spetsificheskie vospalitelnie zabolevaniya jenskix polovix organov

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slayd 1 spetsificheskie vospalitelnie zabolevaniya jenskix polovix organov vozbuditeli spetsificheskix vzpo gonokokki trixomonadi xlamidii mikoplazmi ureaplazmi gribi mikobakterii tuberkuleza virusi k zppp otnosyat: gonoreya xlamidioz trixomanoz virusnaya infektsiya klassifikatsiya zppp 1. svejaya (davnost zabolevaniya 2 mes. ili reinfitsirovanie), stadii: - ostraya - podostraya - torpidnaya 2. xronicheskaya (davnost zabolevaniya svishe 2 mes.), stadii: - obostreniya - remissii 3. nositelstvo (persistentnoe techenie, antibiotikoustoychivaya forma techeniya) povishenie rn ugnetenie rosta i jiznedeyatelnosti laktobakteriy patogenez razvitiya bakterialnogo vaginoza uvelichivaetsya rost anaerobnix bakteriy sintez veshestv, obuslavlivayushix xarakterniy zapax, poyavlenie «klyuchevix» kletok * * * pri bakterialnom vaginoze pod vozdeystviem opredelennix faktorov (gormonalnie narusheniya, primenenie antibiotikov, oslablenie immunnoy sistemi i dr.) proisxodit rezkoe snijenie urovnya n2o2 -produtsiruyu-shix laktobakterii, vplot do ix polnogo ischeznoveniya. pri etom proisxodit zameshenie laktobakterii g.vagi-nalis, kotorie viyavlyayutsya vo vlagalishe v visokoy kontsentratsii. krome togo, sozdayutsya usloviya dlya massivnogo razmnojeniya vo vlagalishe strogix anaerobov (rge-votella/porphyromonas spp., peptostreptococcus spp., fuso-bacteium spp., mobiluncus spp.). …

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velichenie rn vlagalishnogo otdelyaemogo, s odnoy storoni, i virajennoe snijenie molochno-kislix bakteriy, kotorie v norme podderjivayut kisluyu sredu vlagalisha, - s drugoy. bakterialniy vaginoz- eto narushenie mikroekologii vlagalisha, kotoroe xarakterizuetsya rostom obligatnix ili fakultativnix anaerobnix bakteriy- gardnerella vaginalis, prevotella spp., mobiluncus spp., veilonella spp., bacteroides spp., peptococcus spp, pri vozmojnom uchastii mycoplasma spp. i ureaplasma spp. eto privodit k ugneteniyu rosta i jiznedeyatelnosti vlagalishnix laktobakteriy. anaerobnie bakterii sinteziruyut fermenti-aminopeptidazi, kotorie rassheplyayut peptidi do aminokislot, a zatem do aminov, kotorie obuslavlivayut xarakterniy dlya bv ribniy zapax. vaginalniy kandidoz genitalniy kandidoz ne otnositsya k zppp, no chasto yavlyaetsya ix markerom svishe 40% jenshin imeyut c.albicans v nebolshom kolichestve (10³ koe/g) v sostave vaginalnoy mikroflori, no ne imeyut nikakix simptomov bolezni. v normalnix usloviyax c.albicans ne vizivaet zabolevanie. tem ne menee, vse vidi candida – opportunisticheskie patogeni i mogut rasti pri opredelennix usloviyax. vozbuditel – drojjepodobnie gribi roda candida. v 60-95% sluchaev vlagalishe …

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olee 104 koe/g, neobxodimosti vidovoy identifikatsii gribov, opredelenie chuvstvitelnosti k antibiotikam) lechenie vaginalnogo kandidoza antibiotiki: nistatin, levorin, pimafutsin; preparati imidazolovogo ryada ketokonazol (nizoral), izokonazol (gino-travogen), mikonazol (gino-daktanol), ekonazol (gino-pevaril); preparati triazolovogo ryada: flyukonazol, diflyukan; kombinirovannie preparati: polijinaks, terjinan, makmiror, neo-penotran forte*, klion – d. trixomonoz naibolee chastoe infektsionnoe zabolevanie, peredayusheesya polovim putem vozbuditel – trichomonas vaginalis osnovnie puti zarajeniya (polovoy, bitovoy, intranatalniy) yavlyaetsya prichinoy kolpita, uretrita, tservitsita klinika i diagnostika trixomonoza jalobi (zud, jjenie, obilnie penistie videleniya, dizuriya) dannie anamneza (svyaz s polovoy jiznyu) dannie ginekologicheskogo issledovaniya (giperemiya, otek vlagalisha, patologicheskie videleniya) mikroskopiya vlagalishnogo mazka ptsr - diagnostika lechenie trixomonoza peroralniy priem preparatov gruppi nitroimidazolov (metronidazol, ornidazol, tiberal, atrikan 250, tinidazol, makmiro mestnaya sanatsiya (flagil, klion-d, betadin, metragil) obyazatelnoe lechenie polovogo partnera kriterii izlechennosti (etiologicheskoe i klinicheskoe vizdorovlenie) kontrol bakterioskopii i kulturalnogo issledovaniya cherez 7-14 dney posle lecheniya otsutstvie t .vaginalis pri laboratornom issledovanii v techenie 3 mesyatsev urogenitalniy xlamidioz …

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iy klinika i diagnostika xlamidioza jalobi (serozno-gnoynie videleniya, zud) polimorfizm i nevirajennost klinicheskix proyavleniy razvitie spaechnogo protsessa ginekologicheskoe issledovanie ifa, ptsr - diagnostika kulturalniy metod laparoskopiya lechenie xlamidioza kompleksniy podxod i lechenie oboix polovix partnerov 1. antibakterialnaya terapiya makrolidi (sumamed, rulid) ftorxinoloni (sparflo, tarivid) tetratsiklini (vibramitsin, rondomitsin, doksitsiklin, eritromitsin) 2. induktori interferona (neovir, tsikloferon, amiksin) 3. immunomodulyatori (polioksidoniy). 4. sistemnaya enzimoterapiya (vobenzim). 5. antioksidanti (vit.e, metionin) 6. eubiotiki (bifikol, laktobakterin) i antiseptiki (vaginorm – s) mikoplazmennaya infektsiya urogenitalnie mikoplazmi (mycoplasma hominis, mycoplasma genitalis, ureaplasma urealiticum) otnositsya k uslovno-patogennoy mikroflore i chasto viyavlyaetsya u zdorovix lits v nebolshoy kontsentratsii (10³ - 104 koe/g), no v visokix kontsentratsiyax mogut bit prichinoy razvitiya infektsionno-vospalitelnix protsessov mochepolovix organov klinika i diagnostika mikoplazmoza malosimptomnoe, dlitelnoe techenie mojet bit prichinoy tservitsita, endometrita, salpinogooforita, nevinashivaniya beremennosti jalobi na videleniya, dizuricheskie proyavleniya, zud diagnoz: klinicheskie proyavleniya, kulturalniy metod, ptsr ureaplazmoz vozbuditel – ureaplasma urealiticum – unikalniy mikroaerofilniy organizm, …

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tnositsya k samim rasprostranennim virusnim infektsiyam cheloveka infitsirovannost vpg sostavlyaet 90% naseleniya zemnogo shara vozbuditel – virus prostogo gerpesa serotipov vpg-1, vpg-2 infitsirovanie proisxodit (polovim, bitovim, oralno-genitalnim putem, pri iskusstvennom oplodotvorenii, transplatsentarno, intranatalno) klinika i diagnostika vpg inkubatsionniy period 3-9 dney korotkiy prodromalniy period ekstragenitalnie simptomi (slabost, golovnaya bol, ↑ temperaturi) genitalnie priznaki (puzirkovie visipaniya→vezikuli→yazvi→limfadenit diagnoz: jalobi, klinicheskie proyavleniya, ifa, ptsr lechenie genitalnogo gerpesa provoditsya oboim polovim partneram protivovirusnie preparati (atsiklovir, valatsiklovir) induktori interferona (viferon, kipferon, tsikloferon, neovir, amiksin) spetsificheskaya immunoterapiya (p/gerpeticheskiy gamma – globulin, gerpetichekaya vaktsina) mestnaya sanatsiya (epigen) vitaminoterapiya gonoreya infektsionnoe zabolevanie, peredayusheesya polovim putem otnositsya k gruppe venericheskix zabolevaniy vozbuditel – neisseria gonorrhoeae porajaet slizistie obolochki, pokritie tsilindricheskim epiteliem klinika i diagnostika gonorei pri vosxodyashey gonoree soprovojdayutsya yavleniyami pelvioperitonita → differentsialniy diagnoz s ostrim appenditsitom (laparoskopiya) diagnoz: dannie anamneza (svyaz s polovoy jiznyu), jalobi, bakterioskopicheskiy, bakteriologicheskiy metodi, ptsr lechenie gonorei pri gonoree nijnix otdelov ambulatorno: etiotropnoe lechenie …

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slayd 1 spetsificheskie vospalitelnie zabolevaniya jenskix polovix organov vozbuditeli spetsificheskix vzpo gonokokki trixomonadi xlamidii mikoplazmi ureaplazmi gribi mikobakterii tuberkuleza virusi k zppp otnosyat: gonoreya xlamidioz trixomanoz virusnaya infektsiya klassifikatsiya zppp 1. svejaya (davnost zabolevaniya 2 mes. ili reinfitsirovanie), stadii: - ostraya - podostraya - torpidnaya 2. xronicheskaya (davnost zabolevaniya svishe 2 mes.), stadii: - obostreniya - remissii 3. nositelstvo (persistentnoe techenie, antibiotikoustoychivaya forma techeniya) povishenie rn ugnetenie rosta i jiznedeyatelnosti laktobakteriy patogenez razvitiya bakterialnogo vaginoza uvelichivaetsya rost anaerobnix bakteriy sintez veshestv, obuslavlivayushix xarakterniy zapax, poyavlenie «klyuchevix» kletok * *...

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