如何治疗阴道裂伤

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共同创作者是 Cindy Basinski, MD

参考

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性交、分娩、疾病或使用卫生棉条不当，都有可能造成阴道裂伤，让人又痛又不舒服。除了分娩造成的阴道裂伤可能需要缝合外，其它情况大多都很轻微，会自行痊愈。只要保持阴道清洁，避免性交和刺激伤口，大部分阴道裂伤都会自然愈合。如果伤口很深，还是建议就医检查，让医生缝合伤口。

方法 1
方法 1 的 4:

治疗分娩造成的阴道裂伤

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    分娩造成的阴道裂伤可以分成4个等级。一级裂伤是表皮轻微裂伤。二级裂伤涉及皮肤和肌肉。一级和二级基本上属于轻度裂伤。 [1]
    • 三级裂伤深度达到会阴肌肉。四级裂伤深度达到肛管和直肠。
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    分娩造成的阴道裂伤需要缝合。医生会沿着裂伤部位进行简单的缝合。三级和四级裂伤需要进行更复杂的缝合。每一层皮肤和肌肉需要分开缝合。 [2]
    • 在三级和四级裂伤中，医生会将支撑肛管和直肠的肌肉缝合起来。
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    不管是哪个等级的裂伤，你都必须保持患处干净，减少细菌，预防感染。每天清洗阴道和会阴部位数次。 [3]
    • 用干净的毛巾拍干患处。由前往后擦，以免将直肠的细菌带到阴道。
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    每4-6小时更换敷料或卫生巾1次，以保持伤口干净，降低感染细菌的风险。 [4]
  5. 5
    预防便秘，以减轻患处的压力。 便秘会加重伤势和疼痛。服用大便软化剂来预防便秘，同时要多喝水，多吃高纤维食物。
  6. 6
    做凯格尔运动 ，锻练骨盆底肌肉。 一个简单的方法是收紧小便时用到的肌肉，5分钟后再松开。每天重复10次。
方法 2
方法 2 的 4:

减轻疼痛

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    冷敷有助于减轻患处疼痛和炎症。不要直接将冰块或冷敷布放在皮肤上。先用一块布裹着，以免皮肤被冻伤。敷大概10分钟。 [5]
    • 会阴部位每2个小时冷敷1次。
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    如果患处很痛，你可以服用非处方止痛药。扑热息痛（泰诺）、布洛芬（Advil）或非甾体抗炎药（Aleve）等，都可以帮助你减轻疼痛和不适。 [6]
    • 一定要查看标签，严格按指示用药。
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    阴道裂伤时，你应该放轻松，尤其是分娩后。如果伤口很深，不可以站着或坐着太久，以免给阴道部位造成压力。 [7]
    • 生产后接下来2-4天，每个小时应该躺下休息20-40分钟。
  4. 4
    每天最多进行3次坐浴。 坐浴 指的是将骨盆浸在水中，可以促进裂伤部位愈合和缓解疼痛。在温水中坐浴不超过10分钟，之后用干净的毛巾拍干皮肤。 [8]
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    你可以在阴道外部的皮肤涂抹一些有自然疗效的油，包括芦荟胶、维生素E油，或是有舒缓作用的非抗菌油。不要在阴道涂抹抗菌乳霜，以免影响阴道自身的菌群平衡。 [9]
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    裂伤部位在愈合过程中可能会发痒。患处也有可能一触即痛或变得干涩。如果你出现以上情况，可以用燕麦泡澡。在浴缸装满温水，倒入燕麦。浸泡在水中放松身体，让燕麦发挥止痒和消炎的作用。 [10]
方法 3
方法 3 的 4:

治疗轻微裂伤

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    阴道裂伤会导致腹股沟轻微疼痛。你可能会在坐下、走路或穿紧身衣服时感到疼痛。轻微裂伤也会引起轻微出血，患处可能会发痒或不舒服。 [11]
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    具体的治疗方法取决于伤势。如果你不确定伤口有多严重，可以用镜子照一照患处。如果看不到裂伤部位，建议去看医生。 [12]
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    简单的撕裂伤会自然愈合，不需要任何治疗。它们面积小，看起来像被纸张割伤或擦伤。刚开始可能会出血、刺痛、不舒服和发痒。简单的撕裂伤通常都是自己的行为造成的，比如性交或使用卫生棉条不当。 [13]
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    阴道裂伤或割伤期间，每天用温和的清洁剂清洗它。动作要轻柔，不要太用力。使用不含刺激物的低致敏性肥皂。尽量不要洗掉阴道的天然保护层，它帮助保护阴道，促进患处愈合。 [14]
    • 不要清洗伤阴道内部，只洗外部的皮肤就好。
    • 阴道裂伤期间，避免灌洗阴道。这会扰乱阴道原本的酸碱平衡。
  5. 5
    穿干净、舒适的内裤。 在阴道裂伤期间，透气的棉质内裤是最好的选择。稍微宽松但舒适的裤子有助于缓解阴道在愈合期间的不适感。
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    阴道裂伤期间，避免自慰或和伴侣进行性生活。任何会碰到患处的性行为都有可能导致伤口再次裂开，也有可能把身体其它部位的细菌带到患处。 [15]
    • 阴道裂伤愈合后，头几次性交时一定要非常小心，放轻动作，以免再次撕裂敏感的阴道组织。
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    患处愈合期间，不要将任何东西放入阴道，以免刺激它。不要使用卫生棉条、避孕套、避孕膜或其它置于阴道的东西，也不可以使用刺激性润滑液或乳液。 [16]
    • 穿不会压迫阴道的宽松棉质内裤。
  8. 8
    如果伤势恶化，建议去看医生。 如果患处越来越痛，你应该让医生检查。另外，如果患处出血、发臭或有分泌物，你感到头晕或发烧，也必须立即就医。 [17]
方法 4
方法 4 的 4:

就医治疗

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    如果阴道裂伤让你感到非常痛，裂伤面积比一般的小切口或擦伤大，或者迟迟没有愈合，一定要去看医生。医生会检查阴道伤势，确认最适合你的治疗方案。
    • 医生也会检查你是否患有会导致阴道裂伤的潜在疾病。
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    医生可能会给你开药治疗感染或促进伤口愈合。这些处方药有可能是乳霜、药片或凝胶。 [18]
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    雌激素水平低可能引起萎缩性阴道炎，阴道变得干涩，很容易撕裂。癌症、激素失调等情况，也会导致雌激素水平低下。医生可能会给你开雌激素乳霜，并建议你改变饮食，增加从饮食中摄入的雌激素。 [19]
    • 不要在未咨询医生的情况下，擅自提高雌激素水平。这样可能会扰乱身体的化学平衡。
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    有些女性阴道裂伤是因为缺乏特定营养，导致阴道皮肤和粘膜分解。如果你的阴道经常裂伤，无法治愈，不妨和医生讨论你的饮食习惯。营养师可以帮助你确认身体缺乏哪些营养，以及如何安全地增加它们的摄入量。 [20]
    • 缺锌是阴道裂伤的常见原因之一。维生素A、欧米茄-3脂肪酸、钙和维生素C不足，也有可能导致阴道裂伤。
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    有些裂伤很深或很严重，可能出大量血、流脓、发臭、有疏松的组织或是引起剧痛。如果你出现上面其中一种症状，应该立即就医治疗。这类伤口通常是分娩、创伤或性交时发生的意外造成的。 [21]
    • 这些是很严重的伤口，必须接受相应的治疗。
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    许多很深的阴道裂伤都必须缝合。长度超过2.5厘米的裂伤都需要缝合。医生会将皮肤缝在一起。诊所或医院都能进行这项治疗。这些伤口通常会愈合得很好。在恢复期间，注意保持伤口干净和干爽，并穿宽松的衣服。 [22]
    • 不要进行会导致缝线或伤口裂开的活动。

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参考

  1. ↑ https://www.nhs.uk/conditions/pregnancy-and-baby/episiotomy/
  2. ↑ http://www.parents.com/pregnancy/giving-birth/vaginal/vaginal-tearing-during-childbirth-what-you-need-to-know/
  3. ↑ http://www.matermothers.org.au/journey/childbirth/recovering-from-a-perineal-tear
  4. ↑ http://www.matermothers.org.au/journey/childbirth/recovering-from-a-perineal-tear
  5. ↑ https://www.nhs.uk/conditions/pregnancy-and-baby/episiotomy/
  6. ↑ https://www.mayoclinic.org/healthy-lifestyle/labor-and-delivery/in-depth/episiotomy/art-20047282
  7. ↑ http://www.matermothers.org.au/journey/childbirth/recovering-from-a-perineal-tear
  8. ↑ https://medlineplus.gov/ency/patientinstructions/000483.htm
  9. ↑ https://www.allthingsvagina.com/how-to-treat-vaginal-fissures/
  1. ↑ https://www.fairview.org/HealthLibrary/Article/116680EN
  2. ↑ https://www.fairview.org/HealthLibrary/Article/116680EN
  3. ↑ https://www.allthingsvagina.com/how-to-treat-a-simple-vaginal-or-vulvar-tear/
  4. ↑ https://www.allthingsvagina.com/how-to-treat-a-simple-vaginal-or-vulvar-tear/
  5. ↑ https://www.allthingsvagina.com/how-to-treat-vaginal-fissures/
  6. ↑ https://www.allthingsvagina.com/how-to-treat-vaginal-fissures/
  7. ↑ https://www.allthingsvagina.com/how-to-treat-vaginal-fissures/
  8. ↑ https://www.fairview.org/patient-education/116680EN
  9. ↑ https://www.allthingsvagina.com/how-to-treat-a-simple-vaginal-or-vulvar-tear/
  10. ↑ https://www.allthingsvagina.com/treating-mystery-vulvar-or-vaginal-cuts-and-tears/
  11. ↑ https://www.allthingsvagina.com/treating-mystery-vulvar-or-vaginal-cuts-and-tears/
  12. ↑ https://www.allthingsvagina.com/treating-mystery-vulvar-or-vaginal-cuts-and-tears/
  13. ↑ https://www.allthingsvagina.com/treating-mystery-vulvar-or-vaginal-cuts-and-tears/

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