Peb txhua tus tau ntsib kev mob ntawm ib hom lossis lwm qhov. Thiab yog tias nws cov ntaub ntawv loj, xws li mob ntsws lossis mob plab, tshwm sim tshwj xeeb, ces cov teeb meem me me xws li kev txiav lossis kev puas tsuaj yog qhov tshwm sim. Coob leej ntau tus tsis xyuam xim rau lawv kiag li. Tab sis txawm tias qhov mob me tshaj plaws tuaj yeem ua rau exudative o. Qhov tseeb, qhov no yog lub xeev ntawm thaj chaw cuam tshuam, uas cov kua dej tshwj xeeb sau rau hauv nws, thiab tom qab ntawd nkag mus rau ntawm phab ntsa ntawm cov hlab ntsha mus rau sab nraud. Cov txheej txheem no yog qhov nyuaj heev, raws li cov cai ntawm hydrodynamics thiab tuaj yeem ua rau muaj teeb meem hauv chav kawm ntawm tus kab mob. Hauv tsab xov xwm no, peb yuav txheeb xyuas kom meej tias dab tsi ua rau exudative o ua rau. Peb kuj tseem yuav txiav txim siab txog hom (cov txiaj ntsig rau lawv txhua tus tsis sib npaug) ntawm cov txheej txheem inflammatory no, thiab peb yuav piav qhia seb lawv nyob li cas, lawv ua li cas, lawv yuav tsum tau kho li cas.
Ib qho mob zoo los tsis zoo?
Ntau tus yuav hais tias, tau kawg, qhov mob yog qhov phem, vim nwsyog ib feem tseem ceeb ntawm yuav luag txhua yam kab mob thiab coj kev txom nyem rau ib tug neeg. Tab sis qhov tseeb, nyob rau hauv tus txheej txheem ntawm evolution, peb lub cev rau ntau xyoo tau tsim cov txheej txheem ntawm inflammatory txheej txheem nyob rau hauv nws tus kheej kom lawv yuav pab kom ciaj sia cov teeb meem, uas yog hu ua irritants nyob rau hauv cov tshuaj. Lawv tuaj yeem yog cov kab mob, kab mob, txhua qhov txhab ntawm daim tawv nqaij, tshuaj lom neeg (piv txwv li, tshuaj lom, co toxins), tsis zoo ib puag ncig. Exudative o yuav tsum tiv thaiv peb ntawm pathological kev ua ntawm tag nrho cov irritants. Nws yog dab tsi? Yog tias koj tsis mus rau hauv cov ntsiab lus, nws yooj yim heev los piav qhia nws. Txhua yam irritant, ib zaug hauv tib neeg lub cev, ua rau nws cov hlwb puas. Qhov no yog hu ua kev hloov pauv. Nws pib cov txheej txheem inflammatory. Nws cov tsos mob, nyob ntawm seb hom irritant thiab qhov chaw ntawm nws cov lus qhia, yuav txawv. Ntawm cov feem ntau yog:
- nce hauv qhov kub thiab txias thoob plaws hauv lub cev lossis tsuas yog hauv thaj chaw puas;
- o ntawm thaj chaw cuam tshuam;
- mob;
- liab ntawm thaj chaw raug mob.
Cov no yog cov cim tseem ceeb uas koj tuaj yeem nkag siab tias exudative mob twb pib lawm. Daim duab saum toj no qhia meej txog qhov tshwm sim ntawm cov tsos mob - liab, o.
Nyob rau qee theem ntawm cov txheej txheem inflammatory, kua (exudate) pib mus rau hauv cov hlab ntsha. Thaum lawv nkag mus los ntawm cov phab ntsa ntawm cov hlab ntsha mus rau hauv qhov chaw intercellular, qhov mob ua exudative. Thaum xub thawj siab ib muag, qhov no zoo li yog ib qho aggravation ntawm qhov teeb meem. Tab sis qhov tseeb txoj kev tawmexudate, los yog, raws li kws kho mob hais, exudation, kuj xav tau. Ua tsaug rau nws, cov tshuaj tseem ceeb heev nkag mus rau cov ntaub so ntswg los ntawm cov hlab ntsha - immunoglobulins, kinins, plasma enzymes, leukocytes, uas tam sim ntawd maj mus rau qhov tseem ceeb ntawm qhov mob txhawm rau txhawm rau tshem tawm cov khaus thiab kho qhov chaw puas nyob ntawd.
Exudation process
Piav seb qhov exudative o yog dab tsi, pathological anatomy (kev qhuab qhia uas kawm txog cov txheej txheem pathological) them tshwj xeeb rau cov txheej txheem ntawm exudation, "culprit" ntawm hom mob no. Nws muaj peb kauj ruam:
- Muaj kev hloov pauv. Nws tau tsim tshwj xeeb cov organic tebchaw - inflammatory mediators (kinins, histamines, serotonins, lymphokines thiab lwm yam). Raws li lawv qhov kev ua, cov channel ntawm microvessels pib nthuav dav, thiab vim li ntawd, qhov permeability ntawm phab ntsa ntawm cov hlab ntsha tau nce.
- Nyob rau hauv qhov dav ntawm txoj kab, cov ntshav pib txav ntau dua. Muaj qhov hu ua hyperemia, uas, dhau los, ua rau muaj kev nce hauv cov ntshav (hydrodynamic) siab hauv cov hlab ntsha.
- Nyob rau hauv lub siab ntawm cov kua los ntawm microvessels, exudate pib nkag mus rau hauv cov ntaub so ntswg los ntawm loj interendothelial qhov khoob thiab qhov hws, qee zaum mus txog qhov loj ntawm tubules. Cov khoom uas ua rau nws txav mus rau qhov chaw mob.
Nyob ntawm exudates
Nws yog qhov tseeb dua los hu cov kua exudate tawm hauv cov hlab ntsha mus rau hauv cov ntaub so ntswg, thiab tib cov kua dej tawm hauv cov kab noj hniav - effusion. Tab sis hauv tshuaj, ob lub tswv yim no feem ntau ua ke. Cov exudative hom mob yog txiav txim los ntawm cov muaj pes tsawg leeg ntawm daim card, uas yuav ua tau:
- serous;
- fibrous;
- purulent;
- rotten;
- hemorrhagic;
- slimy;
- chile;
- chyle-like;
- pseudochile;
- neutrophilic;
- eosinophilic;
- lymphocytic;
- mononuclear;
- mixed.
cov cholesterol
Cia peb saib ze rau ntawm hom kev mob exudative feem ntau, nws ua rau thiab cov tsos mob.
Daim ntawv serous exudative o
Nyob hauv tib neeg lub cev, lub peritoneum, pleura, pericardium yog them nrog serous daim nyias nyias, yog li lub npe los ntawm Latin lo lus "serum", uas txhais tau tias "serum", vim hais tias lawv tsim thiab nqus cov kua uas zoo li cov ntshav cov ntshav los yog. tsim los ntawm nws. Serous membranes nyob rau hauv ib txwm lub xeev yog du, yuav luag pob tshab, heev elastic. Thaum exudative o pib, lawv ua ntxhib thiab pos huab, thiab serous exudate tshwm nyob rau hauv cov ntaub so ntswg thiab lub cev. Nws muaj cov proteins (ntau tshaj 2%), lymphocytes, leukocytes, epithelial hlwb.
Exudative o tuaj yeem tshwm sim los ntawm:
- kev raug mob ntawm ntau yam etiologies (kev ua txhaum ntawm kev ncaj ncees ntawm daim tawv nqaij, kub hnyiab, kab tom, frostbite);
- kev npam;
- kab mob kis kab mob thiab kab mob (tuberculosis, meningitis, herpes, kab mob qhua pias thiab lwm yam);
- ua xua.
Serous exudate pab tshem cov co toxins thiab irritants los ntawm kev mob o. Nrog rau nws cov yam ntxwv zoo, kuj muaj qhov tsis zoo. Yog li ntawd, yog hais tias serous exudative o tshwm sim nyob rau hauv lub ntsws parenchyma, ua pa tsis ua hauj lwm tej zaum yuav tshwm sim, nyob rau hauv lub pericardium - lub plawv tsis ua hauj lwm, nyob rau hauv lub meninges - cerebral edema, nyob rau hauv lub raum - raum tsis ua hauj lwm, nyob rau hauv daim tawv nqaij nyob rau hauv lub epidermis - exfoliation ntawm nws. dermis thiab tsim ntawm serous hlwv. Txhua tus kab mob muaj nws cov tsos mob. Ntawm cov neeg sawv daws, ib tug tuaj yeem paub qhov txawv ntawm qhov kub thiab txias. Txawm hais tias qhov zoo li txaus ntshai pathology, qhov kev cia siab nyob rau hauv feem ntau ntawm cov neeg mob yog qhov zoo, vim tias cov exudate daws tsis tau tawm hauv cov kab, thiab cov serous membranes tau rov qab los.
Raws li tau sau tseg saum toj no, txhua yam ntawm exudative o yog txiav txim siab los ntawm cov muaj pes tsawg leeg ntawm cov zais cia tso tawm los ntawm microvessels. Yog li, fibrous exudate tau txais thaum, nyob rau hauv kev cuam tshuam ntawm inflammatory stimuli (kev raug mob, kab mob), ib qho ntxiv ntawm fibrinogen protein yog tsim. Feem ntau, tus neeg laus yuav tsum muaj 2-4 g / l. Hauv cov ntaub so ntswg puas, cov tshuaj no hloov mus ua fibrin. Qhov no kuj yog ib qho protein uas muaj cov qauv fibrous thiab tsim lub hauv paus ntawm cov ntshav txhaws. Tsis tas li ntawd, nyob rau hauv fibrous exudate muaj leukocytes, macrophages, monocytes. Ntawm qee theem ntawm o, necrosis ntawm cov ntaub so ntswg cuam tshuam los ntawm irritant tsim. Lawv yog impregnated nrog fibrous exudate, raws li ib tug tshwm sim ntawm uas ib tug fibrous zaj duab xis rau ntawm lawv nto. Microbes nquag tsim nyob rau hauv nws, uas ua rau nyuaj rau cov kab mob. nyob ntawmkab mob diphtheria thiab croupous fibrous exudative o yog txawv los ntawm localization ntawm zaj duab xis thiab los ntawm nws cov nta. Pathological anatomy piav qhia lawv qhov sib txawv raws li hauv qab no:
- Kab mob plab kab mob tuaj yeem tshwm sim hauv cov kabmob uas muaj ntau txheej txheej - hauv pharynx, tsev menyuam, qhov chaw mos, zais zis, plab hnyuv. Nyob rau hauv cov ntaub ntawv no, ib tug tuab fibrous zaj duab xis yog tsim, zoo li yog ingrown rau hauv lub plhaub ntawm lub cev. Yog li ntawd, nws yog ib qho nyuaj rau tshem tawm, thiab tawm ulcers tom qab. Nyob rau tib lub sijhawm, lawv kho tau, tab sis cov caws pliav yuav nyob twj ywm. Muaj lwm qhov kev phem - nyob rau hauv cov yeeb yaj kiab no, cov kab mob microbes sib koom ua ke ntau tshaj plaws, vim tias tus neeg mob muaj kev qaug cawv ntau nrog cov khoom ntawm lawv cov haujlwm tseem ceeb. Cov kab mob nto moo tshaj plaws ntawm hom kab mob no yog kab mob diphtheria.
- Croupous o yog tsim los ntawm cov kab mob mucous uas npog nrog ib txheej: hauv bronchi, peritoneum, trachea, pericardium. Hauv qhov no, cov yeeb yaj kiab fibrous hloov mus ua nyias, yooj yim tshem tawm, tsis muaj qhov tsis xws luag hauv cov mucous membranes. Txawm li cas los xij, qee zaum, nws tuaj yeem tsim teeb meem loj, piv txwv li, yog tias lub trachea ua rau mob, nws tuaj yeem ua rau nws nyuaj rau huab cua nkag mus rau hauv lub ntsws.
Exudative purulent o
Cov kab mob no tau pom thaum cov exudate yog cov kua paug - cov kua qaub ntsuab-daj, feem ntau nrog cov yam ntxwv tsw. Nws muaj pes tsawg leeg yog kwv yees li hauv qab no: leukocytes, feem ntau ntawm cov uas raug rhuav tshem, albumins, fibrin threads, enzymes ntawm microbial keeb kwm, roj cholesterol, rog, DNA fragments, lecithin,globulins. Cov tshuaj no tsim cov ntshav purulent. Ntxiv rau nws, purulent exudate muaj cov ntaub so ntswg detritus, nyob thiab / los yog degenerated microorganisms, purulent lub cev. Purulent o tuaj yeem tshwm sim hauv txhua lub cev. Cov "culprits" ntawm suppuration feem ntau yog cov kab mob pyogenic (ntau cocci, E. coli, Proteus), nrog rau Candida, Shigella, Salmonella, Brucella. Cov ntaub ntawv ntawm exudative o ntawm ib tug purulent xwm yog raws li nram no:
- Ascess. Nws yog ib qho ua kom pom tseeb nrog cov tshuaj tiv thaiv kab mob uas tiv thaiv cov kua paug los ntawm kev nkag mus rau cov ntaub so ntswg nyob sib ze. Purulent exudate accumulates nyob rau hauv cov kab noj hniav ntawm lub tsom, nkag mus rau hauv lub capillaries ntawm barrier capsule.
- Phlegmon. Nrog rau daim ntawv no, tsis muaj ib tug meej ciam teb ntawm lub hom phiaj ntawm o, thiab purulent exudate kis mus rau cov nyob sib ze cov ntaub so ntswg thiab kab noj hniav. Cov duab zoo li no tuaj yeem pom nyob rau hauv cov txheej txheem subcutaneous, piv txwv li, hauv cov ntaub so ntswg adipose, nyob rau hauv retroperitoneal thiab pararenal zones, nyob qhov twg cov qauv morphological ntawm cov ntaub so ntswg tso cai rau cov kua paug mus dhau qhov ua kom pom tseeb ntawm qhov mob.
- Nkauj. Daim ntawv no zoo ib yam li tus kab mob abscess thiab tau pom nyob rau hauv kab noj hniav, ib sab ntawm qhov uas muaj qhov ua kom pom tseeb ntawm qhov mob.
Yog tias muaj ntau qhov degenerative neutrophils hauv cov kua paug, cov exudate hu ua purulent neutrophil. Feem ntau, lub luag haujlwm ntawm neutrophils yog los rhuav tshem cov kab mob thiab cov fungi. Lawv, zoo li cov neeg saib xyuas siab tawv, yog thawj zaug maj nrawm ntawm cov yeeb ncuab uas tau nkag mus rau peb lub cev. Yog li ntawd, nyob rau hauv thawj theem ntawm o, feem ntau neutrophils tsis zoo, undestroyed, thiab cov exudate hu ua micropurulent. Raws li tus kab mob no zuj zus, leukocytes raug rhuav tshem, thiab hauv cov kua paugfeem ntau lawv twb degenerated lawm.
Yog tias cov kab mob putrefactive microorganisms (feem ntau, cov kab mob anaerobic) nkag mus rau hauv qhov ua kom pom tseeb, cov purulent exudate loj hlob mus rau hauv putrefactive. Nws muaj cov yam ntxwv tsw thiab xim thiab pab txhawb rau decomposition ntawm cov ntaub so ntswg. Qhov no yog fraught nrog siab intoxication ntawm lub cev thiab muaj ib tug heev unfavorable tshwm sim.
Kev kho mob purulent yog ua raws li kev siv tshuaj tua kab mob thiab ua kom cov kua dej tawm ntawm qhov ua kom pom tseeb. Qee zaum qhov no yuav tsum tau phais. Kev tiv thaiv ntawm xws li mob yog kev tua kab mob ntawm qhov txhab. Kev kho mob ntawm cov kab mob no tuaj yeem muaj txiaj ntsig zoo tsuas yog nrog kev kho mob hnyav nrog kev phais ib txhij tshem tawm cov tawg tawg.
Hemorrhagicitis
Hauv qee cov kab mob txaus ntshai, xws li kab mob anthrax, kab mob dub, kab mob plague, mob khaub thuas, mob khaub thuas, hemorrhagic exudative o yog kuaj. Yog vim li cas rau nws yog qhov nce permeability ntawm microvessels mus txog rau lawv ruptures. Nyob rau hauv cov ntaub ntawv no, lub exudate yog dominated los ntawm erythrocytes, vim nws cov xim txawv ntawm liab mus rau tsaus liab. Qhov tshwm sim sab nraud ntawm hemorrhagic o yog zoo li hemorrhage, tab sis, tsis zoo li yav tas los, tsis tsuas yog erythrocytes pom nyob rau hauv lub exudate, tab sis kuj muaj ib tug me me feem ntawm neutrophils nrog macrophages. Kev kho mob ntawm hemorrhagic exudative o yog sau rau hauv tus account hom kab mob uas coj mus rau nws. Qhov tshwm sim ntawm tus kab mob tuaj yeem ua rau tsis zoo yog tias kev kho mob pib lig thiab yog tiastus neeg mob lub cev tsis muaj zog txaus los tiv thaiv tus kab mob.
Catarrhalitis
Ib qho tshwj xeeb ntawm cov kab mob no yog tias cov exudate nrog nws tuaj yeem ua serous, purulent, thiab hemorrhagic, tab sis ib txwm nrog cov hnoos qeev. Nyob rau hauv xws li mob, ib tug mucous secretion yog tsim. Tsis zoo li serous, nws muaj ntau mucin, cov tshuaj tua kab mob lysozyme, thiab A-class immunoglobulins. Nws yog tsim los rau cov laj thawj hauv qab no:
- kis kab mob lossis kab mob;
- raug rau lub cev ntawm cov tshuaj, qhov kub thiab txias;
- metabolic ntshawv siab;
- kev tsis haum (xws li kev ua xua rau lub ntsej muag).
Catarrhal exudative o yog kuaj pom muaj mob ntsws, mob catarrh, rhinitis, gastritis, catarrhal colitis, mob ua pa nyuaj, pharyngitis thiab tuaj yeem tshwm sim hauv cov mob hnyav thiab mob ntev. Hauv thawj kis, nws kho tau tag nrho hauv 2-3 lub lis piam. Hauv qhov thib ob, kev hloov pauv tshwm sim hauv mucosa - atrophy, uas daim nyias nyias ua nyias, lossis hypertrophy, uas, ntawm qhov tsis sib xws, cov mucosa ua tuab thiab tuaj yeem nkag mus rau hauv cov kab noj hniav.
Lub luag haujlwm ntawm mucous exudate yog ob npaug. Ntawm qhov tod tes, nws pab tiv thaiv kab mob, thiab ntawm qhov tod tes, nws tsub zuj zuj hauv cov kab noj hniav ua rau cov txheej txheem pathological ntxiv, piv txwv li, hnoos qeev hauv cov sinuses pab txhawb kev loj hlob ntawm sinusitis.
Kev kho mob ntawm catarrhal exudative o yog ua nrog cov tshuaj tua kab mob, cov txheej txheem physiotherapeutic thiab pej xeem txoj kev, xws li cua sov, yaug nrog ntau yam kev daws teeb meem,Kev noj haus ntawm infusions thiab decoctions ntawm tshuaj ntsuab.
Exudative mob: tus yam ntxwv ntawm cov kua exudative tshwj xeeb
Chylous thiab pseudochylous exudates tau hais los saum toj no, tshwm sim nrog kev raug mob ntawm cov hlab ntsha lymphatic. Piv txwv li, nyob rau hauv lub hauv siab, qhov no tej zaum yuav nrog ib tug rupture ntawm lub thoracic duct. Chylous exudate yog xim dawb vim muaj cov roj ntau ntxiv hauv nws.
Pseudochylous kuj muaj xim dawb, tab sis nws muaj tsis ntau tshaj 0.15% rog, tab sis muaj mucoid tshuaj, protein lub cev, nucleins, lecithins. Nws tau pom hauv lipoid nephrosis.
xim dawb thiab chyle zoo li exudate, tsuas yog cov decayed degenerate hlwb muab xim rau nws. Nws yog tsim thaum lub sij hawm mob o ntawm cov serous membranes. Nyob rau hauv lub plab kab noj hniav, qhov no tshwm sim nrog cirrhosis ntawm daim siab, nyob rau hauv lub pleural kab noj hniav - nrog tuberculosis, pleural cancer, syphilis.
Yog tias muaj ntau cov lymphocytes hauv exudate (ntau dua 90%), nws hu ua lymphocytic. Nws raug tso tawm los ntawm cov hlab ntsha hauv pleural tuberculosis. Yog tias cov roj (cholesterol) nyob hauv qhov zais cia, los ntawm kev sib piv nws yog hu ua cholesterol. Nws muaj qhov sib xws, xim daj lossis xim av thiab tuaj yeem tsim los ntawm lwm cov kua dej exudative, yog tias cov dej thiab cov ntxhia hauv cov ntxhia tau rov qab los ntawm cov kab noj hniav uas nws khaws tau ntev.
Raws li koj tuaj yeem pom, muaj ntau hom exudates, txhua tus yam ntxwv ntawm qee hom exudative o. Tseem muaj cov xwm txheej thaum, rau ib yam kab mob,Kev sib xyaw exudative mob yog kuaj pom, piv txwv li, serous-fibrous lossis serous-purulent.
Cov ntawv mob hnyav thiab mob ntev
Exudative o tuaj yeem tshwm sim hauv daim ntawv mob hnyav lossis mob ntev. Nyob rau hauv thawj rooj plaub, nws yog ib qho instant teb rau ib tug stimulus thiab yog tsim los tshem tawm cov stimulus no. Yuav muaj ntau yam laj thawj rau daim ntawv no o. Feem ntau:
- mob;
- kab mob;
- tshuaj lom neeg;
- cuam tshuam hauv kev ua haujlwm ntawm lub cev thiab lub cev.
Tus mob exudative mob tshwm sim los ntawm qhov liab thiab o ntawm qhov chaw raug mob, mob, ua npaws. Qee lub sij hawm, tshwj xeeb tshaj yog vim kev kis kab mob, cov neeg mob muaj cov tsos mob ntawm kev tsis txaus ntseeg thiab kev qaug cawv.
Tus mob o yog qhov luv luv, thiab yog tias txoj kev kho tau ua tiav, nws kho tau tag nrho.
Cov kab mob exudative mob tuaj yeem nyob tau ntau xyoo. Nws yog sawv cev los ntawm purulent thiab catarrhal hom ntawm cov txheej txheem inflammatory. Nyob rau tib lub sijhawm, kev puas tsuaj ntawm cov ntaub so ntswg txhim kho ib txhij nrog kev kho. Thiab txawm hais tias nyob rau theem ntawm kev tso tawm tus mob mob ntev ntawm tus neeg mob yuav luag tsis thab, nws tuaj yeem ua rau qaug zog (cachexia), kev hloov pauv hauv cov hlab ntsha, cuam tshuam tsis zoo ntawm lub cev thiab txawm tias tsim cov qog. Kev kho mob feem ntau yog tsom rau kev tswj xyuas lub sijhawm tshem tawm. Hauv qhov no, qhov tseem ceeb tseem ceeb yog txuas nrog rau daim duab kom raug.lub neej, noj haus, tiv thaiv kab mob.
