2Seren-2_Post partum disease_Zoetis_IVCC_2015_LIMITED PHOTOS.pptxVIP

产后疾病Post partum disease 学习目标Learning Objectives 诊断和管理产后出血/创伤/撕裂 Diagnose and manage haemorrhage/trauma/lacerations in the post partum cow 描述如何管理和预防阴道/子宫脱出 Describe management and prevention of vaginal/uterine prolapses 胎衣停滞的病因学、预防和临床管理 Describe the aetiology and presentation of retained foetal membranes and its clinical management 描述如何管理和预防母牛产后瘫痪 Describe management and prevention of the ‘down cow’ 产后出血Post-partum Haemorrhage 简单的定义产后出血——可以有多种因素引起 Simply meaning blood passage after parturition – can have many causes: 大量出血可能由于：Profuse bleeding can be due to: 脐带破坏，大量血液从胎盘流出 Breakage of the umbilicus and blood leaking from the placenta 子宫或阴道撕裂 Uterine or vaginal laceration 例如青年牛强行助产使胎儿排出时阴道动脉大出血 Ie vaginal artery haemorrhage in heifer after forced extraction 偶尔可能从宽韧带子宫动脉流出；除了瘫痪和死亡之外的出血损失往往被忽视 Occasionally bleeding from uterine artery in broad ligament occurs; often external blood loss is not noted, rather collapse and death 子宫出血Uterine Rupture 不常见Uncommon 可能表现出母牛肠道脱出，所以把它和血吸虫病相区别很重要 May present as prolapse of the dam’s intestines and so it is important that you recognise this rather than confuse with a schistosoma 病因学Etiology: 可能由于助产移动犊牛位置和牵引时犊牛四肢刺穿了子宫（尤其是畸形胎儿） May be by extremities perforating the uterus during repositioning and traction (particularly fetal monsters) 可能由于过度的向后牵拉 May be due to excessive vigorous retropulsion 可能由胎儿窒息时剧烈移动引起 May be by forceful movements due to asphyxia fetus 可能是子宫扭转时自发产生的（脆弱的子宫） May be spontaneous with uterine torsion (friable uterus) 其次才是器械导致的穿孔 May be secondary to instrument perforation 阴道撕裂Vaginal Rupture 阴道撕裂（母牛很常见） Vaginal rupture (common in cow) （肥胖的）青年牛，通常只是阴道附近脂肪脱出到阴道腔；阴道往往可以自愈，理论上可以缝合 (Obese) heifers, usually only prolapse of peri-vaginal fat into the vaginal cavity. The vagina often heals satisfactorily on its own, theoretically it could be sutured 有时小肠，膀胱或子宫脱出由于阴道撕裂 Sometimes small intestines, bladder or uterus can prolapse through a fully perforating vaginal tear 继发感染，阴道炎可能发生（坏死梭杆菌，梭状芽孢杆菌）Secondary infection, necrotis