Purulent mastitis yog kab mob hnyav tshaj plaws thiab tsis zoo rau cov poj niam. Niaj hnub no peb yuav xyuam xim tshwj xeeb rau qhov hnyav tshaj plaws ntawm nws cov ntaub ntawv - non-lactational purulent mastitis, vim hais tias kev noj qab haus huv ntawm ib tug poj niam yog lub ntsiab mob rau kev noj qab haus huv thiab kev vam meej ntawm lub teb chaws.
Tshawb nrhiav keeb kwm
Txij thaum ub, ib tug poj niam tsawg tsawg tau dhau los paub txog cov ntsiab lus ntawm tus kab mob, uas txij li thaum ub tau hu ua kev pub niam mis, thiab tom qab ntawd tau hu ua mastitis. Yog, thiab tsis xav tsis thoob, vim qhov no pathology, uas yog ib tug loj heev kis kab mob thiab inflammatory txheej txheem nyob rau hauv lub caj pas mammary, thiab txawm tending mus rau actively kis, feem ntau coj mus rau ib tug purulent lesion ntawm lub glandular glandular caj pas nws tus kheej thiab cov ntaub so ntswg nyob ib sab, thiab. ces mus sepsis los ntawm -rau qhov generalization ntawm tus txheej txheem kis.
Subtleties of statistics
Tam sim no, mastitis feem ntau yog muab faib ua lactational, thaum cov kua mis tsim tawm hauv lub caj pas mammary (feem ntau purulent lactating mastitis), thiab tsis yog lactational, uas peb xav tham txog hnub no. Raws li kev txheeb cais tsis ntev los noxyoo caum, nyob rau hauv 90-95% ntawm cov ntaub ntawv hais txog mastitis, nws tsim nyob rau hauv lub sij hawm tom qab yug me nyuam, thaum uas tsis yog-lactational mastitis, uas tsis txuam nrog cev xeeb tub thiab yug me nyuam, muaj feem xyuam rau qhov nruab nrab ntawm li 5% ntawm cov poj niam.
hnub nyoog qeb
Cov mastitis uas tsis yog lactational feem ntau cuam tshuam rau cov poj niam hnub nyoog 15 txog 60 xyoo. Nyob rau hauv lub hnub nyoog teev, daim ntawv no ntawm mastitis, nyob rau hauv sib piv rau lactation, tsis manifest nws tus kheej hnyav, thiab septic teeb meem xyaum tsis tshwm sim. Nyob rau hauv sib piv, cov poj niam uas poob mob thaum lub sij hawm lub hnub nyoog hais tias yuav tsum tau kawm ua ke nrog mastitis rau ntau xyoo, vim hais tias nws feem ntau mus rau hauv ib tug mob rov qab daim ntawv. Txawm li cas los xij, tsis yog lactating mastitis tuaj yeem cuam tshuam tsis tau rau cov poj niam nkaus xwb, tab sis kuj yog txiv neej thiab menyuam yaus ntawm ob leeg poj niam.
Etiology
Tsis yog lactational purulent mastitis tsis cuam tshuam nrog lactation, tshwm sim tsis tshua muaj thiab feem ntau tshwm sim los ntawm hormonal tsis txaus thiab txo qis hauv kev tiv thaiv kab mob rau cov kab mob sib kis. Raws li txoj cai, nws tau nthuav tawm los ntawm kev mob unilateral lossis ob sab o ntawm cov qog mammary.
Txoj laj thawj
Nws tsuas yog tshwm sim uas feem ntau tsis yog lactational purulent mastitis tshwm sim thaum cov keeb kwm hormonal cuam tshuam hauv poj niam lub cev lossis kev tiv thaiv kab mob rau cov kab mob txo qis. Feem ntau, cov sijhawm no suav nrog cov hauv qab no:
1. Kev txo qis hauv cov tshuaj estrogen ntau, thiab tib lub sijhawm muaj kev tiv thaiv tseem ceeb ntawm kev tiv thaiv kab mob, tshwm sim nws tus kheej nyob rau hauv lub sij hawm ntawm postmenopausal.
2. Lub sij hawmLub hnub nyoog ntawm ib tug hluas nrog nws cov keeb kwm tsis ruaj tsis khov hormonal kuj dhau los ua ib qho kev ntxhov siab rau cov kab mob loj hlob, uas tsim cov av fertile rau kev loj hlob ntawm cov kab mob uas tsis xav tau. Tsis tas li ntawd, nws tsim nyog sau cia tias tsis yog lactational mastitis cuam tshuam tsis tau rau cov ntxhais xwb, tab sis kuj yog cov tub hluas thaum lub sij hawm puberty.
3. Nws yog tsis yooj yim sua kom tsis txhob hais txog cov kab mob ntawm lub qhov txhab tom qab kev khiav hauj lwm ntawm lub caj pas mammary, piv txwv li, tom qab tso ib qho kev cog qoob loo los yog tshem tawm cov kab mob fibrocystic, nrog rau kev raug mob ntawm lub caj pas mammary, uas tau nrog los ntawm kev nyem ntawm nws cov ntaub so ntswg.
4. Txawm tias qhov kev raug mob uas pom tsis tau tshaj plaws rau ntawm daim tawv nqaij ntawm cov qog mammary lossis cov txiv mis tuaj yeem ua rau muaj kev nkag mus ntawm tus kab mob thiab kev loj hlob ntawm cov tsis yog lactational mastitis.
kab mob daim ntawv
Tus kab mob peb tab tom txiav txim siab feem ntau tshwm sim hauv ob hom - mob thiab mob ntev. Tus mob uas tsis yog lactational mastitis tsis tau mus rau lub tsev kho mob raws sij hawm thiab kev kho mob txaus los ntawm catarrhal (infiltrative) daim ntawv sai heev thiab kuj imperceptibly rau ib tug poj niam tuaj yeem hloov mus rau hauv purulent non-lactational mastitis nrog kev mob hnyav heev, thaum nws tsis tuaj yeem ua tau. ua tsis tau mus pw hauv tsev kho mob, thiab txawm tias ua ntej kev nthuav dav ntawm cov txheej txheem tsuas muaj ob peb hnub, lossis txawm teev.
Pathogenesis
Yog hais tias tsis yog lactational mastitis, cov kab mob kis feem ntau nkag mus rau hauv lub caj pas mammary los ntawm qhov txhab ntawm daim tawv nqaij, uas yog tshwm sim los ntawm kev raug mob los yog raug mob thermal, piv txwv li, thaumsiv lub tshuab cua sov los yog kev kub nyhiab, thiab qee zaum vim muaj pustules me me ntawm daim tawv nqaij ntawm lub caj pas mammary. Tom qab ntawd cov kab mob ua ntej ua rau lub subcutaneous rog txheej thiab cov rog rog ntawm lub caj pas mammary, thiab tom qab ntawd tawm tsam cov qog nqaij hlav rau zaum ob.
Qhov twg tsawg dua cov poj niam yuav tsum tau nrog cov mob ntev uas tsis yog lactational mastitis, uas feem ntau tshwm sim thaum mob mastitis tsis kho, xav txog thawj cov tsos mob ntawm kev txhim kho raws li kev sib cav rau kev txwv cov tshuaj thiab cov txheej txheem los ntawm kws kho mob. Nyob rau hauv xws li mob, rov tshwm sim ntawm mastitis ua ib tug tas mus li tus khub ntawm ib tug poj niam, manifest nws tus kheej ntawm me ntsis hormonal cuam tshuam, tom qab hypothermia, kev nyuaj siab, los yog nrog ib tug general tsis muaj zog ntawm lub cev tiv thaiv.
Tsis yog lactation purulent mastitis. Symptoms
Thaum pib ntawm txoj kev loj hlob ntawm tus mob uas tsis yog-lactational mastitis - nyob rau hauv lub serous theem, thaum cov ntaub so ntswg ntawm lub cuam tshuam ib feem ntawm lub caj pas mammary yog successive impregnated nrog serous kua thiab leukocytes nquag nkag mus rau nws - tus poj niam sau ntawv. qhov tshwm sim ntawm qhov mob nyob rau hauv lub caj pas mammary, nyob rau hauv uas ib tug muaj peev xwm palpate lub compacted cheeb tsam nrog meej ciam teb nyob rau hauv ib los yog ntau tshaj shares. Lub cev kub nce mus rau 37-38 degrees, thiab qee zaum nce mus txog 39. Tsis tas li ntawd, lub sijhawm no, tus poj niam yuav raug cuam tshuam los ntawm kev qaug zog loj. Hauv cov xwm txheej tsis tshua muaj tshwm sim, qhov rov qab txhim kho ntawm theem serous thiab qhov pib ntawm kev rov qab los ntawm tus kheej tshwm sim, txawm li cas los xij, ntau zaus, theem ntawm infiltration tshwm sim tom qab theem serous.
Blub infiltrative theem nyob rau hauv lub qog mammary cuam tshuam tsim ib tug mob foob tsis muaj meej meej ciam teb, hu ua infiltrate. Nyob rau tib lub sij hawm, daim tawv nqaij saum toj no infiltrate tsis zoo li inflamed nyob rau hauv tag nrho cov, tsis muaj edema nyob rau hauv lub cheeb tsam no, thiab lub zos kub nyob rau hauv ib txwm txwv. Lub cev kub tseem nce siab, uas yog vim muaj cov kab mob nkag mus rau hauv cov ntshav los ntawm foci ntawm lactostasis los ntawm cov ducts puas ntawm cov qog mammary. Nws yog ib qho tseem ceeb heev uas tus poj niam nrhiav kev pab kho mob los ntawm tus kws kho mob mammologist, gynecologist lossis kws phais mob thaum thawj cov tsos mob tshwm sim, tsis tas tos rau lawv qhov kev loj hlob thiab hloov mus rau hauv daim ntawv purulent. Nyob rau hauv lub catarrhal theem, mastitis yog kho tau zoo heev thiab tsis muaj teeb meem loj, xws li nyob rau hauv cov ntaub ntawv ntawm non-lactational purulent mastitis.
Thaum tsis muaj kev kho mob txaus, tom qab 5 hnub theem ntawm infiltration dhau mus rau theem ntawm kev puas tsuaj, uas yog, kev puas tsuaj. Cov txheej txheem inflammatory yuav ua rau purulent, thiab cov qog mammary hloov mus ua ib qho zoo li daim txhuam cev, soaked los ntawm cov kua paug.
Nyob rau theem kev puas tsuaj, uas tseem hu ua mob purulent mastitis, qhov kev mob ntawm tus poj niam deteriorates sharply, raws li co toxins los ntawm lub hauv paus ntawm purulent o tsis tu ncua nkag mus rau hauv cov hlab ntsha. Lub cev kub tseem nce ntxiv thiab feem ntau nyob rau lub sijhawm no yog 38-40 degrees, thiab nrog rau nws cov tsos mob ntawm intoxication nce. Cov qog mammary cuam tshuam loj tuaj, ua nruj. Cov tawv nqaij dhau ntawm thaj chaw puas tsuaj dhau los ua liab, cov leeg saphenous nthuav dav. Raws li qhov mob nce, nws kis mus rau thaj chawarmpits, txij li cov qog ntshav hauv cheeb tsam kuj tau koom nrog hauv cov txheej txheem sib kis. Tus neeg mob pw tsis taus thiab noj tsis tau.
Views
Tsis yog lactational purulent mastitis, ib daim duab uas tuaj yeem pom hauv phau ntawv kho mob, yuav tsum muaj kev txawj ntse hauv kev kuaj mob.
Muaj ntau yam hauv qab no:
1. Mastitis yog abscessing, uas yog yus muaj los ntawm qhov tseeb hais tias ib tug loj tus naj npawb ntawm abscesses yog tsim nyob rau hauv lub cuam tshuam mammary caj pas - kab noj hniav uas muaj paug. Feem ntau, nyob rau hauv qhov chaw ntawm infiltrate, koj muaj peev xwm palpate softening los yog hnov nyob rau hauv koj cov ntiv tes ib tug kua uas shimmers thaum koj hnov - ib tug zoo tsos mob ntawm fluctuation (nyob rau hauv 99% ntawm cov neeg mob).
2. Mastitis yog infiltrative-abscessing. Nws nyhav hnyav dua li yav dhau los. Qhov Infense tuab muaj ntau lub abscesses me me ntawm ntau qhov ntau thiab tsawg thiab cov duab, yog li cov tsos mob ntawm kev hloov pauv ntawm 5% ntawm cov neeg mob. Xws li ib qho infiltrate feem ntau nyob tsis pub ntau tshaj ob quadrants ntawm lub caj pas mammary.
3. Phlegmonous mastitis. Nyob rau hauv tas li ntawd, lub caj pas mammary yog kiag li loj thiab markedly edematous. Cov tawv nqaij ntawm lub mis cuam tshuam yog qhia tau liab (thiab qee zaum xiav-liab), nruj, nrog lub txiv mis inverted. Kev soj ntsuam lub caj pas yog qhov mob heev, cov tsos mob ntawm kev hloov pauv yog qhov zoo. Hauv ntau tshaj li ib nrab ntawm cov neeg mob, cov kab mob purulent txuas mus rau yam tsawg kawg peb lub quadrants.
4. Gangrenous mastitis, raws li txoj cai, yog nrog los ntawm kev puas tsuaj rau cov hlab ntsha thiab nquag.thrombus tsim. Txij li thaum cov ntshav ib txwm muab rau cov qog mammary ua tsis tau, nws cov necrosis tshwm sim. Nyob rau tib lub sij hawm, lub caj pas yog ho loj, nyob rau hauv nws nto muaj thaj chaw ntawm cov nqaij mos necrosis, hlwv uas muaj ichor, daim tawv nqaij ua bluish-ntsuab. Inflammation npog tag nrho cov qog mammary. Thaum lub sij hawm no, tus mob ntawm cov neeg mob yog heev nyuaj, tsis nco qab yuav tsis meej pem, tachycardia nce tawm tsam keeb kwm ntawm ib tug txo nyob rau hauv cov ntshav siab. Daim duab meej ntawm sepsis yog tsim nyob rau hauv cov ntshav. Tau kawg, nyob rau theem no, kev pheej hmoo rau tus neeg mob lub neej dhau los ua siab heev.
kev kho mob phais
Yog tias "tsis yog lactational purulent mastitis" raug kuaj pom, nws txoj kev kho mob tuaj yeem yog phais lossis kev saib xyuas.
Cov lus qhia ncaj qha rau kev cuam tshuam kev phais yog txhua yam kev puas tsuaj ntawm cov txheej txheem sib kis, purulent-catarrhal mastitis, cov cim qhia uas tau piav qhia los ntawm peb saum toj no.
Nyob rau hauv rooj plaub thaum cov tshuaj kho tsis tau txhim kho tseem ceeb hauv ob hnub, qhov muaj cov txheej txheem purulent hauv lub caj pas mammary feem ntau raug txiav txim, uas yog qhov qhia ncaj qha tshaj plaws rau kev phais, uas tau ua tshwj xeeb hauv ib lub tsev kho mob, feem ntau yog nyob rau hauv txoj kev siv tshuaj loog.
Subtleties of operation
Thaum lub sijhawm ua haujlwm, qhov abscess tau ua tib zoo qhib, ntxuav, tag nrho cov ntaub so ntswg uas tsis tuaj yeem raug tshem tawm thiab tshem tawm. Yog li, purulent mastitis yog tshem tawm tag nrho. Kev ua haujlwm feem ntau yog zam los ntawm cov poj niamyooj yim. Tom qab kev cuam tshuam hauv lub caj pas mammary, cov dej ntws yuav tsum tau muab tso rau los ntxuav lub qhov txhab thiab tsis txhob muab cov kab mob me me los qhib. Kev ntxuav lub qhov txhab yog nqa tawm los ntawm 5 mus rau 12 hnub, uas sib haum rau kev ua tiav ntawm kev ua haujlwm zoo los ntawm tus neeg mob thiab kev ploj ntawm fibrin, kua paug thiab cov khoom ntawm necrosis los ntawm kev ntxuav.
Kev kho mob tom qab phais
Tsis tas li, tom qab kev ua haujlwm, kev kho tshuaj yog ua tiav, uas yog txhawm rau tshem tawm cov co toxins los ntawm lub cev sai li sai tau thiab ua kom huv thiab kho cov kab mob uas tau tsim tawm tsam keeb kwm yav dhau los ntawm cov txheej txheem purulent. Yuav tsum muaj tshuaj tua kab mob (intramuscularly lossis intravenously). Feem ntau cov no yog cov tshuaj ntawm cephalosporin series I, II, los yog, nyob rau hauv cov ntaub ntawv ntawm ib tug thib ob kab mob, III-IV tiam.
Tsis yog lactating purulent mastitis: kho yam tsis tau phais
Txoj kev kho mob tsuas yog ua tau tsuas yog thaum tus neeg mob feem ntau zoo siab, tus kab mob kav ntev li peb hnub, lub cev kub tsis tshaj 37.5 degrees, tsis muaj cov tsos mob hauv zos ntawm purulent o, mob. Nyob rau hauv qhov projection ntawm infiltrate yog nruab nrab, lub infiltrate yog palpable tsis muaj ntau tshaj li ib tug quadrant ntawm lub mis, thiab nyob rau hauv lub general kev ntsuam xyuas ntshav tsis ua rau kom cov duab ntawm o.
Feem ntau cov poj niam nrhiav kev pab kho mob nyob rau hauv thawj theem ntawm mastitis - serous los yog infiltrative, nyob rau hauv uas conservative kev kho mob yog ua tau thiab zoo heev. Ua ntej tshaj plaws, nws txhais tau tias muab kev so rau cov qog mammary, rauuas cov poj niam tau qhia kom txav mus los tsis tshua muaj zog, hnav ib lub tsho xoob xoob lossis ntaub qhwv, uas koj tuaj yeem txhawb nqa lub mis mob, tab sis tsis txhob nyem nws tag nrho, yog li tsis txhob ua rau qhov kev loj hlob ntawm cov txheej txheem. Txhawm rau cuam tshuam rau cov kab mob sib kis, cov tshuaj tua kab mob (Cefalexin, Cefixime, Levofloxacin) tau sau tseg, feem ntau lawv tau muab tshuaj intramuscularly, hauv koob tshuaj tsis pub tshaj qhov nruab nrab koob tshuaj. Ntxiv nrog rau cov tshuaj tua kab mob, txhawm rau txo qhov mob thiab o, lub cev yog desensitized nrog cov tiam tshiab ntawm cov tshuaj tiv thaiv kab mob kom tsis txhob ua rau qaug zog ntawm tus neeg mob thiab txo cov kev mob tshwm sim.
Ntxiv rau qhov "hnyav artillery", cov vitamins ntawm pab pawg B thiab vitamin C raug tshuaj los txhawb lub cev tiv thaiv.
Saib xyuas koj tus kheej, nco ntsoov txog cov kab mob insidious xws li tsis yog lactational purulent mastitis. Kev kho mob tuaj yeem tsis yooj yim yog tias pib thaum ntxov. Kev noj qab haus huv rau koj!
