiyure. Ngaphambi kokuba ulungele ukunyuswa kwamanzi, ukupholisa kunye noxinzelelo;
- uthathe isipuni sesithelo se-cherry, ubilise ngomlilo olinganiselayo kwimitha engama-20-25, ukupholisa, ukucima. Sebenzisa ukuhlambulula umfazi.
Amanzi okuhlamba:
- cwina ama-250 gram ye-oak bark emanzini apholileyo, shiya iiyure ezingama-2-3, xuba umxube ubilise, wongeza kubhedi olungiselelwe ngaphambili. Inkqubo yokwelapha iphelisa ukuvutha, ikhuthaza ukuphulukiswa kwesilonda;
- ukudibanisa amaqabunga, i-oat straw, i-juniper berries, i-chamomile, i-oak bark. Ubilise imizuzu engama-30-40 ngotshani oluphantsi, yongeza umhluzi kwindawo yokuhlambela. Isilwayo sinomdla we-antimicrobial, untiviral, intifungal action.
I-bacterium vaginosis ekukhulelweni
Ukugqithiswa kwe-microflora ye-vaginal ngexesha lokukhulelwa kukuxhomekeka kwengozi yokusuleleka kwintsholongwane kunye neengxaki zokuvutha kumama. Kukho ubudlelwane ngqo phakathi kobunzima be-bacterial vaginosis kunye nenkambo enzima yokukhulelwa. I-bacteria vaginosis ingakhokelela ekuphumuleni kokusabalalisa, ukuzalwa kwangaphambi kokuzalwa, ukukhulelwa okungapheliyo kwe-amniotic fluid, endometritis, i-chorioamnionitis (ukusuleleka kwimbumba). Ukukhulelwa ngokwemvelaphi yentsholongwane yezilwanyana ezinzima kubonakala kunzima ngokuphuhliswa kokukhula komntwana - ukulibaziseka ekuphuculweni kwe-intrauterine, ukungaphumeleli kwenkqubo ye-cardiovascular, i-hypoxia.
Unyango lwe-bacterial vaginosis kwabasetyhini abakhulelweyo
Ulwalathiso oluphambili lwonyango - ukusetyenziswa kweziyobisi zenkqubo okanye zendawo zineempembelelo zokulwa ne-antianaerobic:
- Clindamycin. Nika enye yefayili yefayili: i-cream Invavaginally once kanye ngosuku iintsuku ezi-6, iipilisi zangasese 100 mg ngokukhawuleza kanye ngosuku ngosuku lweentsuku ezintathu;
- Hexicon. Isetyenziswe ngendlela yekhandlela, ubuyisela i-microflora enempilo yesini, ikhusela ukuqhubela phambili kweenkqubo ezithathelwanayo kunye nokuvuvukala kwixesha lokuhamba emva;
- Metronidazole. Musa ukumisela kwi-trimester yokuqala yokukhulelwa ngenxa yempembelelo engafanelekiyo kumntwana, inqanaba leyonyango iMetronidazole lwenziwa emva kweveki leshumi. Xa ukhulelwe, kucetyiswa ukuba usebenzise iyeza ngendlela yekhandlela. Indlela yokusebenzisa i-vaginal yonyango nge-BV ayiyona into embi kunonyango lomlomo, kwaye kwezinye iimeko zize zidlule. Ngokusetyenziswa kwesicatshulwa, into esebenzayo ingena ngqo kwiqela lezilwanyana ezifo-isifo-oku kuphelisa umphumo wenkqubo kwiimveliso eziphilileyo, kunciphisa ubunzima bokuphendula okubi;
- Limafucine. Kubonakaliswe isenzo esinamandla sendawo, sisebenza ngokumelene ne-anaerobic microflora, ayikuchaphazeli kakubi umntwana.
Ngaba ndiyakhulelwa nge-bacterial vaginosis? Unako, ubukho besi sifo ukukhulelwa akubandakanyi. Kodwa akufanelekile ukubeka ingozi kwimpilo yakho kunye nempilo yengomso wengane. Ngeengxaki ze-BV, i-10-35% yabasetyhini kusekhona kwisigaba sokucwangcisa ukukhulelwa. Ngelishwa, izibonakaliso eziphazamisayo zikhokelela ekubeni i-pathology ifunyanwe ngengozi. I-bacterium vaginosis kufuneka isuswe ngaphambi kokukhulelwa-oku kuya kukunceda ukuphepha iingxaki ezinzima ngexesha lokubeletha nokuzala.
Ukuthintela ukuphindaphinda nokuvela kwebhakteria vaginosis:
- Ukutya okunomsoco, ukugcina ukusebenza ngokuqhelekileyo kwamathumbu;
- ukusetyenziswa ngokuchanekileyo kweziyobisi ezichasayo;
- Ukunyamekela ngokufanelekileyo ukuziphatha ngoncedo lwangaphandle kwezitho zangasese;
- ukusetyenziswa kokukhusela ukukhulelwa ngexesha loqhagamshelwano lwezesondo kunye neqabane elingatshatanga.
I-bacterium vaginosis yinto eqhelekileyo yokukhubazeka kwezilwanyana zesisu, ezifuna unyango olunzulu nolwaneleyo. Ukungabi nonyango olufanelekileyo ngexesha elifanelekileyo ligalela kwinkqubo yokulungisa, ukuvela kwezifo zenkqubo yokuzala, ukuphuhliswa kweengxaki ngexesha lokukhulelwa nokubeletha. Izazi ze-gynecologists zincoma ukuba kukho naziphi iimpawu ezingathandabuzekiyo (ukukhutshwa okungavamile, ukutshisa / ukutshisa, iintlungu kwisisu esezantsi) kubonakala, ziqhube iimviwo ezipheleleyo kwaye, ukuba kuyimfuneko, ikhosi yeyeza eyenza iintsuku eziyi-12-14.