Amoebic kamwazi: tizilomboto, zizindikiro, chithandizo

matenda matumbo ndi gulu lalikulu la matenda amene Chili kugonjetsedwa kwa thirakiti m'mimba ndi khalidwe zizindikiro matenda monga nseru, kusanza, kutsekula m'mimba (ndi mamina komanso magazi) kapena kudzimbidwa. wothandizila Causative matenda pachimake matumbo akhoza kuchita tizilombo toyambitsa matenda,, mogwirizana ndi helminths. Izi zimapangitsa kuti zovuta oterewa ndi kumafuna zambiri chithandizo syndromic.

tanthauzo

Amoebiasis (amoebic kamwazi) - izo anthroponotic matenda ndi fecal-m'kamwa limagwirira wa HIV. Ake mawonetseredwe ofunika kwambiri ndi aakulu relapsing matenda a m'matumbo ndi mawonetseredwe extraintestinal monga abscesses chiwindi, zilonda ndi ena. Nthawi zambiri, mawuwa ankatanthauza amoebiasis amoebic kamwazi, amene amayamba ndi tiziromboti Entamoeba histolytica.

Mwa zina amebiasis olekanitsidwa amoebic keratitis ndi encephalitis. Malinga ndi World Health Organization, pafupi zaka khumi peresenti ya anthu padziko lonse ali ndi matenda matenda awa, ndipo ndi imodzi mwa ntchito zomwe zikubweretsa imfa matenda parasitic. mawonetseredwe owonjezera matumbo amakhala ovuta kwambiri oterewa, kotero kuti matenda ndi kuchitira amoebiasis Sizotheka.

EPIDEMIOLOGY

M'mayiko onse ndi otentha ndi chinyezi nyengo wamba amoebic kamwazi. Zizindikiro za matenda zambiri mungazipeze anthu amene amanyalanyaza thanzi ndi ukhondo malamulo. Kuderako kuti tizilomboto ali Central ndi South America, makamaka Mexico, ndi India.

Nthawi zina kubuka chachikulu matenda matumbo mayina a mayiko olemera ndithu, monga mu 1933, pa Expo World, umene unachitikira ku Chicago. Panopa milandu misa ndi ayi zimachitika malo ochokera m'madera kuderako. Nthawi zambiri, matenda kumaonekera nyengo ofunda.

Gwero la matenda ndi kudwala munthu kapena chonyamulira mogwirizana. Infection kumachitika kokha kudzera mwa zonyansa, chakudya ndi madzi. Komanso, matenda imafalikiranso kudzera mosadziteteza amuna anzanga kukhudzana. Amadziwika kuti enaake mawonekedwe amoebas akhoza kufalitsa kwa miyendo ndi mapiko a tizilombo.

exciter

N'chifukwa chiyani amoebic kamwazi? Tizilomboto limatanthauza losavuta, amene akhoza kukhalapo mu njira zitatu zosiyana:

- minofu (imapezeka odwala anthu);

- luminal;

- enaake.

Otsiriza awiri zimapezeka zonyamulira za matendawa. Ndi kukula kwa khungu la micrometers 40, lomwe lili pakati ndi zambiri vacuoles. Kusunthira mu thupi la munthu amagwiritsa phazi onyenga. Kuti tipereke mabakiteriya abwino, bowa, particles chakudya. Amoebic kamwazi ndi mawonekedwe imeneyi.

Chotupa ndi kuzungulira kapena chowulungika selo kukula 30 micrometers. Kungakhale mtima angapo (ziwiri kapena zinayi), izo zimatengera pa siteji ya chitukuko.

Kayendedwe ka moyo wa amoeba

Chotupa akulowa intestine yaing'ono kudzera mwa anthu zonyansa, madzi, kapena masamba. Pali chotupa chipolopolo zikadzawonongedwa, ndi lumen thupi kupitirira okhwima kholo amoeba. Izi mawonekedwe a pachiyambi kugawana. Chifukwa cha ndondomeko iyi inatulutsa eyiti latsopano tizilombo toyambitsa matenda umodzi-pachimake. Amoebic kamwazi akuyamba pa mphindi ino. Pa confluence a zinthu zabwino thupi ndi zokwanira umodzi njira pakati vegetative wa amoeba akupitiriza kuti achulukane ndi kusuntha zambiri intestine lapansi.

Mu ndondomeko ya moyo wosalira awo secrete zinthu kuti anthu ululu ndi chifukwa zizindikiro mmene matenda matumbo. Ndi ndowe vegetative ndi mitundu enaake kugwera mu malo akunja. Kumene iwo angakhoze amapitirizabe kwa nthawi yaitali. Komanso, ndi kugonjetsedwa disinfectants.

pathogenesis

Akanakhoza bwanji kukulitsa matenda monga kamwazi, amoebic? Infection ayamba kudya chakudya osasamba. Chifukwa amoeba kulowa akhungu ndi kukwera m'matumbo, kumene kungakhale nthawi yaitali kuonekera. Koma zinthu chowawa anthu (madzi m'thupi zakudya m'thupi, dysbiosis) cysts anakhetsa chigoba chake, ndipo pali luminal mawonekedwe amoebas.

Mothandizidwa ndi mwini michere awo cytolytic ndi proteolytic wa tizilomboto pa likulowerera makulidwe a minofu, kuchititsa kutupa ndi mapangidwe zilonda ndi madera aang'onoang'ono necrosis. Mu zina, amoeba kulowa ziwiya magazi ndi nthenda ya kugwa madzi mu ziwalo zina, kupanga kumeneko abscesses.

Mu mawonekedwe matumbo matenda a kutupa chimafikira m'njira kunsi kwa cecum kwa mzere. Mucous edematous thupi, ndi kuonekera hyperemia tinatake tozungulira ang'ono ndi zilonda amene ali necrotic zinyalala ndi njira vegetative amoebae. M'kupita kwa nthawi, tinatake tozungulira anawonongedwa, kusiya malo ake zilonda watsopano mpaka masentimita awiri ndi theka awiri. zopindika kwambiri pansi yokutidwa ndi mafinya. Ngati wina amasanthula biopsy a linga chilonda, inu mudzapeza amoebas.

matenda aakulu limodzi ndi mapangidwe cysts, ndi tizilombo ting'onoting'ono, ndipo amoebae. Izi mapangidwe chotupa zomwe zigwirizana granulation minofu fibroblasts ndi eosinophils.

mawonekedwe extraintestinal

Amoebic kamwazi ali ndi zizindikiro onse dyspeptic, ndi somatic. Pamene njira vegetative amoebae kudutsa mu unyinji wa pakhoma matumbo, iwo asalowe kufalitsa zokhudza zonse. Zimenezi zimabweretsa kufala kwa tizilomboto mwa thupi. Mogwirizana ndi dongosolo la zipata mtsempha amoeba kulowa parenchyma chiwindi.

Limba angathe zotupa madigiri osiyanasiyana a mwamphamvu, ku mapuloteni.Tiligu kapena kusonyeza steatosis chiwindi ndi chiwindi abscess, yomwe ili pansi pa mzikiti wa chifundamtima. Nthawi zina ndi amatchedwanso cysts chokoleti chifukwa cha mtundu enieni mafinya. Ngati kutupa si ankachitira, apo pakubwera apitirize kutsegula abscess ndi mu zonse m'mimba ndi chitukuko cha peritonitis. Kapena chotupa mwina anagumula zakulera mu mapapo, mediastinum kapena pericardium, kuchititsa mavuto lolingana. Kuwonjezera chiwindi, wothandizila ndi wokhoza kuononga ubongo, khungu ndi ziwalo zina.

chipatala

Nthawi makulitsidwe kumatenga za sabata, kenako kuwawonetsera amoebic kamwazi. Zizindikiro kuyamba ndi kufooka ambiri, kupweteka kwa dera iliac ndi kuwuka mu kutentha thupi. peresenti khumi la milandu matenda amachita zinthu fulminant. Iwo amakhala ndi m'mimba profuse ndi magazi ndi ntchofu, zomwe zimabweretsa madzi m'thupi kwambiri ndi imfa. Kwinakwake mu chachitatu cha odwala malungo molumikizana ndi kukulitsa chiwindi. Kutupa pa chiyambi cha matenda ndi ofooka, kotero mu kusanthula ambiri a magazi si akuona kusintha khalidwe.

Mu mawonekedwe ena extraintestinal limodzi kamwazi. Zizindikiro kuti angatchedwe pathognomonic, Pankhaniyi palibe. Amebiasis zayamba osati kuonekera mu thupi mpaka anapeza mpaka misa kuweruza wothandizira.

Ngati mulibe kanthu pa nkhani ya mankhwala a matenda, ndiye patapita kanthawi matenda zimatengera chikhalidwe aakulu. Pang'onopang'ono, magazi m'thupi ndi cachexia. M'munsi kulimbikira kwa thupi, mofulumira mawonekedwe matumbo akudutsa mu extraintestinal lapansi. Chiopsezo gulu zikuphatikizapo ana aang'ono, okalamba, akazi apakati ndi odwala kutenga immunosuppressants.

diagnostics

Zimene i anakhazikitsa matenda a "kamwazi"? Matendawa ndi mankhwala a matenda izi chimakhudzana ndi kayendedwe ka moyo wa mogwirizana. Pofuna kulongosola bwino etiology otsegula m'mimba, adokotala amatenga chopondapo chitsanzo, mmene muli minofu mitundu ya amoebas. Ngati ndowe ndi cysts kapena mtundu translucent, amasonyeza chikuku ndi sangathe kutumikira monga chitsimikiziro cha matenda.

Popeza thupi monga zomera salembedwa tizilombo kale mitundu yambiri ya amoebas, matenda kungakhale kovuta kwambiri. Molakwika matenda angathe kuonedwa ndi Entamoeba dispar. Ndi sanali tizilombo amoeba, zomwe kwathunthu vuto lililonse kwa anthu, koma ndi morphologically zofanana kwambiri ndi kamwazi.

Kutsimikizira matenda ndi ntchito polymerase unyolo anachita ndi mayesero serological. Kudziwa njira extraintestinal wa amoebiasis, m'pofunika kuchita X-ray bwinobwino ultrasound ndi yopangidwa tomography. Kusiyanitsa amoebic matenda ndi shigellosis, salmonellosis ndi nonspecific anam'peza matenda a m'matumbo.

chithandizo

Chithandizo cha kamwazi amoebic akuyamba ndi mankhwala cytotoxic monga mankhwala a metronidazole kapena tinidazole. Ngati wodwalayo popanda zizindikiro, ndi kuthetsa tizilombo angagwiritsidwe ntchito yodohinod kapena paromomycin.

Mankhwala oyamba kwambiri amoebiasis anali emetine, amene anali ncho ku America South wa ipecac. Tsopano ntchito kawirikawiri, chifukwa kwambiri poizoni osati ogwira zokwanira. Ichi chimatanthauza apilo okha mwambo otaya yaitali, mitundu kugonjetsedwa ndi ziwengo kuti metronidazole.

Zochizira mitundu owonjezera matumbo ndi mankhwala a metronidazole pamodzi ndi yatrenom, doydohinom, meksaformom ndi mankhwala ena. Nthawi zina amachita opaleshoni.

zosokonezeka

Amoebic kamwazi anthu amatha kukhala zovuta ndi perforation wa matumbo khoma. Izi zidzachitika mapangidwe chilema kwambiri. Pamene perforation zili matumbo mu zonse m'mimba ndi kuwononga iwo. Khalani ndi mavuto otsatirawa - peritonitis. Kuti apulumutse moyo wa wodwala, m'pofunika amachita chithandizo opaleshoni: Pangani midline laparotomy ndi ziwalo m'mimba kuchita kafukufuku.

Vuto lina lalikulu - matumbo magazi. Komanso akufotokozera mu ndondomeko ya mapangidwe zilonda. Mpumulo wake zotheka adzatenga njira onse ndiwofatsa komanso kugwira ntchito. Kuchiritsa zilonda ndi chifukwa mapangidwe minofu yovulazidwa lumen yopapatiza, kuswa Choncho Ndime ya chakudya.

kupewa

Amoebic kamwazi - matumbo matenda, kotero kukuletsa, ayenera yake decontaminated magwero a tizilomboto: amatunga pamthunzi, Madamu ndi zina dongosolo kugawa madzi.

Komanso, kufunika amayesetsa kudziwa onyamula ndi sporovydeliteley, komanso kuchiza odwala ndi mitundu pachimake kumvera ndi miyeso odana ndi mliri. anthu Convalescent ndi magalimoto mu nkhani ayi ayenera kuloledwa kugwira ntchito Catering.

Njira ina yochepetsera chiwerengero cha anthu kachilombo ndi kulimbikitsa ukhondo ndi kusamala chakudya pamaso mowa. Pambuyo matenda yapita munthu ayenera nthawi zonse pa chaka anamuona pa kafukufuku wa matenda opatsirana. Izo zinali kokha pambuyo nkhani pasanathe miyezi itatu adzakhala oipa kwa amoebiasis, mtima wa tidzakambirana monga potsiriza wathanzi.