Bacterial vaginosis - pathology ea tikoloho ea botšehali, e bakoang ke kholo ea mafolofolo ea baktheria ea anaerobic (mycoplasmas, peptococci, gardnerell). Mokhoa oa ho ruruha ha o eo. Vaginosis e khetholloa ka phekolo e telele le e ngata, moo likokoana-hloko tse nyenyane (trichomonads, gonococci) li sa fumanoeng. Ho ata ha limela tse ngata tse amanang le limela ho amahanngoa le ho lahleheloa ke lactobacilli e tloaelehileng e hlahisang likokoana-hloko tsa botšehali, ho etsa mosebetsi oa thibelo e sireletsang ho kenella ho kenngoa ha likokoana-hloko ho tsoa ka ntle. Sena se etsa mobu o nonneng bakeng sa nts'etsopele le nts'etsopele ea maloetse a sa foleng a pelvic a fokolang.
Bacterial vaginosis: lisosa
Likokoana-hloko tse ka sehloohong tsa lefu lena ke libaktheria tsa anaerobic (Mycoplasma hominis, Mobiluncus spp, Gardnerella vaginalis). Ka baktheria vaginosis, mahloriso a bona a phahama ka litaelo tse 'maloa, tseo baahi ba lactobacilli ba fokolang ho tsona, palo ea lactic acid le acidity ea botšehaling e fokotseha. Bacterial vaginosis ke lefu la maiketsetso leo ho lona karolo e ka sehloohong e fuoang likhathatso tsa microflora tsa botšehali tse hlahang ka lebaka la tšusumetso ea lintho tse sa feleng le tse sa tloaelehang tsa lefu lena:
- mafu a endocrine, phekolo ea meriana ea antibacteria;
- liphetoho sebakeng sa ho itšireletsa;
- Matšoao a khotsofatsang / a fetisitsoeng a litho tsa botona kapa botšehali tsa botona kapa botšehali ba tšoaetso;
- ho pepeseha kamehla mahlaseli a ionang;
- ho sebelisa lithibela-pelehi (spermicide, intrauterine, molomo);
- tloaelo ea ho kopanya;
- mehato ea ho hlahloba / ho buoa;
- dysbacteriosis ea maleng, ho sebelisa lithethefatsi tse fokolang maikutlo.
Bacterial vaginosis e fetisoa joang
Hangata baktheria vaginosis e bitsoa mafu a tšoaetsanoang ka thobalano. Lintlha tse peli li tiisa taba ena. Ea pele ke karolo e phahameng ea ho khutlela morao ho basali ba phekotsing bao balekane ba bona ba thobalano ba sa kang ba tšoaroa. Maloetse a bobeli a tlaleho ea mafu a basali ba phetseng hantle ka mor'a hore ba be le banna, litlhahlobo tse bontšang boteng ba baktheria ea anaerobic.
Bacterial vaginosis ho banna
Ho banna, lefu lena le fumanoa hangata haholo ho feta basali. Hangata libaktheria tsa anaerobic li arohane ka mefuta e sa tšoaneng ea bacteroides. Mokhoa oa ho ruruha o ama sebete sa ka hare, setšoantšo sa kliniki sa banna se baktheria vaginosis se kentse, se se na matšoao a matla, 'me ka linako tse ling se senyenyane se hlahisang li-serous-mucous se tsejoa. Tlhahisoleseding, nts'etsopele ea mathata (pyelonephritis, epididymitis, cystitis, gardnerelleous prostatitis) e khoneha, empa ka mokhoa o tloaelehileng ba haella haholo (1-2%). Banna ba nang le mefuta ea asymptomatic / asymptomatic ea lefu lena ba ba mohloli oa tšoaetso ho basali.
Matšoao a baktheria vaginosis ho basali
Litlhahlobo tsa lik'hemik'hale tsa baktheria vaginosis ha li na likarolo tse itseng, letšoao feela le totobetseng ke boteng ba ho tsoa boteng ba botšehali, bo nang le monko o sa thabiseng oa tlhapi. Ha ba le boemong ba pele ba na le bohlooho bo botle kapa bo bosoeu, ka mokhoa o tsoelang pele oa ho khetha ba fumana lehlasehla le mosehla le ho feta. Lipontšo tsa ho ruruha (li-hyperemia, boikhohomoso) ha li eo, nakong ea tlhahlobo ea mafu a basali e senola mafu a sefuba a uteri- cervicitis , ho tsolloa ha mokokotlo, sebopeho sa lik'hemik'hale. Bakuli ba 50% ba amehile ka ho tsosoa sebakeng sa liphatsa tsa lefutso tsa ka ntle, bohloko ba perineum, mathata a ho tlohela, ho ea khoeling.
Li-degree tsa baktheria vaginosis
- E lefisoa. E tšoantšetsoa ke ho se be teng ha li-lactobacillary microflora ka lisele tse "tloaelehileng" tsa epithelial tse nkiloeng tlas'a lipatlisiso. Boemo ha bo bue ka likokoana-hloko, leha ho le joalo ho bontša hore ho na le monyetla oa hore libaktheria tsa anaerobic li hlahise sekhahla se se nang letho le sebopeho se hlahelang sa botšehali.
- E lefelloe. E khetholloa ke ho fokotseha ho matla ka lactobacilli, ponahalo ea lisele tse ka sehloohong khahlanong le semelo sa leukocytosis e bonolo.
- E nyelisoa. Tlhahisoleseding e hlalositsoe bacterial vaginosis: ho na le mehlala ea lefu lena le limela tsa baktheria tse emetsoeng ke anaerobes, ha ho na lactobacilli.
Mehato ea ho tseba
Ntho ea bohlokoa ka ho fetisisa ha ho fumanoa hore baktheria vaginosis e fuoa mekhoa ea ho hlahloba - e na le tharollo ea potassium hydroxide (10%) le pH-metry. Ha lysing ea glycogen ea vagin e epithelium nakong ea lactobacillus metabolism e hlahisa li-lactic acid, e thehoa. Haeba mochine ona o hatakeloa, lefu la lactobacillus le hlaha 'me pH e kheloha ka mokelikeli oa alkaline, e leng se lebisang hoketseho e boima ea anaerobes. Tlhahlobo e ntle ea amine ke ponahalo ea monko oa "litlhapi" tse bolileng nakong ea ho kopanya tharollo ea potassium hydroxide le botšehali bo arohaneng.
Lipontšo tsa meriana le tsa microbiological, motheong oa hore na lefu la bacterial vaginosis le etsoa joang:
- phekolo e kholo ea botšehali ea botšehali ka monko o sa thabiseng;
- tlhahlobo e ntle ea amine;
- ho eketseha ha pH ea ho thibela botšehali ho feta 4.5;
- Boteng ba sehlopha se seholo sa epitheliocyte tsa botšehali; "Lisele tsa bohlokoa" (anaerobes);
- ho se be teng ka ho feletseng / ho fokotseha ho matla ka lactobacilli;
- ho ba teng habonolo / ho ba sieo ha li-leukocyte tsa polynucleated;
- ho ba teng ka bongata ba Fusobacterium spp, Bacteroides spp, Gardnerella vaginalis.
Bacterial vaginosis, phekolo
Phekolo e atlehang ea BV e itšetlehile ka ho hlahlojoa ka nako e nepahetseng le e nepahetseng, kalafo e loketseng le e fokolang likokoana-hloko, morero oa eona ke ho tsosolosa likokoana-hloko tse tloaelehileng tsa botšehali, ho thibela ho hlahisa likokoana-hloko tse sa tloaelehang ho microcenosis. Ho fihlela joale, phekolo ea BV e ntse e le mosebetsi o rarahaneng, o bakoang ke ts'ebetso e tlase ea lithethefatsi le ho pheta-pheta ha lefu lena.
Meriana e metso e 'meli ea phekolo ea pathogenetic le etiotropic
Ho felisoa ha likokoana-hloko tsa baktheria vaginosis
Lithethefatsi tse khethollang - meriana khahlanong le likarolo tsa anaerobic tsa microflora tsa botšehali. Katleho ea bona ea kliniki e fihla ho 87-95%. Ka tsela e tšoanang, systemic prophylaxis ea vaginal candidiasis e etsoa. Sephetho se setle sa phekolo ea BV e ne e le Metronidazole (Trichopol, Metrogil), e leng karolo ea sehlopha sa lithibela-mafu tse nang le lesale la imidazole. E kenella ka seleng ea microbial, e tlamella DNA, e thibela karolo ea nucleic acid. Metronidazol shiroko e sebelisoa mefuteng e sa tšoaneng ea phekolo, empa hangata e baka maikutlo a mahlakoreng - ho se tloaelehe ha metsoako, ho kula, tatso ea tšepe molomong. Tsela e khethiloeng ea tsamaiso ke ea botonahali.
Bakeng sa phekolo ea lehae, hangata lingaka li sebelisa Clindamycin. Lithethefatsi li na le tšebetso e matla ea li-antibacteria, e fokolisang liprotheine ka har'a sele ea microbial. Hoa khoneha ho kenyelletsa tšebeliso ea molomo le molomo oa Clindamycin. Lehlakoreng le leng: ho hōla ha li-fungus joaloka tomoso, liphello tsa tlhaho.
Ho tsosolosoa ha biocenosis ea botšehali
E etsoa ka lebaka la kopo ea libaka tsa eubiotics - Bifidumbacterin, Acilacta, Lactobacterin. Lithethefatsi tsena li khothalletsa ho hōla ha li-lactoflora tsa tlhaho tsa botšehali, li tlatsetsa ho fokotsa palo ea ho pheta-pheta ha baktheria vaginosis ka ho eketsa litšobotsi tse sireletsang tsa botšehali.
Litlhahiso tsa katleho ea phekolo:
- matla a matšoao a meriana a lefu lena;
- ho fela ha subjective sensations;
- ho tsitsisa litsamaiso tsa laboratori.
Boleng ba phekolo bo hakanngoa matsatsi a 10-14 kamora ho phethoa ha thupelo. Ho khothalletsoa ho sebelisa mekhoa ea thibelo ea thibelo ea bokhachane nakong eohle ea phekolo.
Litokisetso tsa phekolo ea baktheria vaginosis:
- Lactagel (gel). E lekanya pH ea botšehali, e tsosolosa microflora ea tlhaho, e bōpa maemo a matle bakeng sa ho hōla ha microflora e phetseng hantle. E thusa ho tlosa liphiri tse ngata, monko o sa thabiseng, o sa phutholoha;
- Femilex (thibelo ea botona le botšehali). Ho latela mochine oa liketso, Femilex e tšoana le Lactagel. Ka 5-10% ea linyeoe, e ka tsosa matla a ho tsuba ka har'a botšehali. Litlhaloso tse sa lumellaneng: ho ruruha, bokhachane, lactation;
- Vaginorm-G (lipilisi tsa botšehali). E fokotsa pH ea botšehali, e sitisa kholo ea libaktheria tse kotsi, e hlasimolla limela tse tloaelehileng tsa botšehali. E mamelletsoe hantle, maemong a ikhethang e ka etsa hore ho tsosoa / ho chesoa ka botšehaling, ho eketsa matla a sekhukhu. Ho fapana le histori ea thrush;
- Acylact (li-vaginal suppositories). E na le lactobacilli e phelang, e hlahisang libaktheria tsa anaerobic, e thusang ho tsosolosa tlhaho ea tšoaetso ea tlhaho. Ho thibetsoe ho sebelisoa bakeng sa ho tsuba;
- Clindamycin (tranelate ea botšehali). Antibacterial agent bakeng sa tšebeliso ea litlhapi. Ka potlako e bolaea libaktheria tse kotsi, e tloaelehileng limela tse tloaelehileng tsa botšehali. Litla-morao: bohlooho, setulong, thrush, bohloko ba mpeng, mathata a ho senya lijo;
- Bifidumbacterin (thibelo ea botšehali). Ho tsosolosa ho lekanngoa ha microflora tsa botšehali, ho senya likokoana-hloko tsa anaerobic;
- Trichopolum (lipilisi tsa botšehali). E ntlafatsa maemo a tloaelehileng, e fokotsa boholo ba liphiri, e felisa monko o sa thabiseng, o tsosolosa limela tse tloaelehileng tsa botšehali. Litlhaloso tse ling: ho ima, ho se sebetse ha sebete. Lehlakoreng le leng: ho tsuba hangata, ho nyeheloa ke pelo, molomo o omileng, candidiasis (thrush).
Bacterial vaginosis e tšoara mekhoa ea batho joang?
Pele ho qala ts'ebetso ea phekolo, ho kgothaletswa ho botsa ngaka ho qoba mathata le litla-morao. Ka mokhoa o nang le bokhoni, tšebeliso ea mekhabiso ea batho e thusa ho tlosa matšoao a sa thabiseng le ho tsosolosa microflora e ntle ea botšehali.
Lisebelisoa tsa ho etsa li-syringing:
- nka lipalesa tsa chamomile meriana le li-fuzz (setpo e le 'ngoe), tšela litha e le nngwe tsa metsi a belang, tsitlella metsotso e 30-40, e sebetse ka foromo e mofuthu;
- nka karolo e lekanang le motso oa angelica, badana, chicory, dandelion, calendula setlama, makhasi a 'mè le bo-'mè ba lenyalong la bobeli, thyme. Ho kopanya, kopanya, lekanya lisepisi tse peli tsa tablespoon ea pokello, e noa ka litha e le nngwe tsa metsi a belang, tsitlella lihora tse 10-12, sebelisa ka mokhoa o mofuthu;
- Thapone ea makhapetla a koahetsoeng a oak ho kopanya le lilithara tse 250 tsa metsi a hloekileng, ho noa metsi a metsotso e 10-15, ho tsitlella lihora tse 3-4. Pele ho tšeloa ka letsoho, ho pholile le mathata;
- nka apopu ea litholoana tsa ciliegia, pheha ka mollo o itekanetseng bakeng sa metsotso e 20-25, pholile, e ts'oane. Sebelisa ho hlatsoetsa botšehali.
Letsoho le hlabang:
- soak likhase tse 250 tsa oak metsing a pholileng, tlohelang lihora tse 2-3, kopanya motsoako pheha, eketsa ho hlapela pele ho itokiselitse. Mokhoa oa phekolo o felisa ho ruruha, o khothalletsa pholiso ea maqeba;
- kopanya makhasi a linate, joang bo nang le mafura, monokotsoai oa junipere, chamomile, oak bark. Pheha metsotso e 30-40 mocheso o tlase, eketsa moro ho ea ho itlhatsoa. Lithethefatsi li na le likokoana-hloko tse thibelang likokoana-hloko, likokoana-hloko, liketso tse sa thekeseleng.
Bacterial vaginosis nakong ea bokhachane
Ho hlekefetsoa ha li-microflora tsa botšehali nakong ea bokhachane ke ntho e bontšang hore ho na le kotsi ea tšoaetso ea intrauterine ea mathata a lesea le ho ruruha ho 'mè. Ho na le kamano e tobileng pakeng tsa matla a bakteria vaginosis le tsela e rarahaneng ea bokhachane. Bacterial vaginosis e ka lebisa ho senyeheloa ha maikutlo ka nakoana, ho tsoaloa pele ho nako, ho tšolloa ho sa hlokahaleng ha amniotic fluid, endometritis, chorioamnionitis (tšoaetso ea lisele). Bokhachane khahlanong le semelo sa mafu a likokoana-hloko hangata ho rarahane ke ho se tloaelehe ha nts'etsopele ea botho - ho lieha ho ntlafatsoa ke intrauterine, ho hlōleha ha pelo ea methapo ea pelo, hypoxia.
Phekolo ea baktheria vaginosis ho basali ba bakhachane
Tsela e ka sehloohong ea phekolo - tšebeliso ea lithethefatsi tsa tsamaiso kapa tsa moo li nang le phello ea ho thibela lefu:
- Clindamycin. Fana ka e mong oa mefuta ea litekanyetso tsa lithethefatsi: tranelate Ka nako e le 'ngoe ka letsatsi matsatsi a 6, matlapa a botšehali a 100 mg ka nako e le' ngoe ka letsatsi matsatsi a mararo;
- Hexicon. E sebelisoa ka mefuta ea likerese, e tsosolosa microflora e phetseng hantle ea botšehali, e sitisa tsoelo-pele ea ts'ebetso e tšoaetsanoang le ea ho ruruha nakong ea postpartum;
- Metronidazole. U se ke ua beha khetho ea pele nakong ea bokhachane ka lebaka la phello e mpe ea lesea, empa tsela ea phekolo ea metronidazole e etsoa ka mor'a beke ea mashome a mabeli. Ha u le moimana, ho molemo ho sebelisa meriana ka mokhoa oa likerese. Tsela ea phekolo ea botšehali le BV ha e mpe ho feta phekolo ea molomo, 'me maemong a mang le ho feta ho feta. Ka ts'ebeliso ea lihlooho tsa tšebetso, ntho e sebetsang e kenella ka ho toba ho lihlopha tsa likokoana-hloko tsa lefu lena - sena se felisa phello ea tsamaiso ea lisele tse phetseng hantle, e fokotsa menyetla ea liphello tse mpe;
- Limafucine. E khetholloa ke ketso e matla ea sebakeng seo, e sebetsang khahlanong le microflora ea anaerobic, ha e ame hampe fetus.
Na nka ima le baktheria vaginosis? U ka khona, ho ba teng ha lefu lena ha ho kenyehe. Empa ha hoa lokela ho beha bophelo ba hao kotsing le bophelo ba bokamoso ba ngoana. Le bothata ba BV, basali ba 10 ho isa ho 35% ba ntse ba le sethaleng sa ho ima. Ka bomalimabe, matšoao a hlabang a lebisa tlhokomelong ea hore lefu lena le fumanoa ka tsietsi. Bacterial vaginosis e lokela ho felisoa pele ho ima - sena se tla thusa ho qoba mathata a tebileng nakong ea ho beleha le ho beleha.
Thibelo ea phetoho le ketsahalo ea baktheria vaginosis:
- phepo e nepahetseng, ho boloka tšebetso e tloaelehileng ea mala.
- ho noa ho nepahetseng ha lithethefatsi tsa antibacteria;
- tlhokomelo e nepahetseng ea bohloeki ho litho tsa thobalano tse ka ntle;
- ho sebelisa thibelo ea thibelo ea bokhachane nakong ea ho ikopanya le thobalano le molekane ea sa nyaloang.
Bacterial vaginosis ke mokhoa o tloaelehileng oa ho fokola ha tikoloho ea botšehali, e hlokang phekolo e feletseng le e lekaneng. Ho hloka phekolo e nakong ho tlatsetsa ts'ebetsong ea khatiso, ho hlaha ha maloetse a mokhoa oa ho ikatisa, tsoelo-pele ea mathata nakong ea bokhachane le pelehi. Litsebi tsa li-gynecologists li khothalletsa haeba lipontšo leha e le life tse belaetsang (ho tsoa ka tsela e sa tloaelehang, ho hlohlelletsa / ho chesa, bohloko ka mpeng e ka tlaase) ho hlaha, ho hlahlojoa ka botlalo, mme ha ho hlokahala, phekolo ea phekolo e nka matsatsi a 12-14.