Meningitis yog ib yam kab mob inflammatory thiab kis kab mob uas cuam tshuam rau lub paj hlwb. Tus neeg sawv cev ntawm nws yog ntau yam kab mob, tshwj xeeb tshaj yog cov kab mob, kab mob, fungi. Pathology tuaj yeem txhim kho nws tus kheej lossis tshwm sim los ntawm kev cuam tshuam ntawm lwm yam kab mob. Nws yog ib qho tseem ceeb heev kom paub meej tias dab tsi yog thawj cov tsos mob ntawm tus mob meningitis hauv cov neeg laus, yog li koj tuaj yeem paub txog cov kab mob pathology raws sijhawm thiab ua tiav kev kho mob.
Tus yam ntxwv ntawm tus kab mob
Meningitis yog ib yam kab mob uas tshwm sim los ntawm cov txheej txheem inflammatory nyob rau hauv daim nyias nyias ntawm lub paj hlwb, uas tshwm sim los ntawm kev nkag mus ntawm tus kab mob mus rau hauv lub cev. Ntawm cov tsos mob tshwm sim, cov hauv qab no tuaj yeem paub qhov txawv:
- caj dab leeg;
- mob taub hau;
- tsis nco qab;
- kub nce.
Cov tsos mob ntawm tus mob meningitis hauv cov neeg laus yuav txawv, txhua yam nyob ntawm tus kab mob. Nws manifests nws tus kheej raws li ib tug thawj tshuaj tiv thaiv rau tus kab mob ntawm meninges los yog lwm yam o uas tshwm sim thaummob hnyav ntawm lwm yam mob. Xws li ib tug pathology hem nrog rau qhov tshwm sim tuag taus, kev tsis taus ntawm tus neeg mob, nrog rau cov kab mob tsis zoo ntawm lub cev.
Sheaths npog lub hlwb, lawv tuaj yeem mos lossis tawv. Muaj qee yam kab mob, nyob ntawm thaj tsam ntawm qhov mob. Lawv tuaj yeem ua tau raws li hauv qab no:
- leptomeningitis - kev puas tsuaj rau cov tawv nqaij mos;
- pachymeningitis - mob ntawm lub plhaub tawv;
- panmeningitis - swb ntawm txhua daim nyias nyias ntawm lub hlwb.
Yeej, qhov mob ntawm cov nqaij mos ntawm lub hlwb raug pom. Tus kab mob no yog ib qho txaus ntshai tshaj plaws, vim nws provokes qhov tshwm sim ntawm cov teeb meem loj, kev tsis taus, thiab teeb meem kev noj qab haus huv. Kev kho mob yog nqa tawm nrog kev pab los ntawm ntau yam tshuaj tua kab mob uas pab rhuav tshem cov kab mob feem ntau. Tshuaj tiv thaiv tshwj xeeb yog siv los tiv thaiv kab mob.
Kev tshwm sim
Txhawm rau txiav txim siab seb cov tsos mob ntawm tus mob meningitis hauv cov neeg laus thiab menyuam yaus yog dab tsi, koj yuav tsum nkag siab meej tias vim li cas tus kab mob no tshwm sim. Kev mob ntawm meninges tuaj yeem tsim nyob rau hauv kev cuam tshuam ntawm ntau yam kab mob. Nyob ntawm seb hom kab mob, cov tsos mob ntawm tus mob meningitis hauv cov neeg laus yuav txawv me ntsis, thiab cov tswv yim ntawm kev kho kuj raug xaiv nyias.
Qhov zoo tshaj plaws ntawm kev rov zoo yog hom kab mob kis. Nyob rau tib lub sijhawm, qhov kev puas tsuaj ntawm lub hlwb yog tsawg, thiab nrog rau kev kuaj mob thiab kho raws sijhawm, cov teeb meem txaus ntshai thiab kev tuag ntawm tus neeg mob tshwm sim.tsawg txaus. Viral meningitis tshwm sim raws li qhov teeb meem ntawm cov kab mob uas twb muaj lawm, xws li:
- measles;
- hmoob;
- mob syphilis thiab lwm yam.
Txoj kev rau kev nkag mus ntawm cov kab mob mus rau hauv daim nyias nyias ntawm lub hlwb txawv heev. Lawv tuaj yeem tau los ntawm cov ntshav, los ntawm cov kua cerebrospinal, thiab nrog rau cov qog ntshav. Tsis zoo li cov kab mob hauv daim ntawv, cov kab mob provoke ib tug complex o ntawm ib tug serous xwm yam tsis tau tso cov kua paug. Hauv daim ntawv kis kab mob, qhov mob hnyav yuav siv sijhawm li 2-3 hnub, tom qab ntawd muaj qhov txo qis, thiab tom qab ntawd cov tsos mob nce ntxiv.
Daim ntawv kab mob muaj cov tsos mob tshwm sim ntau dua thiab yog tus cwj pwm los ntawm cov kab mob hnyav, nrog rau kev txhim kho cov teeb meem txaus ntshai. Qhov kev pheej hmoo siab tshaj plaws ntawm kev tuag yog pom meej nrog hom kev ua txhaum cai no.
Thaum cov txheej txheem inflammatory tshwm sim rau ntawm qhov chaw ntawm lub meninges, tsim cov kua paug tau sau tseg, uas ua rau muaj kev cuam tshuam loj heev ntawm cov kua dej cerebrospinal, uas ua rau muaj kev nce siab hauv intracranial. Ntawm cov cim tseem ceeb ntawm meningitis nyob rau hauv cov neeg laus yog intoxication thiab kub kub.
Daim ntawv no feem ntau nrog kev tsis meej pem ntawm kev xav, kev cuam tshuam ntawm kev nco qab, muaj kev hnov lus, nrog rau kev ua kom puas siab puas ntsws. Nrog rau qhov sib ntxiv ntawm cov kab mob, tus neeg mob tuaj yeem poob rau hauv coma. Feem ntau, kab mob meningitis tshwm sim raws li qhov teeb meem ntawm kev mob ntevtonsillitis, mob ntsws, pyelonephritis, abscesses, sinusitis, osteomyelitis. Boils tuaj yeem ua rau muaj kev phom sij, vim lawv ua raws li cov kab mob uas, ua ke nrog cov ntshav, tuaj yeem kis thoob plaws lub cev.
Tuberculosis meningitis tshwm sim los ntawm qhov tseeb tias tuberculosis microbacteria kis thoob plaws hauv lub cev thiab nkag mus rau hauv daim nyias nyias ntawm lub hlwb. Tsis tas li ntawd, lwm yam kab mob pathogenic microorganisms thiab lawv cov kev sib xyaw ua ke tuaj yeem ua rau muaj kev loj hlob ntawm o. Tias yog vim li cas ib daim ntawv protozoan thiab fungal tuaj yeem tshwm sim. Meningitis tuaj yeem txhim kho raws li qhov teeb meem ntawm cov txheej txheem thaum lub sijhawm metastasis ntawm neoplasms, nrog rau cov kab mob ntawm cov ntaub so ntswg.
Kev faib tawm
Cov tsos mob ntawm tus mob meningitis nyob rau hauv ib tug neeg laus tuaj yeem sib txawv heev nyob ntawm kev faib tawm ntawm cov txheej txheem pathological. Raws li qhov tshwm sim ntawm qhov mob, cov kws kho mob paub qhov txawv hauv qab no:
- purulent;
- kab mob;
- serous.
- viral.
Hom kab mob meningitis yog qhov tshwm sim los ntawm qhov tsis muaj paug tawm, nrog rau kev kawm yooj yim dua. Cov pab pawg ntawm hom mob xws li:
- fluy;
- tuberculous;
- enteroviral;
- syphilitic;
- hmoob.
Cov kws kho mob faib cov kab mob meningitis raws li nws qhov xwm txheej thiab paub qhov txawv ntawm cov chav kawm fulminant, mob hnyav thiab mob ntev. Lub teeb ci-ceev zoo li tsim nyob rau lub sijhawm tsuas yog ob peb teev, tshwj xeeb tshaj yog nwstus yam ntxwv ntawm cov me nyuam mos. Lub sijhawm incubation yuav luag tsis tuaj, thiab kev tuag tuaj yeem tshwm sim ib hnub tom qab kis kab mob.
Daim ntawv mob hnyav cuam tshuam rau lub cev nyob rau hauv ob peb hnub thiab muaj cov tsos mob hnyav ntawm tus mob meningitis hauv cov neeg laus. Feem ntau xaus nrog kev txhim kho ntawm cov teeb meem txaus ntshai lossis kev tuag ntawm tus neeg mob. Daim ntawv mob ntev zuj zus, cov tsos mob nce ntxiv txhua lub sijhawm thiab ua kom pom tseeb.
Tsis tas li ntawd, meningitis yog cais los ntawm qhov chaw ntawm qhov mob, nws tuaj yeem cuam tshuam rau qee qhov ntawm lub hlwb lossis tag nrho ntawm nws.
Cov kab mob hauv cov neeg laus
Tus kab mob feem ntau cuam tshuam rau cov txiv neej hluas hauv lawv cov 20s thiab 30s. Feem ntau cov kab mob pathology yog pneumococci, meningococci thiab Haemophilus influenzae. Tsis tas li ntawd, muaj daim ntawv tuberculosis. Feem ntau ua rau mob yog kab mob xws li:
- sinusitis;
- txheej txheem carious;
- otitis media;
- kab mob ua pa;
- bronchitis.
Cov poj niam feem ntau tsis tshua muaj kab mob meningitis, tab sis thaum cev xeeb tub, qhov no yuav nce siab heev, vim tias muaj kev tiv thaiv qis dua. Yog tias muaj cov tsos mob ntawm tus mob meningitis nyob rau hauv ib tug neeg laus, koj yuav tsum sab laj nrog kws kho mob kom tsim nyog kuaj thiab kho. Tsis tas li ntawd, kev tiv thaiv yog yuav tsum tau, lub hauv paus ntawm uas yog txhaj tshuaj tiv thaiv, kev kho mob ntawm inflammatorycov txheej txheem, kho kom raws sijhawm, txwv kev sib cuag nrog tus neeg mob.
Kev mob ntawm cov menyuam yaus
Nyob rau hauv ib tug menyuam yaus hnub nyoog qis dua 5 xyoos, meningitis ua rau muaj kev phom sij ntau, vim tias kev pheej hmoo ntawm kev tuag muaj ntau heev. Cov teeb meem ntawm lub hnub nyoog no kuj muaj kev cuam tshuam tsis zoo rau tus menyuam. Hom kab mob hnyav tshaj plaws tshwm sim thaum tus me nyuam kis tau tus kab mob thaum lub sij hawm dhau los ntawm txoj kev yug me nyuam. Kev mob tshwm sim tshwm sim nrog xob laim nrawm, ua rau muaj kev phom sij tshaj plaws. Rau cov menyuam yaus hnub nyoog 1-5 xyoos, feem ntau cov kab mob ntawm cov kab mob meningitis yog cov yam ntxwv, vim lawv txawv ntawm cov tsos mob thiab qhov tshwm sim. Cov kab mob ntawm tus kab mob no nyuaj dua, yog li yuav tsum tau txhaj tshuaj tiv thaiv.
Cov tsos mob tseem ceeb
Tus kab mob no feem ntau tshwm sim los ntawm kev mob hnyav. Feem ntau, thawj cov tsos mob ntawm tus mob meningitis hauv cov neeg laus raug pom, xws li:
- kub nce;
- ua pa nrawm;
- nce ESR thiab leukocytes;
- tachycardia.
Lawv zoo ib yam li cov mob khaub thuas, uas yog vim li cas nws nyuaj heev los kuaj xyuas qhov tseeb hauv thawj theem. Tsis tas li ntawd, muaj cov tsos mob tshwj xeeb thiab cov tsos mob ntawm tus mob meningitis hauv cov neeg laus, uas suav nrog cov hauv qab no:
- xeev siab thiab ntuav;
- mob taub hau;
- nce hauv cov leeg nqaij occipital;
- pob khaus;
- lub teeb thiab lub suab tsis kam.
Tsis muaj qhov chaw ntawm qhov mob taub hau thiab dhau sijhawm nws dhau los ua tsis yooj yim, thiab txhua qhov kev txav ua rau nws hnyav dua. Qee zaum, tus kab mob tuaj yeem tshwm sim hauv ib tus neeg laus uas tsis muaj qhov kub thiab txias. Cov tsos mob ntawm tus mob meningitis nyob rau hauv cov ntaub ntawv no yog sib tov me ntsis, uas yog ib qho nyuaj rau paub.
Thaum mob me, tus kab mob tuaj yeem tshwm sim nws tus kheej li pob liab liab me me uas ploj hauv ob peb hnub xwb. Yog tias qhov nqaij tawv nqaij thiab pob liab liab loj heev, qhov no yuav qhia tau tias mob meningitis hnyav heev.
Diagnostics
Meningitis yog ib qho teeb meem nyuaj thiab txaus ntshai heev. Cov tsos mob ntawm tus kab mob hauv cov neeg laus tuaj yeem ua rau qhov muag tsis pom, vim li ntawd, txhawm rau tiv thaiv kev txhim kho ntawm cov teeb meem, nws yog ib qho tsim nyog yuav tsum tau kuaj xyuas thiab kho raws sijhawm. Nws yog ib qho tseem ceeb tsis yog tsuas yog ua rau kev kuaj mob, tab sis kuj txiav txim siab txog qib ntawm txoj kev loj hlob, hom kab mob, nws tus neeg sawv cev ua rau thiab hauv cheeb tsam. Cov kev kuaj mob tseem ceeb suav nrog cov hauv qab no:
- neeg tsis txaus siab;
- kev tshuaj xyuas tus neeg mob;
- kuaj ntshav kuaj;
- lumbar puncture.
Puncture tsuas yog ua los ntawm tus kws tshaj lij siv rab koob ntev thiab nyias. Nws yuav tsum tau ua ib qho puncture ntawm daim tawv nqaij ntawm theem ntawm sab nraub qaum thiab nqa cov kua cerebrospinal rau kev tshawb fawb ntxiv. Txhawm rau kawm txog cov yam ntxwv ntawm meninges thiab kuaj mob, tomography yuav tsum tau ua. Txhawm rau txheeb xyuas tus kab mob ua rau tus kab mob thiab xaiv cov kev kho mob zoo tshaj plaws, kev tshuaj xyuas PCR raug sau tseg.
Txoj kev kho mob
Thaum nws tshwm simcov tsos mob ntawm meningitis nyob rau hauv cov neeg laus, yuav ua li cas kho tus kab mob tsuas yog txiav txim los ntawm ib tug kws kho mob tsim nyog. Txoj kev kho sai dua yog pib, qhov ntau dua tus neeg mob txoj hauv kev kom rov zoo dua. Kev kho mob tsuas yog ua hauv tsev kho mob xwb. Feem ntau, cov ntaub ntawv tseem ceeb raug kho hauv chav saib xyuas kab mob sib kis, thiab cov theem ob - hauv qhov profile, nyob ntawm qhov kev kuaj mob loj.
Yog hais tias, nrog hypothermia ntawm lub taub hau, cov tsos mob ntawm meningitis nyob rau hauv cov neeg laus nce sai txaus thiab cerebral edema loj hlob sai heev, tus neeg mob yuav tsum nyob rau hauv lub intensive care unit. Lub tsev kho mob tau sau tshuaj tua kab mob, kho cov tsos mob thiab kev ntsuas txhawm rau tshem tawm cov txheej txheem pathogenic.
Cov tshuaj tua kab mob dav dav tau raug sau rau cov kab mob meningitis. Cov tshuaj kws tshaj lij tshaj plaws yog Ceftriaxone, Cefotaxime ua ke nrog Ampicillin thiab Benzylpenicillin.
Yog tias muaj cov tsos mob ntawm tus kab mob meningitis hauv cov neeg laus, cov tshuaj tiv thaiv kab mob xws li Tiloron, nrog rau cov tshuaj immunoglobulins, interferons, raug tshuaj rau kev kho. Yog hais tias tus mob meningitis tau provoked los ntawm tubercle bacillus, ces cov tshuaj tiv thaiv kab mob yog muab.
Muaj Teeb Meem
Thaum thawj cov tsos mob ntawm tus mob meningitis tshwm rau cov neeg laus, kev kho mob yuav tsum tau pib tam sim ntawd kom txo tau qhov tshwm sim. Tom qab muaj mob yav dhau los, qhov tshwm sim yuav tshwm sim nyob ntawm seb nws yog kab mob twg.ua tsaug.
Ib yam tshwm sim thiab txaus ntshai tshwm sim los ntawm tus mob meningitis yog cerebral edema. Nws feem ntau tshwm sim hauv cov menyuam yaus thiab cov tub ntxhais hluas thaum thawj hnub tom qab pib tus kab mob.
Thaum meningococci nkag mus rau hauv cov hlab ntsha, ib qho kev poob siab-tshuaj lom raug tsim. Tom qab qhov teeb meem zoo li no, nws tshwm sim hauv 3 hnub. Cov tub ntxhais hluas tuaj yeem tsim cov tshuaj lom neeg poob siab thiab nthuav dav cerebral edema tib lub sijhawm. Qee lub sij hawm migraines, tsaug zog thiab kev cia siab rau huab cua los ua qhov tshwm sim ntawm tus mob meningitis yav dhau los ntev. Hauv lwm qhov xwm txheej, teeb meem xws li:
- hnov tsis hnov;
- psychopathy thiab qaug dab peg;
- kev puas tsuaj thiab cuam tshuam;
- strabismus.
Tom qab cov kab mob meningitis thaum yau, cov teeb meem loj tuaj yeem nyob nrog ib tus neeg mus rau lub neej, yog li tus kab mob yuav tsum tau kho mus ntev thiab saib xyuas los ntawm kws kho mob tsis tu ncua txawm tias tom qab ua tiav.
Huab cua thiab tiv thaiv
Nws yog qhov nyuaj heev los tiv thaiv kev txhim kho ntawm tus kab mob txaus ntshai thiab nyuaj, vim tias muaj ntau cov kab mob, yog li kev tiv thaiv kev tiv thaiv rau txhua tus yog sib txawv kiag li. Cov kev cai dav dav yog:
- kev kuaj mob ntxov;
- kev cais tus neeg mob raws sijhawm;
- ua raws li cov cai ntawm kev tu tus kheej;
- siv cov khoom tiv thaiv tus kheej;
- kev tiv thaiv ib txwm muaj.
Txoj kev nkaus xwbtiv thaiv kev txhim kho ntawm meningitis yog txhaj tshuaj tiv thaiv. Feem ntau, cov tshuaj tiv thaiv kab mob meningococcal, MMR, thiab Haemophilus influenzae yog siv rau lub hom phiaj no.
Kev ntsuas ntawm chav kawm feem ntau nyob ntawm tus kheej tus yam ntxwv ntawm tus neeg mob thiab ntau lwm yam. Nws yog qhov tsis meej meej, txij li qee zaum tus kab mob pib rov ua haujlwm, thiab tsis muaj kev ntsuas kub ceev pab cawm tus neeg mob, thiab lwm yam, tus neeg mob rov zoo tag nrho yam tsis muaj qhov tshwm sim.
