I-bacterial vaginosis - i-pathology ye-ecosystem ecosystem, eyenziwa ukukhula okusebenzayo kwamabhaktheriya anaerobic (mycoplasmas, peptococci, gardnerell). Inqubo yokuvuvukala ayikho. I-Vaginosis ibonakala ngokukhipha isikhathi eside nokuchichima, lapho izidakamizwa ze-pathogenic (trichomonads, gonococci) zingatholakali. Ukukhula okukhulu kwe-flora ehlanganisiwe kuhlobene nokulahlekelwa kwe-lactobacilli evamile ephakathi kwe-microflora yangasese, okwenza umsebenzi wesithintelo sokuzivikela ngokumelene nokungena kwamagciwane ezivela ngaphandle. Lokhu kudala umhlabathi ovundile wokuthuthukiswa kanye nokuqhubeka kwezifo ezingapheli zomoya ezivuvukala.
I-bacterial vaginosis: izimbangela
Ama-pathogens ayisisekelo esi sifo yi-bacterial anaerobic (Mycoplasma hominis, Mobiluncus spp, Gardnerella vaginalis). Ngama-bacterial vaginosis, ukuhlushwa kwabo kuphakama ngama-oda amaningana amaningi, lapho inani labantu lactobacilli linciphisa khona, inani lactic acid kanye ne-acidity yezinto zangaphakathi zesisu liyancipha. I-bacterial vaginosis iyisifo se-multitifactorial lapho inendima ehola phambili inikezwa ukuphazanyiswa kwe-microflora yama-vagin eyenzeka ngenxa yethonya lezici ezingapheli futhi ezingavamile zesifo:
- izifo eziphethwe yi-endocrine, ukwelashwa okungahambi kahle kwe-antibacterial;
- izinguquko esimweni sokuzivikela;
- Izifo ezihambisanayo / ezidlulisiwe zezinsikazi zesisu zomsuka wokuvutha;
- ukuvezwa njalo emisebeni ye-ionizing;
- ukusetshenziswa kwezizalo zokubeletha (spermicide, intrauterine, ngomlomo);
- i-douching evamile;
- ukuhlinzekwa kwezifo / ukuhlinzwa;
- i-dysbacteriosis yamathumbu, izidakamizwa ezithinta izifo.
I-bacterial vaginosis isakazwa kanjani
I-vaginosis vaginosis ivame ukubhekwa ngezifo ezithathelwana ngocansi. Amaqiniso amabili aqinisekisa lokhu. Owokuqala uyiphesenti ephakeme yokuphindaphinda phakathi kwabesifazane abaphulukisiwe abalingani babo bobulili abangazange baphathwe. Amacala abhalwe phansi okwesibili kwezifo zabesifazane abaphilile ngemuva kokuhlangana nabantu, ukuhlaziywa okubonisa ukuthi kukhona amabhaktheriya anaerobic.
I-vaginosis vaginosis emadodeni
Emadodeni, lesi sifo sitholwa kaningi kakhulu kunabesifazane. Ama-bacterium amaningi ajwayelekile ngokuvamile ahlukaniswa nezinhlobo ezahlukene ze-bacteroides. Inqubo yokuvuvukala ithinta i-urethra yangaphakathi, isithombe somtholampilo se-bacterial vaginosis sesilisa sinamathele, ngaphandle kwezimpawu ezinzima, futhi ngezinye izikhathi ukuphazamiseka okukhulu kwe-serous-mucous kuveziwe. Ngokweqile, ukuthuthukiswa kwezinkinga (pyelonephritis, epididymitis, cystitis, gardnerelleous prostatitis) kungenzeka, kodwa ngokusemthethweni zithandwa kakhulu (1-2%). Amadoda abhekana nezinhlobo ze-asymptomatic / asymptomatic zesifo asebenza njengemithombo yokutheleleka kwabesifazane.
Izimpawu ze-bacterial vaginosis kwabesifazane
Ukubonakaliswa kwemitholampilo ye-bacterial vaginosis ayinalo izici eziphawulekayo, uphawu olubonakalayo kuphela ukuthi kukhona ukuqubuka kwamanzi okwesibhakabhaka okukhulu, okunomfutho ongathandeki wezinhlanzi ezincane. Esigabeni sokuqala banamahlunga noma abamhlophe, ngenqubo yokukhetha eqhubekayo bathola i-hue ephuzi obomvu futhi baba mnandi kakhulu. Ukubonakaliswa kokuvutha (i-hyperemia, i-puffiness) ayitholakali, ngesikhathi sokuhlolwa komzimba kubonisa ukuthi i-uvi - cervicitis yomlomo wesibeletho, ukuguguleka kwamanzi, ukubunjwa kwamakhemikhali. Iziguli ezingu-50% zikhathazeka ngokuzulazula endaweni yangaphandle, ubuhlungu e-perineum, ukuphazamiseka kokungqubuzana, ukuya esikhathini.
Izigigaba ze-bacterial vaginosis
- Ihlawuliswa. Efaniswa nokungabikho okuphelele kwe-microflora ye-lactobacillary kuma-"evamile" amangqamuzana e-epithelial kulwazi oluphenywayo. Lesi simo asibhekiseli kuma-pathological, kodwa sibonisa ukuthi kungenzeka ukuthi ama-bacterial anaerobic ahlasela i-niche engenalutho nokubunjwa kwe-vaginosis.
- Kukhokhwe. Ibonakala ngokunciphisa okukhulu kwe-lactobacilli, ukubonakala kwamangqamuzana ayisihluthulelo ngokumelene nesizinda se-leukocytosis emnene.
- Ihlukunyezwa. Ukwelashwa nge-clinically ibhaktheriya vaginosis: kunezibonakaliso zesifo kanye nomthamo webhaktheriya omelelwa ama-anaerobes, awekho i-lactobacilli.
Izinyathelo zokuhlola
Inani elibaluleke kakhulu ekuxilongweni kwe-bacterial vaginosis linikezwa izindlela zokuhlola zesifundo - iyakhuluma ngesisombululo se-potassium hydroxide (10%) ne-pH-metry. Lapho uhlaziya i-glycogen ye-epithelium yama-vagin ngesikhathi se-lactobacillus metabolism, i-lactic acid yakhiwa. Uma le ndlela iphulwa, ukufa kwe-lactobacillus kwenzeka futhi i-pH iyaphambukela ekubeni i-alkaline reaction vector, okuholela ekukhuleni okukhudlwana kwama-anaerobes. Ukuhlolwa okuhle kwe-amine kubonakala iphunga lezinhlanzi "ezibolile" ngesikhathi kuhlanganiswa isisombululo se-potassium hydroxide kanye nesisindo sokuhlukana.
Izibonakaliso zemitholampilo kanye ne-microbiological, ngesisekelo sokuthi i-bacterial vaginosis ixilongwa kanjani:
- inqwaba yokukhipha okwesisu ngokukodwa komzimba ngephunga elimnandi;
- ukuhlolwa okuhle kwe-amine;
- ukwandisa i-pH ye-secretion yesisindo kuphezulu kune-4.5;
- Ukuba khona kwenhlangano enkulu yama-epitheliocyte esithombeni; "Amaseli angukhiye" (anaerobes);
- ukuqedwa okungapheli / ukwehla okukhulu kwe lactobacilli;
- ukutholakala okungavamile / ukungabikho kwe-leukocyte ye-polynucleated;
- ukutholakala kwesamba esikhulu seFusobacterium spp, Bacteroides spp, Gardnerella vaginalis.
I-vaginosis ye-bacterial, ukwelashwa
Ukwelashwa okuphumelelayo kwe-BV kuncike ekuxilongweni okufika ngesikhathi futhi okulungile, ukwelashwa okufanele futhi okunamandla, okuhloswe ngalo ukuvuselela i-microflora yangokwemvelo yangasese, ukumisa ukukhiqizwa kwezinambuzane ezincane ezingavamile ukucubungula i-microcenosis. Kuze kube manje, ukwelashwa kwe-BV kuqhubeka umsebenzi oyinkimbinkimbi, obangelwa ukusebenza okuphansi kwezidakamizwa nokuphindaphinda kwesifo.
I-complex ezimbili-isigaba se-pathogenetic and therapy etiotropic
Ukuqedwa kwama-bacterial vaginosis
Izidakamizwa zokuzikhethela - imithi ngokumelene nezinto ezingezansi ze-vaginal microflora. Ukuphumelela kwabo emtholampilo kufinyelela ku 87-95%. Ngokufanayo, uhlelo lwe-systemic prophylaxis lwe-candidiasis yesisindo lwenziwa. Imiphumela emihle yokwelashwa kwe-BV yayinguMetronidazole (i-Trichopol, i-Metrogil), eyingxenye yeqembu lama-antibiotic aqukethe i-imidazole ring. Ingena esitokisini se-microbial, ibophezela ku-DNA, ivimbela i-nucleic acid component. I-Metronidazol shiroko isetshenziselwa izinqubo ezihlukahlukene zokwelashwa, kodwa ngokuvamile ivusa ukusabela okuhlangene - okungavamile kokulimala, imithi, ukunambitheka, ukunambitheka kwensimbi emlonyeni. Umzila wokukhetha wokuphatha ungowesifazane wesifazane.
Ukuze ukwelashwa kwendawo, odokotela bavame ukusebenzisa i-Clindamycin. Isidakamizwa sinomsebenzi oqinile we-antibacterial, neutralizing protein synthesis esakhiweni se-microbial. Kungenzeka ukwethula uhlelo lwe-Clindamycin ngomlomo nangomlomo. Umphumela wesici: ukukhula kwe-fungus-like fungi, ukusabela kokugula.
Ukubuyiselwa kwe-biocenosis yesifazane
Kuqhutshwa ngenxa yesicelo sendawo ye-eubiotics - i-Bifidumbacterin, i-Acilacta, i-Lactobacterin. Lezi zidakamizwa zishukumisa ukukhula kwe-lactoflora yesisu sangokwemvelo, kunomthelela ekunciphiseni inani lokuphindaphinda kwe-bacterial vaginosis ngokukhulisa izimfanelo zokuvikela zesifazane.
Imigomo yokuphumelela kokwelashwa:
- ukuguquguquka kwempawu zomtholampilo zesifo;
- ukunyamalala kwezinzwa ezithintekayo;
- ukuqiniswa kwezinkomba ze-laboratory.
Ikhwalithi yokwelapha ilinganiselwa ezinsukwini ezingu-10-14 emva kokuqedwa kwenkambo. Kunconywa ukusebenzisa izindlela zokuvimbela ukukhulelwa ngesikhathi sokuphulukisa.
Ukulungiselela ukwelashwa kwe-bacterial vaginosis:
- I-Lactagel (i-gel). Iqondisa i-pH yesifazane, ivuselela i-microflora yemvelo, idale izimo ezinhle zokukhula kwe-microflora enempilo. Isiza ekususeni imfihlo eminingi, iphunga elimnandi, ukunganaki;
- I-Femilex (i-suppositories yama-vaginal). Ngokusho kwesenzo, i-Femilex ifana ne-Lactagel. Ku-5-10% wamacala, angabangela ukushaywa okukhulu ngaphakathi kwesifazane. Ukungahambisani nalokhu: i-thrush, ukukhulelwa, i-lactation;
- I-Vaginorm-G (amaphilisi wesisindo). Iyanciphisa i-pH yesisu, ivimbela ukukhula kwamabhaktheriya anobungozi, ivuselela izitshalo ezivamile zesisu. Kubekezeleleke kahle, ezimweni ezingavamile kungabangela ukutshisa / ukushisa emzimbeni, ukwandise ukuqina kwemfihlo yamangcwaba. Kuqhathaniswa nomlando we-thrush;
- I-acylact (i-suppositories yama-vaginal). Iqukethe i-lactobacilli ephilayo, ehlukanisa amabhaktheriya e-anaerobic, esiza ukubuyisela ukuzivikela kwemvelo. Kuvinjelwe ukusebenzisa i-thrush;
- I-Clindamycin (ukhilimu wesisu). I-antibacterial agent yokusebenzisa ama-topical. Ngokushesha ibhubhisa amabhaktheriya anobungozi, evamile ukuveza izitshalo ezivamile zasendlini. Imiphumela emibi: ikhanda, isizungu, thrush, ubuhlungu besisu, ukuphazamiseka kokugaya ukudla;
- I-Bifidumbacterin (i-suppositories yama-vaginal). Ivuselela ukulinganisela kwe-microflora yesifazane, ibhubhisa izinhlobo ze-anaerobic;
- I-Trichopolum (amaphilisi wesifazane). It ngcono isimo jikelele, kunciphisa inani lemfihlo, kuqeda iphunga elimnandi, ubuyisele imifino evamile yeziswini. Ukungafani: ukukhulelwa, ukwehluleka kwesibindi. Umthelela ohlangothini: ukuvuthwa okuvamile, isicanucanu, umlomo owomile, i-candidiasis (thrush).
I-bacterial vaginosis iphatha kanjani amakhambi abantu?
Ngaphambi kokuqala ukwelashwa, kunconywa ukuthi uxoxe nodokotela ukuze ugweme izinkinga nemiphumela emibi. Ngendlela efanele, ukusetshenziswa kwama-folk zokupheka kusiza ukususa izimpawu ezingathandeki futhi ubuyisele i-microflora yesifazane ephilile.
Izixazululo zokuvumelanisa:
- uthathe izimbali ze-chamomile zokwelapha kanye ne-goose fuzz (isipuni esisodwa), uthele ilitha lamanzi abilayo, ugcizelele imizuzu engu-30-40, ufake ifomu elifudumele;
- uthatha isilinganiso esilinganayo impande ye-angelica, i-badana, i-chicory, i-dandelion, i-calendula imifino, amaqabunga omama nomama wesisu, i-thyme. Gaya, uhlanganise, ulinganisa amathisipuni amabili eqoqo, uphuze ngelitha elilodwa lamanzi abilayo, ubambe amahora 10-12, usebenzise ifomu elifudumele;
- I-isipuni segxolo elichotshoziwe le-oki ukuze liphuze ngamamitha ayizigidi ezingu-250 zamanzi ahlanzekile, ukungena emanzini okugeza ngamaminithi angu-10-15, ukugxilisa amahora angu-3-4. Ngaphambi kokukhipha ukumnika, ukupholisa nokucindezela;
- uthathe isipuni sezithelo ze-cherry, ubilise ngomlilo olinganiselayo imizuzu engu-20-25, epholile, idle. Sebenzisa ukuhlanza ubulili.
Amanzi okugeza:
- cwilisa ama-gramu angu-250 e-oak emanzini apholile, shiya amahora angu-2-3, hlanganisa ingxube yamabilana, engeza ebhodini elenziwe ngaphambilini. Inqubo yokwelapha iqeda ukuvuvukala, ikhuthaza ukuphulukiswa kwesilonda;
- hlanganisa amaqabunga ama-walnut, utshani we-oat, amajikijolo omjunipha, i-chamomile, i-oak bark. Bilisa amaminithi angu-30-40 ngokushisa okuphansi, engeza umhluzi ebhodini elungisiwe. Isidakamizwa sinokulwa namagciwane, i-antiviral, isenzo se-antifungal.
I-bacterial vaginosis ekukhulelwe
Ukuhlukunyezwa kwe-microflora yangasese ngesikhathi sokukhulelwa kuyisici sokubikezela ingozi yokutheleleka kwe-intrauterine ye-fetus nezinkinga zokuvuvukala kumama. Kukhona ubudlelwano obuqondile phakathi kobuchopho be-bacterial vaginosis kanye nenkambo eyinkimbinkimbi yokukhulelwa. I-bacterial vaginosis ingabangela ukukhulelwa kwesisu okuzenzekelayo, ukubeletha ngaphambi kwesikhathi, ukuthululwa okungazelelwe kwe-amniotic fluid, i-endometritis, i-chorioamnionitis (ukutheleleka kwezibungu). Ukukhulelwa ngokumelene nesimo sempilo ye-microbial pathology ngokuvamile kuvame ukungalingani kokuthuthukiswa komntwana - ukulibaziseka ekuthuthukiseni i-intrauterine, ukwehluleka kwesimiso senhliziyo, i-hypoxia.
Ukwelashwa kwe-bacterial vaginosis kwabesifazane abakhulelwe
Isiqondiso esiyinhloko sokwelashwa - ukusetshenziswa kwezidakamizwa zesistimu noma zendawo ezine-antianaerobic effect:
- I-Clindamycin. Nika elinye lamafomu wokulinganisa komuthi: ukhilimu Ngenhla kanye ngosuku ngosuku lwezinsuku ezingu-6, amaphilisi wesisindo 100 mg ngokuphindaphindiwe kanye ngosuku izinsuku ezintathu;
- I-Hexicon. Isetshenziswe ngendlela yamakhandlela, kubuyisela i-microflora enempilo yesifazane, ivimbela ukuqhubekela phambili kwezinqubo ezithathelwanayo nokuvuvukala esikhathini sokuhamba kwesikhathi;
- I-Metronidazole. Ungakhethi ku-trimestre yokuqala yokukhulelwa ngenxa yomphumela ongalungile emntwaneni, isifundo semithi ye-Metronidazole senziwa ngemuva kweviki leshumi nambili. Uma ukhulelwe, kunconywa ukusebenzisa imithi ngendlela yamakhandlela. Indlela yokwelashwa kwe-vaginal nge-BV ayikubi kakhulu ukwelashwa ngomlomo, futhi kwezinye izimo ngisho nokuyidlula. Ngesicelo se-topical, into esebenzayo ingena ngqo kwi-cluster yezinambuzane zesifo - lokhu kuqeda umphumela wesistimu kuma-tissue enempilo, kunciphisa amathuba okuphendula okubi;
- Limafucine. Ibonakala ngesenzo sendawo esinamandla, esisebenza ngokumelene ne-anaerobic microflora, ayithinti kabi ingane.
Ngingakhulelwa yini ne-bacterial vaginosis? Ungakwazi, ukutholakala kokukhulelwa kwesifo akufaki. Kodwa akufanelekile ukufaka ingozi empilweni yakho kanye nempilo yengane yengane. Ngenkinga ye-BV, abesifazane abangu-10-35% basesimweni sokuhlela sokukhulelwa. Ngeshwa, izibonakaliso eziphazamisayo ziholela eqinisweni lokuthi lesi sifo sitholakele ngengozi. I-vagterial vaginosis kufanele isuswe ngaphambi kokukhulelwa - lokhu kuzosiza ekugwemeni izinkinga ezinkulu ngesikhathi sokubeletha nokubeletha.
Ukuvimbela ukuphindaphinda kanye nokuvela kwebhaktheriya vaginosis:
- ukudla okunengqondo, ukugcina ukusebenza okuvamile kwamathumbu;
- ukudla okufaneleko kwezidakamizwa zokulwa namagciwane;
- ukunakekelwa okufanele kwezempilo ezingxenyeni zangaphandle zobulili;
- ukusetshenziswa kwesithiyo sokuvimbela ukukhulelwa ngesikhathi sokuxhumana kocansi nomlingani ongatholakali.
I-bacterial vaginosis iyisifo esivamile sokuphila kwesisu, okudinga ukwelashwa okuphelele nokwanele. Ukuntula ukwelashwa okufika ngesikhathi kunomthelela ohlelweni lokuvuselela, ukuvela kwezifo zesimiso sokuzala, ukuthuthukiswa kwezinkinga ngesikhathi sokukhulelwa nokubeletha. Izazi zezinkinga zezinzwa zincoma ukuthi noma yiziphi izimpawu ezingathandabuzi (ukukhishwa okungavamile, ukushaywa / ukuvutha, ubuhlungu esifubeni esingaphansi) kubonakala, kuhlolwa ngokugcwele futhi, uma kunesidingo, inkambo yokwelapha ethatha izinsuku ezingu-12-14.