Kab mob vaginosis: cov tsos mob, kev kuaj mob, kev kho mob

Kab mob vaginosis - pathology ntawm qhov chaw mos ecosystem, provoked los ntawm txoj kev loj hlob ntawm cov kab mob hauv anaerobic (mycoplasmas, peptococci, gardnerell). Cov txheej txheem inflammatory tsis tuaj. Tus mob vaginosis yog thaum lub caij nyoog thiab ntau paug, uas muaj kab mob pathogenic (trichomonads, gonococci) tsis kuaj. Kev loj hlob loj (kev loj hlob) ntawm cov khoom sib xyaws sib xyaws yog txuam nrog qhov tsis tau zoo ntawm cov lactobacilli prevailing hauv qhov chaw mos ntawm microflora, ua qhov haujlwm ntawm qhov tiv thaiv tiv thaiv tawm tsam kev nkag mus ntawm cov kab tawm ntawm sab nraud. Qhov no tsim ib qho av hauv av rau txoj kev loj hlob thiab kev mob ntawm cov mob pelvic inflammatory kab mob.

Kab mob vaginosis: ua rau

Cov kab mob qog thawj tus kab mob yog hom kab mob hauv tsev (Mycoplasma hominis, Mobiluncus spp, Gardnerella vaginalis). Nrog cov kab mob vaginosis, lawv cov concentration nce los ntawm ntau qhov kev txiav txim siab ntawm qhov siab, uas cov pejxeem ntawm cov lactobacilli tsawg zuj zus, qhov lactic acid thiab acidity ntawm qhov chaw mos qhov zuj zus. Tus kab mob vaginosis yog ib hom kab mob plawv (multifactorial syndrome) uas ua rau lub luag hauj lwm tseem ceeb rau cov teeb meem ntawm qhov chaw mos ntawm microflora uas tshwm sim los ntawm kev cuam tshuam ntawm cov yam ntxwv ntawm cov kab mob thiab exogenous yam:

• endocrine mob hlwb, unsystematic antibacterial therapy;
• kev hloov hauv lub xeev ntawm kev tiv thaiv;
• Cov kab mob sib kis / kis kab mob ntawm cov poj niam lub cev hauv plab hnyuv siab raum ntawm cov keeb kwm tuaj yeem inflammatory;
• niaj zaus raug rau cov neeg tawg taus ionizing;
• kev siv cov tshuaj tiv thaiv kab mob (phevicide, intrauterine, qhov ncauj);
• nquag douching;
• kuaj xyuas kev mob / phais mob;
• dysbacteriosis ntawm txoj hnyuv, tshuaj fab tshuaj.

Kab mob vaginosis kis tau zoo li cas

Tus kab mob vaginosis feem ntau yog los ntawm cov kab mob sib kis los ntawm kev sib deev. Ob qhov tseeb paub tseeb qhov tseeb. Thawj yog qhov feem pua ​​ntawm cov neeg mob uas kho tsis tau cov poj niam uas kho tsis tau kho. Qhov thib ob - kaw cov mob ntawm cov kab mob ntawm cov poj niam muaj kev noj qab haus huv tom qab coitus nrog cov txiv neej, cov kev soj ntsuam uas qhia tau tias muaj cov kab mob hauv anaerobic.

Kab mob vaginosis hauv cov txiv neej

Nyob rau hauv cov txiv neej, tus kab mob yog kuaj ntau zaus tsawg tshaj li ntawm cov poj niam. Feem ntau cov kab mob hom mob siab feem ntau yog raug rho tawm hauv kev koom nrog ntau hom kab mob bacteroides. Cov txheej txheem inflammatory muaj feem xyuam rau cov hlab ntaws ntawm sab hauv, cov duab ntawm cov txiv neej tus kab mob vaginosis yog lubricated, tsis muaj cov tsos mob nyhav, thiab qee zaum scant serous-mucous discharge yog sau tseg. Raws li, kev tsim kho ntawm cov teeb meem (pyelonephritis, epididymitis, cystitis, gardnerelleous prostatitis) yog tau, tab sis nyob rau hauv kev xyaum lawv yog cov tsis tshua muaj heev (1-2%). Txiv neej mob siab ntawm asymptomatic / asymptomatic cov kab mob ntawm tus kab mob no yog qhov chaw ntawm tus kab mob rau cov poj niam.

Cov tsos mob ntawm tus kab mob vaginosis hauv cov poj niam

Kev ntsuam xyuas kab mob ntawm cov kab mob vaginosis tsis muaj tus cwj pwm txawv, qhov tsuas pom muaj cov tsos mob yog qhov muaj ntau ntawm qhov chaw mos, uas muaj ib qho tsis hnov ​​ntxhiab tsw ntawm cov ntseg ntses. Ntawm theem pib lawv yog grayish los yog dawb, nrog rau cov txheej txheem kev xaiv zoo lawv tau hawj daj-ntsuab thiab ua dua ntom. Cov kev tshwm sim ntawm o (hyperemia, puffiness) tsis tuaj yeem, thaum kuaj gynecological qhia pathologies ntawm lub ncauj tsev menyuam - lub tsev me nyuam, mob ntsws, tsim muaj kab mob. 50% ntawm cov neeg mob muaj kev txhawj xeeb txog khaus rau thaj tsam ntawm lwm qhov chaw mos, mob hauv perineum, tso zis muaj mob, ua kev coj ua poj niam.

Cov kab mob ntawm cov kab mob bacterial vaginosis

1. Compensated. Cov cwj pwm los ntawm kev tsis tuaj ntawm lactobacillary microflora nyob rau hauv "lub cev" epithelial hlwb nyob rau hauv cov khoom nyob rau hauv kev tshawb nrhiav. Tus mob tsis hais txog kev mob ntsws, tab sis nws qhia tau hais tias cov kab mob ntawm tus kab mob voos yog ib qho niche nchuav nrog cov kab mob vaginosis tom qab ntawd.
2. Subcompensated. Nws yog ib qhov kev txo qis qis hauv lactobacilli, cov tsos mob ntawm cov hlwb tseem ceeb tiv thaiv tus keeb kwm yav dhau ntawm cov tsos mob me me.
3. Decompensated. Clinically expressed kab mob bacterial vaginosis: muaj tshwm sim ntawm tus kab mob thiab cov kab mob bacterial flora uas sawv cev los ntawm anaerobes, tsis muaj lactobacilli.

Diagnostic ntsuas

Qhov muaj txiaj ntsig zoo tshaj plaws hauv kev kuaj kab mob bacterial vaginosis yog muab rau kev ntsuam xyuas ntawm txoj kev tshawb no - aminotest nrog ib qho kua tshuaj potassium hydroxide (10%) thiab pH-metry. Thaum lysing lub glycogen ntawm lub paum epithelium thaum lub caij cov kab mob metabolism hauv lactobacillus, lactic acid yog tsim. Yog hais tias qhov mechanism ua txhaum, lactobacillus tuag tshwm sim thiab cov pH ntog rau hauv alkaline cov tshuaj tiv thaiv vector, uas ua rau ib qho kev nce siab hauv kev nyuaj. Ib qho kev kuaj amine zoo yog qhov txawv ntawm qhov tsis hnov ​​tsw "lwj" thaum lub sij hawm sib tov ntawm ib qho kua tshuaj potassium hydroxide thiab ib qho chaw sib cais.

Cov tsos mob ntawm chaw kho mob thiab cov tshuaj microbiological, raws li kev kuaj mob ntawm cov kab mob bacterial vaginosis:

• ntau homogeneous qhov paug mos nrog ib tus tsis kaj siab;
• kuaj zoo amine;
• nce hauv pH ntawm qhov chaw mos ntawm qhov chaw mos yog siab dua 4.5;
• Lub xub ntiag ntawm ib lub koomhaum loj ntawm cov pojniam qhov chaw mos; "Cov Ntsiab Tseem Ceeb" (Homerobes);
• ua tiav / tseem ceeb hauv lactobacilli;
• tsawg zaus / tsis tuaj ntawm cov leukocytes hnyuv;
• muaj tus nqi loj ntawm Fusobacterium spp, Bacteroides spp, Gardnerella vaginalis.

Kab mob vaginosis, kev kho mob

Kev khomob zoo ntawm BV nyob ntawm lub sijhawm thiab kev kuaj mob, tsim nyog thiab qhov kev kho mob tsis tsim nyog, lub hom phiaj ntawm qhov twg yog los tsim kho qhov qub chaw mos qhov microflora, kom tsis txhob tu tub tu kiv ntawm cov kab mob uas tsis peculiar rau microcenosis. Txog hnub, txoj kev kho mob ntawm BV tseem yog ib txoj haujlwm tseem ceeb, uas yog tshwm sim los ntawm kev siv tshuaj thiab tsawg heev ntawm tus kab mob.

Ua ob-theem kab mob thiab kev kho etiotropic

1. Ntaus cov kab mob ntawm cov kab mob vaginosis

   Tshuaj ntawm xaiv - noj tshuaj tiv thaiv kev mob ntawm lub plab me me microflora. Lawv cov kev ua haujlwm raug mob hnyav 87-95%. Nyob rau hauv parallel, systemic prophylaxis ntawm qhov chaw mos candidiasis yog ua. Qhov zoo tshaj plaws nyob rau hauv kev kho mob ntawm BV yog Metronidazole (Trichopol, Metrogil), uas yog ib feem ntawm cov tshuaj tua kab mob uas muaj lub nplhaib imidazole. Nws penetrates rau hauv microbial cell, binds rau DNA, nplov cov nucleic acid compound. Metronidazol shiroko yog siv ntau hom kev kho mob, tab sis feem ntau ua rau tib neeg muaj kev tsis sib haum - kev tsis haum txav, kev ua xua, kev sib xyaw hauv lub qhov ncauj. Txoj kev nyiam tshaj plaws ntawm kev tswj hwm yog qhov chaw mos.

   Rau kev kho mob hauv zos, kws kho mob siv ntau Clindamycin. Cov tshuaj muaj tus kab mob tua kab mob muaj zog, tshem tawm cov protein synthesis hauv microbial cell. Nws yog tau los qhia txog qhov ncauj thiab qhov ncauj ntawm Clindamycin. Sab nyhuv: qhov kev loj hlob ntawm cov poov xab zoo li cov hu ua fungi, kev fab tshuaj.

2. Restoration ntawm qhov chaw mos biocenosis

   Nws yog nqa tawm vim lub zos daim ntawv thov ntawm eubiotics - Bifidumbacterin, Acilacta, Lactobacterin. Cov tshuaj no ua rau mob plawv lactoflora loj hlob tuaj, ua rau txo cov kab mob ntawm cov kab mob bacterial vaginosis los ntawm kev ua kom zoo dua ntawm qhov chaw mos.

Cov hau kev rau kev ua tau zoo ntawm txoj kev kho mob:

• dynamics ntawm cov kev mob tshwm sim ntawm tus kab mob;
• disappearance ntawm subjective ncus;
• stabilization ntawm kev ntsuas.

Qhov kev khomob zoo yog kwv yees li ntawm 10-14 hnub tomqab kawm tas hoob no. Nws raug nquahu kom siv cov txheej txheem tiv thaiv kev tiv thaiv txhua lub sij hawm kho mob.

Npaj rau cov kev kho mob ntawm cov kab mob bacterial vaginosis:

• Lactagel (gel). Qee lub cev pH ntawm lub paum, restores lub ntuj microflora, tsim kom zoo rau cov kev loj hlob ntawm kev noj qab haus huv microflora. Pab tshem tawm cov kua qaub tshaj tawm, tsis kaj siab, tsis xis nyob;
• Femilex (thaj chaw mos). Raws li qhov kev nqis tes ua, Femilex zoo ib yam li Lactagel. Hauv 5-10% ntawm tus neeg mob, nws tuaj yeem ua rau khaus khaus qhov chaw mos. Contraindications: nrau, cev xeeb tub, lactation;

• Kev mob vaginorm-G (qhov paum ntsiav tshuaj). Txo cov pH ntawm qhov chaw mos, inhibits qhov kev loj hlob ntawm cov kab mob teeb meem, rov ua dua qub qhov chaw mos. Nws yog zoo tolerated, nyob rau hauv exceptional mob nws muaj peev xwm provoke khaus / hlawv nyob rau hauv lub paum, nce qhov siv ntawm mucous secretions. Contraindicated nrog keeb kwm ntawm thrush;
• Acylact (thaj chaw mos). Muaj cov kab mob nyob hauv lactobacilli, uas tawm hauv cov kab mob hauv lub cev, pab kho kom rov qab tiv thaiv kab mob. Nws yog txwv tsis pub siv rau kev sib zog;
• Clindamycin (chaw mos). Cov tshuaj tiv thaiv kab mob rau kev siv tshuaj pleev. Ceev nrooj txav cov kab mob phem, ua rau lub cev tsis muaj zog. Kev mob tshwm sim: mob taub hau, kiv taub hau, mob plab, mob plab, mob plab;
• Bifidumbacterin (thaj chaw mos). Hloov cov equilibrium ntawm lub microflora ntawm lub paum, tua cov kab mob hauv cov kab mob;
• Trichopolum (paum ntsiav tshuaj). Nws pab txhim kho rau txoj kev mob hnyav, txo cov kua qaub, tshem tawm cov ntxhiab tsw, rov ua rau lub cev ntawm qhov chaw mos. Contraindications: cev xeeb tub, daim siab tsis ua haujlwm. Lwm cov nyhuv: nquag tso zis, xeev siab, qhov ncauj qhuav, candidiasis (thrush).

Tus kab mob vaginosis yuav kho tus neeg li cas?

Ua ntej pib ntawm txoj kev kho mob, nws raug pom zoo los mus sab laj nrog ib tus kws kho mob kom tsis txhob muaj teeb meem thiab cov kev mob tshwm sim. Nrog txoj kev mus kom ze, kev siv cov zaub mov hauv pej xeem pab tshem tawm cov tsos mob tsis zoo thiab rov qab muaj kev noj qab haus huv qhov chaw mos microflora.

1. Kev daws teeb meem rau koob txhaj tshuaj:

   • noj paj ntawm chamomile medicinal thiab Goose fuzz (ib tablespoon), ncuav ib liter ntawm boiling dej, insist 30-40 feeb, thov nyob rau hauv ib daim ntawv sov;
   • noj nyob rau hauv vaj huam sib luag ntawm lub hauv paus ntawm angelica, badana, chicory, dandelion, calendula tshuaj ntsuab, nplooj ntawm niam thiab yawg, thyme. Zom, sib tov, ntsuas ob dia ntawm kev sau, brew nrog ib tug liter ntawm boiling dej, hais kom 10-12 xuab moos, thov rau hauv ib daim ntawv sov;
   • Ib tug tablespoon ntawm daim tawv ntoo ntawm crushed ntawm ib lub pob zeb ua rau brew nrog 250 milliliters dej ntshiab, coj hauv dej da dej ntawm 10-15 feeb, hais kom 3-4 teev. Ua ntej syringing infusion, txias thiab lim;
   • noj ib tablespoon ntawm Cherry txiv hmab txiv ntoo, boil ntawm sim tua hluav taws rau 20-25 feeb, txias, ntws. Siv rau yaug qhov chaw mos.

2. Cov chav dej dai:

   • soak 250 gram ntawm Oak bark nyob rau hauv dej txias, tawm rau 2-3 teev, sib tov lub boil tov, ntxiv mus rau lub qub da dej npaj. Txoj kev kho cov txheej txheem tshem tawm kev mob, txhawb nqa qhov mob kho;
   • ua ke Walnut nplooj, oat straw, juniper berries, chamomile, Oak bark. Boil rau 30-40 feeb on tsawg cua sov, ntxiv broth mus rau lub npaj da dej. Cov tshuaj muaj antimicrobial, antiviral, antifungal kev txiav txim.

Kab mob vaginosis thaum cev xeeb tub

Kev ua txhaum ntawm qhov chaw mos ntawm microflora thaum cev xeeb tub yog qhov zoo tshaj plaws ntawm kev pheej hmoo ntawm kev mob intrauterine ntawm fetus thiab inflammatory complications hauv leej niam. Nws muaj kev sib raug zoo ntawm qhov kab mob ntawm cov kab mob vaginosis thiab qhov nyuaj ntawm kev xeeb tub. Kab mob vaginosis tuaj yeem ua rau mob qis qis qis, yug ntxov, tsis tuaj yeem tawm ntawm amniotic kua, endometritis, chorioamnionitis (kab mob ntawm cov tsiaj). Cev xeeb tub tiv thaiv cov keeb kwm ntawm microbial pathology yog feem ntau nyuab los ntawm kev txawv txav ntawm fetal txoj kev loj hlob - ncua kev tawm hauv kev loj hlob, tsis ua rau cov hlab plawv, hypoxia.

Txoj kev kho kab mob bacterial vaginosis hauv cov poj niam cev xeeb tub

Lub ntsiab ntawm kev kho mob - kev siv cov kab mob los sis cov tshuaj hauv zos uas muaj cov kab mob antianaerobic:

• Clindamycin. Muab ib hom kev siv tshuaj rau cov yeeb tshuaj: Cov tshuaj nplaum nplaum ib zaug ib hnub rau 6 hnub, cov poj niam ntsiav tshuaj 100 mg intravaginally ib zaug ib hnub rau 3 hnub;
• Hexicon. Nws siv nyob rau hauv daim ntawv ntawm tswm ciab, rov qab muaj kev noj qab haus huv microflora ntawm lub paum, tiv thaiv kev mob ntawm kev kis mob thiab kev mob rau lub sijhawm tom qab lub sijhawm tom qab;
• Metronidazole. Tsis txhob xaiv thawj zaug ntawm lub cev xeeb tub uas muaj qhov tsis zoo rau ntawm tus me nyuam hauv plab, qhov kev kho mob Metronidazole yog yug tom qab lub lim tiam thib ob. Thaum cev xeeb tub, nws yog ib qho tsim nyog siv cov tshuaj raws li cov tswm ciab. Txoj kev kho qhov chaw mos ntawm kev kho nrog BV tsis yog mob tshaj qhov ncauj ntawm qhov ncauj, thiab qee lub caij txawm hla dhau nws. Nrog rau cov ntaub ntawv tshuaj pleev, cov khoom nquag nkag ncaj qha mus rau hauv pawg ntawm cov kab mob ntawm cov kab mob - qhov no tshem tawm cov kab mob kev noj qab haus huv cov kev noj qab haus huv cov ntaub so ntswg, txo cov kev phom sij;
• Limafucine. Nws yog tsiag ntawv los ntawm lub hwj chim hauv zos, yog tiv thaiv kev mob hauv anaerobic microflora, tsis tuaj yeem cuam tshuam rau tus me nyuam hauv plab.

Kuv tuaj yeem cev xeeb tub puas muaj kab mob bacterial vaginosis? Koj tuaj yeem, qhov kuaj pom tus kabmob no tsis suav nrog. Tab sis nws tsis tsim nyog rau koj txoj kev noj qab nyob zoo thiab kev noj qab haus huv ntawm tus me nyuam lub neej yav tom ntej. Nrog rau qhov teeb meem BV, 10-35% ntawm cov poj niam tseem nyob theem ntawm kev xeeb tub. Hmoov tsis, qhov qhov muag plooj tswm sim ua rau qhov tseeb hais tias pathology yog tshwm sim los ntawm kev sib tsoo. Tus kab mob vaginosis yuav tsum tau muab tshem tawm ua ntej cev xeeb tub - qhov no yuav pab kom tsis txhob muaj teeb meem loj thaum muaj me nyuam thiab me nyuam yug los.

Kev tiv thaiv ntawm kev rov muaj dua thiab tshwm sim ntawm kab mob bacterial vaginosis:

• noj qab haus huv, ua haujlwm kom zoo ntawm txoj hnyuv;
• qhov kom txais tau cov tshuaj tua kab mob;
• kev tu cev kom zoo rau lwm qhov hauv nruab nrog cev;
• siv kev tiv thaiv kev tiv thaiv thaum muaj kev sib daj sib deev nrog tus neeg uas tsis tau tso cai.

Tus kab mob vaginosis yog ib hom kab mob ntawm cov kab mob hauv chaw mos, uas yuav tsum tau kho kom zoo thiab tsim nyog. Kev tsis kho ntawm cov kev kho mob raws sij hawm yuav pab rau txoj kev chronis, qhov tshwm sim ntawm cov kab mob ntawm qhov kev ua me nyuam, kev tsim teeb meem thaum cev xeeb tub thiab kev yug menyuam. Cov kws kho mob (Gynecologists) pom zoo yog tias muaj tej yam tsis paub tseeb (qhov txawv txav txawv, khaus / hlawv, mob hauv plab hauv plab yog), kuaj xyuas tag thiab, yog tias tsim nyog, txoj kev kho mob uas siv 12-14 hnub.