CDC Malangizo ndi Njira Zina
Bacterial vaginosis (BV) ndi matenda opatsirana omwe amachititsa kuti chithokomiro, umaliseche, ndi "fungo" likhale labwino. Nthawi zambiri zimakhala zovuta ndipo zimatha kuchizidwa ndi mankhwala osokoneza bongo, omwe amatchulidwa pamlomo kapena ndi mavitamini kapena ma gels. Matenda a BV amadziwika kuti amatha kubwereza, kawirikawiri mkati mwa miyezi itatu kapena 12, akufuna njira zina zowonjezera kapena zina.
Chithandizo chingathenso kuperekedwa pa nthawi yomwe mimba ili kuchepetsa chiopsezo cha mavuto monga kuchepa kwa thupi lochepa komanso kusamalidwa msanga.
Zothetsera Pakhomo
Chinthu chimodzi chokhumudwitsa kwambiri chochiza bacterial vaginosis ndicho kuchuluka kwa kubwereza. Kafukufuku wina wasonyeza kuti mlingowo ukhoza kukhala wapamwamba kuposa 50 peresenti; ena amakhulupirira kuti ndi wamkulu kwambiri. Ndipo, izi zimabweretsa vuto kuti kugwiritsidwa ntchito mobwerezabwereza kwa maantibayotiki kungapangitse chiopsezo cha kusakaniza mankhwala.
Pofika pamapeto pake, mankhwala ambiri apanyumba akhala akuphunzitsidwa kwa amayi omwe ali ndi zizindikiro za BV zomwe zimachitika . Mmodzi mwa iwo ndi boric acid ndi hydrogen peroxide, zomwe zonsezi ndi zosagula komanso zimapezeka mosavuta ku sitolo ya mankhwala popanda mankhwala.
Nazi zomwe tikudziwa:
- Boric asiya agwiritsidwa ntchito pochiza matenda a yisiti ( vaginal candidiasis ) kwa zaka zoposa 100. Kuphunzira kwa 2015 kunayesa kugwiritsiridwa ntchito kwachikazi kwa amayi omwe ali ndi BV ndipo adapeza kuti, patatha masiku khumi, chiwerengero cha chiwopsezo cha matenda chinali chofanana ndi cha antibiotic.
- Hyrojeni peroxide, yomwe imatulutsidwa mu njira ya 3% yothetsera vutoli, idagwiritsidwanso ntchito kwa mibadwo kuti ikhale ndi BV. Komabe, kafufuzidwe mu 2011 kuchokera ku yunivesite ya John Hopkins inasonyeza kuti mankhwalawa sanathe kuthetsa mabakiteriya "oipa" omwe ali ndi kachirombo ka BV, kuwononga kufunika kwake kwa amayi omwe ali ndi zizindikiro zosavuta.
Ngakhale mankhwalawa akuwoneka kuti ndi otetezeka komanso osakwera mtengo, sayenera kugwiritsidwa ntchito popanda dokotala wodwalayo. Izi ndizowona makamaka kwa odwala oyamba, amayi oyembekezera, kapena omwe ali ndi zizindikiro za matenda aakulu (kuphatikizapo malungo, thupi, mavupa ndi / kapena kupweteka m'mimba, kapena kuvuta kovuta).
Malemba
Chithandizo cha antibiotic cha bacterial vaginosis chilimbikitsidwa kwa amayi onse omwe ali ndi zizindikiro. Kuchita zimenezi sikungothandiza kuthetsa kachilomboko, kumachepetsa mwayi wamayi wopeza matenda opatsirana pogonana monga gonorrhea , chlamydia , ndi trichomoniasis .
Mankhwala operekedwa
Pali mitundu itatu yokha ya ma antibayotiki yomwe imayamikiridwa ndi Centers for Disease Control and Prevention (CDC) yothandizira BV:
- Metronidazole: mamiligalamu 500 otengedwa pamlomo (pakamwa) kawiri tsiku lililonse kwa masiku asanu ndi awiri
- Metronidazole: 0,75 peresenti ya gel imagwiritsidwa ntchito kamodzi pa tsiku masiku asanu pogwiritsira ntchito 5.0-gram yosasinthika
- Clindamycin 2.0 peresenti ya kirimu: amagwiritsiridwa ntchito kamodzi pa nthawi yogona masiku asanu ndi awiri pogwiritsira ntchito 5.0-gram pulojekiti yoyenera
Njira Zochiritsira Zina
Mankhwala ena amawasungira mankhwala achiwiri ngati mankhwala akubwera kapena ngati munthu akudziwiratu mankhwala otsutsa mankhwala.
Njira zina zothandizira ndi izi:
- Clindamycin: ma milligrams 300 amatengedwa kamodzi kawiri tsiku ndi tsiku kwa masiku asanu ndi awiri
- Clindamycin: suppository 100-milligram amagwiritsidwa ntchito pa nthawi yogona masiku atatu
- Tinidazole: 2.0 gramu amatengedwa kamodzi tsiku ndi tsiku kwa masiku awiri
- Tinidazole: 1.0 magalamu omwe amatengedwa kamodzi tsiku ndi tsiku kwa masiku asanu
Kulemba Malangizo
Chilichonse chomwe chithandizo chimaperekedwa, muyenera kumaliza maphunziro ngakhale zizindikiro zanu zikuwonekera bwino. Kulephera kuchita zimenezi kungapangitse chiopsezo cha mankhwala osokoneza bongo.
Amalangizidwa kuti musamamwe mowa panthawi ya mankhwala komanso kwa maola 24. Kumwa kungayambitse zizindikiro zosokoneza mutu monga kupweteka mutu, kuthamanga, kuthamanga kwa mtima, kupuma pang'ono, kunyoza, kusanza, ndi kutaya.
Pofuna kuteteza mabakiteriya ndi tizilombo toyambitsa matenda, muyenera kupewa kugonana kapena kugwiritsa ntchito kondomu nthawi zonse. Ngakhale kuti BV sichidziwikanso kuti ndi matenda opatsirana pogonana, tizilombo toyambitsa matenda tingawonongeke pa mbolo yamwamuna, makamaka pansi pa khungu. Ngakhalenso mwamuna kapena mkazi mnzanu amakhala ndi chiopsezo chifukwa cha kugonana kwa khungu kapena kubereka.
Ngakhale zoopsa izi, nthawi zambiri chithandizo cha munthu wogonana sichifunika.
Zotsatira Zogwirizana
Ambiri ndi ofatsa. Mwa iwo:
- Mankhwala ammimba angayambitse m'mimba, kunyozetsa, zizindikiro zozizira (chifuwa, mphuno, pakhosi), ndi kukoma kwachitsulo m'kamwa.
- Mankhwala opangira maantibayotiki angayambitse kupweteka kwa m'mimba, kupwetekedwa mutu, kupwetekedwa mtima, zizindikiro zozizira, kumverera kwa manja ndi mapazi, ndi kukoma kwachitsulo m'kamwa.
Malingaliro a Mimba
Matenda a BV okhudzidwa panthawi yomwe ali ndi mimba akhoza kuonjezera chiopsezo cha kubereka, kubereka kochepa, kuperewera kwa msanga (PROM), ndipo kawirikawiri, kutuluka padera.
Mankhwala oletsa maantibayotiki amachitidwa kawirikawiri, mwina clindamycin 300 milligrams kapena metronidazole 500 milligrams atengedwa kawiri tsiku lililonse kwa masiku asanu ndi awiri. Ma antibayotiki, makamaka, amawoneka kuti sagwira bwino kwambiri popewera mavuto a mimba.
Ngakhale kuti kafukufuku ambiri amasonyeza kuti kugwiritsa ntchito mankhwala opatsirana ammimba kungachepetse chiopsezo cha PROM ndi kulemera kochepa, umboni ulibe kuthekera kwawo kuteteza kubereka kusanafike.
Kukana kwa Antibiotic
Kawirikawiri, chiopsezo cha antibiotic kukana mu bacterial vaginosis sichikhala pafupi monga momwe munthu angayembekezere. Izi zimadalira mtundu wa mabakiteriya omwe amapezeka mu BV (omwe ali anaerobic ndipo safuna mpweya) poyerekeza ndi omwe amapezeka mu mitundu ina ya vaginitis (yomwe ndi aerobic ndipo imafuna oxygen).
Mabakiteriya a aerobic amapezeka kunja kwa thupi ndipo amafalitsidwa mosavuta kwa munthu aliyense. Izi zimaphatikizapo mitundu yotchuka monga Staphylococcus aureus, Streptococcus, ndi Escherichia coli ( E. coli ). Kugwiritsidwa ntchito kwa mankhwala opha tizilombo kuti athetse matendawa kwachititsa kuti chiwerengero cha anthu asamayende bwino.
Ngakhale izi sizikhala zochepa kwambiri ndi mabakiteriya omwe akuphatikizidwa ku BV, nthawi zina kumatsutsa. Izi zimadalira mtundu wa mabakiteriya "oipa" omwe angakhale nawo pa matenda a BV. Mwachitsanzo:
- Matenda a Metronidazole amakhulupirira kuti amamanga pogwiritsa ntchito mtundu wa mabakiteriya omwe amadziwika kuti Atopobium. Zomwezo siziwoneka mofanana ndi clindamycin.
- Mosiyana ndi zimenezi, matenda a clindamycin akhala akudandaula kwambiri ndi mavitamini a Prevotella . Zomwezo sizinawonedwe ndi metronidazole.
- Palinso nkhani za metronidazole kukana ndi mabakiteriya ena omwe amadziwika monga Gardnerella vaginalis.
Koma, mu chiwembu chachikulu, chiopsezochi chimaonedwa kuti n'chochepa ndipo phindu la chithandizo limaposa zotsatira zake.
Pachifukwa ichi, mankhwala oletsa maantibayotiki sayenera kupezeka chifukwa cha mwayi waukulu wosatsutsika. Pamapeto pake, kukana kungapeĊµe mwa kumwa mankhwala anu mwathunthu ndi momwe mwakhalira. Komanso, ngati zizindikiro zimabwereranso, musamanyalanyaze koma muwachitire mankhwala mosakhalitsa.
Mankhwala Osakaniza Owonjezera (CAM)
Mabakiteriya vaginosis amayamba pamene zomera zabwino zowona, zomwe zimatchedwa lactobacilli, zatha, zomwe zimapangitsa kuti mabakiteriya "oipa" aziwopsa kwambiri. Choncho, tawonedwa kuti ma probiotics , omwe ali ndi mabakiteriya abwino monga Lactobacillus acidophilus , angakhale othandizira kubwezeretsa zomera zakuthambo. Ndipo, pali umboni wina wotsimikizira izi.
Kuyambira mu 2014, kafukufuku wa maphunziro a zachipatala amatsimikizira kuti kugwiritsa ntchito tsiku ndi tsiku mankhwala opatsirana pogwiritsa ntchito mankhwala owonjezera, kapena kupyolera mu zakudya monga yogurt, kungateteze matenda a BV kapena kuthandizira kuchiza ma antibayotiki.
Izi zikunenedwa kuti, kuthekera kwawo kochizira matenda a BV okha sikungatheke. CDC yakhala ikudandaula kuti kugwiritsa ntchito mankhwala a antibiotics kuchitira BV, ngakhale ngati njira yothetsera mankhwala. Izi sizikutanthauza kuti ma probiotics alibe phindu; Ndizomveka kuti palibe umboni wosonyeza kuti mabakiteriya amatha kusintha kuchokera m'mimba mpaka kumaliseche.
Pakhala pali umboni wofanana wochirikiza kugwiritsa ntchito njira zina zakuthupi (monga adyo kapena mafuta a tiyi) pochiza BV.
> Zotsatira:
> Zolinga za Kuletsa ndi Kuteteza Matenda. "2015 Matenda Opatsirana Mwachiwerewere Njira Zothandizira: Mabakiteriya Vaginosis." Atlanta, Georgia; zasinthidwa pa June 4, 2015.
> Homayouni, A .; Bastani, P .; Ziyadi, S. et al "Zotsatira za maantibiobio pa kubwerera kwa bacterial vaginosis: ndemanga." J Low Genit Tract Dis. 2014; 18 (1): 79-86. DOI: 10.1097 / LGT.0b013e31829156ec.
> O'Hanlon, D .; Moench, T. ndi Cone, R. "M'zimayi, mabakiteriya omwe amagwiritsidwa ntchito ndi bacterial vaginosis akhoza kuponderezedwa ndi lactic acid koma osati hydrogen peroxide." BMC Infect Dis. 2011; 11: 200. DOI: 10.1186 / 1471-2334-11-200.
> Younos, N., Gobinath, R. Jegasothy, R. et al. "Kusintha kwa Gardnerella vaginalis kumayambitsa matenda a bacterial vaginosis ku Malaysia." Asia Pac J Trop Bio. 2017; 7 (9): 831-35. DOI: 10.1016 / j.apjtb.2017.08.011.
> Zeron Mullins, M. ndi Trouton, K. "BASIC kuphunzira: kodi intravaginal boric acid si yoperewera kwa metronidazole m'maganizo a bakiteriya vaginosis? Phunziro loyesa kuyesedwa mwachidziwitso." Mayesero. 2015; 16: 315. DOI 10.1186 / s13063-015-0852-5.