Kev mob ntsws ntsws yog ib yam kab mob ntawm txoj hlab ntsws uas tshwm sim nrog intraalveolar exudation thiab yog nrog los ntawm cov chaw kho mob thiab hluav taws xob.
Ntawm cov neeg nyob hauv kev tuag, mob ntsws yog nyob rau thib plaub tom qab cov kab mob plawv thiab vascular, malignant neoplasms, raug mob thiab kab mob hauv plab. Raws li qhov hnyav ntawm kev mob ntsws, tus kab mob tuaj yeem ua tiav hauv cov neeg mob qaug zog, nrog lub plawv tsis ua haujlwm, nrog cov kab mob oncological, cerebrovascular pathologies, thiab cuam tshuam cov txiaj ntsig ntawm cov kab mob yav dhau los. Hauv cov neeg mob AIDS, mob ntsws yog suav tias yog qhov ua rau tuag.
Symptoms
Kev tsis txaus siab nrog mob ntsws muaj ntau yam. Cov tsos mob hauv qab no ntawm kev mob ntsws muaj qhov txawv:
- nrawm nrawm, nce mus txog 39-40 degrees;
- mob hnoos hnoos qeev;
- mob plab thaum hnoos.
Signs
Tus neeg sawv cev ntawm tus kab mob ntsws tau piav qhia yog pneumococcus. Daim ntawv atypical muaj peev xwm muaj lwm yam cimkab mob:
- hnoos qhuav;
- mob leeg;
- xav mob caj pas;
- kev qaug zog.
Cov chav kawm zoo li no yog tus yam ntxwv ntawm mycoplasma thiab chlamydial pneumonia.
Diagnosis
Kev kuaj mob yog nyob ntawm tus neeg mob qhov kev tsis txaus siab. Cov yam ntxwv ntawm kev kuaj mob ntsws ntsws yog qhov muaj infiltration hauv lub ntsws cov ntaub so ntswg. Vim li no, electroradiography ntawm lub ntsws yog suav hais tias yog ib qho tseem ceeb ntawm kev kuaj mob, thaum infiltration yog kuaj pom tias yog ib qho darkening nyob rau hauv lub ntsws cov ntaub so ntswg.
Tab sis nrog atypical mob ntsws, qee zaum, qhov chaw ntawm infiltration tsuas yog kuaj tau nrog kev txhawb nqa ntawm kev suav tomography. Ntawm chav kuaj txoj kev tshawb fawb, kev kuaj ntshav dav dav yog qhov tseem ceeb tshwj xeeb.
Rau cov kab mob ntsws zoo tib yam, nws yog ib qho ua rau yuam cov erythrocyte sedimentation rate (ESR), neutrophil leukocytosis nrog kev hloov mus rau sab laug (qhov nce ntawm cov stab - cov ntawv hluas ntawm neutrophils), nce hauv Tus naj npawb ntawm monocytes thiab txo qis hauv lymphocytes.
Viral pneumonia yog tus yam ntxwv los ntawm kev nrawm ESR, ib txwm suav cov qe ntshav dawb, txo qis ntawm cov neutrophils nrog kev nce ntawm cov monocytes thiab lymphocytes.
Txhawm rau txhawm rau kuaj mob chlamydial lossis mycoplasmal pneumonia, kuaj pom qhov nce ntawm titer ntawm cov tshuaj tiv thaiv tshwj xeeb hauv thawj 2 lub lis piam ntawm kev mob yog qhov tseem ceeb. Thaum sowing, ib qho irritant yog kuaj thiab nws susceptibility rau tshuaj tua kab mob yog txiav txim. Nws yuav tsum tsis txhob hnov qab tias sowing yuav tsum tau ua ua ntej pibtshuaj tua kab mob.
Kev cais tawm ntawm mob ntsws
Kev ntsuas rau qhov hnyav ntawm mob ntsws yog nyob ntawm hom kab mob.
Cov ntaub ntawv kis kabmob kis tau raws li:
- tawm-ntawm-tsev kho mob (tawm-ntawm-tsev kho mob);
- tsev kho mob (tsev kho mob).
Raws li tus mob etiological nrog cov ntsiab lus ntawm cov kab mob:
- kis;
- fungal;
- combined.
Raws li kev hloov pauv ntawm kev tsim, muaj mob ntsws:
- thawj, tawm los ua tus kab mob ywj pheej;
- secondary, tsim los ua qhov hnyav ntawm cov kab mob sib kis, piv txwv li, kab mob congestive;
- aspiration, tsim thaum lub cev txawv teb chaws nkag mus rau hauv lub bronchi (khoom noj, ntuav, thiab lwm yam);
- kev raug mob postoperative infarction-pneumonia, uas yog tsim los ntawm thromboembolism ntawm me me venous ceg ntawm pulmonary artery.
Raws li qhov chaw nyob hauv lub ntsws, lawv txawv:
- ib leeg nrog kev puas tsuaj rau sab xis lossis sab laug sab xis;
- bilateral tag nrho, lobular, segmental, sublobular, hilar (main).
Los ntawm qhov kev taw qhia ntawm kev mob ntsws tuaj yeem yog:
- ntsim;
- mob.
Tau tsim cov kab mob ua haujlwm ntau yam ntawm kev mob ntsws:
- nrog rau qhov muaj ntau yam pathologies (nrog rau cov tshuaj ntawm lawv cov yam ntxwv thiab qhov hnyav);
- tsis muaj kab mob ntau yam.
Tau tsim cov teeb meem ntawm kev mob ntsws tuaj yeem ua tau:
- chav kawm tsis yooj yim;
- kev taw qhia nyuaj (nrog pleurisy, abscess, enterobacterial toxic shock, myocarditis, endocarditis, thiab lwm yam).
Raws li kev kho mob thiab morphological thaj chaw, mob ntsws muaj qhov txawv:
- parenchymal (croupous lossis lobular);
- focal (bronchopneumonia, lobular pneumonia);
- interstitial (tam sim no hauv mycoplasma lesions).
Degrees ntawm qhov hnyav
Kev faib tawm ntawm mob ntsws los ntawm qhov hnyav:
- Qib Siab Me - tus cwj pwm los ntawm kev qaug cawv me me (kev nkag siab meej, lub cev kub siab txog 38 ° C, ntshav siab yog ib txwm muaj, lub plawv dhia tsis tshaj 90 neeg ntaus ib feeb), tsis muaj qhov ua tsis taus pa thaum so, qhov chaw tsis tseem ceeb tau sau tseg ntawm kev kuaj x-ray o.
- Qib Nruab Nrab - cov tsos mob ntawm kev qaug cawv me me (kev nkag siab meej, hyperhidrosis, tsis muaj zog, siab lub cev kub txog 39 ° C, ntshav siab sib npaug, lub plawv dhia - kwv yees li 100 neeg ntaus ib feeb.), ua pa ua pa - nce mus txog 30 feeb ntawm so, X-ray kev kuaj pom pom pom kev nkag mus.
- Kev mob ntsws loj heev - tshwm sim los ntawm kev qaug dab peg (ua npaws, kub nce mus rau 39-40 ° C, tsis meej pem, tsis muaj zog, delirium, tachycardia - tshaj 100 ntaus ib feeb,cev qhuav dej), ua tsis taus pa - mus txog 40 ib feeb ntawm so, cyanosis, dav infiltration yog txiav txim radiographically, tsim cov teeb meem ntawm mob ntsws.
cwj pwm
Raws li cov kws kho mob cov lus pom zoo, qhov xaus "kev mob ntsws hauv zej zog ntawm qhov mob hnyav" raug pom zoo yog tias tus neeg mob muaj qhov tshwm sim hauv lub ntsws ntawm kev kuaj x-ray thiab tsawg kawg 2 lossis ntau cov tsos mob tshwm sim:
- fever (>38, 0°C) nrog qhov pib sai sai;
- hnoos hnoos;
- suab hloov;
- leukocytosis tshaj 10.
kho mob ntsws ntsws
Cov tshuaj tseem ceeb rau kev kho mob ntsws me me yog cov tshuaj tua kab mob. Lawv xaiv, koob tshuaj thiab lub sijhawm siv yog txiav txim los ntawm tus kws kho mob tuaj koom. Tsis tas li ntawd, cov tshuaj bronchodilators thiab cov hnoos qeev-thinning tshuaj, tshuaj tua kab mob thiab cov tshuaj tonic tau muab sau ua ke nrog cov kua dej ntau.
Nrog kev kho mob kom zoo ntawm cov mob ntsws hauv zej zog nruab nrab, cov tsos mob txaus ntshai ploj hauv 3-4 lub lis piam nrog kev rov ua kom pom tseeb ntawm lub ntsws. Txawm li cas los xij, kev ua haujlwm ntawm cov kab mob ua pa tseem txo qis rau lwm 1-6 lub hlis, thiab yog li ntawd, nyob rau lub sijhawm no, nws yog ib qho tsim nyog los ua cov kev kho ua pa thiab zaws lub hauv siab, physiotherapy ce, thiab climatotherapy. Yog hais tias pneumonic infiltration tsis ploj nyob rau hauv lub sij hawm, nws yog nqa tawmntau qhov kev ntsuam xyuas kom paub meej txog qhov ua rau muaj kev cuam tshuam (kev tiv thaiv qis, cov yam ntxwv ntawm cov kab mob, muaj lwm yam mob ntsws).
Mode
Rau qhov kev kho mob zoo rau mob ntsws, koj xav tau txoj haujlwm niaj hnub zoo: txhua qhov kev tswj hwm thiab kev tshawb fawb yuav tsum tsis tshua muaj txiaj ntsig, kev saib xyuas tus kheej ntawm tus neeg mob yog qhov tseem ceeb. Kev so hauv txaj yog raug sau tseg, thiab feem ntau nws yog qhov tsim nyog los hloov txoj hauj lwm ntawm lub cev. Nws yog ib qho tsim nyog yuav tsum tau txo qis kev ua si ntawm lub cev thaum lub sij hawm mob ntsws, tshwj xeeb tshaj yog nrog kev mob hnyav, nrog rau kev maj mam nce ntxiv tom qab cov xwm txheej zoo dua. Lub cev hnyav dhau tom qab mob ntsws yog contraindicated rau lwm 6-12 lub lis piam.
Kev kho mob rau mob ntsws
Nrog rau kev kho cov kab mob tua kab mob, kev kho mob kom zoo ntawm kev mob ntsws yuav tsum tau kho cov kev kho mob nyuaj thiab kho cov tsos mob.
Ua pa tsis ua haujlwm yog cuam tshuam nrog microcirculation teeb meem, qhov mob loj ntawm lub ntsws lossis cov ntaub so ntswg interstitial, pathology ntawm bronchial conduction, tsim cov exudative pleurisy loj heev.
Nws yog ib qho tsim nyog los kho cov kab mob bronchial (bronchodilators, mucolytics thiab expectorants), txo cov kev txwv kev hloov pauv (piv txwv li, sau ib qho enema nyob rau hauv cov ntaub ntawv ntawm flatulence thiab siab sawv ntawm lub diaphragm)..
Hauv cov hlab plawv pathologies, cov tshuaj cardiotropic yog siv ("Strophanthin-K", "Korglikon", "Digoxin") thiab cov neeg ua haujlwm uas kho microcirculation (parenteral). Kev taw qhia txog cov tshuaj nruab nrab-molecular colloidal, cov tshuaj uas ua kom cov ntshav zoo meej, thiab vasodilators).
Thaum muaj kev mob toxic, kev kho infusion yuav tsum tau ua nrog rau cov sib xyaw ua ke ntawm kev quab yuam diuresis. Hauv cov theem hnyav, kev tswj hwm ntawm glucocorticoids intravenous ntawm koob tshuaj 4-5 mg / kg / hnub yog qhia. Nrog rau kev kis kab mob, kev siv plasmapheresis yuav ua tau zoo heev. Kev hloov pauv hauv acid-base tshuav yuav tsum tau kho kom raug.
Kev noj haus rau mob ntsws
Khoom noj khoom haus yuav tsum ua raws li qhov xav tau ntawm lub hnub nyoog rau lub zog, proteins, rog thiab carbohydrates. Tab sis, coj mus rau hauv tus account qhov txo qis qab los noj mov nyob rau hauv cov kev mob hnyav, tus neeg mob yuav tsum tau noj ntau zaus, noj me me, thiab noj nws cov tais diav uas nyiam. Twb tau tom qab txhim kho kev noj qab haus huv, normalizing lub cev kub, qab los noj mov ua kom zoo dua.
Cov menyuam yaus hnub nyoog qis dua 6 lub hlis yuav tsum tau pub mis niam lossis cov khoom noj mis tshwj xeeb. Nws yog ib qho tsim nyog los txo qis cov carbohydrates hauv cov zaub mov, vim tias lawv ua kom cov fermentation txav hauv cov hnyuv, thiab tsam plab thiab siab sawv ntawm diaphragm ua rau ua pa nyuaj, ua rau ua pa luv. Kev noj haus zoo tshaj plaws yog qhov tseem ceeb heev, suav nrog kev siv dej txhua hnub. Cov kua dej uas tau txais yuav tsum raug kho raws li nws qhov poob ntawm tus neeg mob lub cev (ua npaws thiab ua tsis taus pa).
Kev tiv thaiv kab mob ntsws
Siv rau kev tiv thaiv:
- Ntxhais. Txhim kho cov txheej txheem ntxiv dag zog rau lub cev tiv thaiv kab mob thiab ua kom lub cev tiv thaiv ntau yam kab mob. Kev tiv thaiv kab mob ntsws feem ntau suav nrog kev kho dej zoo sib xws thiab so ko taw. Peb yuav tsum tsis txhob hnov qab tias qhov kub ntawm cov dej pib yuav tsum tsis txhob qis dua 35 degrees. Nyob rau tib lub sijhawm, daim duab no tau txo qis rau 25 degrees.
- ua pa ua pa. Ib hom prophylaxis zoo sib xws kuj tseem siv rau cov neeg mob pw hauv txaj. Ua pa gymnastics yog tsom rau kev txhim kho lub ntsws ua pa. Txhawm rau tiv thaiv suppuration, nws yog ib qho tsim nyog yuav tsum tau ua kom lub pob balloons los yog ua pa sib sib zog nqus thiab exhalations.
- Tshem tawm qhov chaw kis kab mob. Nws tau raug tsim los hais tias banal tonsillitis los yog cov hniav carious uas tsis kho tuaj yeem ua rau mob ntsws loj, vim tias cov kab mob no yog ib qho ntawm cov kab mob uas tuaj yeem mus rau hauv lub ntsws.
- Kev tiv thaiv kab mob. Rau cov laj thawj no, immunomodulators ntawm cov nroj tsuag feem ntau siv: echinacea, chamomile, kua txob qus thiab lwm yam. Noj li infusions los yog tshuaj yej.
- Massaging. Ib txoj hauv kev los tiv thaiv kab mob ntsws yog massage. Nws yog siv rau cov neeg laus thiab cov menyuam yaus, suav nrog cov neeg uas nyuam qhuav yug los. Tib lub sijhawm, thaum zaws, nws siv cov txheej txheem tseem ceeb - patting.
