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"lead": "воспаление бартолиновой железы",
"description": "<p>Бартолинит - это инфекционное воспаление больших (бартолиновых) желез, расположенных в преддверии влагалища, чаще одностороннего характера.</p>",
"etiology": "<p>Острый бартолинит и <a title=\"Перейти на страницу симптома абсцесс\" href=\"/symptom/abscess/\">абсцесс</a> бартолиновой железы имеют инфекционную этиологию. Наиболее часто это заболевание вызывают представители пиогенной флоры, которая при попадании в бартолиновую железу из влагалища или уретры вызывает <a title=\"Перейти на страницу симптома воспаление\" href=\"/symptom/vospalenie/\">воспаление</a> протока железы, а затем его закупорку и образование ретенционной кисты с последующим ее возможным нагноением и формированием абсцесса. К этиологическим агентам можно отнести неспецифическую условно-патогенную микрофлору, гонококк, трихомонады, кандиды, хламидии, уреаплазмы, микоплазмы, вирусы.</p>",
"pathogenesis": "<p>Патогенез включает все признаки воспалительной реакции, возникающие в железистом эпителии протока и самой железе (отек, <a title=\"Перейти на страницу симптома Покраснение кожи\" href=\"/symptom/pokrasnenie_kozhi/\">гиперемия</a>). воспалительная инфильтрация распространяется на стенку железы и окружающие мягкие ткани большой половой губы и влагалища, а также околовлагалищную клетчатку с формированием инфильтрата, а затем и абсцесса.</p>",
"diagnostics": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Врач-гинеколог подтверждает диагноз пациентки в ходе осмотра. Дополнительные диагностические процедуры назначаются для выявления осложнений и сопутствующих заболеваний. Для этого проводятся:</span></p>\r\n<ul style=\"margin-top: 0; margin-bottom: 0; padding-inline-start: 48px;\">\r\n<li style=\"list-style-type: disc; font-size: 7pt; font-family: Verdana; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre; margin-left: 36pt;\" dir=\"ltr\">\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 7pt; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">общеклинический анализ крови;</span></p>\r\n</li>\r\n<li style=\"list-style-type: disc; font-size: 7pt; font-family: Verdana; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre; margin-left: 36pt;\" dir=\"ltr\">\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 7pt; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">общеклинический анализ мочи;</span></p>\r\n</li>\r\n<li style=\"list-style-type: disc; font-size: 7pt; font-family: Verdana; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre; margin-left: 36pt;\" dir=\"ltr\">\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 7pt; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">забор мазков из влагалища, шейки матки и канала бартолиновых желез;</span></p>\r\n</li>\r\n<li style=\"list-style-type: disc; font-size: 7pt; font-family: Verdana; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre; margin-left: 36pt;\" dir=\"ltr\">\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 7pt; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">посев на микрофлору при вскрытии абсцесса;</span></p>\r\n</li>\r\n<li style=\"list-style-type: disc; font-size: 7pt; font-family: Verdana; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre; margin-left: 36pt;\" dir=\"ltr\">\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 7pt; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">ПЦР-диагностика половых инфекций;</span></p>\r\n</li>\r\n<li style=\"list-style-type: disc; font-size: 7pt; font-family: Verdana; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre; margin-left: 36pt;\" dir=\"ltr\">\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 7pt; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">анализ крови на ВИЧ и сифилис.</span></p>\r\n</li>\r\n</ul>",
"treatment": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Выбор метода лечения бартолинита зависит от стадии развития болезни и определяется на приеме врачом-гинекологом.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Консервативное лечение. При отсутствии острого воспалительного процесса отдают предпочтение консервативной терапии (противовоспалительная, антибактериальная). Местно могут применяться мазь Вишневского, левомеколь, мирамистин и др. Такое лечение бартолинита без операции можно проводить в домашних условиях. Как именно лечить, какие антибиотики и сколько дней принимать, какое проводить местное лечение определяется на консультации врачом- гинекологом.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Оперативное лечение. В случае перехода заболевания в стадию образования кисты или абсцесса необходимо оперативное лечение (марсупиализация, установка word-катетера).</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">В случае развития истинного абсцесса осуществляется хирургическое лечение бартолинита – операция по вс</span><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-style: normal; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">крытию гнойника. После операции рану промывают антиспетическим раствором, полость дренируют word-катетером для оттока воспалительного экссудата. Ежедневно делают перевязки. Назначают курс лечения бартолинита антибиотиками, чтобы снизить риск его перехода в хроническую форму.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Киста бартолиновой железы (хронический бартолинит) вскрывается по особой методике, с созданием широкого выводного отверстия (марсупиализация), либо проводится её полное удаление (вылущивание) вместе с капсулой. Операцию проводят вне обострения.</span></p>",
"prevention": "<p>Профилактика состоит в соблюдении правил личной гигиены, гигиены половой жизни и своевременном лечении заболеваний, передающихся половым путем.</p>",
"clinical_picture": "<p>Клиническая картина характеризуется острым началом заболевания с появлением пульсирующей боли в области наружных половых органов на стороне воспаления (чаще возникает односторонний процесс). Боль усиливается при ходьбе, сидении, дефекации. Общее состояние ухудшается, температура повышается до 38 °C и выше (в стадии нагноения), могут возникать <a title=\"Перейти на страницу симптома Озноб\" href=\"/symptom/oznob/\">озноб</a> и общая <a title=\"Перейти на страницу симптома Слабость\" href=\"/symptom/slabost/\">слабость</a>. При визуальном осмотре отмечают <a title=\"Перейти на страницу симптома Отек тканей\" href=\"/symptom/otek_tkaney/\">припухлость</a> и гиперемию в области большой половой губы и локализации бартолиновой железы. При пальпации — резкая болезненность. Если выявляют флуктуацию, следует думать об истинном абсцессе бартолиновой железы. В этом случае происходит гнойное расплавление железы и окружающих тканей, что сопровождается усилением местных проявлений (<a title=\"Перейти на страницу симптома воспаление\" href=\"/symptom/vospalenie/\">воспаление</a>, боли, высокая температура тела, нарастание лейкоцитоза). Иногда происходит спонтанное вскрытие абсцесса с излитием гноя.</p>\r\n<p>Классификация:</p>\r\n<p>I. По локализации воспалительного процесса различают:</p>\r\n<p>1) каналикулит (микроорганизмы поражают выводной проток железы без закупорки протока);<br />2) ложный <a title=\"Перейти на страницу симптома абсцесс\" href=\"/symptom/abscess/\">абсцесс</a> бартолиниевой железы;<br />3) <a title=\"Перейти на страницу симптома абсцесс\" href=\"/symptom/abscess/\">абсцесс</a> бартолиниевой железы.</p>\r\n<p>II. По течению процесса: острый и хронический.<br /><br />Каналикулит. Общее состояние женщины изменяется незначительно.<br />Locus morbi: вокруг наружного отверстия выводного протока бартолиниевой железы отмечается красное пятнышко и выступающий воспалительный валик; при надавливании на проток выделяется капелька гноя (берут для бактериологического исследования).</p>\r\n<p>Ложный <a title=\"Перейти на страницу симптома абсцесс\" href=\"/symptom/abscess/\">абсцесс</a> бартолиниевой железы — возникает при закупорке выводного протока бартолиниевой железы.<br />Общее состояние изменяется незначительно, температура обычно субфебрильная, периодически могут возникать <a title=\"Перейти на страницу симптома Колика\" href=\"/symptom/kolika/\">резкие боли</a> при ходьбе, дискомфорт или появление болей при половом акте, соприкосновении с одеждой.<br />Locus morbi: <a title=\"Перейти на страницу симптома Отек тканей\" href=\"/symptom/otek_tkaney/\">припухлость</a> овоидной формы на границе средней и нижней трети большой половой губы, кожа над припухлостью подвижна; <a title=\"Перейти на страницу симптома Покраснение кожи\" href=\"/symptom/pokrasnenie_kozhi/\">гиперемия</a> кожи; псевдоабсцесс выпячивает внутреннюю поверхность большой половой губы и закрывает вход во влагалище; иногда отмечается незначительная болезненность при пальпации.</p>\r\n<p><a title=\"Перейти на страницу симптома абсцесс\" href=\"/symptom/abscess/\">Абсцесс</a> бартолиниевой железы — возникновение гнойной полости с пиогенной капсулой в области большой железы преддверия влагалища.<br />Причины : инфекционная этиология. Чаще всего возбудители инфекции (строгие анаэробы) проникают в паренхиму железы и окружающую клетчатку, вследствие чего происходит расплавление паренхимы.<br />Первичный очаг — вагинит, уретрит.<br />Клиника: постоянная острая, пульсирующая боль в области наружных половых органов на стороне воспаления , усиливающаяся при сидении и ходьбе; ухудшение общего состояния; <a title=\"Перейти на страницу симптома Высокая температура 38-42° \" href=\"/symptom/vysokaya_temperatura_38-42/\">повышение температуры</a> тела до 38,5 °С и выше; увеличение СОЭ, лейкоцитоз.<br />Locus morbi: <a title=\"Перейти на страницу симптома Отек тканей\" href=\"/symptom/otek_tkaney/\">припухлость</a> в области большой и малой половых губ; серповидная половая щель при одностороннем поражении; <a title=\"Перейти на страницу симптома Покраснение кожи\" href=\"/symptom/pokrasnenie_kozhi/\">гиперемия</a> и резкая отёчность в поражённой области; <a title=\"Перейти на страницу симптома Ступор\" href=\"/symptom/stupor/\">неподвижность</a> кожи над абсцессом; пальпация железы резко болезненная, определяется флюктуация; иногда увеличиваются паховые лимфатические узлы.</p>\r\n<p>Хронический бартолинит — характеризуется маловыраженными явлениями воспаления, незначительными болями, более плотной структурой железы. Хронический бартолинит часто рецидивирует, при длительном существовании в полости железы накапливается жидкий <a title=\"Перейти на страницу симптома Выпот\" href=\"/symptom/vypot/\">экссудат</a>, образуется безболезненная опухоль — киста бартолиниевой железы.</p>",
"image": "http://api.symptomd.ru/storage/383039c2fe80563f0ad646bc6b7f3bf8_PkYPkXi.png",
"image_alt": "Бартолинит",
"standard_type": 0,
"danger": 26,
"published": 1,
"parent": null,
"block_rubric": 155,
"standards": []
}
]
}
