Diphyllobothriasis yog kab mob cab, nrog rau cov kab mob loj heev ntawm lub plab zom mov, nrog rau megaloblastic anemia. Nws cov kab mob ua rau muaj kab mob loj - kab mob dav dav (D.latum), qhov ntev tuaj yeem ncav cuag 10 m, nrog rau ntau dua 10 hom kab mob tsawg dua los ntawm genus Diphyllobothrium.
Ua rau kab mob
Kab mob ntawm tus neeg mob diphyllobothriasis tshwm sim thaum noj cov kab mob, tsis txaus thermally ua los yog cov khoom noj ntses tsis zoo, nrog rau thaum txiav ntses thiab ua cov tais diav tsis txaus tom qab nws. Ntxiv mus, kev nkag mus ntawm helminths rau hauv tib neeg lub cev tshwm sim raws li txoj hlua ntev.
Txoj kev sib kis ntawm diphyllobothriasis
Tapeworm qe loj hlob hauv dej tshiab ntawm qhov kub ntawm 10-20 ° C rau ib hlis. Tom qab ntawd embryos-coradiions raug cais tawm ntawm lawv, uas, dhau los, tau noj los ntawm cov crustaceans me me, piv txwv li, copepods. Qhov no yog thawj theem nruab nrab ntawm tus kab mob, thaum lub sij hawm uas helminth larvae tsim - plerocercoids. Tom qab ntawd theem thib ob tshwm sim, thaum dej tshiabntses, xws li pike, ruff, perch, burbot, trout, thiab lwm yam., noj crustaceans, thiab nyob rau hauv nws lub cev cov larvae ua tiav lawv txoj kev loj hlob mus rau theem ntawm kev sib deev paub tab. Thiab tsuas yog tom qab ntawd, helminth pom nws tus tswv tsev zaum kawg thiab, raws li, qhov chaw ntawm kev ntxeem tau - tus neeg, lossis, tsawg dua, tus neeg sawv cev ntawm cov tsiaj noj ntses, piv txwv li, npua, hma, dais, foob pob., lwm. Nws yog nyob rau hauv lawv lub cev uas cov neeg laus helminth twb parasitizes, cov qe uas tau tso tawm thaum lub sij hawm defecation thiab nkag mus rau hauv cov dej tshiab nrog cov dej phwj tuaj, pib ib tug tshiab kab mob.
Ib kab kab kab mob dav dav hauv txoj hnyuv muaj ntau txhiab ntu (proglottids) uas muaj cov qe, thiab ruaj khov rau ntawm phab ntsa ntawm tus neeg pub cov hnyuv nrog kev pab los ntawm ob qhov slits (bothria) nyob ntawm nws lub taub hau kawg. Thiab txawm hais tias qhov ntev ntawm tus kab mob qee zaum nce mus txog 10 meters, nws tsis yog qhov tsis yooj yim rau ob peb kab cab tuaj yeem nyob hauv tib neeg lub cev ib zaug.
thaj chaw kis tus kabmob
Tib neeg diphyllobothriasis feem ntau tshwm sim ntawm cov neeg nyob hauv thaj chaw uas muaj huab cua txias, qhov twg cov zaub mov tseem ceeb ntawm cov pejxeem yog ntses thiab nws cov caviar. Tus kab mob no tshwm sim nyob rau hauv cov teb chaws Europe, tshwj xeeb tshaj yog Scandinavian, Nyiv, South America, Africa, USA, Canada, thiab Russia.
Pathogenesis thiab pathoanatomical duab diphyllobothriasis
Nkag mus rau hauv tib neeg lub cev, kab kab mob dav dav muaj cov kab mob pathogenic rau nws ntawm cov neeg kho tshuab, tshuaj lom-ua xua thiab neuro-reflex xwm. Ua ntej, qhov nokev ua txhaum ntawm txoj hnyuv mucosa los ntawm Bothria thaum lub helminth txuas rau phab ntsa. Yog li ntawd, atrophy thiab necrosis ntawm mucosa tshwm sim. Cov khoom lag luam metabolic ntawm cov kab mob parasite provoke autosensitization txheej txheem. Qhov tseem ceeb endogenous hypoavitaminosis ntawm folic acid thiab vitamin B12 yog pom, uas, ua ke nrog intoxication ntawm lub cev nrog cov cab cov khoom pov tseg, provokes kev loj hlob ntawm megaloblastic anemia nyob rau hauv 2% ntawm cov neeg mob. Lub sijhawm ntawm kev ntxeem tau mus txog kaum xyoo.
Cov tsos mob ntawm diphyllobothriasis
Los ntawm 20 mus rau 60 hnub - qhov no yog lub sijhawm incubation uas diphyllobothriasis muaj, cov tsos mob ntawm tus neeg pib tshwm tom qab lub sijhawm no. Nws yog lub sijhawm no uas helminths tau txais kev sib deev paub tab, txuas mus rau phab ntsa ntawm txoj hnyuv thiab pib ua haujlwm. Diphyllobothriasis pib tshwm sim nws tus kheej maj mam. Kev tawm tsam ntawm xeev siab, belching thiab ntuav, tsam plab, mob epigastric, tsis qab los noj mov, cov quav tsis zoo yog tag nrho cov tsos mob tshwm sim thaum ntxov diphyllobothriasis. Ib daim duab ntawm tus neeg uas muaj diphyllobothriasis siab heev yuav qhia tau tias nws muaj cim pallor ntawm daim tawv nqaij thiab cov mucous daim nyias nyias, thiab tus neeg mob nws tus kheej yuav raug kev txom nyem los ntawm qaug zog, kiv taub hau, tsis muaj zog, mob plab, paresthesia, hepatosplenomegaly, achylia, nplaig fissures (tom qab ntawm lub nto. ntawm tus nplaig yuav du).
Muaj tachycardia, hypotension, tsaug zog, systolic yws ntawm apex, yws ntawm sab saum toj. Kev kuaj ntshav ntawm tus neeg mob uas xav tias muaj tus kab mob no qhia cov duab hauv qab no:txo hemoglobin, qis qe ntshav liab, nce ncaj qha bilirubin, siab xim Performance index, neutropenia, leukocytosis, nce ESR. Qhov hnyav ntawm cov ntshav tsis txaus, nrog rau qhov mob hnyav ntawm cov kab mob, cuam tshuam los ntawm kev siv ntawm helminthic ntxeem tau, muaj cov kab mob sib xyaw ua ke, kev ua haujlwm dav dav ntawm lub cev, qhov zoo thiab qhov ntau ntawm cov zaub mov noj.
Rau ib hom mob hnyav ntawm diphyllobothriasis, funicular myelosis yog yam ntxwv, uas qhia los ntawm kev ua txhaum ntawm kev sib sib zog nqus rhiab heev, tsis muaj zog ntawm ob txhais ceg, thiab tsis ntse paresthesias. Hauv qee cov neeg mob, cov pob khaus khaus (urticaria) tshwm sim ntawm daim tawv nqaij, daim siab thiab tus po loj tuaj. Hauv cov xwm txheej sib cais, kev qaug dab peg (convulsive) qaug dab peg, loog ntawm cov extremities, instability thaum taug kev raug kaw. Cov no yog cov tsos mob hnyav ntawm diphyllobothriasis, thiab kev kho mob ntawm tus kab mob no yuav tsum tau pib tam sim tom qab kuaj pom. Lub sijhawm ntev ntawm diphyllobothriasis ua rau mob plab hnyuv.
Tab sis, nws tsim nyog sau cia tias diphyllobothriasis, cov tsos mob uas muaj cov npe zoo ntawm cov kab mob, qee zaum muaj cov kab mob latent kiag li (asymptomatic) ntawm tus kab mob, hauv cov kab mob no tsuas yog kuaj pom cov khoom tawg. ntawm cov kab mob hauv cov quav.
YKev kuaj mob diphyllobothriasis
Lub hauv paus rau kev kuaj mob ntawm "tib neeg diphyllobothriasis" yog tus neeg mob cov lus tsis txaus siab thiab cov ntaub ntawv kuaj mob. Eosinophilia nyob rau hauv cov ntshav (nrog rau kev ntxeem tau tsis ntev los no), nrog rau thrombocytopenia thiab leukopenia, nce sedimentation tus nqi tuaj yeem ua rau muaj kev poob siab ntawm tus kab mob.erythrocytes thiab hyperchromic anemia. Cov yam ntxwv ntawm tus kab mob yog megaloblastic hom hematopoiesis. Kev tsom xam qhia ntau tus tub ntxhais hluas cov ntaub ntawv ntawm erythrocytes (megaloblasts, normoblasts, polychromatophiles, poikilocytes, thiab lwm yam). Lub luag haujlwm tseem ceeb hauv kev kuaj mob yog ua los ntawm keeb kwm kev kis kab mob: qhov tseeb ntawm tus neeg mob nyob hauv thaj chaw endemic, noj cov ntses dej tsis qab los yog cov caviar unders alted. Tab sis qhov kev ntsuam xyuas zaum kawg tsuas yog ua thaum kev soj ntsuam ntawm tus neeg mob cov quav pom tias muaj qe lossis ntu ntawm cov kab mob dav dav hauv nws.
Tseem muaj qee zaus cov neeg mob tuaj txog uas tau pom cov kab mob cab hauv lawv cov quav.
Nws yog ib qho tseem ceeb kom tsis txhob ua rau Addison-Birmer anemia thiab diphyllobothriasis, cov tsos mob uas zoo sib xws. Rau lub hom phiaj no, cov ntsiab lus ntawm lub plab yog kuaj xyuas seb puas muaj lub tsev fuabtais zoo, uas tsis muaj nyob rau hauv anemia.
YDiphyllobothriasis: kho
Yog tias tus neeg mob tau kuaj pom tias muaj tus kab mob diphyllobothriasis, kev kho mob yog nqa tawm tam sim ntawd hauv tsev kho mob. Nrog rau qhov mob hnyav heev, ua ntej pib cov txheej txheem rau tshem tawm helminth, kev kho cov tshuaj vitamin (B12, folic acid, hlau) raug sau tseg. Vitamin B12 yog muab raws li intramuscular txhaj ntawm 200-500 mcg 2 los yog 3 zaug ib lub lim tiam. Lub sijhawm ntawm kev kho cov tshuaj vitamin yog 30 hnub.
Rau deworming, siv tshuaj xws li Biltricid, Praziquantel, Niclosamide lossis Azinox. Tsis tas li ntawd, cov tshuaj "Fenasal" tuaj yeem siv los tshem tawm cov cab. Txhua yam tshuaj raug muab coj los sivnyob rau hauv qhov ncauj thiab muaj ib tug paralyzing helminth nyhuv. Yog li ntawd, tus kab mob no poob nws lub peev xwm nyob hauv txoj hnyuv thiab tawm mus. Nws yog ib qho tseem ceeb heev nyob rau tib lub sij hawm kom paub tseeb tias daim kab xev tawm tag nrho. Yuav kom ua tiav qhov kawg tshwm sim, nws muaj peev xwm ntxuav cov hnyuv nrog ib qho enema.
Qhov kev ua tau zoo ntawm kev kho tshuaj no yog kwv yees li 95%, tsuas yog qee qhov tsis tshua muaj, nyuaj los ntawm plab hnyuv, deworming yog ua phais. Cov neeg mob uas tau kuaj pom tus mob diphyllobothriasis, uas nws txoj kev kho mob tau ua tiav dhau los ntawm kev deworming, raug xa mus rau qhov chaw soj ntsuam nrog kev noj cov quav txhua hli rau rau lub hlis.
kev kho neeg zoo
Hauv cov tshuaj pej xeem, cov noob taub dag thiab cov decoction ntawm lawv ib txwm siv los tshem tawm helminths. Cov noob taub dag, nyoos los yog qhuav, yog av nrog dej thiab zib mu thiab noj nyob rau hauv ib tug npaum li ntawm 300 g. nyob rau hauv lub plab khoob nyob rau hauv feem rau ib teev. Txoj kev no zoo kawg nkaus tua cov teeb meem xws li tib neeg diphyllobothriasis. Cov lus pov thawj txog kev ua tiav deworming nrog cov noob taub dag paub meej tias qhov ua tau zoo ntawm txoj kev no.
Nyob zoo, khoom noj khoom haus
Thaum kho diphyllobothriasis, tus neeg mob yuav tsum ua raws li kev noj zaub mov tshwj xeeb uas tsis suav nrog cov khoom noj uas ua rau mob plab hnyuv mucosa. Nws raug nquahu kom suav nrog hauv cov khoom noj uas muaj vitamin B12, nrog rau folic acid.
Txoj hauv menyuam yaus
Kab mob los ntawm cov menyuam yaus nyuaj rau dais,Cov tsos mob ntawm anemia thiab hypovitaminosis nyob rau hauv cov neeg mob hluas tau tshaj tawm.
Tiv thaiv diphyllobothriasis
Yog tias koj yog tus hlub ntses dej qab zib thiab nyob rau sab qaum teb ze ze ntawm lub cev dej, yog li kom tsis txhob poob rau cov kab mob tsis zoo li tib neeg diphyllobothriasis, kev tiv thaiv yuav tsum dhau los ua koj txoj cai1.
Txhawm rau kom tsis txhob kis tus kab mob diphyllobothriasis, cov ntses dej tshiab yuav tsum tsuas yog noj kom zoo los yog kib, nrog rau nws cov caviar tsuas yog cov ntsev zoo. Nws yog ib qho tsim nyog yuav tsum ua raws li cov cai ntawm kev nyiam huv thaum txiav ntses thiab npaj cov tais diav los ntawm nws.
Koj yuav tsum paub tias thaum s alting ntses, nyob ntawm qhov concentration ntawm ntsev, cov larvae tuag tom qab 2-7 hnub. Helminth qe, thaum caviar yog s alted, tuag tom qab ib nrab ib teev ntawm 10% loj feem ntawm lub rooj ntsev nyob rau hauv relation mus rau qhov hnyav ntawm caviar. Yog tias ntsev yog 5%, ces cov khoom yuav muaj kev nyab xeeb rau noj tsis ntxov dua tom qab 6 teev, ntawm 3% - tsis ntxov dua tom qab ob hnub.
Helminth larvae kuj tuag thaum khov khov (2-4 hnub ntawm qhov kub ntawm -18 ° C, ib lub lim tiam tom qab ntawm qhov kub ntawm -6 ° C).
Thaum kuaj mob rau tus neeg mob, nws yuav tsum tau kuaj xyuas tag nrho nws tsev neeg, vim qhov no lawv muaj kev pheej hmoo.
Ntawm thoob ntiaj teb, txhawm rau txo qis qhov yuav kis tau tus kab mob, feem pua ntawm cov neeg nqa khoom nruab nrab hauv cov dej hauv lub cev yuav tsum raug txo los ntawm kev txo lossis tshem tawm cov quav tso rau hauv pas dej thiab cov dej ntws,ua kom muaj kev tswj xyuas kev huv ntawm cov txheej txheem no, nrog rau cov xwm txheej dav dav ntawm cov ntug dej hiav txwv, ntug hiav txwv dej thiab cov khoom siv ntses nkag mus rau hauv kev lag luam zaub mov thiab khw muag khoom. Qhov tshwm sim ntawm cov tsos mob tshwm sim hauv cov kab mob xws li diphyllobothriasis yuav tsum tau ua tib zoo saib xyuas hauv tsev kho mob. Kev kho mob, thaum kuaj pom tseeb, yuav tsum tau pib tam sim ntawd thiab yuav tsum tau kuaj xyuas txhua tus neeg hauv tsev neeg kom pom muaj kev cuam tshuam.
Ntawm cov poj niam cev xeeb tub thiab lactating
Kab mob kab mob, uas yog, hypovitaminosis thiab ntshav ntshav nrog nws, ua rau muaj kev phom sij loj rau kev noj qab haus huv ntawm leej niam thiab kev loj hlob ntawm tus menyuam hauv plab. Cov poj niam cev xeeb tub yuav tsum ceev faj tshwj xeeb thaum noj ntses thiab caviar. Nws yog ib qho tseem ceeb kom tsis txhob nco thawj cov cim qhia ntawm tus kab mob xws li diphyllobothriasis, cov tsos mob uas tuaj yeem yooj yim tsis meej pem nrog kev tshwm sim ntawm toxicosis (preeclampsia), thiab maj mam thov rau kev xa mus rau kev kuaj xyuas cov quav rau lub xub ntiag ntawm helminthic qe nyob rau hauv. nws.
Kev kho tus kab mob hauv cov poj niam cev xeeb tub yog ua los ntawm ib txoj kev uas muaj kev nyab xeeb rau kev noj qab haus huv ntawm tus menyuam hauv plab. Yog li, rau cov poj niam cev xeeb tub, cev xeeb tub thiab pub niam mis tsis tau sau tshuaj xws li "Biltricid", tab sis siv cov tshuaj muaj kev nyab xeeb - cov noob taub dag. Qee zaum, kev pub niam mis nrog kev kuaj mob ntawm tib neeg diphyllobothriasis yog pom zoo kom kho los ntawm kev noj cov tshuaj zoo rau diphyllobothriasis, thiab tus menyuam raug xa mus rau kev pub mis nyuj.
