Cov kab mob ua pa feem ntau raug kuaj pom hauv cov tshuaj niaj hnub no. Ib qho mob uas mob ntev heev yog bronchiectasis (los yog bronchiectasis), uas yog tus cwj pwm los ntawm kev txhim kho cov txheej txheem purulent inflammatory hauv lub ntsws. Feem ntau qhov no pathology tsis tsim ntawm nws tus kheej, tab sis yog qhov tshwm sim ntawm lwm yam kab mob. Tus mob no ua rau tus neeg muaj kev cuam tshuam rau cov kab mob ntawm cov kab mob ua pa, yog li nws yuav tsum nyob rau hauv kev saib xyuas kev kho mob thiab kev txhawb nqa kev kho mob, uas tuaj yeem ua rau muaj kev mob hnyav ntxiv.
yam ntxwv thiab piav qhia txog qhov teeb meem
Kab mob Bronchoectatic yog ib yam kab mob tshwm sim los ntawm kev hloov pauv tsis tau ntawm lub bronchi, uas cuam tshuam lawv txoj haujlwm thiab ua rau muaj kev loj hlob ntawm cov txheej txheem purulent-inflammatory ntawm qhov xwm txheej. Cov kab mob no tau kuaj pom hauv 1% ntawm cov neeg, feem ntau ntawm cov hnub nyoog ntawm tsib thiab nees nkaum tsib xyoos. Nws yog tus cwj pwm los ntawm kev rov ua dua ntawm cov txheej txheem sib kis hauv bronchi thiab ntsws,uas nrog hnoos thiab hnoos qeev nrog cov kua paug.
Pathological thaj chaw (bronchiectasis) tuaj yeem kis mus rau txhua lub bronchi, txwv rau ib qho ntawm nws ntu lossis ib lub lobe ntawm lub ntsws. Bronchiectasis yog thaj chaw ntawm kev nthuav dav ntawm cov phab ntsa ntawm lub bronchi, lawv muaj cov pob txha mos thiab cov qog, thaum cov leeg nqaij tsis tuaj.
Feem ntau, tus kab mob no tshwm sim tawm tsam keeb kwm ntawm lwm yam kab mob ua pa, xws li tuberculosis, ntsws abscess lossis mob ntsws, tab sis kab mob hauv lub cev kuj tuaj yeem tshwm sim. Nws feem ntau cuam tshuam rau txiv neej.
kab mob
Tus kab mob Bronchoectatic ntsws tuaj yeem ua tau ntau yam nyob ntawm cov duab thiab thaj chaw ntawm cov kab mob pathological.
Hauv tshuaj, hom kab mob hauv qab no txawv nyob ntawm daim ntawv thiab thaj chaw:
- Cistoid (saccular) yog tus cwj pwm los ntawm qhov chaw ntawm bronchiectasis nyob rau sab sauv ntawm lub bronchi. Nyob rau tib lub sijhawm, lawv cov phab ntsa o hauv ib qho chaw thiab zoo li lub hnab hauv qhov tsos.
- Cylindrical, nyob rau hauv qhov chaw deformed nyob rau hauv tej thaj chaw deb ntawm lub cev, thiab lawv zoo li lub tog raj kheej.
- Varicose, uas yog tus cwj pwm los ntawm kev sib kis ntawm pathology ntawm thaj chaw sab sauv thiab thaj chaw deb ntawm lub bronchi, hauv lawv cov tsos lawv zoo li cov leeg nrog varicose leeg, txij li cov phab ntsa ntawm lub cev sib npaug o raws nws tag nrho ntev.
- Sib xyaw, uas bronchiectasis tshwm sim hauv ntau qhov chaw ntawm lub cev.
Tsis tas li, tus kab mob tuaj yeem ua taucongenital thiab kis tau, unilateral thiab ob tog.
kab mob daim ntawv
Bronchiectasis los ntawm ntau hom:
- daim ntawv me me, uas pom muaj qhov tshwm sim ob zaug hauv ib xyoos, thaum lub sijhawm tshem tawm tus neeg zoo.
- Daim ntawv tshaj tawm yog tus cwj pwm los ntawm lub caij nyoog exacerbations, nyob rau hauv uas purulent hnoos qeev tau pom txhua hnub. Thaum lub sij hawm tshem tawm, hnoos, hnoos qeev, ua pa luv thiab ua tsis taus pa tsis zoo.
- Daim ntawv hnyav yog tshwm sim los ntawm kev ua kom hnyav ntxiv nrog rau qhov nce hauv lub cev kub. Nyob rau tib lub sij hawm, tus nqi ntawm cov hnoos qeev nce, nws muaj ib qho tsis kaj siab tsw ntawm rot. Thaum lub sij hawm ncua sij hawm luv luv, tus neeg muaj peev xwm ua hauj lwm tau khaws cia.
- Daim ntawv nyuaj muaj tag nrho cov cim ntawm ib qho mob hnyav, thaum cov kab mob thib ob koom nrog lawv: lub plawv thiab lub ntsws tsis ua haujlwm, amyloidosis ntawm lub raum thiab daim siab, ntshav tsis txaus, ntsws abscess, kev loj hlob ntawm pulmonary los ntshav, nephritis thiab lwm yam.
Ua rau kev loj hlob ntawm pathology
Primary bronchiectasis ntawm lub ntsws tshwm sim los ntawm congenital anomalies nyob rau hauv kev loj hlob ntawm lub cev, uas provokes underdevelopment ntawm cov phab ntsa ntawm lub bronchi. Xws li pathologies yog tsawg. Cov yam ntxwv uas ua rau muaj kev txhim kho ntawm cov txheej txheem no yog kev tsim txom ntawm tus cwj pwm tsis zoo los ntawm tus poj niam cev xeeb tub, cov kab mob uas nws tau raug kev txom nyem. Qhov no ua rau deformation ntawm lub bronchi nyob rau hauv tus me nyuam, nws cov hlab ntsha yog clogged nrog hnoos qeev, lub qis seem ntawm lub bronchi nthuav, hnoos qeev accumulates nyob rau hauv lawv,uas yog rotting. Congenital malformations tau pom nyob rau hauv Sievert tus kab mob - Kartagenera.
Kab mob kis tau tshwm sim vim muaj kab mob ua pa ntau zaus hauv cov menyuam yaus lossis lub cev txawv teb chaws nkag mus rau lumen ntawm bronchi. Cov kab mob ua pa ntev ua rau deformation hauv cov leeg thiab cov mucous membrane ntawm bronchi, lawv cov phab ntsa nthuav dav, lub ntsws parenchyma shrinks, stretches thiab deforms. Cov txheej txheem pathological kuj txuas mus rau cov hlab ntsha, hlab ntsha, capillaries, uas muab khoom noj rau lub bronchi. Thaum tus kab mob koom nrog, cov txheej txheem inflammatory pib, bronchiectasis tau ntim cov hnoos qeev nrog cov kua paug, thiab bronchiectasis tsim.
Tus kab mob purulent yog khaws cia hauv lub cev vim yog kev ua txhaum ntawm kev ua kom huv ntawm tus kheej ntawm tsob ntoo bronchial, txo qis hauv kev tiv thaiv hauv zos, muaj kab mob ntev hauv nasopharynx. Cov kab mob kis mus rau menyuam yaus uas ua rau muaj kev txhim kho ntawm cov kab mob xws li kab mob khaub thuas, hnoos hawb pob, qhua pias, staphylococcus aureus, streptococcus.
Cov tsos mob thiab cov cim qhia ntawm tus kab mob
Cov tsos mob ntawm bronchiectasis yog ib qho hnoos tsis tu ncua, nrog cov hnoos qeev tawm nrog cov kua paug tawm. Feem ntau, hnoos qeev yog zais hauv qhov ntau thaum sawv ntxov, nrog rau qee qhov haujlwm ntawm lub cev. Qee zaum, cov hnoos qeev purulent mus txog ob puas milliliters. Raws li nws accumulates nyob rau hauv lub bronchi, hnoos rov pib dua. Qee lub sij hawm hnoos muaj zog provokes ib qho rupture ntawm cov hlab ntsha nyob rau hauv cov phab ntsa ntawm lub pa system, yog li ntawd muaj yog ib tug rupture ntawm cov hlab ntsha nyob rau hauv lub phab ntsa ntawm lub pa system.hemoptysis los yog pulmonary hemorrhage. Qee zaum, cov tsos mob ntawm bronchiectasis ntawm lub ntsws yog tshwm sim nyob rau hauv daim ntawv ntawm ua pa luv thaum lub sij hawm lub cev ua si, ua pa tsis ua hauj lwm, kev loj hlob ntawm lwm yam kab mob, thiab nce nyob rau hauv lub cev kub.
mob ntev ntawm cov kab mob ua pa ua rau ua rau qaug zog thiab qaug zog ntawm lub cev, anemia pib tshwm sim hauv ib tus neeg, poob phaus, hloov pauv ntawm daim tawv nqaij, kev loj hlob qeeb tshwm sim hauv cov menyuam yaus.
theem kab mob kev loj hlob
Hauv tshuaj, muaj peb theem ntawm pathology:
- Thawj theem yog tus cwj pwm los ntawm kev nthuav dav me ntsis ntawm lub bronchi, cov phab ntsa uas yog kab nrog cylindrical epithelium. Nyob rau tib lub sijhawm, muaj hnoos qeev tsis muaj paug hauv cov kab noj hniav.
- theem thib ob yog tshwm sim los ntawm kev sib ntxiv ntawm cov txheej txheem inflammatory thiab suppuration. Qhov kev ncaj ncees ntawm daim npog epithelial yog tawg, nws yog hloov los ntawm ib tug squamous epithelium thiab ulceration qhov chaw.
- theem thib peb, uas cov txheej txheem kis tau cuam tshuam rau lub ntsws, tsim cov kab mob pneumosclerosis. Muaj cov chaw necrotic nyob rau hauv cov phab ntsa ntawm lub bronchi, lawv cov kab noj hniav muaj cov kua paug, intoxication ntawm lub cev tshwm sim.
Lub ntsws sab laug feem ntau cuam tshuam, 30% ntawm cov neeg mob muaj kev cuam tshuam ob sab ua pa.
Cov Teeb Meem thiab qhov tshwm sim
Nrog rau txoj kev loj hlob ntawm cov txheej txheem pathological, muaj cov teeb meem ntawm bronchiectasis li ua pa tsis ua haujlwm, cyanosis, thickening ntawm cov ntiv tes, deformity ntawm lub hauv siab, ntxiv cov kab mob ua pa thib ob.
Tsis kho lossisKev kho tsis zoo tuaj yeem ua rau muaj kev txhim kho ntawm lub ntsws thiab lub hlwb, mob ntsws, sepsis, pleurisy, sinusitis. Qee zaum muaj teeb meem metabolic nyob rau hauv daim ntawv ntawm cachexia, amyloidosis ntawm lub raum, daim siab thiab tus po yog ua tau. Ntau tus neeg mob muaj hemoptysis. Tag nrho cov tsos mob tsis zoo no tuaj yeem ua rau tuag taus yog tias tsis kho.
Txoj kev kuaj mob
Thaum cov tsos mob ntawm bronchiectasis pib tshwm sim, kev kuaj mob yuav tsum tau ua los ntawm kws kho mob tom qab kuaj xyuas kom meej. Ua ntej, nws kawm txog keeb kwm ntawm tus kab mob, ua ib qho kev ntsuam xyuas thiab kev ntsuam xyuas nyiaj txiag ntawm lub ntsws. Nyob rau hauv cov ntaub ntawv no, ib tug neeg muaj ib tug tsis muaj zog ua tsis taus pa, ib tug loj tus naj npawb ntawm ntub rales nyob rau hauv qis qhov chaw ntawm lub cev, uas yuav txo tau tom qab hnoos qeev tawm. Qee zaum hawb pob tuaj yeem tshwm sim.
Tsis tas li, bronchiectasis, kev kuaj mob uas yuav tsum tau ua los ntawm cov kws kho mob paub txog, yuav tsum muaj cov kev tshawb fawb hauv qab no:
- X-ray, uas cov duab qhia duab ntxoov ntxoo nyob rau hauv cov cheeb tsam ntawm kev nthuav dav ntawm bronchial ntu uas muaj cov hnoos qeev, lossis cov no yuav yog cov hlwv nrog cov pa lossis kua dej. Lub pob tshab ntawm lub ntsws hauv cov duab yuav raug txo vim yog mob, cov phab ntsa ntawm lub bronchi yuav thickened.
- High expansion CT yog txoj kev qhia paub ntau tshaj plaws rau kev kuaj mob bronchiectasis, uas ua rau nws muaj peev xwm ua kom paub qhov tseeb.
- Bronchoscopy yog sau nyob rau hauv lub xub ntiag ntawm hemoptysis. Cov txheej txheem no ua rau nws muaj peev xwm txiav txim siab cov ntsiab lus purulent, nrog rau coj cov khoom no rau cytologicalresearch.
- Bronchography tso cai rau koj pom kev sib kis ntawm cov txheej txheem pathological, nws qhov chaw thiab cov duab.
- Sputum kab lis kev cai raug sau los txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau kis kab
- Spirometry thiab peak flow yog ua txhua xyoo los txiav txim siab qhov ua pa tsis ua haujlwm.
- CT ntawm cov sinuses, saccharin kuaj raws li kev kuaj mob ntxiv.
- Saib xyuas cov hnoos qeev uas tawm thaum nruab hnub.
Tom qab kev tshuaj ntsuam xyuas, tus kws kho mob ua qhov kev kuaj mob kom raug thiab txhim kho kev kho mob hauv txhua kis.
YPathology Therapy
Kev kho mob ntawm bronchiectasis feem ntau yog hais txog kev kho mob ntawm bronchi thiab tshem tawm cov txheej txheem purulent kis kab mob hauv lub ntsws. Rau qhov no, tus kws kho mob sau tshuaj tua kab mob thiab bronchoscopic kua. Txhawm rau kho cov kab mob ua pa, cephalosporins, xws li Ceftriaxone, lossis penicillins hauv daim ntawv Ampicillin, nrog rau gentamicins, tau siv.
Tsis tas li ntawd, rau kev kho mob ntawm bronchiectasis, nws yuav tsum tau ua kom huv ntawm lub ntsws. Kev huv huv ntawm lub bronchi yog tsom rau kev tshem tawm cov hnoos qeev ntawm lawv, nrog rau cov nyhuv hauv zos ntawm cov tshuaj tua kab mob ntawm cov kab mob microflora. Ua li no, tus neeg mob tau muab lub cev tshwj xeeb, ib lub catheter muab tso rau hauv lub bronchi, thiab tshuaj tua kab mob, tshuaj tua kab mob thiab mucolytic txhaj los ntawm nws.
TsiNws yog ib qho tseem ceeb uas yuav tsum tau siv cov txheej txheem ntxiv uas yuav ua rau cov hnoos qeev tawm, txij li thaum muaj bronchiectasis, cov hnoos qeev yuav tsum raug tshem tawm ntawm lub ntsws. Rau qhov no, ua tsis taus pa, massage hauv siab, alkaline haus, electrophoresis thiab inhalation, noj zaub mov, siv tshuaj ntsuab infusions thiab tswj kev noj qab haus huv txoj kev ua neej feem ntau tau sau tseg. Kev noj zaub mov yuav tsum suav nrog ntau cov vitamins thiab protein. Hauv qhov no, nws raug nquahu kom noj ntses, tsev cheese, zaub, txiv hmab txiv ntoo thiab nqaij.
Tus kab mob Bronchoectatic ntsws feem ntau kho nrog bronchoalveolar lavage, uas lub bronchi yog flushed thiab purulent hnoos qeev yog aspirated nrog ib tug bronchoscope. Cov txheej txheem no ua rau nws muaj peev xwm los ntxuav lub bronchi ntawm cov kua qaub, qhia cov tshuaj tua kab mob rau hauv lub cev, thiab siv kev huv.
kho mob phais
Nyob rau hauv qhov tsis muaj contraindications, kev phais yog ua nyob rau hauv cov ntaub ntawv ntawm cov organic puas rau lub ua pa system. Hnub nyoog ntawm xya mus rau kaum plaub xyoo yog suav tias tsim nyog rau kev ua haujlwm, hauv lwm qhov xwm txheej nws tsis tuaj yeem tsim cov ciam teb ntawm cov txheej txheem pathological.
Kev phais rau cov kab mob xws li bronchiectasis tsuas yog tom qab kev soj ntsuam ntxaws txog kev txhim kho tus kab mob, nrog rau kev cuam tshuam ntawm kev kho tshuaj thiab rov kuaj xyuas dua. Nco ntsoov ua haujlwm raws li kev soj ntsuam, piv txwv li, los ntshav tsis tu ncua. Kev phais tsuas tuaj yeem ua tau thaum twgTom qab tshem tawm ntawm lub ntsws, txoj kev ua pa ntawm lub ntsws yuav muab cov ntaub so ntswg txaus.
Nyob rau hauv rooj plaub uas tsis muaj kev puas tsuaj rau lub cev, kev tshem tawm ntawm lub ntsws deformed ntawm lub ntsws yog siv, tsis muaj kev cuam tshuam rau cov ntaub so ntswg noj qab haus huv. Nyob rau hauv cov ntaub ntawv ntawm ib tug ob sab lesion, ib tug resection ntawm lub cev yog ua nyob rau sab uas tau raug kev txom nyem tshaj plaws. Kev kho mob ntxiv yog ua tiav, uas yog txhawm rau txo qhov kev pheej hmoo ntawm kev rov qab los. Txoj hauv kev no feem ntau ua rau nws ua tau kom tau txais txiaj ntsig zoo, kev hloov pauv ntawm qhov tsis ua haujlwm ntawm lub cev tsis ua tiav.
Nyob rau hauv cov ntaub ntawv ntawm symmetrical lesions ntawm lub cev lobes, ib tug ob tog resection yog ua nyob rau hauv ob theem, ntawm uas li ntawm ib xyoos yuav tsum dhau. Yog tias thaj chaw loj raug cuam tshuam, kev ua haujlwm tsis ua.
Tom qab kho bronchiectasis, cov lus pom zoo kom txo qhov kev pheej hmoo rov tshwm sim yuav raug muab los ntawm tus kws kho mob. Nws qhia txog kev ua raws li kev noj qab haus huv kom zoo, zaws, kho lub cev qoj ib ce, electrophoresis.
Huab cua
Kev phais feem ntau ua rau tus neeg mob rov zoo tag. Nyob rau hauv cov chav kawm ntawm kev kho tshuaj, cov kws kho mob tau sau cov kev kawm zoo ntawm kev kho mob los tiv thaiv, uas ua rau nws muaj peev xwm ua tau kom tau txais txiaj ntsig mus ntev. Relapses tuaj yeem tshwm sim nrog hypothermia thiab kis kab mob. Yog li ntawd, nws raug pom zoo thaum lub caij txias los tiv thaiv koj tus kheej ntau li ntau tau los ntawm kev cuam tshuam ntawm qhov tsis zoo.
Thaum tsis kho, nrog rau cov kab mob hnyav, qhov kev cia siab yuav tsis zoo. Kab mob feem ntau ua rauKev tsis taus ntawm ib tug neeg, thiab kev tuag yog ua tau.
Kev Tiv Thaiv
Cov neeg uas muaj mob ntsws ntev lossis mob ntsws yuav tsum tau saib xyuas kev kho mob tas li, tau txais kev kho mob raws sijhawm. Cov neeg mob zoo li no yuav tsum tsis suav nrog kev quav tshuaj, tshwj xeeb tshaj yog kev haus luam yeeb, tsis txhob nyob hauv cov chav plua plav, ua raws li txheej txheem tawv. Txhawm rau tiv thaiv kev loj hlob ntawm tus kab mob, nws yog ib qho tsim nyog yuav tsum ua kom huv si raws sijhawm nrog sinusitis, sinusitis, ethmoiditis, nrog rau cov kab noj hniav ntawm qhov ncauj nrog pathologies ntawm cov hniav thiab cov pos hniav. Ua raws li tag nrho cov lus pom zoo yuav zam kev txhim kho ntawm cov kab mob tsis zoo li bronchiectasis.
