{"id":12481,"date":"2009-06-11T18:00:00","date_gmt":"2009-06-11T18:00:00","guid":{"rendered":""},"modified":"2016-03-25T00:16:18","modified_gmt":"2016-03-25T00:16:18","slug":"bakterine-vaginoze-paprasta-pacientes-problema","status":"publish","type":"post","link":"https:\/\/www.pasveik.lt\/lt\/naujausi-medicinos-straipsniai\/bakterine-vaginoze-paprasta-pacientes-problema\/12481\/","title":{"rendered":"Bakterin\u0117 vaginoz\u0117: paprasta pacient\u0117s problema?"},"content":{"rendered":"<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><b><i><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Gyd. intern\u0117 Edita \u0160veikauskait\u0117<\/span><\/i><\/b><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><i><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Jonavos ligonin\u0117<\/span><\/i><\/p>\n<h2 style=\"margin: 0cm 0cm 0pt;\"><span><em>Aku\u0161eris\u2013ginekologas \u017dydr\u016bnas \u017d\u0117ba<\/em><\/span><\/h2>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\"><em>klinika \u201eMotina ir vaikas\u201c, Kaunas<\/em><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><b><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 12.0pt;\">\u00a0<\/span><\/b><\/p>\n<p class=\"MsoBodyText\" style=\"margin: 0cm 0cm 0pt; text-align: justify;\"><span style=\"font-weight: normal; color: windowtext; font-family: Arial; mso-ansi-language: LT;\">Bet kuri moteris gali sirgti bakterine vaginoze, ne i\u0161imtis ir n\u0117\u0161\u010diosios. Vienoms pacient\u0117ms pasirei\u0161kia simptom\u0173, kitoms \u2013 ne. I\u0161kyla klausimai: kokia tai b\u016bkl\u0117? kokios moterys tur\u0117t\u0173 b\u016bti gydomos ir tiriamos? kokias pasekmes gali sukelti \u0161ios b\u016bkl\u0117s negydomos? kaip diagnozuojama? kaip tur\u0117t\u0173 b\u016bti gydoma <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/bakterine-vaginoze\/55699\">bakterin\u0117 vaginoz\u0117<\/a>?<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 12.0pt;\"><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\">\u00a0<\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><strong><span style=\"font-size: 10pt; color: windowtext; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 12.0pt;\">Kas tai yra <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/bakterine-vaginoze\/55699\">bakterin\u0117 vaginoz\u0117<\/a><\/span><\/strong><span style=\"font-size: 10pt; color: windowtext; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 12.0pt;\"><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\">\u00a0<\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\"><a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/bakterine-vaginoze\/55699\">Bakterin\u0117 vaginoz\u0117<\/a> (BV) \u2013 tai da\u017eniausiai pasitaikanti ir sunkius klinikinius padarinius sukelianti i\u0161orini\u0173 lyties organ\u0173 ir mak\u0161ties infekcijos forma. BV \u2013 tai ne egzogenin\u0117 infekcija, o mak\u0161ties ekologijos sutrikimas. Tai polimikrobinis sindromas, kurio metu gerokai suma\u017e\u0117ja vandenilio peroksid\u0105 (H<\/span><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 6.0pt;\">2<\/span><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">O<\/span><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 6.0pt;\">2<\/span><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">) gaminan\u010di\u0173 laktobacil\u0173 (<i>Lactobacillus spp.<\/i>) ir padid\u0117ja normaliai mak\u0161tyje esan\u010di\u0173 gramteigiam\u0173, gramneigiam\u0173 bakterij\u0173 ir daugelio anaerobini\u0173 mikroorganizm\u0173 (<i>Gardnerella vaginalis, Bacteroides spp., Mobiluncus spp., Fusobacterium spp., Prevotella spp. <\/i>ir <i>Peptostreptococcus spp.<\/i>) ir mak\u0161ties mikoplazm\u0173 (<i>Mycoplasma hominis <\/i>ir <i>Ureaplasma urealyticum<\/i>) skai\u010dius kelis \u0161imtus ar t\u016bkstan\u010dius kart\u0173 (1 pav.).<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\"><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\"><img loading=\"lazy\" decoding=\"async\" src=\"\/wp-content\/uploads\/2020\/11\/BV.bmp\" alt=\"Bakterin\u0117 vaginoz\u0117: paprasta pacient\u0117s problema?\" width=\"431\" height=\"605\"><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\">\u00a0<\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Mikrob\u0173 santykis skiriasi atsi\u017evelgiant \u012f am\u017ei\u0173 bei lytin\u012f aktyvum\u0105: vienoks yra mergait\u0117s, kitoks \u2013 lytin\u012f gyvenim\u0105 gyvenan\u010dios arba menopauz\u0117s tarpsnio moters mak\u0161tyje. Ta\u010diau r\u016b\u0161ys nekinta (lentel\u0117). Bakterij\u0173 labai padaug\u0117ja po menstruacij\u0173, n\u0117\u0161tumo metu pagaus\u0117ja laktobacil\u0173 ir suma\u017e\u0117ja anaerob\u0173.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 12.0pt;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><strong><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 12.0pt;\">Bakterin\u0117s vaginoz\u0117s paplitimas<\/span><\/strong><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 12.0pt;\"><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Bakterin\u0119 vaginoz\u0119 (BV) turb\u016bt galima diagnozuoti 40\u201350 proc. niekuo nesiskund\u017eian\u010di\u0173 moter\u0173. \u0160i gan\u0117tinai da\u017ena b\u016bkl\u0117 pasitaiko nuo 10 iki 50 proc. vis\u0173 n\u0117\u0161\u010di\u0173j\u0173. Iki 50 proc. bakterin\u0117s vaginoz\u0117s atvej\u0173 n\u0117\u0161tumo metu simptom\u0173 neb\u016bna. BV yra siejama su persileidim\u0173, prie\u0161laikini\u0173 gimdym\u0173, prie\u0161laikini\u0173 vaisiaus vanden\u0173 nutek\u0117jimo rizika. BV n\u0117\u0161tumo prad\u017eioje ar net buvusi iki n\u0117\u0161tumo \u0161i\u0105 rizik\u0105 padidina 1,9 karto. Esant simptomams, moterys skund\u017eiasi pagaus\u0117jusiomis, homogeni\u0161komis, pilk\u0161vos ar baltos spalvos nemalonaus ar specifinio \u201e\u017euvies\u201c kvapo i\u0161skyromis i\u0161 mak\u0161ties. Da\u017eniausiai \u0161is kvapas atsiranda po lytini\u0173 santyki\u0173, kai i\u0161skyros susimai\u0161o su sperma. Kadangi BV diagnozuojama 12 proc. moter\u0173, kurios lytinio gyvenimo negyvena, ji nepriskiriama lyti\u0161kai plintan\u010di\u0173 infekcij\u0173 grupei, ta\u010diau yra susijusi su lytiniu aktyvumu ir partneri\u0173 skai\u010diumi. Partnerio gydyti ir n\u0117ra rekomenduojama.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 12.0pt;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><strong><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 12.0pt;\">Ar <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/bakterine-vaginoze\/55699\">bakterin\u0117 vaginoz\u0117<\/a> daro \u012ftakos n\u0117\u0161tumui?<\/span><\/strong><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 12.0pt;\"><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Sergant BV n\u0117\u0161tumo metu padid\u0117ja prie\u0161laikinio gimdymo, persileidimo, prie\u0161laikinio vaisiaus vanden\u0173 nutek\u0117jimo, ma\u017eo gimimo svorio, chorioamnionito, pogimdyminio endometrito rizika. Tai ai\u0161kinama tuo, kad anaerobai ir kiti mikrobai aktyvina vietin\u012f imunin\u012f atsak\u0105 ir i\u0161siskiriantys citokinai ir endotoksinai stimuliuoja prostaglandin\u0173 sintez\u0119, sukelian\u010di\u0105 prie\u0161laikin\u012f gimdym\u0105. Kiti autoriai mano, kad BV sukelia iki n\u0117\u0161tumo prasid\u0117jus\u012f l\u0117tin\u012f endometrit\u0105, kuris yra prie\u0161laikinio gimdymo prie\u017eastis.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Da\u017enesn\u0117s infekcin\u0117s komplikacijos po cezario pj\u016bvio operacijos, aborto. Ginekologijoje BV siejama su cervicitu, kartotin\u0117mis \u0161lapimo tak\u0173 infekcijomis, pooperacin\u0117mis komplikacijomis (pvz., mak\u0161ties big\u0117s celiulitu po histerektomijos), endometritu, ma\u017eojo dubens u\u017edegimu, gimdos kaklelio displazija, veikdama kartu su \u017emogaus papilomos virusu (\u017dPV).<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 12.0pt;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><strong><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 12.0pt;\">Predisponuojantys veiksniai<\/span><\/strong><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 12.0pt;\"><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Mak\u0161ties ekologij\u0105 veikia \u012fvair\u016bs veiksniai:<\/span><\/p>\n<ul style=\"margin-top: 0cm;\">\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l2 level1 lfo1; tab-stops: list 36.0pt;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Hormonai<\/span><\/li>\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l2 level1 lfo1; tab-stops: list 36.0pt;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Ligos<\/span><\/li>\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l2 level1 lfo1; tab-stops: list 36.0pt;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Antibiotikai<\/span><\/li>\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l2 level1 lfo1; tab-stops: list 36.0pt;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Imunoglobulinai<\/span><\/li>\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l2 level1 lfo1; tab-stops: list 36.0pt;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Kontraceptikai<\/span><\/li>\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l2 level1 lfo1; tab-stops: list 36.0pt;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Lytinis partneris<\/span><\/li>\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l2 level1 lfo1; tab-stops: list 36.0pt;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Cheminiai dirgikliai (kvepiantys \u0161amp\u016bnai, muilai, \u012fklotai, tamponai, basein\u0173 vanduo, skalbimo detergentai, vaistai, mak\u0161ties plovikliai, spermicidai, talkas)<\/span><\/li>\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l2 level1 lfo1; tab-stops: list 36.0pt;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Mechaniniai dirgikliai (prezervatyvai, diafragmos gaubteliai, sportin\u0117 \u012franga ir drabu\u017eiai, sintetinis apatinis trikota\u017eas, tamponai, vibratoriai)<\/span><\/li>\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l2 level1 lfo1; tab-stops: list 36.0pt;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">R\u016bkymas<\/span><\/li>\n<\/ul>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 12.0pt;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><strong><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 12.0pt;\">Kaip diagnozuojama BV?<\/span><\/strong><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 12.0pt;\"><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\"><a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/bakterine-vaginoze\/55699\">Bakterin\u0117 vaginoz\u0117<\/a> nustatoma remiantis simptomais, kuriais skund\u017eiasi pacient\u0117, ginekologinio tyrimo ir laboratorini\u0173 tyrim\u0173 duomenimis. Diagnostiniai kriterijai n\u0117\u0161\u010diosioms ir nen\u0117\u0161\u010diosioms yra tie patys. Da\u017eniausias pacient\u0117s nusiskundimas \u2013 nemalonaus kvapo <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/isskyros-is-maksties\/55698\">i\u0161skyros i\u0161 mak\u0161ties<\/a>. Ap\u017ei\u016bra mak\u0161ties sk\u0117tikliais<i>:<\/i><\/span><\/p>\n<ul style=\"margin-top: 0cm;\">\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l0 level1 lfo2; tab-stops: list 36.0pt;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">i\u0161skyros homogeni\u0161kos, pilk\u0161vos ar baltos, kartais putotos, da\u017enai turi specifin\u012f \u201e\u017euvies\u201c kvap\u0105;<\/span><\/li>\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l0 level1 lfo2; tab-stops: list 36.0pt;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">u\u017edegimo sukelti pakitimai mak\u0161ties sieneli\u0173 gleivin\u0117je neb\u016bdingi.<\/span><\/li>\n<\/ul>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">M\u0117gini\u0173 pa\u0117mimas: nuo mak\u0161ties skliauto ar \u0161onin\u0117s sienos. Mikroskopinio tyrimo duomenys:<\/span><\/p>\n<ul style=\"margin-top: 0cm;\">\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l4 level1 lfo3; tab-stops: list 36.0pt;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">epitelio l\u0105steli\u0173 daugiau negu leukocit\u0173;<\/span><\/li>\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l4 level1 lfo3; tab-stops: list 36.0pt;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">laktobacil\u0173 ma\u017eiau negu kit\u0173 bakterij\u0173 (kok\u0173, anaerob\u0173);<\/span><\/li>\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l4 level1 lfo3; tab-stops: list 36.0pt;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">yra l\u0105steli\u0173\u2013indikatori\u0173.<\/span><\/li>\n<\/ul>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Pagrindiniai BV kriterijai atliekant tiesiogin\u0119 mikroskopij\u0105 (dr\u0117gnas tepin\u0117lis) yra:<\/span><\/p>\n<ul style=\"margin-top: 0cm;\">\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l7 level1 lfo4; tab-stops: list 36.0pt;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">indikatori\u0173 l\u0105steli\u0173 aptikimas (2 pav.);<\/span><\/li>\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l7 level1 lfo4; tab-stops: list 36.0pt;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">laktobacil\u0173 nebuvimas.<\/span><\/li>\n<\/ul>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">\u00a0<img loading=\"lazy\" decoding=\"async\" src=\"\/wp-content\/uploads\/2020\/11\/BV2.bmp\" alt=\"Bakterin\u0117 vaginoz\u0117: paprasta pacient\u0117s problema?\" width=\"430\" height=\"393\"><\/span><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\"><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Pas\u0117lis d\u0117l <i>G. vaginalis <\/i>nustatymo bakterinei vaginozei diagnozuoti neinformatyvus, nes daugeliui moter\u0173 \u0161i\u0173 mikroorganizm\u0173 gali b\u016bti ir nesant BV. Diagnoz\u0117 nustatoma remiantis po\u017eymiais (Amsel\u2019io kriterijais): BV b\u016bdingi bent 3 i\u0161 4 po\u017eymi\u0173 pagal Amsel\u2019\u012f:<\/span><\/p>\n<ul style=\"margin-top: 0cm;\">\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l1 level1 lfo5; tab-stops: list 36.0pt;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">homogeni\u0161kos i\u0161skyros,<\/span><\/li>\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l1 level1 lfo5; tab-stops: list 36.0pt;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">pH&gt;4,5,<\/span><\/li>\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l1 level1 lfo5; tab-stops: list 36.0pt;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">teigiamas amin\u0173 tyrimas \u2013 \u017euvies amin\u0173 kvapas i\u0161 mak\u0161ties i\u0161skyr\u0173, sumai\u0161ius su 10 proc. KOH tirpalu,<\/span><\/li>\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l1 level1 lfo5; tab-stops: list 36.0pt;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">randama l\u0105steli\u0173\u2013indikatori\u0173.<\/span><\/li>\n<\/ul>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">L\u0105stel\u0117s indikatoriai yra epitelio l\u0105stel\u0117s, kuri\u0173 pavir\u0161ius yra padengtas dideliu kiekiu bakterij\u0173, d\u0117l ko l\u0105steli\u0173 ribos pasidaro nery\u0161kios. Aminus gamina gausi mi\u0161ri vaginalin\u0117 flora. J\u0173 buvim\u0105 galima nustatyti sumai\u0161ius ant mikroskopinio stiklelio ar m\u0117gintuv\u0117lyje 1 la\u0161\u0105 mak\u0161ties i\u0161skyr\u0173 su 1 la\u0161u 10 proc. KOH \u2013 atsiranda \u201e\u017euvies\u201c kvapas.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Jeigu dominuoja leukocitai, reikia galvoti apie kitos etiologijos vaginit\u0105, atmesti lyti\u0161kai plintan\u010dias ligas, kadangi BV neb\u016bdingas padid\u0117j\u0119s leukocit\u0173 kiekis.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 12.0pt;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><strong><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 12.0pt;\">Ar reikia tikrinti ir gydyti n\u0117\u0161\u010di\u0105sias d\u0117l BV?<\/span><\/strong><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 12.0pt;\"><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">N\u0117\u0161tumo metu pagaus\u0117jusios i\u0161skyros yra da\u017enas rei\u0161kinys ir paprastai yra norma, susijusi su n\u0117\u0161tumo fiziologija. Nepaisant to, kad niekas neabejoja BV ry\u0161iu su padid\u0117jusia aku\u0161erini\u0173 komplikacij\u0173 rizika, BV gydymo nauda prie\u0161laikinio gimdymo profilaktikai yra abejotina. Tarptautin\u0117je mokslo \u012frodym\u0173 baz\u0117je Cochrane pateikiama 15 atsitiktini\u0173 im\u010di\u0173 tyrim\u0173 metaanaliz\u0117 (n=5888): vaginoz\u0117s gydymas veiksmingas tik pirmoje n\u0117\u0161tumo pus\u0117je. Ma\u017eos rizikos n\u0117\u0161\u010diosioms antibiotikai, skirti BV gydyti, nesuma\u017eino nei prie\u0161laikinio gimdymo, nei prie\u0161laikinio vaisiaus vanden\u0173 nutek\u0117jimo rizikos. Gydymas buvo veiksmingas tik tais atvejais, kai buvo skirtas iki 20 n\u0117\u0161tumo savait\u0117s arba kai buvo skiriamas n\u0117\u0161\u010diosioms, praeityje pagimd\u017eiusioms prie\u0161 laik\u0105. \u0160ioms didel\u0117s rizikos n\u0117\u0161\u010diosioms buvo pasteb\u0117ta retesni prie\u0161laikinio vaisiaus vanden\u0173 nutek\u0117jimo bei ma\u017eo svorio naujagimio gimimo atvejai.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Apibendrinant \u0161iandien turimus duomenis, galima teigti, kad n\u0117ra pagr\u012fst\u0173 tyrim\u0173, kad ma\u017eos rizikos grup\u0117s n\u0117\u0161\u010di\u0173j\u0173 tyrimas ir gydymas d\u0117l besimptom\u0117s bakterin\u0117s vaginoz\u0117s ma\u017eina prie\u0161laikinio gimdymo ir kit\u0173 komplikacij\u0173 rizik\u0105, tod\u0117l nerekomenduojamas. Tirti rekomenduojama tik didel\u0117s rizikos grupi\u0173 n\u0117\u0161\u010di\u0105sias, jau patyrusias v\u0117lyv\u0105j\u012f <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/abortas\/4530\">persileidim\u0105<\/a>\u00a0ar prie\u0161laikin\u012f gimdym\u0105. Taip pat tikslinga b\u016bt\u0173 tirti n\u0117\u0161\u010dias moteris, kurios skund\u017eiasi gausiomis ar \u012ftartinai pakitusiomis i\u0161skyromis, siekiant iki 20 n\u0117\u0161tumo savait\u0117s diagnozuoti BV, kai anksti paskirtas gydymas dar gal\u0117t\u0173 suma\u017einti aku\u0161erini\u0173 komplikacij\u0173 rizik\u0105. Geriausia tai atlikti dar iki pastojant, t.y. planuojant n\u0117\u0161tum\u0105.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 12.0pt;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><strong><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 12.0pt;\">Gydymas<\/span><\/strong><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 12.0pt;\"><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Gydoma tik klinikiniais simptomais pasirei\u0161kianti BV. Jei klinikini\u0173 simptom\u0173 n\u0117ra, bet patologija diagnozuojama atlikus laboratorinius tyrimus, gydyti reikia \u0161ias pacientes:<\/span><\/p>\n<ul style=\"margin-top: 0cm;\">\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l3 level1 lfo6; tab-stops: list 36.0pt;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">planuojan\u010dias pastoti,<\/span><\/li>\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l3 level1 lfo6; tab-stops: list 36.0pt;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">rizikos grup\u0117s n\u0117\u0161\u010di\u0105sias (buv\u0119s <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/prieslaikinis-gimdymas\/4334\">prie\u0161laikinis gimdymas<\/a> arba v\u0117lyvas <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/persileidimas\/4329\">persileidimas<\/a>),<\/span><\/li>\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l3 level1 lfo6; tab-stops: list 36.0pt;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">planuojan\u010dias nutraukti n\u0117\u0161tum\u0105 chirurginiu b\u016bdu,<\/span><\/li>\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l3 level1 lfo6; tab-stops: list 36.0pt;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">kurioms numatyta atlikti ginekologines operacijas.<\/span><\/li>\n<\/ul>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Rekomenduojamas sisteminis BV gydymas:<\/span><\/p>\n<ul style=\"margin-top: 0cm;\">\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l3 level1 lfo6; tab-stops: list 36.0pt;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">klindamicino kapsul\u0117s \u2013 po 300 mg gerti 2 kartus per par\u0105 7 dienas. Veikia <i>G.vaginalis<\/i>, anaerobus, <i>M.hominis<\/i>,<\/span><\/li>\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l3 level1 lfo6; tab-stops: list 36.0pt;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">metronidazolio tablet\u0117s \u2013 po 500 mg gerti 2 kartus per par\u0105 7 dienas,<\/span><\/li>\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l3 level1 lfo6; tab-stops: list 36.0pt;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">galima skirti ir nifuratelio.<\/span><\/li>\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l3 level1 lfo6; tab-stops: list 36.0pt;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">BV gydymas vietiniais preparatais Nedidel\u0117s vaisto doz\u0117s tiesiogiai veikia suk\u0117l\u0117jus, preparato labai ma\u017eai patenka \u012f kraujotak\u0105, taip nekyla sistemini\u0173 \u0161alutini\u0173 poveiki\u0173):<\/span><\/li>\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l3 level1 lfo6; tab-stops: list 36.0pt;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Klindamicino mak\u0161ties ovul\u0117s, 1 ovul\u0117 (100 mg) nak\u010diai, 3 naktis. Patogu pacientei, nes trumpas gydymo kursas. Veiksmingumas: po gydymo \u2013 93,5 proc., bakteriologin\u012f tyrim\u0105 atlikus pra\u0117jus 3\u20134 sav. \u2013 89,7 proc.<\/span><\/li>\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-list: l3 level1 lfo6; tab-stops: list 36.0pt;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Metronidazolio mak\u0161ties \u017evakut\u0117s, kapsul\u0117s ar gelis \u2013 1 kart\u0105 per par\u0105 5 dienas.<\/span><\/li>\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l3 level1 lfo6; tab-stops: list 36.0pt;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Nifuratelio\/nistatino mak\u0161ties \u017evakut\u0117s (<i><a href=\"https:\/\/pasveik.lt\/vaistai-paieska\/?srch=Macmiror\">Macmiror<\/a> complex<\/i>) \u2013 500 mg nak\u010diai 8 dienas.<\/span><\/li>\n<\/ul>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Po gydymo rekomenduojama skirti preparat\u0173 normaliai mak\u0161ties mikroflorai atkurti. Pvz., vaginalin\u0117s \u017evakut\u0117s su vitaminu C <i>Feminella Vagi C <\/i>normalizuoja mak\u0161ties pH, skatina moters endogenini\u0173 laktobacil\u0173 augim\u0105, normalizuoja mak\u0161ties flor\u0105 po antibakterinio gydymo, apsaugo nuo bakterin\u0117s vaginoz\u0117s pasikartojimo. Kartotin\u0117s BV atveju metronidazolio ir klindamicino gydymo kursas prat\u0119siamas iki 14 dien\u0173 arba skiriamas kartu sisteminis ir vietinis gydymas. Po gydymo antibiotikais kartotin\u0117s infekcijos profilaktikai rekomenduojamas preparatas <i>Feminella Vagi C<\/i>.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 12.0pt;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><strong><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 12.0pt;\">Rekomenduojamas BV sergan\u010di\u0173 n\u0117\u0161\u010di\u0173j\u0173 gydymas<\/span><\/strong><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 12.0pt;\"><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Gydyti reikia visas n\u0117\u0161\u010di\u0105sias, kai yra simptom\u0173 ir kai n\u0117ra, bet yra didel\u0117 rizika (buv\u0119s <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/prieslaikinis-gimdymas\/4334\">prie\u0161laikinis gimdymas<\/a> arba v\u0117lyvas <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/persileidimas\/4329\">persileidimas<\/a>). Efektyviausias gydymas yra sisteminis. Gydymas metronidazoliu praktikoje pirm\u0105j\u012f n\u0117\u0161tumo trimestr\u0105 da\u017eniausiai neskiriamas. Ta\u010diau sisteminis gydymas gali b\u016bti skiriamas pirmo n\u0117\u0161tumo trimestro metu \u012fvertinant individuali\u0105 rizik\u0105 ir potencialios naudos\/\u017ealos santyk\u012f. Pirm\u0105j\u012f n\u0117\u0161tumo trimestr\u0105 BV gydoma vietinio poveikio preparatais:<\/span><\/p>\n<ul style=\"margin-top: 0cm;\">\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l5 level1 lfo7; tab-stops: list 36.0pt;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Klindamicino mak\u0161ties globul\u0117s \u2013 100 mg nak\u010diai 3 dienas.<\/span><\/li>\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l5 level1 lfo7; tab-stops: list 36.0pt;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Metronidazolio mak\u0161ties \u017evakut\u0117s, kapsul\u0117s ar gelis \u2013 1 kart\u0105 per par\u0105 5 dienas.<\/span><\/li>\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l5 level1 lfo7; tab-stops: list 36.0pt;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Nifuratelio\/nistatino mak\u0161ties \u017evakut\u0117s (<i><a href=\"https:\/\/pasveik.lt\/vaistai-paieska\/?srch=Macmiror\">Macmiror<\/a> Complex<\/i>) \u2013 500 mg nak\u010diai 8 dienas; preparatas yra saugus n\u0117\u0161\u010dioms bei \u017eindan\u010dioms moterims.<\/span><\/li>\n<\/ul>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Antr\u0105j\u012f ir tre\u010di\u0105j\u012f n\u0117\u0161tumo trimestr\u0105 geriamieji vaistai:<\/span><\/p>\n<ul style=\"margin-top: 0cm;\">\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l6 level1 lfo8; tab-stops: list 36.0pt;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Klindamicino kapsul\u0117s \u2013 po 300 (150) mg gerti 2 kartus per par\u0105 7 dienas.<\/span><\/li>\n<li class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none; mso-list: l6 level1 lfo8; tab-stops: list 36.0pt;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Metronidazolio tablet\u0117s \u2013 po 500 mg gerti 2 kartus per par\u0105 7 dienas.<\/span><\/li>\n<\/ul>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Antr\u0105j\u012f ir tre\u010di\u0105j\u012f n\u0117\u0161tumo trimestr\u0105 rekomenduojama skirti tik sistemin\u012f BV gydym\u0105, nes tik taip galima paveikti infekcij\u0105, patekusi\u0105 \u012f gimdos kaklel\u012f, apatin\u012f gimdos segment\u0105, ir m\u0117ginti suma\u017einti chorioamnionito, prie\u0161laikinio gimdymo ir prie\u0161laikinio vaisiaus dangal\u0173 ply\u0161imo rizik\u0105. Efektyviausias yra metronidazolis, sistemi\u0161kai skiriamas savait\u0119. Po gydymo yra naudinga ir pla\u010diai naudojami preparatai, atstatantys normali\u0105 mak\u0161ties mikroflor\u0105. Galima vartoti ir ne kasdien, o kart\u0105 per savait\u0119, tuomet ilgesn\u012f laikotarp\u012f palaikysime tinkam\u0105 mak\u0161ties mikroflor\u0105.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Apibendrinant galima teigti, kad BV yra da\u017enai pasitaikanti b\u016bkl\u0117, taip pat ir n\u0117\u0161tumo metu. BV \u2013 tai normali klinikin\u0117 b\u016bkl\u0117, kai normali mak\u0161ties flora pasikei\u010dia anaerobiniais mikroorganizmais. Apie pus\u0119 moter\u0173 skund\u017eiasi pagaus\u0117jusiomis, turin\u010diomis nemalon\u0173 ar specifin\u012f \u201e\u017euvies\u201c kvap\u0105 i\u0161skyromis i\u0161 mak\u0161ties, gali jausti nie\u017eul\u012f. Da\u017eniausiai BV nesukelia joki\u0173 komplikacij\u0173, bet gali sukelti rimtas komplikacijas: aku\u0161erijoje \u2013 padid\u0117ja prie\u0161laikinio gimdymo, persileidimo, chorioamnionito, komplikacijos po cezario pj\u016bvio operacijos, aborto; ginekologijoje BV siejama su cervicitu, kartotin\u0117mis \u0161lapimo tak\u0173 infekcijomis, pooperacin\u0117mis komplikacijomis, ma\u017eojo dubens u\u017edegimu (3 pav.). Diagnozuojama, kai yra 3 i\u0161 4-i\u0173 <i>Amsel\u2019io <\/i>simptom\u0173, mak\u0161ties i\u0161skyr\u0173 tepin\u0117lyje, da\u017eytame Gramo b\u016bdu, nustatoma BV b\u016bding\u0173 poky\u010di\u0173. Gydyti reikia visas n\u0117\u0161\u010di\u0105sias ir ne n\u0117\u0161\u010di\u0105sias, kai yra simptom\u0173. Geriausias pasirinkimas yra geriamasis metronidazolis ir klindamicinas. Pirmame n\u0117\u0161tumo trimestre gydoma vietinio poveikio metronidazolio ir klindamicino grup\u0117s preparatais, nifuratelio\/nistatino (<i><a href=\"https:\/\/pasveik.lt\/vaistai-paieska\/?srch=Macmiror\">Macmiror<\/a> Complex<\/i>) mak\u0161ties \u017evakut\u0117mis, antrame ir tre\u010diame trimestre \u2013 geriamaisiais vaistais: metronidazoliu, 500 mg 2 k.\/p., 7 dienas, klindamicinu, 300 mg 2 k.\/p., 7 dienas. Po gydymo rekomenduojama skirti preparat\u0173, kurie atkuria ir palaiko mak\u0161ties mikroflor\u0105, pvz., <i>Feminella Vagi C<\/i>.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\"><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\"><img loading=\"lazy\" decoding=\"async\" src=\"\/wp-content\/uploads\/2020\/11\/BV31.bmp\" alt=\"Bakterin\u0117 vaginoz\u0117: paprasta pacient\u0117s problema?\" width=\"430\" height=\"345\"><\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify; mso-layout-grid-align: none;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT;\">Patikra ir gydymas rekomenduojama tik rizikos grup\u0117s n\u0117\u0161\u010di\u0173j\u0173 (<a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/prieslaikinis-gimdymas\/4334\">prie\u0161laikinis gimdymas<\/a> arba v\u0117lyvas <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/persileidimas\/4329\">persileidimas<\/a> anamnez\u0117je). Nusta\u010dius BV n\u0117\u0161tumo metu gydyti reikia visada, neatsi\u017evelgiant \u012f n\u0117\u0161tumo laik\u0105, rizik\u0105 n\u0117\u0161\u010diajai ar nusiskundimus.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify;\"><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 12.0pt;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"margin: 0cm 0cm 0pt; text-align: justify;\"><strong><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 12.0pt;\">\u017durnalas \u201cGydymo menas\u201d<\/span><\/strong><span style=\"font-size: 10pt; font-family: Arial; mso-ansi-language: LT; mso-bidi-font-size: 12.0pt;\"><\/span><\/p>\n<p>\u00a0<\/p>\n","protected":false},"excerpt":{"rendered":"<p class=\"MsoBodyText\" style=\"margin: 0cm 0cm 0pt; text-align: justify;\"><span style=\"font-weight: normal; color: windowtext; font-family: Arial; mso-ansi-language: LT;\">Bet kuri moteris gali sirgti bakterine vaginoze, ne i\u0161imtis ir n\u0117\u0161\u010diosios. Vienoms pacient\u0117ms pasirei\u0161kia simptom\u0173, kitoms \u2013 ne. I\u0161kyla klausimai: kokia tai b\u016bkl\u0117? kokios moterys tur\u0117t\u0173 b\u016bti gydomos ir tiriamos? kokias pasekmes gali sukelti \u0161ios b\u016bkl\u0117s negydomos? kaip diagnozuojama? kaip tur\u0117t\u0173 b\u016bti gydoma bakterin\u0117 vaginoz\u0117?<\/span><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[27313],"tags":[24789,6767,7689,1617,206,1824,8193,357,6566,7616,1825,873,125,64,1818,1823,7617,138,727],"site":[],"post_item_type":[27345],"class_list":["post-12481","post","type-post","status-publish","format-standard","hentry","category-gydymo-naujienos","tag-amsel","tag-bukle","tag-complex","tag-flora","tag-gelis","tag-homogeniskos","tag-kapsules","tag-kvapas","tag-lasteles","tag-macmiror","tag-persileidimas","tag-preparatas","tag-rukymas","tag-tabletes","tag-tamponai","tag-vaginalis","tag-vaginoze","tag-vaistai","tag-veiksmingas"],"acf":{"post_sites":false},"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/posts\/12481","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/comments?post=12481"}],"version-history":[{"count":0,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/posts\/12481\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/media?parent=12481"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/categories?post=12481"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/tags?post=12481"},{"taxonomy":"site","embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/site?post=12481"},{"taxonomy":"post_item_type","embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/post_item_type?post=12481"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}