Tib neeg clonorchiasis yog biohelminthiasis los ntawm pawg trematodes, tus cwj pwm los ntawm cov kab mob tseem ceeb ntawm cov kab mob biliary, pancreas thiab daim siab parenchyma.
Kab mob kis
Lub hauv paus tseem ceeb ntawm kev ntxeem tau yog tus neeg kis tus kabmob clonorchs. Tsis tas li ntawd, cov dev thiab miv ntxeem tau lub reservoir. Suav fluke yog dav faib nyob rau hauv Nyiv, Nyab Laj, Tuam Tshoj, North Kauslim, lub Amur phiab, lub Ob thiab Primorye. Helminth qe excreted nrog faeces, thaum tso rau hauv dej ib puag ncig, yog nqos los ntawm mollusks, nyob rau hauv lub cev uas cercariae (larvae) tsim tom qab li ntawm 14 hnub. Thaum cov larvae nkag mus rau hauv lub cev ntawm cov ntses thiab crayfish los ntawm txoj hnyuv, lawv pib txav mus rau hauv cov leeg thiab cov nqaij mos subcutaneous. Yog li, metacercariae yog tsim. Ib tug neeg kis tau tus mob clonorchiasis los ntawm kev noj cov nqaij nyoos, tsis txaus thermally ua cov ntses los yog crayfish. Qhov no yog li cas clonorchiasis tshwm sim. Cov tsos mob hauv cov neeg mob feem ntau pib tshwm sim tom qab tus kab mob nkag mus rau hauv txoj hnyuv me.
Flukes: yam ntxwv
Trematodes (flukes) yog helminths uas yog hom flatworms. Raws li txoj cai, lawv muaj nplooj-zoo li daim ntawv. Qhov loj ntawm lawvNws txawv ntawm qhov dav ntawm 0.1 hli mus rau 15 cm ntev. Suav fluke tuaj yeem ua rau cab hauv lub cev ntawm cov tsiaj thiab tib neeg. Txhua yam kab mob kis ua rau muaj kab mob cab.
Morphology thiab biology ntawm flukes
Tus kab mob npaws lub cev yog compressed nyob rau hauv lub dorso-ventral kev taw qhia. Lub cuticle ua ke nrog cov leeg nqaij txheej tsim lub musculoskeletal bursa, nyob rau hauv uas cov kabmob sab hauv yog nyob. Trematodes yog kho nrog kev pab los ntawm cov leeg nqaij tshwj xeeb - suckers. Nws tuaj yeem muaj ob ntawm lawv - qhov ncauj thiab plab. Lub cev ntawm fixation kuj muaj xws li spikes ntawm lub cuticle thiab glandular pits.
YDigestive system
Pem hauv ntej ntawm lub cev, lub qhov ncauj nqus tsev yog nyob hauv zos, nyob rau hauv qab ntawm lub qhov ncauj qhib. Lub qhov ncauj yog ua raws li lub pharynx (pharynx) thiab ib qho elongated esophagus. Cov kab mob hauv plab - ob lub qhov muag tsis pom kev kawg. Flatworms feem ntau tsis muaj qhov qhib qhov quav. Cov khoom noj uas tsis yog hydrolyzed yog pov tseg los ntawm lub qhov ncauj qhib. Kev noj haus ib nrab ntawm flatworms tuaj yeem nqa los ntawm tesument.
Ntshai thiab excretory system
Lub paj hlwb muaj cov hlab ntsha nyob hauv qab lub pharynx, thiab cov pob tw txuas mus rau lwm qhov ntawm lub cev. Lub excretory system yog sawv cev los ntawm ib tug complex system ntawm tubules uas tsim ob excretory kwj dej.
Reproductive system
Lub cev xeeb tub ntawm trematodes tau tsim zoo heev. Flukes (nrog rau kev zam ntawm cov neeg sawv cev ntawm genus Schistosomatata) yog hermaphrodites (bisexual creatures).
Tus txiv neej cov cuab yeej ua tub luam, raws li txoj cai, muaj ob lub qes. Semen ducts tawm ntawm lawv,uas koom rau hauv cov vas deferens. Nws feem ntau yog nyob rau hauv qhov chaw mos bursa (tshwj xeeb muscular sac). Qhov kawg ntawm vas deferens yog cirrus (cov khoom nruab nrog cev).
Cov khoom siv ntawm cov poj niam cev xeeb tub muaj xws li zes qe menyuam, oviduct, ootype, seminal receptacle, vitelline glands, Laur kwj dej, Melis 'corpuscles thiab lub tsev menyuam, uas xaus nrog poj niam qhov chaw mos qhib.
Etiology
Tus neeg sawv cev ntawm clonorchiasis yog ib qho trematode - Suav fluke. Qhov no helminth belongs rau tsev neeg Opisthorchidae - Clonorchis sinensis. Helminthiasis tau piav qhia thawj zaug los ntawm McConnell hauv xyoo 1874. Suav fluke nyob rau hauv tib neeg lub cev tuaj yeem kis tau mus txog 40 xyoo. Lub cev ntawm helminth yog tiaj, lanceolate, 10-20 mm ntev thiab 2-4 mm dav. Cov qe ntawm flukes muaj lub teeb golden xim, ntawm ib qho ntawm tus ncej lub hau yog pom meej. Clonorchis sinensis nyob rau theem neeg laus tuaj yeem ua rau tib neeg thiab tsiaj txhu tsiaj txhu. Cov tom kawg yog cov tswv tsev. Cov dej qab zib mollusks ua raws li cov neeg nruab nrab, cov dej qab zib crayfish thiab cyprinids ua ntxiv.
Lub voj voog ntawm trematodes
Lub neej voj voog ntawm flukes muaj 4 lub sijhawm:
- embryogonia;
- parhenogony;
- Ycystogonia;
- maritogonia.
Embryogony yog lub sijhawm ntawm embryonic kev loj hlob ntawm cov kab mob hauv lub qe trematode los ntawm fertilization mus rau kev tso tawm ntawm miracidium. Lub sijhawm ntawm theem no yog hais txog ib hlis. Parthenogony - lub sij hawm tom qab embryonic ntawm kev loj hlob ntawm larval theem nyob rau hauv lub cevnruab nrab host. Lub sijhawm nthuav tawm pib los ntawm kev tsim cov sporocyst mus rau kev tso tawm ntawm cercariae rau hauv ib puag ncig. Lub sijhawm ntawm lub sijhawm no tuaj yeem txawv ntawm ob lub lis piam mus rau tsib lub hlis.
Cystogony yog cov txheej txheem ntawm kev hloov pauv ntawm cercariae rau hauv adolescariae (hauv ib puag ncig) lossis metacercariae (hauv lub cev ntawm tus tswv tsev ntxiv). Lub sijhawm ntawm cystogonia yog los ntawm ob peb teev mus rau ob lub hlis.
Maritogony yog lub sijhawm ntawm kev loj hlob ntawm cov kab mob flukes hauv lub cev ntawm tus tswv tsev meej mus rau theem kev sib deev (tus neeg laus), uas tso qe rau hauv ib puag ncig. Lub sijhawm ntawm theem no yog los ntawm ib lub lis piam mus rau ob lub hlis.
Pathogenesis
Cov neeg mob nyob hauv thaj chaw muaj kev tiv thaiv kab mob, uas kis tau los ntawm niam mus rau tus menyuam los ntawm cov placenta. Yog li ntawd, txawm tias cov neeg zoo li no tau kuaj pom muaj tus kab mob, nws muaj qhov mob me dua. Txoj kev loj hlob ntawm pathology yog raws li cov neeg kho tshuab cov nyhuv ntawm fluke, ntxiv rau cov microflora theem nrab, neurotrophic mob thiab tshuaj lom-allergic tshuaj. Tsis tas li ntawd, clonorchs ua rau cirrhotic hloov hauv daim siab.
Cov tsos mob
Yog tias koj tau kuaj pom tus mob clonorchiasis, cov tsos mob ntawm cov kab mob zoo ib yam li opisthorchiasis. Nyob rau hauv lub mob theem ntawm tus kab mob, muaj ib tug txo nyob rau hauv qab los noj mov, malaise, general tsis muaj zog, manifestation ntawm tsis haum tshuaj. Nrog rau txoj kev loj hlob ntawm tus kab mob, cov cim qhia txog kev puas tsuaj rau daim siab, pancreas thiab biliary tract tshwm sim. Mobyws ntawm kub taub hau, nrog rau qhov mob hnyav nyob rau hauv txoj cai hypochondrium.
Yuav muaj teeb meem ntawm tus kab mob
Nws tuaj yeem yog:
- chronic cholecystitis;
- cirrhosis ntawm daim siab;
- mob plab gastroduodenitis;
- mob qog noj ntshav pancreatic thiab mob plab;
- kab mob siab mob siab.
YKev kuaj mob ntawm pathology
Kev kuaj mob yog tsim los ntawm cov ntaub ntawv epizootic thiab kev kho mob, nrog rau cov txiaj ntsig ntawm kev tshawb fawb helminthocoprological. Txhawm rau kom paub meej qhov kev kuaj mob, kuaj ntshav biochemical (tag nrho cov protein, ntshav qab zib, bilirubin, kev ua haujlwm ntawm alkaline phosphatase, aminotransferases, amylase, trypsin thiab lipase), instrumental (cholecystography, ultrasound kuaj ntawm lub gallbladder, daim siab, txiav, fibrogastroduodenoscopy) thiab serological (RID, RNGA, PCR) txoj kev tshawb fawb.
Kev kho mob
Yog tias tus neeg mob tau kuaj pom tias muaj tus mob clonorchiasis, kev kho mob yuav tsum ua tiav:
- kev noj haus;
- tshuaj tiv thaiv kab mob ("Biltricid", "Niklofolan", "Chloxil");
- tshuaj tiv thaiv kab mob ("Calcium Gluconate", "Loratidin", "Suprastin");
- tsis yog-steroidal tshuaj tiv thaiv kab mob (Ibuprofen, Nimisulide);
- enzymes ("Panzinorm", "Mezim", "Creon");
- sorbents ("Enterosgel", "Ataxil", "Polysorb");
- antispasmodics ("Papaverine", "No-shpa", "Mebeverine");
- macrolides ("Oleandomycin", "Spiramycin", "Azithromycin",Roxithromycin, Flurithromycin);
- tshuaj choleretic (Xylitol, Sorbitol, pob kws txhob lo lo ntxhuav, immortelle, sawv hips, mint nplooj);
- hepatoprotectors ("Essentiale", "Ursochol").
