Mob mastitis yog tus cwj pwm los ntawm kev txhim kho cov txheej txheem inflammatory hauv cov ntaub so ntswg ntawm lub caj pas mammary. Tus kab mob no tshwm sim los ntawm kev mob hnyav thiab mob hnyav hauv lub hauv siab, nws cov compaction, o, redness ntawm daim tawv nqaij, ib tug ntse nce nyob rau hauv kub, thiab febrile syndrome. Mastitis raug kuaj pom thaum kuaj los ntawm tus kws kho mob mammologist, ib qho ultrasound ntawm cov qog mammary ntxiv, thiab yog tias tsim nyog, mammography. Cov txheej txheem pathological tuaj yeem ua rau muaj phlegmon, abscess, necrosis hauv lub caj pas cuam tshuam, kev loj hlob ntawm sepsis, thiab qee zaum txawm tuag. Nyob rau hauv cov ntaub ntawv ntawm cov kab mob paug ntawm cov mis nyuj, kev pub niam mis yuav tsum tsis txhob siv. Nyob rau hauv lub neej yav tom ntej, deformation ntawm lub caj pas mammary yuav tsim, qhov tshwm sim ntawm kev loj hlob mastopathy thiab oncological qog nyob rau hauv lub mis nce.
Kev mob lub mis
mob mastitis tshwm sim feem ntau vim yog mob ntawm lub miskab mob. Lub pathology yog tshwm sim los ntawm o ntawm lub mis, ib tug muaj zog nce nyob rau hauv loj, mob thiab nce rhiab heev, hyperemia ntawm daim tawv nqaij thiab kub taub hau.
Qhov tshwm sim ntawm mastitis hauv cov niam pub niam mis nws txawv ntawm 1 txog 16%. Qhov nruab nrab daim duab yog 5% ntawm cov poj niam, thiab kev ntsuas los txo qhov tshwm sim hauv xyoo tas los no tsis muaj txiaj ntsig. Feem coob ntawm cov neeg mob mastitis yog nulliparous lossis cov poj niam pub niam mis thawj zaug. Qhov no yog vim qhov tshwm sim ntau tshaj plaws ntawm cov mis nyuj stasis vim tsis muaj zog.
Cov poj niam tom qab peb caug xyoo, uas tsis pub niam mis thawj zaug, feem ntau mob mastitis vim qhov txo qis hauv kev tiv thaiv ntawm lub cev, uas yog vim muaj ib los yog lwm yam concomitant mob. kab mob. Hauv cov xwm txheej zoo li no, cov tsos mob pathological nrog rau kev tshwm sim ntawm tus kab mob hauv qab.
Vim txoj kev loj hlob
Tus mob mastitis feem ntau yog tshwm sim los ntawm tus kab mob staphylococcal. Tab sis yog tias muaj lwm qhov chaw ntawm cov kab mob muaj nyob rau hauv tus poj niam lub cev (kab mob ntawm qhov ncauj kab noj hniav, ua pa system, urinary ib ntsuj av, genitourinary caj pas), mastitis tuaj yeem tshwm sim los ntawm cov foci. Qee zaum cov qog mammary kis tau Escherichia coli. Cov kab mob nkag mus rau hauv cov ntaub so ntswg ntawm lub mis nrog cov ntshav ntws, thiab los ntawm cov kua mis.
Qhov feem ntau ua rau mob lactational mastitis yog ntev pathological lactostasis (stagnation ntawm mis nyuj hauv qog). NtawmThaum tsis muaj cov kua mis tawm ntawm ib qho duct ntawm lub caj pas mammary, ib qho chaw zoo yog tsim rau kev loj hlob thiab kev loj hlob ntawm cov kab mob pathogenic. Ib qho kev mob tshwm sim ua rau muaj kev mob tshwm sim, cov ntaub so ntswg suppuration, thiab febrile syndrome. Nyob rau tib lub sijhawm, tus neeg mob yuav hnov mob tsis zoo - tsis muaj zog, qaug zog, qee zaum - ntuav, xeev siab.
Kev faib tawm ntawm tus mob mastitis
Mastitis yog cov txheej txheem pathological uas ib txwm ua tiav hauv daim ntawv mob. Tus kab mob tau muab faib ua hom raws li qhov tsim ntawm cov txheej txheem inflammatory: infiltrative, serous, purulent, gangrenous, abscessing thiab phlegmonous. Infiltrative, serous thiab purulent hom mastitis yog theem theem ntawm ib qho txheej txheem inflammatory nyob rau hauv cov ntaub so ntswg ntawm lub caj pas - los ntawm kev tsim ntawm ib tug compacted cheeb tsam ntawm serous o mus rau tsim ib tug infiltrate thiab qhov pib ntawm ib tug purulent txheej txheem.
Abscess form
Nrog abscessing mob ntawm mastitis, lub hom phiaj ntawm suppuration yog nyob rau hauv lub zos thiab kom meej meej txwv. Phlegmonous mastitis yog tus cwj pwm los ntawm kev sib kis ntawm cov txheej txheem purulent los ntawm cov ntaub so ntswg ntawm lub caj pas mammary. Nrog rau kev kawm ntev lossis lub cev tsis muaj zog, cov ntaub so ntswg ntawm lub caj pas pib necrotize, thiab theem gangrenous ntawm mastitis pib.
Tseem muaj qee yam kev kho mob ntawm mastitis, feem ntau yog: mob lactational, tshwm sim tom qab yug me nyuam, mastitis neonatal thiab ntshav plasma cell.
Symptoms
mob mastitis- Qhov no feem ntau yog ib qho teeb meem ntawm lactostasis ntawm inflammatory etiology hauv cov niam laus. Qee zaum, tus kab mob no tshwm sim yam tsis muaj cov tsos mob tshwm sim ntawm cov kua mis stagnation. Tus kab mob no tshwm sim los ntawm qhov mob induration nyob rau hauv lub caj pas mammary, hyperemia thiab hyperthermia ntawm daim tawv nqaij nyob rau hauv lub cheeb tsam ntawm induration. Tus neeg mob muaj kub taub hau thiab cov tsos mob ntawm intoxication. Nrog rau txoj kev loj hlob ntawm tus kab mob, qhov mob intensifies, lub caj pas nce, nws ua kub thiab ntom rau qhov kov. Kev pub niam mis thiab qhia cov mis hauv tus mob no yog mob heev. Nrog rau cov kua mis, cov ntshav thiab cov kua paug tuaj yeem raug tso tawm. Purulent mastitis ntawm qhov mob tshwm sim feem ntau nce nrog kev tsim ntawm lub caj pas mammary.
Cov poj niam tsis pub cev xeeb tub
Tseem muaj mob mastitis nyob rau hauv ib tug poj niam uas tsis yog neeg laus. Peb yuav tham txog kev kho mob hauv qab no. Cov xwm txheej zoo li no cuam tshuam txog cov kab mob xws li plasma cell mastitis, ib yam kab mob tsawg uas tshwm sim hauv cov neeg laus uas tau rov yug dua tom qab lub sijhawm lactation kawg. Cov txheej txheem pathological yog tus cwj pwm los ntawm kev nkag mus ntawm cov ntaub so ntswg nyob rau hauv lub txiv mis nrog cov ntshav plasma thiab hyperplasia ntawm cov ntaub so ntswg ntawm lub excretory ducts. Mob mastitis ntawm daim ntawv no tsis suppurate thiab muaj cov yam ntxwv zoo sib xws nrog mob qog noj ntshav.
Mastitis hauv cov menyuam yug tshiab yog ib qho tshwm sim hauv cov menyuam yaus ntawm ob leeg. Nws yog manifested los ntawm engorgement ntawm cov qog mammary thiab pob tshab tawm thaum lub sij hawm siab rau lawv. Qhov no pathology, raws li txoj cai, yog qhov tshwm sim ntawm qhov seem ntawm cov tshuaj hormones poj niam txiv neej. Nrog rau kev loj hlob ntawm mob tsis-lactationmastitis thiab tsim ntawm abscess, phais debridement ntawm lub purulent tsom xam yog ua, tab sis feem ntau cov tsos mob ntawm mastitis nyob rau hauv cov me nyuam mos yuav ploj mus ntawm lawv tus kheej tom qab ob peb hnub.
ntsuas ntsuas
Lub hom phiaj ntawm cov txheej txheem inflammatory hauv lub caj pas mammary yog kuaj los ntawm palpation. Tsis tas li ntawd, tus poj niam muaj qhov nce hauv axillary lymph nodes nyob rau sab ntawm lub caj pas cuam tshuam (qee zaum mob me me ntawm palpation). Suppuration yog tus yam ntxwv ntawm lub ntsiab lus ntawm kev hloov pauv.
Thaum ultrasound ntawm cov qog mammary pom cov duab ntawm cov txheej txheem inflammatory. Mastitis ntawm hom serous yog tus cwj pwm los ntawm daim duab smoothed echographic ntawm cov qauv ntawm lub caj pas, thickening ntawm daim tawv nqaij, nthuav ntawm cov mis nyuj ducts thiab cov ntaub so ntswg subcutaneous. Lub infiltrate nyob rau hauv lub caj pas zoo li ib tug kom meej meej txwv cheeb tsam ntawm txo echogenicity, nrog ntxiv kev vam meej, ib tug "honeycomb" qauv yog kuaj. Tsis tas li ntawd, nrog ultrasound, kev loj hlob ntawm abscesses yog pom tau zoo thiab cov cheeb tsam necrotic tau txiav txim siab. Kev ntseeg tau thiab qhov tshwj xeeb ntawm txoj kev no nce mus txog 90%.
Vim tias mob mastitis feem ntau yooj yim rau kev kuaj mob, mammograms feem ntau tsis ua. Nrog rau daim duab dubious ntawm ultrasound, ib qho aspirate yog coj mus kuaj histological (aspiration fine-needle biopsy ntawm lub mis hauv qab ultrasound tswj). Rau kev kuaj kab mob bacteriological, cov kws kho mob tshwj xeeb tuaj yeem nqa cov kua mis los ntawm cov qog mammary.
Nrog kev ua haujlwm qeeb ntawm cov txheej txheem o thiab vim tsim cov ntaub so ntswg ncig nws(sacking ntawm kev tsom xam) hais txog kev hloov pauv ntawm pathology mus rau hauv daim ntawv ntev. Hauv qhov no, cov tsos mob tshwm sim feem ntau yog mob me, tab sis nyob rau hauv palpation, ib qho tsis muaj zog rau cov menyuam soldered rau ntawm daim tawv nqaij raug kuaj pom. Tom ntej no, peb yuav tham txog kev kho mob mastitis.
Kev kho mob
Thaum qhov tsis txaus ntseeg me ntsis ntawm kev txhim kho ntawm tus mob mastitis, nws yog qhov ceev kom hu rau tus kws kho mob mammologist, vim tias hauv kev kho mob ntawm cov kab mob no nws yog ib qho tseem ceeb uas yuav tsum tau txheeb xyuas raws sij hawm thiab ntsuas kom tshem tawm cov tsos mob ntawm tus mob mastitis thiab tiv thaiv kev kis kab mob. txheej txheem. Kev ncua mus nrhiav kev kho mob lossis kev noj tshuaj rau tus kheej yog qhov tsis tsim nyog, vim tias tus kab mob no tuaj yeem ua rau muaj kev loj hlob sai thiab tsim cov abscess. Nyob rau hauv cov ntaub ntawv ntawm purulent mastitis, kev kho mob phais yog tsim nyog.
Thaum kuaj pom tus kab mob no nyob rau theem ntawm cov txheej txheem serous lossis tsim cov infiltrate, kev kho kom zoo yog ua tiav. Tus neeg mob tau muab tshuaj tua kab mob nrog kev siv cov tshuaj muaj zog broad-spectrum. Hauv qhov no, serous mastitis ploj hauv 2-3 hnub. Lub resorption ntawm infiltrate tuaj yeem siv sijhawm li 7 hnub. Yog hais tias, thaum lub sij hawm o, tus neeg mob muaj ib tug pronounced intoxication ntawm lub cev, nws tau qhia detoxification ntsuas (glucose infusions, electrolyte daws). Nyob rau hauv cov ntaub ntawv ntawm lactation ntau dhau lawm, cov tshuaj tau muab tshuaj los suppress nws.
Dab tsi yog kev kho mob mastitis mob. Daim ntawv purulent ntawm tus kab mob, raws li txoj cai, yuav tsum muaj kev phais. Tus tsim abscess ntawm lub caj pas yog ib qho qhia ncaj qha rau kev phais mob ceev -mastitis tau qhib thiab ua kom pom tseeb purulent yog drained.
Contraindication rau kev pub niam mis
Cov ntaub ntawv loj hlob ntawm mastitis, tsis hais txog theem ntawm tus kab mob, yog ib qho kev txwv ncaj qha rau kev pub niam mis ntxiv (txawm tias lub mis noj qab haus huv), vim tias cov mis nyuj muaj cov kab mob thiab cov tshuaj lom ntawm cov ntaub so ntswg lwj. Rau ib tug me nyuam, xws li kev noj haus tuaj yeem ua rau dysbacteriosis thiab kev ua haujlwm ntawm lub plab zom mov. Txij li thaum kev kho mob mastitis suav nrog kev siv tshuaj tua kab mob, kev pub mis rau lub sijhawm no kuj tsis zoo rau tus menyuam. Cov tshuaj tua kab mob tuaj yeem ua mob hnyav rau kev loj hlob ntawm cov kabmob thiab cov ntaub so ntswg. Thaum lub sij hawm kho mob mastitis, mis nyuj yuav qhia tau, pasteurized thiab ces pub rau tus me nyuam.
Cov lus qhia rau kev tawm tsam ntawm lactation yog: qhov tsis muaj qhov zoo ntawm cov kab mob hauv cov kab mob thiab cov kab mob serous mastitis rau 3 hnub ntawm kev kho tshuaj tua kab mob, kev hloov pauv ntawm tus kab mob mus rau hauv daim ntawv purulent, tsom mus rau kis kab mob ncaj qha rau ntawm lub txiv mis, purulent mastitis. yav dhau los, concomitant systemic pathologies uas ua rau cov poj niam noj qab nyob zoo.
Muaj Teeb Meem
Txhua tus txheej txheem kis tau los ntawm staphylococcus aureus tuaj yeem cuam tshuam los ntawm kev nthuav dav ntawm tus kab mob thiab qhov tshwm sim ntawm cov kab mob septic:
- meningoencephalitis lossis meningitis;
- kab mob pericarditis lossis endocarditis;
- sepsis (muajntau foci ntawm tus kab mob - mob ntsws, osteomyelitis, thiab lwm yam);
- DIC;
- kev poob siab.
Cov teeb meem ntawm tus mob mastitis tuaj yeem ua rau muaj kev phom sij rau lub neej.
Kev Tiv Thaiv
Kev ntsuas kev tiv thaiv kab mob ua ke nrog kev ntsuas los tiv thaiv lactostasis, raws li tus mob no ua ntej mastitis nyob rau hauv feem ntau ntawm cov xwm txheej.
Rau qhov kev tiv thaiv ntawm congestion nyob rau hauv lub caj pas mammary, yuav tsum tau ceev faj lub mis ntawm lub mis: ntau zaus noj thiab ntxiv cov kua mis residue. Nyob rau hauv rooj plaub thaum tus me nyuam muaj cov kua mis txaus los ntawm ib lub mis, thaum pub mis ntxiv nws yuav tsum tau siv rau lwm lub caj pas mammary.
Qhov kev tiv thaiv tseem ceeb los tiv thaiv mastitis yog kev kuaj mob raws sijhawm thiab kev huv ntawm cov kab mob foci hauv lub cev, tab sis nws yuav tsum nkag siab tias kev siv tshuaj tua kab mob hauv lub sijhawm lactation yog categorically contraindicated.
Kev tiv thaiv kab mob yog qhov tseem ceeb tshwj xeeb hauv lub sijhawm tom qab yug menyuam, tshwj xeeb tshaj yog tias tus poj niam tau yug thawj zaug. Nyob rau tib lub sijhawm, cov kua mis thiab lub txiv mis tseem tsis tau npaj rau kev pub niam mis, yog li nws yuav tsum tau sab laj nrog tus kws kho tsiaj hauv lub sijhawm thiab siv kev ntsuas los tshem tawm cov kua mis stagnation. Ib txoj hauv kev zoo los tiv thaiv lactostasis yog kev zaws lub mis hauv thawj hnub tom qab yug menyuam. Cov qog nyob rau tib lub sijhawm yog mob, muaj cov tawv nqaij sib zog, txawm tias, txawm tias muaj kev tso tshuaj thiab zaws kom tsis tu ncua.
