Thaum lub sij hawm perinatal, nyuj raug cuam tshuam los ntawm kev ntxhov siab ntawm kev yug menyuam, uas ua rau txo qis ntawm lub cev tiv thaiv thiab tshwm sim ntawm cov kab mob cuam tshuam nrog kev yug menyuam. Qhov tshwm sim ntawm cov kab mob no feem ntau ua rau poob qis ntawm kev ua me nyuam thiab kev tsim cov mis nyuj ntawm cov nyuj, txawm tias raug yuam kom tshem tawm, ua rau muaj kev puas tsuaj loj rau mus ua teb.
NO.1 Endometritis
1. Kab mob
Endometriosis yog ib qho ntawm cov kab mob ntau tshaj plaws hauv kev ua me nyuam ntawm cov nyuj, thiab nws kuj yog qhov ua rau muaj menyuam tsis taus nyob rau hauv cov nyuj mis nyuj. Cov kab mob tseem ceeb ua rau endometriosis yog Staphylococcus aureus, Escherichia coli, Streptococcus pyogenic, Brucella, Mycobacterium tuberculosis, Proteus leishmania, thiab Trichomonas. Qhov laj thawj tseem ceeb ntawm perinatal endometriosis nyob rau hauv cov nyuj yog cov tshuaj tua kab mob tsis txaus thaum yug menyuam lossis kev yug menyuam thiab kev saib xyuas tsis zoo tom qab yug menyuam, uas ua rau muaj kab mob. Thaum noj nyuj cev nqaij daim tawv tsis zootsis muaj vitamin E, vitamin A thiab kab kawm selenium thiab iodine hauv pub, tsis muaj calcium thiab phosphorus lossis tsis tsim nyog, thiab kev noj cov protein tsis txaus tom qab yug me nyuam, qhov tshwm sim ntawm endometriosis hauv nyuj nyuj yuav nce ntxiv.
2.Kev Tiv Thaiv
Kev mloog yuav tsum tau them rau lub kev noj haus thiab kev tswj hwm ntawm cov nyuj uas cev xeeb tub. Kev noj zaub mov yuav tsum muaj kev sib luag thiab sib npaug, thiab kev tawm dag zog yuav tsum txaus. Thaum lub sij hawm ua hauj lwm thiab tom qab yug me nyuam, tua kab mob cowshed, combed, thiab qhov chaw mos nyob rau hauv lub sij hawm; Ua tib zoo saib xyuas cov tshuaj tua kab mob ntawm cov neeg ua haujlwm caj npab thiab cov cuab yeej siv thaum lub caij yug me nyuam, nruj me ntsis ua raws li cov cai ntawm kev khiav hauj lwm, thiab zam kev puas tsuaj rau lub tshuab kom deb li deb tau.
3. Kev kho mob
Cov kws kho mob feem ntau siv tshuaj rau endometritis yog tshuaj tua kab mob, anti-inflammatory hormones, thiab antiseptics. 0.1-0.3% poov tshuaj permanganate 200-300 ml, rhuab mus txog 40 degrees Celsius los ntxuav lub tsev menyuam, thaum massage lub tsev menyuam los ntawm lub qhov quav los ntxuav lub tsev menyuam kom huv si. Tom qab ntxuav, 1.6 lab thoob ntiaj teb units ntawm penicillin thiab 1 lab thoob ntiaj teb units ntawm streptomycin tau yaj nyob rau hauv 100 ml ntawm sterile dej, ib zaug txhaj rau hauv lub tsev menyuam, los yog 2 grams ntawm oxytetracycline raug txhaj rau hauv lub tsev menyuam. Rau cov kab mob endometritis ntev ntev, hypertrophic uterine phab ntsa thiab purulent secretion, 20 ml ntawm ethylene-stilbestrol tuaj yeem txhaj tshuaj intramuscularly los txhawb txoj kev loj hlob ntawm lub tsev menyuam.
NO.2 Ketosis
Mis nyuj nyuj ketosis kuj tseem hu ua ketonemia thiab ketonuria.
Tus kab mob no feem ntau tshwm sim nyob rau hauv high-yielding nyuj thiab nyuj nrog tsis zoo noj thiab tswj. Qhov tshwm sim ntawm tus kab mob yog siab dua nyob rau hauv nyuj ntawm 3 lub lis piam mus rau 2 lub hlis thiab 3 mus rau 6 parities tom qab yug me nyuam, thiab siab dua nyob rau hauv lub caij ntuj no tshaj lub caij ntuj sov.
1.Etiology thiab pathogenesis
Thaum cov nyuj yog lactating, muaj qhov tsis zoo ntawm lub zog thaum noj zaub mov tsis tuaj yeem ua tau raws li lub zog xav tau ntawm lactation. Cov nyuj yuav tsum tau siv lawv lub cev rog thiab cov protein kom txo qis kom ua tau raws li lub zog xav tau thiab tsim cov acetic acid thiab butyric acid ntau dhau (lub cev ketone) thaum hloov cov roj protein rau hauv lub zog, uas ua rau ketosis. Cov nyuj rog rog thaum lub sij hawm calving yog ua rau ketosis. Tsis txaus vitamin B12 (tsis muaj qhov drilling) txhawb qhov tshwm sim ntawm ketosis. Kev tso tawm ntau dhau ntawm oxytocin vim yog lactation tom qab yug menyuam ua rau muaj qhov tsis txaus ntawm insulin thiab thyroid ua haujlwm.
2. Cov tsos mob
Ketosis tuaj yeem muab faib ua cov plab zom mov, mob hlwb thiab tuag tes tuag taw:
(1) Kev zom zaub mov: ib txwm lossis me ntsis ntawm lub cev kub, ua tsis taus pa (acidosis), hyperactivity ntawm lub plawv suab, pungent tsw ntawm ketone nyob rau hauv exhaled gas thiab tso zis thiab mis nyuj, kev nyuaj siab, ceev thiab cim emaciation, limp gait, sai poob rau hauv lactation , thawj zaug noj quav nyab los yog nyom, thaum kawg tsis kam noj, rummination nres, flaccid forestomach, thawj cov quav zais cia, feem ntau ntawm lawv tawm odorous quav, daim siab percussion lub suab ciam teb, tuaj yeem tshaj kaum peb tav, thiab rhiab rau qhov mob.
(2) Cov tsos mob ntawm lub paj hlwb: Ntxiv rau cov tsos mob tseem ceeb ntawm kev zom zaub mov hauv ntau qhov sib txawv, muaj cov tsos mob ntawm lub paj hlwb xws li agitation, roaring, npliag zom thiab nquag tus nplaig tig, lub voj voog tsis muaj kev sib hloov thiab txawv txav, lub taub hau lossis lub taub hau, pillar, tsis pom kev nyob rau hauv ib co nyuj, sensory allergy, somatic nqaij thiab nystagmus, thiab ib co ntawm lawv zoo siab heev. Nws tuaj yeem hloov nrog kev nyuaj siab.
(3) Hom tuag tes tuag taw: Ntxiv rau ntau cov tsos mob zoo ib yam li cov tuag tes tuag taw, kuj tseem muaj qee cov tsos mob tseem ceeb ntawm ketosis, xws li tsis qab los yog tsis kam noj, cov tsos mob plab xws li flaccidity ntawm lub plab anterior thiab ua xua rau stimulation, nqaij tremor, spasm, cia li poob rau hauv lactation, thiab lwm yam, xws li concurrent tuag tes tuag taw, thiab cov nyhuv ntawm calcium tsis zoo.
3. Kev kuaj mob:
Tus kab mob no feem ntau tshwm sim nyob rau hauv lub sij hawm tom qab lactation, uas yog tus cwj pwm los ntawm emaciation, txo cov mis nyuj ntau lawm, tsis muaj qab los noj mov, anterior gastric flaccidity thiab neurological tsos mob, o ntawm daim siab percussion kuaj cheeb tsam, ketone tsw nyob rau hauv zis, mis nyuj thiab exhaled roj, thiab kev kuaj mob tuaj yeem ua tau.
Nws yuav tsum txawv ntawm lwm yam kab mob xws li tuag tes tuag taw, raug mob reticulum-peritonitis-pericarditis, dyspepsia, uteritis, thiab abomasum metastasis.
4.Kev Tiv Thaiv
Cov nyuj cev xeeb tub yuav tsum tsis txhob dhau fattened, tshwj xeeb tshaj yog cov uas muaj ntau tog hauv lub sij hawm mis nyuj qhuav. Lub plab zom mov yuav tsum tau kho kom zoo ua ntej xa khoom. Piv txwv li, lub mloog zoo yuav tsum tau muab ntxiv maj mam 3-4 lub lis piam ua ntej tus me nyuam kom nyuj yoog rau cov mis nyuj noj tom qab calving, tab sis concentrated sow protein yuav tsum tsis txhob siab dhau, feem ntau tsis ntau tshaj 16%. Tsis txhob pub moldy, lwj, inferior quav nyab thiab silage tsis zoo, tsis txhob dheev hloov lub pub, pub yuav tsum muaj txaus cov vitamins thiab kab kawm.
5. Kev kho mob
(1) Sugar supplementation thiab qab zib-derived tshuaj: 40-50% qabzib 500-1000 ml intravenous infusion, 3-4 zaug ib hnub twg, zoo dua lub sij hawm ntev intravenous infusion, sodium propionate 110-225 g ob zaug nrog dej, propylene glycol los yog glycerol 225 g nrog dej, ob zaug ib hnub twg, ob hnub sib law liag tom qab noj cov tshuaj ntawm kev txiav txim siab.
(2) Hormone therapy: Corticosteroids xws li cortisone acetate, hydrocortisone, prednisolone, thiab flumethasone kuj muaj txiaj ntsig zoo.
(3) Relieving acidosis: 50% sodium bicarbonate yog txhaj tshuaj intravenously, zoo dua ua ke nrog kev txiav txim siab ntawm plasma carbon dioxide binding peev. Sodium lactate kuj yog ib qho tshuaj los kho cov kab mob kua qaub.
NO.3 Dystocia
1. Kab mob
Yog vim li cas nyuj nyuj dystocia kev feem ntau yog los ntawm fetal thiab niam txiv. Cov poj niam manifestations yog obstetric nruj thiab tsis muaj zog ntawm contraction. Fetal manifestations yog fetal oversize, ntxaib, txawv txav fetal peev xwm thiab lwm yam.
2.Kev Tiv Thaiv
Kev saib xyuas yuav tsum tau them rau kev tswj kev noj haus thaum lub sij hawm cov mis nyuj qhuav kom tsis txhob hnyav dhau los yog thinning ntawm cov mis nyuj. Cov nyuj uas muaj lub pelvis nqaim thiab primipara feem ntau tsis tas yuav ua niam txiv nrog cov menyuam yug tshiab kom tsis txhob muaj menyuam hauv plab dystocia vim qhov loj ntawm fetal ntau dhau.
3. Kev kho mob
Dystocia mis nyuj nyuj yuav tsum tau cawm nyob rau hauv lub sij hawm. Kev xa menyuam hauv plab tseem tsis tuaj tom qab mob tas li. Cov midwives'hands raug tshuaj tua kab mob thiab muab tso rau hauv qhov chaw yug me nyuam los ntawm saum toj no. Tom qab kho lub fetus txoj hauj lwm, lub fetus yuav tsum tau rub tawm maj mam. Yog hais tias tus me nyuam mos tseem tsis tawm, nres rub, thiab xaiv qhov chaw ua me nyuam hauv plab los yog fetal amputation raws sij hawm.
NO.4 Retention of placenta
1. Kab mob
Retention of placenta tseem hu ua retention of the placenta. Raws li cov ntaub ntawv txawv teb chaws, tus nqi ntawm cov placenta tuav ntawm ib txwm nyuj yog 11-30%, thiab cov nyuj hauv tsev yog 20-38%. Feem ntau ntawm cov placenta retention yog vim kev noj zaub mov tsis zoo thiab kev tswj xyuas thaum cev xeeb tub lig, uas ua rau tus nyuj lub cev tsis muaj zog, lossis lub tsev menyuam tsis muaj zog thiab ua haujlwm tsis zoo ntawm Qi thiab ntshav los ntawm kev txhawb nqa ntawm qhov tsis zoo sab nraud thaum yug menyuam. Cov placenta o thiab cov qauv placenta tshwj xeeb tshwm sim los ntawm microbial ntxeem tau ntawm lub tsev menyuam kuj yog vim li cas rau qhov tshwm sim tsis tu ncua ntawm placenta retention.
2.Kev Tiv Thaiv
Peb yuav tsum ntxiv dag zog rau kev pub mis thiab tswj cov nyuj thaum cev xeeb tub lig thiab muab kev tawm dag zog kom raug. Ua tsaug thiab ib puag ncig huv si Thaum lub sij hawm tus me nyuam, sim cia nyuj tsim ib txwm, txo qhov tsis zoo stimulating yam, midwifery yuav tsum tsis txhob ntxov dhau (30 feeb ua ntej lov dej), thiab tsis txhob blindly yuam midwifery. Sodium selenite, 0.5g ntawm vitamin E hmoov los yog Leonurus tshuaj ntsuab kua zaub tom qab yug me nyuam tuaj yeem tiv thaiv qhov tshwm sim ntawm placenta retention.
3. Kev kho mob
Peb yuav tsum ntxiv dag zog rau kev pub mis thiab tswj cov nyuj thaum cev xeeb tub lig thiab muab kev tawm dag zog kom raug. Khaws ib qho chaw nyob ntsiag to thiab huv si thaum lub caij yug me nyuam, sim ua kom cov nyuj tsim tau ib txwm muaj, txo qis qhov cuam tshuam tsis zoo, kev tsim yug me nyuam yuav tsum tsis txhob ntxov dhau (30 feeb ua ntej dej tawg), thiab tsis txhob ua qhov muag tsis pom kev midwifery. Sodium selenite, 0.5g ntawm vitamin E hmoov los yog Leonurus tshuaj ntsuab kua zaub tom qab yug me nyuam tuaj yeem tiv thaiv qhov tshwm sim ntawm placenta retention.
NO.5 Prolapse ntawm lub tsev menyuam
1. Kab mob
Kev noj zaub mov tsis zoo, kev tawm dag zog tsis txaus lossis kev laus thaum cev xeeb tub tuaj yeem txo qis cov leeg nqaij uterine, fetal oversize, fetal malformations, ntxaib thiab cov kua dej ntau dhau ntawm fetal ua rau ntau lub tsev menyuam dilation, kev yug menyuam ntxov, thiab kev yug menyuam. Muaj zog rub tawm ntawm fetus, tom qab yug menyuam nyuj tshaj-nurturing yuav ua rau uterine prolapse.
2.Kev Tiv Thaiv
Ntxiv dag zog rau kev noj zaub mov thiab kev tswj hwm ntawm cov nyuj tsis pub noj mis kom tsis txhob muaj qhov hnyav dhau ntawm lawv lub cev, thiab ua haujlwm zoo ntawm kev saib xyuas rau cov nyuj uas muaj hnub nyoog laus dua. Kev ua haujlwm midwifery kom raug, ua raws li cov txheej txheem kev khiav haujlwm, txo cov uterine prolapse tshwm sim los ntawm kev midwifery tsis raug.
3. Kev kho mob
Cov mis nyuj uas muaj lub tsev menyuam prolapsed yuav tsum siv zog rau kev kho mob thaum ntxov kom tsis txhob kis kab mob los ntawm lub tsev menyuam mus ntev. Thaum pom tias lub tsev menyuam ntawm cov nyuj yog prolapsed tom qab yug me nyuam, nws yuav tsum tau kho raws sijhawm. Oxytetracycline hmoov tau siv rau hauv lub tsev menyuam kom tiv thaiv kab mob. Txhawm rau tiv thaiv lub tsev menyuam ntawm prolapsing dua, txhaj tshuaj uterine contractile agents lossis suture ib ntus ntawm qhov chaw mos.
TSIS MUAJ. 6 Postpartum paralysis
1. Kab mob
Tom qab yug me nyuam tuag tes tuag taw ntawm cov nyuj mis nyuj yog ze ze rau cov metabolism hauv calcium. Kev pib ntawm cev xeeb tub tom qab yug me nyuam thiab kev tso tawm ntau ntawm calcium los ntawm cov mis nyuj, lub sijhawm no, cov ntsiab lus calcium hauv plasma yuav tsum tau ntxiv los ntawm kev ua kom lub plab zom mov thiab cov pob txha calcium nag lossis daus. Txawm li cas los xij, kev ua haujlwm hauv plab hnyuv ntawm nyuj ua ntej thiab tom qab yug me nyuam tsis zoo, uas txo qis kev nqus ntawm calcium thiab nce qib estrogen ntawm nyuj. Tiv thaiv kom lub sijhawm hloov cov pob txha calcium mus rau cov ntshav, ua rau muaj qhov tsis zoo ntawm calcium, thiab thaum kawg ua rau hypocalcemic tuag tes tuag taw.
2.Kev Tiv Thaiv
Nyuj tau noj tsawg calcium thiab kev noj zaub mov phosphorus siab ob lub lis piam ua ntej tus me nyuam kom qhib lub caj pas parathyroid ua haujlwm thiab txhim kho lub cev muaj peev xwm nqus calcium. Ua kom cov ntsiab lus calcium hauv cov khoom noj (ntau dua 1%) tom qab yug me nyuam, thiab noj tsawg kawg ib koob tshuaj calcium npaj ntawm qhov ncauj. Nyob rau tib lub sijhawm, noj qee cov tshuaj ua kom lub plab kom txhawb kev zom zaub mov thiab nqus calcium hauv plab hnyuv. Tsis txhob maj kom nchuav cov mis nyuj tom qab yug menyuam. Thawj cov kua mis yog 1/5 ntawm qhov qub, thiab tom qab ntawd maj mam nce, mus txog qhov qub mis nyuj tom qab 4 hnub.
3.Kev Tiv Thaiv
Kev txhaj tshuaj ntawm 10-20% calcium gluconate 200-400 ml, hydrocortisone 400-500 mg, 10% sodium kas fes 20-40 ml thiab 5% saline 2000 ml. Nyob rau tib lub sijhawm, cov nyuj uas tuag tes tuag taw tau muab tso rau hauv lub mis tam sim ntawd, uas ua rau cov hlab ntsha mammary thiab inhibited lactation, thiaj li tsis ua kom txo cov ntshav calcium ntau ntau.