Sputum: zolinga ndi njira

Sputum chinsinsi adzamasulidwa pa kutupa kwa trachea, bronchi ndi mapapo. maonekedwe ake amalembedwa osati ndi kugonjetsedwa kwa dongosolo kupuma, komanso kuti mtima ndi matenda a mtima. Njira sputum kumafuna macroscopic, tosaoneka ndi mankhwala tanthauzo la makhalidwe ake.

Analysis limasonyeza kuti

Sputum limachititsa kuti azindikire majeremusi amene amayambitsa ndondomeko matenda, tisonyezeni pamaso pa Mycobacterium TB, kudziwa maselo a khansa, magazi ndi purulent zosafunika, komanso kudziwa kukana bakiteriya opha tizilombo.

Mu kusanthula kodi zinthu kukuonetsedwa

Sputum mu kusanthula chonse anachita pansi zinthu zotsatirazi:

• kutsokomola;
• kutukusira kwa mapapo;
• kutupa bronchi ndi;
• m'mapapo abscess;
• chifuwa chachikulu;
• bronchiectasis;
• chilonda m'mapapo mwanga;
• m'mapapo chotupa;
• chifuwa mu mawonekedwe pachimake;
• chifuwa;
• mu zilonda zapakhosi aakulu;
• chifuwa chachikulu;
• akuphokosera chifuwa;
• silicosis;
• pachimake mawonekedwe a matenda obstructive;
• kutukusira kwa mapapo;
• tizilombo ta matenda.

Kukonzekera Survey

Amatope adzakhala bwino allocated, ngati madzulo pamaso kugonja ndi kutenga kusanthula chida expectoration, kapena kumwa yambiri zakumwa ofunda. Pamaso kusonkhanitsa analimbikitsa kuyeretsa mano ndi m'kamwa zibowo zam'mano, rinsing ndi madzi ofunda yophika.

malamulo Basic a kusonkhanitsa

Sungani sputum kufufuza bacteriological wokha kubala m'mawa (iye amatenga usiku pamaso chakudya) mu chidebe wosabala, amene wosindikiza zasayansi. Pakuti kusanthula kuchuluka okwanira 5 ml. Analysis wa katulutsidwe wapangidwa pasanafike 2 hours pambuyo deta awo. Mpaka nthawi kutumiza kuphunzira nkhani za chidebe asungike chatsekedwa mu firiji.

Kuchuluka kwa sputum matenda osiyanasiyana

Number allocated katulutsidwe zimasiyanasiyana malinga ndi chikhalidwe cha ndondomeko pathological. Childs, izo zimasiyanasiyana ndi kulavulidwa angapo 1 lita imodzi patsiku. A pang'ono adzamasulidwa pa kutupa kwa bronchi, njira congestive kuyambira ndi mapapo ndi bronchial mphumu kuukira. Kumapeto kwa ukuwonjezeka kuukira buku. Kungakhale kuti malita 0.5, ndi kuima ambiri, ngati pali edema m'mapapo mwanga.

ntchofu kwambiri adzamasulidwa pa ndondomeko purulent mu mapapo pamene kulankhulana ndi bronchi, ndi zamafinya zinangoti, bronchiectasis ndi chilonda.

TB sputum m'mapapo minofu limasonyeza kuwonongeka. Makamaka, ndondomeko oterowo amakwiya ndi M'mimbamo amene amalankhula bronchi ndi.

Kuyambira chimene chinayambitsa kuchepa kapena kuwonjezeka katulutsidwe kudzipatula

Kuchuluka excretion katulutsidwe akhoza kugwirizana ndi chikhalidwe kuwonongeka kwa wodwala ndi kuunikira pa exacerbation. Kuwonjezeka Akunenanso za mphamvu zabwino chitukuko cha matenda.

Kuchepetsa kuchuluka kwa ntchofu tochoka angasonyeze mgwirizano kutupa kapena kulakwila mu ngalande M'mimbamo wodzazidwa ndi mafinya. Pankhaniyi, kuwonongeka kwa thanzi mtima.

chikhalidwe cha kumaliseche kwa

Mucous katulutsidwe limaimira matenda mu mawonekedwe pachimake kapena aakulu mphumu bronchial, chibayo, khansa, zotupa za m'mapapo, bronchiectasis, m'mapapo mwanga hydatid chotupa, limodzi ndi suppuration, actinomycosis.

Sputum ndi kusakanizikana kwa mafinya zimawonedwa mu m'mapapo abscess, bronchiectasis ndi echinococcosis.

Ntchofu wothira magazi kapena wopangidwa kwathunthu magazi khalidwe TB. Maonekedwe a magazi angasonyeze pamaso pa khansara, bronchiectasis, m'mapapo zamafinya zinangoti. Komanso, ngati chinthu zimawonedwa mu syndrome pakati Lobe, m'mnyewa wamtima infarction mu phapo, zoopsa, actinomycosis ndi zotupa chinzonono. Magazi kungakhale kopanda ndi lobar ndi focal chibayo, njira congestive, mphumu mtima ndi edema m'mapapo mwanga.

Serous sputum zimawonedwa mu edema m'mapapo mwanga.

sputum mtundu

Sputum mupeza mosiyana akuda. Mucous ndi serous kumaliseche alibe mtundu umodzi kapena azioneka yochitidwa.

Kulumikizana mafinya amapereka chidaliro Kamaoneka hue uliri njira pathological monga abscess m'mapapo, chilonda, bronchiectasis, m'mapapo actinomycosis.

Kusankha ndi zowawa za dzimbiri kapena mtundu bulauni amasonyeza kuti mulibe magazi atsopano, ndi kuvunda zopangidwa - hematin. chinsinsi ichi ukhoza kumasulidwa ndi lobar chibayo, matenda a anthrax, infarction m'mapapo mwanga.

Kamaoneka mtundu ndi zowawa za chikasu dothi kapena umboni chinsinsi cha matenda kupuma osakaniza ndi matenda a chikasu ndiyo.

The yowala mtundu chikasu sputum ndi wodetsedwa ndi chibayo eosinophilic.

Ntchofu ocher amapezeka siderosis mosavuta.

Blackish kapena grayish chinsinsi taonera pamaso zosafunika khala fumbi. Pamene m'mapapo mwanga edema serous sputum anati anthu ambiri. Monga ulamuliro, ndi utoto mtundu uniformly pinki chifukwa kukhalapo kwa maselo ofiira a magazi. Chotero kulekana madzi ngati madzi kiranberi.

Utoto chinsinsi akhoza ndi mankhwala ena. Mwachitsanzo, mankhwala "Rifampicin" akhoza kupereka mtundu wofiira.

fungo

Chikhalidwe cha ndondomeko pathological kapepala kakuti kupuma zingasonyeze katulutsidwe ndi fungo. Sputum amapereka fungo la zowola ndi chilonda ya m'mapapo kapena bronchus zosauma zotupa, khansa, zotupa, necrosis complicating bronchiectasis.

Kupezeka kwa zigawo

Nthawi zambiri kafukufuku ukusonyeza pamaso pa zigawo secretions. Pamene patsogolo phlegm ndi kusakanizikana kwa mafinya zimawonedwa ndi zamafinya zinangoti m'mapapo ndi bronchiectasis.

Chinsinsi kuvunda kusakanizikana lili zigawo zitatu. Pamwamba wosanjikiza ndi ofanana ndi thovu serous sing'anga, ndi doped m'munsi mafinya. Chotero zikuchokera ndi amakhala ndi chilonda m'mapapo.

zosafunika

Kusakanizikana chakudya zingaoneke mu kukhalapo kwa chotupa chotupa wa kum'mero pa kulankhulana ake ndi bronchi ndi trachea. Pambuyo kukhudzana ndi njoka zam'mimba za matepi mu bronchi mu sputum akhoza wapezeka kapena ngowe scolex tiziromboti. kawirikawiri anapeza akuluakulu a Ascaris kuti kudutsa dongosolo kupuma mwa anthu immunocompromised.

m'mapapo fluke dzira cysts kuonekera pa yopuma kuti aumbike mwa phapo pamaso pa majeremusi.

Chilonda m'mapapo abscess chifukwa maonekedwe a zidutswa za m'mapapo necrosis. Pamene zotupa akhoza kupezeka mu secretions zidutswa zake.

Convolution munali Ulimbo zimapezeka odwala fibrinous matenda, TB ndi chibayo.

Rice ng'ombe mandala kapena Koch chibadidwe TB.

Oyembekezera Dietrich, kuphatikizapo mankhwala kuwonongeka mabakiteriya ndi maselo m'mapapo minofu zidulo mafuta, zimachitika matenda zosauma kapena chilonda m'mapapo.

Aakulu zilonda zapakhosi mawonekedwe kumafuna kulekana tonsils mapulagi ofanana sankafuna Dietrich.

njira mankhwala a

Sputum mankhwala njira kumafuna kudziŵa:

• mapuloteni index, omwe angathandize mu masiyanidwe matenda a mawonekedwe aakulu chifuwa ndi chifuwa chachikulu. Matenda mawonekedwe aakulu amalembedwa kuda chinsinsi cha mapuloteni, ndipo adzakhala apamwamba kwambiri mu zotupa chifuwa chachikulu cha kuchuluka kwa mapuloteni mu sputum, ndipo mwina anasonyeza mwa manambala (kwa 100-120 g / l).
• Ya ndulu inki. Zikupezeka mu sputum mu kugonjetsedwa kwa dongosolo kupuma osakaniza ndi chiwindi. Pankhaniyi chiwindi amalankhulira ndi mapapo. Ya ndulu inki ndi chibadidwe chibayo kuti chifukwa cha kugwa kwa m'mapapo mkati erythrocytes ndi kusintha wotsatira mu hemoglobin.

Cytological chinsinsi njira zofufuzira

Pakuti masiyanidwe matenda a TB ndipo ambiri zotupa zina m'mapapo ndi ambiri amagwiritsa ntchito Pap njira, chomwe ndi mbali ziwiri: matenda ndi tosaoneka Kupenda sputum.

kafukufuku pa chipatala kumathandiza kudziwa njira iyenera kusonkhanitsidwa chuma kupeza zotsatira olondola a kuwunika.

Pali mitundu iwiri chachikulu cha chuma, chimene chimafuna kuona tosaoneka sputum: padera ndi kuchepetsedwa. Mtundu wachiwiri wa katulutsidwe analandira chikoka cha zikuchitika zosiyanasiyana (kwa wothandizila expectoration, inhalations ndi zina zotero. D.).

Zofunika akamagwira singano biopsy

Cytological Kupenda sputum kumaphatikizapo kuphunzira Kupenda macroscopic ndi tosaoneka maselo ake.

Uthenga kwa kusanthula cytological wa sputum watenga m'mawa pa chopanda kanthu m'mimba. Isanafike kuphunzira izo ziyenera kusungidwa maora osaposera 4.

• Mu sputum zimachitika squamous maselo zaminyewa, amene anaphunzira microscopically. Koma kwa matenda, alibe tanthauzo. columnar zaminyewa maselo - osakwatira ndiponso mu gulu - zingaoneke matenda monga chifuwa cha mphumu bronchial, matenda ndi khansa ya m'mapapo. Onani kuti epithelium columnar uonekere chifukwa malowedwe a ntchofu m'mphuno.
• macrophages Alveolar ndi reticuloendothelial maselo. Macrophages zimapezeka cytoplasm ndi (fumbi kapena maselo phagocytic) angapezeke odwala amene ali yaitali fumbi Mpweya.
• Macrophages protoplasm (popangidwa ndi kuwonongedwa kwa hemoglobin) mtima chilema otchedwa maselo. Iwo angayambe pa njira patsogolo mu mapapo, mitral vavu stenosis, infarction m'mapapo mwanga.

• A ochepa leukocytes ali sputum iliyonse. amanena mkulu wa taonera kusakanizikana ndi mafinya katulutsidwe.
• Eosinophils. maselo amenewa ntchofu wolemera asthmatics. Maselo lingamakumane ndi mawonekedwe a eosinophilic chibayo zotupa helminths chamoyo, TB ndi infarction m'mapapo mwanga.
• Erythrocytes. Munthu maselo ofiira alibe chithunzi cha matenda. Zikamera wa ndalama kuchuluka kwa umboni wa kukhalapo kwa magazi mu mapapo. The erythrocytes atsopano magazi anatsimikiza zonse. Ngati pali kusakanizikana kwa magazi, omwe okhathamira mu mapapo kwa nthawi yaitali, anapeza erythrocytes leached.
• Cancer Maselo. Angapezeke mu magulu chinsinsi. Iwo akusonyeza pamaso pa chotupa. Pamene muli selo zambiri vuto matenda. Zikatero, kukonzanso kusanthula sputum.
• Zotanuka ulusi, amene maonekedwe chifukwa cha kugwa kwa minofu ya m'mapapo, TB chikwiyire, abscess, chilonda, chotupa. Chilonda maselo oterowo nthawi yodziwika monga chifukwa zochita za michere, ndiwo chinsinsi, iwo akhoza zidzasungunuka.
• Kurshmana mwauzimu. Thupi wapadera, ofanana ndi chubu. Zikupezeka mu phunziro pansi maso a. Nthawi zina noticeable ndi diso. Childs helix matenda chibadidwe monga mphumu bronchial, TB m'mapapo mwanga ndi chibayo.
• timibulu Charcot-Leyden zimapezeka sputum ndi okhutira mkulu wa eosinophils mu zotupa awa, monga mphumu bronchial, eosinophilic chibayo. Mliri Autopsy TB mu lumen wa bronchi mwina yodziwika ndi kukhalapo mu katulutsidwe wa zotanuka ulusi mafuta timibulu, ndi amorphous laimu MBT (otchedwa tetrad Ehrlich) - 100%.

Ntchito wamamamayikirosikopu

Collection sputum kuipitsa mbiri wamamamayikirosikopu phunziro njira ikukhudza kusanthula secretions kwa kudziwika ndi Mycobacterium yeniyeni TB. Iwo amafanana ndi wochepa thupi, wandiweyani mbali kapena zokhotakhota pakati timitengo wa amayesetsa zosiyanasiyana ndi mtima onse singly ndi magulu.

Kudziwika Mycobacterium TB si mbali lalikulu kwa matenda ndipo amafuna kutsimikizira mwa njira bacteriological. Mycobacterium TB pa mlingo wa chinsinsi sungathe wapezeka.

Maziko a kuwunika ndi particles purulent atengedwa kuchokera makumi asanu m'madera osiyana ndi triturated mpaka panes yosalala awiri. Kenako, iwo zouma mu mlengalenga ndipo anakakonza ndi burner lawi.

Bacteriological Kupenda sputum Ziehl-Nielsen kudetsa zikusonyeza mu wofiira. Pankhaniyi, zinsinsi zonse za tinthu, ndi kupatulapo mycobacteria, amakhala tinged ndi buluu, ndipo mycobacteria kukhala wofiira.

Pamene TB chamoyo amaganiziridwa chotupa pambuyo maphunziro atatu pamaso pa mycobacteria ndi kuyankha zoipa ayamba kugwiritsa ntchito njira flotation (kusanthula Pottenger).

Kudacita kuphunzira othimbirira kuipitsa mbiri MTB amapereka zabwino zokha pamene chiwerengero cha MTB osachepera 50 000 mayunitsi pa 1 ml ya sputum. Malinga ndi chiwerengero cha Mycobacterium TB kuweruza pamaso zosatheka.

odwala Bacterioscopy ndi matenda nonspecific m'mapapo

Laboratory maphunziro a sputum pamaso pa matenda omwe si yeniyeni ya m'mapapo ndi wamamamayikirosikopu zingasonyeze mabakiteriya zotsatirazi:

• Pamene kutukusira kwa mapapo - pneumococci, diplococci Frenkel, Friedlander mabakiteriya streptococci, staphylococci (100%).
• Pamene chilonda kuwala angathe kuonedwa ndodo spindle osakaniza spirochaete Vincent (80%).
• Yisiti bowa (70%), kudziwa mtundu chimene chimafuna mbewu chinsinsi.
• Drusen actinomycete (100%) pa actinomycosis.

Voliyumu ya katulutsidwe anthu athanzi

Kusamutsidwa kwa ntchofu tochoka trachea ndi bronchi anthu sakuvutika pathologies aliyense, kuyambira 10 mpaka 100 ml / tsiku.

Bwinobwino pamlingo wochepa wa leucocytes, kuphunzira pa papezeka kuipitsa mbiri mycobacteria amapereka chifukwa negative.