Hauv cov tshuaj niaj hnub no, cov kab mob hu ua "bronchiectasis" feem ntau tau sau tseg. Qhov no yog ib qho xwm txheej txaus ntshai uas tsim tawm tsam keeb kwm yav dhau los ntawm ntau yam kab mob ntawm cov kab mob ua pa. Tau kawg, cov neeg mob uas tau ntsib qhov kev kuaj mob no tab tom nrhiav cov ntaub ntawv hais txog kev phom sij, cov tsos mob thiab txoj hauv kev kho tus kab mob.
Bronchiectasis - yog dab tsi?
Ntau yam kab mob ntawm cov kab mob ua pa yog txuam nrog cov kab mob no. Yuav ua li cas rau cov neeg mob uas ntsib nrog kev kuaj mob bronchiectasis? Cov mob no yog nrog los ntawm kev nthuav dav ntawm ntu ntawm bronchi raws li kev puas tsuaj rau phab ntsa bronchial.
Tus kab mob tuaj yeem cuam tshuam ntau qhov chaw ntawm lub bronchi, tab sis feem ntau muaj kev nthuav dav ntawm phab ntsa ntawm qhov nruab nrab bronchioles. Cov txheej txheem yog txuam nrog kev poob ntawm cov ntaub so ntswg elasticity. Raws li kev txheeb cais, hauv cov txiv neej, xws li pathology tau sau txog 3 zaug ntau dua li cov poj niam ntawm cov poj niam sib txawv. Lub ntsws sab laug raug tus kab mob ntau dua, tab sis bronchiectasis ntawm lub ntsws sab xis yog tsawg dua. Cov kws tshaj lij ntaus nqi cov txheeb cais no rau qhov tseeb tiasLub lumen ntawm sab laug bronchus yog me dua thiab ua rau lub cev nqaim ntawm lub kink ntawm cov hlab ntsha pulmonary.
Hmoov tsis zoo, nws tsis tshua muaj peev xwm tshem tawm bronchiectasis kom tiav, tab sis nrog kev pab los ntawm kev xaiv txoj kev kho kom raug, nws muaj peev xwm tso tseg cov txheej txheem ntawm kev puas tsuaj ntawm phab ntsa bronchial.
Cas of disease development
Bronchiectasis tuaj yeem ua tau los yog kis tau. Yog hais tias peb tham txog congenital pathology, ces nws yog feem ntau txuam nrog lub xub ntiag ntawm noob caj noob ces thiab physiological txawv txav. Bronchial dilatation feem ntau pom nyob rau hauv cov menyuam yaus uas muaj cystic fibrosis thiab kev tiv thaiv kab mob, nrog rau ntau yam kab mob, suav nrog Young, Marfan, Kartagener syndrome.
Kev mob bronchiectasis feem ntau tshwm sim tawm tsam keeb kwm ntawm cov kab mob ntawm cov kab mob ua pa, suav nrog mob ntsws, mob ntsws, hnoos hawb pob. Cov kab mob ua xua kuj tseem muaj feem cuam tshuam. Pathology tuaj yeem cuam tshuam nrog qhov muaj cov qog nqaij hlav bronchial uas cuam tshuam qhov kev tso pa tawm ntawm cov pa thiab hnoos qeev. Cov npe ua rau muaj xws li kab mob ntawm lub cev tiv thaiv kab mob, suav nrog AIDS.
Bronchiectasis tsis yog ib txwm cuam tshuam nrog pathologies ntawm txoj hlab pa nws tus kheej. Kev nthuav dav ntawm phab ntsa bronchial tuaj yeem yog qhov tshwm sim ntawm kev mob ulcerative colitis, rheumatoid mob caj dab, Crohn tus kab mob, kab mob staphylococcal tsis hais qhov chaw, hiatal hernia hauv diaphragm. Cov xwm txheej txaus ntshai muaj xws li tus cwj pwm phem (kev haus dej cawv, haus luam yeeb, siv yeeb tshuaj), lom nrog cov pa phem txaus ntshai.
Nws yog ib qho tseem ceeb heev rau tus kws kho mob los txiav txim seb qhov ua rau ntawm cov kab mob pathological hloov hauv lub bronchi, vim tias kev ua tiav ntawm kev kho mob feem ntau nyob ntawm qhov no.
Cov tsos mob tseem ceeb ntawm bronchiectasis
Bronchiectasis yog ib qho pathology uas maj mam txhim kho. Thaum pib, qee cov tsos mob tshwm sim tuaj yeem tsis tuaj. Cov neeg mob feem ntau raug kev txom nyem los ntawm cov kab mob ntawm lub ntsws, nrog rau mob ntsws thiab pleurisy. Bronchitis nrog bronchiectasis kuj tshwm sim.
Tsis tas li ntawd, muaj cov hnoos qeev ntau ntxiv, tshwj xeeb tshaj yog thaum huab cua txias. Nws tsis yog qhov txawv txav uas pom hawb pob thaum koj nqus tau thiab exhale.
Raws li tus kab mob loj tuaj, cov neeg mob pom qhov tshwm sim ntawm hnoos - qhov kev tawm tsam tshwj xeeb tshaj yog thaum sawv ntxov thiab nrog kev tso tawm ntau ntawm cov hnoos qeev mucopurulent. Qhov paug tawm feem ntau yog ntxhiab tsw.
Hloov pauv hauv cov phab ntsa bronchial cuam tshuam rau cov pa oxygen tau txais los ntawm lub cev. Hypoxia yog nrog los ntawm kev tsis muaj zog - cov neeg mob yws ntawm qhov tsis muaj zog, tsaug zog, thiab kiv taub hau. Tus neeg mob daim tawv nqaij yog xim daj ntseg, qee zaum ua xiav. Cov tsos mob muaj xws li ua tsis taus pa luv, uas ua tas li nyob rau tom qab theem ntawm txoj kev loj hlob thiab kev txhawj xeeb ib tug neeg tsis yog thaum lub sij hawm cev xeeb tub, tab sis kuj thaum so.
theem ntawm tus kab mob kev loj hlob
Cov kws kho mob paub qhov txawv peb theem ntawm kev txhim kho tus kab mob:
- Thawj theem ntawm bronchiectasis yog nrog los ntawm kev puas tsuaj rau cov txheej ntawm cov mucous membranebronchi. Yeej tsis muaj cov tsos mob tshwm sim, thiab qhov kawg ntawm tus kab mob nws tus kheej yog suav tias yog benign.
- Ntawm theem thib ob ntawm kev txhim kho, cov txheej txheem kev puas tsuaj cuam tshuam rau tag nrho cov phab ntsa bronchial. Cov neeg mob yws yws ntawm mob ntsws ib nrab thiab nce cov hnoos qeev txhua hnub.
- Nyob rau theem thib peb, cov txheej txheem pathological tau pom tsis yog hauv bronchi nkaus xwb - nws kis mus rau cov ntaub so ntswg nyob ze. Cov neeg mob raug kev txom nyem los ntawm mob o, yws ntawm copious tawm ntawm fetid hnoos qeev. Hemoptysis feem ntau tshwm sim nyob rau theem no.
YKev faib tawm ntawm bronchiectasis
Muaj ntau ntau cov txheej txheem kev faib tawm rau cov kab mob no. Raws li twb tau hais lawm, bronchiectasis tuaj yeem tshwm sim los yog kis tau. Cov txheej txheem kev puas tsuaj qee zaum tsuas yog thaj tsam me me ntawm lub bronchi, tab sis kuj tuaj yeem kis mus rau lwm qhov ntawm cov kab mob ua pa (qhov no peb tab tom tham txog qhov loj bronchiectasis). Tej zaum qhov tsos ntawm ob peb qhov txhab nyob rau hauv ntau qhov chaw ntawm lub bronchi.
Nyob ntawm seb qhov kev tshwm sim ntawm cov tsos mob, muaj cov mob me, nruab nrab thiab hnyav ntawm cov kab mob. Nyob ntawm cov kab mob pathology, bronchiectasis tuaj yeem yog hypertrophic lossis atrophic.
Nws tsim nyog sau cia tias yog tias tsis kho, tus kab mob tuaj yeem ua rau muaj qhov tshwm sim txaus ntshai, suav nrog emphysema, los ntshav ntau, amyloidosis theem nrab, ua pa thiab lub plawv tsis ua haujlwm.
Bronchiectasis: instrumental and laboratory diagnostics
Kev kuaj mob tus kab mob no yog txheej txheem ntev. Thaum lub sijhawm kuaj lub cev niaj hnub, tus kws kho mob yuav pom qee qhov kev hloov pauv ntawm tus neeg mob lub ntsej muag - lub hauv siab zoo li lub thoob, cov phalanges ntawm cov ntiv tes hloov pauv (yog tias peb tham txog cov theem tom ntej ntawm kev loj hlob ntawm tus kab mob). Thaum lub sij hawm kuaj auscultatory, tus kws kho mob tshwj xeeb sau ua pa nyuaj thiab muaj cov av noo.
Raws li kev kuaj mob hauv chaw kuaj mob, tus neeg mob tau sau thawj zaug kuaj ntshav. Tawm tsam keeb kwm ntawm bronchiectasis, muaj qhov nce hauv erythrocyte sedimentation tus nqi, nce ntawm leukocytes thiab ntshav ntshav, uas cuam tshuam nrog oxygen tshaib plab ntawm lub cev. Hauv kev tshawb nrhiav cov hnoos qeev, koj tuaj yeem pom tias qhov paug tawm muaj peb txheej txheej.
Ntau yam cuab yeej siv los ua qhov kev kuaj mob zaum kawg. Cov ntaub ntawv yog lub hauv siab X-ray, uas ua rau nws muaj peev xwm pom cov cheeb tsam ntawm fibrosis, paub meej tias muaj cov cysts thiab bronchial extensions, thiab txiav txim siab hloov pauv ntawm cov hlab ntsha. Tsis tas li ntawd, bronchoscopy tau ua (kev tshuaj xyuas sab hauv ntawm lub bronchi nrog lub endoscope), nrog rau suav tomography.
Drug therapy
Kev kho mob ntau yog nyob ntawm theem ntawm kev loj hlob ntawm tus kab mob. Raws li txoj cai, cov neeg mob tau muab tshuaj rau cov hnoos qeev. Feem ntau siv immunomodulators, multivitamin complexes. Thaum muaj mob ntsws thiab lwm yam kab mob, cov neeg mob yuav tsum tau noj tshuaj tua kab mob - macrolides ("Azithromycin") thiab pneumotropic fluoroquinolones feem ntau siv.(Moxifloxacin, Levofloxacin).
Ib feem tseem ceeb ntawm kev kho mob yog kev kho mob ntawm lub bronchi, vim hais tias cov hnoos qeev stagnation hauv lub ntsws yuav tsum tsis txhob tso cai - cov neeg mob tau teem sijhawm ib ntus ntawm kev vibration massage. Ib qho kev xaiv ua kom zoo ntawm kev siv lub cev kho mob yuav pab ua kom cov hnoos qeev tso tawm. Kev kho mob ntawm bronchiectasis yuav tsum suav nrog kev ua pa ua pa. Thaum lub lumen ntawm txoj hlab pa yog txhaws nrog purulent masses, microdrainage yog siv tshuaj tua kab mob thiab tshuaj tua kab mob. Qee zaum cov tshuaj mucolytic thiab cov enzymes proteolytic tau txhaj rau hauv lub lumen ntawm lub bronchus, uas ua rau cov hnoos qeev thiab pab txhawb nws tawm.
Qhov no yog kho bronchiectasis li cas. Cov kws kho mob cov lus hais qhia tias nrog txoj kev kho kom raug, nws muaj peev xwm ua kom rov ua haujlwm zoo ntawm txoj kev ua pa.
Kev phais thiab nws cov yam ntxwv
Tsis yog ib txwm muaj kev saib xyuas kev kho mob pab tiv nrog cov kab mob xws li bronchiectasis. Kev phais yog qee zaum tsim nyog. Nyob ntawm seb qhov kev puas tsuaj loj npaum li cas, tus kws kho mob yuav pom zoo kom tshem tawm tag nrho lub ntsws los yog ib feem ntawm qhov chaw cuam tshuam ntawm bronchi.
Kev kho mob rau tus kab mob no nyuaj heev, tom qab ntawd tus neeg mob xav tau kev kho mob ntev.
Kev noj haus rau cov neeg mob
Kev kho mob bronchiectasis yuav tsum suav nrog kev noj zaub mov kom raug. Kev noj zaub mov yuav tsum suav nrog cov zaub mov muaj protein ntau, tab sis cov rog tau pom zoo kom txo qis rau 90 g ib hnub.
Cov zaub mov yuav tsum muaj ntau cov khoom noj uas muaj cov vitamins B thiab A, nrog rau ascorbic acid. Cov neeg mob tau qhia kom noj zaub nyoos thiab txiv hmab txiv ntoo ntau dua, haus cov kua txiv hmab txiv ntoo tshiab. Cov ntawv qhia zaub mov yuav tsum muaj lub siab. Rau haus, decoctions ntawm nplej bran thiab rosehips yog siv.
ntsuas kev tiv thaiv
Hmoov tsis zoo, tsis muaj cov tshuaj uas tuaj yeem tiv thaiv kev loj hlob ntawm tus kab mob. Tab sis koj yuav tsum nkag siab tias bronchiectasis yog ib qho mob hnyav, kev txhim kho uas yooj yim dua los tiv thaiv. Cov neeg mob uas muaj kev pheej hmoo raug qhia kom tso tus cwj pwm phem (tshwj xeeb, haus luam yeeb), saib xyuas khoom noj khoom haus, ntxiv dag zog rau lub cev tiv thaiv kab mob thiab tau txais kev txhaj tshuaj tiv thaiv kab mob, suav nrog hnoos hawb pob, mob khaub thuas, qhua pias thiab lwm yam.
Cov neeg mob uas twb tau txais kev kho mob yuav tsum tau sau npe nrog kws kho mob, kuaj thiab kuaj peb zaug hauv ib xyoos. Cov neeg uas muaj bronchiectasis uas twb muaj lawm thaum lub sij hawm tshem tawm yuav tsum tau ua kom huv bronchial ib ntus, kho lub cev, tiv thaiv kev kho mob.
