mob ntsws nyob rau hauv cov neeg laus muaj ntau heev. Cov neeg mob Bedridden thiab debilitated, nrog rau cov neeg mob uas muaj kab mob ntev, tshwj xeeb tshaj yog raug rau cov kab mob no. Thaum muaj hnub nyoog laus, mob ntsws feem ntau tshwm sim nrog cov tsos mob atypical. Vim li no, kev kuaj mob thiab kev kho mob feem ntau qeeb, thiab kev mob ntsws hnyav tuaj yeem ua rau muaj teeb meem loj. Nyob rau hauv tsab xov xwm, peb yuav txiav txim siab nyob rau hauv kom meej qhov ua rau thiab nta ntawm cov tsos mob ntawm mob ntsws nyob rau hauv lub hnub nyoog laus, raws li zoo raws li txoj kev kho no pathology.
hnub nyoog hloov pauv hauv lub cev ua pa
Ib qho ua rau muaj kev mob ntsws ntsws hauv cov neeg laus thiab cov neeg laus yog cov hnub nyoog cuam tshuam txog kev hloov pauv hauv lub ntsws. Nyob rau lub sijhawm no ntawm lub neej, tib neeg lub cev ua pa yog qhov txawv ntawm cov yam ntxwv hauv qab no:
- Cov phab ntsa ntawm lub ntsws vesicles (alveoli) ua thinner thiab tsawg duaelastic.
- Muaj atrophy ntawm bronchial thiab tracheal mucosa.
- Lub peev xwm ntawm lub ntsws deteriorates.
- Kev nqus pa tob dhau thiab tso pa tawm qeeb feem ntau tau sau tseg. Qhov no yog vim qhov tseeb tias lub ntsws ntawm tus neeg laus noj cov pa ntau dhau.
- Cov pob txha ntawm lub bronchi thiab trachea raug dystrophy.
Cov kev hloov pauv hnub nyoog no ua rau muaj kev cuam tshuam tsis zoo ntawm cov pa pauv, oxygen tshaib plab ntawm cov ntaub so ntswg thiab nce siab ntawm carbon dioxide hauv cov ntshav.
Txhob Cia Siab
Muaj ntau yam tsis zoo uas ua rau muaj kev pheej hmoo mob ntsws rau cov neeg laus. Cov no suav nrog:
- Mobility tsawg. Feem ntau pneumonia tshwm sim hauv cov neeg laus uas tsis muaj txaj pw. Qhov tsis muaj zog ua rau stagnation ntawm cov ntshav, thiab tom qab ntawd mus rau kev nthuav dav ntawm cov hlab ntsha pulmonary. Enlarged capillaries nias ntawm pulmonary vesicles. Cov ntaub so ntswg compressed yog qhov kis tau yooj yim thiab kis tau yooj yim.
- Kab mob ntawm cov kab mob hauv nruab nrog cev. Thaum muaj hnub nyoog laus, mob plawv pathologies, ntshav qab zib mellitus, thiab kab mob raum feem ntau tau sau tseg. Tag nrho cov kab mob no tuaj yeem ua rau mob ntsws ntsws.
- Nyob hauv tsev kho mob. Thaum muaj hnub nyoog laus, ntau yam kab mob ntev heev feem ntau zuj zus, thiab cov neeg laus yuav tsum mus rau hauv tsev kho mob. Cov kws kho mob paub qhov txawv ntawm nosocomial (tsev kho mob) daim ntawv ntawm mob ntsws. Cov kab mob no tuaj yeem tshwm sim ob peb hnub tom qab tus neeg mob nkag mus rau hauv tsev kho mob. Hom mob ntsws no tshwm sim hauv cov neeg mob tom qab bronchoscopy, thiabtom qab kev phais mob. Cov neeg mob ua pa kuj tseem muaj kev pheej hmoo ntawm mob ntsws.
- Kev haus luam yeeb. Raws li twb tau hais lawm, nyob rau hauv cov neeg laus, lub ntsws cov ntaub so ntswg undergoes lub hnub nyoog kev hloov. Yog li ntawd, cov teebmeem ntawm nicotine ntawm cov hlab ntsws ua rau muaj kev phom sij tshwj xeeb.
- Kev siv tshuaj tua kab mob tsis muaj zog. Feem ntau, cov neeg laus uas muaj kab mob sib kis tau siv cov tshuaj tua kab mob ntau dhau. Qhov no tuaj yeem ua rau txo qis hauv kev tiv thaiv.
Kev mob ntsws ntsws hnyav dua yog tias tus neeg mob keeb kwm muaj ntau dua ob yam saum toj no. Nyob rau hauv cov ntaub ntawv no, kev soj ntsuam ntawm mob ntsws nyob rau hauv cov neeg laus yog loj heev.
Cov tsos mob thiab hom kab mob
Cov tsos mob ntawm tus kab mob nyob ntawm qhov loj thiab qhov chaw ntawm qhov txhab. Txawm li cas los xij, cov tsos mob tshwm sim ntawm mob ntsws hauv cov neeg laus tuaj yeem txheeb xyuas:
- hnoos (qhuav lossis ntub);
- ua pa nyuaj;
- ntiv tes xiav;
- kub nce;
- mob hnyav thiab mob hauv siab.
Txawm li cas los xij, thaum muaj hnub nyoog laus, daim duab kho mob ib txwm ua rau mob ntsws tsis tshua pom. Tus kab mob no feem ntau yog atypical. Tus neeg mob laus zuj zus, nws nyuaj rau kuaj mob ntsws.
Tus kab mob tuaj yeem pib tshwm sim hauv paj hlwb vim ua pa tsis ua haujlwm thiab hypoxia. Hauv qhov no, tus neeg laus muaj cov tsos mob ntawm cerebral ischemia thiab kev puas siab puas ntsws. Feem ntaumob ntsws nyob rau hauv cov neeg laus yog nrog los ntawm mob nyob rau hauv lub plawv los yog dyspeptic tsos mob. Tsis tas li ntawd, ntau lwm cov kab mob ntev ntev tshwm sim thaum mob ntsws hauv cov neeg laus.
mob ntsws rau cov neeg laus feem ntau nrog cov tsos mob tshwm sim ntxiv:
- pab siab;
- drowsy;
- kev tsis sib haum;
- kev tsis nco qab;
- mob ob txhais ceg vim mob venous;
- arrhythmia.
Raws li twb tau hais lawm, cov tsos mob ntawm tus kab mob feem ntau yog nyob ntawm hom txheej txheem inflammatory. Hauv cov tshuaj, cov kab mob ntsws hauv qab no yog qhov txawv:
- unilateral focal;
- tag nrho;
- ob npaug;
- stagnant;
- interstitial.
Tom ntej no, peb yuav txiav txim siab nthuav dav cov tsos mob thiab cov yam ntxwv ntawm mob ntsws rau cov neeg laus, nyob ntawm seb hom kab mob.
Local form
Unilateral focal pneumonia tshwm sim ntau zaus hauv cov neeg mob uas muaj kab mob plawv thiab cov hlab ntsha, nrog rau ischemia. Hauv cov kab mob no, cov txheej txheem pathological cuam tshuam rau ib ntu ntawm lub ntsws cov ntaub so ntswg. Pathology yog nrog los ntawm kub taub hau thiab tachycardia. Cov neeg laus mob siab rau tus kab mob no.
mob ntsws rau cov neeg laus dua 85 feem ntau tshwm sim hauv daim ntawv macrofocal. Nyob rau hauv rooj plaub no, ib ntu loj ntawm cov kab mob ua pa cuam tshuam. Muaj qhov txo qis hauv qhov ntim ntawm lub hauv siab los ntawm ib sab ntawm lub ntsws o. Qhov no pathology yog nrog los ntawm sai thiab ua pa nyuaj, thiabua tsis taus pa.
daim foos
Nyob rau hauv lobar pneumonia, tag nrho ntu ntawm lub ntsws ua rau mob. Feem ntau cov txheej txheem pathological kis mus rau pleura. Hom mob ntsws no thaum muaj hnub nyoog laus yog tsawg heev.
Croupous pneumonia nyob rau hauv cov neeg laus feem ntau atypical. Hauv cov neeg mob hluas, tus kab mob no ib txwm pib ua npaws muaj zog thiab ua rau muaj kev noj qab nyob zoo. Hauv cov neeg mob laus, qhov kub thiab txias feem ntau yog nce siab, thiab kev kuaj ntshav pom tsuas yog me ntsis leukocytosis. Tus kab mob feem ntau tshwm sim nyob rau hauv daim ntawv erased. Feem ntau lobar pneumonia pib nrog mob hauv plawv, zoo ib yam li kev tawm tsam ntawm angina pectoris. Qhov no ua rau kev kuaj mob nyuaj dua.
Cov neeg mob laus yws ntawm hnoos qhuav. Nyob rau tib lub sijhawm, hnoos qeev tawm lawv nyuaj. Xws li daim duab kho mob tshem tawm ntawm tus kab mob no yog qhov txaus ntshai heev. Nyob rau hauv cov neeg laus, lub plawv thiab ua pa tsis ua hauj lwm tshwm sim sai heev tiv thaiv keeb kwm ntawm lobar pneumonia. Cov teeb meem zoo li no nrog rau kev puas tsuaj loj hauv tus mob:
- ua tsis taus pa hnyav;
- daim tawv nqaij xiav;
- pab tawm.
Vim vim tsis muaj oxygen, lub hlwb hypoxia tshwm sim, uas ua rau muaj kev hloov pauv tsis zoo ntawm lub paj hlwb. Nyob rau hauv lub xub ntiag ntawm cov teeb meem, croupous pneumonia nyob rau hauv cov neeg laus xaus tuag nyob rau hauv 30-40% ntawm cov neeg mob.
Bilateral pneumonia
Nyob rau hauv cov kab mob no, qhov mob tau kuaj pom hauv ob lub ntsws. Nws tuaj yeem yog focal, hauv qhov norooj plaub, tsuas yog ib feem ntawm cov ntaub so ntswg raug cuam tshuam. Tseem muaj tag nrho ob sab ntsws ntsws, uas cov txheej txheem inflammatory cuam tshuam rau tag nrho lub ntsws cov ntaub so ntswg.
Kev mob ntsws ob sab hauv cov neeg laus feem ntau tshwm sim tawm tsam keeb kwm ntawm kev ua pa. Feem ntau, pathology tshwm sim nyob rau hauv daim ntawv focal. Hauv qhov no, cov tsos mob hauv qab no tau sau tseg:
- kub nce (txog +40 degrees);
- ua pa nyuaj;
- daim tawv nqaij xiav;
- mob plab;
- hnoos aggravated by txav.
Tus kab mob muaj qhov tsis zoo, vim qhov mob feem ntau cuam tshuam rau cov ntsws loj.
Tag nrho qhov mob yog qhov tsawg heev. Hom kab mob no yog nrog los ntawm kev ua tsis taus pa hnyav. Vim yog lub paj hlwb hypoxia, cov kab mob neurological tshwm sim: tsis meej pem, tsaug zog los yog arousal ntau dhau.
Congestive Pneumonia
Hom kab mob no tshwm sim hauv cov neeg mob pw hauv txaj. Qhov ua rau ntawm tus kab mob yog kev ua txhaum ntawm cov ntshav ncig thiab ntxiv rau cov kab mob sib kis. Congestive pneumonia nyob rau hauv cov neeg laus feem ntau yog disguised raws li cov cim qhia ntawm ib tug hauv paus pathology. Piv txwv li, hauv cov neeg mob pw hauv txaj nrog mob stroke, cov tsos mob ntawm lub paj hlwb yuav raug sau tseg thaum pib ntawm tus kab mob. Tsis tas li ntawd, nyob rau hauv cov neeg mob uas muaj pob txha pob txha, qhov pib tshwm sim ntawm mob ntsws yuav mob pob txha. Yog li ntawd, nrhiav pom kab mob ntsws nyob rau theem pib yog qhov nyuaj heev.
Cov cim qhia txog kev mob ntsws ntsws hauv cov neeg laus feem ntau tshwm sim tsuas yog nyob rau theem siabkab mob. Qhov no tau qhia hauv cov tsos mob hauv qab no:
- nce me ntsis hauv qhov kub (txog +38 degrees);
- hnoos;
- hnoos qeev nrog cov kua paug thiab cov ntshav;
- poob qab los;
- nausea.
Cov kab mob ntsws ib txwm muaj nrog kev mob ntawm lub plawv: mob hauv lub sternum, arrhythmia, cuam tshuam. Qee qhov xwm txheej, hauv cov neeg laus, cov kab mob pathology nce atypically. Tsis muaj cov tsos mob ua pa, tab sis cov tsos mob dyspeptic tshwm sim (raws plab, xeev siab, ntuav).
Daim paib phom sij yog ua pa nrawm (ntau dua 20 ua pa ib feeb) thiab hnov tsw. Cov tsos mob zoo li no qhia kev puas tsuaj rau thaj tsam loj ntawm lub ntsws. Raws li qhov tshwm sim ntawm hypoxia, cov neeg mob tsim kev puas tsuaj ntawm lub hauv paus paj hlwb. Tus neeg mob pw tsaug zog feem ntau ntawm ib hnub, nws hais lus tsis sib haum.
Interstitial shape
Nyob rau hauv cov kab mob no, qhov mob ntawm lub ntsws interstitial tshwm sim, nrog rau kev hloov pauv fibrotic. Qhov tseeb ua rau mob ntsws interstitial hauv cov neeg laus tsis tau piav qhia. Tus kab mob no feem ntau tshwm sim hauv cov neeg mob uas tsis muaj kev tiv thaiv thiab cov neeg haus luam yeeb.
Interstitial pneumonia yog nrog los ntawm cov tsos mob hauv qab no:
- ua tsis taus pa;
- mob plab;
- xov xwm;
- kev tshaib kev nqhis;
- qhov kub nce mus rau subfebrile cov nuj nqis.
Nov yog ib hom mob ntsws uas txaus ntshai tshaj plaws. FibrousCov kev hloov pauv hauv cov ntaub so ntswg tsis tu ncua, uas ua rau muaj kev ua pa hnyav thiab lub plawv tsis ua haujlwm. Nrog rau qhov mob sclerotic ntau ntawm lub ntsws, qhov kev cia siab ntawm tus kab mob yog qhov tsis zoo.
Diagnosis
mob ntsws hauv cov neeg laus feem ntau atypical, nrog cov tsos mob tsis pom kev. Qhov no pathology tuaj yeem ua rau ntau yam kab mob senile. Vim li no, kev kuaj mob ntsws yog qhov nyuaj heev.
Tus kws kho mob auscultating tus neeg mob. Nws yog ib qho tseem ceeb rau kev sib txawv ntawm kev mob ntsws los ntawm cov kab mob plawv, kab mob hauv lub paj hlwb, thiab tuberculosis. Rau lub hom phiaj no, cov neeg mob tau muab tshuaj ntsuam xyuas hauv qab no:
- lung X-ray;
- bronchoscopy;
- kuaj ntshav thiab zis (kom pom qhov mob);
- hnoos qeev rau bakposev (nrog kev txiav txim siab ntawm cov kab mob rhiab heev rau cov tshuaj tua kab mob);
- MRI thiab CT ntawm lub ntsws.
mob ntsws nyob rau hauv cov neeg laus feem ntau yog kho hauv tsev kho mob. Tus kab mob no thaum muaj hnub nyoog laus heev feem ntau tshwm sim tsis zoo thiab ua rau muaj teeb meem loj. Yog li, tus neeg mob yuav tsum nyob rau hauv kev saib xyuas ntawm cov neeg ua haujlwm kho mob. Kev kho mob hauv tsev tsuas yog ua tau thaum mob me.
YAntibacterial therapy
Kev kho mob tseem ceeb rau mob ntsws hauv cov neeg laus yog kev kho tshuaj tua kab mob. Ua ntej sau tshuaj, nws raug nquahu kom ua cov tshuaj hnoos qeev rau bakposev txhawm rau txiav txim siab qhov rhiab ntawm cov kab mob mus rau cov tshuaj. Txawm li cas los xij, tos rau qhov tshwm simkev tshawb fawb qee zaum yuav siv sij hawm ntev heev, thiab kev kho mob ceev heev. Yog li ntawd, broad-spectrum tshuaj tua kab mob raug sau tseg thaum pib ntawm tus kab mob, thiab tom qab ntawd kho kho kho raws li cov txiaj ntsig ntawm kev kuaj kab lis kev cai.
Cov tshuaj tua kab mob hauv qab no tau sau tseg:
- Y"Amoxiclav".
- "Benzylpenicillin".
- "Ampicillin".
- "Ceftriaxone".
- "Erythromycin".
Lub sijhawm kho yog nyob ntawm hom kab mob ntsws. Feem ntau, kev kho tshuaj tua kab mob kav ntev li 10 hnub. Yog tias qhov mob tshwm sim los ntawm chlamydia lossis mycoplasma, ces nws yuav tsum tau noj tshuaj tua kab mob li 2 lub lis piam.
Nws yog ib qho tseem ceeb uas yuav tsum nco ntsoov tias kev siv nyiaj mus sij hawm ntev tuaj yeem ua rau muaj kab mob fungal. Thaum kho, cov neeg laus muaj kev pheej hmoo ntawm candidiasis. Yog li ntawd, nrog rau cov tshuaj tua kab mob, cov neeg laus yuav tsum tau noj tshuaj tiv thaiv kab mob ("Nystatin") thiab cov vitamin complexes kom muaj zog tiv thaiv kab mob ("Dekamevit", "Undevit").
kev kho ntxiv
Ua ke nrog kev kho tshuaj tua kab mob, kev kho mob ntsws ntsws hauv cov neeg laus tau ua tiav. Thaum muaj hnub nyoog laus, cov neeg mob feem ntau txhawj xeeb txog kev hnoos, thaum hnoos qeev feem ntau nyuaj los tawm. Yog li, cov neeg mob tau muab tshuaj bronchodilators:
- "Eufillin".
- "Euspiran".
- "Salbutamol".
- "Berotek".
Nyob rau hauv hnub nyoog laus, bronchodilators raug pom zoo nyob rau hauv daim ntawv ntawm aerosols. Qhov no tso cai rau koj txo cov tshuaj thauj khoom ntawm lub cev.
Mucolitics tau qhia rau cov hnoos qeev hauv cov neeg laus:
- "Lazolvana".
- "Muk altina".
- "ACC".
- "Ambrobene".
Broncholytics thiab mucolytics pab txhawb tus neeg mob ua pa thiab pab txo qis hypoxia. Nyob rau hauv qhov ua tsis taus pa hnyav heev, cov tshuaj uas txhawb txoj kev ua pa ntawm txoj kev ua pa ("Cordiamin", "Caffeine")
Nyob rau hauv cov neeg laus, mob ntsws ntsws feem ntau nrog rau kev mob plawv. Nrog cov tsos mob ntawm lub plawv tsis ua hauj lwm, kev siv plawv glycosides raws li strophanthin tau qhia. Yog tias tus neeg mob muaj arrhythmia, ces muab cov tshuaj uas normalize lub plawv dhia ("Bisoprolol", "Metaprolol", "Verapamil")
Muaj Teeb Meem
Kev mob ntsws ntsws thaum laus yog qhov tseem ceeb heev kom kho tau raws sijhawm. Yog tias qhov kev kuaj mob tau lig dhau lawm, tom qab ntawd qhov kev kho tsis ntev ntev tuaj yeem ua rau muaj teeb meem hauv qab no:
- mob plawv thiab ua pa tsis ua haujlwm;
- pulmonary edema;
- ntshav lom;
- pleurisy.
Nws tseem ceeb heev kom tsis txhob cuam tshuam kev kho mob. Txawm hais tias tus neeg mob tus mob tau zoo tuaj tom qab ob peb hnub, nws yog ib qho tsim nyog yuav tau ua kom tiav cov kab mob tua kab mob.kev kho mob. Ib qho ua rau muaj teeb meem yog kev txiav tawm ntxov ntxov ntawm cov tshuaj tua kab mob. Hauv qhov no, cov tsos mob ntawm mob ntsws tuaj yeem rov qab los, thiab tus kab mob yuav hnyav dua.
Huab cua
Kev mob ntsws ntsws hauv cov neeg laus nyob ntawm ntau yam:
- hnub nyoog ntawm tus neeg mob;
- muaj cov kab mob ntev;
- xeev ntawm cov hlab plawv;
- thaj chaw thiab kis ntawm cov txheej txheem inflammatory hauv lub ntsws;
Ob sab, croupous thiab congestive daim ntawv ntawm mob ntsws muaj ib tug tsis zoo prognosis. Cov pathologies sai sai ua rau kev loj hlob ntawm lub plawv thiab ua pa tsis ua haujlwm.
Interstitial pneumonia kuj yog qhov txaus ntshai heev. Tus kab mob no ua rau muaj kev hloov pauv tsis tau sclerotic hauv lub ntsws, uas feem ntau ua rau tuag taus.
Kev kuaj mob rau tus mob pneumonia yog qhov zoo dua. Nrog rau kev kho raws sijhawm, tus kab mob feem ntau xaus rau hauv kev rov zoo. Txawm li cas los xij, qhov muaj cov kab mob ntev tuaj yeem ua rau qhov kev mob tshwm sim.
Kev Tiv Thaiv
Yuav ua li cas tiv thaiv mob ntsws thaum laus? Cov kws kho mob qhia ua raws li cov lus qhia no:
- zam hypothermia;
- txiav luam yeeb;
- ua pa ua pa tsis tu ncua;
- tsis txhob siv yeeb tshuaj;
- mus kuaj mob tsis tu ncua thiab x-ray.
Nws yog ib qho tseem ceeb heev los tiv thaiv mob ntsws nyob rau hauv cov neeg mob bedridden. Nws yog ib qho tsim nyog yuav tau saib xyuas cov neeg mob zoo li no. cov laustus neeg yuav tsum tau tig txhua ob teev. Hloov txoj hauj lwm ntawm lub cev tiv thaiv stagnation ntawm cov ntshav. Nyob rau tib lub sijhawm, nws yog ib qho tsim nyog yuav tsum tau nqa tawm massage thiab rubbing nrog kev daws ntawm camphor ntawm lub hauv siab cheeb tsam. Tsis tas li ntawd, cov neeg mob bedridden yuav tsum ua pa ua pa txhua hnub. Qhov no yuav pab tiv thaiv kom tsis txhob muaj kab mob ntsws, uas feem ntau ua rau muaj qhov tsis zoo.
