Zimayambitsa matenda. Mitundu chifuwa, Zizindikiro ndi Chithandizo mu Akuluakulu

Monga mwana, nthawi zambiri makolo kunena, osamwa ozizira - ozizira, usayende Mesiya zisoti - amenewa kutukusira kwa mapapo, si yonyowa mapazi - zilonda zapakhosi. Koma ife sanamvere kudwala. Ngati kunja kwa makani, kapena chifukwa cha chidwi kafukufuku amayesedwa kwa mphamvu ya thupi lanu. Choncho pambuyo onse kuti chimachitika matenda ndi ndichiyani?

matenda pachimake

Matenda - ndi yotupa matenda a thirakiti m'munsi kupuma, ndi zizindikiro zomwe ndi anthu ambiri padziko lonse kupita ku chipatala. Zimayambitsa matenda akhoza zosiyanasiyana: tizilombo toyambitsa matenda, kapena mogwirizana.

Pa nthawi yomweyo kugonjetsedwa kwa minofu ya m'mapapo zimachokeradi, ndi kutukusira isanafalikire mwapadera mu mtengo bronchial.

Kusiyanitsa zotsatirazi mitundu chifuwa :

- pachimake pamene kukula voliyumu ya secretions bronchial ndipo zikuoneka chifuwa reflex;
- aakulu, pamene kusintha Kakhungu mucous limapezeka pa mlingo ma, imbaenda hypersecretion ndi mkhutu mpweya wabwino.

etiology

Monga tanena zimayambitsa matenda akhoza kukhala osiyana kwambiri. Bakiteriya sipekitiramu wa tizilombo toyambitsa matenda zambiri ndi streptococci, mycoplasma, chlamydia, anaerobic zomera. A etiology tizilombo zikufotokozedwa fuluwenza, parainfluenza ndi rhinovirus.

A pang'ono matenda zochepa wamba chifukwa cha mankhwala kapena poizoni zimakhudzanso thupi. Koma mu nkhani iyi kugwirizana mosalephera a matenda a sekondale. Malinga ndi gulu la International wa Matenda Lakhumi kuzilembanso, olekanitsidwa pachimake matenda chifukwa tizilombo toyambitsa matenda anakhazikitsa ndi proximate pachimake matenda.

Pakuti nthawi ya matenda amadziŵika:
- pachimake (masabata atatu);
- nthawi yaitali (pa mwezi).

matenda pachimake akhoza ikuyenda zochokera kuphipha bronchial, ndipo popanda izo. Kutanthauzira angathe kusiyanitsa tracheobronchitis, kusintha yotupa pamene anaikira mu kumtunda kwa mtengo bronchial, ndi bronchiolitis (pathological ndondomeko amakhudza bronchioles ang'ono ndi alveoli). Ndi chikhalidwe cha purulent exudate kusiyana, necrotizing matenda ndi catarrh.

pathophysiology

Kodi angathe matenda? Zizindikiro ndi mankhwala mwachindunji akuluakulu zimadalira limagwirira cha matenda, monga mankhwala umalimbana makamaka pa mfundo za ndondomeko pathological.

zinthu Etiological mwanjira kuwononga bronchial maselo mucosa ndi imfa awo. Awa "mabowo" chitetezo kulenga zinthu kwa malowedwe a tizilomboto lapansi. Ngati epithelium chachikulu njuchi HIV, ndiye patapita masiku awiri kapena atatu kuti agwirizane naye ndi mtundu wina wa mabakiteriya zambiri Streptococcus pneumoniae.

The kutupa minofu zochita (kutupa, redness, kuchuluka kutentha m'dera ndi kukanika) oyambitsa chisokonezo wa magazi pa kama capillary, psinjika a molekezera mitsempha ndi magazi kuundana.

Ngati mphamvu zabwino za ndondomeko ndi mankhwala ntchito pa nthawi, pambuyo kutha kwa kutupa nembanemba mucous mu wobwezeretsedwa m'miyezi yochepa. Koma ochepa odwala satero. Ndiye matenda amakhala aakulu. Ngati kusintha bwanji okha mucosa, si zimakhudza kwambiri pa moyo wa munthu. Koma kugonjetsedwa kwa zigawo zonse bronchus ndi zingachititse magazi mu minofu m'mapapo, ndipo magazi kudetsa ndi sputum.

chipatala

Zimayambitsa matenda obstructive, monga mabakiteriya kapena mavairasi amene amayambitsa khalidwe mawonetseredwe matenda. The gawo prodromal ikusonyezedwa kuwonjezeka thupi kutentha kwa manambala febrile, kufooka, kugona, kusafuna kudya, litsipa, thukuta, palpitations mtima.

Odwala kufotokoza zomverera zawo monga soreness kapena scratchy pakhosi ndi chifuwa, amene nakweza ndi inhalation ozizira mpweya. Komanso nkhawa wouma kuwakhadzula chifuwa kuti wosatenga mpumulo. Patatha masiku awiri kapena atatu, odwala ndi ntchofu wandiweyani kwa ntchofu kapena mafinya. chifuwa akhoza limodzi ndi ululu mmunsi mwa chifuwa. Ichi ndi chifukwa cha funde la minofu pectoral.

Pa kafukufuku ambiri nakokera chidwi cha chinyezi mopitirira muyezo khungu, redness pa maziko ake cyanosis cha milomo. Minofu ndi aliyense mpweya kukopedwa mu malo intercostal, wothandiza kupuma minofu ntchito.

Pa avareji wopepuka matenda kumatenga pafupifupi milungu iwiri ndipo itha kuchira kwathunthu.

diagnostics

Amachititsa matenda mosavuta kudziwa ngati ntchito mwanzeru zipangizo matenda. Pambuyo kuyendera zithunzi m'pofunika kafukufuku njira thupi monga palpation, percussion ndi auscultation. Kumverera ndi percussion Pankhaniyi sangosonyeza chilichonse zachilendo, koma pano pali stethoscope akhoza kumva kupuma zovuta, limodzi ndi anamwazikana wheezing. Pamene pali phlegm, wheezing kukhala yonyowa krupnopuzyrchatymi.

Ambiri, kusanthula magazi leukocyte achiyesa zingawonjezere ndi kuwonjezeka anati mlingo erythrocyte sedimentation (ESR). Mu kusanthula mkodzo, monga ulamuliro, palibe kusintha, koma kutalika kwa malungo zikhoza mapuloteni. Amuzolengedwa kusanthula magazi zimathandiza kuona maonekedwe a C-zotakasika mapuloteni ndi kuwonjezeka mu mapuloteni alpha-nusu. Mu sputum ndi Ulimbo, leukocytes, desquamated epithelium wa bronchi ndi maselo ofiira. Komanso, zasayansi kuchita zili mbewu ya bronchi pamaso pa mabakiteriya ndi tizilombo tina.

Pa radiograph Sadzathandiza kusintha zenizeni, koma kuti kunandithandiza chitsanzo m'mapapo mwanga. Kunyamula spirogram adzakhala ngoziyo kukhalapo ndi digiri cha kutsekeka.

chithandizo

Zimayambitsa matenda komanso chifukwa kusankha njira chithandizo pa nkhani iliyonse. Malinga ndi kuopsa kwa ndondomeko pathological, matenda pachimake angathe kuchizidwa ngati outpatient ndi inpatient ola kuunikira madokotala.

Therapy pazikhalanso mavairasi oyambitsa kapena antibacterial chigawo chimodzi, komanso mankhwala kuti kumapangitsanso bronchi. Komanso, m'pofunika kuthetsa zimene azipereka kwa kupitirira kwa matenda a AIDS. The njira ya mankhwala chofunika kudutsa, osayang'ana kapena zizindikiro matenda apitiriza.

Panopa, madokotala mwachangu monga physiotherapy chithandizo, kutikita, masewero olimbitsa thupi. Izi zimathandiza kuti achoke bwino secretions bronchial, komanso amalola kusintha njira zakayendesedwe ka mu thupi.

chifuwa

Chifukwa chachikulu cha matenda - ndi kuwonongeka kwa mucosal epithelium wa kapepalako m'munsi kupuma. Nkhani za chifuwa akhoza kukhala masabata anai kuchokera isanayambike matenda pokhalabe ndi matenda ndi pathological kusintha mu mapapo.

chikhalidwe ichi amakhala ndi akakufunsani chotupa bronchial mpanda, amagwirizana ndi yaitali yotupa ndondomeko zikubweretsa minofu sclerosis. Secretory bronchi chipangizo amaloŵamo tikusintha ndi kusintha kwa kupanga kuchuluka kwa ntchofu.

Gawo

Pali zingapo classifications matenda a chifuwa. Pali zotsatirazi mitundu matenda a matenda:
- Easy (kapena catarrhal);
- purulent obstructive;
- losavuta mawonekedwe kuphwanya mpweya ndi;
- purulent obstructive;
- wapadera Mwachitsanzo, fibrous kapena hemorrhagic.

Ndi kuchuluka kwa chiwonongeko matenda gawo la Airways yaikuluikulu. Ganizirani pamaso pa chizindikiro cha mphumu ndi ukulu wake. Ndi chikhalidwe cha otaya, komanso matenda ena yotupa, matenda ndi zobisika ndi exacerbations apo, ndi zonse kobwereza.

Zovuta pambuyo akudwala chifuwa - ndi:
- ndiko kumayambitsa;
- kutsokomola magazi;
- mapangidwe kulephera kupuma;
- aakulu m'mapapo mwanga mtima.

zifukwa

Aakulu, kawirikawiri yoyamba ya matenda pachimake. Zimayambitsa ndondomeko izi ndi kuganizira m'thupi ndi kunja. Chinthu choyamba kuganizira chivomerezocho wa chitetezo cha m'thupi. Ngati ali ndi mphamvu kwambiri kapena wofooka, zingayambitse kutupa kwa nthawi yaitali ndiponso kuwononga minofu. Komanso, yafupika chitetezo chokwanira kukopa madera atsopano mabakiteriya ndi tizilombo, choncho matenda kudzachitika mobwerezabwereza.

Komanso, nthawi yaitali, zaka, mkwiyo wa machubu bronchial ndi kouma ndi ozizira mpweya, fodya, fumbi, mpweya monoxide ndi mankhwala ena anakumana ena mafakitale zingathe kusokoneza zochita za matenda.

Pali umboni kuti matenda ena kumtundu zachititsanso kutupa aakulu mu mapapo.

pathogenesis

Zimayambitsa matenda amagwira zokhudzana limagwirira mapangidwe matenda. Makamaka yafupika malo bronchopulmonary chitetezo, akuti: ndi ciliated epithelium wa villi liwiro, kuchepetsa kuchuluka kwa surfactant, lysozyme, interferon ndi immunoglobulin A, magulu osiyanasiyana a maselo T ndi macrophages alveolar.

Kachiwiri, mu bronchi akufotokozera tizilombo wa ku:
- hyperfunction bronchial mucous zopangitsa (giperkriniya);
- kuwonjezeka mu kukhuthala sputum (dyscrinia);
- stagnation wa secretions mu bronchi (mukostaz).

Ndipo chachitatu, kupanga zina kuti nthumwi causative, ndi mtanda anachita ndi maselo a thupi lomwe. Mfundo zitatu kulola kuteteza kutupa koposera masabata anayi.

zizindikiro

matenda akuwonetseredwa chifuwa amphamvu ndi sputum kwa Botolo zana ndi makumi asanu pa tsiku, nthawi zambiri m'mawa. Tikakumana ndi zochita pachimake yotupa kungakhale auka kutentha, kutuluka thukuta, kufooka.

Ndi kupitirira ya m'mapapo ndi mtima insufficiency akufotokozera phalanges thickening ( "drumsticks"), ndipo thickening wa mbale msomali ( "ola galasi"). Ululu matenda kuchitika pokhapokha ngati ndondomeko yotupa kutengela pleura kapena panthawi yaitali kutsokomola kwambiri sefani akuthandiza musculature.

mayesero labu

Matenda "chifuwa" pamwamba pa maziko a zasayansi ndi maphunziro malangizo. Ambiri, kusanthula magazi zimawonedwa kuwonjezeka leukocyte kosangalatsa leukocyte kumanzere, kuchuluka erythrocyte sedimentation mlingo. Biochemically chinawonjezeka chiwerengero cha zidulo sialic mu magazi, seromucoid, alpha- ndi Popanga madzi a gamma-globulin, pali C-zotakasika mapuloteni. Mucous sputum kapena purulent, akhoza streaked ndi magazi. Lili khungu, maselo ofiira ndi neutrophils.

Kwa morphological chitsimikiziro cha matenda ikuchitika bronchoscopy. Pa radiographs ankaona kuchuluka chitsanzo m'mapapo mwanga ndi mauna ake mapindikidwe, ndi zizindikiro za ndiko kumayambitsa m'mapapo mwanga. Spirography amathandiza oyendetsa dokotala za kukhalapo kapena kusapezeka kwa zizindikiro za kutsekeka bronchial.

chithandizo

Kodi kutenga pambuyo matenda a "chifuwa"? Zizindikiro ndi Chithandizo mu Akuluakulu si wosiyana kwambiri kuchokera mu mawonekedwe pachimake. Kawirikawiri, dokotala n'kukulemberani ena mankhwala mu ziyembekezo zimakhudza causative wothandizila mmene yotupa. Ngati sichitha, ndiye m'pofunika ziziyenda alili. Chifukwa chaichi, anthu awa mankhwala:
- mankhwala;
- expectorants;
- bronchodilators;
- mankhwala;
- inhalations ndi physiotherapy.