Lo lus "mob ntsws mob ntsws" yog hais txog cov txheej txheem pathological ntawm qhov mob. Kev swb ntawm tsob ntoo bronchial feem ntau tshwm sim tawm tsam keeb kwm ntawm lub neej nquag ntawm cov kab mob. Kev sib cuag ntawm lub cev tsis tu ncua nrog cov tshuaj lom tshuaj lom neeg kuj tuaj yeem ua qhov ua rau muaj kev cuam tshuam. Cov tsos mob ntawm tus mob bronchitis zoo ib yam li cov tsos mob ntawm tus mob khaub thuas, thiab yog li ntawd qee tus neeg tsis mus ntsib kws kho mob raws sijhawm. Lub caij no, tsis quav ntsej cov pathology ua rau kev hloov pauv ntawm qhov mob mus rau hauv daim ntawv ntev. Pulmonologists koom nrog hauv kev kho tus kab mob. Nws yog rau cov kws tshaj lij ntawm qhov profile no uas koj yuav tsum tau tiv tauj thaum cov tsos mob ntawm tus mob bronchitis tshwm sim.
Etiology thiab pathogenesis
Kev nkag mus ntawm tus neeg ua haujlwm puas tsuaj rau hauv lub cev tshwm sim ua ke nrog cov pa nqus pa, tsawg dua - los ntawm txoj kev lymphogenous lossis hematogenous. Yog li ntawd, nyob rau hauv lub bronchicov txheej txheem ntawm kev loj hlob ntawm o pib. Nws yog nrog los ntawm o ntawm mucous daim nyias nyias, hyperemia thiab, raws li, impaired patency. Tom qab ib ntus, cov mucous lossis purulent zais cia pib tsim. Tsis tas li ntawd, mob bronchitis yog tshwm sim los ntawm degenerative hloov nyob rau hauv lub ciliated epithelium. Nyob rau hauv cov ntaub ntawv loj ntawm tus kab mob, tsis yog tsuas yog cov mucous daim nyias nyias koom nyob rau hauv lub pathological txheej txheem, tab sis kuj nyob rau hauv cov ntaub so ntswg tob.
Bronchitis yog kab mob sib kis. Cov kab mob kis tau los ntawm cov kab mob hauv huab cua. Qhov laj thawj tseem ceeb ntawm kev txhim kho tus kab mob:
- Kev ua haujlwm tseem ceeb ntawm cov kab mob (strepto-, pneumo- thiab staphylococci).
- Kab mob (ua pa syncytial, mob npaws, thiab lwm yam).
- Lub neej ua haujlwm ntawm cov neeg sawv cev atypical (piv txwv li, mycoplasmas thiab chlamydia).
- Fungi.
- Qhov muaj cov kab mob ntawm cov xwm txheej ntev, tshwj xeeb yog cov kab mob ntawm lub ntsws.
Cov hauv qab no yog qhov ua kom yuam kev:
- Tseem ceeb ua rau lub cev tsis muaj zog.
- Kev ua haujlwm tshaj lij cuam tshuam nrog kev sib cuag ntawm lub cev nrog cov tshuaj lom.
- cua kub lossis txias dhau.
- Dust.
- Smoke.
- Chlorine.
- pairs ntawm alkalis thiab acids.
- YHydrogen sulfide.
- Kev haus luam yeeb.
- Pob cawv.
- Nyob rau qhov tsis haum tshuaj.
- Zaj caj ces.
- Ntau zaus ntawm hypothermia.
- Yav dhau los mob hnyavpathology.
- noj tsis sib haum.
Raws li kev txheeb cais, feem ntau cov tsos mob ntawm tus mob bronchitis yog kuaj pom hauv cov menyuam yaus thiab cov neeg laus dua 50.
Kev faib tawm
Pathology muaj ntau hom. Mob bronchitis yog cais raws li hauv qab no:
- Raws li qhov etiological yam. Tus kab mob tuaj yeem kis tau, tsis kis thiab sib xyaw.
- Raws li cov txheej txheem ntawm kev txhim kho. Bronchitis tuaj yeem yog thawj lossis theem nrab. Nyob rau hauv rooj plaub tom kawg, pathology yog qhov tshwm sim ntawm lwm yam kab mob uas twb muaj lawm.
- Raws li qhov chaw ntawm qhov txhab (bronchiolitis, tracheobronchitis).
- Los ntawm cov txheej txheem inflammatory. Tus kab mob no yuav yog purulent los yog catarrhal.
- Los ntawm qhov ua txhaum ntawm txoj kev ua pa. Muab cov kab mob uas tsis muaj teeb meem thiab obstructive mob bronchitis. Cov tsos mob hauv thawj kis yog xyaum tsis tuaj, txij li cov txheej txheem ntawm lub ntsws ua pa yog xyaum tsis cuam tshuam. Hauv daim ntawv obstructive, me me bronchi thiab bronchioles raug cuam tshuam.
- Nyob ntawm qhov ntws. Tus kab mob no tuaj yeem ncua ntev lossis rov tshwm sim.
Tus kws kho mob pulmonologist yuav tsum cuam tshuam nrog txhua hom kab mob. Kev tsis quav ntsej txog cov tsos mob ntawm tus mob bronchitis feem ntau ua rau muaj kev cuam tshuam uas ua rau muaj kev phom sij tsis yog rau kev noj qab haus huv xwb, tab sis kuj rau lub neej ntawm tus neeg mob.
Kev kho mob tshwm sim
Cov tsos mob thiab lawv qhov hnyav ncaj qha nyob ntawm qhov ua rau muaj kev cuam tshuam thiab qib ntawm cov ntaub so ntswg puas. Lub pathology yog tus cwj pwm los ntawm qhov pib mob hnyav, nrog rau cov tsos mobintoxication thiab kev puas tsuaj rau lub ntsws. Bronchitis yog ua los ntawm cov tsos mob ntawm SARS. Tus neeg mob yws ntawm qhov ntswg congestion, mob thiab mob caj pas.
Cov tsos mob tseem ceeb ntawm tus mob bronchitis yog hnoos. Nws tshwm tam sim ntawd thiab nyob mus ib txhis. Raws li txoj cai, hnoos yog paroxysmal nyob rau hauv qhov xwm txheej. Nws yog sonorous thiab ntxhib, tsis tshua muaj barking. Thaum hnoos, qhov mob ntawm sternum nce ntxiv. Qhov tshwm sim ntawm overstrain ntawm cov leeg nqaij hauv cheeb tsam no yog qhov pom ntawm qhov tsis xis nyob hauv phab ntsa plab.
Thawj qhov cim ntawm mob ntsws ntsws mob rau cov neeg laus thiab menyuam yaus yog hnoos qhuav. Tom qab ib ntus, kev sib cais ntawm cov kua qaub thiab cov hnoos qeev pib tshwm sim. Tom qab ntawd qhov xwm ntawm pathological zais cia hloov. Tom qab ob peb hnub, cov hnoos qeev yuav khov. Nws tuaj yeem yog mucous lossis purulent hauv qhov xwm txheej. Nws yog sib cais yooj yim dua li ntawm thawj theem ntawm txoj kev loj hlob ntawm pathology.
Lwm cov cim qhia ntawm tus mob bronchitis:
- nce hauv lub cev kub, raws li txoj cai, rau cov ntsuas subfebrile.
- Zoo pib ntawm qaug zog.
- Tsis muaj zog.
- Headache.
- tawm hws ntau dhau.
- mob nraub qaum thiab qis qis.
Qhov kev siv ntawm cov tsos mob ntawm tus mob bronchitis nce ntxiv thaum tsis kho raws sijhawm. Cov txheej txheem inflammatory kis mus rau bronchioles, raws li qhov tshwm sim ntawm cov lumens ntawm tsob ntoo nqaim, ib qho kev cuam tshuam loj heev tshwm sim, kev sib pauv roj thiab cov ntshav ncig cuam tshuam.
Cov tsos mob ntawm tus kab mobntawm theem no:
- Fever.
- Cyanosis.
- Ntxhais tawv nqaij.
- ua tsis taus pa hnyav.
- mob hnoos, nrog rau cov pa tawm ntawm cov hnoos qeev scanty.
- Kev ntxhov siab, tam sim ntawd hloov los ntawm kev qaug zog thiab qaug zog.
- Txuag ntshav siab.
- Tachycardia.
Yog bronchitis ua xua nyob rau hauv qhov xwm txheej, ib qho kev mob obstructive tshwm sim, nrog los ntawm ib qho hnoos paroxysmal nrog tso tawm ntawm lub teeb ci ntsa iab. Tom qab kev sib cuag nrog cov tshuaj lom, laryngospasm tsim. Cov neeg mob yws yws ntawm lub hauv siab nruj, hnoos thiab ua tsis taus pa.
Cov tsos mob ntawm tus mob bronchitis hauv menyuam yaus yog tib yam li cov neeg laus. Tab sis cov me nyuam mob siab rau tus kab mob hnyav dua.
Auscultatory signs of acute bronchitis
Thaum thawj cov tsos mob ceeb tshwm sim, koj yuav tsum sab laj nrog kws kho mob pulmonologist. Tus kws kho mob yuav tsum tau muab cov ntaub ntawv hais txog cov tsos mob tshwm sim, lawv qhov hnyav thiab ntev.
Tom qab kev xam phaj, tus kws kho mob pib tshuaj xyuas tus neeg mob. Tus kws kho mob tshwj xeeb yam tsis tau ua tsis tiav mloog cov kab mob ua pa.
Auscultatory signs of acute bronchitis:
- Nkauj. Lawv tuaj yeem ua tau ob qho tib si noj qab haus huv thiab pathological. Nrog rau kev nthuav dav ntawm alveoli thiab ncab ntawm lawv cov phab ntsa, lub suab nrov nrov tau hnov. Bronchial ua pa yog hnov me ntsis nrov. Cov suab nrov no suav tias yog ib txwm muaj. Lub ntsiab auscultatory kos npe rau mob bronchitis nyob rau hauv cov neeg laus thiab cov me nyuam yogdej rales. Nyob rau hauv txhua rooj plaub, lub suab gurgling thiab hawb pob tau hnov zoo.
- Txhim kho lub exhalation ntawm alveolar ua pa. Cov yam ntxwv ntawm obstructive bronchitis. Tus mob no yog tshwm sim los ntawm obstructed cua nkag thiab nro nyob rau hauv lub alveolar phab ntsa.
Tom qab ua auscultation, tus kws kho mob yuav ua bronchophony. Lub ntsiab lus ntawm txoj kev yog ntsuas tsis yog ua pa, tab sis qhov xwm ntawm lub suab ua thaum nws. Tus kws kho mob hais kom tus neeg mob ntxhi lus uas muaj cov ntawv "h" thiab "p". Nyob rau hauv ib tug neeg noj qab nyob zoo, lub suab yog heev ntsiag to. Lawv patency nyob rau hauv mob bronchitis deteriorates ho.
Lab kuaj mob
Raws li cov txiaj ntsig ntawm kev tshawb fawb thiab kev kuaj mob, tus kws kho mob tau xa mus rau kev kuaj mob. Kev kuaj mob ntawm tus mob bronchitis muaj xws li cov khoom hauv qab no:
- Kev kuaj ntshav dav dav. Txoj kev tshawb no tau sau tseg kom paub meej lossis tsis suav nrog cov txheej txheem inflammatory hauv lub cev. Nrog bronchitis, cov leukocytes nce thiab ESR nce me ntsis.
- Kev kuaj ntshav biochemical. Qhov ntsuas tseem ceeb hauv kev kho mob yog tus nqi ntawm C-reactive protein. Nws yog suav hais tias yog ib hom cim ntawm cov txheej txheem inflammatory. Qhov siab dua nws tus nqi, qhov hnyav dua qhov pathology. Tsis tas li ntawd, kev nce hauv alpha-2 globulins yog ib qho cim ntawm kev mob ntsws ntsws.
- kuaj zis. Nws yog nqa tawm nyob rau hauv thiaj li yuav soj ntsuam kev ua hauj lwm ntawm ob lub raum tiv thaiv keeb kwm yav dhau ntawm cov txheej txheem inflammatory uas twb muaj lawm. Ntxiv mus, thaum txhais lusCov txiaj ntsig ntawm kev tshuaj xyuas, tus kws kho mob tuaj yeem txheeb xyuas txhua yam teeb meem ntawm bronchitis.
- Kev kuaj kab mob hnoos qeev. Nrog bronchitis, coob tus neutrophils, tuag epithelial hlwb thiab macrophages muaj nyob rau hauv lub pathological zais cia. Nyob rau hauv daim ntawv obstructive ntawm tus kab mob, Kurshman tus kauv raug kuaj.
- Kev kuaj kab mob ntawm cov hnoos qeev. Kev tshuaj ntsuam tso cai rau koj txheeb xyuas tus neeg sawv cev ua rau tus kab mob.
Raws li cov ntaub ntawv tau txais, tus kws kho mob tuaj yeem xaiv cov tshuaj tua kab mob zoo tshaj plaws rau tus neeg mob.
Instrumental diagnostics
Tus kws kho mob tshwj xeeb tuaj yeem xav tias muaj tus kab mob ntsws uas twb muaj lawm thaum lub sijhawm auscultation. Txhawm rau kom paub meej lossis tsis suav nrog qhov kev kuaj mob, tus kws kho mob pulmonologist tau xa mus rau x-ray.
Cov tsos mob ntawm tus mob bronchitis:
- Nyob hauv lub ntsws, cov kua dej nkag mus rau hauv lub ntsws yog pom meej.
- cov hlab ntsha me tsis pom ntawm daim duab.
- Lub hauv paus ntawm lub ntsws ua qhov muag plooj. Tsis tas li ntawd, nws yog loj thiab deformed.
Thaum mob hnyav, tsis muaj cov hlab ntsha ntawm x-ray, thiab lub ntsws hloov pauv heev.
Yog tias tsim nyog, tus kws kho mob tau sau cov kev tshawb fawb ntxiv (pneumotachography, peak flowmetry, spirography).
Drug therapy
Txawm hais tias qhov mob hnyav ntawm cov tsos mob ntawm tus mob bronchitis, kev kho cov neeg laus thiab menyuam yaus yuav tsum tsis txhob ncua. Qhov no yog fraught nrog txoj kev loj hlob ntawm cov teeb meem ntawm lub neej.
thawj kab ntawm kev kho mob bronchitis yog tshuaj tua kab mob. Cov kws kho mobsau cov lus hauv qab no:
- Aminopenicillins. Cov no suav nrog: "Amoxiclav", "Augmentin", "Amoxicillin"
- YMacrolides. Piv txwv ntawm cov nyiaj: "Sumamed", "Macrofoam".
- YFluoroquinolones. Feem ntau, cov kws kho mob muab tshuaj Levofloxacin.
- YCephalosporins. Piv txwv li, Cefazolin.
Kev xaiv tshuaj tua kab mob yog tsim los ntawm kws kho mob raws li cov txiaj ntsig ntawm kev kuaj mob. Nyob rau theem pib ntawm txoj kev loj hlob, lawv cov kev tswj qhov ncauj tau raug sau tseg. Hauv qhov xwm txheej hnyav, txhaj tshuaj yog qhia.
Tsis tas li ntawd, kev kho mob ntawm pathology suav nrog kev noj tshuaj tiv thaiv kab mob thiab tshuaj tua kab mob, nrog rau cov tshuaj bronchodilators thiab multivitamin complexes. Thaum kho, pw tsaug zog yuav tsum tau soj ntsuam.
ua pa ua pa
Tshaj tawm kom tshem tawm stagnation ntawm cov hnoos qeev, nrog rau rov ua kom cov mucous membrane. Feem ntau siv ua pa ce raws li Strelnikova. Nws lub ntsiab lus yog nyob rau hauv qhov tseeb hais tias ua pa yuav tsum tau coj los ntawm lub qhov ntswg, thaum lawv yuav tsum nquag thiab nrov. Koj yuav tsum exhale passively thiab ntsiag to. Qhov no tuaj yeem ua tiav ntawm qhov ntswg thiab qhov ncauj.
ua pa ua pa tuaj yeem ua tau rau txhua txoj haujlwm. Nws tshwm sim txij hnub thib ob ntawm kev noj tshuaj tua kab mob.
kev kho neeg zoo
Kev siv cov txheej txheem tsis yog ib txwm ua kom muaj txiaj ntsig zoo ntawm kev kho tshuaj. Tab sis nws yog ib qho tseem ceeb uas yuav tsum nco ntsoov tias pej xeem txoj kev yuav tsum tsis txhob suav hais tias yog kev kho mob tseem ceeb rau mob ntsws ntsws.
MuajDaim ntawv qhia ua noj:
- Kev nqus pa. Boil ob peb qos tubers. Nqa lawv tawm ntawm lub thawv. Cia cov kua kom txias me ntsis. Rau ob peb feeb, ua pa tshaj cov dej uas cov tubers tau boiled. Yog tias cov kua tsis tso cai kom txias me ntsis, cov kab mob tuaj yeem ua rau mob hnyav heev.
- Muab qhov sib npaug ntawm oregano, thyme, linden, coltsfoot, licorice thiab plantain. Ua tib zoo sib tov cov khoom ua ntej qhuav thiab hauv av. Noj 1 tbsp. l. sau thiab ncuav nws nrog 500 ml ntawm boiling dej. Cia nws brew rau 2 teev. Haus dej me me thoob plaws ib hnub.
- Finely chop ib nrab dos. Sib tov nws nrog zib mu nyob rau hauv ib tug ratio ntawm 3: 1. Cia nws brew rau 3-4 teev. Noj 1 tsp. ob zaug ib hnub. Dos tuaj yeem hloov nrog qej. Nws tsis pom zoo kom noj cov tshuaj no rau cov tib neeg uas muaj kab mob pathologies ntev ntawm lub plab zom mov.
Txhua yam kev kho pej xeem yog ib qho ua xua. Yog tias cov tsos mob tshwm sim tsis zoo tshwm sim, kev kho tus kab mob nrog cov txheej txheem tsis zoo yuav tsum raug tso tseg.
Nyob hauv kaw
Lo lus "mob ntsws mob ntsws" yog hais txog cov txheej txheem inflammatory cuam tshuam rau tsob ntoo bronchial. Thaum pib ntawm txoj kev loj hlob, kev kho mob tshwm sim ntawm pathology zoo ib yam li cov tsos mob ntawm tus mob khaub thuas. Hauv qhov no, cov neeg feem coob mus ntsib kws kho mob nyob rau theem ntawm kev loj hlob ntawm cov teeb meem. Tus kws kho mob pulmonologist tuaj yeem ua qhov kev kuaj mob ua ntej lawm thaum lub sijhawm teem sijhawm thawj zaug. Nws sau ib qho anamnesis thiab ua auscultation. Raulees paub nws qhov kev tsis txaus siab, tus kws kho mob xa tus neeg mob mus rau qhov kev ntsuam xyuas dav dav. Nws suav nrog ob qho tib si kuaj thiab ntsuas ntsuas ntsuas.
