Sputum yog ib qho zais cia thaum lub sij hawm o ntawm trachea, bronchi thiab ntsws. Nws cov tsos yog sau tseg tsis tau tsuas yog nrog kev puas tsuaj rau cov kab mob ua pa, tab sis kuj nrog kev ua txhaum ntawm lub plawv thiab cov hlab ntsha. Cov txheej txheem rau kev kawm cov hnoos qeev suav nrog kev txiav txim siab macroscopic, tshuaj thiab microscopic ntawm nws cov yam ntxwv.
Yam kev tsom xam pom dab tsi
Kev kuaj hnoos qeev ua rau nws tuaj yeem kuaj xyuas cov kab mob uas ua rau cov txheej txheem pathological, qhia tias muaj mycobacteria hauv tuberculosis, txheeb xyuas cov qog nqaij hlav cancer, ntshav thiab purulent impurities, thiab txiav txim siab cov kab mob tiv thaiv kab mob rau cov tshuaj tua kab mob.
Raws li cov xwm txheej twg yog qhov kev tshuaj ntsuam pom
Sputum kuaj rau kev soj ntsuam dav dav yog ua raws li hauv qab no:
- hnoos;
- pneumonia;
- mob ntawm lub bronchi;
- suppuration ntawm lub ntsws;
- tuberculosis;
- bronchiectasis;
- pulmonary gangrene;
- qog nqaij hlav hauv ntsws;
- mob bronchitis;
- chronic bronchitis;
- mob tonsillitis;
- tuberculosis;
- hnoos;
- silicosis;
- mob khaub thuas obstructive bronchitis;
- pneumonia;
- anthrax.
Npaj rau kev kawm
Mucus yuav sawv tawm zoo dua yog tias koj noj cov tshuaj expectorant hnub ua ntej kuaj lossis haus dej sov ntau. Ua ntej sau, nws raug nquahu kom txhuam koj cov hniav thiab qhov ncauj los ntawm kev yaug nrog dej sov.
Basic collection rules
Nws raug nquahu kom sau cov hnoos qeev rau kev kuaj kab mob bacteriological thaum sawv ntxov (nws khaws hmo ua ntej noj mov) hauv lub thawv uas tsis muaj menyuam uas tau muab los ntawm chav kuaj. Rau kev tsom xam, qhov ntau ntawm 5 ml yog txaus. Qhov zais cia yog txheeb xyuas tsis pub dhau 2 teev tom qab nws sau. Txog rau lub sijhawm xa mus kuaj, lub thawv nrog cov ntsiab lus yuav tsum kaw hauv lub tub yees.
Ntau cov hnoos qeev hauv ntau yam kab mob
Tus nqi ntawm cov tso tawm tso tawm txawv nyob ntawm qhov xwm txheej ntawm cov txheej txheem pathological. Feem ntau nws txawv ntawm ob peb spittles mus rau 1 liter ib hnub twg. Ib qho me me yog tso tawm thaum lub sij hawm o ntawm lub bronchi, congestive txheej txheem nyob rau hauv lub ntsws thiab thaum pib ntawm ib tug nres ntawm bronchial hawb pob. Thaum kawg ntawm kev tawm tsam, lub ntim nce. Nws tuaj yeem ncav cuag li 0.5 litres, thiab tseem sawv tawm hauv qhov ntau yog tias muaj pulmonary edema.
Ntau cov hnoos qeev tawm thaum lub sijhawm ua paug hauv lub ntsws thaum sib txuas lus nrog bronchi, nrog suppuration, bronchiectasis thiabgangrene.
Sputum TB kuaj pom tias mob ntsws puas. Tshwj xeeb, xws li cov txheej txheem provokes kab noj hniav uas sib txuas lus nrog bronchi.
Dab tsi yog vim li cas thiaj li txo lossis nce hauv qhov zais cia
Kev nce ntxiv ntawm qhov tso tawm zais cia tuaj yeem cuam tshuam nrog kev tsis zoo ntawm tus neeg mob tus mob thiab raug soj ntsuam thaum lub sijhawm exacerbation. Qhov kev nce no kuj tseem hais txog qhov muaj txiaj ntsig zoo ntawm kev txhim kho tus kabmob.
Ib qho kev txo qis ntawm cov hnoos qeev zais cia yuav qhia tau tias muaj kev rov qab los ntawm qhov mob lossis ua txhaum cai hauv thaj tsam ntawm cov kua dej ntawm cov kab noj hniav uas muaj cov paug. Tib lub sijhawm, muaj kev puas tsuaj rau tus neeg mob txoj kev noj qab haus huv.
Tus yam ntxwv tawm
Mucoid secretion yog secreted nyob rau hauv mob los yog mob bronchitis, bronchial hawb pob, pneumonia, mob ntsws cancer, bronchiectasis, ntsws echinococcosis nrog suppuration, actinomycosis.
Sputum tov nrog cov kua txiv tau pom nyob rau hauv lub ntsws abscess, echinococcosis thiab bronchiectasis.
Mucus sib xyaw nrog cov ntshav los yog cov ntshav tag nrho yog muaj nyob rau hauv tuberculosis. Cov tsos mob ntawm cov ntshav yuav qhia tau tias muaj oncology, bronchiectasis, suppuration ntawm lub ntsws. Tsis tas li ntawd, qhov tshwm sim no tau pom nyob rau hauv cov tsos mob ntawm nruab nrab lobe, infarction hauv lub ntsws, raug mob, actinomycosis thiab syphilitic lesions. Cov ntshav tseem tuaj yeem tso tawm thaum lub sij hawm lobar thiab focal o ntawm lub ntsws, cov txheej txheem congestive, mob hawb pob thiab pulmonary edema.
Serous sputum yog sau nrog o ntawm lub ntsws.
Sputum kuaj pom nws cov xim sib txawv. Mucous thiab serous paug tsis muaj xim los yog dawb.
Qhov sib ntxiv ntawm cov kua paug muab cov zais zais ntsuab ntsuab, uas qhia txog cov txheej txheem pathological xws li ntsws abscess, gangrene, bronchiectasis, actinomycosis ntawm lub ntsws.
Kev tso tawm nrog cov lus pom ntawm xeb lossis xim av qhia tias lawv tsis muaj cov ntshav tshiab, tab sis cov khoom ntawm nws qhov kev puas tsuaj - hematin. Xws li qhov zais cia tuaj yeem tso tawm nrog lobar pneumonia, anthrax, pulmonary infarction.
Ntsuab xim nrog cov khoom sib xyaw ntawm cov av lossis cov zais zais daj qhia txog kev ua pa ntawm txoj hlab pa ua ke nrog jaundice.
Sputum stains bright yellow in eosinophilic pneumonia.
Ocher-xim mucus muaj nyob rau hauv siderosis ntawm lub ntsws.
Ib daim dub lossis greyish zais cia yog sau thaum muaj cov hmoov av los ntawm cov thee. Nrog pulmonary edema, serous sputum yog pom nyob rau hauv ntau qhov ntau. Raws li txoj cai, nws yog xim sib npaug hauv cov xim pinkish, uas tau piav qhia los ntawm qhov muaj cov qe ntshav liab. Cov paug no zoo ib yam li kua txiv cranberry.
Qhov zais cia kuj tuaj yeem stains los ntawm qee yam tshuaj. Piv txwv li, cov tshuaj tua kab mob Rifampicin tuaj yeem tig liab.
Small
Cov ntxhiab tsw ntawm qhov zais cia tseem tuaj yeem qhia qhov xwm txheej ntawm cov txheej txheem pathological hauv cov kab mob ua pa. Sputum muab cov ntxhiab tsw ntawm rot nrog gangrene ntawm lub ntsws los yog putrefactive kev puas tsuaj rau lub bronchi, oncological neoplasms,Nyuaj necrosis ntawm bronchiectasis.
Nyob hauv txheej
Ntau zaus, txoj kev tshawb fawb ntawm cov zais zis qhia pom muaj cov txheej txheem. Nrog rau tus cwj pwm tsis ruaj khov, cov hnoos qeev sib xyaw nrog cov kua qaub tau pom nrog cov suppuration ntawm lub ntsws thiab bronchiectasis.
Lub rotted zais cia muaj peb txheej. Sab saum toj txheej zoo li ua npuas ncauj, nruab nrab yog serous, thiab hauv qab txheej yog purulent. Cov tshuaj no ua rau lub ntsws gangrene.
Impurities
Admixture ntawm cov zaub mov tuaj yeem pom nyob rau hauv lub xub ntiag ntawm cov qog nqaij hlav hauv txoj hlab pas thaum nws sib txuas nrog bronchi thiab trachea. Thaum echinococcus nkag mus rau hauv bronchi, hooks lossis scolex ntawm cov cab tuaj yeem kuaj pom hauv cov hnoos qeev. Tsawg heev, cov neeg laus ascaris pom, uas nkag mus rau hauv lub ntsws ntawm cov neeg tsis muaj zog.
Pulmonary fluke qe tshwm thaum lub cyst ruptures, uas tsim nyob rau hauv lub ntsws thaum muaj kab mob.
Gangrene thiab suppuration ntawm lub ntsws ua rau cov tsos mob ntawm lub ntsws necrosis. Nrog cov qog, lawv cov khoom tawg tuaj yeem tshwm sim hauv qhov tso tawm.
Cov pob khoom uas muaj Fibrin muaj nyob hauv cov neeg mob fibrinous bronchitis, tuberculosis thiab pneumonia.
Lub cev nplej, lossis Koch lo ntsiab muag, muaj nyob hauv tuberculosis.
Dietrich plugs, uas suav nrog cov khoom lwj ntawm cov kab mob thiab cov ntaub so ntswg ntawm lub ntsws ntawm cov roj ntsha fatty acids, muaj nyob rau hauv putrefactive bronchitis los yog gangrene ntawm lub ntsws.
Daim ntawv mob ntev ntawm tonsillitis cuam tshuam nrog kev tso tawm ntawm cov tonsils, zoo ib yam li Dietrich plugs.
Tshuaj Tshuaj
Sputum tshuaj ntsuam xyuas muaj kev txiav txim siab:
- Qhov taw qhia ntawm cov protein uas tuaj yeem pab hauv kev kuaj mob sib txawv ntawm cov kab mob bronchitis thiab tuberculosis. Nrog rau kev mob ntsws ntev ntev, cov kab mob ntawm cov protein tau sau tseg hauv qhov zais cia, thiab nrog cov kab mob tuberculous, cov protein ntau hauv cov hnoos qeev yuav ntau dua, thiab nws tuaj yeem qhia tau los ntawm cov lej (txog 100-120 g / l).
- Bile pigments. Lawv pom muaj nyob rau hauv cov hnoos qeev thaum cov kab mob ua pa cuam tshuam nrog rau kab mob siab. Hauv qhov no, daim siab sib txuas nrog lub ntsws. Cov kua tsib pigments muaj nyob rau hauv mob ntsws, uas yog vim kev tawg ntawm cov qe ntshav liab hauv lub ntsws thiab qhov kev hloov pauv hauv hemoglobin.
cytological method rau tshuaj xyuas qhov zais cia
Rau qhov kev kuaj mob sib txawv ntawm tuberculosis thiab ntau lwm yam mob ntsws, txoj kev cytological tau siv dav, uas suav nrog ob theem: kev kuaj mob thiab kev kuaj xyuas cov hnoos qeev.
Kev kuaj mob pab txiav txim siab seb txoj kev twg yuav tsum tau sau kom tau txais cov txiaj ntsig kev xeem raug.
Muaj ob hom khoom tseem ceeb uas yuav tsum tau kuaj xyuas cov hnoos qeev: qhov tshwm sim thiab txo qis. Hom thib ob ntawm kev zais cia yog tau los ntawm kev raug ntau yam stimuli (expectorants, inhalation, thiab lwm yam).
Needle biopsy material
Kev kuaj mob cytological ntawm cov hnoos qeev cuam tshuam nrog kev kawm ntawm macroscopic thiab microscopic tsom xam ntawm nws cov hlwb.
Ntau cov ntaub ntawv rau kev soj ntsuam cytological yog hnoos qeev thaum sawv ntxov rauplab khoob. Ua ntej kuaj, nws yuav tsum khaws cia tsis pub dhau 4 teev.
- Squamous epithelial hlwb muaj nyob rau hauv cov hnoos qeev, uas tau kuaj xyuas microscopically. Tab sis rau kev kuaj mob lawv tsis muaj teeb meem. Cells ntawm cylindrical epithelium - ob leeg ib leeg thiab hauv ib pab pawg - tuaj yeem pom hauv cov kab mob xws li mob ntsws asthma, bronchitis thiab mob ntsws cancer. Nws yuav tsum tau muab sau tseg tias cylindrical epithelium kuj tuaj yeem tshwm sim vim qhov nkag mus ntawm cov hnoos qeev los ntawm nasopharynx.
- Alveolar macrophages yog cov hlwb reticuloendothelial. Macrophages, uas muaj nyob rau hauv protoplasm (phagocytic hais los yog plua plav hlwb), tuaj yeem pom nyob rau hauv cov neeg mob uas nqus plua plav ntev ntev.
- Macrophages ntawm protoplasm (tsim los ntawm kev tawg ntawm hemoglobin) hu ua kab mob plawv. Lawv tuaj yeem tshwm sim thaum cov txheej txheem congestive hauv lub ntsws, mitral valve stenosis, pulmonary infarction.
- Ib qho me me ntawm cov qe ntshav dawb pom muaj nyob hauv txhua qhov hnoos qeev. Lawv cov ntsiab lus nce ntxiv tau sau tseg hauv qhov zais cia nrog cov kua paug tawm.
- Eosinophils. Cov hlwb zoo li no muaj cov hnoos qeev hauv cov mob hawb pob. Cells tuaj yeem pom hauv eosinophilic mob ntsws, kab mob helminth, tuberculosis, thiab pulmonary infarction.
- Erythrocytes. Ib leeg erythrocytes tsis pom daim duab ntawm tus kab mob. Cov tsos mob ntawm qhov nce ntxiv qhia tau tias muaj ntshav hauv lub ntsws. Hauv cov ntshav tshiab, tsis hloov pauv erythrocytes tau txiav txim siab. Yog hais tias muaj ib tug admixture ntawm cov ntshav, uasnyob rau hauv lub ntsws ntev, ces kuaj pom cov qe ntshav liab.
- Cov kab mob qog noj ntshav. Lawv tuaj yeem pom tsis pub leej twg paub hauv pab pawg. Lawv qhia tias muaj qog nqaij hlav. Thaum pom ib lub hlwb, feem ntau nyuaj rau kev kuaj mob. Nyob rau hauv tas li ntawd, kev kuaj hnoos qeev zaum ob.
- Elastic fibers, cov tsos mob tshwm sim los ntawm kev tawg ntawm lub ntsws cov ntaub so ntswg, provoked los ntawm tuberculosis, abscess, gangrene, qog. Gangrene tsis yog ib txwm ua los ntawm cov hlwb, vim tias vim yog kev ua ntawm cov enzymes zais cia, lawv tuaj yeem yaj.
- Kurshman spirals. Cov no yog lub cev tshwj xeeb uas zoo li cov hlab ntsha. Lawv pom thaum kuaj xyuas hauv lub tshuab kuaj kab mob. Qee zaum pom qhov muag. Feem ntau, cov kauv muaj nyob rau hauv cov kab mob xws li mob ntsws asthma, pulmonary tuberculosis thiab mob ntsws.
- Charcot-Leiden crystals muaj nyob rau hauv cov hnoos qeev nrog cov ntsiab lus siab ntawm eosinophils hauv cov kab mob xws li mob ntsws asthma, eosinophilic pneumonia. Qhov qhib ntawm qhov tseem ceeb ntawm tuberculosis nyob rau hauv lub lumen ntawm lub bronchi tuaj yeem tshwm sim los ntawm qhov muaj nyob rau hauv lub zais ntawm elastic fibers-krystals ntawm cov cholesterol, MBT thiab amorphous txiv qaub (lub thiaj li hu ua Ehrlich's tetrad) - 100%.
Siv cov kab mob bacterioscopy
Sputum sau rau kev kuaj kab mob bacterioscopic suav nrog kev tshuaj xyuas ntawm qhov zais cia txhawm rau txheeb xyuas cov kab mob mycobacteria tus yam ntxwv ntawm tuberculosis hauv nws. Lawv zoo li nyias nyias, nkhaus sticks ntawm qhov ntev sib txawv, tuab ntawm ob sab lossis hauv nruab nrab, uas nyob ib leeg lossis hauv pab pawg.
Kev kuaj mob Mycobacterium tuberculosis tsis yogNws yog ib qho tseem ceeb rau kev kuaj mob thiab xav tau kev pom zoo bacteriological. Tuberculous mycobacteria tsis raug kuaj pom hauv ib txwm muaj.
Lub hauv paus rau kev tshuaj xyuas yog cov khoom purulent, uas tau muab los ntawm plaub caug rau qhov sib txawv thiab ua tib zoo hauv av rau ib homogeneous loj nrog ob lub iav. Tom qab ntawd lawv qhuav hauv huab cua thiab tsau nrog cov nplaim taws.
Kev kuaj kab mob ntawm cov hnoos qeev los ntawm Ziel-Neelsen txoj kev qhia tias nws muaj xim liab. Hauv qhov no, tag nrho cov khoom zais cia, tshwj tsis yog cov kab mob mycobacteria, tau txais cov xim xiav, thiab mycobacteria ua liab.
Yog xav tias tuberculosis, tom qab peb zaug kev sim rau qhov muaj mycobacteria nrog cov lus teb tsis zoo, txoj kev flotation (Pottenger tsom xam) yog siv.
Txoj kev niaj zaus los kawm txog cov tshuaj pleev xim rau MTB muab cov txiaj ntsig zoo tsuas yog tias tus naj npawb ntawm MTB tsis tsawg dua 50,000 units hauv 1 ml ntawm cov hnoos qeev. Nws tsis tuaj yeem txiav txim siab muaj tus kab mob los ntawm tus lej ntawm mycobacteria.
Bacterioscopy ntawm cov neeg mob uas tsis muaj kab mob ntsws tshwj xeeb
Kev kuaj cov hnoos qeev nyob rau hauv lub xub ntiag ntawm cov kab mob ntsws uas tsis yog tshwj xeeb thaum lub sij hawm bacterioscopy tuaj yeem pom cov kab mob hauv qab no:
- Thaum mob ntsws - pneumococci, Frenkel diplococci, Friedlander bacteria, streptococci, staphylococci (100%).
- Nrog gangrene ntawm lub ntsws, koj tuaj yeem nrhiav tau ib tug spindle-shaped stick nyob rau hauvua ke nrog Vincent's spirochete (80%).
- Yeast-zoo li fungi (70%), uas yuav tsum muaj kab lis kev cai zais cia los txiav txim hom.
- Druze ntawm actinomycete (100%) nrog actinomycosis.
zais ntim hauv tus neeg noj qab haus huv
Qhov ntim ntawm mucus secreted los ntawm trachea thiab bronchi nyob rau hauv ib tug neeg uas tsis raug kev txom nyem los ntawm pathologies li ntawm 10 mus rau 100 ml / hnub.
Nquag, theem ntawm leukocytes qis, thiab kev tshawb fawb ntawm cov stained smear rau mycobacteria yog qhov tsis zoo.
