Pneumocystis chibayo: zimayambitsa, zizindikiro, chithandizo. Pneumocystis chibayo ku kachirombo ka HIV

Health - chinthu chamtengo wapatali munthu akhoza kukhala. Aliyense ikufuna moyo wautali ndipo sazunzika matenda makamaka. Matendawa zimasintha anthu kupitirira kuzindikira - iwo maganizo, maonekedwe awo ali osauka, pali mphwayi kuti chilichonse chimene chikuchitika padziko, ndi zina kamodzi mtundu ndi zothandiza kwa anthu ena mavuto anthu kuwasandutsa chosakhulupirira zimene iye anafotokoza ndi choonadi.

Matendawa Sazengereza kuwachitira aliyense. Ngakhale ana nawonso kuchokera angathe kutenga matenda alionse. Komanso, mavuto anakumana osati odwala okha, komanso okondedwa awo. Zimakhala zovuta kwambiri makamaka kupirira maganizo awo ndi maganizo a makolo omwe ali ndi ana kuti kapena kudwala anali wapezeka. Kids chifukwa cha msinkhu wawo uja sindingakhoze kufotokoza zimene nkhawa, kodi ziwalo zowawa, ndi mmene kumaonekera.

matenda sioneka ndi PCP. Mungathe kukhala ndi kachilombo kulikonse ndipo, zodabwitsa, ngakhale mu zipatala. Zinthu zovuta chifukwa chakuti azindikire matenda pa siteji oyambirira a chitukuko zovuta. Nthawi zambiri, anthu adziŵe kuti akufunika thandizo kuchipatala pamene nthawi wapatali kale anataya. N'chifukwa chake mlingo imfa pneumocystosis kwambiri. Madokotala si nthawi zonse kutsindikiza kupulumutsa moyo wa munthu.

Anapezeka "pneumocystis"

Anthu amene alibe chochita ndi mankhwala, ambiri a iwo pang'ono odziwa terminology zachipatala. Choncho, matenda a kumva "pneumocystis" kapena "PCP", iwo akulephera, ndi kugwa mu stupor a. Ndipotu, musati mantha. Choyamba, muyenera kukhadzikika, kukokera nokha pamodzi ndi kufunsa dokotala anu mwatsatanetsatane, mu mawu osavuta kufotokoza chomwe icho chiri.

Pneumocystis zambiri amatchedwa PCP, omwe ndi matenda protozoan zokhudza mapapo. Activators kudwala ankaona tizilombo, lotchedwa Pneumocystis carinii. Mpaka posachedwapa, asayansi ankaganiza kuti iwo ali mtundu wa losavuta. Koma ndi posachedwapa pa maziko a maphunziro ambiri amene anali anapeza kuti tizilombo izi ndi ziwalo zina yeniyeni bowa. Pneumocystis carinii ndi tiziromboti kuti infects anthu okha. Osachepera nyama mpaka lero ayi wapezeka ngakhale kamodzi.

Kodi chimachitika mu PCP wodwalayo?

Kusintha kwa thupi chifukwa pneumocystosis zimadalira zinthu ziwiri: zimene katundu enieni tizilombo toyambitsa matenda a chibayo, ndipo boma la dongosolo anthu m'thupi. Pneumocystis, kamodzi mu thupi, yambani pasadakhale awo kudzera mundawo kupuma, kuti Kuzemba iwo ndi kulowa alveoli lapansi. Apa akuyamba mwachindunji mkombero moyo wawo. Ndi kuchuluka kwawo, iwo amakhudzana ndi surfactant ndi kumasula metabolites poizoni. Akulimbana ndi Pneumocystis carinii T-lymphocytes, komanso otchedwa macrophages alveolar. Komabe, wofooka chitetezo cha m'thupi, zikhoza sateteza khamu ake ku matenda, koma ndithu mwake - zimakhala zosemphana: Zimathandiza ndi kuonjezera chiwerengero cha Pneumocystis.

Kwathunthu wathanzi munthu kuchuluka kwa Pneumocystis carinii si pangozi. Koma zinthu ukasintha ngati chitetezo cha m'thupi ndi osauka. Pankhaniyi, nthendayo adamulowetsa ndi liwiro mphezi, ndi yochepa nthawi chiwerengero cha Pneumocystis, atagwidwa mu kuwala ukufika biliyoni. Pang'onopang'ono malo alveolar ladzala kwathunthu, kuti pakhale ndi foamy exudate, kusokonezeka nembanemba kukhulupirika leukocytes alveoli ndipo pamapeto pake kuwononga ndi moyenera, wotsatira chiwonongeko alveolocytes. Chifukwa chakuti Pneumocystis woyenera snugly kuti alveolocytes, yafupika pamwamba kupuma a m'mapapo. Chifukwa, m'mapapo minofu kuwonongeka imayamba ndi anatseka misewu alveolar-capillary.

Kumanga khungu lanu Kakhungu, Pneumocystis carinii zofunika surfactant phospholipids munthu. Choncho, pali siudzalandilidwa ngathi lamulo la kagayidwe surfactant ndipo kwambiri kukula m'mapapo minofu hypoxia.

Amene ali pa chiopsezo cha matenda ena?

mitundu ya chibayo kudziwika kwa tsiku amadziŵika ndi mzake, kuphatikizapo kuti chiopsezo kukhala poyera kuti magulu osiyana a anthu. Pneumocystis tinganene yotero. Ndi ambiri amangoti akufotokozera mu:

• makanda msanga;
• makanda ndi ana omwe kukumana ndi matenda pachimake bronchopulmonary kwambiri, kuumirizidwa kwa nthawi yaitali kukhala mu chipatala ndi kubatizidwa kuipidwa ndi yaitali mankhwala;
• anthu akuvutika oncological ndi gemozabolevaniyami ndi mankhwala cytostatics ndi corticosteroids, komanso akulimbana ndi pathologies zosiyanasiyana aimpso ndipo zimakhala connective, akuwuka chifukwa cha kupatsidwa zina za makamaka limba mkati;
• odwala TB amene analandira nthawi yaitali amphamvu antibacterials;
• Ali ndi HIV odwala.

Monga ulamuliro, matenda imafalikira ndi m'malovu airborne ndipo gwero lake la anthu athanzi, koposa zonse - ogwira ntchito mu zipatala. Pa mfundo imeneyi, anthu ambiri asayansi amati PCP - yekha n'kupuma matenda. Ngakhale izi, m'pofunika kuti anthu amvetse kuti ena mwa madokotala kuthandiza view kuti chitukuko cha pneumocystosis mu nthawi neonatal chifukwa cha matenda a mwana wosabadwayo m'mimba.

Zizindikiro Kodi mbendera za chitukuko cha chibayo pneumocystis ana?

Moms ndi abambo ali nthawizonse tcheru kwambiri thanzi la ana awo. N'zosadabwitsa kuti iwo akufuna kuti adziwe mmene tingadziwire chibayo nthawi. Kumene, matenda komaliza zitha kukhala dokotala, koma kuzindikira zizindikiro woyamba wa matenda iyenela kholo lililonse sadziwa. Tsiku lililonse anataya kungachititse chakuti mwanayo akhale ndi chibayo amgwirizano, pneumocystis, ndi mavuto ena.

Pneumocystis chibayo ana bwinobwino, kuyambira pa miyezi ziwiri zakubadwa. Nthawi zambiri matendawa amakhudza ana amene akhala kuzindikiridwa kale matenda cytomegalovirus. Matendawa amapezeka mu chakale mawonekedwe interstitsianalnoy chibayo awo. Mwatsoka, madokotala azindikire kuti pa siteji koyamba kuli kovuta kudziwa matenda amenewa, monga Pneumocystis chibayo. Zizindikiro kuonekera ina. Zizindikiro zazikulu kunenanso chitukuko mofulumira matenda monga:

• amphamvu kwambiri akuphokosera chifuwa kuti;
• kubuka nthawi ya breathlessness (makamaka usiku);
• ana ena pali kumaliseche a kunyezimira, foamy, imvi ndi viscous ntchofu.

The makulitsidwe nyengo ya matenda ndi masiku 28. Popeza mankhwala okwanira nthawi yake, imfa mlingo wa ana akuvutika pneumocystis, ukufika 60%. Komanso, ana amene ali Pneumocystis chibayo sikuchita zizindikiro zosonyeza, pali imabwera kwambiri zimene zimasonyeza obstructive syndrome posachedwapa. Izi zili choncho makamaka chifukwa kutupa kwa mucous. Ngati mwana wanu osati mwachangu woyenerera thandizo kuchipatala adzakhala anapereka, syndrome obstructive akhoza lidzasinthidwa laryngitis, ndi ana okulirapo - mu syndrome mphumu.

Zizindikiro amene amapezeka akulu

Chibayo mwa anthu achikulire ndi achichepere kumachitika m'njira zovuta kuposa mu makanda ndi ana aang'ono. kuukira matenda makamaka anthu amabadwa ndi immunodeficiency, kapena anthu amene iye zachitika pa moyo. Komabe, si lamulo kuti brooked osati kupatuka pang'ono. Nthawi zina, Pneumocystis chibayo amapezeka odwala ndi dongosolo thanzi langwiro m'thupi.

The makulitsidwe nyengo ya matenda zimasiyanasiyana masiku 2 mpaka 5. Wodwala ali ndi zizindikiro zotsatirazi:

• malungo,
• migraine,
• kufooka m'thupi lonse,
• kwambiri thukuta,
• ululu adazindikira chifuwa,
• aakulu kupuma mavuto limodzi ndi chifuwa youma kapena yonyowa ndi tachypnea.

Kuwonjezera zizindikiro pamwamba zofunika, zizindikiro amenewa nthawi zina ananena kuti acrocyanosis, Anabweza wa mipata pakati pa nthiti, cyanosis (bluish) nasolabial makona.

Ngakhale patapita kwathunthu mankhwala odwala ena pali chiwerengero enieni Pneumocystis chibayo zosokonezeka. Odwala ena amakhalanso ndi zisadzachitikenso. Madokotala amanena kuti ngati pali kusuta mkati miyezi 6 kuchokera yoyamba ya matenda, izo zikusonyeza kuti matenda m'thupi mwathu akonzedwa kwatsopano. Ndipo ngati kumachitika miyezi yoposa 6, ndiye tikulankhula za matenda atsopano kapena reinfection.

Popanda mankhwalawa pa pamatenda odwala wamkulu ndi ranges pneumocystis kuchokera 90 mpaka 100%.

Zizindikiro za matenda ali ndi HIV

Pneumocystis chibayo ku kachirombo ka HIV, monga kuyenera anthu amene alibe HIV akufotokozera pang'onopang'ono. Kuyambira nthawi pamene akuyamba zochitika prodromal, ndi asanaukile zizindikiro zake zapadera m'mapapo mwanga, zingatenge kwa masabata 4 8-12. Choncho, madokotala a kukayikirana pang'ono pamaso pa matenda mu thupi, kuwonjezera pa mayesero ena, izo tikulimbikitsidwa odwala zoterozo pachifuwa X-ray.

Zizindikiro zazikulu za pneumocystosis odwala AIDS monga:

• Mkulu kutentha (38 ndi 40 ° C), zomwe si kugwa mu miyezi 2-3;
• mwadzidzidzi kuwonda;
• youma chifuwa;
• kufupika kwa mpweya;
• kuwonjezeka insufficiency kupuma.

Ambiri a akatswiri a maganizo kuti njira zina chibayo odwala ali ndi HIV ndi zizindikiro zofanana monga pneumocystosis. Choncho, magawo oyambirira a matenda kudziwa zimene mtundu wa chibayo wodwalayo chikuchitika zosatheka. Mwatsoka, pamene Pneumocystis chibayo odwala ali ndi HIV anawulula, udatha anataya nthawi yochuluka kwambiri, ndi kutha thupi zovuta kulimbana ndi matenda.

Kodi matenda ndi pneumocystis?

Ndithudi aliyense akudziwa Kuyang'ana kwa mapapo munthu. Photos thupi ili anachira lililonse kapena buku pa thunthu kapena pa nthandala kuchipatala kapena zina zilizonse. The mudziwe kuti tsiku, palibe kuchepa. Komanso, madokotala kukumbutsa odwala onse kuti apange pachaka pachifuwa X-ray. Mosiyana ndi maganizo a ambiri, izi si potengera anzawo, "chabe" madokotala, ndiponso chifukwa kunali kofunika. Izi zimathandiza kudziwa nthawi kumathima kuwala kwa X-ray, ndipo sanachedwe kuyamba chithandizo. Mwamsanga tidzadziwa za matenda, m'pamenenso mpata adzakhala kuchira.

Komabe, nkomwe aliyense wa ife akudziwa kusonyeza pa radiographs PCP. Photos wa mtundu uwu mu mabuku sukulu samapeza mabuku mankhwala Buku ndi mainsaikulopediya anthu ambiri wamba musati chifukwa chidwi. Komanso, ife ngakhale mulibe chifaniziro ngati nthendayo matenda, ngakhale tidziwe kuti asawononge.

Choyamba, matenda kuyambirira wapangidwa. adokotala anafunsa wodwala za anzanu wake ndi anthu a anthu okhudzidwa (amene ali ndi HIV ndi odwala AIDS).

Pambuyo kuti matenda komaliza. Zotsatirazi zasayansi zoimbidwa maphunziro:

1. dokotala n'kukulemberani malangizo a mtima pa wamba magazi kusintha kusanthula. chidwi limachokera kwa amaudindo apamwamba eosinophils, lymphocytes, leukocytes ndi monocytes. Odwala ndi pneumocystis akhale wachete magazi m'thupi ndi pang'ono adatchithisira hemoglobin.
2. Anamuika Kupenda malangizo. Ndi za rengenografii zimene siteji anatsimikiza za matendawa. Ndi X-ray, umene uli bwino mapapo kuonekera munthu. chithunzi amamangiriridwa khadi mtima. Mu gawo loyamba n'zosavuta kwambiri phindu chitsanzo. Ngati pneumocystis n'kukakhala ku gawo lachiwiri, ndi bwino kuonekera pa X-ray kuwala kumathima. Matenda akhoza kukhala mwina yekha kumanzere kapena okha m'mapapo lamanja, koma akhoza kugunda ndi wina ndi mzake.
3. Pofuna kudziwa kumene kuli pneumocystosis, dokotala zambiri wasankha kukachititsa phunziro parasitological. Ndi chiyani icho? Wodwala woyamba amatengedwa kuti tisanthule chitsanzo cha ntchofu. Pakuti achisangalalo izi njira monga bronchoscopy, bronchoscopy ndi biopsy. Komanso, chitsanzo akhoza zopezera ntchito otchedwa njira kupatsidwa ulemu wa chifuwa.
4. Pofuna kudziwa chitetezo kwa Pneumocystis imachitika kuphunzira serological tichipeza mu chakuti kusiyana mu masabata 2 wodwalayo ali ku kusanthula seramu 2. Ngati aliyense wa iwo akukumana kuposa mtengo yachibadwa titer pafupifupi chinthu a 2, zikutanthauza kuti munthu akudwala. phunziro ili kunachitidwa kuti kuthetsa TV mwachizolowezi, monga chitetezo opezeka 70% ya anthu.
5. Kudziwa antigens tiziromboti mu sputum, ndi chitsanzo biopsy ndi broncho-alveolar lavage anachita PCR diagnostics.

siteji pneumocystosis

Pali magawo atatu motsatizana PCP:

• oedematous (masabata 1-7);
• atelektaticheskuyu (pafupifupi 4 masabata);
• emphysematous (a durations osiyana).

Edematous siteji pneumocystosis yodziwika koyamba kufooka thupi lonse, ulesi, chifuwa ndiyeno zina pang'onopang'ono kwambiri, ndi kokha pa mapeto a nthawi - amphamvu youma chifuwa, ndi kupuma movutikira pa thupi. Ana zoipa kuyamwitsa, musati anenepa ndipo nthawi zina amakana mkaka wam'mawere. Palibe kusintha kwakukulu mu X-ray kuwala si wapezeka.

Panthaŵi atelektaticheskoy malungo febrile zimawonedwa. Chifuwa kumadalira ndipo zikuoneka foamy sputum. Kufupika kwa mpweya limapezeka ngakhale pa masewera olimbitsa thupi laling'ono. Pa X-ray kusintha kumaoneka atelektaticheskie.

Odwala amene anapulumuka woyamba 2 nthawi osauka emphysematous pneumocystosis siteji, imene yafupika zinchito ntchito kupuma ndipo akusonyeza zizindikiro za ndiko kumayambitsa.

chibayo digiri

Mu mankhwala, kusiyanitsa digiri kutsatira kukula kwa matenda:

• kuwala, amene amakhala ndi kawopsedwe ofooka (kutentha ayi choposa 38 ° C, ndi nezatumanennoe chikumbumtima) pa mpumulo ndi unalibe dyspnoea, kadamsana kuwala wapezeka pa yaing'ono x-ray;
• pafupifupi, yodziwika zolimbitsa kuledzera (kutentha kuposa 38 ° C, ufikira 100 mtima ukugunda pa mphindi, wodwalayo anadandaula za kuchuluka thukuta , etc ...), pa dyspnea zina zimawonedwa pa x-ray filimu kuoneka bwino kusalola mapapo;
• lolemera loyenda kuledzera aakulu (sitampu kutentha kuposa 39 ° C, palpitations kuposa kumenyedwa 100 pa mphindi imodzi, pali kuona zilubwelubwe), mwapang'onopang'ono kupuma insufficiency ndi kumaoneka pa x-ray kusalola kwambiri m'mapapo, angayambe mavuto osiyanasiyana.

Kodi mankhwala Kwalamulidwa kwa odwala PCP?

Palibe kukaika kuti chidziwitso cha mmene tingadziwire kutupa m'mapapo, ndi kuphatikiza yaikulu munthu aliyense. Komabe, izi sikokwanira. Ife sitiri madokotala ndi matenda zolondola simungakhoze kuyika. Palibe mtundu wina wa chibayo ndi kudziwa unilateral kapena amgwirizano chibayo, pneumocystis, ndi zina matenda layman sangakwanitse. Choncho, kudziletsa mankhwala sangathe kuyenda ndi kuyankhula. Chinthu chachikulu - osati kuzengereza ndi kukhulupirira madokotala. Pambuyo kuchititsa zonse zofunika kafukufuku dokotala molondola jambulani mapeto kaya chifukwa cha matenda wodwalayo Pneumocystis chibayo. Chithandizo wapatsidwa pokhapokha chitsimikiziro cha matenda lagona pa khalidwe la miyeso gulu chitetezo ndi mankhwala.

M'gulu-boma ntchito monga singasiyanitsidwe m'chipatala. M'chipatala wodwala amalandira mankhwala ndi zakudya analimbikitsa ndi dokotala.

mankhwala tichipeza etiotrop, pathogenetic ndi mankhwala symptomatic. Odwala zambiri prescribers "Pentamidine" "furazolidone" "Trichopolum" "Biseptolum" ndi mankhwala osiyanasiyana odana ndi yotupa, mankhwala amene amalimbikitsa atsogolere expectoration wa sputum expectoration, mucolytics.

"Biseptol" chikuyendetsedwera kuwauza kapena kudzera m'mitsempha. Mankhwala ndi bwino analekerera ndi bwino "Pentamidine" poika odwala osati akudwala AIDS. "Pentamidine" kutumikiridwa intramuscularly kapena kudzera m'mitsempha.

Ali ndi HIV odwala, mwa zina, kulandira mankhwala ochepetsa mphamvu chifukwa iwo Pneumocystis chibayo kumachitika chifukwa cha chitetezo wofooka. Pneumocystosis kwa odwala AIDS zisakuyenda akupitiriza ntchito Alefa difluoromethylornithine (DFMO).

kupewa

Kuteteza pneumocystosis zikuphatikizapo angapo ntchito, Pakati zotsatirazi tisaiwale:

1. Kuthetseratu matenda zipatala ana m'zipatala, amene ankachita oncological ndi hematological odwala, ndodo zonse, popanda yekha, ayenera nthawi anafufuza pamaso pa matenda.
2. Mankhwala prophylaxis wa anthu pangozi. kupewa izi ndi mitundu iwiri: chachikulu (musanayambe kukhala matenda) ndi sekondale (njira pambuyo kuchira kwathunthu kuteteza zisadzachitikenso).
3. kuzindikira mwamsanga pneumocystis chibayo ndi kudzipatula yomweyo wodwala.
4. Zonse disinfection m'madera kubuka analemba pneumocystosis. Kuti tichite zimenezi, kuchita chonyowa kuchapa ntchito 5% njira ya chlorine zothetsa kuthimbirira.