兽医产科学产后疾病.ppt

单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,第十章 产后期疾病,Chapter ten Postpartum Disease,第一节 产道及子宫损伤,Lesson One Abnormality of birth canal and uterine,包括阴门、阴道、宫颈的撕裂和子宫破裂。按外科方法进行修补。具体自学。,Including tear of the cunnus,、,vagina,、,neckofuterus and hysterorrhexis.study by yourself.,1,第二节 胎衣不下,Lesson Two Retention of Afterbirth,又称胎衣滞留。,母畜在分娩后，胎衣在一定时间内不排出称胎衣不下,。各种家畜产后胎衣正常排出时间：,牛：,12h,猪：,1h,羊：,4h,马：,1-1.5h,retention of afterbirth:After the delivery of the female livestock,afterbirth cant excrete in some time.,The right time of some livestocks afterbirth were excreted after delivery:,Cattle:12h swine:1h sheep:4h horse:1-1.5h,奶牛的发生率,10%,左右，个别地区或单位可高达,40%,。,The incidence of the dairy cow is about10%,，,someplace may reach up to 40%.,与饲养管理（运动等）和生殖道疾病及胎盘组织结构类型有关。并有一定的地区性。,It is related to the feeding and management,the disease or genital tract,and the placental tissue structure types.Its aslo has provincialism.,2,一、病因,Section one,、,pathogeny,1,产后子宫收缩无力：,与营养不良、运动不足、胎儿过大过多及难产时间过长等因素有关。同时与催产素的释放有关。如果让仔猪吸吮母猪的乳，母猪的胎衣不下发生率下降。,1,、,Postpartum uterus weak,：,Its related to the malnutrition,、,hypomotility,、,Fetals excessive and overmuch and childbirth time is too long .The release of the oxytocin is aslo a factor.The incidence will decline if you let the piglet suck.,2,胎盘炎症：,怀孕期间子宫受到感染，（如李氏杆菌、胎儿弧菌、沙门氏菌、支原体、霉菌、毛滴虫、弓形虫等），发生子宫内膜炎及胎,盘炎使结缔组织化，,胎儿,-,母体胎盘粘连。,2,、,Placenta inflammation,：,The uterus was infected during gestation time,(Listeria monocytogenes,vibrio fetus,salmonella,Mycoplasma,mould,trichomonad,toxoplasma gondii,and so on),endometritis and placentitis made the connective tissue,fetal-maternal placenta accreta.,上一胎手术剥离过胎衣的，以后发生率高。,If the afterbirth has been strippinged,the incidence will be high.,3,3,与胎盘类型有关：,以牛最易发生,3,、,Concerned with the placenta typeMost occur on the cattle.,4.,胎盘未成熟或老化,:,成熟后的胎盘结缔组织胶原化,变湿润,纤维膨胀呈直 红型，子宫腺窝上皮层变平，多核细胞增多，吞噬能力增强，组织变松，易受激素影响；胎盘老化是指胎盘组织增生增厚，内分泌功能减退。,4,、,Placenta are immaturate or ageing:The ripe placenta connective tissue became collagenzation,moist,and the fibre swelled to linear type,the uterine glandular nest on cortex became flat,apocyte increase,phagocytic activity strengthen,tissue loosen,vulnerable hormones influence;aging of placenta:Placental tissue hyperplasia thickening,hypoendocrinism.,5.,胎盘充血和水肿,:,分娩过程中,子宫异常强烈的收缩或脐带血管关闭太快等。,5.Placenta hyperemia and edema:During the delivery,uterine contraction extremly intense or cordvessels closed fast.,4,二、症状,Section two,、,symptom,可分,全部不下,和,部分不下,两种,All retention and half retention,胎衣下垂于阴门外，时间长而恶臭，严重时出现全身症状。,The afterbirth descended out of the cunnus,the time is long and it is effluvial,even occur of the whole body.,5,Normal placenta,6,7,8,三、预后,Section three,prognosis,1,经治疗能够排出的，子宫不发生感染，预后良好；,1.The afterbirth can excrete with some treat,and there havent infection in the uterus,the prognosis is well.,2,排不出,-,胎衣腐烂，引起子宫积脓、内膜炎、败血症，引起死亡；,2.Retentionafterbirth become rot,pyometra,intimitis,ichorrhemia,and death.,3,子叶脱落、损伤多者，可造成习惯性流产。,3.If the cotyledon drop and were harm too much,it may cause habitual abortion.,9,四、治疗,Section four,、,Treatment,1,牵引,-,可挂轻物，但不能挂一重物，防止子宫内翻及脱出；,1.haulHang some light thing,not the heavy,prevent the inversion of uterus and the uterineprolapse.,2,药物疗法,：,2.pharmacotherapy,A,：雌激素：,20-30mg.Im,A:estrogen 20-30mg.Im,B,：催产素：,100u.,雌激素后,6,小时。,Im,。,B,：,oxytocin,：,100u.After estrogen 6 hours.Im,。,C,：宫炎净,B,或罗泰净：,2%-100ml.,3,高渗盐水法,：使子叶脱水，母子胎盘分离。在子宫内灌入,5-10%,氯化钠盐水,2000-3000ml.,3.Dehydration:Make the cotyledon dehydration ,mazolysis.Inject 2000-3000 ml 5-10%sodium chloride brine to the uterus.,10,4.,中药治疗,4.,Treatment by Chinese herbs,成 分：黄芪,50,克，党参,50,克，当归,80,克，川芎,80,克，核仁,50,克，红花,80,克，益母草,50,克，三棱,80,克，莪术,80,克，瞿麦,80,克，肉桂,50,克，牛膝,30,克，乳香,50,克，赤芍,50,克，香附,50,克。,用法与用量：煎药灌服,1,次，或磨成药粉温开水灌服,1,次,疗 效：用药后,612,小时胎衣排出,composition:Astragalus mongholicus 50 g.,codonopsis pilosula 50g,Angelica sinensis 80 g,Ligusticum wallichii Franch 80 g,semen juglandis 50 g,red flower 80 g,leonurus 50g,rhizoma sparganii 80 g,curcuma zedoary 80g,fringed pink 80g,cassia bark 50g the root of bidentate achyranthes 30 g,olibanum 50g,root of common peony50g,rhizoma cyperi 50g.,Method&Dosage of using:boil medicine or wear to powder and dissolve lukewarm boiled water.,curative effect:After the pharmacy 6-12h the afterbirth excrete.,5,手术剥离法,：略,5.Operation omit,11,7.,子宫冲洗：,无论何种方法，胎衣下来后，应用消毒液反复冲洗子宫,2-3,次，至流出的液体与注入的液体颜色一致为止。但需注意冲洗压力不易太大，防止流入输卵管。,7.,uterinewatering:When the afterbirth came down,wash the uterus with disinfectant for 2-3 times until the influent and the excurrent liquid are of the same colour.Look out that the washing pressure should not be too high,in case of influxing the fallopian tube.,0.1%,高锰酸钾,0.25-0.5%,利凡诺,0.05%,洗必泰,0.1%potassium permanganate,0.25-0.5%rivanol,0.05%,chlorhexidine,8.,防止感染,:,冲洗子宫后，给予子宫收缩剂和抗菌素，防止感染；,8.Prevention of infection:After washing the uterus,use hysterotonics and antibiotics to prevent infection.,9.,注意全身变化,。,9.Pay attention to the change of the whole body.,12,五、预防,Section five,、,prevention,1,饲喂含钙及维生素丰富的饲料；,1.Feed the livestock with the feed that was rich in Ca and vitamin.,2,加强运动；,2.Do more exercise,3,尽可能灌服羊水，并让母畜自己添干仔畜身上的粘液；,3.Irrigate with amniotic fluid,and let the female livestock lick the mucus on the newborn animal by itself.,4,产后饮服益母草煎剂。,4.,Take leonurus decoctum after delivery.,13,第三节 子宫弛缓（子宫复旧不全）,Lesson Three Atony of uterus,一、定义,Section one,、,definition,分娩后，子宫恢复至未孕时的状态所需的时间延长，称为,子宫弛,缓,（子宫复旧不全）。,Atony of uterus:After partum,the time that the uterus recover to the unpregnancy condition expand.(subinvolution of uterus),正常恢复时间：,牛：,12-24,天基本恢复，,40,天完全恢复；,羊：,24,天；,猪：,28,天。,The right time:,Cattle:12-24 days half-recovery,40 days will full-recovery.,Sheep:24 days.Swine:28 days.,14,二、病因,Section two,、,pathogeny,凡能引起阵缩微弱的各种原因，均能导致子宫弛缓。,如老龄、瘦弱、肥胖、运动不足、胎儿过大、胎水过多、多胎怀孕、难产时间过长等，以及催产素分泌不足。,The cause that can lead to dolorespostpartum weak will cause atony of uterus.Such as ageing,emaciation,fat,hypomotility,oversized of the fetus,too much of placentalfluid,polyembryony pregnancy,the time of dystocia is too much,and the hyposecretion of the oxytocin,胎衣不下、产后子宫内膜炎常继发本病。,Retention of afterbirth,puerperal endometritis will secondary onset this disease.,15,三、症状及诊断,Section three,、,symptom and diagnosis,1,恶露排出的时间大为延长,:,产后,1-2,天内无恶露或很少；,1.The time of the exhausting the lochia prolong greatly:After delivery 1-2 days,there is no lochia or rarely.,2,产后第一次发情时间延迟,；,2.The time of the postpartumheat delay.,3,努责、腹痛,:,时常排尿但量少，影响食欲，奶量、体温升高；,3.Valsalva,、,stomachache:urinate frequently but the quantity is few,affect theappetite,output of milk and the body temperature increased.,4,阴道检查,：子宫颈口弛缓开张；,4.Examination of vagina:Cervical orifice stretch atony.,5,直肠检查,：子宫壁厚而软，收缩反应微弱，体积比产后同期子宫大。,5.Examination of rectum:uterus wall is thick and soft,agonist response is weak,the volume is biigger than the uterus of the same term after delivery.,16,四、治疗,Section four,、,Treatment,1,子宫收缩剂：,已烯雌酚,20-30mg Im,垂体后叶制剂：100u Im,1.Hysterotonics,1.Diethylstilbestrol:20-30mg Im,2.posterior pituitary preparation:100u Im,2,益母草煎剂：,灌服,1,斤益母草加红糖半斤,2.Decoctum of leonurus:injection,1/2 kilograms leonurus and brown sugar,3,益母草流浸膏：,100-200ml 2-3,次,/,日,3.Fluid extract of leonurus:100-200ml 2-3 times/day.,4,10%,高渗盐水冲洗子宫：,增强子宫,410%hypertonic saline wash the uterus:strengthen the uterus.,5,或宫炎净,B,：,2%-100ml,注入宫腔,5.:inject 2%-100ml to uterine cavity,6,防止感染：,在子宫内投入抗生素,6.Prevention of infection:inject antibiotic to the uterus.,17,五、预防,Section five,、,prevention,对于分娩时间过长（难产时间太久）的牛，可应用子宫收缩剂。,For the cattle that have the overlong delivery time(the,dystocia,time is too long),we can use the hysterotonics.,18,第四节 阴道脱,lesson four Prolapse of the vagina,阴道脱为阴道壁的一部分（部分脱出）或全部（完全脱出）突出于阴门或阴门之外,称为阴道脱。,多发生于怀孕末期。其它时间亦可发生，如怀孕中期、产后等。,Prolapse of the vagina:some of the vaginalwall or the whole vaginalwall extrude from the cunnus.It always happen during the telophase of the pregnancy.Some other time,such as metaphase of the pregnancy or postpartum,it will also happen.,奶牛阴道脱出的发生率较高，狗偶尔发生。,Prolapse of the vagina often happens on dairy cattle,and,occasionally,happens on dog.,19,一、病因,Section one,、,pathogeny,固定阴道的组织、阴道壁及外阴松弛。,特别是怀孕末期，因胎盘分泌较多的雌激素，导致上述组织松弛,如衰老,营养不良,疾病等。,1.The tissue and vaginalwall and vulva that fasten the vaginal are relaxed.,由于种种原因使腹内压过高。,如胎儿过大，胎水过多，瘤胃膨胀，努责，长期栓于前高后低的厩舍内。,2.Some reasons lead to intra-abdominalpressure.Such as oversize of the fetus,too much placentalfluid,distention of rumen,，,valsalva,，,tack the livestock in the cattle-shed where the former is high and the behind is low for a long time,.,阴道脱出必须同时具备以上两个条件。,T,he happen of the prolapse of the vagina must be with these two conditions.,20,二、症状,Section two,、,symptom,部分脱出：,常在卧地后，阴道壁形成拳头大、粉红色瘤样物夹在阴门之中，或露在阴门外，当母牛起立后，能自行缩回。,P,artial,prolapse:After lay stiff,the vaginalwall become a fist-size pink tumour,stuck in the cunnus,or outside of cunnus,when the cow stand up,it will retract voluntarily.,完全脱出：,由部分脱出发展而来，在阴门外突出一排球大的囊状物，表面光滑，粉红色。病畜起立后也不能缩回。在脱出的末端可以看到子宫颈外口及怀孕的粘液塞，下壁可看到尿道口。,Completely prolapse:Develop from the p,artial,prolapse,there is a volleyball-sized bladder,the surface is smooth and pink.When the cow stand up,it cant retract voluntarily.In the tail end you can see the external os of vervix and the slime plug,from the paries inferior you can see the urethral orifice.,21,Prolapsed Vagina,22,Vaginal&cervical prolapse,23,Prolapsed Cervix24,Prolapsed cervix,25,脱出的阴道，由于长期不能缩回、瘀血，很快发紫，粘膜水肿变肿白，（表明粘膜开始坏死）。受地面磨擦及粪尿污染，常有脏物或有破口，血管破裂、流血，久之，坏死、糜烂。,The,prolapse,d vagina,because it cant retract for a long time,it will stasis blood,and turn blue,the mucousedema turn tumoralbus(it means the mucosa begin to become necrotic).Because of the attrition and the pollution of the fecaluria,there is always foul and crevasse,the blood vessel breaks,bleed,necrose,and become erosion at last.,由于脱出的阴道压迫尿道口，导致排尿困难，反之又加剧努责。完全脱出常因阴道及子宫颈受到刺激，发生强烈努责，可能引起直肠脱出。,Because the,prolapse,d vagina stress the urethral orifice,it will lead to dysuresia,and aggravate the valsalva.Due to the cervix uterus is Stimulated,the completely prolapse will aggravate the valsalva,even lead to rectal hernia,习惯性阴道脱,一般为部分脱出，进出自如，卧地时脱出，站立时缩回。,C,hronic,Prolapse of the vagina:It is often,partial,prolapse,pass in and out freely,lay stiff,prolapse,stand up,retract,.,26,三、预后,Section three,、,prognosis,部分脱出，预后良好；完全脱出，与发病时间有关，发生在产前，一般距分娩越近，预后越好，产后多能自行恢复。,1,、,The prognosis,of the,partial,prolapse is well;the prognosis,of the,completely,prolapse is,relate to,the disease time,the near be apart from the delivery the better ,and the prognosis will be better,and it will recover after delivery.,不易整复，一再反复脱出的，则易发生阴道炎，子宫颈炎，破坏子宫颈塞，引起胎儿死亡，流产。,2.It is not easy to restitut.If it prolapse repeatedly,there will be vaginitis,trachelitis easy,and it will destroy the cervix uterus,cause foetal death and abortion.,发生过阴道脱者，再受孕，容易复发，也容易发生子宫炎。,3.The livestock that ever happen prolapse of the vagina,will easy happen again when it is fertilized,and there will also be hysteritis easily.,27,四、治疗,Section four,、,treatment,一般采用手术固定,Generally,use the operation to fix.,整复：,站立保定：,选一前低后高的地方；,麻醉：,第十尾椎间隙，硬膜外腔或后海穴,0.2%,的普鲁卡因,10-15ml,。,冲洗：,用,0.1%,高锰酸钾溶液溶液，或,0.05-0.1%,新洁尔灭冲洗阴道；,Restitution,(1).Stand:A place where the former is high and the behind is low .,(2).Anesthesia:The interval between tenth vertebra to the second caudal,epidural space and Houhai acupoint 0.2%procaine 10-15ml.,(3).Washing:0.1%potassium permanganate,or 0.05-0.1%bromogeramine wash the vagina.,28,外科处理：,表面出血进行结扎，破口缝合；,(4)surgical intervention:If the surface bleed,ligate,suture the crevasse.,排尿：,移动阴道排尿；,(5)Urination:shift the vagina to urinate.,水肿处理：,消毒纱布起来，用针刺放水，控制,0.5mm,深长，缓慢挤压放血水；,(6)Dispose of edema:tie up with the sterile gauze,disembogue with acupuncture,control 0.5mm,extrude slowly to effuse the blood.,纳还：用拳头顶回。,(7):reject with you fist.,29,防止重脱：,2.Prevention of reprolapse,阴门缝合：,用兽用号缝线双股缝合；,(1)Suture of cunnus.Suture with bifilar18 suture,.,注意：在阴门下部分不要缝合，以免妨碍排尿；,Attention:Dont suture 1/3 of the below of the cunnus,prevent obstructing urination.,阴门固定：,根据阴门大小，做成阴门扣，用绳子固定。为防止变位，可以用缝线固定于阴门皮肤上。,(2),Fixation of cunnus:on the basis of the size of the cunnus,make cunnus button,fixed with a rope.you can fixed on the skin of the cunnus with suture,prevent deflection.,阴道侧壁与臀部皮肤缝合：,对于努责强烈的习惯性阴道脱，可行阴道侧壁与臀部皮肤缝合。,(3),Suture of side wall of vagina and buttocks:For the c,hronic,prolapse of the vagina,you can,Suture the side wall of vagina and buttocks,30,方法：,牛会阴部,20-25cm,臀中部，皮下注射,1%,普鲁卡因,5ml,；一只手伸入阴道内，将阴道壁尽量贴紧骨盆侧壁，另一手先在皮肤上切一小孔，用钻鞋针插入，穿号双股缝线，在阴道侧壁和臀中部皮肤上栓上一大纽扣，尽可能栓紧，两侧方法相同。,Method:I,njec,t,subcutaneous,on the perineum of the,cattle,with 1%procaine 5ml.stretch one fist into vagina,the other fist cut an opening on the skinInsert the needle with 18,bifilar,suture.Plug a big fastener,tightly,both the two sides are with the same method.,机理：,由于缝线穿过自的结缔组织发生增生增生，最后使阴道壁与骨盆侧壁发生粘连。因而固定比较结实，阴道不易再脱出。,Principle:The connective tissue are hyperplastic after suturing,the vaginalwall,and the side wall of pelvis adhere.The fixation is burly.,固定后，在阴道两侧深部组织内各注入酒精,20-40ml,，刺激组织发炎，肿胀，加速粘连。,After fixing,inject alcohol 20-40 ml into the two sides of vagina,inflame,swell,and adhere.,31,术后护理：,防止感染，尤其手术固定部分，严防化脓,抗菌素,有胎的。注射,50-100mg,孕酮，防止流产；,无胎的，注射,50-80u,催产素，加强子宫收缩。,3.postoperative care:,Prevent infection,antibiotics,Pregnant,，,inject 50-100mg progesterone,Not pregnant,inject 50-80u oxytocin.,32,第五节 子宫脱,Lesson five Prolapse of the uterus,子宫脱分为：,半脱,-,子宫角前端翻入子宫腔或阴道内，,全脱,-,子宫全部翻出于阴门外，同时伴有阴道脱。,divide into:,P,artial,prolapsethe front end of cornua uteri turn into uterine cavity or vagina.,Completely prolapsethe whole uterus turn out of the cunnus,and Prolapse of the vaginac company.,牛最为常见。发生于胎儿刚排出，子宫颈还开张时，其它时间不会发生。子宫全脱危险性较大，不及时抢救易引起死亡。,It happens most on cattle when the fetus were just born,and it is not easy to happen on other time.It is very dangerous and may cause death if the rescue is not in time.,33,Cow-uterine prolapse,34Cow-uterine prolapse1,35,Prolapsed uterus with intestines,36,Replacement in the standing cow,37,Uterine replacement in down cow,38,一、子宫脱与阴道脱异同点,Section one,、,The similarities and differences of prolapse of the uterus and prolapse of thevagina,1,发病时间：,子宫脱,-,刚产后子宫颈仍开张时，其它时间均不发生；,阴道脱,-,任何时间。,the time of the onset:,prolapse of the uterusjust,after delivery,and the cervix is still open.,prolapse of the,vaginaAnytime.,2,在子宫脱出的同时，阴道必定也被拉出。,2.When the,uterus prolapse,the,vagina,will also prolapse,.,3,病因两者相同。,3.The pathogenesis are the same.,39,二、子宫脱的特点,Section two,、,characteristic prolapse of the uterus,大多为突发，死亡率高。其原因：,1,极痛,休克死亡,2,大出血,由于子宫血管撕裂，可造成内外出血，,3,感染,脱出之后发生。,Most happen suddenly,the mortality is high.Reason:,be in anguish:shock and die.,massive haemorrhage:the angiorrhoxis may cause bleeding.,Infection:happen after the,prolapse.,40,三、病因,Section three,、,pathogeny,1,固定子宫组织松弛。,1.,The tissue fix the uterus are flabby.,2,腹内压很高。,表现强烈努责，或猛烈拉出胎儿，使子宫内压突然降低，而腹压相应增高，子宫随即翻出于阴门之外。,2.The intra-abdominalpressure is high:intense valsalva and pull-out the fetus fierce will reduce the intrauterine pressure,while the abdominal pressure rise,the uterus turn out of the cunnus.,3,子宫角一定具有发生内翻的可能。,3.The c