Chilankhulo chindoko: Zizindikiro ndi Chithandizo

Chindoko akuyenda padziko lapansili kwa zaka zambiri, ndi bwino kale anamvetsa. Pakali pano, anayamba njira nzeru matenda ndi mankhwala, komabe chiwerengero cha anthu amene ikukula. Only mu Russia kotala watha zaka, chiwerengero chawo chinawonjezeka ndi nthawi 7.

Chindoko pa lilime mkamwa limapezeka kamodzikamodzi kuposa pa kumaliseche, koma mochepa oopsa. Mbali yaikulu ya fomu iyi ndi m'kamwa mucosa ndi chinenero ndi mosavuta amasokonezeka ndi matenda kwathunthu vuto lililonse, nchifukwa chake odwala ambiri sakhala kufulumira kwa dokotala, ndipo chinkhoswe kudzipatsa medicate ndi Abiti nthawi. Koma chindoko machiritso madokotala ananena zawo zikudalira pa chithandizo yake.

Taganizirani mmene chindoko akuwonetseredwa mu chinenero, kugwira iwo, mmene koopsa ndi anthu ena, ndi kumene njira zake mankhwala.

Chithunzi cha tizilomboto ndi

Chindoko amachititsa tosaoneka tizilombo toyambitsa matenda - ". Wotumbululuka treponema" anaerobic, dzina Wotumbululuka kuzitcha izo chifukwa Romanovsky-Giemsa zochita amakhala wotumbululuka pinki. thupi lake tosaoneka ali mawonekedwe a mwauzimu woonda ndi malekezero zisonga ndi 12-TH kapena 14-TH, 8-TH kawirikawiri mapini. majeremusi Awa ndi mafoni kwambiri, koma osati akhama kwambiri. Iwo amatha kupirira chilengedwe ndi T = 55 ° C 15 okha Mphindi ndi pansi Reflux, i.e. pa T = 100 ° C ndi pamwamba, akuphedwa yomweyo. Ndi zophweka kuti awononge njira iliyonse masaka ngakhale wamba sopo. Choncho, pofuna kuti akakole chindoko mu chinenero mwa tsiku ndi tsiku, tikufuna kusunga ukhondo. Chinthu chapadera cha treponemes kuti amasangalala yokha mu mapangidwe ofunda ndi lonyowa. Mu ozizira, komanso atamwa mankhwala ena, iwo akhoza kupanga cysts ndi kuyembekezera mapiko kwa zaka. Mu kutentha, makamaka popanda mame, iwo anafa monga kuyanika wa gawo lapansi lonyowa. Treponema kuchulukitsa ndi kugawikana yosavuta, ndipo pang'onopang'ono ndithu. Childs, ndondomeko ya kubadwa kwa tizilombo latsopano amatenga maola 32. Mbali imeneyi zimakhudza nthawi za nthawi makulitsidwe.

Njira kachilombo

Wolakwika amene amaganiza kuti chinenero a chindoko akhoza anatola lokha pa kugonana m'kamwa ndi bwenzi osadalirika. Malinga WHO ziwerengero, kotero ali ndi matenda, pafupifupi theka la odwala. Adakali ndi kachilombo Treponema pallidum m'kamwa mwa njira ina:

• kumpsompsona ndi chindoko (zoopsa, kuya);
• kuikidwa magazi unscreened;
• Anawona mano mokondera ntchito ndi zida unsterile;
• kuchita jakisoni kwa anthu angapo ndi syringe wina (makamaka za mankhwala osokoneza bongo);
• ntchito wamsuwachi ndi, supuni chikho, atatha wodwala ndi chindoko;
• treponem kufala kuchokera kwa mayi kupita kwa mwana wosabadwayo (kobadwa nako chindoko);
• makanda kachilombo nthawi yoyamwitsa;
• matenda a ogwira ntchito zaumoyo.

limagwirira kachilombo

chilankhulo cha mawonetseredwe a chindoko ndi zotheka, ngati Treponema pallidum anakwanitsa umalowa mu nembanemba mucous wa M'mimbamo m'kamwa. Oral kugonana kufala limagwirira ntchito ndi yosavuta. Treponema nthawi massively alipo umuna wodwala, ngakhale zowoneka kumaliseche mulibe zizindikiro za matenda.

Kamodzi m'kamwa mwa atavutika latsopano, mabakiteriya kuyesera umalowa mu mucosal minofu. Makamaka chisomo kwa tiziromboti, ngati iwo ali ndi zilonda. Pankhaniyi, nthenda chikuchitika ndi 100% Mwina. Mu malovu wodwala ndi chindoko treponema wapezeka pokhapokha ngati pakamwa ake totupa khalidwe. Izo zimatengera kuchuluka kwa kuthekera kwa matenda ndi chipsompsono.

Anadzetsa danga extracellular wa zimakhala ndi mabakiteriya amathandiza mwauzimu maonekedwe a matupi awo, kuti "tili m'mavuto" ngati corkscrew, ndipo kamodzi mkati, anayamba kubereka. chitetezo cha m'thupi akutsogolera wozunzidwayo ndi wankhanza chitetezo, macrophages, lymphocytes. Ngati chitetezo munthu ali ndi mphamvu, ndi kukhudzana ndi wodwalayo limodzi nthawi ndi yochepa, mwina atagwira matenda. Koma ambiri a nthumwi za chitetezo cha m'thupi sangathe kulimbana ndi asilikali atagonjetsa mu thupi la majeremusi amene ali komanso kuteteza kapisozi thupi yokutidwa ndi amatope. Treponema akuchulukila poyamba kudzaza kusiyana lymph, lymph kuyambira 0.1 okha% oxygen. Kenako, kulowa m'magazi ndi kuyamba kuyenda mwa thupi, zokhudza ziwalo zina.

Gawo

Zochita dziko, timagwiritsa ntchito gulu otsatirawa a chindoko:

• pulayimale
• sekondale (oyambirira ndi mochedwa);
• kobadwa nako.

Aliyense wa njira izi anati matenda awo a chinenero chindoko.

Nthawi zambiri ntchito gulu losavuta:

• chindoko oyambirira (mosavuta matenda, ambiri opatsirana, zizindikiro akhoza kutha, wosasiya kufufuza);
• chindoko mochedwa (wamba matupi onse, ngakhale kuti iye akanatha kuyamba pakamwa).

Mu mankhwala, pali angapo osiyana gulu la chindoko:

• chachikulu (seropositive ndi seronegative);
• sekondale (mwatsopano, zobisika, kobwereza);
• Ukachenjede (lotseguka, zobisika);
• kobadwa nako (oyambirira ndi mochedwa);
• choipidwa.

The ndondomeko ya matenda lagawidwa magawo anayi:

• makulitsidwe;
• pulayimale
• sekondale;
• Ukachenjede.

Tiyeni tione iwo mwatsatanetsatane.

nthawi makulitsidwe

Zizindikiro za chindoko m'chilankhulo pa chiyambi cha matenda ndi kwina. Izi siteji zobisika, zomwe zimatha kwa mphindi mu mucosal malowedwe tizilombo toyambitsa matenda ndi pamaso woyamba zithunzi chizindikiro.

Panthawi imeneyi, Treponema ambiri awo kenako kufalikira ku otaya lymph m'thupi. chitetezo cha m'thupi adakali kuwasunga mwakhama nkhondo, kwambiri kuchepetsa chiwerengero chawo. munthu alibe koma amaona kuti anadwala, ngakhale ena kuyenera oopsa. makulitsidwe Pitirizani nthawi mwina masiku 15 mpaka 60. Wapakati mawu a masiku 20-21 mwaganizapo losadziwika. Zizindikiro mofulumira kuwonekera anthu chokumana ndi matenda ena (TB, AIDS, uchidakwa). Zizindikiro anachedwa zingachitike ngati wodwalayo m'nyengo ya chindoko ndi kutenga mankhwala ndi kuchitira angina, chinzonono ndi matenda okhudzana.

nthawi yaikulu

Iye akuyamba ndi maonekedwe a chancre, ndipo limatha ndi mofulumira wake ndi maonekedwe a zotupa pa. Mawu "chancre" yomasulira ku Old French amatanthauza "zilonda." mapangidwe nthawi zambiri sabweretsa chisoni, wandiweyani, amapezeka mu malo oyamba treponemes mu minofu. Padziko chancre mwina kuwataya osati kuwalanditsa ululu kukokoloka. Mofananamo, imasonyezedwa mu nthawi yoyamba ya chindoko chinenero. Photo amasonyeza chancre padziko lilime. Iye udzadutsa magawo angapo a chitukuko, kuyambira wamng'ono wofiira malo. Patangotha masiku awiri kapena atatu pa likulu lake pali chisindikizo, amene pang'onopang'ono kumawonjezera awiri. Ikufanana ndi izi, pakati pa nsalu nekrotiruetsya chancre ndi kukatenga chofiira (nyama) mtundu.

Ngati pamalo kutenga kuchipala, chikaonekera zikwi treponemes. Nthawi zina, zilonda pakati pa chancre chimakwirira yochitidwa ❖ kuyanika. Pa malo m'dera la chinenero makutu ku anthu ena anati mpita kukokoloka. Pamene pabwino kumbuyo kwa lilime, iye kawirikawiri amakhala pamwamba pamwamba.

Chinthu china chofunika ndi lymphadenitis dera (wakulitsidwa lymph mfundo). Ngati chindoko zinachokera pa kamwa, lymph mfundo pansi pachibwano ndi kumawonjezera chibwano, ndipo nthawizina mu khosi.

Features wa nthawi yaikulu

Zilonda pa lilime mu chindoko, ngati si aliyense zizindikiro zina matenda (malaise, malungo, kupweteka kwa mutu, etc.), odwala ambiri chifukwa chilichonse (mwachitsanzo, stomatitis), koma osati kwa matenda opatsirana pogonana. Zimenezi zikugwira ntchito makamaka kwa anthu, kuti amagonana zokayikitsa ndi kachilombo ndi banja. Choncho kuyamba zilonda zawo rinses, sear iwo ndi ayodini. Treponem njira zimenezi Usaphe, koma munthu ndi chancre pa lilime kapena mbali zina za mkamwa (pa m'kamwa, milomo) akukhala kwambiri opatsirana chifukwa cha mabakiteriya zilonda zonse kulowa malovuwo. Komabe, pamene kutsokomola kapena sneezing chindoko si opatsirana kudzera kupsompsona, ndudu mbale.

Analysis RW (Wassermann anachita) mu gawo loyamba ikhoza kukhala zoipa (seronegative mawonekedwe) ndi anayi lakuthwa pluses zabwino (seropositive mawonekedwe).

nthawi yachiwiri

M'pamene kutha kwa chancre, kuti anthu ambiri kuzindikira ngati "kumasuka ku stomatitis." Mu chindoko ndi chakale panthawi imeneyi, totupa pa manja, ndi mapazi, thupi lonse. Komanso, pakhala kuwonongeka kwa wamanjenje dongosolo. Padziko zizindikiro zomwezo zomwe chindoko chinenero. Photo limasonyeza tione mawanga rozeolnye kuti akhoza kuoneka pamodzi ndi papules (mipukutuyi). Ngati iwo amaoneka pa malo papillae bwino umaonetseredwa, kuti protrude pamwamba zimakhala ozungulira mu mawonekedwe a grayish foci ndi zodziwika bwino kapena mosinthanitsa, losongoka m'mbali. Koma nthawi zambiri malo kugonjetsedwa kwa papillae ali kwina, ndiye papule amakhala chonyezimira, cheza chofiirira bluish, yomwe ili pansipa zigawo pafupi. Language Motero amayamba akufanana ndi mumbali dambo zidutswa osiyana.

Odwala ena pa chiyambi cha nthawi yachiwiri pali kufooka, kupweteka kwa mutu, kutentha thupi, amene amaona ngati chimfine pang'ono. Izi "matenda" odwala anadziika okha makamaka mtima ngati ntchito confluent mawanga ofiira pa tonsils ndi pakhosi, mochuluka ngati angina zazing'ono. Chachikulu kusiyana kwagona kuti chindoko ndi ululu pamene Pomeza.

nthawi yachiwiri akuyamba pafupifupi 9-10 masabata pambuyo matenda ndi 6 7 - pambuyo chancre woyamba, ndi kumatenga zaka ziwiri kapena zambiri. Pa nthawi imeneyi, pali kulephera zokhudza zonse za ziwalo, ndi totupa ndi mawanga pa lilime mu chindoko Kenako kutha kwathunthu, ndiye kachiwiri kuonekera.

ukachenjede

Mu mkhalidwe matenda kunyalanyaza amapezeka kugonjetsedwa ambiri ziwalo (fupa, chiwindi, mtima, ndulu). chitetezo cha m'thupi amakhala wofooka ndi wodwala mwina kwambiri zinakhudza zochitika za matendawa. Komabe, exacerbation ndi kukhululukidwa pa siteji ukachenjede agona. Chifukwa iwo choipa, nkhawa, kutupikana, matenda ena, mwachitsanzo, elemental ozizira.

Classically Ukachenjede nyengo iyamba pambuyo zaka 4.5-5.0 pambuyo matenda, koma pali nthawi zambiri pamene anayamba zaka 10 kapena kuposa. The chizindikiro chachikulu ndi maonekedwe a chiyambi gummas wake - minofu mfundo, kwambiri deforming matupi. Language limapezeka chindoko Ukachenjede wokongola wamba, chotero izo sizingakhoze kukhala kolakwika kwa matenda opatsirana pogonana ndi chifuwa kapena zilonda zapakhosi.

Gunma chinenero zingachititse nodular kapena akakufunsani glossitis. inawo akuganiza Vuto aakulu a chindoko pakamwa. Language wodwalayo chifukwa akakufunsani kusalola thickens, amakhala lolemererapo, amene ali omangika ndi katchulidwe ka phokoso. Kenako, pamalo kusalola kuoneka minofu yovulazidwa, chinenero umakhala wandiweyani masamba ankawachotsera pamwamba m'goli, ndipo ikusonyeza ming'alu chowawa ndi zironda, amene chimayambitsa zotupa zilonda. Ngakhale zizindikiro zosasangalatsa, wodwalayo Low ngozi ena, monga Gunma treponem pafupifupi kumeneko.

diagnostics

Chindoko m'chilankhulo cha dotolo wodziwa tingadziwire ndi mawonetseredwe kunja, koma nthawi zambiri wodwala Kwalamulidwa angapo nkhani. Ambiri, komanso kwambiri zolakwika - izo RW. Pa siteji serological, akhoza kupereka chifukwa zoipa mu mtima anthu ndi wathanzi zinthu zabwino monga:

• mimba;
• chifuwa chachikulu;
• malungo;
• matenda magazi;
• pambuyo mankhwala ochititsa dzanzi;
• pa msambo.

PCR ndi kusanthula zolondola, koma akupereka yankho bwino kuti magawo pulayimale ndi sekondale a chindoko chitukuko. Komanso, maganizo ntchito kupeza Treponema: RIBT, RIF, TPHA, RHS, RPR, RNC.

Palibe njira izi si wolondola pa 100%, kotero kupeza zotsatira olondola ambiri anachita nkhani ziwiri. Chifukwa cha khalidwe lawo wodwala akutaya magazi kuchokera mu mtsempha pa chopanda kanthu m'mimba. Mtundu wachiwiri wa kafukufuku kwa chindoko ndi anafukula ku chancre ndi zotupa papules ndi tinatake tozungulira, koma rezultativen yekha magawo pulayimale ndi sekondale ya matenda.

A zabwino akusonyeza "++++" kapena "+++". Izi zimafuna mayeso wina confirmatory.

zotsatira zokayikitsa anatchulidwa "++" kapena "+". Pankhaniyi, matenda akubwerezedwa pambuyo masiku 10-12.

Pa matenda a chindoko m'chinenero

Popeza pallidum amakhudzidwa kwambiri Mercury kwa chindoko pamaso kupeza mankhwala kuchotsa ofotokoza. Anatulukira wa penicillin, amene pallidum ndi yamphamvu kwambiri, mchitidwe umenewu ndi chinthu chakale. Kwa zaka zingapo kuti matenda a chindoko ntchito mankhwala a penicillin. Pokhapokha ngati wodwala ali ndi ziwengo kwa iwo, m'malo mwa "mankhwalawa", "Cephalosporin" "Tetracycline". Nthawi zina ntchito aminoglikozity, amene amathanso ziletsa kukula kwa treponemes, koma ayenera amwedwa kwambiri, ndi sangadziteteze wodwalayo.

Kuwonjezera mankhwala a anthu anapezeka ndi chindoko, kuti apezeke ndipo ngati n'koyenera, mankhwala ayenera onse amene akhala naye.

kaonedwe

Magawo pulayimale ndi sekondale ya chinenero chindoko ndi mankhwalawa anachiritsa pafupifupi 100%, koma ayenera adzanyamula kukumbukira kuti Treponema kufotokoza ndi zochita za mankhwala. Ngati vuto akufotokozera zoipa, iwo anasiya namondwe wa ntchito, mawonekedwe cysts ndi kuyamba dikirani. Kamodzi ankachitira munthu chichitike adatchithisira chitetezo chokwanira, iwo kachiwiri kupanga zonse helical mawonekedwe ndi kuyamba kubereka. Choncho, nditamaliza mankhwala pa miyezi 3, odwala pochitika zitsanzo mayeso. Chimakhala zaka 2. Ndiye mayesero chaka china adzakhala kamodzi pa miyezi 6. Pambuyo kuona lathunthu la mtima, ndi zotsatira zabwino atachotsedwa m'kaundula.

Mbali ukachenjede a chindoko tsopano ankachitira, koma anayamba Usatong'olere chinenero salinso anachira. Komanso, musati kutha kwambiri stellate zipsera pambuyo gummas.