Bronchial hawb pob nyob rau hauv tus menyuam yog ib yam kab mob ntev, thaum lub sij hawm ua pa ua pa thiab cov yam ntxwv ntawm lub bronchi hloov. Lawv feem ntau tshwm sim hauv cov menyuam yaus uas muaj feem cuam tshuam rau kev ua xua.
Qhov kev kuaj mob no hauv cov menyuam yaus hnub nyoog qis dua 5 xyoos feem ntau yog muab rau cov tub. Nws yog ib qho nyuaj rau cov niam txiv los ntawm nws tus kheej paub txog thawj cov cim qhia ntawm bronchial hawb pob hauv tus menyuam, vim li ntawd tsis muaj txoj hauv kev los kho lub sijhawm. Qee qhov xwm txheej, kev xiam oob qhab raug muab tam sim.
Kev tshwm sim
Tsuas yog ua rau mob hawb pob hauv cov menyuam yaus tseem tsis tau tshawb pom, tab sis muaj ntau yam uas ua rau muaj tus kabmob no. Genetic predisposition yog qhov tseem ceeb heev, tshwj xeeb tshaj yog nyob rau hauv cov menyuam ntxaib.
Tsis tas li ntawd, mob kis kab mob ntawm cov kab mob ua pa cuam tshuam nrog lub cev tiv thaiv kab mob ntawm tus menyuam muaj qhov tshwj xeeb. Cov niam txiv xav tauua tib zoo saib xyuas kev noj qab haus huv ntawm tus menyuam txij li thawj hnub ntawm nws yug los. Cov yam pheej hmoo suav nrog:
- genetic predisposition;
- mob ua pa hnyav;
- ua xua;
- ua pa nyuaj;
- yug tsis hnyav;
- haus luam yeeb hauv tsev.
Nws yog ib txwm ua kom paub qhov txawv ntawm ob hom mob hawb pob hauv cov menyuam yaus, raws li qhov ua rau nws cov tsos mob. Nws yog ib qho tseem ceeb kom paub txog tus kab mob raws sij hawm thiab ua txoj kev kho mob nyuaj.
kab mob daim ntawv
Irritation ntawm bronchi tuaj yeem tshwm sim los ntawm ntau yam sib txawv. Ib qho ntawm feem ntau hom yog kev ua xua hawb pob, provoked los ntawm kev nkag mus ntawm ntau yam allergens rau hauv lub cev. Lawv tuaj yeem tau txais tsis yog nrog huab cua, tab sis kuj nrog zaub mov lossis los ntawm daim tawv nqaij. Yog tias, tawm tsam keeb kwm yav dhau los no, mob ntsws asthma tshwm sim hauv cov menyuam yaus, cov lus pom zoo rau cov niam txiv yog kom tshem tawm cov tshuaj tsis haum ntawm tus menyuam lub neej, lossis tsawg kawg txo nws cov nyiaj.
Tus kab mob no yuav tsis ua xua, vim muaj ntau yam kab mob sib txawv. Ntau lub bronchi tuaj yeem teb rau kev siv zog ntawm lub cev, xws li nqus cua kub lossis txias, jogging, physiological stress. Lwm qhov tseem ceeb yog kev siv qee yam tshuaj. Xws li mob hawb pob yog suav tias yog ib qho mob hnyav tshaj plaws.
Ntau zaus lub bronchi hnov mob rau ob peb lub stimuli lossis tag nrho ib zaug. Xws li tus kab mob hu ua sib xyaw. Cov menyuam yaus muaj kev ntxhov siab heevhnov tsw thiab ntau yam kev ntxhov siab.
Tus yam ntxwv ntawm cov tsos mob
Cov tsos mob ntawm hawb pob hauv tus menyuam tuaj yeem sib txawv heev. Txawm li cas los xij, nyob rau hauv txhua rooj plaub, muaj qhov ua tsis taus pa, uas tuaj yeem tshwm sim tom qab kev tawm dag zog lub cev lossis kev ntxhov siab. Cov menyuam yaus feem ntau yws yws txog qhov nyuaj ntawm exhaling. Cov huab cua yog exhaled rau lub sij hawm ntev, hnyav thiab nrog ib tug yam ntxwv hawb pob los yog xuav.
Yog tias cov niam txiv pom tias ua pa ntawm tus menyuam mos, ces koj yuav tsum tau sau npe tam sim rau kev sab laj nrog kws kho mob, vim qhov no suav tias yog cov tsos mob tseem ceeb ntawm bronchial hawb pob hauv cov menyuam yaus. Nws yog ib nqi sau cia hais tias xws li ib tug tshwm sim kuj tshwm sim nrog rau lwm yam kab mob, tshwj xeeb tshaj yog, xws li mob khaub thuas, mob khaub thuas, bronchitis. Txawm li cas los xij, hauv qhov no, lwm cov tsos mob kuj tshwm sim.
Kev mob ntsws asthma hauv cov menyuam yaus tuaj yeem pib tam sim ntawd thiab nws pib nrog hawb pob, hnoos, ua tsis taus pa. Qee zaum, nws tuaj yeem txhim kho qeeb heev, nrog cov tsos mob maj mam nce ntxiv. Lub xeev no tuaj yeem kav ntev li ob peb feeb lossis rub rau ob peb teev lossis txawm hnub. Ob peb hnub ua ntej qhov pib ntawm cov cim tseem ceeb ntawm tus kab mob, tus me nyuam yuav pom thawj cov tsos mob ntawm tus mob hawb pob. Thaum lub sij hawm no, cov me nyuam yog capricious, khaus heev thiab tsis tsaug zog zoo. Ntawm cov tsos mob tseem ceeb ntawm bronchial hawb pob hauv tus menyuam tuaj yeem raug sau tseg xws li:
- kua muv tom qab tus me nyuam sawv;
- hnoos qhuav;
- sawv tom qab pw tsaug zog.
Nws tsim nyog sau cia tias cov tsos mob yuav txawv nyob ntawm lub hnub nyoog ntawm tus menyuam. Hauv cov menyuam mos, hnoos paroxysmal tuaj yeem tshwm simua ntej lossis tom qab pw tsaug zog. Nws yog ib qho tsim nyog sau cia tias qhov kev tawm tsam yuav tsawg dua yog tias tus menyuam nyob hauv qhov chaw ncaj. Tsis ntev ua ntej no, tus menyuam pib ua thiab quaj ntau heev. Cov niam txiv yuav pom tias ua tsis taus pa me me, thiab hawb pob thiab xuav tshwm sim thaum ua pa. Kev ua pa ua tsis zoo.
Yog tias tag nrho cov tsos mob no tsis ploj mus ob peb hnub thiab ntxiv nrog rau kev mob hawb pob, ces koj yuav tsum hu rau lub tsheb thauj neeg mob.
Diagnostics
txhawm rau kuaj xyuas "bronchial hawb pob" hauv cov menyuam yaus, nco ntsoov sab laj nrog kws kho mob thiab ua tiav tag nrho cov kev tshawb fawb xav tau. Thaum xub thawj, tus kws kho mob ua ib qho anamnesis ntawm chav kawm ntawm tus kab mob, tshwj xeeb, xam phaj cov niam txiv ntawm tus me nyuam, thiab kuj kuaj tus me nyuam. Kev kuaj pom tus kab mob nyob rau hauv thawj theem yog qhov nyuaj heev, yog li cov niam txiv yuav tsum tau ceev faj tshwj xeeb los qhia rau tus kws kho mob txog txhua yam ntawm kev mob hawb pob. Cov keeb kwm kho mob yuav tsum tau kawm. Kev mob ntsws asthma hauv tus menyuam tuaj yeem muaj ntau yam tshwm sim, yog li tus kws kho mob yuav tsum nkag siab meej tias qhov peculiarity thiab qhov hnyav ntawm pathology yog dab tsi.
Thaum kuaj thawj zaug, tus kws kho mob ua auscultation, uas yog, nws mloog tus menyuam lub ntsws, suav cov pa thiab qhov tob. Lwm txoj hauv kev los kuaj mob yog kev soj ntsuam ntawm bronchi. Tsis tas li ntawd, kev kuaj mob bronchial hawb pob hauv cov menyuam yaus txhais tau tias:
- kuaj ntshav;
- lub hauv siab x-raycells;
- sputum tsom xam;
- cardiogram.
Yog tias qhov kev kuaj mob tau lees paub, ces yuav tsum tau kuaj kev tsis haum tshuaj los txiav txim seb qhov ua rau ua rau tus kab mob. Tom qab ntawd, txoj kev kho nyuaj tau raug sau tseg, uas yuav pab tshem tawm cov teeb meem uas twb muaj lawm thiab ua kom muaj kev noj qab haus huv zoo.
Dab tsi tuaj yeem ua rau muaj kev tawm tsam
Kev mob hnyav ntawm tus menyuam tuaj yeem tshwm sim los ntawm ntau yam uas ua rau muaj mob hawb pob. Feem ntau, tus mob no provoked los ntawm:
- tsev thiab phau ntawv plua plav;
- kab mob sib kis;
- kub qhov txawv;
- kev raug mob ntawm lub hlwb.
Vim tias hmoov av yog qhov ua rau muaj kev cuam tshuam loj, nws yog ib qho tsim nyog yuav tsum tau ntxuav qhov chaw txhua hnub kom txo tau qhov cuam tshuam ntawm qhov teeb meem no. Tsis txhob nkim lub chaw zov me nyuam nrog tej yam uas tsis tsim nyog, muab cov rooj tog zaum, thiab txo cov khoom ua si mos. Nws tsis pom zoo kom siv cov ntaub pua plag hauv pem teb, nrog rau tso cov phau ntawv ntau.
Kev mob ntsws asthma hauv tus menyuam tuaj yeem ua rau cov paj ntoo, cov tawv nqaij ntawm cov tsiaj, nrog rau qee yam khoom noj. Txhawm rau txo qhov qaug dab peg, koj yuav tsum txwv txoj kev taug kev thaum lub sijhawm ua paj paj ntawm cov nroj tsuag, txo qhov kev sib cuag ntawm tus menyuam nrog cov tsiaj, thiab tsis txhob feather txaj thiab hauv ncoo.
Feem ntau, qee cov khoom noj ua rau ua xua, uas yog vim li cas koj yuav tsum tau ua raws li kev noj zaub mov nruj nruj nrog kev cais tawm ntawm cov khoom noj uas tuaj yeem ua rau muaj kev phom sij.exacerbation. Rau txhua tus, cov khoom lag luam no yog tus kheej, yog li koj yuav tsum tau taug qab cov tshuaj tiv thaiv ntawm lub cev kom paub tseeb tias koj yuav tsum tau muab dab tsi.
Bronchial hawb pob hauv tus menyuam tuaj yeem ua rau kis tau tus kabmob, yog vim li cas nws thiaj li yuav tsum tau txhaj tshuaj tiv thaiv raws sijhawm, ua kom lub cev tawv, thiab tseem siv lwm yam kev tiv thaiv. Nws yog ib qho tseem ceeb rau ib puag ncig tus me nyuam nrog kev saib xyuas thiab saib xyuas, nrog rau kev tiv thaiv nws los ntawm kev ntxhov siab tsis xav tau. Cov menyuam yaus muaj kev nkag siab zoo txog kev hloov pauv ntawm niam txiv lub siab, yog li koj yuav tsum tau sim ua kom lub siab zoo txhua lub sijhawm.
Nyob rau lub caij txias, koj yuav tsum tau txo cov neeg taug kev ntawm txoj kev, vim huab cua txias, qhuav qhuav heev thiab cov av noo siab tuaj yeem ua rau bronchospasm, uas ua rau hnoos haum.
Pab thaum muaj kev tawm tsam
Nyob ntawm keeb kwm ntawm tus kab mob, bronchial hawb pob hauv tus menyuam tuaj yeem mob hnyav heev. Thaum lub sij hawm tawm tsam, tus me nyuam tam sim ntawd pib muaj kev qaug zog heev, ua rau tsis xis nyob, ntxhov siab heev, nws feem ntau raug mob los ntawm hnoos qhuav tsis sib haum. Tib lub sijhawm, tawm hws nce, lub plawv dhia thiab lub plawv dhia nrawm.
Yog tus me nyuam muaj mob hawb pob, ces koj yuav tsum tsis txhob ntshai, koj yuav tsum nyob twj ywm thiab sim ua kom tus me nyuam mos, tshem cov khaub ncaws nruj ntawm nws, qhib qhov rais kom muaj huab cua ntshiab. Nws yog qhov tsis xav muab tus menyuam pw, vim qhov no yuav ua rau ua pa nyuaj.
Koj yuav tsum muab dej sov rau tus menyuam haus, vim nws yuav pab ntxuavntsws los ntawm cov hnoos qeev thiab qhov no yuav txo qhov kev tawm tsam. Lub tshuab nqus tsev lossis lub tshuab nqus tsev tuaj yeem pab tau, uas tuaj yeem ntxiv nrog Eufillin. Nws yog ib advisable mus ua ib tug sov so da dej rau ob txhais taw thiab tes. Yog tias tag nrho cov kev ntsuas no tsis txwv qhov kev tawm tsam li ntawm 30 feeb, ces koj yuav tsum hu rau lub tsheb thauj neeg mob, vim tias kev tos tom ntej tuaj yeem ua rau ua pa nres.
Txoj kev kho mob
Kev kho mob bronchial hawb pob hauv cov menyuam yaus raug xaiv nyob ntawm qhov kev ntsuas ntawm qhov kev kuaj mob. Koj yuav tsum tau mus ntsib kws kho mob tsawg kawg 1 zaug hauv 3-4 lub lis piam. Qhov zoo ntawm kev kho mob yog nyob ntawm qhov zaus ntawm qaug dab peg thaum nruab hnub thiab hmo ntuj, nrog rau lawv qhov hnyav thiab qhov mob ntawm tus menyuam mob.
Kev kho mob bronchial hawb pob hauv cov menyuam yaus yog ua los ntawm cov tshuaj tsis yog tshuaj. Txhawm rau ua qhov no, koj yuav tsum tau sim tshem tawm cov xwm txheej uas ua rau muaj kev loj hlob ntawm tus kab mob, tshwj xeeb tshaj yog cov tshuaj tsis haum thiab cov pa luam yeeb. Nws yog los ntawm lub sijhawm no uas kev kho mob nyuaj yuav tsum pib.
Thaum muaj kev tawm tsam, tshwj xeeb bronchial receptor stimulants pab tau zoo, uas tau noj tsuas yog thaum muaj cov cim qhia ntawm tus kab mob. Tsis tas li ntawd, nrog rau kev mob hawb pob, nws tseem yuav tsum tau ua cov kev kho mob rau cov kab mob sib kis, tshwj xeeb tshaj yog tias lawv cuam tshuam nrog kev puas tsuaj rau lub ntsws. Cov tsos mob thiab kev kho mob bronchial hawb pob hauv cov menyuam yaus feem ntau yog nyob ntawm cov yam ntxwv ntawm pathology. Yog tias nws qhov kev kawm hnyav, ces cov me nyuam raug sau ntawv kho mob yooj yim tsim los tiv thaiv kev tawm tsam.
Feem ntau, nqus tau cov tshuaj uas ua hauv zos ntawm cov mucous membrane yog siv rau qhov nobronchi. Hauv particular, glucocorticosteroids, xws li Beclomethasone, yog siv.
Drug therapy
Nws yog ib qho tseem ceeb kom sai thiab meej pab tus me nyuam uas muaj mob hawb pob bronchial, vim tus kab mob no tuaj yeem ua rau tuag taus. Muaj ntau yam tshuaj sib txawv rau kev kho cov menyuam yaus uas muaj mob hawb pob. Tag nrho cov ntawm lawv tau muab faib ua txoj hauv kev kom sai sai ntawm kev tawm tsam thiab kev tiv thaiv. Qhov kev txiav txim ntawm cov tshuaj tsim los kom ceev nrooj nres yog raws li kev nthuav dav ntawm bronchi.
Tshwj xeeb, koj tuaj yeem siv cov tshuaj nqus pa xws li Berotek, Salbutamol, Ventalin. Lawv yuav tsum nyob nrog tus menyuam muaj mob tas li, yog li ntawd nws tseem ceeb heev uas nws yuav tsum nqa mus tas li, txawm tias nws tawm hauv tsev rau lub sijhawm luv.
Cov tshuaj tiv thaiv muaj xws li cov tshuaj bronchodilators ntev, tshuaj antileukotriene, thiab corticosteroids. Lawv raug siv los kho cov mob hnyav. Hauv cov xwm txheej tshwj xeeb, cov tshuaj lom neeg tuaj yeem siv tau.
Qee zaum, theophyllines tuaj yeem raug sau ntxiv, tab sis lawv yuav tsum tau ua tib zoo saib, vim tias muaj kev pheej hmoo siab ntawm kev phiv. Cov tshuaj uas tsis yog tshuaj hormones tsis tshua muaj tshuaj, vim tias lawv tsis zoo txaus.
Corticosteroids pab txo qhov mob hauv lub cev. Bronchodilators sai tshem tawm cov tsos mob, ua kom cov pa tawm, tab sis tsis kho qhov mob. Lawvtsuas tuaj yeem noj nrog tshuaj tiv thaiv kab mob.
Qee tus kws kho mob tau sau tshuaj tua kab mob thaum lub sij hawm exacerbation, tab sis nws tsim nyog nco ntsoov tias pawg tshuaj no siv tsis tau rau kev kho mob hawb pob zoo. Txawm hais tias cov hnoos qeev daj tawm thaum hnoos, qhov no tsis txhais tau tias muaj cov paug hauv tus menyuam lub cev.
Ntseeg haiv neeg
Ua ke nrog cov tshuaj, lwm txoj kev kho yog qee zaum raug sau tseg. Lawv pab ua kom lub sij hawm ncua ntawm kev tawm tsam, txo qhov tshwm sim ntawm kev phiv los ntawm cov tshuaj thiab txo tus me nyuam tus mob. Feem ntau, thaum ua tsis taus pa thiab hnoos, nws raug nquahu kom siv cov tshuaj sau los ntawm:
- nettles;
- coltsfoot;
- elecampane;
- licorice;
- ledum.
Cov khoom no pab cov hnoos qeev thiab muaj cov nyhuv expectorant. St. John's wort, ib decoction los yog infusion uas muaj ib tug nruab nrab aftertaste, yuav pab txo tau cov tsos mob ntawm kev ua xua, uas yog vim li cas cov me nyuam haus nws nrog zoo siab heev. Kuj tseem muaj kev kho tus kab mob hauv cov menyuam yaus nrog kev pab ntawm Ginger. Nws cov tincture yuav tsum tau noj txhua txhua 2 hnub, thiab ua ntej yuav mus pw nws raug nquahu kom da dej ko taw. Thaum kho, hypothermia ntawm tus menyuam yuav tsum tsis txhob tso cai. Aromatherapy, uas yog ua nrog thyme, lavender lossis tshuaj yej tsob ntoo roj, muaj txiaj ntsig zoo.
Qee lub sij hawm, nyob rau hauv lub zog ntawm kev nyuaj siab, muaj ib tug tshwm sim ntawm bronchial hawb pob nyob rau hauv cov me nyuam. Cov lus pom zoo kho mob hauv qhov no cuam tshuam nrog yoga, ua pa ua pa. Nws yog ib qho tseem ceeb uas yuav tsum tswj koj qhov ua tsis taus pa, vim qhov no yuav tshem tawm cov kev paub tsis zoo. Yoga yog qhov zoo rau menyuam yaus txhua hnub.
Rau kev kho mob, acupuncture, ua pa tawm, thiab kev kho mob-kev kho mob qee zaum siv. Tag nrho cov kev kho no raug xaiv los ntawm tus kheej nkaus xwb thiab ua tib zoo.
Muaj Teeb Meem
Kev mob hawb pob hauv cov menyuam yaus feem ntau tshwm sim thaum lub caij txias. Yog li ntawd, muaj qhov nce hauv qhov mob ntawm cov hlab ntsha. Thaum lub sij hawm no, yuav tsum tau nce qhov koob tshuaj ntawm cov tshuaj. Lub ntsiab ntsuas los tiv thaiv exacerbation yog txhaj tshuaj tiv thaiv. Cov mob hnyav yuav tsum tau sau npe tsis taus thiab cov txiaj ntsig.
Cov teeb meem ntawm bronchial hawb pob tshwm sim tsis tshua muaj thiab feem ntau lawv yog tshwm sim los ntawm kev kho tsis raws sijhawm lossis tsis raug. Raws li qhov tshwm sim ntawm stagnation ntawm huab cua hauv lub ntsws, pneumothorax tuaj yeem tshwm sim, uas txhais tau hais tias kev tawg ntawm lub ntsws thiab kev nkag mus ntawm huab cua mus rau hauv cov kab noj hniav pleural. Tsis tas li ntawd, emphysema thiab mob ua pa tsis ua haujlwm tuaj yeem tshwm sim.
prophylaxis
Nws yog ib qho tseem ceeb tsis yog tsuas yog ua raws li kev kho mob kom raug, tab sis kuj yuav tsum ua txhua yam tsim nyog kom qhov kev tawm tsam ntawm tus kab mob tshwm sim tsawg li sai tau. Kev tiv thaiv muaj peev xwm ntawm bronchial hawb pob hauv cov menyuam yaus yog qhov tseem ceeb heev, thiab nws yuav tsum tau ua tsis tau tsuas yog txo tus naj npawb ntawm kev tawm tsam, tab sis kuj yog thaum muaj cov caj ces predisposition raukab mob.
Cov kws kho mob pom zoo kom pub niam mis rau koj tus menyuam txij thawj hnub ntawm nws lub neej mus txog 1 xyoos. Yog tias vim li cas qhov no tsis tuaj yeem ua tau, ces koj yuav tsum ua tib zoo xaiv cov kua mis sib tov thiab sab laj nrog tus kws tshaj lij txog qhov no. Cov khoom noj ntxiv yuav tsum tau qhia tsuas yog nrog kev pom zoo ntawm tus kws kho mob, thiab cov khoom raug muab rau tus menyuam maj mam. Cov zaub mov uas muaj allergens yuav tsum zam.
Kev tiv thaiv kev txhim kho ntawm bronchial hawb pob txhais tau hais tias siv cov ntaub pua chaw uas muaj cov tshuaj hypoallergenic. Nws yog ib qho tsim nyog yuav tsum tau ua tib zoo saib xyuas kev nyiam huv hauv chav uas tus menyuam nyob. Koj yuav tsum ua kom ntub dej txhua lub sijhawm. Nws yog ib qho tseem ceeb kom muaj kev tiv thaiv kab mob, nrog rau kev tiv thaiv kev loj hlob ntawm kev ua xua. Kev noj zaub mov ntawm tus menyuam yuav tsum muaj ntau yam. Nrog rau cov khoom noj, nws yuav tsum tau txais tag nrho cov vitamins thiab lwm yam khoom muaj txiaj ntsig.
Kev Ua Haujlwm Kho Mob
Nrog bronchial hawb pob hauv menyuam yaus, tus kws kho mob cov lus pom zoo yuav tsum ua tib zoo ua raws. Yuav tsum tau kho tus kab mob no, suav nrog:
- khaw;
- kev siv lub cev kho mob;
- kev kho mob sanatorium;
- massage.
Kev kho kom rov zoo tsuas yog tom qab kev kho mob tshwm sim ntawm tus kab mob tau raug tshem tawm. Qhov no yuav normalize kev noj qab nyob zoo ntawm tus me nyuam thiab tiv thaiv kev loj hlob ntawm cov teeb meem. Ib txoj hauv kev zoo ntawm kev tiv thaiv yog kev kho mob sanatorium, txij li cov dej ntxhia, huab cua huv, zooclimatic tej yam kev mob, cov txheej txheem kev noj qab haus huv. Cov menyuam yaus muaj kev tsis taus tau txais daim pib. Ua ntej mus xyuas lub sanatorium, nws raug nquahu kom kho cov kab mob hnyav thiab tiv thaiv kab mob ntev.
Nws raug nquahu kom mus xyuas sanatoriums nyob hauv thaj chaw uas tus menyuam nyob. Qhov no yuav tiv thaiv kev mob hawb pob, vim nws yuav tsis tas yuav hloov mus rau cov xwm txheej huab cua. Lub sij hawm nyob hauv lub sanatorium yog tsawg kawg ib hlis.
Ua pa gymnastics yog txhawm rau nce elasticity ntawm lub ntsws cov ntaub so ntswg. Xws li prophylaxis zoo heev thaum muaj kev tawm tsam, vim nws pab tiv thaiv qhov tshwm sim ntawm cov teeb meem. Txoj kev yooj yim tshaj plaws yog suav tias yog qhov ua kom lub zais pa.
Bronchial hawb pob yog qhov tshwm sim, vim muaj ntau yam uas ua rau nws txoj kev loj hlob. Yog vim li cas thiaj yuav tsum tau muaj kev tiv thaiv nyuaj, thiab, yog tias tsim nyog, kho.
