Pneumonia yog ib qho mob kis mob uas tshwm sim hauv lub ntsws. Pathology yog kab mob txaus ntshai rau cov menyuam yaus thiab cov tub ntxhais hluas. Cov menyuam yaus hnub nyoog qis dua 1 xyoos yog qhov nyuaj rau tus kab mob. Cov teeb meem ntawm mob ntsws nyob rau hauv cov me nyuam tsis yog ib qho yooj yim. Zaj lus qhia txog qhov tshwm sim ntawm tus kab mob no.
Kev tsis sib haum xeeb feem ntau
Raws li WHO, txhua xyoo kwv yees li 15% ntawm cov neeg mob kuaj pom tus kab mob ua rau tuag. Kev tuag ntau ntxiv yog txuam nrog cov yam tsis zoo: nws tuaj yeem yog qhov tsis muaj kev kho mob raws sijhawm lossis xaiv txoj kev kho tsis raug. Qhov ua rau muaj mob ntsws ntsws hauv cov menyuam yaus kuj suav nrog cov kab mob kho tsis zoo, nrog rau kev noj tshuaj rau tus kheej hauv tsev.
Ntawm qhov tshwm sim tshwm sim, cov kws tshaj lij paub qhov txawv txav tam sim thiab qeeb. Thawj pab pawg muaj xws li kev txhim kho cov teeb meem purulent hauv pulmonary system thiab bronchi, neurotoxicosis lossismalignant intoxication ntawm lub cev. Cov kev tshwm sim no tshwm sim nyob rau hauv lub ntsws ntawm cov me nyuam nyob rau 2nd-3rd hnub ntawm qhov pib ntawm ib tug mob hnyav. Tag nrho cov teeb meem tshwm sim ntawm kev mob ntsws hauv cov menyuam yaus tau piav qhia hauv qab no.
Tsab ntawm qhov tshwm sim
Cov tsos mob hnyav ntawm mob ntsws hauv cov menyuam yaus tshwm sim tom qab ua tiav ntawm theem mob ntawm tus kab mob. Lawv ua rau ib tug deterioration nyob rau hauv tus mob ntawm tus me nyuam. Qhov tshwm sim tau muab faib ua 2 hom:
- mob ntsws ntsws ntawm cov menyuam yaus uas tsis tuaj yeem kis mus rau lwm yam kabmob. Cov pab pawg no suav nrog pleural empyema lossis exudative pleurisy.
- Cov teeb meem mob ntsws ntsws ntawm cov menyuam yaus uas kis mus rau lwm yam kabmob. Cov no muaj xws li lub plawv tsis ua hauj lwm, ua tsis taus pa, sepsis, abscess.
Txhua yam zoo ib yam (pulmonary, extrapulmonary) teeb meem tshwm sim nrog croupous pneumonia hauv menyuam yaus.
Hauv lub cev ntawm cov menyuam yaus, qhov mob ntawm sab laug ntawm lub ntsws feem ntau tshwm. Tus me nyuam raug kuaj pom muaj mob ntsws sab laug, thiab nyob rau hauv ib tug neeg laus - ib qho mob ntawm sab xis ntawm lub ntsws. Pneumonia yog qhov txaus ntshai tshwj xeeb rau cov menyuam mos. Feem ntau, kev kis mob tshwm sim thaum yug menyuam lossis thawj hnub ntawm lub neej.
Tam sim teeb meem
Qhov laj thawj tseem ceeb ntawm kev mob ntsws ntsws hauv cov menyuam yaus yog xaiv tsis raug lossis kho tsis tiav. Cov kab mob tam sim ntawd suav nrog:
- Intoxication lossis Waterhouse-Friderichsen syndrome. Nws tshwm sim thaum endotoxins nkag mus rau hauv cov hlab ntsha. Xws li cov kab mob lom kab mob ua rau muaj kev lom lom heev. Tus me nyuam raug soj ntsuamQhov kub nce mus txog 39 degrees, nws yog ib qho nyuaj rau coj nws mus. Lwm cov cim qhia muaj xws li lethargy, tsis kam noj, qaug zog, febrile fever. Cov cim no tuaj yeem cuam tshuam ua pa, ua rau muaj teeb meem. Qhov tshwm sim txaus ntshai ntawm tus mob no suav nrog kev tuag.
- Neurotoxicosis. Cov yam ntxwv muaj xws li lub siab ntawm tus me nyuam, uas yog hloov los ntawm ib tug ntse apathy. Tej zaum yuav muaj kev nyuaj siab thiab qaug zog. Tom qab kev tawg, qhov kub nce mus rau 40 degrees. Tom qab ntawd cov tsos mob ntawm convulsions yog zoo li, tej zaum yuav muaj ib tug luv luv lub sij hawm tsis ua pa.
Nyob tsis tu ncua
Cov no yog cov teeb meem ntawm mob ntsws ntsws hauv cov menyuam yaus. Nyob rau hauv lub ntsws cov ntaub so ntswg muaj o tshwm sim los ntawm pathogenic microflora. Cov menyuam yaus muaj lub sijhawm nyuaj nrog tus mob no. Muaj kev pheej hmoo ntawm ntau qhov tshwm sim hnyav.
Cov teeb meem lig ntawm mob ntsws ntsws hauv cov menyuam yaus suav nrog:
- Exudative pleurisy lossis tsub zuj zuj ntawm cov kua hauv lub pleura. Yog tias sab laug tsis kho, qhov xwm txheej ntawm "hauv siab dropsy" tshwm. Cov tsos mob ntawm cov teeb meem tom qab mob ntsws nyob rau hauv cov me nyuam muaj xws li mob hnyav nyob rau hauv lub hauv siab cheeb tsam. Nws yuav tuaj yeem txhim kho qhov teeb meem nrog kev sib tsoo lossis ua haujlwm.
- Purulent pleurisy. tshwm tom qab txheej txheej ntawm lub cev ntawm tus kab mob ntawm ib tug thib ob xwm. Muaj kev nkag mus ntawm cov kab mob pathogenic rau hauv cov kab mob ua pa thiab purulent o tshwm. Cov tsos mob muaj xws li lub cev kub qis, ntuav, hnoos expectorant nrog kua paug.
- Gangrene. Ua rau lwj thiab lwjlub ntsws. Qhov teeb meem tshwm sim thaum daim ntawv tab tom khiav. Nyob rau hauv lub ntsws, ua kom pom tseeb uas muaj cov kua paug, cov ntaub so ntswg melting yog pom. Qhov no tshwm sim tshwm sim nyob rau hauv daim ntawv ntawm grey-ntsuab hnoos qeev, ib qho tsis kaj siab tsw, o ntawm cov ntiv tes thiab cov ntiv taw.
- Kev mob ntsws ntawm lub ntsws. 1 tsom ntawm qhov mob tshwm sim hauv lub cev. Nyob rau theem 1, cov tsos mob ntawm intoxication, mem tes ceev, ua tsis taus pa yog txawv. Nws tsis tshua pom muaj menyuam yaus. Feem ntau tshwm sim rau cov neeg laus uas haus cawv.
- Kev puas tsuaj ntau. Nyob rau hauv no purulent-inflammatory txheej txheem, kab noj hniav tshwm nyob rau hauv lub ntsws cov ntaub so ntswg. Piv nrog rau qhov abscess, muaj ob peb foci thiab cov hnoos qeev muaj zog (txog li 1 litre ib hnub). Lub tom kawg sawv tawm "nrog lub qhov ncauj".
- Pulmonary edema. Yog vim li cas yog lub tsub zuj zuj ntawm cov kua nyob rau hauv lub ntsws cov ntaub so ntswg. Nrog rau qhov teeb meem no, oxygen txo qis thiab carbon dioxide accumulates hauv cov ntshav, ua tsis taus pa thiab cyanosis tshwm sim. Cov rales yog cov dej noo, lawv pom tau txawm tias nyob deb. Thaum hnoos, paj yeeb ua npuas ncauj tawm ntawm qhov ncauj - qhov ntxoov ntxoo no cuam tshuam nrog kev nkag mus ntawm cov qe ntshav liab los ntawm cov ntshav mus rau alveoli.
Ua pa tsis ua haujlwm
Qhov no yog ib qho teeb meem ntawm kev mob ntsws hauv cov menyuam yaus, feem ntau pom hauv cov menyuam kawm ntawv preschool. Nws manifests nws tus kheej nyob rau hauv daim ntawv ntawm ua tsis taus pa luv, ua pa ntiav, los yog ib tug nquag ua pa / exhalations. Hauv cov menyuam yaus, muaj kev hloov pauv ntawm qhov ntxoov ntxoo ntawm daim di ncauj, cyanosis tshwm sim. Pathology tuaj yeem ua tiav hauv 3 theem. Ntawm thawj qhov, ua tsis taus pa tshwm sim tom qab lub cev ua haujlwm lub zog, ntawm qhov thib ob - tom qab me ntsis ntxiv, ntawm peb, ua tsis taus pa thiab ntuav tshwm sim hauv lub xeev siab.
Kev mob siab rau
Tom qab mob ntsws ntsws hauv cov menyuam yaus - qhov teeb meem tshwm sim tshaj plaws. Kev tsis ua haujlwm ntawm cov hlab plawv system tshwm sim nrog ntau hom kab mob. Sab laug tsis kho, cov kab mob no ua rau cov ntshav tsis txaus los yog endocarditis.
Qib kev qaug cawv thiab lub cev qhuav dej ntawm lub cev cuam tshuam qhov tshwm sim ntawm cov tsos mob. Nrog kev ua txhaum ntawm lub siab, qhov zoo li yuav tshwm sim:
- ntshav siab;
- kev ncig tsis zoo;
- permeability ntawm cov phab ntsa capillary thiab daim nyias nyias;
- o thiab ua tsis taus pa.
Lwm yam tshwm sim
Qhov tshwm sim txaus ntshai yog sepsis lossis ntshav lom. Tus me nyuam tsim bacteremia - qhov nkag ntawm microbes rau hauv cov hlab ntsha. Tus neeg sawv cev ntawm tus kab mob ua rau tso tawm cytkins los ntawm cov hlwb ntawm lub cev tiv thaiv kab mob. Cov tsos mob ntawm tus kab mob sepsis muaj xws li kub taub hau, ntshav siab, tsis txaus ntseeg ntawm tus me nyuam, lub plawv dhia thiab ua tsis taus pa, thiab tsis nco qab. Ntshav lom muaj kab mob peritonitis, septic mob caj dab, meningitis.
Lwm qhov teeb meem yog pyopneumothorax. Nws tshwm sim tom qab kev tawg ntawm abscess mus rau hauv lub pleura. Hauv kab noj hniav muaj qhov nce ntawm huab cua, muaj kev hloov pauv hauv qhov chaw anatomical ntawm lub sternum. Cov tsos mob tshwm sim sai sai: mob, ua pa tsis ua haujlwm, ua pa tsis ua haujlwm. Thaum kho, yuav tsum tau ceev decompression (txo qiskua).
hnoos thiab ua npaws tom qab mob
hnoos tom qab mob los ntawm lub hom phiaj yog vim li cas. Tom qab kev kho mob ntawm lub ntsws, me foci nyob twj ywm uas tsis pom ntawm x-rays tom qab kho. Cov ntu no tuaj yeem ua rau hnoos tsis pub dhau ob peb lub lis piam. hnoos los ntawm paroxysmal thiab feem ntau pom thaum sawv ntxov.
Thaum hnoos tsis tu ncua thiab hnyav, koj yuav tsum mus ntsib kws kho mob:
- tshuaj;
- ua pa ua pa;
- nqus pa;
- plab massage;
- kho lub cev thiab ua kom sov.
Thaum hnoos ntev dua 2 lub lis piam, tus menyuam tau muab tshuaj expectorants thiab bronchodilators, mucolytics. Cov no suav nrog "ACC", "Bronchoton". Yog tias qhov kub thiab txias nyob tom qab tus kab mob, qhov no tej zaum yuav yog cov tsos mob ntawm o uas tseem tsis tau ploj mus. Nrog ntev hnoos thiab ua npaws, txhawm rau tshem tawm qhov kev pheej hmoo ntawm qhov tshwm sim tsis zoo, tshuaj tua kab mob thiab kws kho mob pulmonologist tau sab laj.
Kev tsis taus vim mob ntsws
Cov teeb meem ntawm mob ntsws yog lub hauv paus rau kev sau npe kev tsis taus. Yog hais tias tus me nyuam muaj 2 thiab 3 degrees ntawm kev ua pa tsis ua hauj lwm, kev tsis taus yuav qhib. Ua rau thiab tej yam kev mob yuav raug pom thaum lub sij hawm kuaj los ntawm ib tug immunologist.
Kev tsis taus yog tsim los nrog kev ua txhaum cai ntawm kev tiv thaiv kab mob, uas tshwm sim los ntawm kev mob ntsws tsis tu ncua, nrog rau cov kab mob congenital pathologies ntawm bronchopulmonary.tshuab. Txhawm rau ua raws li txoj cai no, ib qho tshuaj tiv thaiv kab mob thiab cov ntaub ntawv qub rau lub xyoo raug xa mus rau tus thawj tswj hwm ntawm kev kho mob. Qhov kev txiav txim siab yog ua los ntawm kev kuaj mob thiab kev sib raug zoo.
Kev kho mob
Txhawm rau tshem tawm cov teeb meem mob ntsws ntsws hauv cov menyuam yaus, cov txheej txheem kho mob yuav tsum ua raws. Tab sis yog tias lawv twb tau txheeb xyuas lawm, ces yuav tsum tau kho. Kev kho mob yog tsom rau kev kho lub cev ntawm cov menyuam yaus. Nws yog tsim nyog los tshem tawm tag nrho cov residual teebmeem, cov nti nyob rau hauv lub pleura yuav tsum daws thiab lub cev tsis muaj zog yuav tsum optimized. Kev rov qab ua tiav siv cov haujlwm hauv qab no:
- Resorbable hom kev npaj thiab cov tshuaj lom neeg siv tau, uas tuaj yeem siv rau menyuam yaus.
- Kev kho lub cev ua haujlwm tau ua tiav.
- Decoctions thiab infusions ntawm tshuaj ntsuab yog siv, uas muaj ib tug restorative muaj nuj nqi. Lawv tuaj yeem siv tau tom qab sab laj nrog kws kho mob, tshwj xeeb tshaj yog nrog daim ntawv ntev.
- Cov kab mob hauv plab yuav tsum tau txhim kho tom qab siv tshuaj tua kab mob.
- Vitamin kho mob xav tau.
Nws yog qhov pom zoo los siv txoj kev kho mob aerotherapy, nthuav tawm hauv daim ntawv ntawm kev kho cov pa oxygen los ntawm lub qhov ntswg catheter. Nws yog nruab rau hauv lub qhov ntswg qhov ntswg. Hauv qhov no, tus menyuam yuav tau txais 25-35% ntawm qhov xav tau ntawm cov pa oxygen. Cov khoom yuav tsum tau muab xa mus tsis muaj kev cuam tshuam rau lub sijhawm ntev. Feem ntau 2-10 teev, nws nyob ntawm qhov mob hnyav.
Thaum kho, nws yuav tsum tau kho qhov ua pa ntawm txoj hlab pa. Rau qhov no, mucolytics yog siv (cov tshuaj uas nyias cov mucous daim nyias nyias).xaiv). Txhawm rau txhim kho kev ncig ntawm cov kab mob hauv cov hlab ntsha, 2.4% aminofillin yog siv, uas tau muab tso rau hauv qhov nyiaj ntawm 0.1 ml / kg rau cov menyuam yaus hnub nyoog qis dua 1 xyoos. Tom qab ntawd ntxiv 1 ml rau txhua xyoo ntawm lub neej. Pab "Xanthinol nicotinate" thiab nqus tau pa ntawm hom sov-nqus.
Tshuaj tiv thaiv thiab tiv thaiv
Muaj tshuaj los tiv thaiv lossis txhaj tshuaj tiv thaiv kab mob uas cuam tshuam rau qhov yuav tshwm sim. Yog tias muaj kev pheej hmoo ntawm kev kis kab mob kis tau zoo, cov tshuaj tiv thaiv yuav pab tiv thaiv kab mob tsis muaj zog.
Tom qab muaj mob, nws yog ib qho tseem ceeb uas yuav tsum tswj kom tus menyuam tsis txhob muaj cov hnoos qeev hauv lub ntsws. Cov av noo txaus yuav tsum tau khaws cia hauv chav tsev, nws yuav tsum ua kom tsis tu ncua ventilate chav. Kev haus dej ntau ua rau liquefaction ntawm mucus. Tom qab mob ntsws, physiotherapy thiab kev kho mob hauv sanatoriums tau zoo.
Yog tias muaj mob ntsws, koj yuav tsum tau nyob hauv kev saib xyuas ntawm tus kws kho mob rau 1 xyoos. Thaum lub sij hawm rov qab, koj yuav tsum tau haus cov vitamins, ua kom muaj huab cua ntshiab. Nws yog tsim nyog los kho cov hnyuv microflora. Qee lub sij hawm tom qab muaj mob, nws yuav tsum tiv thaiv tus menyuam kom tsis txhob muaj kev sib cuag nrog tus neeg mob uas muaj tus kab mob ua pa hnyav.
Txhawm rau tiv thaiv cov teeb meem los ntawm kev mob ntsws, koj yuav tsum mus ntsib kws kho mob yog tias koj muaj tsos mob khaub thuas, SARS lossis hnoos ntev. Kev kuaj mob raws sij hawm yog yooj yim kho dua li tsis saib xyuas. Kev rov qab los yuav tsum muaj kev noj qab nyob zoo. Peb xav tau kev ua kis las, so, noj zaub mov zoo. Kev tiv thaiv zoo heev yog kis tautswj. Txhua txoj hauv kev qhia yuav tso cai rau tshem tawm cov teeb meem hauv lub sijhawm luv luv.
Zoo kawg
Cov teeb meem tshwm sim nrog kev kho tsis raug lossis tsis raws sijhawm. Yog tias thawj cov tsos mob tshwm sim, tsis txhob ncua sijhawm mus ntsib kws kho mob. Nws yog ib qho tsim nyog yuav tsum tau ua raws li cov lus pom zoo ntawm tus kws kho mob tshwj xeeb, thiab tsis txhob kho tus kheej. Tsuas yog nrog tus cwj pwm lub luag haujlwm rau kev noj qab haus huv xwb thiaj li ua tau kom tsis txhob muaj kev phom sij.
