Cov kab mob ntsws tsis tshwj xeeb (COPD) yog ib qho teeb meem tseem ceeb tshaj plaws ntawm pulmonology niaj hnub no, sawv cev rau cov txheej txheem etiological thiab pathomorphological hauv cov kab mob ua pa, nrog rau cov hnoos ntev ntev vim kev puas tsuaj rau lub ntsws thiab parenchyma. Cov pab pawg ntawm cov kab mob no muaj xws li cov kab mob pathological hauv cov kab mob ua pa, uas tshwm sim vim muaj ntau yam ua rau thiab cov txheej txheem ntawm txoj kev loj hlob, tab sis muaj cov cim qhia zoo sib xws ntawm cov chav kawm thiab cov kev ua tsis zoo morphofunctional zoo sib xws.
CHNLD yog dab tsi
Kev lig kev cai, cov kab mob ntsws uas tsis yog tshwj xeeb muaj xws li cov pab pawg hauv qab no ntawm cov kab mob ntsws:
- Chronic bronchitis.
- Asthma.
- Emphysema.
- Bronchiectasis.
- mob ntsws ntsws.
- Pneumosclerosis.
Txawm li cas los xij, qee tus kws sau ntawv xa mus rau hom kev ywj pheej ntawm NHPLinterstitial pathologies ntawm lub pa system. Lwm tus tsis pom zoo, ntseeg tias tsuas yog mob ntsws ntsws ntev, emphysema thiab bronchial hawb pob yog kev ywj pheej ntawm cov kab mob tsis tshwj xeeb ntawm kev ua pa. Yog li ntawd, kev faib tawm ntawm cov kab mob ntsws uas tsis muaj qhov tshwj xeeb tseem ua rau qee cov lus nug thiab txawm tias muaj kev tsis sib haum xeeb ntawm cov kws tshaj lij.
Yog vim li cas thiaj pom
Lub ntsiab tseem ceeb ua rau pom qhov tsis zoo ntawm cov kab mob pulmonary hauv cov pej xeem yog:
- huab cua hauv nroog;
- kev phom sij;
- nquag kis tus kab mob;
- tus cwj pwm phem.
COPD feem ntau kuaj pom hauv cov neeg nyob hauv cov nroog muaj kev lag luam, qhov chaw loj (ntau zaus siab dua li qhov kev tso cai) ntawm cov khoom phom sij muaj nyob hauv huab cua: nitrogen oxide, sulfur thiab carbon dioxide, hmoov av. thiab lwm yam khoom. Hauv cov cheeb tsam zoo li no, qhov zaus ntawm kev kuaj mob ntsws ntev (raws li kev kho mob thiab teeb meem kev sib raug zoo) feem ntau mus txog qib tseem ceeb.
Cov kab mob ntsws ua haujlwm ntev feem ntau tshwm sim hauv cov neeg uas pheej raug cov cua ntsawj ntshab, roj thiab hmoov av. Tsis tas li ntawd, raws li kev tshawb fawb ntau, cov neeg haus luam yeeb muaj feem cuam tshuam rau cov kev pheej hmoo ntawm cov kab mob uas tsis yog tshwj xeeb ntawm kev ua pa.
Lwm yam uas ua rau mob ntsws tsis muaj kab mob xws li: nquag thiab mus sij hawm ntev tus kab mob ua pa nyuaj, rov mob ntsws thiab mob ntsws. Ntev ntev thiab kis kab mob ntawm cov kab mob ua pa, ntau yam kev tsis haum tshuaj thiab kev tiv thaiv kab mob tuaj yeem yog lub hauv paus ua rau kev loj hlob ntawm COPD.
Qhov tshwm sim ntawm qhov tshwm sim ntawm cov kab mob tsis tshwj xeeb hauv lub ntsws, tshwm sim nyob rau hauv daim ntawv ntev, nce rau cov neeg uas muaj hnub nyoog 40 xyoo. Nyob rau tib lub sijhawm, xws li pathologies feem ntau pom hauv cov txiv neej. Daim ntawv teev cov kab mob ntsws ntev, raws li kev txheeb xyuas kev kho mob, qhov no zoo li qhov no:
- mob ntsws ntsws - txog 59%.
- Asthma - txog 36%.
- Bronchiectasis - txog 3.5%.
- Lwm cov kab mob ntsws tsawg dua 1.5%.
Cov kab mob ntawm cov kab mob tsis muaj mob ntev tuaj yeem ua raws li ib qho ntawm peb qhov xwm txheej rau kev txhim kho tus kabmob: bronchitogenic, pneumoniogenic thiab pneumonitogenic ua rau.
Lub pathogenesis ntawm bronchitiogenic txoj kev loj hlob yog vim qhov tshwm sim ntawm kev ua txhaum ntawm bronchial patency thiab kua muaj peev xwm ntawm lub bronchi. Feem ntau, cov kab mob cuam tshuam nrog kev faib tawm ntawm cov kab mob pulmonary txhim kho raws li cov tswv yim no: mob ntsws ntsws, mob hawb pob, mob ntsws, thiab BEB (bronchiectasis disease).
Pneumoniogenic thiab pneumonitogenic mechanisms cuam tshuam nrog kev tsim cov kab mob ntsws ntev thiab lub ntsws abscess, uas, dhau los, yog cov teeb meem ntawm broncho- lossis croupous pneumonia.
Qhov tshwm sim ntawm cov txheej txheem no feem ntau yog cov kab mob xws li pneumosclerosis (pneumofibrosis, pneumocirrhosis), cardiopulmonary tsis ua haujlwm thiab lwm yam.tsis xav tau qhov tshwm sim. Nyob rau hauv xyoo tas los no, COPD tau pom ntau zuj zus raws li qhov ua rau tuberculosis thiab mob ntsws cancer.
Major non-specific pulmonary disease
Kev faib tawm ntawm cov kab mob ntsws uas tsis muaj mob tshwj xeeb suav nrog cov kab mob uas yog tshwm sim los ntawm cov kab mob hnyav uas tau tsim tawm tsam keeb kwm yav dhau los ntawm tus kab mob kis los yog kab mob genesis. Lawv tuaj yeem tshwm sim lawv tus kheej tawm tsam keeb kwm yav dhau los ntawm kev cuam tshuam ntev rau cov tshuaj tsis zoo thiab lub cev.
bronchitis ntev
Nyob rau hauv cov nqe lus ntawm kev nthuav dav, bronchitis yog hauv zos los yog diffuse, raws li hom txheej txheem inflammatory - catarrhal los yog mucopurulent. Nws tuaj yeem ua rau obstructive thiab tsis cuam tshuam, hauv qhov xwm txheej - atrophic, polypous, deforming.
Kev kho mob tshwm sim ntawm cov kab mob ntsws uas tsis yog tshwj xeeb ntawm hom no tau nthuav tawm nyob rau hauv ib xyoos, ib ntus rov tshwm sim, mob mus ntev hauv lub bronchi. Feem ntau, exacerbations ntawm mob ntsws ntsws tshwm sim txog li 4 zaug hauv ib xyoos, thaum lub sij hawm txhua xyoo ntawm cov kab mob no tuaj yeem ncav cuag 3-6 lub hlis.
Ib tus tsos mob ntawm tus mob bronchitis yog ib qho hnoos tsis tu ncua nrog phlegm. Thaum exacerbations, hnoos feem ntau yuav hnyav dua, hnoos qeev ua purulent, tawm hws thiab kub taub hau ntxiv. Qhov tshwm sim ntawm cov kab mob no tuaj yeem yog kev txhim kho mob ntsws, mob ntsws atelectasis, emphysema, pneumofibrosis.
Asthma
Ntau yammuaj ntau yam mob hawb pob bronchial: nws tuaj yeem tsis yog atopic, atopic, sib xyaw, tshuaj aspirin-induced lossis kab mob ua haujlwm. Qhov no pathology yog qhov thib ob feem ntau kuaj pom ntawm tag nrho cov kab mob ntsws tsis tshwj xeeb. Lawv cov tsos mob ntawm cov neeg laus thiab cov me nyuam yog cov yam ntxwv ntawm hyperreactivity ntawm tsob ntoo bronchial, uas ua rau hypersecretion ntawm bronchial mucus, edema thiab paroxysmal airway spasms.
Ntawm twg los xij, qhov kev kho mob tshwm sim ntawm bronchial hawb pob yog kev tawm tsam ntawm kev ua tsis taus pa. Txoj kev loj hlob ntawm cov phenomena tshwm sim nyob rau hauv peb theem:
- Harbiners. Qhia qhov pib ntawm tus mob hawb pob nyob rau hauv daim ntawv ntawm hnoos, hnoos qeev los ntawm lub qhov ntswg, qhov tsos ntawm o thiab liab ntawm conjunctiva ntawm lub qhov muag.
- Txhob poob siab. Nws yog tus cwj pwm los ntawm qhov tshwm sim ntawm hawb pob, ua tsis taus pa luv nrog lub sijhawm exhalation, diffuse cyanosis, thiab hnoos tsis ua haujlwm. Thaum lub sijhawm ua pa, tus neeg mob yuav tsum pw kom lub taub hau thiab lub xub pwg nyom nyob rau ntawm ib lub toj. Thaum ua pa hnyav, tus neeg mob yuav tuag vim ua pa tsis ua haujlwm.
- theem ntawm kev rov qab txhim kho ntawm kev tawm tsam. Nws yog tus cwj pwm los ntawm kev sib cais ntawm cov hnoos qeev, txo qis hauv cov pa hawb pob thiab ua pa tawm. Maj mam, ua tsis taus pa kiag li ploj mus.
Ntawm qhov tshwm sim ntawm kev mob ntsws asthma, cov neeg mob tseem txaus siab, muab cov lus pom zoo ntawm cov kws kho mob ua raws: kab mob ntsws tsis muaj mob ntev nrog kev kawm ntev ua rau kev txhim kho ntawm obstructive emphysema, cor pulmonale, thiab pulmonary heart. ua tsis tiav.
Kev tshwm sim ntawm cov kab mob ntsws ntev ntev emphysema
Lub hauv paus morphological ntawm tus kab mob no tau tshwm sim nyob rau hauv kev nthuav dav ntawm lub lumen ntawm bronchioles thiab alveoli vim muaj kev cuam tshuam ntev ntawm cov hlab ntsws tiv thaiv keeb kwm yav dhau los ntawm kev txhim kho mob ntsws ntev thiab bronchiolitis. Lub ntsws tau nce airiness thiab nce loj.
Daim duab kho mob ntawm COPD no yog vim qhov txo qis hauv thaj tsam ntawm kev sib pauv roj thiab txo qis hauv lub ntsws. Cov tsos mob ntawm cov txheej txheem pathological no tshwm sim maj mam, thaum tus neeg mob ntsib kev ua tsis taus pa, hnoos me me nrog hnoos qeev, poob phaus.
Nyob rau hauv kev tshuaj xyuas, lub thoob-puab hloov pauv hauv cov qauv anatomical ntawm lub hauv siab, cyanosis ntawm daim tawv nqaij, kev hloov ntawm cov ntsia hlau daim hlau ntawm cov ntiv tes tau pom. Pathology ntsig txog kev faib tawm dav dav ntawm cov kab mob ntsws ntev feem ntau nrog cov kab mob sib kis, pulmonary los ntshav, pneumothorax. Kev ua pa tsis ua haujlwm tuaj yeem ua rau tus neeg mob tuag taus.
Bronchiectasis
Pathological anatomy ntawm cov kab mob ntsws uas tsis muaj qhov tshwj xeeb muaj xws li kev hloov pauv hauv cov qauv ntawm txoj kev ua pa. Bronchiectasis yog tus cwj pwm los ntawm sac-zoo li, cylindrical lossis fusiform extensions ntawm bronchi. Cov phenomena no hu ua bronchiectasis. Lawv tuaj yeem ua tau hauv zos lossis txawv txav, congenital lossis kis tau.
Qhov tshwm sim ntawm congenital chronic nonspecific kab mobMob ntsws nyob rau hauv cov me nyuam feem ntau yog vim kev loj hlob tsis zoo ntawm cov qauv ntawm lub bronchopulmonary system nyob rau theem ntawm prenatal thiab postnatal lub sij hawm. Feem ntau, cov kab mob no cuam tshuam nrog kev loj hlob ntawm cov kab mob hauv plab, Sievert-Kartagener syndrome, cystic fibrosis, thiab lwm yam.
Cov cim qhia ntawm daim ntawv tau txais ntawm bronchiectasis tshwm sim tawm tsam keeb kwm yav dhau ntawm bronchopneumonia, mob ntsws ntev lossis muaj lub cev txawv teb chaws nyob rau hauv lub bronchi. Bronchiectasis, zoo li ntau lwm cov kab mob ntsws thiab lawv cov tsos mob hauv cov neeg laus, tshwm sim nws tus kheej hauv daim ntawv hnoos nrog hnoos qeev. Ib tug txawv feature nyob rau hauv cov ntaub ntawv no yog tso tawm daj-ntsuab pus nrog ib tug tsw, thiab nyob rau hauv tsawg zaus hemoptysis yog manifested. Nrog rau qhov exacerbations ntawm cov kab mob no, cov tsos mob tshwm sim zoo ib yam li cov txheej txheem ntawm exacerbations ntawm purulent bronchitis.
Cov teeb meem ntawm tus kab mob ua rau cov ntshav pulmonary, ntsws abscess, ua pa tsis ua haujlwm, amyloidosis, purulent meningitis, sepsis. Ib qho ntawm cov xwm txheej no yog qhov ua rau muaj kev phom sij rau tus neeg mob uas muaj keeb kwm ntawm tus kab mob ntsws uas tsis muaj mob tshwj xeeb. Hauv cov menyuam yaus thiab cov neeg laus, los ntawm txoj kev, xws li pathology yog qhov tsawg heev: feem pua ntawm cov kab mob bronchiectasis nyob rau hauv kev sib raug zoo rau lwm yam kab mob ntawm lub ntsws yog li ob feem pua.
mob ntsws ntev
Tsis tshua muaj kev hem thawj rau lub neej ntawm tus neeg mob yog mob ntsws ntsws, uas tuaj yeem ua ke cov khoom siv inflammatory, carnification, mob ntsws thiab mob ntsws abscesses,bronchiectasis, pneumofibrosis. Tias yog vim li cas tsis yog txhua tus kws sau ntawv pom zoo nrog kev suav nrog cov kab mob no hauv kev faib cov kab mob ntsws raws li kev ywj pheej nosology. Nrog rau txhua qhov exacerbation ntawm mob ntsws, qhov ua kom pom tseeb ntawm qhov mob tshwm sim hauv lub ntsws cov ntaub so ntswg thiab thaj tsam ntawm sclerotic hloov zuj zus.
Cov tsos mob ntawm tus mob ntsws ntev: hnoos tsis tu ncua nrog cov hnoos qeev thaum lub sij hawm tshem tawm, purulent - thaum lub sij hawm exacerbation, nrog rau mob hawb pob hauv lub ntsws. Thaum lub sijhawm mob hnyav ntawm tus kabmob, qhov nce hauv lub cev kub feem ntau tshwm sim, mob hauv siab tshwm sim, thiab ua pa tsis ua haujlwm tshwm sim. Feem ntau tus kab mob no nyuaj los ntawm pulmonary plawv tsis ua hauj lwm, abscesses thiab gangrene ntawm lub ntsws.
Pneumosclerosis
Rau cov kab mob ntsws uas tsis yog tshwj xeeb nrog cov kab mob pneumosclerosis, tshwm sim nrog kev hloov pauv ntawm cov ntaub so ntswg parenchyma nrog cov ntaub so ntswg sib txuas, suav nrog cov kab mob hu ua "pneumosclerosis". Qhov tshwm sim no tshwm sim los ntawm inflammatory-dystrophic tej yam kev mob nyob rau hauv lub ntsws thiab ua rau kom qhuav, airlessness thiab compaction ntawm lub ntsws. Feem ntau cov kab mob no yog qhov tshwm sim ntawm kev mob ntsws ntev, BEB (bronchiectasia), COPD, mob ntsws ntsws, fibrosing alveolitis, tuberculosis thiab ntau lwm cov txheej txheem inflammatory.
Cov tsos mob tseem ceeb ntawm qhov tshwm sim ntawm pneumosclerosis yog ua tsis taus pa, uas tshwm sim txawm tias muaj kev siv zog me ntsis. Tsis ntev nws pib cuam tshuam tas li, txawm tias thaum so. Lwm qhov cim qhia ntawm tus kab mob no yog hnoos. Nyob ntawm qhovqhov degree ntawm kev puas tsuaj rau lub ntsws pneumosclerosis tuaj yeem tshwm sim nws tus kheej hauv daim ntawv ntawm hnoos me ntsis los yog hacking thump. Qee zaum daim duab kho mob tau ntxiv los ntawm cyanosis ntawm daim tawv nqaij thiab mob hauv siab. Raws li cov ntaub so ntswg sib txuas hauv lub ntsws nce, cov tsos mob tau pom ntau dua.
COPD in pediatrics
Cov menyuam yug ntxov ntxov yog qhov muaj feem pheej hmoo ntawm cov kab mob ntsws ntev hauv cov menyuam yug tshiab, vim tias cov kabmob ntawm cov kab mob bronchopulmonary tau tsim nyob rau theem kawg ntawm kev loj hlob ntawm lub tsev menyuam. Yog li ntawd, cov me nyuam ntxov ntxov nyob rau hauv qhov kev pheej hmoo ntawm ib feem ntawm lub ntsws underdeveloped. Feem ntau cov kab mob ntawm lub bronchopulmonary system nyob rau hauv cov me nyuam mos yog bronchopulmonary dysplasia (BPD) thiab congenital malformations ntawm lub ntsws, txawm li cas los xij, lawv feem ntau kuaj tau nrog lwm cov kab mob inflammatory.
mob ntsws yog ib yam mob tshwm sim hauv cov menyuam yaus, feem ntau tshwm sim los ntawm tus mob khaub thuas, mob caj pas, lossis kis tau yooj yim hauv huab cua. Feem ntau cov menyuam yaus uas muaj tus kab mob no nyob rau hauv daim ntawv mob hnyav hauv thawj 3 xyoos ntawm lub neej yuav mob ntsws ntsws. Qhov kev ncua ntev thiab tom qab mob ntev ntawm cov kab mob no yog vim muaj kev ua txhaum ntawm kev ua haujlwm ntawm lub bronchi, uas provokes txoj kev loj hlob ntawm hypoventilation, atelectasis, lub zos purulent bronchitis, kab mob ntawm bronchopulmonary lymph nodes thiab kev puas tsuaj ntawm lub ntsws cov ntaub so ntswg.
Nrog tag nrho cov kev ua haujlwm tsis zoo thiab cov kab mob ntawm lub ntsws, lawv cov tsos mob qhia tias muaj qhov deformations thiab nthuav dav hauv cov qauv ntawm bronchi, nrog raucov tsos mob ntawm tus mob bronchitis. Qhov no tshwm sim vim qhov kev loj hlob ntxov ntawm mob ntsws ntsws, thaum nyob rau hauv cov ceg me me ntawm cov bronchi muaj qhov sib txuam ntawm cov hnoos qeev.
Predisposing Factors rau kev loj hlob ntawm cov kab mob ntev feem ntau:
- cuam tshuam hauv kev tsim thiab malformations ntawm bronchopulmonary thiab vascular systems ntawm lub ntsws;
- congenital thiab kis tsis ua haujlwm ntawm mucociliary apparatus;
- mob ntev ntawm cov kab mob ENT;
- kab mob immunodeficiency;
- kev cuam tshuam ecopathogenic cuam tshuam ntawm ib puag ncig;
- kev haus luam yeeb;
- tsis zoo rau keeb kwm yav dhau los: kev pub mis, diathesis, congenital pathologies ntawm immunogenesis, thiab lwm yam.
Kev tshawb fawb microbiological ntawm hnoos qeev thiab bronchial swabs feem ntau qhia cov kab mob pneumococcal thiab staphylococcal. Hauv cov menyuam yaus feem ntau thaum lub sij hawm exacerbation ntawm tus kab mob no tsis yog tshwj xeeb ntawm lub ntsws, kev koom tes ntawm cov kab mob kis tau raug lees paub. Mob ntsws ntsws ntev yog tus cwj pwm los ntawm qhov muaj kev hloov pauv ntawm sclerotic hauv thaj chaw cuam tshuam ntawm lub ntsws. Hauv qhov no, cellular lymphoid infiltrates feem ntau tsim, ua rau compression ntawm cov pa me me.
Cov txheej txheem inflammatory, uas tshwm sim thawj zaug nrog lub sijhawm ntev thiab tom qab ntawd mob ntsws ntsws, maj mam txo qis, muab txoj hauv kev rau kev mob ntsws hauv zos. Thaum tsis muaj kev kho mob txaus, nrog rau lub hnub nyoog ntawm tus neeg mob, cov tsos mob ntawm bronchiectasis pib muaj nyob rau hauv daim duab kho mob ntawm tus kab mob. Feem ntau tus neeg laus tus neeg mob tsis txawmkwv yees txog kev sib raug zoo ntawm bronchiectasis tam sim no nyob rau hauv nws thiab qhov tsis zoo tam sim no ntawm kev mob ntsws ntsws raug mob thaum yau.
Kev kuaj mob thiab kho tus mob COPD thaum yau
Cov mob ntsws ntev hauv cov menyuam yaus tuaj yeem kuaj tau hauv tsev kho mob nkaus xwb nrog kev pab ntawm cov kws kho mob nyuaj thiab kev tshawb fawb hluav taws xob siv bronchoscopy, bronchography thiab kuaj kuaj. Nyob rau hauv x-ray duab ntawm lub ntsws nyob rau hauv mob ntsws, muaj ib tug txhim khu kev qha pulmonary qauv, uas muaj ib tug kom meej meej deformation nrog ib tug txo nyob rau hauv lub ntim ntawm ib tug segments thiab thickening ntawm phab ntsa ntawm lub bronchi.
Cov theem ntawm exacerbation thiab tshem tawm yog txiav txim siab los ntawm kev txiav txim siab txog kev ua haujlwm ntawm daim duab kho mob, kev kuaj kab mob microbiological thiab cytological ntawm cov hnoos qeev thiab cov ntsuas kev ua haujlwm ntawm qhov mob (qhov sib piv ntawm ESR hauv cov ntshav, hloov pauv ntawm leukocyte suav, zoo CRP).
Nyob rau hauv kev kho mob ntsws ntsws nyob rau hauv cov me nyuam, tib txoj kev yog siv raws li nyob rau hauv kev kho mob ntawm tus mob. Lub hom phiaj tseem ceeb ntawm kev kho mob tsis tu ncua yog kev kho dua tshiab ntawm kev ua haujlwm ntawm lub bronchi thiab normalization ntawm kev tiv thaiv kab mob hauv lub cev. Tom qab kev kho mob zoo, sanatorium theem ntawm kev rov zoo thiab kev kuaj mob tsis tu ncua hauv tsev kho mob raug pom zoo. Yog tias kev kho mob tsis zoo, kev phais yuav raug siv.
Nrog rau lub koom haum tsim nyog ntawm kev soj ntsuam hauv lub tsev kho mob thiab kev kho mob kom txaus ntawm cov mob ntsws ntev hauv cov menyuam yaus, qhov kev cia siab ntawm cov kab mob no kuj muaj txiaj ntsig zoo. Txawm li cas los xij, tseem muaj kev pheej hmoo ntawm kev tsim lwm hom COPD tom qab hauv lub neej.
Kev tiv thaiv kab mob ntsws ntev hauv menyuam yaus
Kev tiv thaiv los tiv thaiv kev loj hlob ntawm cov kab mob ntsws hauv cov menyuam yug tshiab yog, ua ntej ntawm tag nrho:
- Kev tiv thaiv fetal fetal.
- Nco ntsoov pub mis niam.
- Tiv thaiv tus menyuam los ntawm kev mob ua pa nyuaj.
- Kev kho mob ntawm cov kab mob sib kis thiab nyuaj ntawm cov kab mob ua pa.
- Systematic hardening.
Kev kuaj mob ntawm cov kab mob ntsws tsis zoo rau cov neeg laus
Kev txheeb xyuas ntau hom COPD yog ua los ntawm tus kws kho mob pulmonologist. Hauv qhov no, cov yam ntxwv ntawm kev kho mob tshwm sim ntawm pathology, nrog rau cov txiaj ntsig ntawm kev kuaj thiab ntsuas ntsuas tau muab coj los rau hauv tus account:
- txhawm rau kuaj xyuas cov txheej txheem pathological, nws yog ib qho tsim nyog yuav tsum tau ua daim ntawv ntsuam xyuas hluav taws xob, uas, yog tias tsim nyog, tuaj yeem ntxiv los ntawm cov kab lossis suav tomography ntawm lub hauv siab. Ib txwm siv hauv siab x-ray tseem yog qhov kev xaiv thawj zaug rau kev kuaj mob ua pa ntawm cov menyuam yaus thiab cov neeg laus. Cov txheej txheem no muaj cov hluav taws xob tsawg tshaj plaws, yog qhov qhia tau zoo thiab siv tau. Nws yog raws li cov lus qhia ntawm cov xov tooj cua tshawb fawb uas xav tau kev siv cov kev tshawb fawb ntxiv lossis tshwj xeeb yog txiav txim siab. Nrog kev pab ntawm X-ray ntawm lub ntsws, nws muaj peev xwm los saib xyuas kev txhim kho ntawm cov txheej txheem pathological. Qhov no tso cai rau kev kho kho yog tias tsim nyog.
- txhawm rau txheeb xyuas cov kev hloov pauv hauv tsob ntoo bronchialbronchoscopy, angiopulmonography thiab bronchography tau ua (kev kuaj hnoos qeev lossis kuaj ntshav yog tias tsim nyog).
- Txhawm rau txiav txim siab txog kev ua haujlwm ntawm cov txheej txheem pathological thiab qhov xwm txheej ntawm nws cov tsos, koj tuaj yeem siv txoj kev tshawb fawb ntawm cov hnoos qeev lossis cov tshuaj tua kab mob thiab microbiological swabs los ntawm bronchi.
- Koj tuaj yeem ntsuas qhov kev ua haujlwm ntawm lub bronchopulmonary system siv txoj kev tshawb fawb txog kev ua pa (kev ua haujlwm ntawm kev ua pa sab nraud).
- Cov tsos mob ntawm kev hloov pauv hauv lub siab ntawm lub plawv tuaj yeem lees paub siv EchoCG thiab ECG.
Raws li cov txiaj ntsig ntawm kev tshawb fawb txog kev hloov pauv morphological hauv kev ua pa, tus kws kho mob yuav tuaj yeem muab cov lus pom zoo rau kev kho mob. Cov kab mob uas tsis yog mob ntsws ntev yuav tsum tau saib xyuas thiab kho tas li.
kho COPD hauv cov neeg laus
Kev kho mob ntawm cov kab mob ntsws tsis tshwj xeeb feem ntau txiav txim siab los ntawm cov yam ntxwv ntawm etiological, cov txheej txheem pathogenetic, qib ntawm kev hloov pauv morphofunctional thiab qhov hnyav ntawm cov txheej txheem. Txawm li cas los xij, nws muaj peev xwm txheeb xyuas qee qhov kev lees paub feem ntau rau kev kho mob ntawm kev ywj pheej ntawm COPD.
Txhawm rau kom tsis txhob kis kab mob thiab mob pathologies hauv bronchopulmonary system, cov tshuaj tua kab mob raug xaiv nyob ntawm qhov rhiab heev ntawm microflora. Nco ntsoov sau tshuaj bronchodilators, expectorants thiab secretolytic tshuaj.
Bronchoalveolar lavage yog siv rau kev huv bronchial. Nyob rau theem no, physiotherapy, postural drainage thiab hauv siab vibration massage feem ntau yog muab.hlwb. Thaum ua tsis taus pa tshwm sim, kev siv cov tshuaj bronchodilators thiab cov pa oxygen kho tau raug pom zoo.
Nyob rau theem ntawm kev zam txim, nws raug nquahu kom ua raws li tus kws kho mob pulmonologist, kev kho mob sanatorium, kev kho mob qoj ib ce, kev siv speleotherapy thiab aerophytotherapy, nrog rau kev siv tshuaj ntsuab adaptogens thiab immunomodulators. Qee zaum, nws raug nquahu kom sau cov tshuaj glucocorticosteroids. Txhawm rau kom tswj tau qhov tshwm sim ntawm cov kab mob ntsws ntev thiab cov kab mob sib kis tau zoo, nws yog qhov tsim nyog los xaiv txoj kev kho mob yooj yim.
Cov lus nug ntawm kev cuam tshuam kev phais hauv COPD tsuas yog hais txog qhov tshwm sim ntawm kev kho mob ntawm qhov tsis tu ncua hauv zos morphological hloov pauv hauv tus neeg mob ua pa. Nyob rau hauv cov ntaub ntawv no, resection ntawm cov cheeb tsam cuam tshuam yog feem ntau resorted rau. Nrog rau kev loj hlob ntawm ob sab diffuse pneumosclerosis, kev hloov lub ntsws tuaj yeem raug pom zoo.
