Cia peb saib seb yog vim li cas cystitis nrog ntshav tshwm nyob rau hauv cov poj niam. Tus kab mob no yog dab tsi? Ib qho kev mob tshwm sim txawv ntawm hemorrhagic cystitis nyob rau hauv uas nrog cov kab mob no, cov ntshav impurities muaj nyob rau hauv cov zis. Qhov no yog tib yam cystitis, tab sis cov ntshav hauv cov zis qhia qhov tob ntawm kev puas tsuaj rau lub stratified epithelium ntawm cov mucous membrane ntawm lub zais zis, nrog rau kev sib kis ntawm cov txheej txheem pathological mus rau capillary endothelium ntawm nws cov microvasculature.
Tus kab mob muaj tus lej ICD-10 N 30. Qhov ua rau mob cystitis nrog cov ntshav hauv cov zis hauv cov poj niam yuav tsum raug tshawb pom.
Kab mob kis
Kab mob tso zis cuam tshuam txog kwv yees li 150 lab tus tib neeg txhua xyoo. Raws li kev tshawb fawb tshawb fawb, hemorrhagic infectious cystitis tshwm sim ntau zaus hauv cov poj niam dua li cov txiv neej. Qhov no tshwm sim tshwj xeeb tshaj yog thaum cev xeeb tub, vim yog qhov txo qis ntawm cov tshuaj estrogen hauvntshav, cov khoom tiv thaiv ntawm mucous daim nyias nyias pib txo qis. Txog rau tam sim no, cov ua rau cystitis nrog cov ntshav hauv cov poj niam, uas txiav txim siab nws ntau yam, tau muab faib ua cov kab mob tsis sib xws.
Kev kis kab mob ua rau kev txhim kho
Feem ntau, mob hemorrhagic cystitis ntawm cov kab mob etiology tshwm sim vim muaj kab mob ntawm lub zais zis sab hauv nrog Escherichia coli, kab mob uropathogenic, Proteus bacilli, saprophytic staphylococcus, lossis cov kab mob kis tau zoo Klebsiella
Lub pathogenesis ntawm qhov txhab yog vim muaj peev xwm ntawm Escherichia (sawv cev rau lub plab hnyuv synanthropic, tab sis nrog cystitis lawv pom lawv tus kheej nyob rau hauv cov zis) ua raws li intracellular opportunistic pathogens. Nrog kev pab los ntawm adhesion organelles, cov microbes nkag mus rau lub hlwb thiab colonize lub mucous daim nyias nyias ntawm lub zais zis thiab urethra. Ntawm no, lawv haus cov tshuaj hlau uas tau muab rho tawm los ntawm cov hlwb thiab tsim cov co toxins uas rhuav tshem cov ntshav liab, uas ua rau muaj kev mob tshwm sim thiab cov lus teb los ntawm urothelial effector hlwb. Dab tsi yog lwm yam ua rau cystitis nrog ntshav hauv cov poj niam? Cov tsos mob ntawm tus kab mob yuav tham hauv qab no.
Feem ntau cov kab mob no tshwm sim los ntawm ureaplasmas, mycoplasmas, trichomonas, chlamydia, gardnerella, gonococci. Thawj cov kab mob fungal cystitis tsis tshua muaj tshwm sim los ntawm kev kho cov kab mob cystitis: kev tawm tsam ntawm cov kab mob microflora ntawm qhov chaw mos nrog tshuaj tua kab mob tso cai rau lactobacilli thiab Candida fungi.multiply freely.
Tsis yog kis kab mob
Cystitis nrog cov ntshav hauv cov poj niam uas tsis yog kab mob keeb kwm, raws li kws kho mob urologist, tuaj yeem txhim kho vim muaj cov calculi hauv lub zais zis - tshwj xeeb tshaj yog cov pob zeb urate nrog kev loj hlob ntawm uric acid diathesis - thaum lub mucous ntawm lub zais zis. raug mob, thiab microdamages nyob rau hauv tus ntawm cov kua qaub ntau dhau los ua tob. Ntau tus kws kho mob hauv tsev hu ua cystitis nrog cov ntshav hauv cov zis ulcerative.
Ntxiv rau, hom kab mob hemorrhagic cystitis li hluav taws xob (kua hluav taws xob) lossis tshuaj lom neeg tsis cuam tshuam nrog cov ntaub so ntswg puas. Radiation o ntawm lub zais zis mucosa feem ntau txhim kho tom qab kho rau malignant neoplasms nyob rau hauv me me pelvis. Nyob rau hauv cov ntaub ntawv no, lub pathogenesis ntawm tus kab mob yog vim lub fact tias irradiation provokes ib tug so nyob rau hauv DNA chains. Tsis tas li ntawd, hluav taws xob nkag mus rau hauv cov txheej sib sib zog nqus ntawm cov leeg nqaij ntawm lub zais zis, uas txo cov impermeability ntawm cov phab ntsa vascular.
Tshuaj lom neeg mob cystitis nrog cov ntshav hauv cov zis hauv cov poj niam yog qhov tshwm sim ntawm cov tshuaj txhaj tshuaj tiv thaiv kab mob - cytostatics, xws li ifosfamide, cyclophosphamide, doxorubicin thiab bleomycin.
Hemorrhagic cystitis hauv cov poj niam tuaj yeem txhim kho thaum cov tshuaj intravaginal nkag mus rau hauv lub zais zis los ntawm lumen ntawm cov urethra. Qhov no tuaj yeem tshwm sim, piv txwv li, thaum douching nrog tshuaj "Gentian violet", npaj rau kev kho mob ntawm qhov chaw mos candidiasis, nrog rau cov kab mob spermicidal,Piv txwv li, xws li Nonoxynol.
Hormonal failures
Lwm qhov laj thawj tsis kis rau kev loj hlob ntawm cov kab mob no hauv cov poj niam tuaj yeem ua rau hormonal cuam tshuam hauv lub cev, noj tshuaj tiv thaiv qhov ncauj. Cov txheej txheem ntawm kev loj hlob ntawm tus kab mob nyob rau hauv qhov teeb meem no yog vim lub fact tias thaum lub sij hawm sib npaug ntawm cov tshuaj hormones cuam tshuam, muaj pes tsawg leeg ntawm cov microflora ntawm cov mucous daim nyias nyias hloov, thiab qhov no ua rau ib tug tsis muaj zog ntawm lub ntuj barrier tiv thaiv kev nkag mus ntawm lub microflora. cov kab mob pathogenic rau hauv lub cev. Yog li qhov ua rau cystitis nrog cov ntshav hauv cov poj niam muaj ntau haiv neeg.
Risk factors
Qhov tseem ceeb ntawm kev pheej hmoo rau hemorrhagic cystitis yog vim:
- txo qis hauv kev tiv thaiv kab mob;
- muaj kab mob latent urogenital lossis kab mob oncological hauv tus poj niam lub cev;
- YUrolithiasis thiab urinary stasis;
- thrombocytopenia (tsawg platelets hauv cov ntshav);
- tsis ua raws li txoj cai asepsis thaum lub sijhawm ua haujlwm urological thiab gynecological;
- kev ua txhaum ntawm qhov chaw mos.
Symptoms of disease
Feem ntau, cov tsos mob thawj zaug ntawm kev txhim kho cystitis nrog cov ntshav hauv cov poj niam tau tshwm sim hauv daim ntawv ntawm pollakiuria - ntau zaus yaug kom tso zis nrog ib txhij txo cov kua dej tso tawm. Yuav luag ib txhij nrog cov tsos mob no, muaj qhov sib ntxiv ntawm cov yam ntxwv ntawm qhov tshwm sim thaum ntxov ntawm kev mob tshwm sim raws li ntau qhov kev yaum kom zais zais zis (ntau zaus thaum hmo ntuj), nrog rau mob hnyav thiab kub hnyiab thaum kawg ntawm txoj cai.tso zis.
Lwm cov kev kho mob tshwm sim
Tsis tas li ntawd, muaj cov kev kho mob tshwm sim ntawm hemorrhagic cystitis:
- mob hauv thaj chaw pubic;
- mob hauv plab, tawg mus rau hauv pliaj thiab sab nraub qaum;
- turbidity thiab hloov ntawm qhov tsw thiab xim ntawm cov zis (los ntawm liab mus rau ci liab);
- yuav muaj kev tso zis tsis muaj zog (tso zis tsis muaj zog).
Tus neeg mob qhov mob hnyav zuj zus - nws ua rau tsis muaj zog txaus, tsis qab los noj mov, mob febrile thiab kub taub hau.
Yog tias nyob rau theem twg ntawm cov txheej txheem pathological tus neeg mob xav tias nyuaj thaum tso zis, qhov no qhia tias tamponade - thaiv qhov qhib ntawm lub zais zis nrog cov ntshav txhaws.
Diagnosis
Kev kuaj mob cystitis nrog cov ntshav hauv cov poj niam feem ntau yog ib qho yooj yim. Nyob rau hauv cov ntaub ntawv no, nws yog tsim nyog los sib txawv urethritis, mob cystitis thiab zais zis diverticulum. Kev kuaj ntxiv muaj xws li:
- ua qhov kuaj zis dav dav;
- YUltrasound ntawm lub zais zis;
- cystoscopy;
- Vaginal Swb Rau Flora;
- urine culture.
Kev kho mob ntawm pathology
Qhov tseem ceeb yog kom paub txog cov tsos mob ntawm cystitis nrog cov ntshav hauv cov poj niam raws sijhawm. Kev kho mob yuav tsum tau ua kom tiav. Nws yog ib qho tseem ceeb kom nkag siab tias kev ua kom tiav ntawm cov mucous membrane ntawm lub zais zis yog ua tau tsuas yog nrog kev siv cov tshuaj muaj zog. Nws yuav tsum raug sau tseg tias muaj feem yuav ua tiavkev rov ua kom rov zoo dua nrog kev kuaj xyuas raws sij hawm ntawm kev kuaj mob thiab kev siv tshuaj tua kab mob ntawm pab pawg rhiab heev. Kev kho mob lig ntawm cystitis nrog cov ntshav hauv cov zis hauv cov poj niam thiab kev teem sijhawm ntawm cov tshuaj uas tsuas yog tshem tawm cov tsos mob ntawm tus kab mob yam tsis muaj kev cuam tshuam rau cov kab mob pathogenic tuaj yeem ua rau kev hloov pauv ntawm cov kab mob hemorrhagic mus rau hauv daim ntawv mob ntev.
Lub luag haujlwm tseem ceeb ntawm tus kws tshaj lij yog kev puas tsuaj ntawm cov kab mob pathogenic uas tau nkag mus rau hauv lub zais zis thiab ua rau mob ntawm cov mucous txheej.
Tshuaj
Txoj kev xaiv ntawm kev siv tshuaj tua kab mob ntawm cov kab mob cystitis nrog cov ntshav hauv cov poj niam yog txiav txim siab los ntawm qhov tsis xws li qhov hnyav ntawm cov tsos mob thiab lub sijhawm ntawm tus kab mob. Tsis tas li ntawd, kev xaiv cov tshuaj siv rau hauv tus account qhov yuav tshwm sim ntawm cov kev mob tshwm sim, muaj cov kab mob sib xyaw ua ke, thiab lwm yam.
Nyob rau hauv daim ntawv mob cystitis, tshuaj tua kab mob, tshuaj antispasmodics, tshuaj ntsuab uas muaj cov nyhuv diuretic. Nrog rau qhov mob tshwm sim, nws raug nquahu kom noj cov tshuaj uas txo cov leeg nqaij ntawm lub zais zis ("Papaverine", "Drotaverine"). Lawv tuaj yeem siv tau ob qho tib si hauv cov ntsiav tshuaj thiab lub qhov quav suppositories. Siv lub tshuab cua sov rau hauv qab lub plab yuav pab tshem tawm qhov mob hnyav.
tshuaj diuretic xws li bearberry, raum tshuaj yej, lingonberry nplooj yog dav siv nyob rau hauv mob cystitis nrog cov ntshav ntawm cov poj niam. Tseem muaj cov phytopreparations npaj txhij - Cyston, Canephron, Fitolizin. Yam yuavtsum tau kawm uantej kom rov qab los sai yog haus dej haus kom ntau.
Ib qho tseem ceeb ntawm kev tawm tsam tus kab mob yog cov tshuaj fosfomycin, raws li cov tshuaj nrov rau cystitis "Monural" yog tsim. Nws yog ib tug dav-spectrum tshuaj tua kab mob, uas yog ib tug derivative ntawm phosphonic acid. Cov tshuaj muaj ib tug bactericidal nyhuv, lub mechanism ntawm uas yog vim lub tsub zuj zuj ntawm cov synthesis ntawm cov kab mob phab ntsa. Cov tshuaj siv tau ib txhij nrog lwm cov tshuaj tua kab mob.
Metronidazole yog siv dav hauv kev kho mob cystitis nrog cov ntshav hauv cov zis. Nws, nrog rau cov tshuaj tua kab mob tseem ceeb, tuaj yeem muab tso rau hauv qhov ncauj lossis qhov ncauj. Cov tshuaj yog ib qho zoo antiprotozoal thiab antibacterial synthetic kho mob npaj nrog ib tug dav spectrum ntawm cov teebmeem. Ib qho tshuaj tua kab mob raug xaiv los ua cov tshuaj tseem ceeb. Feem ntau, lawv yog qee yam tshuaj cephalosporin - Ceftriaxone, Cefotaxime, thiab lwm yam.
Fluoroquinolones zoo heev rau cystitis, piv txwv li, Norfloxacin (Nolicin, Norbactin, Bactinor, Urobacil).
"Norfloxacin" raug pom zoo kom noj tsis pub dhau ob lub lis piam. Nws yuav tsum tau borne nyob rau hauv lub siab hais tias cov tshuaj no rau kev kho mob ntawm cystitis nrog cov ntshav nyob rau hauv cov poj niam yog contraindicated nyob rau hauv lub raum kab mob, cev xeeb tub thiab qaug dab peg.
Qhov tshwm sim ntawm cov kab mob no
Cov teeb meem tseem ceeb ntawm hemorrhagic cystitis suav nrog:
- ua txhaum cov txheej txheem tso zis (raws li qhov tshwm sim ntawmcov lus hais tamponade ntawm cov ntshav txhaws), uas tuaj yeem ua rau urosepsis, raum tsis ua haujlwm thiab zais zis;
- thaj chaw puas ntawm cov urothelium tuaj yeem ua rau muaj kab mob thiab ua rau lawv nkag mus rau hauv lub cev;
- kev ua txhaum ntawm kev ncaj ncees ntawm cov hlab ntsha ntawm lub zais zis tuaj yeem ua rau cov ntshav poob hnyav thiab tshwm sim ntawm cov tsis muaj hlau tsis muaj ntshav liab, tshwj xeeb tshaj yog tias tus neeg mob tau kuaj pom muaj mob hemorrhagic cystitis;
- qhib rwj nyob rau sab hauv ntawm lub zais zis maj mam kho, tab sis caws pliav nyob rau hauv lawv qhov chaw, provoking sclerotic hloov nyob rau hauv cov phab ntsa, deformation ntawm lub zais zis thiab ib tug txo nyob rau hauv nws loj.
Kev cuam tshuam kev phais rau qhov kab mob no
Kev phais yuav tsum tau kho rau refractory hemorrhagic cystitis. Ntxiv nrog rau cystoscopy nrog electrocoagulation, xaiv embolization ntawm hypogastric ceg ntawm cov hlab ntsha yog ua tau. Qee qhov xwm txheej (nrog rau qhov caws pliav ntawm cov phab ntsa loj thiab deformation ntawm lub zais zis), cystectomy (tshem tawm ntawm lub cev) yog qhia. Kev cuam tshuam ntawm kev phais tsis tshua muaj, feem ntau, cystitis nrog cov ntshav hauv cov poj niam yog kho nrog tshuaj.
Txoj kev ua neeg
Txoj kev ntawm lwm cov tshuaj yog qhov tsim nyog tsis yog tom qab kev kho hluav taws xob nkaus xwb, tab sis kuj yog ib qho kev pab kho mob rau tus mob cystitis, nws yuav rov qab los. Nyob rau hauv kev sib ntaus tawm tsam cov ntshav nyob rau hauv cov zis muaj pes tsawg leeg, decoctions ntawm tshuaj ntsuab tshuaj, uas yuav tsum tau noj nyob rau hauv tag nrho cov chav kawm, zoo pab. Nov yog cov pov thawj pej xeem zaub mov txawv:
- Txhob qhuav parsley. Ncuav 1 tbsp. l. raw cov ntaub ntawv 2 tbsp. dej txias. Infuse qhov muaj pes tsawg leeg rau 8-10 teev, thiab tom qab ntawd haus ob peb zaug hauv ib hnub.
- 1 tbsp l. lingonberry nplooj ncuav 1 tbsp. boiling dej, insist. Noj ib nrab khob 3 zaug hauv ib hnub ua ntej noj mov.
- Crush tshiab cranberries ua berry puree yuav tsum noj txhua hnub thaum noj tshais.
