Omphalitis: Nzira yekuziva sei kana tambo yembilical ine utachiona?

La Rukuvhute chirwere, inonziwo granuloma, umbilical fungus kana omphalitis Kuzvimba kusingaperi kweguvhu (omphalon), kubva kune purulent, kazhinji inonhuwa zvinhu zvinobuda.

Recurrent omphalitis yakanyorwa kunyanya mucheche nevana; zvisinei, umbilical kuzvimba dzimwe nguva zvinogona kukanganisa vakuru zvakare.

Tingaona sei omphalitis?

Icho chiitiko chisingawanzoitiki chezvirwere munyika dzakabudirira; zvisinei, munzvimbo shoma dzakasimukira uko kuwana mishonga hakuna kuvimbiswa, omphalitis inoramba iri chikonzero chinowanzokonzera kufa kwevacheche.

Omphalitis inotanga nezviratidzo zvakada kufanana neizvo zve infectious cellulitis (kutsvuka, marwadzo mashoma, kuzvimba), saka hazvishamisi kuti mamiriro maviri aya avhiringike.

Zvikonzero zvehutachiwana hwemuguvhu

Chikonzero che omphalitis kazhinji hutachiona hwehutachiona, saka antibiotic therapy ndiyo kurapa kwesarudzo.

Inofungidzirwa kuti 70-75% ye omphalitis inokonzerwa polymicrobial zvirwere. Zvirwere zvinonyanya kubatanidzwa mu etiopathogenesis ndezvi:

• Staphylococcus aureus (giramu+)
• Boka A beta-hemolytic streptococcus, yakadai Streptococcus pyogenes (giramu+)
• Escherichia coli (giramu-)
• Klebsiella pneumoniae (giramu-)
• Proteus mirabilis (Gramu-)

Varwere vane njodzi yakanyanya ye omphalitis vana vachangozvarwa (kunyanya vacheche vanozvarwa nguva isati yakwana), varwere vari muchipatara vari kurapwa, uye vasina immunocompromised.

Sepsis uye pneumonia zvimwewo zvinokonzeresa omphalitis. Mumwana achangozvarwa,kudonha kwe umbilical tambo chinokonzera ronda diki diki: ronda iri rinogona kunge rinopinda utachiona (omphalitis).

Zviratidzo zve omphalitis

Zviratidzo zvinogara zvichiitika zvinosanganisira kubuda hurwa hunonhuwa kubva paguvhu, erythema, edema, kupfava, uye kurwadziwa kushoma. Vana vanotapukirwa vanowanzosangana nazvo hypotension, tachycardia, fivha uye jaundice. Pakati pezvisingawanzo kunetsa hatifanire kukanganwa sepsis, septic embolization uye kufa.

Muzviitiko zvakawanda, omphalitis inoshanduka kuva a banal umbilical kuzvimba, iyo inogona kugadziriswa nekukurumidza nepamusoro pekushandisa uye/kana vabereki kutonga kwemishonga inorwisa mabhakitiriya.

Zvinonyanya kuzivikanwa zviratidzo zvakanyorwa pazasi:

• Purulent uye inonhuwa inobuda kubva paguvhu (inogara iripo)
• periumbilical erythema
• Edema
• kudzvinyirirwa kurwadziwa
• Marwadzo mashoma/kutsva

Matambudziko (kashoma kuitika)

Kana isina kurapwa zvakanaka, chiratidzo chechiratidzo che omphalitis chinogona kuoma: munyaya iyi, murwere anogona kuona ecchymoses, petechiae, maronda eganda anotubuka uye kuoneka kweganda reorenji pedyo neguvhu. Zviratidzo zviri pamusoro ndezvekufanotaura kwematambudziko uye zvinoratidza kubatanidzwa kwezvirwere zvakawanda muhutachiona.

Mune zvimwe zviitiko zvishoma nezvishoma, mufananidzo wekliniki wemurwere unogona kuwedzera: chirwere chembilical chinogona kupararira kuti chibatanidze madziro ose emimba.

Pakati pemamwe matambudziko tinotaurawo nezve myonecrosis, sepsis, septic embolization uye rufu.

Muchiitiko chezvinetso nekuda kwe omphalitis, kuwirirana kwezviratidzo zvakawanda zvinowanzoonekwa mumurwere akabatwa:

• kuchinja kwekushisa kwemuviri (fivha / hypothermia)
• kusagadzikana kufema (kuora mwoyo, tachypnea, hypoxemia, nezvimwewo)
• kusagadzikana dumbu (semuenzaniso, bloating)
• kuchinja kwetsinga (kushatirwa, hypo / hypertonia, nezvimwewo)
• kutsimwaira
• matambudziko emwoyo (semuenzaniso, tachycardia, hypotension, nezvimwewo).

Diagnostics uye marapirwo

Kuongororwa kwe omphalitis ikiriniki uye inosanganisira kuongororwa kwechiremba kweguvhu (mumwana achangoberekwa). Kuongororwa kwekuongorora kunowanikwa nekuongororwa kweropa uye biopsy yemuenzaniso.

Kana omphalitis ichifungidzirwa, a differential diagnosis ane congenital umbilical fistulas, zvakare inobatanidzwa nepurulent discharge kubva paguvhu.

Kurapa kwechisarudzo ndiko kushandiswa kwemishonga inorwisa mabhakitiriya; kurapa kunotsigira kunogona kusanganiswa kubata nezviratidzo zvechipiri. Vanogona kunyorerwa chete navanachiremba.

Penicillins inonyanya kuratidzwa pakurapa kwenyoro omphalitis inokonzerwa ne Staphylococcus aureus, nepo aminoglycosides ariwo mushonga wesarudzo kune giremu-negative zvirwere.

Para invasive zvirwere, kunyanya neanaerobes, inokurudzirwa kusanganisa mishonga inorwisa mabhakitiriya, kusanganisira metronidazole.

Mishonga inorwisa mabhakitiriya ye omphalitis mucheche inofanira kugara inenge de Mazuva mashanu kusvika makumi matatuzvichienderana nemhando uye kuoma kwehutachiona.

Kudzivirirwa kwechirwere cheguvhu

Nekudzivirira kwe omphalitis mucheche, inokurudzirwa shandisa antiseptic zvinhu: mishonga inorwisa mabhakitiriya inobva pabacitracin kana sirivheri sulfadiazine zvakananga pachigutsa chembilical.