I-CDC Isiqondiso kanye Nezinye izindlela
I-bacterial vaginosis (BV) isifo esithathelwanayo sangasese esithinta uketshezi, ukugcwala kwamasipha, kanye ne-"fishy" iphunga. Amacala amaningi ayinkimbinkimbi futhi angaphathwa ngezidakamizwa zemithi elwa namagciwane, ethathwe ngomlomo noma ngama-creams noma ama-gel. Izifo ze-BV ziyaziwa ukuthi ziphindaphinda njalo, ngokuvamile zingakapheli izinyanga ezintathu kuya kwezingu-12, zidinga izindlela ezengeziwe zokwelapha.
Ukwelashwa kungase kubekiwe ngesikhathi sokukhulelwa ukuze kuncishiswe ingozi yezinkinga ezifana nesisindo sokuzalwa esincane kanye nokuqhekeka ngaphambi kwesikhathi.
Izifo zasekhaya
Enye yezinkathazo ezinkulu zokwelapha i- bacterial vaginosis yizinga eliphakeme lokuphindaphindiwe. Ezinye izifundo ziphakamisa ukuthi izinga lingase liphakeme ngamaphesenti angu-50; abanye bakholelwa ukuthi kukhulu kakhulu. Futhi, lokhu kubangela inkinga enikezwe ukuthi ukusebenzisa okuphindaphindiwe kwama-antibiotic kungangandisa ingozi yokuphikisa izidakamizwa.
Kuze kube sekugcineni, izixazululo eziningana zasendlini ziye zafundiswa kwabesifazane abanezimpawu ze- BV eziphindaphindiwe. Oyinhloko kulawa yi-boric acid ne-hydrogen peroxide, kokubili engabizi futhi etholakala kalula esitolo sezidakamizwa ngaphandle kwemithi.
Nakhu esikuziyo:
- I-boric acid isetshenziselwe ukwelapha izifo zesilonda ( ubulili candidiasis ) iminyaka engaphezu kwengu-100. Ucwaningo lwango-2015 lwaluhlola ukusetshenziswa kwalo njengesidakamizwa se-vaginal kulabo besifazane abane-BV futhi lithole ukuthi, emva kwezinsuku ezingu-10, izinga lokutheleleka kwesiguli lifana nelinye lama-antibiotic.
- I-hydrogen peroxide, eyanikezwa isisombululo se-intravaginal ye-3%, isetshenziselwe izizukulwane zokwelapha i-BV. Kodwa-ke, ucwaningo ngo-2011 oluvela kuJohn Hopkins University lubonise ukuthi ukwelashwa akukwazanga ukuvimbela amabhaktheriya athi "amabi" ahlobene nokutheleleka kwe-BV, okwehlisa inani lalo kwabesifazane abanezimpawu eziphindaphindiwe.
Ngesikhathi lezi zindlela zibhekwa njengeziphephile futhi ezingabizi, akufanele zisetshenziswe ngaphandle kokuxilongwa ngokuphelele kanye nokufakelwa okuvela kudokotela wakho. Lokhu kuyiqiniso ikakhulukazi kubagulayo bokuqala, abesifazane abakhulelwe, noma labo abanezimpawu zokutheleleka okunzima (kubandakanya umkhuhlane, ama-aches omzimba, ubuhlungu be-pelvic / / noma besisu, noma ubunzima bokuvuthwa).
Imigomo
Ukwelashwa kwama-antibiotic we-bacterial vaginosis kunconywa kubo bonke abesifazane abanezimpawu. Ukwenza kanjalo akusizi nje kuphela ukuqeda ukutheleleka, kunciphisa ithuba lomfazi lokuthola izifo ezithathelwana ngocansi ezifana ne- gonorrhea , chlamydia , ne- trichomoniasis .
Ukwelashwa okuthandwayo
Kunezinhlobo ezintathu zezidakamizwa ezithandwayo zokulwa nezidakamizwa eziphakanyiswa yiCenter for Disease Control and Prevention (CDC) yokwelashwa kwe-BV:
- I-Metronidazole: ama-milligram ama-500 athathwa ngomlomo (ngomlomo) kabili ngosuku ngezinsuku eziyisikhombisa
- I-Metronidazole: i-gel ayi-0.75 yamaphesenti isetshenziswa kanye ngosuku nsuku zonke ngezinsuku ezinhlanu besebenzisa i-applicator ye-5.0-gram efakekayo ye-intravaginal applicator
- Ukhilimu we-Clindamycin 2.0 wamaphesenti: usetshenziswe kanye ngesikhathi sokulala izinsuku eziyisikhombisa usebenzisa i-5.0-gram efravaginal applicator
Ezinye zokwelapha
Ezinye zokwelashwa zigcinwe ukwelashwa kwesibili emininingwaneni uma izimpawu zibuyela emuva noma uma umuntu ephikisana nokulwa nemithi ekhethwayo.
Ezinye izindlela zokwelashwa zihlanganisa:
- I-Clindamycin: ama-milligram angu-300 athathwa ngomlomo kabili ngosuku nsuku eziyisikhombisa
- I-Clindamycin: i-100-milligram suppositories isetshenziswa ngesikhathi sokulala izinsuku ezintathu
- I-Tinidazole: 2.0 amagremu athathwa ngomlomo kanye ngosuku ngalunye izinsuku ezimbili
- I-Tinidazole: 1.0 amagremu athathwa ngomlomo kanye nosuku zonke izinsuku ezinhlanu
Ukubeka izincomo
Noma yikuphi ukwelashwa okushiwo, udinga ukuqedela inkambo ngisho noma izimpawu zakho zicacile. Ukwehluleka ukwenza kanjalo kungandisa ingozi yokulwa nokulwa namagciwane.
Kunconywa ukuba ubale utshwala ngesikhathi sokulashwa futhi ngemva kwamahora angu-24. Ukuphuza kungabangela izimpawu ezinzima ezifana nokukhanda ikhanda, ukuqhuma, ukushaya kwenhliziyo okusheshayo, ukuphefumula, ukucabangela, ukuhlanza nokuphelelwa amandla.
Ukuvimbela ukutholakala kwamabhaktheriya nezinye izinambuzane eziyingozi, kufanele ubaleke ucansi noma usebenzise amakhondomu kulo lonke ukwelashwa. Ngenkathi i-BV ingabhekwa njengesifo esithathelwana ngokocansi, izinambuzane ezinobungozi ezingase zibe yingozi zingase zibheke epenisini yesilisa, ikakhulukazi ngaphansi kwejwabu. Ngisho nomlingani wesifazane ocansini ubeka ingozi ngenxa yokuxhumana kwesikhumba noma kokubeletha ngokocansi.
Naphezu kwalezi zingozi, ukwelashwa komlingani wobulili ngokuvamile akudingeki.
Imiphumela Ejwayelekile Ejwayelekile
Iningi lincane kakhulu. Phakathi kwazo:
- Imithi yomlomo ingabangela ukucasuka kwesisu, isicashu, izimpawu ezibandayo (ukukhwehlela, impumu egijima, umphimbo), kanye nomusa wensimbi emlonyeni.
- Imithi ye-antibiotics ingabangela ubuhlungu besisu, ubuhlungu bekhanda, isicanucanu, izimpawu ezibandayo, ukuzwa okuthinta izandla nasezinyaweni, nokunambitheka komtholo emlonyeni.
Izincomo zokukhulelwa
Ukutheleleka kwe-BV esebenzayo ngesikhathi sokukhulelwa kungandisa ingozi yokuzalwa kwangaphambi kokubeletha, ukuzala okuphansi, ukukhulelwa ngaphambi kwesikhathi ngaphambi kwesikhathi (PROM) futhi, ngokungajwayelekile, ukukhulelwa kwesisu.
Ama-antibiotic omlomo ajwayelekile kakhulu, noma i-clindamycin 300 milligram noma i-metronidazole 500 milligrams ethathwa kabili ngosuku ngezinsuku eziyisikhombisa. Ama-antibiotiki e-topical, ngokuphambene, avela engasebenzi kakhulu ekuvimbeleni ukucindezeleka kokukhulelwa.
Yize ucwaningo oluningi lubonisa ukuthi ukusetshenziswa kwezidakamizwa zomlomo kunganciphisa ingozi ye-PROM nesisindo sokuzalwa esincane, ubufakazi abukho emandleni abo okuvimbela ukuzalwa kwangaphambi kokuzalwa.
Ukuphikiswa kwama-antibiotic
Ngokuvamile, ingozi yokuphikiswa kwama-antibiotic ku-bacterial vaginosis ayikho indawo eseduze kakhulu njengoba umuntu angalindela. Lokhu kubangelwa yizinhlobo zamabhaktheriya ahilelekile ku-BV (okuyi-anaerobic futhi ayidingi oksijini) uma kuqhathaniswa nalabo abatholakala kwezinye izinhlobo ze- vaginitis (okuyi-aerobic futhi idinga umoya-mpilo).
Ama-bacterium aerobic atholakala ngaphandle komzimba futhi asakazwa kalula kusuka komunye nomuntu. Lezi zihlanganisa izinhlobo ezinjalo ezaziwayo njenge- Staphylococcus aureus, Streptococcus, no- Escherichia coli ( E. coli ). Ukusetshenziswa okubanzi kwemithi elwa namagciwane ukuphatha lezi zifo kuye kwabangela ukwanda kwamazinga okuphikisa.
Nakuba lokhu kungavamile kakhulu amabhaktheriya abandakanyekile ku-BV, ukuphikiswa kungahle kwenzeke ngezinye izikhathi. Kuxhomeke kakhulu ekutheni uhlobo lwama-bacteria "amabi" angaba khona ngesikhathi sokutheleleka kwe-BV. Ngokwesibonelo:
- Ukukholelwa kwe-Metronidazole kuthathwa ukuthi kwakhiwa ngokuphendula uhlobo lwamabhaktheriya angasese wesifazane owaziwa ngokuthi i- Atopobium vaginae. Okufanayo kuvame ukubonwa nge-clindamycin.
- Ngokuphambene nalokho, ukumelana nokucindezeleka kwama-clindamycin sekube nokukhathazeka okukhulayo ngokuphathelene nezinkinga ze- Prevotella ze-bacterial. Okufanayo akubonwanga nge-metronidazole.
- Kubuye kube nemibiko ye-metronidazole ukumelana nomunye amagciwane asemzimbeni avamile okuthiwa i- Gardnerella vaginalis.
Kodwa, ohlelweni olukhudlwana, usongo lusabhekwa njengento ephansi kanti izinzuzo zokwelashwa zidlula kakhulu imiphumela.
Kuze kube sekugcineni, ukwelashwa kwama-antibiotic akufanele neze kugwenywe ngenxa yithuba elingenalutho lokumelana. Ekugcineni, ukugwema kungagwenywa ngokuthatha imithi yakho ngokuphelele futhi njengoba kunqunywe. Ngaphezu kwalokho, uma izimpawu zibuyele emuva, akufanele neze uzibambelele kodwa kunalokho zizitholwe ngokushesha kunokuba kamuva.
Imithi yokwelapha ehambisanayo (i-CAM)
I-vaginosis ye-bacterial ibangelwa uma i-"good" igciwane lesisu, ebizwa ngokuthi i-lactobacilli, seliphelile, okuvumela ukuthi "amagciwane" amabi kakhulu futhi abangele ukutheleleka. Ngenxa yalokho, kuye kwaphakanyiswa ukuthi ama-probiotics , acebile amabhaktheriya anempilo afana neLacbabacillus acidophilus , angase abe usizo ekugcwaliseni izitshalo zangasese. Futhi, kukhona ubufakazi bokusekela lokhu.
Ukubuyekezwa kuka-2014 kwezifundo zokwelashwa sekuphelile ukuthi ukusetshenziswa kwansuku zonke komlomo we-probiotic, noma ngokufaka ukwesekwa noma ukudla okunjenge-yogurt, kungavimbela ukutheleleka kwe-BV noma ukusekela ukwelashwa kwama-antibiotic.
Lokhu kuthiwa, amandla abo okuphatha isifo sofuba nge-BV ayedwa ayinakwenzeka. Ngalokhu, i-CDC isilokhu ibuza ukusetshenziswa kwama-probiotics ekunakekeleni i-BV, ngisho neyindlela yokwelashwa okuqondisayo. Lokhu akusikisela ukuthi ama-probiotics ayinanzuzo; kumane nje ukuthi abukho ubufakazi bokuthi ama-bacterium e-probiotic angakwazi ukudlulisela esiswini ukuya kwesiswini ngobuningi obubhekwe njengokwelapha.
Kube nokuntuleka kobufakazi obufanayo okusekela ukusetshenziswa kwezinye izindlela zokwelapha (njengegalikhi noma i-oli tree tree) ekuphatheni i-BV.
> Imithombo:
> Amasevisi Okulawula Nokuvimbela Izifo. "Izifo Zokudluliswa Ngokwecansi Ngo-2015: Iziqondiso Zokwelashwa: I-Bacterial Vaginosis." E-Atlanta, eGeorgia; ibuyekezwe ngo-Juni 4, 2015.
> Homayouni, A .; I-Bastani, P .; Ziyadi, S. et al "Imiphumela ye-probiotics ngokuphindaphindiwe kwe-bacterial vaginosis: ukubuyekezwa." I- J Low Genit Tract Dis. 2014; 18 (1): 79-86. I-DOI: 10.1097 / LGT.0b013e31829156ec.
> O'Hanlon, D .; I-Moench, T. kanye neCone, R. "Emzimbeni wamanzi angasese, ama-bacteria ahlobene ne-bacterial vaginosis angasuswa nge-lactic acid kodwa hhayi i-hydrogen peroxide." BMC Infect Dis. 2011; 11: 200. I-DOI: 10.1186 / 1471-2334-11-200.
> Younos, N., Gobinath, R. Jegasothy, R. et al. "Isibuyekezo ku- Gardnerella vaginalis ehambisana ne-bacterial vaginosis eMalaysia." I- Asian Pac J Trop Bio. 2017; 7 (9): 831-35. I-DOI: 10.1016 / j.apjtb.2017.08.011.
> Zeron Mullins, M. kanye ne-Trouton, K. "Ukucwaninga okuyisisekelo: ingabe i-intravaginal boric acid engeyona engaphansi kwe-metronidazole ku-bacterial vaginosis yesifo? 2015; 16: 315. I-DOI 10.1186 / s13063-015-0852-5.