Kev phais mob yog ib qho nyuaj ntawm cov kab mob tshwm sim los ntawm kev nkag mus ntawm cov kab mob pathological uas txaus ntshai rau hauv cov ntaub so ntswg tom qab ua haujlwm. Rau cov xwm txheej zoo li no, qhov tshwm sim ntawm kev ua kom pom tseeb ntawm qhov mob thiab kev cuam tshuam ntawm lub cev rau cov kab mob txawv teb chaws yog cov yam ntxwv. Kev lig kev cai, cov tshuaj niaj hnub no tau siv tshuaj tua kab mob raws li kev kho mob thiab tiv thaiv kev phais mob. Txawm li cas los xij, muaj cov xwm txheej thaum kev cuam tshuam kev phais yog qhov tseem ceeb, vim tias muaj ntau yam kab mob nrog rau cov teeb meem purulent-septic.
Kev faib tawm ntawm kev phais mob
Cov txheej txheem postoperative pathological, uas muaj kev sib kis ntawm kev loj hlob, muab faib ua mob thiab ntev. Thawj qeb suav nrog:
- purulent;
- rotten;
- anaerobic;
- kab mob tshwj xeeb (xws li tetanus, anthrax thiab diphtheria) kab mob.
qeb thib ob yog:
- non-specific;
- specific(xws li Mycobacterium tuberculosis, kab mob syphilis, actinomycosis, thiab lwm yam).
Muaj ntau qhov kev faib tawm rau cov kab mob phais nrog cov txheej txheem purulent.
Etiological signs
Tsis tas li ntawd, kev phais mob yog cov kab mob uas tau muab faib raws li cov yam ntxwv etiological, uas yog:
Los ntawm qhov kis kab mob:
- endogenous;
- exogenous.
Los ntawm hom kab mob:
- staphylococcal;
- streptococcal;
- pneumococcal;
- colibacillary;
- gonococcal;
- anaerobic non-spore-forming;
- clostridial anaerobic;
- mixed type.
Los ntawm lub hauv paus chiv keeb muaj cov kab mob phais:
- tsev kho mob;
- out-of-hospital.
Los ntawm hom kab mob:
- kab mob kis thiab phais keeb kwm;
- mob kis kab mob-kev phais;
- kev mob kis mob tom qab;
- muaj teeb meem ntawm qhov kis kab mob hauv qhov raug kaw thiab qhib.
Raws li chav kho mob:
- in a sharp form;
- nrawm.
Raws li qhov chaw nyob, ntau hom kev phais mob tuaj yeem cuam tshuam:
- daim tawv nqaij thiab cov ntaub so ntswg subcutaneous;
- lub hlwb thiab nws daim nyias nyias;
- caj dab qauv;
- hauv siab, kab noj hniav pleural, ntsws;
- mediastinal organs complex;
- peritoneum thiab plab hnyuv;
- lub cev me mepelvis;
- pob txha thiab pob qij txha.
kab mob tseem ceeb
Kev phais mob yog, ua ntej ntawm tag nrho cov, cov kab mob uas ua rau muaj kev kawm tshwj xeeb thiab tsis yog tshwj xeeb. Txawm hais tias muaj ntau yam kab mob tshwm sim los ntawm kev kis kab mob, lawv muaj ntau yam sib xws.
Tsis muaj kab mob tshwj xeeb
Feem ntau tshwm sim thaum qee hom kab mob nkag mus rau hauv cov ntaub so ntswg ntawm lub cev. Hauv qhov no, cov lus teb ntawm lub cev, txawm tias qhov sib txawv ntawm cov kab mob, yuav zoo sib xws, i.e. tsis tshwj xeeb. Hauv kev xyaum, cov tshuaj tiv thaiv no hu ua purulent-inflammatory txheej txheem. Lawv tuaj yeem tshwm sim los ntawm gram-positive thiab gram-negative, aerobic thiab anaerobic kab mob thiab cov kab mob fungi. Feem ntau cov kab mob uas ua rau tsis muaj kab mob phais tshwj xeeb yog:
- Staphilicoccus aureus (Staphylococci) yog ib hom kab mob uas ua rau kev loj hlob ntawm cov txheej txheem purulent-inflammatory. Muaj peb hom: golden, epidermal, saprophytic. Thawj ntau yam yog qhov txaus ntshai tshaj plaws thiab belongs rau cov kab mob pathogenic. Epidermal, saprophytic yog cov kab mob uas tsis yog kab mob, tab sis nyob rau hauv xyoo tas los no lawv tau pom ntau ntxiv hauv cov kab mob purulent-inflammatory.
- Pseudomonas aeruginosa (Pseudomonas aeruginosa) - ib txwm txiav txim siab ntawm daim tawv nqaij thiab tsis tshua ua rau mob purulent nws tus kheej, tab sis yooj yim koom nrog cov kab mob pathological tshwm sim. Thaum nws nkag mus rau lub hom phiaj ntawm kev kis kab mob, lub inflammatoryCov txheej txheem raug ncua vim Pseudomonas aeruginosa tiv taus ntau yam tshuaj tua kab mob.
- Eisherichia coli (E. coli) ua rau purulent-inflammatory pathologies ntawm plab hnyuv (appendicitis, cholecystitis, peritonitis, abscesses, thiab lwm yam).
- Enterococcus (Enterococci) - gram-zoo cocci tam sim no nyob rau hauv muaj pes tsawg leeg ntawm microflora ntawm lub plab zom mov. Nyob rau hauv lub xub ntiag ntawm cov xwm txheej tsim nyog, lawv ua rau cov txheej txheem purulent.
- Enterobacter (enterobacteria) - ib yam li enterococci, nyob hauv txoj hnyuv. Lawv tuaj yeem ua rau cov txheej txheem purulent-inflammatory pathological.
- Streptococcus (Streptococcus) - muaj txog 20 hom kab mob no. Thaum kis kab mob, lawv ua rau muaj kev quav yeeb quav tshuaj hnyav thiab ua rau cov txheej txheem mob ntev.
- Proteus vulgaris (Proteus) yog Gram-negative rods ib txwm pom nyob rau hauv tib neeg lub qhov ncauj thiab cov hnyuv. Lawv yog cov kab mob nosocomial txaus ntshai. Nyob rau hauv cov kev mob tsim nyog thiab nyob rau hauv tandem nrog rau lwm yam kab mob pathogens, lawv provoke kev loj hlob ntawm purulent mob. Resistant rau ntau yam tshuaj tua kab mob.
- Pneumococcus (Pneumococcus) - muaj nyob rau hauv microflora ntawm lub ntsws sab sauv thiab nasopharynx. Pab txhawb kev loj hlob ntawm pneumococcal peritonitis, abscess ntawm lub ntsws thiab lub hlwb.
- Cov kab mob teej tug mus rau cov pab pawg ntawm cov nonfermenters. Lawv sawv cev rau tag nrho pawg ntawm heterogeneous aerobic thiab anaerobic phais kab mob. Lawv muaj cov kab mob tsawg, txawm li cas los xij, nyob rau hauv cov xwm txheej tsim nyog, lawv provoke putrefactive inflammatorys.
kab mob purulent tuaj yeem tshwm sim los ntawm ib qhokab mob (monoinfection) lossis ob peb hom kab mob ib zaug (sib xyaw sib xyaw), tsim kom muaj kev sib koom ua ke ntawm microbial.
Cov xwm txheej thaum cov txheej txheem inflammatory tshwm sim los ntawm ntau yam kab mob uas muaj nyob hauv tib lub chaw (piv txwv li, aerobic) hu ua polyinfection. Yog tias cov kab mob ntawm cov pab pawg sib txawv koom nrog cov txheej txheem inflammatory, ces qhov no yog kev sib xyaw ua ke.
Kev phais mob tshwj xeeb
Hauv thawj kis, cov txheej txheem pathological yog tshwm sim los ntawm qee yam kab mob thiab ua rau pom foci ntawm qhov mob, tus yam ntxwv tsuas yog rau cov kab mob no. Cov no suav nrog: cov kab mob fungal, actinomycetes, spirochetes, corynobacteria diphtheria, kab mob anthrax.
Pathogenesis
Kev txhim kho ntawm kev phais mob kis tau los ntawm peb yam tseem ceeb:
- Hom kab mob kab mob thiab nws cov khoom.
- Cov kab mob nkag mus (qhov rooj nkag).
- Cov tshuaj tiv thaiv lub cev rau kev nkag mus ntawm tus kab mob.
Kev txiav txim siab ntawm cov khoom ntawm cov kab mob pathogenic cuam tshuam nrog kev tshawb pom ntawm nws cov kab mob (pathogenicity), uas yog kwv yees los ntawm qhov tsawg kawg nkaus ntawm cov kab mob uas ua rau muaj kev kis kab mob. Cov yam ntxwv no nyob ntawm lawv qhov kev tawm tsam (muaj peev xwm kov yeej kev tiv thaiv thiab nkag mus rau cov ntaub so ntswg) thiab toxigenicity (muaj peev xwm tsim cov co toxins uas ua rau lub cev puas tsuaj).
Cov khoom ntawm cov kab mob pathogenic
Tau kawg, nyob ntawm ntau yamHom kab mob thiab muaj lwm yam kab mob, cov yam ntxwv ntawm cov kab mob tuaj yeem sib txawv. Yog li ntawd, monoinfections yog qhov yooj yim dua thiab kho tau yooj yim dua.
Cov kab mob phais mob hnyav heev yog tias lawv nrog cov kab mob thib ob, uas feem ntau ua rau cov kab mob tseem ceeb nce ntxiv. Qhov ntau yam tseem ceeb kuj tseem ceeb: ntau cov kab mob pathogenic tau nkag mus rau hauv cov ntaub so ntswg, qhov ntau dua qhov yuav kis tau tus kab mob purulent-inflammatory.
nkag rooj vag
Thawj theem ntawm kev pib kis kab mob yog kev nkag mus ntawm cov kab mob mus rau hauv cov ntaub so ntswg. Qhov tshwm sim no yog hu ua kab mob thiab tuaj yeem ua rau exogenous (cov kab mob pathogenic nkag mus rau cov ntaub so ntswg los ntawm sab nraud, ua qhov tseem ceeb ntawm kev kis kab mob) thiab endogenous (ua kom cov kab mob uas twb muaj nyob hauv lub cev uas yav tas los tsis ua rau muaj kev hem thawj).
Cov tawv nqaij thiab cov mucous daim nyias nyias ntawm lub cev yog ib qho kev tiv thaiv kab mob. Nyob rau hauv cov ntaub ntawv ntawm kev puas tsuaj rau lawv txoj kev ncaj ncees los yog ua txhaum ntawm lub zos tiv thaiv mechanisms ntawm lub cev, pom tej yam kev mob tshwm sim rau kev nkag mus ntawm pathogenic microflora. Lub qhov rooj nkag tuaj yeem yog cov ducts ntawm hws, sebaceous lossis cov qog mammary.
Txawm li cas los xij, qhov kev taw qhia no tsis yog ib txwm ua rau muaj kev sib kis, vim feem ntau cov kab mob tuag vim yog kev tiv thaiv kab mob. Yog li ntawd, qhov yuav tshwm sim ntawm kev tsim cov txheej txheem pathogenic nyob ntawm qhov chaw ntawm kev phais mob dav dav thiab muaj cov xwm txheej zoo.
Lub xeev ntawm kev tiv thaivsystems
Cov xwm txheej ntawm lub cev feem ntau ua lub luag haujlwm tseem ceeb. Nrog rau tus kab mob me me nrog cov cim qhia tsis muaj zog, nrog kev tiv thaiv zoo ntawm lub cev, cov txheej txheem pathological tuaj yeem cuam tshuam sai lossis tsis txhim kho txhua.
Cov tshuaj tiv thaiv dav dav yog txiav txim siab los ntawm qhov tsis muaj kev cuam tshuam tshwj xeeb (nyob ntawm tus kheej tsis kam, caj ces yam, saturation ntawm cov ntaub so ntswg nrog cov ntsiab lus tseem ceeb) thiab lub xeev ntawm kev tiv thaiv kab mob.
Txoj kev tshwj xeeb
Txhua lub cev muaj peev xwm tsim tau nws cov tshuaj tua kab mob uas tiv thaiv nws los ntawm kev cuam tshuam ntawm cov kab mob nkag mus. Kev tiv thaiv kab mob yog muab los ntawm kev tsim cov tshuaj tiv thaiv ntawm hom humoral thiab cellular. Cov tshuaj no hauv lub cev pib tsim los ntawm kev raug rau co toxins thiab enzymes ntawm cov kab mob, nrog rau lawv cov khoom metabolic thiab cov khoom lwj ntawm lawv cov ntaub so ntswg.
uas txo kev tiv thaiv
Nyob rau qee kis, cov kab mob kis tau los ntawm cov kab mob pathogenic tuaj yeem muaj qee qhov kev ua haujlwm tsis zoo uas muaj cov kab mob sib kis. Qhov no ua rau tsis muaj peev xwm ua tau raws li qhov tseem ceeb ntawm kev tiv thaiv kev tiv thaiv, uas ua rau muaj kev pom zoo rau kev loj hlob ntawm tus kab mob.
Yam uas cuam tshuam rau qhov muaj feem kis tau tus kab mob xws li:
- Poj niam los txiv neej. Tus poj niam lub cev muaj kev tiv thaiv kev tiv thaiv ntau dua, yog li nws tiv taus ntau dua rau cov kab mob sib kis.
- hnub nyoog pawg. Los ntawm cov kab mob sib kis ntau duacov me nyuam thiab cov laus raug kev txom nyem.
- Nyob ntev.
- noj zaub mov tsis zoo thiab tsis muaj cov vitamins. Cov zaub mov tsis txaus ua rau lub cev tsis muaj zog tag nrho.
- Npaj. Tus kab mob no ua rau tsis muaj zog tiv thaiv lub cev, thaum nyob rau hauv cov kab mob sib kis anemia tuaj yeem txhim kho sai heev tiv thaiv keeb kwm ntawm tus kab mob.
- Hypoglobulinemia, hypovolemia thiab lwm yam pathologies. Pab txhawb rau txoj kev loj hlob ntawm tus kab mob.
Txaus siab rau txoj kev loj hlob ntawm tus kab mob thiab ntau lwm yam mob ntawm lub cev uas muaj cov ntshav khiav tsis zoo (piv txwv li, kab mob ntawm cov hlab plawv), kab mob tiv thaiv kab mob (piv txwv li, ntshav qab zib mellitus).
Cov txheej txheem ntawm cov txheej txheem pathogenic
Cov txheej txheem kis tau muab faib ua theem: incubation, ncov thiab rov qab los. Thaum lub sij hawm txhua lub sij hawm no, ntau yam txheej txheem tshwm sim ob qho tib si nyob rau hauv lub tsom xam ntawm o thiab nyob rau hauv lub cev tag nrho. Cov kev hloov pauv uas tshwm sim thaum tus txheej txheem kis tau muab faib ua kev tiv thaiv (kev tiv thaiv ntawm lub cev) thiab kab mob (kev puas tsuaj ntawm kev kis kab mob).
Lub sijhawm pib ntawm theem incubation yog suav tias yog lub sijhawm thaum cov kab mob pathogenic nkag mus rau hauv lub cev, txawm li cas los xij, kev kho mob tshwm sim ntawm cov txheej txheem no tsuas yog tshwm sim tom qab qee lub sijhawm (qhov nruab nrab, kwv yees li 6 teev).
Lub sijhawm ntawm qhov kawg ntawm kev kis kab mob yog lub sijhawm txij li qhov kawg ntawm theem incubation mus rau kev kho kom tiav. Nws manifests nws tus kheej nrog ib tug yam ntxwv duab rau ib tug yam ntxwv kab mob nyob rau hauv ua ke nrog nrog rau kev tiv thaiv ntawm lub cev.
Txoj kev rov qab los(rov qab) tshwm sim tom qab muab cov tshuaj tua kab mob tsim nyog rau kev phais mob. Raws li kev kho kom txaus, kev ua haujlwm ntawm cov txheej txheem kis tau qis, lub cev rov zoo, tshem tawm qhov tshwm sim thiab kev puas tsuaj los ntawm tus kab mob.
Symptoms
Cov tsos mob dav dav hauv kev phais mob tshwm sim lawv tus kheej nyob ntawm lub sijhawm ntawm tus kab mob thiab nws theem. Lub sij hawm incubation feem ntau yog asymptomatic, tsuas yog qee cov kab mob kis tau nrog mob taub hau, tsis muaj zog, thiab lwm yam.
Thaum lub sijhawm muaj tus kab mob siab, cov kev kho mob tshwm sim tshwm sim lawv tus kheej li endogenous intoxication syndrome, vim lawv tshwm sim los ntawm kev raug cov kab mob microbial co toxins thiab cov khoom lwj ntawm lub cev cov ntaub so ntswg. Cov tsos mob ntawm tus txheej txheem no tshwm sim nyob rau hauv daim ntawv ntawm: malaise, lethargy, qaug zog, insomnia, mob taub hau, kub taub hau, thiab lwm yam.
Daim duab kho mob ntawm cov tsos mob tshwm sim tau tshaj tawm nyob rau hauv theem purulent-necrotic dua li ntawm serous-infiltrative. Tsis tas li ntawd, cov tsos mob nyob ntawm qhov hnyav ntawm intoxication.
