Matenda opatsirana m'mimba mwa amayi apakati amagawidwa m'magulu atatu:
• mabakiteriya - kukhalapo kwa mabakiteriya mu tsamba la mkodzo;
• Matenda a m'munsi mwa tsamba la urinary (cystitis, urethritis);
• Kutenga kachilombo kameneka (pyelonephritis).
Azimayi amavutika ndi pyelonephritis kawiri kawiri kuposa amuna, ndipo amadwala zaka zawo zobereka. Chifukwa chiyani? Chimodzi mwa zolakwika ndi zomwe zimachitika thupi lachikazi: kukhalapo kwafupipafupi ndi kutsekula kwapakati pa chiberekero cha umaliseche (kutanthauza kupezeka kwakukulu kwa matenda). Kuonjezera apo, panthawi yachiwiri ya msambo komanso nthawi yonse ya kuchepa kwa thupi, kusintha kwa thupi kumachitika mumtambo excretory wa akazi, zomwe zimachepetsanso kukana matenda.
Apeza kuti chiopsezo chotenga kachilombo ka HIV chimakhala chachikulu mwa amayi:
• Choyamba anabala ali ndi zaka 28-30;
• obala mitundu;
• omwe adali ndi matendawa kale;
• odwala matenda a shuga;
• kukhala ndi zovuta zenizeni kapena zovuta zokhudzana ndi ntchito ya mkodzo.
Monga mukudziwira, katundu wambiri amaikidwa pa impso pa nthawi ya mimba - ntchito yawo imachitika ndi mavuto aakulu. Ayenera kuchotsa m'thupi thupi lazowonongeka ndi kusinthanitsa osati mkazi yekha, komanso mwana wake amene akukula. Komabe, popanda kuyang'anitsitsa, thupi lakumangirira lokha silinayambe kusintha kwa impso ndipo zimapirira ntchitoyo. Mu miyezi yotsiriza ya mimba mu mkodzo, pakhoza kukhala zizindikiro za mapuloteni - ichi ndi chizindikiro choyamba cha zochitika zotheka za gestosis.
Bacteriuria yotchedwa Asymptomatic
Amadziwika ndi chithandizo cha mkodzo mu 2-7% mwa amayi apakati, ngakhale kuti sizimagwiriridwa (kotero kuti mawu akuti "asymptomatic"). Kusanthula kumatanthauza kuti pali mabakiteriya omwe amatha kukhalabe m'kamwa. Ngakhale kuti palibe chithandizo cha kuchipatala, matenda a bacteriuria omwe ali ndi pakati pafupipafupi nthawi zambiri (mu 20-30%) amachititsa kuti cystitis ndi pyelonephritis zisamalire komanso zimafuna chithandizo chapadera.
Zovuta cystitis
Matendawa amtundu wa mkodzo pa nthawi yomwe ali ndi mimba sichivuta kuwona mu mawonetseredwe apadera a kutupa kwakukulu: mofulumira, kupweteka kovuta. M'mabuku otchuka tsopano mumasindikiza malangizo osiyanasiyana a momwe mungagonjetsere tsoka. Kuzimitsa njira yotupa, ndithudi, mungathe. Koma izi sizingachitike, makamaka mimba! Anasamutsidwa pachimake cystitis mosavuta amapita mu mawonekedwe aakulu. Kuonjezerapo, monga momwe zimakhalira ndi bacteriuria, ndi cystitis, n'zotheka kukwera matenda ku impso ndikupanga pyelonephritis.
Pachimake pyelonephritis
Mu matenda opatsirana opatsirana opatsirana opatsirana pogonana, mitsempha yambiri ya impso ndi mbale-ndi-pelvic system ikukhudzidwa. Kulimbana kwakukulu kwambiri kwa mimba (nthawi imeneyi matendawa amatchedwa gestational pyelonephritis). Ikhoza kupita patsogolo kuti urosepsis ikule bwino ndi kubereka msanga.
Amapezeka mwa amayi oyembekezera opitirira 12% (nthawi zambiri m'mimba yoyamba). Pachifukwa ichi, pali vuto lalikulu pa nthawi ya mimba komanso mwachindunji pa mwana - nthawi zambiri limodzi ndi gestosis, imayambitsa mimba yokhazikika, kukula kwa ubongo wodwala, kuperewera kwapadera kwapadera.
Zimayambitsa ndi tizilombo toyambitsa matenda
Cholinga chokhazikitsa chitukuko cha amayi omwe ali ndi pakati chimatengedwa ndi magulu awiri a zinthu - anatomical ndi hormonal. Kuyambira ndi sabata lachisanu ndi chiwiri, thupi limapangidwanso - kukulitsa kwa calyx ndi miyendo yambiri. Choncho, thupi limayesayesa kuwonjezeka kwa madzi ozungulira. Mkokomo wa ureter ukhoza kufika 200 ml, zomwe zimapangitsa kuswa kwa mkodzo wotuluka, kusungidwa kwake mu ureter, i.es. mkhalidwe wabwino kuti apange bacteriuria.
Chiberekero chimakula pang'onopang'ono, kusintha malo a chikhodzodzo chifukwa cha kusintha kwake ndi kufinya. Mayi amodzi omwe amapezeka m'mimba mwa mimba amatha kukhala pafupi kwambiri ndi mimba, komanso gluco-zuria (shuga mu mkodzo). Maseŵera apamwamba a estrogen amachititsa kuchepa kwa chiwonongeko cha mchere, chomwe chingapangitse kuphwanya kukomoka kwa mkodzo.
Zonsezi zimasintha panthawi ya mimba zingayambe pa nthawi ya masabata asanu ndi atatu ndikufika pachimake pa masabata 18-20, kusunga zizindikiro zake kwa milungu itatu pambuyo pobereka. Pakutha kwa theka lachiwiri la mimba, kupweteka kwa mkodzo kungabwere chifukwa cha kupanikizika kwa odwala ndi chiberekero chabwino. Kuchepetsa ureter kungathenso kutulutsa mitsempha yowonongeka, yotalika komanso yaifupi yomwe imatuluka. Izi zikufotokozera zochitika zazikulu za pyelonephritis.
Otsogolera odwala omwe ali ndi pakati komanso omwe sali ochepa ndi E. coli (80-90%), koma pakhoza kukhala mabakiteriya ena a Gram monga Proteus ndi Klebsiella. Mabakiteriya othandizidwa ndi gram ndi ochepa kwambiri. Amayi pa nthawi yomwe ali ndi mimba, kupweteka kwa impso kungayambitsidwe ndi bowa la Candida. Chinthu chofunika kwambiri pakupezeka kwa pyelonephritis amathandizidwenso ndi mycoplasma, ureaplasma, trichomonads, ndipo magulu 20 odwala tizilombo toyambitsa matenda amapezeka.
Matenda otchedwa Escherichia coli amachititsa kuti matenda a scalosis asokonezeke, chifuwa cha impso ndi minofu yambiri imakhudzidwa. Matenda omwe amabwera chifukwa cha prostate amadziwika ndi kubwereza mwala, ndi mapangidwe a maselo oyera mumtsinje chifukwa cha kuwonongedwa ndi michere ya tizilombo toyambitsa matenda. Maphunziro a pyelonephritis omwe amachititsa chidwi kwambiri ndi zomera zowonongeka, zimakhala zovuta kwambiri, ndipo zimadabwitsa mabakiteriya komanso septicemia.
Kodi pyelonephritis imawonetseredwa bwanji?
Njira yachipatala ya matendawa imakhudzidwa mwachindunji ndi njira ya matenda. Ngati iyi ndi njira yamtendere (ndi kutuluka kwa magazi), zizindikiro zowopsa za matendawa zimapita. Ngati iyi ndi njira ya urogenital (kupyolera mu mkodzo), ndiye kuti zizindikiro zam'deralo zidzachitika. Kuwonetseredwa kwa pirmonephritis yapamwamba kumachitika masiku angapo pambuyo pa kuwonjezereka kwa matendaillitis aakulu kapena kudziwika kwa matenda enaake (furunculosis, mastitis, etc.). Ndicho chifukwa chake matendawa sangathe kupezeka pomwepo. Pali kuwonjezereka kwadzidzidzi kwa kutentha, kuzizira, kumatsatiridwa ndi kutukumula kwambiri, kupweteka mutu, kupweteka kwakukulu kumbuyo kumbuyo, nthawi zambiri kumanja. Zochitika zambiri zimakhala ndi zizindikiro zitatu: ziwombankhanga, zodabwitsa za dysuric, ululu mu dera la lumbar. Ululu umayamba kuwonjezeka, ndipo kutuluka kwatsopano kumatentha, tikhoza kukambirana za maonekedwe atsopano a impso. Kusokonezeka ndi kunyozetsa, kusanza, mabala padziko lonse. Atafotokoza tachycardia, dyspnea. Ndi kuchepa kwa kuthamanga kwa magazi, mantha omwe amabakiteriya amatha.
Chithandizo cha acelonephritis yovuta
Nthawi zonse zimakhala zovuta, nthawi yaitali (masabata 4-8), payekha. Pofotokoza za mankhwala omwe akuyenera kugwiritsira ntchito mankhwalawa ayenera kulingalira nthawi yomwe ali ndi mimba, kuuma kwa nthawi ndi nthawi, matenda a chiwindi ndi chiwindi, kusakanikirana kwa mankhwala osokoneza bongo komanso kusintha kwa mkaka. Pakatikatikati ya matendawa, kupuma kwa bedi kumakhala masiku osachepera 4-6. Pamene malungo atha, ntchito yogwiritsa ntchito regimen imalimbikitsidwa kuti lipititse patsogolo mkodzo.
Kugwiritsidwa ntchito kwa mankhwalawa: 2-3 pa tsiku, malo a knee kwa mphindi 4-5; Gonani kokha kumbali, kumbali ina ya impso za matenda. Sitikufunika kudya chakudya chapadera ndi kuchepetsa mchere. Ngati palibe edema, imwani zambiri, mpaka 2 malita patsiku. Msuzi wa jerryberry, tiyi ya tiyi, infusions ya parsley, horsetail, cowberry - chomera diuretics ndi antiseptics. Pali mankhwala osakaniza okonzedwa bwino (makamaka kanefron), omwe amachititsa kuti anthu asokonezeke kwambiri pochita chithandizo cha pyelonephritis ndi matenda ena omwe amapezeka m'mitsempha.
Posachedwapa, kukonza mchere wa kampani ya Germany "Bionorica AG" wakhala ikugwiritsidwa ntchito mwakhama, yokhala ndi zovuta zambiri. Zina mwazo - antiseptic, anti-inflammatory, spasmolytic, antibacterial, diuretic. Kanefron amagwiritsidwa ntchito pochizira pyelonephritis yokhala ndi mimba popangika mimba. Mothandizidwa, kuwonjezereka kwa pyelonephritis yosatha, chithandizo cha urolithiasis, kupewa zovuta za mimba, zomwe zimaphatikizapo kuphwanya chikhalidwe cha impso. Kanefron ndi yoyenera panthawi ya mankhwala oletsa antibiotic pamene akuchiza matenda opinga mankhwala a katemera komanso kuti agwiritse ntchito mankhwalawa kwa nthawi yayitali. Panalibe zotsatirapo za mankhwala.
Zotsatira za matenda opititsidwa
Pakati pa mimba ndi njira yoperekera yokha, amayi omwe amavutika ndi pyelonephritis ali ndi makhalidwe ena. 6% mwa amayi omwe ali ndi pyelonephritis osatha amatha kuchepa, 25% ali ndi chiopsezo chobadwa msanga, 44-80% ali ndi toxicosis mochedwa kwa amayi apakati. Mimba ndi chitukuko cha fetus zimadalira kukula kwakukulu kwa matenda osokoneza ubongo, kuopsa kwa njira ya matenda.
Ana obadwa nthawi zambiri amakhala ndi zizindikiro zambiri za matenda omwe amapezeka mu utero. Choncho matenda a impso mwa amayi ndiwo amachititsa kuti impso ikule bwino mwanayo (minofu yambiri yachangu, urinary system dysembryogenesis). Fetal fetal fetus, hypotrophy, nthawi zambiri amakumana, ndipo kuyang'anira mosamala kwa mwanayo ndi kofunika.
Pambuyo pa nthawi yobereka, azimayi 22-33% omwe amakhala ndi pyelonephritis amatha kuyamba matenda oopsa. Pa tsiku la 4, la 12 ndi 14 pambuyo pa kubadwa, pyelonephritis ikhoza kukhala yoipitsitsa. Pa 20% ya mavoti atabereka, ntchito yamphongo ikhoza kuchepetsedwa.
Zokhudza matenda okhudzana ndi kupewa ndi kuyamwitsa mukakhala ndi pakati
1. Kukonzekera mimba. Kusamala, mosamala kwambiri, makamaka ngati m'mbuyomo mayi adakhala ndi matenda opatsirana. Dokotala angakuuzeni zomwe mukuyenera kuyesa kuti mupite kwa onse awiri musanakwatire mwana.
2. Mafano oyambirira a foci zonse za matenda m'thupi.
3. Mayi wodwala ayenera kulembetsa pa chipatala cha amayi mwamsanga ndipo nthawi yonse ya mimba azitsatira ndondomeko zonse za dokotala wake, kuyesa nthawi ndi kuyesa zina. Kutetezedwa ku chimfine!