Tsis yog-clostiridial anaerobic kab mob yog cov txheej txheem pathological uas tuaj yeem tshwm sim los ntawm cov kab mob hauv cov xwm txheej zoo rau lawv txoj kev loj hlob thiab kev ua haujlwm tseem ceeb. Cov tsos mob ntawm tus kab mob yog muaj cov tsos mob ntawm intoxication, gas-forming txheej txheem nyob rau hauv lub qhov txhab, putrefactive exudate, thiab sai heev cov ntaub so ntswg necrosis.
Tus kab mob no tau pom tau yooj yim heev los ntawm cov tsos mob uas twb muaj lawm, uas tau lees paub los ntawm kev kuaj mob dav dav. Kev kho mob suav nrog kev phais mob ntawm qhov txhab, nrog rau kev kho tshuaj.
Tus yam ntxwv ntawm tus kab mob anaerobic
Non-clostridial anaerobes tsis tsim spores thiab yog cov tswv cuab ntawm tib neeg cov nroj tsuag. Lawv tag nrho cov mucous daim nyias nyias los ntawm qhov ncauj kab noj hniav mus rau lub qhov quav. Raws li ib txwm muaj, cov kab mob zoo li no tsis muaj teeb meem kiag li, txawm li cas los xij,Nyob rau hauv lub xub ntiag ntawm tej yam kab mob, microbes dhau los ua tus kab mob ntawm kev phais mob txaus ntshai.
Muaj ntau yam uas tshwm sim rau cov kab mob uas tsis yog-clostriadial anaerobic xws li:
- necrosis tshwm sim thaum raug mob lossis cov txheej txheem purulent-inflammatory;
- tsis muaj zog tiv thaiv;
- pab ntshav txaus rau cov ntaub so ntswg;
- tissue acidosis.
Tus kab mob feem ntau tshwm sim hauv daim ntawv phlegmon. Cov txheej txheem pathological cuam tshuam rau ntawm daim tawv nqaij, cov leeg thiab cov ntaub so ntswg subcutaneous. Nws yog tus cwj pwm los ntawm qhov pib mob hnyav thiab kev kawm ceev. Tus kws kho mob tuaj yeem ua qhov kev kuaj mob zaum kawg nkaus xwb tom qab kuaj xyuas.
Cov kab mob ua rau cov kab mob uas tsis yog-clostridial anaerobic tuaj yeem tshwm sim hauv cov kab mob anoxic, uas yog vim li cas cov khaub ncaws tsis huv, av, thiab cov organic sib xyaw ua kom tawg tuaj yeem ua rau kis kab mob. Pathogenic microorganisms muaj cov nyhuv pathogenic thaum muaj ntau yam ua rau muaj kev sib koom ua ke. Kev puas tsuaj rau cov teeb meem ntawm qhov txhab ntawm qhov txhab ua rau nkag mus ntawm pathogenic microflora rau hauv cov ntaub so ntswg tsis muaj menyuam. Yog hais tias cov cheeb tsam cuam tshuam muaj txaus nkag mus rau oxygen, tom qab ib lub sij hawm, cov microbes tuag yam tsis muaj kev phom sij. Raws li kev faib tawm uas twb muaj lawm, anaerobic non-clostridial kab mob tuaj yeem yog:
- monoinfection - swb by one anaerobe;
- polyinfection nrog ob lossis ntau dua anaerobes;
- sib xyaw kab mob -ua ke ntawm anaerobes thiab aerobes.
Cov kab mob uas twb muaj lawm tuaj yeem ua tiav, mob thiab subacute. Anaerobic non-clostridial kab mob yog muaj nyob rau hauv kev phais thiab gynecology. Nyob ntawm qhov muaj peev xwm ntawm cov kab mob mus rau sporulate, cov kab mob zoo li no tshwm sim hauv ntau txoj kev, txawm li cas los xij, nws muaj cov tsos mob zoo sib xws.
Tus yam ntxwv tus kab mob dab tsi
Ntau tus neeg mob xav paub tias tus kab mob anaerobic yog dab tsi, vim li cas nws thiaj li tsim, nws muaj dab tsi thiab yuav kho li cas. Nyob rau hauv lub xub ntiag ntawm non-spore-forming anaerobes nyob rau hauv lub cev, mob xws li mob sinusitis, periodontal abscess, necrotic pneumonia, lub hlwb thiab lub ntsws abscess, phlegmon, pob txha thiab pob qij txha kab mob, sepsis thiab ntau lwm yam kab mob loj tuaj yeem tshwm sim.
Anaerobes feem ntau provoke kev loj hlob ntawm kev kis kab mob ntawm lub plab kab noj hniav, daim siab, thiab ntau lwm yam kabmob. Hauv gynecology, tsis yog-clostridial anaerobic kab mob tuaj yeem ua rau ntau yam pathologies ntawm poj niam qhov chaw mos, tshwj xeeb, xws li:
- endometritis;
- salpingitis;
- kis kab mob rho menyuam thiab ntau ntxiv.
Nws yog ib qho tsim nyog sau cia tias nrog rau tag nrho cov kab mob no, cov tsos mob yog qhov muag tsis pom, yog li kom paub meej tias qhov kev kuaj mob, nws yuav tsum tau kuaj xyuas.
Kev faib tawm
Raws li kev faib tawm ntawm anaerobic non-clostridial kab mob los ntawm thaj chaw hauv zos, muaj ntau hom kab mob xws li:
- kab mob daim tawv nqaij;
- defeatpob txha;
- kwj dej;
- lub cev sab hauv;
- kab noj hniav;
- bacteremia.
kab mob anaerobic provoke cov kab mob ntawm daim tawv nqaij, nrog rau cov kab mob subcutaneous lossis postoperative. Nrog ib tug tob lesion, necrosis yog pom. Thaum cov pob txha cov ntaub so ntswg koom nrog cov txheej txheem pathological, septic mob caj dab tsim, nrog rau purulent-necrotic osteomyelitis.
Kev kis kab mob hauv nruab nrog cev ua rau cov kab mob vaginosis hauv poj niam, kab mob gynecological thiab intrauterine kab mob, qhov chaw mos abscesses, thiab septic rho menyuam.
Kev tshwm sim
Nonclostriadial anaerobic kab mob tshwm sim nrog kev puas tsuaj rau cov kab mob hauv nruab nrog cev thiab yog tus cwj pwm los ntawm kev tuag. Qhov no pathology yog yus muaj los ntawm kev puas tsuaj rau lub connective thiab cov leeg nqaij fibers. Anaerobic clostridial thiab non-clostridial kab mob hauv kev phais tsim nyob rau hauv 30 hnub tom qab kev phais. Xws li cov kab mob feem ntau cuam tshuam nrog nosocomial thiab ua rau kom lub sij hawm tus neeg nyob hauv tsev kho mob.
Ntawm cov laj thawj tseem ceeb uas ua rau muaj kev ua txhaum cai ntawm cov kab mob microflora ntawm lub cev, nws yog qhov yuav tsum tau ua kom pom tseeb xws li:
- microbial pathologies ntawm cov ntaub so ntswg thiab kabmob;
- kab mob hauv lub cev thiab ua tsis taus;
- tshuaj tua kab mob ntev ntev, kho tshuaj hormone thiab tshuaj khomob;
- Nyob tsev kho mob ntev.
Muaj qee yam ua rau mobyam uas tseem ceeb txhim kho cov kab mob pathogenic ntawm anaerobes. Cov no suav nrog cov enzymes tsim los ntawm cov kab mob. Lawv provokes mob hnyav heev ntawm cov ntshav microcirculation, rhuav tshem cov qe ntshav liab, thiab tseem ua rau kom vascular permeability. Cov kab mob ua rau cov ntaub so ntswg puas thiab txhawb kev sib kis.
Endotoxins thiab exotoxins ua rau cov hlab ntsha puas tsuaj, ua rau thrombosis. Clostridia secrete tshuaj lom, nyob rau hauv tus ntawm cov purulent tsub zuj zuj thiab kua dej yog tsim nyob rau hauv cov ntaub so ntswg, cov leeg pib maj mam tuag. Lub pathogenesis ntawm nonclostridial anaerobic kab mob feem ntau yog txuam nrog:
- kis ntawm qhov txhab nrog av nrog excrement;
- muaj qhov txhab ntxiv ntawm lub cev;
- necrosis thiab cov ntaub so ntswg ischemia;
- ua rau daim tawv nqaij thiab cov mucous;
- nkag mus rau cov kab mob hauv cov ntshav;
- malignant neoplasms.
Ntxiv rau, kev mob ntshav siab ntau dhau, kev poob ntshav tseem ceeb, thiab kev tiv thaiv kab mob tuaj yeem ua rau muaj kev sib kis ntawm cov kab mob.
Cov tsos mob tseem ceeb
Anaerobic clostridial thiab non-clostridial kab mob provokes o ntawm cov kabmob, nrog rau lub hlwb, uas feem ntau tshwm sim nrog cov nqaij mos abscess thiab kev loj hlob ntawm sepsis. Cov tsos mob ntawm tus kab mob pib sai sai. Hauv cov neeg mob, cov tsos mob ntawm intoxication predominate. Lawv txoj kev noj qab haus huv poob qis heev kom txog thaum cov tsos mob tshwm sim hauv zos, thaum lub qhov txhab pib tig dub.
Lub sijhawm incubation txuas ntxiv raurau li 3 hnub. Tus neeg mob ua npaws thiab muaj cov tsos mob xws li:
- tawg thiab qaug zog loj;
- drowsy;
- dyspepsia;
- siab poob;
- pab siab;
- reardation;
Maj mam lethargy hloov los ntawm overexcitation, tsis meej pem thiab ntxhov siab vim. Ib tug neeg ua pa thiab lub plawv dhia nce ntxiv. Nws kuj muaj kev nqhis dej heev thiab qhov ncauj qhuav. Cov tawv nqaij ntawm lub ntsej muag dhau los ua daj ntseg, thaum tau txais me ntsis grey tint, thiab lub qhov muag yog me ntsis sunken. Cov neeg mob ntxhov siab thiab tsis muaj kev sib koom tes.
Nws yog ib qho tseem ceeb kom paub meej cov yam ntxwv ntawm lub tsev kho mob, kuaj mob thiab kho cov kab mob uas tsis yog-clostridial anaerobic kom nkag siab meej tias qhov tshwm sim ntawm pathology tuaj yeem ua rau. Ntawm cov cim hauv zos, nws yuav tsum tau ua kom pom xws li:
- mob hnyav arching uas maj mam nce;
- muaj roj nyob hauv cov ntaub so ntswg, uas tuaj yeem kuaj pom los ntawm palpation;
- tsis muaj kev txav mus los thiab tsis muaj zog ntawm ceg ceg;
- purulent-necrotic mob.
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Thaum tsis muaj kev kho mob uas yuav tsum tau ua, cov ntaub so ntswg pib tawg sai heev, uas ua rau qhov kev cia siab rau cov kab mob pathology tsis zoo.
Diagnostics
Nonclostridial anaerobic kab mob yuav tsum tau kuaj xyuas seb yuav kho li cas. Nyob ntawm qhov chaw ntawm lub hearthCov kab mob kis tau raug kuaj los ntawm ntau tus kws tshaj lij, uas yog, kws kho mob otolaryngologist, kws phais mob ntawm ntau lub teb, kws kho mob, kws kho mob gynecologist.
Tsuas yog cov kev tshawb fawb microbiological yuav pab kom paub meej tias muaj cov kab mob anaerobic. Txawm li cas los xij, nws tsim nyog sau cia tias cov lus teb tsis zoo tsis tuaj yeem lav qhov tsis muaj cov kab mob, vim tias ntau ntawm lawv tsis tau cog qoob loo.
Ntau txoj hauv kev muaj tseeb muaj xws li roj-kua chromatography thiab spectrometric tsom xam, uas yuav txiav txim siab tus nqi metabolites thiab volatile kua acids. Tsis tshua muaj txiaj ntsig zoo thiab yog txoj hauv kev yog qhov kev txiav txim siab ntawm qhov muaj cov kab mob lossis lawv cov tshuaj tiv thaiv kab mob hauv cov ntshav uas siv enzyme immunoassay. Tsis tas li ntawd, kev kuaj mob qhia tau siv los txiav txim seb muaj kab mob anaerobic clostridial thiab tsis-clostridial kab mob. Biomaterials tau kawm hauv lub teeb ultraviolet. Txhawm rau ua qhov no, siv:
- bacteriological seeding ntawm cov ntsiab lus ntawm abscess los yog tawm ntawm qhov txhab;
- kab lis kev cai ntshav rau kab mob;
- blood sampling rau biochemical tsom xam.
Kev muaj kab mob hauv lub cev yog qhia los ntawm kev nce hauv cov ntshav ntawm creatine, urea, bilirubin, nrog rau cov ntsiab lus ntxiv ntawm peptides. Thaum kuaj x-ray, koj tuaj yeem kuaj pom cov pa paug hauv cov ntaub so ntswg lossis lub cev kab noj hniav. Thaum kuaj xyuas, nws yog ib qho tsim nyog yuav tsum tsis suav nrog qhov muaj nyob hauv lub cev ntawm erysipelas, cov hlab ntsha sib sib zog nqus, frostbite, pneumothorax, nrog rau cov kab mob purulent-necrotic..
Txoj kev kho mob
Ib qho kev sib koom ua ke rau kev kho mob ntawm cov kab mob uas tsis yog-clostridial anaerobic cuam tshuam nrog kev phais kev kho mob ntawm qhov txhab, nrog rau kev siv tshuaj tua kab mob thiab tshuaj tua kab mob. Kev phais yuav tsum tau ua kom sai li sai tau, vim tus neeg mob lub neej yuav nyob ntawm qhov no.
Yeej, qhov tob tob ntawm qhov txhab tau ua tiav, ua raws li kev tshem tawm cov ntaub so ntswg necrotic, qhib cov kua dej thiab ntxuav cov qhov txhab thiab cov kab noj hniav uas twb muaj lawm nrog cov tshuaj tua kab mob. Qee qhov xwm txheej, rov ua kev phais, kev kho mob ntawm lub qhov txhab nrog lub laser thiab ultrasound, nrog rau kev kho ozone yuav tsum tau ua. Nrog rau kev puas tsuaj ntawm cov ntaub so ntswg, kev txiav caj dab yuav raug qhia.
Ib theem tseem ceeb ntawm kev kho yog siv tshuaj tua kab mob hnyav nrog cov tshuaj broad-spectrum. Yog tias tsim nyog, tus neeg mob tau txhaj tshuaj tiv thaiv kab mob.
Surgery
Nyob rau hauv kev kho mob phais, lub qhov txhab uas twb muaj lawm yog dav dissected, pathological ntaub so ntswg excised, txawv teb chaws lub cev raug tshem tawm, thiab tom qab ntawd, lub resulting kab noj hniav yog kho thiab ntws.
Lub qhov txhab ntawm lub qhov txhab yog ntsaws nrog cov ntaub qhwv ntsej muag hauv kev daws ntawm poov tshuaj permanganate lossis peroxide. Kev ua haujlwm yog ua raws li kev siv tshuaj loog hauv zos. Thaum clamping edematous, tob nyob rau hauv cov ntaub so ntswg, ib tug dav fasciotomy yog qhia. Yog ibanaerobic clostridial thiab non-clostridial kab mob nyob rau hauv kev phais tsim tawm tsam keeb kwm ntawm ib tug puas ntawm cov ceg; nws immobilization nrog ib tug plaster splint yog qhia. Kev puas tsuaj ntau ntawm cov nqaij mos tej zaum yuav yog qhov qhia txog kev txiav caj dab.
Kev Tiv Thaiv Kev Tiv Thaiv
Anaerobic non-clostridial kab mob yog qhov nkag siab tshaj plaws rau cov tshuaj tua kab mob dav dav, tshwj xeeb:
- Ycephalosporins;
- semi-synthetic penicillins;
- aminoglycosides.
Nyob rau hauv cov mob hnyav tshaj plaws, qhov siab tshaj plaws ntawm cov tshuaj tau sau tseg. Cov tshuaj raug xaiv ib tus zuj zus tom qab tshuaj xyuas qhov rhiab heev ntawm cov kab mob rau cov tshuaj tua kab mob. Tsis tas li ntawd, kev saib xyuas kev kho mob txhais tau tias:
- kev kho kom tshem tawm;
- immunotherapy;
- painkillers, anticoagulants, tshuaj hormones, vitamins.
Txoj kev kho mob kom tshem tawm cov tshuaj tiv thaiv kab mob hauv cov hlab ntsha ntawm cov tshuaj crystalloid thiab colloid, tshwj xeeb, xws li Hemodez, Reopoliglyukin, qabzib, saline. Immunotherapy suav nrog kev siv cov tshuaj immunoglobulins, nrog rau cov ntshav plasma. Qhov txiaj ntsig zoo yog kev coj ua ntawm cov txheej txheem kho lub cev uas ua rau kom rov zoo sai dua.
Nyob hauv tsev laus
Cov neeg mob uas muaj tus kab mob anaerobic tsis xav tau kev cais tawm nruj. Txawm li cas los xij, tus neeg mob yuav tsum tau saib xyuas tas li, txij li thaummuaj teeb meem los ntawm kev ua pa, circulatory, thiab paj hlwb. Chav tsev yuav tsum tau tso cua raws li xav tau, tab sis tsawg kawg yog 2 zaug hauv ib hnub.
Cov zaub mov noj yuav tsum muaj calorie ntau ntau nrog cov protein, rog, carbohydrates, kab kawm, vitamins. Tsis tas li ntawd, nws yog ib qho tsim nyog yuav tsum tau ua kom huv si ntsuas, saib xyuas qhov mob ntawm daim tawv nqaij, qhov ncauj kab noj hniav thiab perineum ntawm cov neeg mob. Muab hais tias cov neeg mob muaj kev tsis txaus siab lossis kev ntxhov siab ntau dhau, lawv yuav tsum siv cov tshuaj sedatives xwb, tab sis nws tseem ceeb heev kom ua kom tiav siab, nrog rau ua raws li tag nrho cov txheej txheem.
Muaj Teeb Meem
Kev txhim kho ntawm tus kab mob anaerobic provokes ib qho kev puas tsuaj loj heev hauv kev noj qab haus huv. Nrog rau cov ntaub so ntswg loj heev, necrosis loj tuaj yeem tshwm sim, vim tias tus neeg mob yuav tsum tau txiav tawm ntawm ceg. Hauv qhov xwm txheej txaus ntshai, tus neeg tuaj yeem tuag los ntawm ntshav lom.
Huab cua thiab tiv thaiv
Cov kev mob tshwm sim ntawm cov kab mob pathology feem ntau yog nyob ntawm daim ntawv ntawm tus kab mob, cov yam ntxwv ntawm cov kab mob, lub sijhawm thiab qhov raug ntawm kev kuaj mob thiab kev kho mob. Cov kws kho mob muab kev ceev faj, txawm li cas los xij, feem ntau nws yog qhov zoo. Thaum tsis muaj peev xwm kho tau raws sijhawm, qhov tshwm sim ntawm cov kab mob no poob siab.
Txog tam sim no tsis muaj kev tiv thaiv tshwj xeeb ntawm kev kis kab mob anaerobic. Txawm li cas los xij, txhawm rau txo qhov kev pheej hmoo ntawm kev tsim tus kab mob, nws yog qhov yuav tsum tau uakev kho mob raws sij hawm zoo ntawm qhov txhab.
