Txiv neej yog ib tug neeg tsis yooj yim. Tab sis xwm, uas mob siab rau txoj sia nyob ntawm hom, tau nthuav qhia tib neeg nrog lub txiaj ntsim tseem ceeb - kev tiv thaiv. Nws ua tsaug rau nws tias peb lub cev muaj nyob, txhim kho thiab tiv thaiv cov kab mob sib kis.
Kab mob - ua mob lossis tiv thaiv lub cev?
Lo lus Latin inflammo txhais tau tias "kub", thiab nws lwm lo lus txhais yog mob. Cov theem ntawm o, nws hom thiab cov ntaub ntawv yuav piav qhia nyob rau hauv cov ntaub ntawv no. Ua ntej koj yuav tsum nkag siab lub ntsiab lus ntawm cov txheej txheem thiab nrhiav nws qhov tseem ceeb rau tib neeg lub cev.
Cov kev hloov pauv no nyob rau hauv qee qhov xwm txheej (mob, kev raug mob, muaj cov kab mob parasites, kev tsis haum tshuaj) tsis tshwm sim los ntawm lub sijhawm - qhov no yog kev tiv thaiv kab mob rau kev cuam tshuam ntawm kev kis kab mob, kev puas tsuaj ntawm cellular lug lossis allergens. Cov txheej txheem no yog tsom rau thaj tsam thaj chaw puas, cais nws los ntawm cov ntaub so ntswg noj qab haus huv. Xws li kev ua ntawm lub cev yog vim qhov yuav tsum tau kho cov kab mob pathogenic hauv thaj tsam ntawm qhov mob, siv cov khoom ntawm nws cov lwj thiab kho qhov chaw ntawm kev ntxeem tau. ATqhov tshwm sim yog qhov yuav tsum tau txhim kho kev tiv thaiv.
Nws yog ib qho tseem ceeb uas yuav tsum xav txog tias qhov mob tsis yog qhov sib txawv ntawm kev kis kab mob. Qhov no yog ib qho kev tiv thaiv kab mob rau txhua yam kab mob nkag mus rau hauv lub cev, thaum tus kab mob yog tus neeg sawv cev hnyav uas ua rau muaj qhov tshwm sim.
keeb kwm keeb kwm
Kab mob, theem ntawm qhov mob, nws cov yam ntxwv tau paub thaum pib ntawm peb lub sijhawm. Tshwj xeeb, cov kws tshawb fawb thaum ub Claudius Galen thiab Roman kws sau ntawv Cornelius Celsus txaus siab rau cov teeb meem no.
Nws yog tom kawg uas tau hais plaub lub ntsiab lus ntawm kev mob:
- erythema (zoo li liab);
- edema;
- hyperthermia;
- pain.
Tseem tseem muaj lub cim thib tsib - ua txhaum txoj haujlwm ntawm thaj chaw cuam tshuam lossis lub cev (qhov kawg taw tes tau ntxiv ntau tom qab los ntawm Galen).
Tom qab ntawd, ntau tus kws tshawb fawb tau daws cov ncauj lus no. Lub ntiaj teb nto moo biologist Ilya Ilyich Mechnikov kuj kawm nws. Nws suav hais tias cov tshuaj tiv thaiv kab mob ua kom zoo, qhov khoom plig muaj tseeb, tab sis tseem xav tau kev txhim kho ntxiv, vim tsis yog tag nrho cov txheej txheem no ua rau lub cev rov qab los. Tsis txhob hais qhov tseeb uas tshwj xeeb tshaj yog mob hnyav kawg tuag.
Terminology
Yog tias cov txheej txheem no tshwm sim hauv lub cev (qhov no, cov theem ntawm kev loj hlob ntawm qhov mob tsis raug suav nrog), ces tus yam ntxwv xaus "-nws" yuav tsum tau ntxiv rau lub npe ntawm tus kab mob, raws li ib tug tshwm sim. txoj cai, hauv Latin. Piv txwv li, o ntawm lub larynx, raum,lub plawv, peritoneum, pancreas yog hu ua, ntsig txog, laryngitis, nephritis, myocarditis, peritonitis, pancreatitis. Yog hais tias tus kab mob ntawm cov kab mob sib txuas los yog cov ntaub so ntswg adipose koom nrog kev mob ntawm lub cev, ces cov npe "para-" ntxiv rau lub npe: paranephritis, parametritis (mob ntawm lub tsev menyuam), thiab lwm yam. Tab sis nyob rau hauv qhov teeb meem no, xws li nyob rau hauv lub npe. txhua txoj cai, muaj kev zam, xws li cov ntsiab lus tshwj xeeb xws li angina lossis mob ntsws.
Vim li cas qhov mob tshwm sim?
Yog li cas yog lub ntsiab ua rau mob? Muaj peb hom ntawm lawv:
- Lub cev. Qhov no txhais tau hais tias cov txheej txheem inflammatory hauv lub cev yog tshwm sim los ntawm ntau yam kev raug mob, kub hnyiab, nrog rau hluav taws xob, frostbite, muaj lub cev txawv teb chaws, thiab raug hluav taws xob tam sim no.
- Biological. Hauv qhov no, peb txhais tau tias cov txheej txheem pathological tshwm sim los ntawm microbes, cov kab mob cab thiab cov kab mob. Cov kab mob no kuj suav nrog cov kab mob ntawm qee yam kab mob, xws li Koch's bacillus (tuberculosis), daj ntseg spirochete (syphilis), Mycobacterium leprosy (leprosy) thiab lwm yam.
- tshuaj. Cov pab pawg no yog tsim los ntawm cov teebmeem ntawm ntau yam tshuaj (tshuaj, tshuaj lom, ntsev, alkalis, acids, thiab co toxins tsim hauv lub cev nws tus kheej).
Kuj, kev puas siab puas ntsws loj, kev ntxhov siab tas li thiab haus cawv tuaj yeem ua rau mob.
Cov txheej txheem zoo li no yog mob hnyav lossis nojdaim ntawv mob. Thaum cov tshuaj tiv thaiv rau qhov stimulus tshwm sim tam sim ntawd, uas yog, leukocytes thiab plasma pib txav thiab coj zoo heev nyob rau hauv cov cheeb tsam cuam tshuam, qhov no characterizes precisely cov txheej txheem mob. Yog tias kev hloov pauv ntawm qib cellular tshwm sim maj mam, ces qhov mob hu ua mob ntev. Xav paub ntau ntxiv txog hom thiab cov ntawv yuav raug tham tom qab.
Symptomatics
Txhua theem ntawm qhov mob yog tus cwj pwm los ntawm cov tsos mob tseem ceeb zoo sib xws. Lawv muab faib ua hauv zos thiab dav. Thawj pab pawg muaj xws li:
- Hyperemia (redness) ntawm thaj chaw cuam tshuam. Daim paib no tshwm sim los ntawm cov ntshav khov heev.
- Hyperthermia yog qhov nce hauv qhov kub hauv zos raws li cov metabolism nrawm dua.
- Puffiness yog cov ntaub so ntswg impregnated nrog exudate.
- Acidosis yog nce acidity. Daim paib no feem ntau yog kub taub hau.
- Hyperalgia (mob hnyav). tshwm sim hauv cov lus teb rau cov teebmeem ntawm receptors thiab paj hlwb xaus.
- Poob lossis cuam tshuam ntawm thaj chaw cuam tshuam. tshwm sim los ntawm tag nrho cov tsos mob saum toj no.
Los ntawm txoj kev, qhov mob ntawm lub cev hauv nruab nrog cev tsis yog ib txwm tshwm sim los ntawm kev hnov mob, tab sis yog tias cov txheej txheem ua rau saum npoo, ces yuav luag tag nrho cov tsos mob saum toj no tshwm sim.
Cov paib dav dav tuaj yeem kuaj pom siv cov kev sim kuaj, tshwj xeeb, kuaj ntshav kom ntxaws. Piv txwv li, cov yam ntxwv hloov pauv hauv cov ntshav cov mis hauv nws cov leukocyte ib feem, thiabib qho kev nce ntxiv hauv ESR. Yog li, tau ua tib zoo kawm txog cov tsos mob no, qhov mob tuaj yeem kuaj tau. Cov theem ntawm qhov mob - yog cov lus nug tom ntej uas nyiam cov neeg kawm cov ncauj lus no.
theem thiab hom kev txhim kho ntawm cov txheej txheem inflammatory
Zoo ib yam li txheej txheem, qhov no kuj txhim kho nyob rau theem. Muaj 3 theem ntawm o. Lawv tuaj yeem tsim kho rau qib sib txawv, tab sis ib txwm muaj. Yog tias koj piav qhia lawv hauv cov lus yooj yim, qhov no yog kev puas tsuaj, exudate tso tawm thiab cov ntaub so ntswg loj hlob. Thawj theem ntawm o yog kev hloov pauv. Qhov no yog ua raws li exudation, thiab tom qab nws - proliferation.
Tam sim no nws tsim nyog los tham txog ntau yam kev mob uas cuam tshuam ncaj qha rau theem. Raws li twb tau hais lawm, thaum txoj kev loj hlob sai, nws yog hu ua mob. Feem ntau, txhawm rau kom tsim nyog nws, ntxiv rau lub sijhawm, cov theem ntawm kev mob hnyav xws li exudation thiab proliferation yuav tsum yeej.
Muaj ib qho kev faib ntxiv: banal (ib txwm) thiab txheej txheem tiv thaiv kab mob. Nyob rau hauv rooj plaub thib ob, qhov no yog cov tshuaj tiv thaiv ncaj qha ntawm lub cev tiv thaiv kab mob. Kawm txog cov theem thiab cov txheej txheem ntawm o ntawm hom no, peb tuaj yeem hais nrog kev ntseeg siab tias qhov gradation nyob ntawm seb nws yuav ncua lossis tam sim. Cov lus no tau piav qhia yooj yim heev: ua ntej ntawm tag nrho cov, nws yog tsim nyog sau cia hais tias lub mechanism rau qhov mob no yog antigen-antibody tandem. Yog hais tias cov tshuaj tiv thaiv rau ib qho kev cuam tshuam hauv lub cev tshwm sim tam sim ntawd, qhov tshwj xeeb no tau qhib ua ntej. Cov txheej txheem, thiab tom qab ntawd vim yog cov txheej txheem ntawm phagocytosis, sib xyaw ntawm cov txheej txheem tandem nrog leukocytes thiab kev puas tsuaj rau cov phab ntsa vascular, cov ntaub so ntswg edema thiab ntau cov hemorrhages sai sai. Ib qho piv txwv ntawm qhov mob hnyav no yog anaphylactic poob siab, Quincke's edema (los yog angioedema) thiab lwm yam txheej txheem uas yuav tsum tau ntsuas kom rov zoo.
Nrog cov tshuaj tiv thaiv qeeb rau cov tshuaj tiv thaiv, cov txheej txheem tsis nrawm heev (piv txwv li, Mantoux cov tshuaj tiv thaiv). Hauv qhov no, lymphocytes thawj zaug pom thiab rhuav tshem tus neeg sawv cev txawv teb chaws nrog rau cov ntaub so ntswg. Tom qab ntawd muaj kev loj hlob qeeb ntawm granuloma. Cov txheej txheem no yog tus yam ntxwv los ntawm cov chav kawm uas muaj kev ncua ntev.
Yog li, cov txheej txheem hauv qab no tau paub qhov txawv:
- Spicy. Nws lub sijhawm kwv yees li ob peb teev. Muaj qee zaus nws yuav siv sij hawm li ib lim piam.
- Subacute. Feem ntau ua tiav tom qab ob peb lub lis piam.
- Ntawm. Nws tuaj yeem kav ntev xyoo lossis txawm rau lub neej, ntws hauv nthwv dej: los ntawm exacerbation mus rau kev zam txim.
Kev puas tsuaj: Thawj theem
Yog li, cia peb mus rau qhov kev piav qhia ncaj qha ntawm kev hloov pauv hauv lub cev. Txhua yam mob pib li no. Raws li twb tau hais lawm, theem 1 ntawm qhov mob hu ua alteration (los ntawm lo lus alteratio - "kev puas tsuaj")
Nws yog qhov tawg ntawm cov ntaub so ntswg thiab, raws li, kev ua txhaum ntawm kev ncaj ncees ntawm cov hlwb thiab cov hlab ntsha uas ua rau muaj kev hloov pauv hauv necrotic thiab tso tawm cov tshuaj kho mob. Cov active tshuaj no hloov vascular tone,ua rau mob thiab o.
Exudation
Cov kab mob vascular nyob rau hauv qhov chaw mob ua rau exudation (exudatio). Qhov no yog theem 2 mob. Cov txheej txheem muaj nyob rau hauv kev tso cov kua dej rau hauv cov ntaub so ntswg. Nws yog hu ua exudate, uas tau muab lub laj thawj hu rau txoj kev no. Thaum lub sijhawm no tshwm sim, nws yog qhov ua kom muaj kev sib haum xeeb thiab cuam tshuam ntawm cov hlab ntsha uas ua rau mob.
Vim qhov spasm uas tshwm sim hauv cov hlab ntsha, cov ntshav ntws hauv qhov chaw puas tsuaj nce ntxiv, uas ua rau hyperemia. Tsis tas li ntawd, cov metabolism nce, thiab hyperemia los ntawm cov hlab ntsha nkag mus rau hauv venous. Vascular siab nce sai, thiab cov ntshav cov ntshav tawm ntawm lawv cov ciam teb. Cov exudate tuaj yeem yog qhov sib txawv, daim ntawv inflammatory tshwm sim los ntawm nws yuav nyob ntawm qhov no.
txheej txheem tsim khoom
Qhov thib peb ntawm qhov mob yog hu ua proliferative. Cov kauj ruam inflammatory no yog qhov kawg. Cov txheej txheem regenerative tshwm sim nyob rau hauv cov ntaub so ntswg ua rau nws muaj peev xwm los kho cov cheeb tsam puas los ntawm o, los yog ib qho caws pliav hauv qhov chaw no. Tab sis nyob rau hauv no zoo-tsim thiab ruaj khov tswvyim, muaj nuances: 3 theem ntawm o tuaj yeem sib txawv ntawm kev siv. Yog li ntawd, kuj tseem muaj ntau hom txheej txheem no.
Basic shapes
Hom, hom thiab theem ntawm qhov mob - qhov no yog qhov koj yuav tsum tau ua tib zoo saib ua ntej. Raws li peb twb pom lawm, lub sij hawm ntawm tus txheej txheem yog txiav txim los ntawm xws li ib tug tswvyim raws li hom. Tab sis tsis yog tag nrhoCov yam ntxwv uas qhov mob tuaj yeem ntsuas tau.
Cov theem ntawm qhov mob yog lub hauv paus ntawm nws qhov kev tsim nyog thiab kev ntsuam xyuas. Tab sis nws tshwm sim hais tias lub Cheebtsam ntawm cov txheej txheem yog qhia rau txawv degrees. Nyob ntawm lub hauv paus ntawm cov lus teb inflammatory, peb hom kev hloov pauv tshwj xeeb yog qhov txawv:
- Kev xaiv. Daim ntawv no yog tus cwj pwm los ntawm qhov tseem ceeb ntawm cov txheej txheem necrotic hauv lub cev o. Thaum lwm cov cim qhia tau tsawg dua. Feem ntau, daim ntawv no yog pom nyob rau hauv parenchymal kab mob: lub plawv, ob lub raum, daim siab. Hauv qhov no, kev tuag thiab kev lwj ntawm cov nqaij fibers thiab cov ntaub so ntswg yog yam ntxwv. Lo lus no yog me ntsis dhau lawm, tab sis nyob rau qee qhov chaw ntawm cov tshuaj nws tseem cuam tshuam.
- Exudative. Lub ntsiab lus ntawm lub ntsiab lus yog hais tias nrog xws li ib tug inflammatory daim ntawv, lub xub ntiag ntawm exudate yog yuav tsum tau. Nyob ntawm seb nws yuav ua li cas, muaj ntau yam kab mob xws li mob: purulent, hemorrhagic, serous, fibrinous, catarrhal. Cia peb nyob luv luv ntawm lawv txhua tus. Piv txwv li, serous o yog tus cwj pwm los ntawm kev tsim cov kua proteinaceous. Nws tuaj yeem sau cov kab noj hniav (pleural lossis articular hnab thiab lwm yam). Nws tseem tuaj yeem ua rau impregnate fibers thiab cov ntaub so ntswg nrog nws, ua rau muaj kev hloov pauv edematous. Koj tuaj yeem kho daim ntawv no los ntawm kev tso tawm cov exudate. Lub fibrinous daim ntawv ntawm o yog muab faib ua croupous thiab diphtheria. Nyob rau hauv cov ntaub ntawv no, secreted protein ua cov yam ntxwv dawb films. Qhov txaus ntshai ntawm daim ntawv no yog tias nws tuaj yeem tsimadhesions. Purulent o yog tus cwj pwm los ntawm kev tsim cov protein-leukocyte exudate. Sib tham txog cov ntaub ntawv, theem, hom mob, nws yog ib qho tsim nyog sau cia tias qhov no yog ib daim ntawv hnyav heev uas tuaj yeem ua rau cov ntaub so ntswg uas nws ntaus. Daim ntawv penultimate yog hemorrhagic. Cov exudate nyob rau hauv cov ntaub ntawv no suav nrog ntau cov qe ntshav liab. Qhov ntawd yog, raws li qhov tshwm sim, tso tawm nrog cov tshuaj sib xyaw ntawm cov ntshav yuav tshwm sim. Cov kab mob zoo li no muaj nyob rau hauv cov kab mob loj: anthrax, hemorrhagic meningitis, plague, smallpox thiab lwm yam. Nws cov txiaj ntsig yuav nyob ntawm tus neeg sawv cev ntawm tus kab mob. Tab sis hom mob no yog nyob rau hauv txhua rooj plaub tsis zoo heev. Daim ntawv catarrhal inflammatory yog qhov mob me tshaj plaws ntawm tag nrho cov npe. Nws nyiam tso cov hnoos qeev ntau (kua ntswg, tracheitis).
- Txoj kev loj hlob. Daim ntawv no yog tus cwj pwm los ntawm kev loj hlob sai ntawm cov ntaub so ntswg thiab tsim cov granulomas. Nws provokes cirrhosis (wrinkling) ntawm ntau yam kabmob, tsim nyob ib ncig ntawm txawv teb chaws lub cev thiab parasitic inclusions.
Raws li cov lus hais saum toj no, ib tus yuav tsum nyob hauv kev nthuav dav ntxiv ntawm cov theem ntawm purulent o yog qhov txawv los ntawm cov kws tshaj lij:
- Serous infiltrate.
- txheej txheem Necrotic (phlegmous, gangrenous, abscessing)
Lub ntsiab pustular formations tau muab faib ua hom hauv qab no:
- Focal o (abscess). Txwv tsis pub, xws li txheej txheem hu ua abscess. Nrog xws li o, cov nram qab no tshwm sim: ib tug festering kab noj hniav yog tsim nyob rau hauv lub tsom ntawm tus kab mob nrog ib tug tas li influx ntawm leukocytes rau hauv nws. Yog hais tias lub abscess tawg tawm sab nraud, ces nws yog hu uafistula. Qhov no kuj suav nrog boils thiab carbuncles.
- Empyema yog tsim ntawm purulent exudate nyob rau hauv tej kab noj hniav (appendix, pleura, parenchyma) vim impossibility ntawm outflow ntawm txheem.
- Kev nkag mus. Hauv lwm txoj kev, theem no hu ua phlegmon. Hauv qhov no, kua paug impregnates lub cev tag nrho. Cov txheej txheem tau nthuav dav thoob plaws hauv cov qauv ntawm thaj chaw cuam tshuam.
Purulent exudate tuaj yeem yaj tag, ua rau caws pliav. Tab sis kuj tseem muaj qhov ua tau ntawm qhov tshwm sim tsis zoo. Qhov no tshwm sim yog cov kua paug nkag mus rau hauv cov hlab ntsha. Yog li ntawd, sepsis inevitably tsim, thiab cov txheej txheem yuav txaus ntshai, generalized, tus kab mob kis thoob plaws lub cev.
Tus yam ntxwv piv txwv: mob ntsws
Nov yog ib yam kab mob loj tshaj plaws thiab tsis paub txog, tshwm sim los ntawm ntau yam kab mob uas ua rau mob ntsws. Nws yog lub xub ntiag ntawm exudate nyob rau hauv lub alveoli uas ua rau nws nyuaj rau tus neeg mob ua tsis taus pa thiab provokes ib tug kev hloov nyob rau hauv lub neej zoo rau lub zuj zus. Qhov tshwm sim nyob ntawm ntau yam, feem ntau ntawm tib neeg kev tiv thaiv. Tab sis nyob rau hauv txhua rooj plaub, nws muaj peev xwm taug qab tag nrho peb theem ntawm cov txheej txheem inflammatory siv tus piv txwv ntawm tus kab mob no.
mob ntsws kuj tseem tshwm sim hauv theem. Los ntawm qhov pom ntawm pathogenesis, 4 theem ntawm kev mob ntsws yog qhov txawv: kub ntws, liab hepatization, grey hepatization, daws teeb meem. Thawj ntawm lawv tsuas yog characterizes qhov ntxeem tau ntawm tus neeg sawv cev kis mus rau hauv lub cev, kev puas tsuaj rau kev ncaj ncees ntawm cov hlwb (hloov pauv). Yog li ntawd, muajdej yaug, tawv nqaij ua xua, ua tsis taus pa luv, mem tes ceev, cov tsos mob ntawm kev qaug dab peg.
Nyob rau hauv cov theem ntawm hepatization (liab thiab grey hepatization), exudate yog nquag tsim nyob rau hauv lub ntsws cov ntaub so ntswg. Nws yog cov txheej txheem no uas ua rau muaj qhov sib txawv ntawm hawb pob, tshwm sim ntawm intoxication, thiab neurological teeb meem. Kev tsim cov hnoos qeev ntau heev - cov exudate nyob rau hauv tag nrho cov cheeb tsam cuam tshuam. Qhov mob ntsws loj npaum li cas, hais tias qhov cuam tshuam ntawm qhov txhab (nruab nrab, ntu, lobe ntawm lub ntsws, lossis tag nrho qhov mob). Muaj cov xwm txheej thaum foci sib koom ua ke.
Thaum lub sijhawm ntawm kev daws teeb meem, cov txheej txheem exudate tau sib cais, thaj chaw cuam tshuam ntawm lub ntsws tau rov qab los (proliferation) thiab maj mam rov qab los. Ntawm chav kawm, cov theem ntawm mob ntsws kom meej meej qhia cov txheej txheem yam ntxwv ntawm lub xeev piav qhia ntawm lub cev. Ntxiv nrog rau kev mob ntsws, ib qho piv txwv ntawm cov kab mob feem ntau cuam tshuam ncaj qha rau kev txhim kho ntawm qhov mob tuaj yeem yog:
- Cov qog nqaij hlav cancer.
- Asthmatic hloov pauv.
- Prostatitis: ob qho tib si mob thiab ntev.
- Kab mob ntawm cov hlab plawv (xws li kab mob coronary).
- YGlomerulonephritis.
- plab hnyuv.
- Kab mob ntawm lub cev nyob rau hauv lub plab mog.
- Rheumatoid mob caj dab.
- Pab pawg ntawm cov kab mob autoimmune.
- YCystitis.
- Txoj kev tsis lees paub.
- Sarcoidosis.
Vasculitis
Thaum kawg, pob txuv tshwm sim tshwm sim vimCov txheej txheem inflammatory nyob rau saum npoo ntawm daim tawv nqaij thiab nyob rau hauv cov khaubncaws sab nraud povtseg ntawm cov epidermis.
Nws yog ib qho tseem ceeb uas lub cev tiv thaiv kab mob feem ntau ua si lom zem nrog lub cev, ua rau muaj kev mob tshwm sim. Qhia luv luv txog cov txheej txheem no, peb tuaj yeem hais tias lub cev tiv thaiv kab mob tawm tsam lawv lub cev. Lawv tuaj yeem pom tag nrho cov kab ke hauv nruab nrog cev raws li kev hem thawj rau lub neej ntawm tag nrho cov qauv. Vim li cas qhov no tshwm sim, hmoov tsis, tsis to taub tag nrho.
Summary xaus
Tau kawg, tsis muaj ib qho ntawm cov neeg nyob yog tiv thaiv kab mob los ntawm kev hloov pauv ntawm qhov sib txawv. Tsis tas li ntawd, cov txheej txheem no tau nthuav tawm rau tib neeg los ntawm qhov xwm txheej thiab yog tsim los txhim kho kev tiv thaiv thiab pab lub cev kom ua tiav txoj hauv kev ntawm evolution. Yog li ntawd, kev nkag siab txog cov txheej txheem uas tshwm sim thaum lub sij hawm inflammatory metamorphosis yog qhov tsim nyog rau txhua tus neeg nyob hauv lub ntiaj teb.
