Pneumocystis ciwon huhu: haddasawa, cututtuka, magani. Pneumocystis ciwon huhu, a da Cutar HIV

Health - mafi muhimmanci da abu wani mutum zai iya yi. Kowane mutum na fatan su rayu tsawon kuma kada ku sha daga wani musamman cuta. Cutar ya canjãwa mutane fiye da fitarwa - su zama tawayar, su bayyanar ne matalauta, akwai rashin tunani ga dukan abin da ke faruwa kewaye, da kuma a wasu lokuta da zarar irin da taimako ga sauran mutane ta matsaloli mutane juya zuwa embittered da cynical.

Cutar ya ceci babu daya. Ko jariran ba su rigakafi daga hadarin ƙulla wani kamuwa da cuta. Bugu da kari, na wahalar samu ba kawai marasa lafiya su kansu, amma kuma 'yan uwa. Shi ne musamman wuya mu jimre wa da motsin zuciyarmu da kuma ji na iyaye da 'ya'ya da cewa wannan ko Pathology aka gano. Kids saboda su matasa shekaru har yanzu ba zai iya bayyana abin da suke damu game, abin da sassa na jiki a cikin zafi, da kuma yadda shi bayyana kanta.

Insidious cuta ne PCP. Za ka iya zama kamuwa da ko'ina, kuma, Paradoxically, ko da a cikin likita wurare. A halin da ake ciki da wahala da cewa gane da kamuwa da cuta a wani wuri mataki na ci gaba ne da wuya sosai. Sau da yawa, mutane suna farga cewa suna bukatar likita taimako a lokacin da m lokaci an riga an rasa. Wannan shi ne dalilin da ya sa mutuwa kudi daga pneumocystosis sosai high. Doctors ba ko da yaushe sarrafa domin ya ceci rai na wani mutum.

Bincikar lafiya "pneumocystis"

Mutanen da suka ba da wani abu da ya yi da magani, mafi yawansu kananan masani a likitanci terminology. Saboda haka, ganewar asali na ji "pneumocystis" ko "PCP", su ne a wata asara, har ma ya fada cikin wani mãyen. A gaskiya, ba su tsoro. Da farko, kana bukatar ka kwantar da hankali, cire kanka tare da tambayar ka likita a daki-daki, a cikin sauki kalmomi don bayyana abin da shi ne.

Pneumocystis sau da yawa ake magana a kai a matsayin PCP, wanda shi ne mai protozoan cutar da ke shafar cikin huhu. Activators Pathology dauke kwayoyin da aka fi sani a matsayin Pneumocystis carinii. Har kwanan nan, masana kimiyya sun gaskata cewa su kasance a cikin jinsin daga cikin sauki. Duk da haka, mun gwada kwanan nan a kan tushen da yawa nazarin da aka kammala da cewa wadannan kwayoyin da wasu siffofin na musamman zuwa fungi. Pneumocystis carinii ne m cewa infects kawai mutane. A kalla a cikin dabbobi da shi har yau ba a gano ko da sau daya.

Abin da ya faru a cikin haƙuri ta PCP?

Canje-canje a cikin jiki saboda pneumocystosis dogara ne a kan abubuwa guda biyu: a kan abin da nazarin halittu Properties ne pathogens na ciwon huhu, da kuma jihar na mutum rigakafi da tsarin. Pneumocystis, sau daya a cikin jiki, fara su gaba ta hanyar da numfashi fili, to elude su kuma samu shiga cikin Alveoli. Ga fara kai tsaye da rayuwar sake zagayowar. Shin su yaduwa, da suka zo a cikin lamba tare da surfactant kuma saki mai guba metabolites. Fafitikar da Pneumocystis carinii T-lymphocytes, kazalika da ake kira alveolar macrophages. Duk da haka, a raunana na rigakafi da tsarin, ba kawai ba zai iya kare ta rundunar daga kamuwa da cuta, amma sabanin hakan - yana da kishiyar sakamako: shi stimulates kuma qara yawan Pneumocystis.

Gaba daya lafiya mutum yaduwa na Pneumocystis carinii ba barazana. Amma halin da ake ciki ya canza halin idan na rigakafi da tsarin shi ne matalauci. A wannan yanayin, cutar da aka kunna tare da walƙiya gudun, da kuma a cikin wani in mun gwada gajeren lokaci da yawan Pneumocystis, kama a cikin haske ya kai biliyan daya. A hankali alveolar sarari ne cikakken cika, bada Yunƙurin zuwa foamy exudate, rushewa daga membrane mutunci Alveoli leukocytes da kuma kyakkyawan zuwa lalata da kuma daidai da, da m halaka alveolocytes. Saboda gaskiya cewa Pneumocystis shige da zanen goyo zuwa alveolocytes, rage numfashi surface daga cikin huhu. A sakamakon haka, huhu nama lalacewar fara aiwatar da alveolar-capillary kawancen.

Don gina naka jikin tantanin, Pneumocystis carinii bukatar surfactant phospholipids mutum. Saboda haka, akwai wani ƙeta na surfactant metabolism da muhimmanci aggravated huhu nama hypoxia.

Wane ne mafi a hadarin wasu cututtuka?

-daban na ciwon huhu da aka sani zuwa ranar bambanta daga juna, ciki har da cewa hadarin tasowa da fallasa su daban-daban Categories mutane. Pneumocystis a cikin wannan ma'ana ne ba togiya. An fi tasowa a cikin:

• wanda bai kai jarirai.
• jarirai da kuma yara da ake gittar da m bronchopulmonary cuta mai tsanani, da aka tilasta wa wani dogon lokaci ya zama a asibiti da kuma sha wani hadadden da kuma dogon lokacin far.
• mutanen da ke fama oncological da gemozabolevaniyami kuma bi da tare da cytostatics da corticosteroids, kazalika da fafitikar da daban-daban na koda pathologies da connective nama, tasowa a sakamakon dasawa da wani ciki sashin jiki.
• Da majinyatan tarin fuka da suka karbi dogon lokaci m antibacterials.
• Cutar HIV marasa lafiya.

Matsayin mai mulkin, da kamuwa da cuta yana daukar kwayar cutar ta hanyar Airborne droplets, kuma ta tushen lafiya mutane, mafi yawansu duk - ma'aikata a asibitoci. A wannan hasashe, da mafi yawan masana kimiyya gardamar cewa PCP - kawai tsit kamuwa da cuta. Duk da wannan, shi ne wajibi ne don bayyana cewa wasu daga cikin likitocin ya qarfafa ra'ayin cewa ci gaban pneumocystosis a neonatal lokaci ne sakamakon kamuwa da cuta da tayin a cikin mahaifa.

Abin da cututtuka su ne wata sigina game da ci gaban da pneumocystis ciwon huhu, a da yara?

Uwaye da kuma dads ne ko da yaushe sosai kula da kiwon lafiya na 'ya'yansu. Ba abin mamaki ba cewa su so su san yadda za mu gane ciwon huhu, a lokaci. Hakika, da karshe ganewar asali iya zama likita, amma don gane da farko alamun cutar ya kamata su iya wani m iyaye. Kowane rasa rana zai iya kai wa ga gaskiya cewa yaro zai iya samun hadin ciwon huhu, pneumocystis, da kuma sauran rikitarwa.

Pneumocystis ciwon huhu, a yara masu tasowa kullum, da suka fara a watanni biyu na shekaru. Mafi sau da yawa cutar rinjayar waɗanda yara wanda da aka gano a baya cytomegalovirus kamuwa da cuta. Haka kuma cutar yakan faru a cikin su na gargajiya nau'i interstitsianalnoy ciwon huhu. Abin baƙin ciki, likitoci gane cewa a farko shi ne kusan ba zai yiwu a gane irin wannan cuta, kamar Pneumocystis ciwon huhu. Alamun bayyana daga baya. Babban ãyõyi nuna da m ci gaba da kamuwa da cuta sun hada da:

• sosai karfi whooping tari da cewa;
• Lokaci-lokaci annobar cutar da breathlessness (zai fi dacewa a dare).
• wasu yara akwai sallama daga idon yayi kamar gilashi, foamy, da launin toka da kuma danko sosai gamsai.

A shiryawa zamani da cuta ne kwanaki 28. A rashin isassun kuma dace magani, adadin mutuwar yara fama da pneumocystis, kai 60%. Bugu da kari, jarirai da suke da Pneumocystis ciwon huhu auku ba tare da bayyane ãyõyinMu, akwai babban alama cewa bayyana obstructive ciwo a nan gaba. Wannan shi ne yafi saboda kumburi da mucous. Idan yaro ne ba gaggawa m likita taimako za a bayar, obstructive ciwo za a iya canza kama zuwa laryngitis, kuma mazan yara - a cikin asthmatic ciwo.

Alamun cewa bayyana a manya

Ciwon huhu a cikin tsofaffi da matasa daukan wuri a cikin wani hadadden hanya fiye da a jarirai da kuma kananan yara. Cutar harin yafi mutane haife tare da immunodeficiency, ko wadanda suke tare da waɗanda ya ci gaba a kan rayuwa. Duk da haka, wannan ba mai mulki da cewa brooked ba wata 'yar alamar karkacewa. A wasu lokuta, Pneumocystis ciwon huhu auku a marasa lafiya tare da gaba daya lafiya rigakafi da tsarin.

A shiryawa zamani da cutar dabam daga 2 zuwa 5 days. A haƙuri yana da wadannan cututtuka:

• zazzabi,
• migraine,
• rauni a dukan jiki,
• wuce kima sweating,
• zafi ji a cikin kirji,
• mai tsanani numfashi wuya tare da bushe ko rigar tari da kuma tachypnea.

Bayan sama na asali bayyanar cututtuka, irin cututtuka wani lokacin lura a matsayin acrocyanosis, karyata na gibba tsakanin hakarkarinsa, cyanosis (bluish) nasolabial alwatika.

Ko bayan cikakken hanya na lura a wasu marasa lafiya akwai wani yawan takamaiman for Pneumocystis ciwon huhu rikitarwa. Wasu marasa lafiya fuskanci wani komawa. Likitoci suka ce cewa idan akwai wani da komowa a cikin watanni 6 daga farko idan na cuta, shi da shawara cewa kamuwa da cuta a cikin jiki ne sabunta. Kuma idan shi ya auku fiye da watanni 6, sa'an nan muna magana ne game da wani sabon kamuwa da cuta, ko reinfection.

Ba tare da ta dace lura da mace-mace a adult marasa lafiya da pneumocystis jeri daga 90, kuma har zuwa 100%.

Alamun cutar HIV-kamu

Pneumocystis ciwon huhu, a HIV-kamu, kamar yadda tsayayya wa mutane waɗanda basu da cutar tasowa sannu a hankali sosai. Daga lokacin a lokacin da shi zai fara prodromal mamaki, da kuma kafin kai hare hare jinsin na huhu cututtuka, zai ɗauki daga 4 zuwa 8-12 makonni. Saboda haka, likitoci a yar alamar tuhuma da gaban kamuwa da cuta a cikin jiki, ban da wasu gwaje-gwaje, shi ne shawarar a irin wannan marasa lafiya yi kirji X-haskoki.

Babban bayyanar cututtuka na pneumocystosis a fama da cutar kanjamau sun hada da:

• High zafin jiki (38 zuwa 40 ° C), wanda ba ya fada a cikin 2-3 watanni.
• kwatsam nauyi asara.
• bushe tari.
• shortness na numfashi;
• kara numfashi insufficiency.

A mafi yawan malamai shi ne na da ra'ayin cewa wasu siffofin da ciwon huhu, a Cutar HIV marasa lafiya da wannan bayyanar cututtuka kamar pneumocystosis. Saboda haka, a farkon matakai da cutar domin sanin abin da irin ciwon huhu, a wani haƙuri faruwa kusan ba zai yiwu. Abin baƙin ciki, a lokacin da Pneumocystis ciwon huhu, a Cutar HIV marasa lafiya saukar, an riga an rasa da yawa lokaci, kuma m jiki ne da wuya sosai domin yaki da kamuwa da cuta.

Yadda ake bincikar lafiya tare da pneumocystis?

Lalle ne, sanin kowa ne da look na mutum huhu. Hotuna da wannan jiki an gano kowane ko a cikin wani littafi kan ilimin halittàr jiki da ko a kan tsaye a asibitin ko a wani kafofin. The bayanai zuwa ranar, babu kasawa. Bugu da kari, likitoci tunatar da dukan marasa lafiya da suka kamata sa an shekara-shekara kirji X-haskoki. Sabanin ra'ayi na da yawa, wannan ba wani fad, "picky" likitoci, da kuma wani gaggawa bukatar. Wannan ya sa ya yiwu su gane lokaci-dimming haske zuwa X-haskoki, da kuma kuka da kansa ba lokacin da za a fara jiyya. A jima za mu san game da cutar, da girma samu damar zama don dawo da.

Duk da haka, da wuya kowa na mu san yadda za a bayyana a ranar radiographs PCP. Photos of irin wannan a makaranta litattafan bã su sãmun wani likita reference books da kuma kundayen ga mafi talakawa mutane ba sa da wani amfani. Bugu da ƙari, mu ko da ba su da wakilci a matsayin cutar da ake bincikar lafiya, ko da yake know ba zai cutar.

Na farko, wani na farko ganewar asali da aka yi. Likita ya tambaye ta haƙuri game da lambobi tare da mutane na zuwa hadarin kungiyoyin (HIV-kamu da cutar kanjamau da marasa lafiya).

Bayan da cewa karshe ganewar asali. Wadannan dakin gwaje-gwaje da kuma instrumental nazarin:

1. A likita ta zayyana da shugabanci na haƙuri a kan kowa jini analysis canji. Musamman da hankali ne kõma zuwa ga darajar matakan eosinophils, lymphocytes, leukocytes da monocytes. A marasa lafiya da pneumocystis iya zama m anemia da kuma dan kadan saukar haemoglobin.
2. Nada instrumental jarrabawa. Shi ne game da rengenografii tare da niyya mataki na cutar. Shin wani X-ray, wanda shi ne a fili a bayyane mutum huhu. The m ne a haɗe zuwa haƙuri katin. A mataki na farko shi da yawa sauki riba juna. Idan pneumocystis koma cikin mataki na biyu, shi ne a fili a bayyane a kan X-ray haske dimming. Kamuwa iya zama ko dai kawai hagu ko kuma kawai hakkin huhu, amma za a iya buga da daya da kuma wani.
3. Domin gane gaban pneumocystosis, likita yawanci yanke shawarar da ya rike wani parasitological binciken. Mene ne wannan? A farko haƙuri aka dauka don nazarin wani samfurin na gamsai. Domin wannan makõma zuwa hanyoyin kamar bronchoscopy, bronchoscopy da biopsy. Bugu da kari, cikin samfurin za a iya samu ta amfani da mai da ake kira Hanyar shigar da na tari.
4. Domin gane antibodies for Pneumocystis gudanar serological nazarin kunshi a gaskiyar cewa bambanci a makonni 2 da haƙuri da aka dauka zuwa da bincike na magani 2. Idan kowanne daga cikinsu fuskantar mafi girma fiye da na al'ada darajar titer na akalla wata factor na 2, wannan yana nufin cewa mutumin da ba shi da lafiya. Wannan binciken da aka gudanar domin kawar da saba kafofin watsa labarai, kamar yadda antibodies samu a game da 70% na mutanen da.
5. Don gane m antigens a sputum, da kuma biopsy misali da broncho-alveolar lavage yi PCR bincikowa.

mataki pneumocystosis

Akwai uku m matakai na PCP:

• oedematous (1-7 makonni).
• atelektaticheskuyu (talakawan 4 makonni).
• emphysematous (na daban-daban durations).

Edematous mataki pneumocystosis halin farko bayyanar da rauni a ko'ina cikin jiki, lethargy, tari, kuma sa'an nan a rare, hankali intensifying, kuma kawai a karshen zamani - mai karfi bushe tari, kuma shortness na numfashi a lokacin motsa jiki. Jarirai bad shãyar da mãma, ba sa on nauyi da kuma wani lokacin ki madarar uwarsa. Babu wani gagarumin canje-canje a cikin X-ray haske ba a gano.

A lokacin atelektaticheskoy mataki febrile zazzabi da aka kiyaye. Tari ne ƙwarai inganta da kuma bayyana foamy sputum. Shortness na numfashi bayyana ko a lokacin qananan motsa jiki. A wani X-ray a bayyane atelektaticheskie canje-canje.

A marasa lafiya suka tsira na farko 2 lokaci, tasowa emphysematous pneumocystosis mataki, a lokacin da ya rage aikin yi na numfashi da kuma nuna alamun emphysema.

digiri ciwon huhu

A magani, saboda ya bambanta da wadannan digiri na tsanani da cuta:

• haske, wanda aka halin da rauni yawan guba (zafin jiki ba wucewa 38 ° C, da kuma nezatumanennoe sani) a sauran ba alama dyspnoea, kallon masassarar haske gano a kan wani karamin x-ray.
• matsakaita, halin matsakaici maye (zazzabi ya wuce 38 ° C, kai 100 zuciya beats da minti daya, da mãsu haƙuri tanã kai ƙãra na ƙãra sweating , da dai sauransu ...), a sauran dyspnea aka lura a x-ray film fili bayyane infiltration daga cikin huhu.
• nauyi gudãna da tsanani, abin mãye (hatimi zazzabi ya wuce 39 ° C, palpitations ya wuce 100 lashe minti daya, akwai wani delirium), m numfashi insufficiency, kuma shi ne bayyane a kan x-ray m infiltration na huhu, kusantar wajen samar da daban-daban da rikitarwa.

Abin da magani an wajabta, ga marasa lafiya PCP?

Babu shakka cewa sanin yadda za a gane huhu kumburi, shi ne wata babbar domin kowane mutum. Duk da haka, wannan bai isa ba. Mu ne ba likitoci da kuma cikakken ganewar asali ba zai iya sa. Babu daya da irin ciwon huhu da kuma sanin unilateral ko dangantakar ciwon huhu, pneumocystis, da kuma wasu siffofin na rashin lafiya layman ba zai iya iya. Saboda haka, a kai-magani ba zai iya tafiya da magana. Babban abu - ba da jinkiri ba, kuma ka yarda da likitoci. Bayan gudanar da duk dole bincike likita zai iya daidai zana a ƙarshe a kan ko cikin hanyar da rashin lafiya da haƙuri ne Pneumocystis ciwon huhu. Aka ba da jiyya kawai bayan tabbatar da ganewar asali ya ta'allaka ne a cikin hali na kungiya matakan tsaro da kuma miyagun ƙwayoyi far.

Kungiya-zangar ayyuka sun hada da ba makawa asibiti. A wani asibiti da haƙuri sami magani da kuma rage cin abinci da shawarar da wani likita.

Drug far kunshi etiotrop, pathogenetic da symptomatic magani. Marasa lafiya yawanci prescribers "Pentamidine" "furazolidone" "Trichopolum" "Biseptolum", da kuma daban-daban anti-mai kumburi da kwayoyi, miyagun kwayoyi da inganta da kuma tallafa a expectoration na sputum expectoration, mucolytics.

"Biseptol" da aka gudanar da baki ko intravenously. A miyagun ƙwayoyi ne da jure da yake fin so zuwa "Pentamidine" da saduwa da marasa lafiya ba fama da cutar kanjamau. "Pentamidine" gudanar intramuscularly ko intravenously.

Cutar HIV marasa lafiya, a tsakanin sauran abubuwa, samun maganin rigakafi domin su Pneumocystis ciwon huhu faruwa a sakamakon wani raunana na rigakafi da tsarin. Pneumocystosis ga zalunta cutar a 'yan shekarun nan sun} ara yin amfani da alpha difluoromethylornithine (DFMO).

rigakafin

Rigakafin pneumocystosis hada da wani yawan ayyukan, tsakanin wanda da wadannan kamata a lura:

1. Don kawar da kamuwa da cuta a cikin yara wuraren kiwon lafiya a asibitoci, wanda ake bi oncological kuma hematological marasa lafiya, duk da sandarsa, ba tare da togiya, ya kamata a lokaci-lokaci yayi nazari ga gaban kamuwa da cuta.
2. Drug prophylaxis na mutane a hadarin. Wannan rigakafin ne na iri biyu: na farko (kafin su fara ci gaba da cutar) da sakandare (m bayan cikakken maida su hana komawa).
3. Farkon ganewa na pneumocystis ciwon huhu da kuma nan da nan kadaici na haƙuri.
4. Regular disinfection a yankunan inda annobar cutar da aka rubuta pneumocystosis. Don yin wannan, yi rigar tsabtatawa, ta amfani da wata 5% bayani daga chlorine Bleach.