Tus kab mob ua pa syncytial suav nrog hauv pab pawg kis mob hnyav uas cuam tshuam rau cov neeg coob coob, feem ntau ntawm cov hnub nyoog hluas. Cov menyuam yaus hnub nyoog ib xyoos nyob hauv qhov chaw tseem ceeb ntawm cov neeg mob. Yog hais tias tus kab mob no superficial nyob rau hauv cov neeg laus, ces cov teeb meem loj yuav tshwm sim nyob rau hauv cov me nyuam mos.
Definition
Nov yog tus kab mob uas ua rau mob ua pa. Lub insidiousness yog tias nws yog ib qho nyuaj rau kev kuaj mob, raws li nws tau yooj yim yuav tsis meej pem nrog ib tug yooj yim txias. Tam sim no, tshuaj tiv thaiv tseem tsis tau tsim, yog li tus kab mob qee zaum ua rau tuag taus. Cov uas tau mus pw hauv tsev kho mob tau ua rau muaj qhov tshwm sim ntawm mob ntsws, xuav thiab mob hawb pob.
Etiology
Tus kab mob ua pa syncytial concentrates hauv cytoplasm, tom qab kev loj hlob pib tawg rau hauv daim nyias nyias. Nws belongs rau tsev neeg Paramyxoviridae thiab tsuas yog cov tswv cuab ntawm pab pawg no uas tuaj yeem ua rau mob hnyav. Txawm hais tias cov ntawv sib txawv muaj qee qhov sib txawv ntawm qhov sib txawv, qhov sib txawv yog feem ntau nyob rau hauv ib qho ntawm ob peb glycoproteins, tab sis kev kis mob thiab kev kho mob tseem ceeb ntawm qhov sib txawv no tsis meej. Tus kab mob no loj hlob nyob rau hauv ib tug xov tooj ntawm cell kab lis kev cai, ua rau tsim ib tug yam ntxwv syncytium.
Yog vim li cas
Tus kab mob ua pa syncytial yog hais txog cov kab mob uas kis tau los ntawm cov tee dej. Lawv tuaj yeem kis tau ob tus neeg mob thiab cov neeg nqa khoom. Kev sib sau ua ke thiab kev sib kis ntawm tsev neeg yog tus yam ntxwv, thiab cov neeg mob nosocomial tau sau tseg, feem ntau hauv tsev kho mob menyuam yaus. Kev faib tawm yog ubiquitous thiab round-the-clock, feem ntau nyob rau lub caij ntuj no-caij nplooj ntoos hlav. Qhov kev pheej hmoo loj tshaj plaws yog pom hauv cov menyuam yaus ntawm 4-5 lub hlis mus rau 3 xyoos. Thaum muaj hnub nyoog ntxov, feem ntau ntawm cov menyuam yaus raug kev txom nyem los ntawm tus kab mob no, txij li thaum ntawd, kev tiv thaiv tsis ruaj khov tau pom, rov ua dua ntawm tus kab mob no ntau heev, tsuas yog hauv daim ntawv tshem tawm ntau dua. Txawm li cas los xij, tom qab kev ploj tag ntawm cov tshuaj tiv thaiv kab mob (IgA) los ntawm lub cev, tus kab mob ua pa syncytial tuaj yeem rov tshwm sim.
kis tau los ntawm kev sib cuag nrog cov neeg muaj mob. Nws tau tshuaj xyuas thiab pom tias yog tus neeg mob txham, ces cov kab mob kis tau yooj yim mus txog 1.8 m. Cov kab mob no tuaj yeem muaj sia nyob ntawm tes ntev txog 30 feeb, thiab ntawm cov khoom rau ob peb teev.
Lub pathogenesis ntawm tus kab mob no zoo ib yam li cov txheej txheem ntawm kev loj hlob ntawm tus kab mob khaub thuas thiab parainfluenza, raws li nws yog txuam nrog kev txav ntawm tus kab mob mus rauepithelium ntawm lub ntsws. Kev ua pa ua pa ua haujlwm rau kev nkag mus, thiab kev tsim tawm thawj zaug pib hauv cytoplasm ntawm nasopharynx thiab tom qab ntawd kis mus rau bronchi. Thaum lub sijhawm no, hyperplasia ntawm cov hlwb cuam tshuam thiab symplast tshwm sim. Xws li phenomena yog nrog los ntawm hypersecretion thiab nqaim ntawm bronchioles, uas ntxiv mus rau blockage ntawm lawv cov hnoos qeev tuab. Tom qab ntawd txoj kev loj hlob ntawm tus kab mob yog txiav txim siab los ntawm qib ntawm kev nkag mus ntawm cov nroj tsuag thiab ua pa tsis ua haujlwm.
Symptoms
Tus kab mob ua pa syncytial, uas nws cov kab mob microbiology nyuaj thiab nyuaj rau kev kuaj mob, yog kab mob thaum ntxov caij nplooj ntoos hlav thiab lub caij ntuj no.
Tam sim no, nws tseem tsis tau qhia tias yog vim li cas cov kab mob ua pa hauv qab tau cuam tshuam rau cov menyuam mos thiab cov kab mob ua pa sab saud rau cov neeg laus.
Hauv cov menyuam yaus, tus kab mob pib ua npaws, mob caj pas thiab ua kua ntswg. Lwm cov tsos mob sai sai ua raws li qhov zoo li mob hawb pob. Tus kab mob no tshwm sim los ntawm cov tsos mob hauv qab no:
- ua pa nrawm (ntau tshaj 40 ua pa ib feeb);
- cov tawv nqaij daj (cyanosis);
- hnoos tsis tu ncua;
- kub taub hau;
- ua pa tsis sib xws;
- croupous seals;
- tho pa thiab hawb pob;- nyuaj exhalations.
Cov kab mob ua pa qis tshwm sim thaum lub bronchioles o. Yog tias lub sijhawm no tus neeg mob ntsib teeb meem nrog kev muab cov pa oxygen, nws yog ib qho tsim nyog yuav tsum sab laj nrog kws kho mob tam sim ntawd. Cov kab mob no feem ntau tshwm sim hauv cov menyuam yaus hnub nyoog qis dua ib xyoos, thiab lawv tuaj sai sai.
Kev faib tawm
Muaj ntau ntau yam uas ua rau tus kab mob ua pa syncytial tuaj yeem ua tus yam ntxwv, xws li:
- raug - rhinitis, laryngitis, pneumonia, nasopharyngitis, bronchitis, bronchitis, segmental pulmonary edema thiab otitis tsim;- atypical - plooj lossis asymptomatic ntawm tus kab mob.
Muaj 3 hom kab mob tseem ceeb.
1. Mob me, tshwm sim ntau zaus hauv cov neeg laus thiab cov menyuam hnub nyoog kawm ntawv. Manifested li nruab nrab nasopharyngitis, ua tsis taus pa tsis ua hauj lwm. Feem ntau, lub cev kub tseem nyob li qub lossis nce me ntsis, tab sis qhov tseeb los ntawm ob peb degrees. Cov cim qhia ntawm kev qaug cawv yog qhov tsis tuaj.
2. Nruab nrab, cov tsos mob ntawm tus mob bronchitis los yog bronchiolitis tuaj yeem pom, nrog rau obstructive syndrome thiab ua pa tsis ua haujlwm. Tus neeg mob muaj qhov ncauj cyanosis thiab dysnoea. Yog hais tias tus me nyuam muaj mob, nws yuav ua rau tsis xis nyob, tsaug zog, ntxhov siab, lossis qaug zog. Feem ntau muaj me ntsis nce hauv daim siab lossis tus po. Qhov ntsuas kub feem ntau nce siab, tab sis nws yog qhov qub. Muaj kev npam me ntsis.
3. Mob hnyav, ntawm no bronchiolitis thiab obstructive bronchitis tshwm sim. Muaj qhov tsis muaj huab cua hnyav, uas tsuas yog lub npog ntsej muag oxygen rau kev ua pa tuaj yeem pab tau. Whistles thiab suab nrov yog taug qab, muaj kev hais lus intoxication thiab muaj zog ntawm daim siab thiab tus po.
Cov txheej txheem hnyav feem ntau suav nrog cov yam ntxwv hauv qab no:
- muaj kev hloov hauv zos;- nyuajua pa tsis ua hauj lwm.
Nyob ntawm qhov ntws:
- du - tsis muaj kab mob tshwm sim; - tsis du - qhov pom ntawm mob ntsws, sinusitis thiab purulent otitis.
History
Tus kab mob ua pa syncytial, cov tsos mob uas tuaj yeem cuam tshuam nrog lwm yam kab mob, tau txheeb xyuas xyoo 1956 los ntawm Dr. Morris. Nws, soj ntsuam tus chimpanzee uas tau kuaj pom muaj tus kab mob rhinitis, pom tus kab mob tshiab thiab hu nws CCA - Chimpanzeecoriraagent (tus neeg sawv cev ua rau mob khaub thuas ntawm chimpanzee). Thaum lub sijhawm kuaj xyuas cov neeg ua haujlwm mob uas saib xyuas tus liab, pom tias muaj cov tshuaj tiv thaiv kab mob ntau ntxiv, zoo ib yam li tus kab mob no.
Xyoo 1957, R. Chenok tau cais cov kab mob zoo sib xws hauv cov menyuam yaus mob thiab txiav txim siab tias nws yog tus neeg ua haujlwm rau kev ua kom mob ntsws thiab mob ntsws. Txij thaum ntawd los, thiab txog niaj hnub no, cov kws tshawb fawb tau ua tsis tiav los tsim cov tshuaj tiv thaiv.
Diagnosis
Kev kho mob txhais ntawm tus kab mob yog teeb meem, vim nws zoo sib xws nrog lwm yam kab mob. Hauv cov neeg laus, cov tsos mob ntawm bronchitis thiab pneumonia feem ntau ua rau muaj feem ntau. Thaum lub sij hawm soj ntsuam kuaj, cov txheej txheem serological yog siv uas tso cai rau kev kuaj xyuas cov tshuaj tiv thaiv kab mob titer. Yog tias tsim nyog, tus kws kho mob yuav xaj x-rays thiab kev kuaj mob tshwj xeeb, xws li kuaj kab mob hauv nasopharyngeal washings.
Kev kho mob
Cov neeg mob uas tau kuaj pom muaj tus kab mob ua pa syncytial, kev kho mob tau sau tseg hauv qhov nyuaj, raukom lub cev muaj zog. Lub txaj so yog pom zoo rau tag nrho lub sij hawm ntawm exacerbation. Kev mus pw hauv tsev kho mob yog qhia rau cov menyuam yaus uas muaj tus kab mob hnyav, cov menyuam kawm preschool uas muaj mob hnyav, thiab cov neeg uas muaj teeb meem. Ib qho yuav tsum tau ua ua ntej yog qhov muaj cov khoom noj uas tsim nyog rau lub hnub nyoog. Nws yuav tsum suav nrog cov khoom noj khoom haus thiab tshuaj lom neeg, muaj ntau yam kab mob thiab cov vitamins.
Kev kho Etiotropic kuj tau ua, uas yog tus cwj pwm los ntawm kev siv tshuaj xws li tib neeg leukocyte interferon, Anaferon, Grippferon thiab Viferon. Nyob rau hauv cov ntaub ntawv hnyav, nws raug nquahu kom noj Immunoglobulin thiab Ribavirin, tus nqi rau nws txawv ntawm 240-640 rubles, nyob ntawm qhov ntau npaum. Zoo kawg nkaus pab tiv thaiv qhov tshwm sim ntawm qhov tshwm sim hauv bronchitis tshuaj "Sinagis". Yog tias kuaj pom muaj kab mob tshwm sim, ces qhia txog kev kho tshuaj tua kab mob.
Broncho-obstructive syndrome tau raug tshem tawm zoo los ntawm kev kho mob thiab pathogenetic. Hauv qhov no, siv lub npog ntsej muag oxygen rau kev ua pa, nws txo qis cov tsos mob hnyav thiab ua kom yooj yim rau huab cua.
Kev soj ntsuam lub tsev kho mob yuav tsum muaj rau qhov teeb meem. Tom qab mob ntsws, nws raug nquahu kom kuaj xyuas tom qab 1, 3, 6 thiab 12 lub hlis kom txog thaum rov ua tiav. Kev kuaj mob prophylactic yog qhov tsim nyog tom qab tus mob bronchitis rov tshwm sim thiab raug tshuaj tom qab ib xyoos ntawm kev kho. Yog tias tsim nyog, muaj kev sib tham nrog tus kws kho mob lossis tus kws kho mob pulmonologist, thiab kev kuaj sim kuj tau ua tiav.
Kev kho me nyuam
Cov menyuam yaus ib txwm mob hnyav dua, thiab qhov tshwm sim yuav hnyav dua li cov neeg laus, yog li kev kho yuav tsum tau ua kom zoo thiab siv zog.
Antiviral:
- "Ribavirin", tus nqi ntawm cov tshuaj no, raws li tau piav qhia ua ntej, yog tus nqi pheej yig, yog li nws yuav tsis ntaus niam txiv lub hnab nyiaj ntau; - "Arbidol", "Inosine", " Tiloran” thiab “Pranobex”.
Syndromic therapy yuav tsum tau ua raws li cov txheej txheem cuam tshuam rau kev kho mob ua pa tsis ua haujlwm, mob ntsws thiab Croup's syndrome.
Basic antihomotoxic therapy:
- "Flu-Heel", "Engystol" (pib tswv yim yog siv);
- "Euphorbium compositum C" (nasal spray); - "Lymphomyosot".
Optional:
- "Viburkol" (rectal suppositories);
- "Echinacea compositum C" (ampoules);
- "Angin-Heel C"; - "Traumeel C" (tablets).
Txhua yam kev kho no zoo rau kev tawm tsam tus kab mob ua pa syncytial hauv menyuam yaus.
thawj kauj ruam
Yuav kom kov yeej tus kab mob sai sai, nws yuav tsum tau teb kom raug rau cov tsos mob tshwm sim, kom koj thiaj li tau txais kev pab zoo yog tias xav tau.
1. Koj yuav tsum mus ntsib kws kho mob yog tias ib tug me nyuam yaus muaj cov tsos mob ntawm SARS, xws li mob caj pas, los ntswg thiab hawb pob hnyav. 2. Nco ntsoov hu lub tsheb thauj neeg mob yog tias muaj qhov kub thiab txias, muaj suab nrov, ua pa nyuaj thiab mob hnyav.
Yuav tsum tau mus ntsib kws kho mob xws li kws kho mob thiabinfectiologist.
Kev nyuaj siab
Tus kab mob ua pa syncytial muaj qhov cuam tshuam tsis zoo rau txoj kev ua pa. Qhov tshwm sim ntawm tus kab mob no yog qhov tseem ceeb, vim tias cov kab mob thib ob tuaj yeem koom nrog thiab ua rau mob xws li:
- sinusitis;
- otitis media;
- bronchitis;
- pneumonia;- bronchiolitis.
Kev Tiv Thaiv
Txhua tus kab mob kis tau nyuaj kho, vim tias lawv cov tsos mob feem ntau muab zais. Ib qho ntawm cov kev ntsuas yog kev tshawb pom ntxov ntawm tus kab mob thiab cais cov neeg mob kom txog thaum lawv rov zoo tag nrho. Thaum lub sij hawm muaj tus kab mob no tshwm sim, tshwj xeeb yuav tsum tau them rau kev tu cev thiab kev tu cev. Hauv cov menyuam yaus cov pab pawg thiab tsev kho mob, tau thov kom hnav cov ntaub qhwv ntsej rau cov neeg ua haujlwm. Cov menyuam mos yuav tsum tau tshuaj tua kab mob hauv lawv txhais tes siv cov tshuaj alkaline.
Kev tiv thaiv xwm txheej kub ntxhov hauv foci ntawm kev kis mob suav nrog kev siv tshuaj xws li Anaferon, Viferon, Imunal thiab ntau yam inducers ntawm endogenous interferon.
Immunoprophylaxis suav nrog Motavizubam, RespiGam thiab Palivizubam.
Tshuaj tiv thaiv
Tam sim no, lawv tseem tsis tau tsim cov khoom tiv thaiv uas yuav tiv thaiv tus kab mob no. Kev tsim yog heev nquag, kev sim pib ua txij li xyoo 1960, tom qab ntawd cov tshuaj tsis ua haujlwm nrog formalin thiab precipitated nrog alum. Cov tshuaj tiv thaiv zoo li no ua rau muaj kev tsim cov tshuaj tiv thaiv kab mob hauv cov ntshav, txawm tias qhov tshwm simsiv, cov kev sim no tsim ib qho kab mob hnyav dua. Nyob rau hauv cov khoom sib txuas ua rau cov tsos mob tsis zoo heev lossis tig mus rau tib tus kab mob, tsuas yog hom tsiaj qus xwb. Niaj hnub no, ib txoj kev raug txiav txim siab rau kev ua kom huv cov tshuaj tiv thaiv kab mob tiv thaiv ib qho ntawm cov proteins saum npoo los yog cov ntsiab lus attenuated, thiab tom qab ntawd sim hloov lawv kom txias.
