產褥熱/Puerperal fever

英文引言:Wikipedia:WikiProject Medicine/Translation task force/RTT/Simple puerperal infections  


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Puerperal infections, also known as postpartum infections, puerperal fever or childbed fever, is any bacterial infection of the female reproductive tract following childbirth or miscarriage. Signs and symptoms usually include a fever greater than 38.0 °C (100.4 °F), chills, lower abdominal pain, and possibly bad smelling vaginal discharge.[1] It usually occurs after the first 24 hours and within the first ten days following delivery.[2]

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’’’產褥熱’’’(Puerperal infections 或 puerperal fever)也稱為’’’產後感染’’’(postpartum infections),是在[[分娩]]、[[流產]]或是[[墮胎]]後,[[陰道|產道]]的細菌性[[感染]],其症狀一般會包括[[發燒]]超過38.0 °C(100.4 °F)、寒顫、下腹痛,[[阴道分泌物]]可能會有異味[1]。一般會在分娩後的24小時內出現,會持續十天[2]。

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The most common infection is that of the uterus and surrounding tissues known as puerperal sepsis or postpartum metritis. Risk factors include Cesarean section, the presence of certain bacteria such as group B streptococcus in the vagina, premature rupture of membranes, and prolonged labour among others. Most infections involved a number of different types of bacteria. Diagnosis is rarely helped by culturing the vagina or blood. In those who do not improve medical imaging may be required. Other causes of fever follow delivery include: breast engorgement, urinary tract infections, infections of the abdominal incision or episiotomy, and atelectasis.[1]


最常見的感染是在[[子宮]]及周圍組織的感染,稱為’’’产后败血症’’’(puerperal sepsis)或’’’產後子宮炎’’’(postpartum metritis)。危險因子包括[[剖宫产|剖腹产]]、陰道中有{{le|B型鏈球菌|group B streptococcus}}之類的菌種、[[早期羊膜囊破裂]]、[[滯產]]等原因。大部份的感染會和許多不同種類的細菌有關。對血液或是陰道中的細菌進行{{le|微生物培養|Microbiological culture}}對診斷的幫助不大,此時需進行[[醫學影像]]檢查。其他分娩後發燒的原因有{{le|乳房腫大|Breast engorgement}}、[[泌尿道感染]]、腹壁切口或[[會陰切開術]]傷口的感染,以及{{le|肺不張|atelectasis}}的情形[1]。

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Due to the risks following C-section it is recommended that all women receive a preventative dose of antibiotics such as ampicillin  around the time of surgery. Treatment of established infections is with  antibiotics with most people improving in two to three days. In those  with mild disease oral antibiotics may be used otherwise intravenous antibiotics are recommended. Common antibiotics include a combination of ampicillin and gentamicin following vaginal delivery or clindamycin  and gentamicin in those who have had a C-section. In those who are not  improving with appropriate treatment other complications such an abscess should be considered.[1]



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In the developed world about one to two percent develop uterine infections following vaginal delivery.  This increases to five to thirteen percent among those who have more  difficult deliveries and fifty percent with C-sections before the use of  preventative antibiotics.[1] In 2013 these infections resulted in 24,000 deaths down from 34,000 deaths in 1990.[3] The first known descriptions of the condition date back to at least the 5th century BCE in the writings of Hippocrates.[4]  These infections were a very common cause of death around the time of  childbirth starting in at least the 18th century until the 1930s when  antibiotics were introduced.[5] In 1847, in Austria, Ignaz Semmelweiss through the use of handwashing with chlorine decreased death from the disease from nearly twenty percent to two percent.[6][7]

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已開發國家中,{{le|陰道分娩|vaginal delivery}}的產婦約有1%至2%感染產褥熱,若是較困難的分娩方式,感染產褥熱的比例會到5%至15%,若是剖宮产又沒有使用預防性的抗生素,感染比例會到50%[1]。2013年時因產褥熱死亡的人數為二萬四千人,已較1990年時的三萬四千人要少[3]。第一個有記錄的產褥熱至少可追溯到西元前5世紀[[希波克拉底]]的記載[4]。在18世紀開始,產褥熱開始變成分娩時產婦非常常見的死因,一直到1930年代開始使用抗生素後才改善[5]。1847年時,[[奧地利]]醫生[[伊格納茲·塞麥爾維斯]]推動醫師在接生前用[[次氯酸钙]]水溶液{{le|洗手|Hand washing}},一度將產褥熱的比例從20%降低到2%[6][7]。


產褥熱Puerperal fever or childbed fever)也稱為產褥期發熱,是細菌感染的一種,醫學上稱為產褥感染,可發展成產後敗血症,主要發生在婦女分娩流產墮胎之後,病原體透過未經消毒的手術工具,侵入生殖器官所致。如果沒有適當治療,婦女會有生命危險。