Blogs Blogs

Viem am dao: Nguyen do, dau hieu, nhan biet va chua tri

Published Date 9/21/22 8:09 AM

Tong quat viem nhiem am dao

Am dao cau truc la mo co mac hinh ong det noi giua co tu cung va am dao phia ngoai. Tai phai yeu am ho chinh la con duong giup kinh nguyet thoat ra ngoai cung voi co nhung dung cu hut/ co dung mau kinh nguyet nhu tampon, coc nguyet san. Toi do tuoi duc tinh thi Day cung la cho quan he va dat nhung dung cu tranh thai: film tranh thai, bot tru diet tinh trung.

Viem nhiem am dao la chung benh phu khoa vo cung pho bien o phai yeu, gom lon dau hieu phat hien o am ho- am dao nhu: ra lon khi hu, mau xanh hoac vang, khi hu boc mui hay trang dan den ngua ngay. Day cung la cac nguyen do dan den kho chiu gay cho nguoi phai dep phai di kham bac si phu khoa.

Nguyen nhan viem am dao

Rat nhieu nguyen do duoc tim thay khi tien hanh cac tim hieu ve benh viem am dao. Hien tuong viem am dao duoc phan loai theo li do gay nen benh:

Viem nhiem am dao thong qua nam: nam men, nam soi
Bi viem am dao do trung roi Trichomonas
Viem am dao vi vi khuan: Lau/ Chlamydia/ Gardnerella
Vi viem am dao thong qua virus: Herpes
Venh viem am dao khong co nhan to truyen nhiem
Viem teo "co be" boi khong du hut estrogen

Trong so do, bi viem am dao bang virut la thuong gap nhat no chiem co 30%. Qua trinh viem xay ra luc virut bi loi cua "co be" la Lactobacillus trong am ho mac thay thong qua mot so vi khuan ky khi, sinh hoat virut ky khi tang giam thieu nong cap do cua hydrogen peroxide va cac axit huu co trong am dao. Mui khong de chiu cua bach dai "co be" cung la thong qua san xuat cac amin tu mot so vi rut ky khi gay viem nay. Thoi diem sau day Quan he Tinh duc cung voi sau day ky kinh, pH am ho kiem hon cung sinh cho mui kho chiu cua viem do vi rut tang hon

Bieu hien chinh la ra cao bach dai am ho, bach dai thuong hay doi mau xanh/ vang cung nhu co mui hoi. Bai tiet huyet trang la hien tuong pho bien nhat, thuong khi hu hoac dich ra khong moi lien quan den chu ky kinh. Thuong viem nhiem am dao thong qua vi khuan thi hi huu luc bi dau hieu ngua. Tuy vay, tim hieu cung cho thay khoang 50% nu duoc chan doan bi viem am dao ma chua co bieu hien.

Du rang benh viem nhiem am dao qua vi rut khong lam cho nang cao Co nguy co nhiem trung khoang chau. Nhung truong hop benh viem am dao thong qua virut pho bien tai mot so phai yeu nhiem tien su viem vung chau, viem niem mac tu cung sau day cac phau thuat san phu khoa nhu hut nao thai. Bi viem am dao co nguy co khien tawg Co nguy co say thai muon, sinh non, oi vo le som.

Thanh phan co nguy co benh viem nhiem am dao

Viem da kich thich hay di ung vi xuc tiep duoc cho la nguyen nhan cua viem nhiem am dao khong co tac nhan lay truyen. Khong it nguyen nhan sinh cho hien tuong viem da luc nguoi nhiem benh xuc tiep nhu quan ao moi, dung dich ve sinh phai dep, xa bong, bao cao su, flim phong tranh thai…

Viem teo am dao hay gap o nhom nu thieu hut estrogen nhu phai nu tien man kinh- tat kinh, phai yeu sau day de. Bieu hien pho bien la kho am ho, am ho co the dao thai dich, ngua ngay gay nen kho chiu. Nhan biet viem am dao do khong du estrogen phai bang tien su, kham thuc the, test pH am ho, loai tru cac tac nhan nhiem trung Neu ma "co be" bai tiet cao dich toi test soi tuoi, nhat thiet test PCR can nguyen gay viem sinh duc. Tri benh vi estrogen toan than cung nhu ket hop tai khu vuc duoc danh gia la lieu phap ket qua nhat giup nang cao nhung dau hieu kho rat buot "co be", ngua "co be". Lua chon dau tay la estrogen con duong xoa o vung can gel o am ho se giup cho tham thau va duong am dao Hanh phuc hon va giam sut nhung phan ung phu khi cho them estrogen duong toan than. Nhung che pham cung cap estrogen o khu vuc la nhau: vien dat, type co, tam dat am ho deu cho biet hieu qua chua tri tuong tu nhau.

Cac nhan to khien tang Nguy co cua bi viem am dao lay nhiem nhiem:

Hanh vi tinh duc: Tinh Duc som, cao doi tac, khong ap dung cach phong ngua cac benh lay truyen qua Tinh Duc nhu bao nhieu su
Lay lan mot trong nhung can nguyen truyen den Tinh Duc
Nhung benh ly lien quan giam sut mien dich, de nhiem trung nhu: HIV, dai duong, ung thu
Thai phu, tuoi tien man kinh/man kinh,
Ap dung thuoc tranh thai thuong xuyen, dat khoang tranh thai
Lien tuc ghe rua "co be" hay thut rua cac chat tao am vao trong am ho.
Mac ao xong chat hoac quan am chua phoi kho

Nhung bien phap chuan doan bi viem am dao

Thong thuong am dao cua phai nu cung van chua dich sinh duc, dich thuong hay the hien nhieu vao giua hay truoc/ sau nhung ngay kinh nguyet giup cho giu gin am cung voi khien cho sach "co be". Dich thuong trong trang hay trang duc, khong dan toi ngua, khong co mui hoi. Nhung ma, dich am dao duoc xem la bat thuong cung voi viem khi:

Thay doi mau dung nhan, mui hoac so luong dich bai tiet ra tu am dao: dich mau vang hoac trang duc, co mui hoi, ra cuc ky nhieu;
Gay ra ngua, dan den khong de chiu
Mau nhan sac thay doi: vang, xanh
Mui hoi
Kem benh tieu buot, tieu rat
Nong rat luc di giai hoac khi quan he.

Theo tieu chuan Amsel, nhan biet benh viem am dao do vi rut nen ¾ tieu chuan( cap do nhay 90%, muc do dac hieu 77%)

PH am ho > 4,5
Huyet trang nhieu Tuyet doi sau day quan he, dong nhat, trang xam
Whiff test duong tinh: Nho KOH 10% vao khi hu bieu hien mui ca thoi
Te bao Clue cells chiem chi it 20%( te bao am ho bam dinh cao vi khuan)

Kiem tra te bao hoc co tu cung khong co muc gia chua lam sang trong phat hien viem nhiem am dao do vi rut, nhat la o nhom chua co trieu chung, do xet nghiem nhiem muc do nhay khong cao.

Chan doan theo tac nhan dan toi can benh

Thuc hanh lam sang nham nhan biet benh viem am dao thay thuoc se can:

Khai khan tien su
Kiem tra thuc the phu khoa
Kiem tra dich tiet am dao
Test pH "co be"

Benh viem am dao thong qua vi khuan: bieu hien hay gap dac biet la ra cao khi hu, bach dai doi thay mau dung nhan, co nguy co co mui hoi va thuong hay it luc dan den ngua ngay. Nguyen nhan qua qua trinh thay doi he vi khuan va pH am dao. Thuong dien ra tai nhom phu nu trong lua tuoi sinh de ton kem hon, doi song tinh duc phong phu, nhieu ban tinh la Co nguy co gay nen viem.

Benh viem nhiem am dao bang Lau: nguyen nhan dan den viem la thong qua tuy nhien cau Gram am Neisseria Gonorrhea co hinh hat ca phe. Tren soi tuoi nhung ma cau nam trong bach cau da nhan. Day la chung benh truyen qua Lam tinh, khi hu thuong hay dang mu xanh, hoac co nhung tinh huong khi hu ra it, khong ro rang, co the kem tieu buot.

Viem am dao vi nam: hien tuong khien cho nguoi phai dep di kham thuong hay la ngua, tinh chat ra khi hu thuong loai bot hoac dot cap co the trang, ba dau. Thai phu, cac nhom co the bi dai duong, chua tri mot dot khang sinh thuong hay khong kho lay nhiem nam. Trong dieu tri nam am dao de phong tai phat, khuyen cao quy dinh nen chua tri cho ca doi tac.

Viem nhiem am dao boi trung roi- Trichomonas: nguyen do la do mot can vi khuan don bao bi ten la Trichomonas vagis. Tinh chat bach dai loang xanh bi bot la hien tuong rat dien hinh.

Viem nhiem am dao khong lay truyen trung: thuong hay boi viem da do xuc tiep. Cac Co nguy co nhu: nuoc rua phu khoa, xa phong, chat tieu diet tinh binh, dac biet tampon, nhieu bao su…deu co kha nang dan toi kich ung am dao. Bach dai "co be" ra khong lon, thuong trong trang hay trang duc, co kha nang gay ra ngua ngay.

Viem teo am ho do thieu duong: li do boi luong estrogen suy giam sau day khi tat kinh hoac tieu phau loai bo buong trung co the lam cho niem mac "co be" mong, doi khi gay kich ung "co be", nong rat cung voi kho.

Xet nghiem trong nhan biet benh viem am dao

Soi tuoi bach dai am ho de xac dinh nguyen nhan dan den viem, tinh huong quay tro lai hoac dieu tri khong co ket qua, hay tinh chat khi hu Tuyet doi, bac si co kha nang chi dan tham kham PCR hay cay khi hu, khang de do dung. Dich phai lay khong thieu cung do dac duoi day, hai thanh ben am ho, lo co tu cung.
Test pH am dao: tham kham pH am dao bang giay chi thi, ket qua co the ho tro chan doan cho chuyen gia chuyen khoa lam sang.

Nhung phuong phap dieu tri benh viem nhiem am dao

Nguyen tac:

Tri benh nguyen nhan
Tri benh dau hieu
Chi dan rua ray, phong tai phat

Nen chua benh dung can nguyen can benh. Thuoc dieu tri phu thuoc vao phat hien benh viem am dao theo nguyen nhan, cu the:

Viem am dao bang vi khuan: nhung khang de thuong hay duoc su dung nhu: metronidazole (Flagyl) co duong su dung, hoac kieu gel hay kem metronidazole (MetroGel) thoa o khu vuc hoac dung kem clindamycin (Cleocin) boi vao am ho. Khang sinh thuong gap nhu Quinolon, doxycycllin.

Nam am dao: Thuoc uong duong toan than fluconazole (Diflucan), Itraconazole( spulit/ sporal). Ket hop vien dat thanh phan nhu nystatin/ clotrimazole. Kem xoa vung ngoai "co be" khi ngua ngay cao nhu: canesten, kem clotrimazole.

Bi viem am dao bang Trichomonas: Khang de ket qua nhu: metronidazole (Flagyl) hay tinidazole (Tindamax).

Bi viem am dao bang thieu duong tai phai yeu tat kinh (teo am dao). Estrogen (dang kem) co the chua benh ket qua tinh trang nay.

Bi viem am dao khong lan nhiem trung: chi dinh nguoi mac benh kieu tru nguyen nhan gay kich thich viem da. Cac mam Co nguy co bao gom: chat diet tru tinh trung, bang rua ray, dung dich rua ray phu nu… Tuy truong hop bac si chuyen khoa co nguy co ke thuoc chong di ung, khang Histamin nham suy giam ngua, thuoc boi o cho cho nguoi benh.

Huong dan nguoi bi benh khong rua nuoc lon, duy tri ve sinh kho, mac xong ao thoang mat.

dau hieu cua viem am dao

dau hieu viem am dao

trieu chung cua viem am dao

bi viem am dao

nhung dieu can luu y khi pha thai bang thuoc

luu y khi pha thai bang thuoc

uong thuoc pha thai

pha thai bang thuoc co an toan khong

trieu chung benh giang mai o nam

benh giang mai

dau hieu benh giang mai o nam