Pneumonia pneumonia: sababaha, calaamadaha, daaweynta. pneumonia pneumonia in-qaba cudurka HIV

Caafimaadka - waxa ugu qiimo nin yeelan karaan. Qof kasta ayaa rajeynaya inuu muddo dheer ku noolaado, hana u oggolaan in ka cudur gaar ah. Cudurku wuxuu ku badala dadka ka baxsan aqoonsiga - ay u noqdaan kuwo niyad, muuqashadii waa miskiin, waxaa jira dareen ah in wax walba oo la agagaarka dhacaya, iyo xaaladaha qaarkood mar nooc oo waxtar leh si ay dhibaatooyin dadka dadka kale leexdo xagga layga muday kelyaha iyo Isniinta ah.

Cudurku wuxuu tudho ninna. Xataa dhallaanka ma aha difaaca ka halista ah ku daarashada cudurka kasta. Intaa waxaa dheer, dhibaatada ay soo mareen aan is bukaan oo keliya, laakiin sidoo kale kuwa ay jecel yihiin. Waxaa si gaar ah ay adag tahay si ay ula qabsadaan caadifadda iyo dareenka waalidiinta haysta carruur in tan ama taas cudurada lagu arkay ay. Kids sababta oo ah da 'yar weli ma sharxi karo waxa ay ka walwalsan ah oo ku saabsan, waxa qaybo ka mid ah jidhka ee xanuunka, iyo sida ay u muuqato.

cudurka hornimaadno waa PCP. Waxaad noqon kartaa cudurka meel kasta oo, Habka, xitaa goobaha caafimaadka. xaalada ayaa ah mid qasan xaqiiqda ah in la ogaado cudurka ku jira marxalad hore ee ay horumarka waa mid aad u adag. Inta badan, dadka ayaa la ogaaday in ay u baahan yihiin gargaar caafimaad marka waqti qiimo leh ayaa mar horeba laga badiyay. Taasi waa sababta heerka dhimashada ka pneumocystosis mid aad u sarreeya. Dhakhaatiirta had iyo jeer ma maamuli si loo badbaadiyo nolosha qofka.

Cudurka "pneumonia"

Dadka aan haysan wax ay sameeyaan daawo, Badankoodna wax yar u yaqaanna ee eraybixinta caafimaadka. Sidaa darteed, cudurka maqal "pneumonia" ama "PCP", ay ku jiraan khasaare, iyo xitaa ku dhacaa hurudda ah. Dhab ahaantii, ha argagixin. First, aad u baahan tahay si ay u dejiyaan, adigu isu bahaysanaya oo weydii dhakhtarkaaga si faahfaahsan, in erayada fudud si ay u sharxaan waxa uu yahay.

Pneumonia badanaa loo yaqaan PCP, oo waa cudur protozoan in ku dhaca sambabada. Activators cudurada loo arkaa sheyga, oo loo yaqaan carinii pneumonia. Ilaa dhawaan, saynisyahano rumeysan yahay in ay ka tirsan yihiin noocyada of fudud. Si kastaba ha ahaatee, ku xad dhawaan ku salaysan cilmiga badan waxaa lagu soo gabagabeeyey in sheyga waxay leeyihiin Tilmaamo gaar ah oo gaar ah si ay u fangaska. carinii pneumonia waa noole ah in qaadsiiyo aadanaha oo kaliya. Ugu yaraan xayawaanka waxaa ilaa maanta aan ogaado xitaa hal mar.

Maxaa dhacaya in PCP bukaanka?

Isbedelada ee jirka pneumocystosis mudan yahay ku xidhan yihiin laba arrimood: waxa guryaha noolaha waa wareer ah ee pneumonia, gobolka iyo nidaamka difaaca jirka aadanaha. Pneumonia, mar jidhka, ay bilaabaan in ay ka hor iyada oo mareenka-mareenka, si ay u baxsasho iyo galaan Alfiyoli ah. Halkan si toos ah bilaabmaa wareegga ay nolosha. Waa badashada, waxay u soo galeen xiriir la surfactant iyo sii daayo metabolites sun. Dhibtoonayo pneumonia carinii T-limfosaytis, iyo sidoo kale loogu yeero macrophages alveolar. Si kastaba ha ahaatee, habdhiska difaaca, ma aha oo kaliya ma ilaalin karo ciidankii cudurka, laakiin ka gees ilaa xad ah - leedahay saamayn ka soo horjeeda, waayo, kaasu wuxuu kobciyaa iyo kordhiyaa tirada pneumonia.

Gebi badashada qof caafimaad ee carinii pneumonia aan ku hanjabay. Laakiin xaaladda badashaa haddii habka difaaca jirka waa miskiin. Xaaladdan oo kale, cudurka waxa ku firfircoonaan la xawaaraha hillaac, iyo in muddo gaaban waqti tirada pneumonia, qabtay iftiinka gaaro hal billion. Tartiib tartiib meel alveolar si buuxda loo buuxiyey, siinta asaasmeen exudate foamy ah, carqalad ah daacadnimada xuub leukocytes Alfiyoli iyo ugu dambeyntii in ay waxyeeleeyaan oo sidaas, ee alveolocytes burburinta xiga. Sababo la xaqiiqada ah in pneumonia nalastiko haboon in alveolocytes, hoos dusha neefsashada sambabada. Sidaas darteed, dhaawac jirka sambabada bilaabaa habka of Go'doominta alveolar-gaddoonka ah.

In la dhiso aad xuub gacanta u gaar ah, carinii pneumonia baahan yahay qofka phospholipids surfactant. Sidaas awgeed, waxaa jira xadgudub shiid surfactant oo si weyn u sii xumeeyey hypoxia unugyada sambabada.

Yuu yahay kan ugu khatarta badan ee cudurrada kale?

noocyada pneumonia yaqaan in ay taariikhda waa distinguished ka soo midba midka kale, oo ay ku jirto xaqiiqda ah in halista bandhigi qaybaha kala duwan ee dadka. Pneumonia dareenkan waa laga reebo lahayn. Waxaa inta badan uu yeesho in:

• dhallaanka dhicis ah;
• dhallaanka iyo carruurta kuwaas oo loo bandhigi cudur bronchopulmonary ba'an, ayaa lagu qasbay muddo dheer in ay isbitaalka iyo mari therapy adag oo muddo dheer ah,
• qof oo la silcayey oncological iyo gemozabolevaniyami iyo loola dhaqmo kuwa nudaha iyo corticosteroids, iyo sidoo kale la dhibtoonayo heley kala duwan ee kelyaha iyo unugyada connective, soo shaac baxa iyadoo ay sabab u badalida ah xubin gaar ah gudaha;
• bukaanka TB helay waqti dheer antibacterials awood;
• bukaanka HIV-cudurka.

Sida caadiga ah, cudurka loo kala qaado by dhibco hawada, iyo il dadka caafimaad, ugu of dhan - shaqaalaha isbitaalada. Iyadoo ku saleysan, tirada ugu badan ee saynisyahano ku doodaya in PCP ah - oo keliya cudurka taagan. Iyadoo ay taasi jirto, waxaa lagama maarmaan ah in la caddeeyo in qaar ka mid ah dhakhaatiirta taageero aragtida ah in horumarinta pneumocystosis in muddada dhalaanka waa natiijada cudurka dhiciska uurka.

Waa maxay calaamadaha waa signal ah oo ku saabsan horumarinta pneumonia pneumonia carruurta?

Hooyooyinka iyo aabayaasha had iyo jeer waa mid aad u xasaasi u ah caafimaadka carruurtooda. Ma aha la yaab leh in ay doonayaan in ay ogaadaan sida ay u aqoonsadaan pneumonia wakhtiga. Dabcan, cudurka final noqon karaa oo kaliya dhakhtar, laakiin si ay u aqoonsadaan calaamadaha ugu horreeya ee cudurka waa in ay awoodaan in ay waalidka wax miyir qabo. Maalin kasta laga badiyay waxay keeni kartaa in ay xaqiiqada ah in ilmaha laga yaabaa in pneumonia a laba geesoodka ah, pneumonia, iyo dhibaatooyin kale.

Pneumonia pneumonia in carruurta si caadi ah u koraya, laga bilaabo laba bilood jirka ah. Inta badan cudurka saamayn ku carruurta loo aqoonsaday hore cudurka cytomegalovirus. Cudurku wuxuu ku dhacaa ay classical pneumonia foomka interstitsianalnoy. Nasiib darro, dhakhaatiirta aqoonsadaan in bilowga hore waa wax macquul ah in la ogaado cudurka noocan oo kale ah, sida pneumonia pneumonia. Calaamadaha danbe muuqan. Calaamadaha ugu muhiimsan ee tilmaamaya horumarka deg deg ah ee cudurka waxa ka mid:

• Qiix-dheertu aad u xoog badan in;
• dillaaca wakhtiyeysan ee neefsashada (doorbidayaa habeenkii);
• carruurta qaar ka mid ah waxaa jira dheecaan of madxafka, foamy, cawl iyo xab viscous.

Muddada cudurku cudurka waa 28 maalmood. Maqnaanshaha daaweyn ku filan iyo waqtiga, heerka dhimashada ee carruurta ay hayso pneumonia, gaadho 60%. Intaa waxaa dheer, dhallaanka qaba pneumonia pneumonia dhacdaa oo aan calaamado la arki karo, waxaa jira suurtagalnimada weyn oo muujin syndrome obstructive mustaqbalka dhow. Tani waa inta badan ay sabab u tahay barar-axaleedka ee. Haddii ilmahaagu aanu gargaar caafimaad oo deg-deg ah u qalma waxaa la siin doonaa, obstructive syndrome waxa loo badali karaa jidiinka dhuunta, iyo carruurta waaweyn - in syndrome ee neef.

Calaamadaha muuqda ee dadka waaweyn

Pneumonia in dadka waayeelka ah iyo dhallinyarada qaadataa meel hab ka dhib badan ilmaha yaryar iyo carruurta yar yar. weerar Cudurku wuxuu inta badan dadka ku dhashay difaaca, ama kuwa kaasoo uu kula soo hormariyey la noolyahay. Si kastaba ha ahaatee, tani ma aha sharci in aan brooked weecasho ugu yar. Xaaladaha qaarkood, pneumonia pneumonia dhacdaa bukaanka qaba nidaam gebi ahaanba caafimaad qaba difaaca.

Muddada cudurku cudurka kala duwan tahay 2 ilaa 5 maalmood. Bukaanku waxaa uu calaamadaha soo socda:

• qandho,
• xanuunka dhanjafka,
• daciifnimo in jidhka oo dhan,
• dhidid xad-dhaaf ah,
• xanuun xabadka,
• neefsigu daran Ulasocto qufac qalalan ama qoyan iyo tachypnea.

Ka sokow astaamaha aasaasiga ah ee kor ku xusan, calaamadaha sida mararka qaarkood la ogaadaa sida acrocyanosis, feedhuhu ee nusqaamaha ka dhexeeya feeraha, dhiigrooraan (buluug) ee saddexagalka nasolabial.

Xitaa ka dib markii koorso buuxda oo daaweyn ah in bukaanka qaar ka mid ah ay jirto gaar ah tiro dhibaatooyin pneumonia pneumonia a. Bukaanjiifka qaar ku xoogeystay. Dhakhaatiirta ayaa sheegaya in haddii ay jirto labakaclaynta 6 bilood ka xaaladdii ugu horreysey ee cudurka gudahood, waxa ay soo jeedisay in infakshan ee jirka ku jira oo loo cusboonaysiinayo. Oo haddii ay dhacdo in ka badan 6 bilood, ka dibna waxaan ka hadleynaa cudurka cusub ama reinfection.

Hadii aan la daaweyn habboon ee dhimashada bukaanada qaangaarka ah la safafka pneumonia ka 90 ilaa 100%.

Calaamadaha cudurka ee HIV-cudurka

pneumonia pneumonia ee HIV-qaba cudurka, sida ka soo horjeeda dadka aan haysan virus isbeddesho si tartiib ah. Laga soo bilaabo marka uu bilaabo ifafaale prodromal, iyo ka hor weerarka calaamadaha pulmonary oo kala duwan, waxaa laga yaabaa in 4 ilaa 8-12 toddobaad qaadan. Sidaa darteed, dhakhaatiirta ee shakiga ugu yar ee jiritaanka cudurka jidhka ku, marka lagu daro baaritaano kale, waxaa lagu talinayaa in bukaanka oo kale u samayn xabadka X-rays.

Calaamadaha ugu muhiimsan ee pneumocystosis in bukaan AIDS ka mid ah:

• heerkulka sare (38 ilaa 40 ° C), taas ma dhici 2-3 bilood gudahood;
• lama filaan ah khasaaro miisaankeedii dhan yahay;
• qufac qalalan,
• neefta oo ku qabata;
• sii kordhaya la'aan neefsashada.

Inta badan ee culimada waa aragtida ah in noocyada kale ee pneumonia in bukaanka qaba cudurka HIV-leeyihiin calaamado la mid ah sida pneumocystosis. Sidaa darteed, in marxaladaha hore ee cudurka si loo ogaado nooca pneumonia in bukaan qaadataa meel suurta galayn. Nasiib darro, marka pneumonia pneumonia in bukaanka qaba cudurka HIV-shaaca ka qaaday, waxaa hore u lumay wakhti aad u badan, iyo daalan jidhku waa mid aad u adag si ay ula dagaalamaan cudurka.

Sidee cudurka pneumonia?

Sida xaqiiqada ah qof walba waa ogyahay muuqaal u eg ka sambabada qofka. Photos of jirka waxaa loo soo kabsaday kasta ama buugga a on anatomy ama taribuunka ee rugta ama in kasta oo ilo kale. Macluumaadka taariikhda, waxaa jira yaraanta lahayn. Intaa waxaa dheer, dhakhaatiirta xusuusiyo bukaanka aan inay sanadeed xabadka X-rays oo dhan. Lid ku ah aragtida of badan, tani ma aha qaab a, dhakhaatiirta "picky", iyo baahi degdeg ah. Tani waxay suuro gelineysaa in la ogaado nuurka waqti-dimming in X-rays ah, iyo waqti lahayn in ay bilaabaan daaweynta. Dhaqsiyaha aan garan doonaa cudurka, fursad weyn u noqon doontaa soo kabashada.

Si kastaba ha ahaatee, qof kasta oo naga mid ah si dhib leh waa ogyahay sida ay u muujin on radiographs PCP. Photos of noocan ah ee buugaagta dugsiga ma ka heli a buugaagta tixraaca caafimaad iyo buugaag laga qori inta badan dadka caadiga ah ma keenaan wax xiiso ah. Waxaa intaa dheer, waxaan xitaa aadan lahayn matalaad sida cudurka waxaa lagu gartaa, in kasta oo ogaada waxba kuma yeeli doono.

First, ogaanshaha hordhac ah la sameeyo. Dhakhtarku waxa uu ku weydiinayaa qofka bukaanka ah oo ku saabsan xiriirada uu la leeyahay dad ka tirsan kooxaha halista (HIV-cudurka iyo bukaan AIDS).

Ka dib markii in ogaanshaha kama dambaysta ah. Kuwa soo socda shaybaarka iyo qalabka waxbarashada:

1. takhtarka kuu qoray dhinaca bukaanka ah ee isbadelka falanqaynta dhiig caadi ah. fiiro gaar ah waxaa lagu sawiray heerarka sare ee eosinophils, limfosaytis, leukocytes iyo monocytes. In bukaanka qaba pneumonia waxaa laga yaabaa in dhiig khafiif ah oo hemoglobin wax yar hoos u.
2. Magacaaban baaritaan xarkaha. Waxaa ku saabsan rengenografii waa la kaas oo masraxa ka go'an cudurka. Waa X-ray, kaas oo si cad u arki karo qof ee sambabada. sawir waxaa ku lifaaqan kaarka bukaanka. Marxalada koowaad waxaa hannaankii faa'iido la taaban karo si sahlan. Haddii pneumonia guurtay marxaladda labaad, waa si cad u muuqda on dimming nuurka X-ray. Caabuqan noqon karaa oo kaliya bidix ama sambabada midig oo keliya, laakiin in la garaaco karaa oo ka mid ah oo kale.
3. Si loo ogaado jiritaanka pneumocystosis, dhakhtarka caadiga ah uu go'aansado in la qabto daraasad parasitological. Waa maxay? bukaanka koowaad waxaa la qaaday si ay u falanqeeyaan muunad ah xab. Waayo, miciinka si hababka sida Bronchoscopy, Bronchoscopy iyo biopsy. Intaa waxaa dheer, saamiga waxaa laga heli karaa iyadoo la isticmaalayo a ee loo yaqaan habka of induction of qufac.
4. Si loo ogaado antibodies for pneumonia sameeyay daraasadda fuliyo ka kooban yahay in xaqiiqda ah in farqiga u 2 todobaad qofka loo qaadayo inay falanqaynta ee serum 2. Haddii mid kasta oo iyaga ka mid ah la kulma ka badan-baadh qiimaha ugu yaraan arrin of 2 caadiga ah, waxaa loola jeedaa in qofka jiran yahay. daraasaddan oo la sameeyay si loo baabi'iyo warbaahinta caadiga ah, sida antibodies helay 70% dadka.
5. Si lagu ogaado cudur noole ee xaako, iyo muunada biopsy iyo lavage Baadhista PCR sameeyaa broncho-alveolar.

pneumocystosis stage

Waxaa jira saddex marxaladood oo isdaba joog ah oo PCP:

• oedematous (1-7 asbuuc);
• atelektaticheskuyu (celcelis 4 todobaad);
• emphysematous (ee durations kala duwan).

pneumocystosis stage Edematous lagu gartaa kulankiisii ugu horeysay ee tabar dhan jidhka, feejignaan xumo, qufac iyo markaas dhif ah, si tartiib ah u sii xoogeysaneyso, iyo kaliya dhamaadka muddada - a qufac xoog leh oo qallalan, iyo neefta oo ku qabata inta lagu guda jiro jimicsi. Dhallaanka naasnuujinta xun, ha gelin on miisaanka iyo mararka qaarkood diido in caanaha hooyada. No isbedel la taaban karo iftiinka X-ray ma la ogaado.

Inta lagu jiro marxaladda atelektaticheskoy qandho xummada leh ayaa lagu arkay. Qufac waxaa si wayn u xoojinaya oo u muuqda xaako foamy. Neefta oo ku qabata u muuqataa xitaa inta lagu guda jiro jimicsi fudud. On ah X-ray muuqda isbedel atelektaticheskie.

In bukaanka oo ka badbaaday 2 muddooyinka ugu horreeya, horumarinta stage pneumocystosis emphysematous, inta lagu guda jiro kaas oo waxqabadka hoos u functional ah neefsashada iyo calaamadaha muujinaya of emphysema.

pneumonia degree

In daawada, in la kala saaro ka degrees soo socda ee adkaanta cudurka:

• iftiinka, taas oo ah waxa lagu gartaa sumoobo daciif ah (heerkulka aan ka badnayn 38 ° C, iyo miyir nezatumanennoe) nasan aan la calaamadeeyay dyspnoea, madoobaad iftiinka ogaado on a yar oo x-ray,
• Celcelis ahaan, lagu gartaa sarkhaan dhexdhexaad ah (heerkulka ka badato 38 ° C, gaadho 100 wadnaha garaaca halkii daqiiqo, bukaanka ka cabanaya dhidid kordhay , iwm ...), at dyspnea inteeda kale ayaa lagu arkay on film x-ray dhexgalka si cad u arki karo sambabada;
• culus dal sarkhaan daran (heerkulka stamp ka badan 39 ° C, uurkuna waa ka badan 100 garaac daqiiqaddiiba, waxaa jira a delirium), yaridu neefsashada horusocod ah, oo la arki karo on x-ray dhexgalka ballaaran oo ka mid ah sambabada, ay u badan tahay in ay dhibaatooyin kala duwan.

Waa maxay daawada loo qoro bukaanka PCP?

Shaki kuma jiro in aqoonta sida loo aqoonsan karo caabuq sambabada, waa lagu daray wayn ee qof kasta. Si kastaba ha ahaatee, tani kuma filna. Waxaan ma aha dhakhaatiir, ogaanshaha sax ah ma gelin karaa. Ma jiro hal nooc oo pneumonia iyo go'aan ka geesood ama laba geesood ah pneumonia, pneumonia, iyo noocyada kale ee xirfad laawe cudur aan iska bixin karin. Sidaa darteed, a-daweynta is kuma socon karo iyo hadal. Waxa ugu weyn ee - ma dib u dhigto iyo inuu ku kalsoon yahay dhakhtarrada. Ka dib markii la samaynayo oo dhan dhakhtarka cilmi-baarista loo baahan yahay si sax ah u sawiri kartaa gabagabo in sababta keentay cudurka bukaanka waa pneumonia pneumonia. Daaweynta waxaa la siiyaa oo kaliya ka dib markii xaqiijinta cudurka been dhaqanka tallaabooyin ammaanka urur iyo daaweynta daroogada.

waxqabadka urur-taliska waxaa ka mid ah in isbitaal maarmaan. In isbitaal bukaan helo dawooyinka iyo cuntada lagu taliyey by dhakhtar.

therapy Drug ka kooban yahay etiotrop, pathogenetic iyo daaweynta calaamadaha. Bukaanka inta badan qorayaasha "Pentamidine" "furazolidone" "Trichopolum" "Biseptolum", iyo daawooyinka anti-bararka kala duwan, daroogada in kor loogu qaado oo loo fududeeyo expectoration ee expectoration xaako, mucolytics.

"Biseptol" waxaa maamula afka ama faleebo. Daawada si fiican loo dulqaatay iyo waxaa quman in "Pentamidine" ballan bukaanka aan ka cabanaya AIDS. "Pentamidine" maamula intramuscularly ama faleebo.

bukaanka HIV-qaba cudurka, iyo waxyaabo kale, la helo daaweynta antiretroviral maxaa yeelay, iyagu pneumonia pneumonia dhacaa sabab u ah habdhiska difaaca. Pneumocystosis lagu daweeyo bukaanka AIDS sannadihii la soo dhaafay ayaa sii kordheysa loo isticmaalay difluoromethylornithine Alfa ah (DFMO).

ka hortagga

pneumocystosis Hortagga ka mid ah tiro ka mid ah hawlaha, ka mid ah taas oo soo socda waa in la ogaadaa,

1. Si aad u baabi'iyo cudurka in tas-hiilaadka caafimaadka carruurta ee isbitaalada, oo waxaa lagu daaweeyaa bukaanka oncological iyo hematological, shaqaalaha oo dhan, iyada oo aan marka laga reebo, waa inuu muddo in la baaraa jiritaanka cudurka.
2. prophylaxis Drug dadka halis. ka hortagga Tani waa laba nooc: aasaasiga ah (ka hor intaysan bilaabin si ay u horumariyaan cudurka) iyo sare (hortag ah ka dib markii dhamaystiran kabashada si looga hortago soo noq).
3. goor hore la ogaado pneumonia pneumonia iyo go'doomin degdeg ah bukaanka.
4. jeermi joogtada ah meelaha dillaacay ayaa la diiwaangeliyey pneumocystosis. Si arrintan loo sameeyo, samayn nadiifinta qoyan, adiga oo isticmaalaya xal 5% of bleach chlorine ah.