Pneumocystis pneumonia: oonobangela, iimpawu, unyango. Pneumocystis pneumonia ku yi-HIV

Impilo - eyona nto zexabiso umntu angaba. Wonke umntu onethemba kuphila ixesha elide kwaye uphethwe sisifo ethile. Isifo utshintsha abantu ngaphaya ingqalelo - ukuba wadandatheka, ukubonakala kwazo abaziintsizana, kukho nabantu konke okwenzekayo jikelele, kwaye kwezinye iimeko kanye nobubele kwaye eluncedo kwabanye abantu iinkathazo abantu ndobuyela nomsindo enyemba.

Isifo akamcongi akukho mntu. Nkqu abantwana bayaba ukusuka ingozi yokosulelwa naluphi na usuleleko na. Ukongeza, ukubandezeleka onamava kuphela na izigulane, kodwa nabantwana babo ababathandayo. Kunzima kakhulu ukumelana neemvakalelo zabo neemvakalelo abazali abanabantwana ukuba oku okanye ngezifo kubonakele. Kids ngenxa yobudala babo ngeke akwazi ukuchaza oko abachaphazelekayo ngayo, yintoni amalungu omzimba ziintlungu, yaye oko kubonakala njani ngokwayo.

sifo singanyangekiyo i PCP. Unako zosuleleke naphi na kwaye, ngumzali, nkqu izibonelelo zonyango. Le meko nzima nangakumbi ngumba wokuba lifumanisa usulelo kusekwangoko yophuhliso yayo kunzima kakhulu. Ngokuqhelekileyo, abantu eqonda ukuba bafuna uncedo lwezonyango xa ixesha elixabisekileyo sele ilahlekile. Kungenxa yoko le nto izinga lokusweleka ngenxa pneumocystosis phezulu kakhulu. Oogqirha azisoloko ukuphatha ukusindisa ubomi bomntu.

Kwafunyaniswa ukuba "pneumocystis"

Abantu abangenayo nto yakwenza amayeza, inkoliso yabo encinane abawazi isigama zonyango. Ngoko ke, lokufunyaniswa ukuva 'pneumocystis "okanye" PCP ", baba ilahleko, nkqu kweyela wobuthongo. Eneneni musa ukothuka. Okokuqala, kufuneka umoya, ulungise iindlela zakho ndawonye, cela ugqirha wakho ngokweenkcukacha, ngamazwi alula ukuba uchaze ukuba yintoni na.

Pneumocystis ukubizwa ngokuba PCP, esi sifo protozoan esichaphazela emiphungeni. Activators pathology ingqalelo Cya, eyaziwa ngokuba pneumocystis carinii. Kude kube kamva nje, izazinzulu babekholelwa ukuba basonta iintlobo ezilula. Noko ke, ngokwentelekiso kutshanje ngokusekelwe izifundo zininzi Kwagqitywa ukuba ezi amagciwane iimpawu ezithile ezikhethekileyo zomngundo. Pneumocystis carinii i amaphelo ukuba yosulela abantu kuphela. Ubuncinane izilwanyana kude kube namhlanje ukubonakala nakanye.

Kwenzeka ntoni xa PCP yomguli?

Utshintsho emzimbeni pneumocystosis ngenxa baxhomekeke zinto zimbini: koko iimpawu ababazalayo amagciwane yinyumoniya, kunye nemeko kumajoni omzimba womntu. Pneumocystis, kanye emzimbeni, baqale kwangaphambili kwawo iphecana yokuphefumla, ukuze aphephe abo uze kungena alveoli. Apha iqala ngqo umjikelo wobomi babo. Ingaba proliferation zabo, beza wawumdibanisa lunezinto, ndimkhulule metabolites ityhefu. Ulwa pneumocystis carinii T-lymphocyte, kwakunye ebizwa ngokuba yi-macrophage alveolar. Noko ke, amajoni omzimba buthathaka, hayi kuphela awukwazi ukukhusela umkhosi wayo ukususela ekusulelekeni, kodwa okwahluke - unalo nomkhwezeli: uyayivuselela aze kwandisa inani pneumocystis.

Ngokupheleleyo onempilo nonyebeleziso pneumocystis carinii akukho ezisengozini. Kodwa uguqula imeko kakhulu ukuba amajoni omzimba ulihlwempu. Kulo mzekelo, esi sifo luvuliwe ngesantya esiphezulu, kwaye ngexesha elifutshane ngexesha inani pneumocystis, ukubanjwa ekukhanyeni ifikelela billion omnye. Ngokuthe ngcembe indawo alveolar izaliswe ngokupheleleyo, enika kubekho exudate foamy, ukuphazamiseka inwebu ingqibelelo leukocytes alveoli yaye ekugqibeleni ukonakalisa kwaye ngokufanelekileyo, i alveolocytes intshabalalo olulandelayo. Ngenxa yokuba pneumocystis ukungena snugly ukuba alveolocytes, kuncitshiswa umphezulu yokuphefumla emiphungeni. Ngenxa yoko, umonakalo lung izicwili iqala inkqubo alveolar-capillary kwamabutho.

Ukuze ukwakha eyakho iseli inwebu yakho, pneumocystis carinii kufuneka phospholipids lunezinto umntu. Ngenxa yoko, kukho impazamo ukutya lunezinto kwaye mandundu kakhulu nemiphunga inyama hypoxia.

Ngubani na kakhulu ezisemngciphekweni kwezinye izifo?

iintlobo yinyumoniya eyaziwa ukuya kumhla ahluka enye kwenye, kuquka nento yokuba ingozi ekuphuhliseni baboniswa iindidi ezahlukeneyo zabantu. Pneumocystis kule ndlela akukho ngaphandle. Kukho ezininzi eziqhele ikhula:

• iintsana ngaphambi kwexesha;
• iintsana kunye nabantwana abo yokuxhayelwa kwabo izifo ezihlasela zosulele bronchopulmonary eziqatha, kuye kwanyanzeleka ukuba ixesha elide ukuba esibhedlele bathole kwanonyango kwaye ixesha elide;
• ebantwini oncological kunye gemozabolevaniyami anyangwe kunye cytostatics kunye corticosteroids, kwakunye kanzima ezimbi ezahlukeneyo sezintso nezihlunu nokuqina, ezivela ngenxa abohlukeneyo ye ilungu lwangaphakathi ethile;
• izigulane TB abafumene ixesha elide elwa ezinamandla;
• abosuleleke HIV-kwizigulane.

Njengoko umthetho, usulelo sisasazwa ngamathontsi emoyeni, yaye nomthombo zayo abaphile ngayo abantu, inkoliso yabo bonke - abasebenzi kwizibhedlele. Ngenxa yesi sizathu, uninzi izazinzulu bathi PCP - kuphela usulelo zokubhala. Nakuba kunjalo, kubalulekile ukucacisa ukuba abanye oogqirha ukuxhasa imbono ukuba uphuhliso pneumocystosis kwixesha lweentsana sisiphumo usulelo Umbungu esibelekweni.

Ziziphi iimpawu ezi umqondiso malunga nophuhliso pneumocystis pneumonia ebantwaneni?

Omama kunye abazali basoloko ethe kakhulu impilo yabantwana babo. Akumangalisi ukuba bafuna ukwazi ukubona indlela inyumoniya ngexesha. Kakade ke, uxilongo yokugqibela kuphela ngugqirha, kodwa ukuchonga iimpawu zokuqala zesi sifo kufuneka ibe nako na umzali esazi. Suku ngalunye ezilahlekileyo kungakhokelela ekubeni umntwana abe inyumoniya amabini, pneumocystis, kunye nezinye iingxaki.

Pneumocystis pneumonia kubantwana asakhasayo ngesiqhelo, eqala iinyanga ezimbini ubudala. Isikakhulu sifo sichaphazela abo bantwana abaqatshelwe ngaphambili usuleleko cytomegalovirus. Isifo kwenzeka classic ifomu interstitsianalnoy pneumonia zabo. Ngelishwa, oogqirha bayaqonda ukuba isanda phantse akunakwenzeka ukuba babone isifo esinjalo, ezifana ne-pneumocystis pneumonia. Iimpawu zibonakala kamva. Iimpawu eziphambili esalatha kuphuhliso ngokukhawuleza losulelo ziquka:

• ukukhohlela onamandla kunene Intsingizi ukuba,
• uqhambuko Periodic of Ukuphelelwa (ekukhethwa ukuba ebusuku);
• abanye abantwana kukho yokulahla yiglasi, foamy, engwevu kunye yencindi viscous.

Ixesha elisuke kwesi sifo ziintsuku 28. Xa engekho unyango ngokwaneleyo kwaye ngexesha elifanelekileyo, izinga lokusweleka abantwana abanengxaki pneumocystis, ifikelela 60%. Ukongeza, kuzalwa abo pneumocystis pneumonia lwenzeka ngaphandle iimpawu ezibonakalayo, kukho kubonakala olukhulu sibonakalisa syndrome obstructive kwixa elizayo. Oku kubangelwa ubukhulu becala ekweneni yangaphakathi. Ukuba umntwana wakho ukuba uncedo olungxamisekileyo zonyango ofanelekileyo uya kunikwa, obstructive syndrome unako kuguqulwa laryngitis, kunye nabantwana abadala - kule syndrome somoya.

Iimpawu ezibonakala ngayo abantu abadala

Inyumoniya kubantu abadala nabancinane kwenzeka ngendlela entsonkothileyo ngaphezu kwiintsana kunye nabantwana abancinane. Isifo sihlasela ikakhulu abantu abazalwa kunye immunodeficiency, okanye abo aye phambili phezu ebomini. Noko ke, oku akuthethi ulawulo ukuba brooked hayi kutenxa encinane. Kwezinye iimeko, pneumocystis pneumonia kwenzeka xa izigulane inkqubo esempilweni ngokupheleleyo omzimba.

Ixesha elisuke kwesi sifo yahluka ukusuka kwiintsuku-2 ukuya ku-5. Ogulayo ezi mpawu zilandelayo:

• fever,
• migraine,
• ubuthathaka umzimba uphela,
• ukubila kakhulu,
• abuzwa esifubeni,
• ingxakeko enkulu zemiphunga ekhatshwa ukhohlokhohlo ezomileyo okanye ezimanzi kunye tachypnea.

Ngaphandle iimpawu ezingundoqo ngentla, maxa wambi iimpawu ezifana kuqatshelwe njengoko acrocyanosis, kwaziswa zonke izikhewu phakathi iimbambo, cyanosis (bamantshontsho) unxantathu nasolabial.

Kwanasemva kokuba ikhosi epheleleyo yonyango kwezinye izigulane kukho ethile inombolo ye-pneumocystis kubunzima inyumoniya. Ezinye izigulane zifumana ukuphinda. Oogqirha bathi xa kukho iphinde kwisithuba seenyanga ezi-6 ukusuka kwimeko yokuqala zesi sifo, icebisa ukuba unosulelo emzimbeni ivuselelwa. Ke ukuba kuthe kwenzeka ngaphezu kweenyanga ezi-6, ngoko sithetha malunga usulelo olutsha okanye kwakhona.

Ngaphandle konyango olufanelekileyo yokufa izigulane abadala kunye Amanzi pneumocystis ukusuka 90 ukuya kwi-100%.

abosuleleke HIV-iimpawu zesi sifo

abosuleleke HIV-pneumocystis pneumonia kulo, njengoko kuchasene abantu abangenazo intsholongwane iphuhlisa ngokucothayo kakhulu. Ukususela mzuzu xa iqala nesenzeko prodromal, naphambi ahlasele iimpawu ecacileyo pulmonary, nto leyo yenze kuthathe ukusuka iiveki ezi-4 ukuya 8-12. Ngoko ke, oogqirha urhano incinane lobukho usulelo emzimbeni, ukongeza ezinye iimvavanyo, kucetyiswa kwizigulane ezinjalo ukwenza esifubeni X-reyi.

Iimpawu eziphambili pneumocystosis kubaguli AIDS ziquka:

• lobushushu eliphezulu (38 ukuya kuma-40 ° C), engeyoyangeli kwiinyanga 2-3;
• ngequbuliso komzimba;
• ukhohlokhohlo owomileyo;
• ukuphelelwa umoya;
• ekwandiseni insufficiency sokuphefumla.

Uninzi zesiNtu sinoluvo lokuba ezinye iintlobo yinyumoniya kwizigulane ezine-HIV kufuneka iimpawu ezifanayo pneumocystosis. Ngoko, kwi zigaba zokuqala zesi sifo ukuba loluphi uhlobo yinyumoniya kwi isigulane lwenzeka kwakungenzeki kwaphela. Ngelishwa, xa pneumocystis pneumonia kwizigulane ezine-HIV kutyhilwa, ukuba sele ulahlekelwe ixesha elininzi kakhulu, yaye ediniwe kuba nzima kakhulu umzimba ukuba ulwe usulelo.

kwafunyaniswa ukuba njani na pneumocystis?

Inene, wonke umntu uyazi inkangeleko yemiphunga bomntu. Amafoto kulo mzimba incamatheliswe nganye okanye yesifundo komzimba okanye kwi nqwelo kwi ekliniki okanye nayiphi na eminye imithombo. Le nkcazelo ukuza kuthi ga ngoku, akukho zanela. Ukongeza, oogqirha ukukhumbuza zonke izigulane zam ukuba enze yonyaka esifubeni X-reyi. Ngokwahlukileyo ngokoluvo yabaninzi, lo asingomkhwa, oogqirha "ukhetho", kunye nemfuno engxamisekileyo. Oku kwenza kube lula ukubona ukukhanya ixesha ukufiphala ku-X-reyi, kwaye achithe ixesha ukuqala unyango. Kamsinya siya kwazi ngesi sifo, kokukhona ithuba iya kuba achache.

Noko ke, akukho namnye kuthi uyayazi indlela sibonakalisa kwi radiographs PCP. Amafoto yale hlobo kwiincwadi zesikhokelo esikolweni musa ukufumana iincwadi reference unyango kunye iintyilalwazi kuninzi lwabantu abaqhelekileyo ungabi sisizekabani nayiphi na inzala. Ngaphezu koko, siya kwenza ukuba umelo njengokuba isifo eso, nangona bazi ayisoze inibulale.

Okokuqala, kukho uxilongo lokuqala senziwa. Ugqirha ubuza isigulane malunga nabo bakhe abantu abangabakhe kumaqela umngcipheko (yi-HIV kunye nezigulane AIDS).

Emva koko uxilongo lokugqibela. Elebhu kwaye isisixhobo izifundo zilandelayo:

1. Ugqirha umisele indlela yomguli kwi ngegazi eqhelekileyo uhlalutyo utshintsho. ingqalelo ekhethekileyo itsalelwa nokunyuka eosinophils inqanaba, lymphocyte, leukocytes kunye monocytes. Xa izigulane pneumocystis isenokuba anemia wobulali haemoglobin esehlisa kancinane.
2. Abamiselweyo zoviwo instrumental. Kumalunga rengenografii ne apho isigaba ekrakra sifo. Ingaba i X-reyi yesifuba, ngokucacileyo imiphunga bomntu. Le ifoto iqhotyoshelwe kwikhadi nomonde. Inxaxheba kwinqanaba lokuqala ngayo ipateni inzuzo kakhulu lula. Ukuba pneumocystis wafudukela yesibini sigaba, ebonakala gca phezu X-ray ukukhanya ukufiphala. AboSulelwe ingaba mhlawumbi kuphela ekhohlo okanye kuphela kwemiphunga ekunene, kodwa betha kwaye enye kwenye.
3. Ukuze ukubona ubukho pneumocystosis, ugqirha ngokuqhelekileyo ugqiba ukubamba isifundo parasitological. Yintoni na? Isigulana lokuqala kuthathwa ukuhlalutya isampuli yencindi yomlomo. Ukuze le asebenzise iindlela ezifana bronchoscopy, bronchoscopy kunye biopsy. Ukongezelela, ngaba isampuli zingafumaneka kusetyenziswa ebizwa ngokuba indlela yoqheliso of khohlo.
4. Ukuze ukuchonga izilwa for pneumocystis waqhuba isifundo serological sikuko yokuba umahluko kwiiveki 2 isigulane kuhlalutywa 2 serum. Ukuba ngamnye kubo abafumana ngaphezulu kunesiqhelo ixabiso titer ubuncinane ngumba ka-2, oko kuthetha ukuba umntu egula. Olu phando lwenziwa ukuze kupheliswe kumajelo njengesiqhelo, njengoko izilwa efumaneka malunga nama-70% abantu.
5. Ukubona nezakhi parasite e isikhohlela, kwaye ndlovu biopsy kunye broncho-alveolar lavage eyenziwa uxilongo PCR.

isigaba pneumocystosis

Kukho izigaba ezithathu ezilandelelanayo PCP:

• oedematous (iiveki 1-7);
• atelektaticheskuyu (average kweeveki ezi-4);
• emphysematous (of ubude ezahlukeneyo).

Edematous isigaba pneumocystosis sachaza imbonakalo lokuqala yobuthathaka wonke umzimba, silale, ukhohlokhohlo uze iseliswelekile, ngokuthe ngcembe siqinisa isandla, kwaye kuphela ekupheleni kwexesha - a ukhohlokhohlo olomeleleyo eyomileyo, kwakunye nokubamba-bamba umphefumlo ngexesha umthambo. Iintsana ibele embi, musa nxiba ubunzima kwaye ngamanye amaxesha ukwala ngobisi lukanina. Akukho utshintsho ekukhanyeni X-ray akukho andibhaqwa.

Ngexesha atelektaticheskoy sigaba fever febrile uyabonakala. Ukhohlokhohlo bazimisela kakhulu kwaye kubonakala foamy yesikhohlela. Ukuphelelwa umoya ivela kude ngexesha umthambo minor. Kwi i X-ray utshintsho atelektaticheskie zibonakale.

Xa izigulane abasindayo iiphiriyodi-2 zokuqala, ukuphuhlisa Inqanaba pneumocystosis emphysematous, ngexesha apho kwanciphisa ukusebenza esebenzayo zokuphefumla ukubonisa iimpawu emphysema.

pneumonia degree

Xa amayeza, ukwahlula izidanga ilandelayo nobungozi besi sifo:

• ukukhanya, esibonakala yi zinetyhefu obuthathaka (lobushushu elingadluliyo 38 ° C, nokuphila nezatumanennoe) kwi intsalela zingaphawulwa dyspnoea, eclipse ukukhanya zabonwa encinane x-reyi;
• avareji, ebonakala ukunxila ngcathu (ubushushu kune-38 ° C, ifikelela 100 intliziyo ibetha ngomzuzu, isigulana ikhalazela of yokwanda ukubila , njl ...), xa dyspnea lokuphumla emsebenzini kwi x-reyi film nokungena ibonakale ngokucacileyo emiphungeni;
• ayenzima elibaleka ukunxila kakhulu (ubushushu istampu kune-39 ° C, iyangongoza lidlula 100 ibetha ngomzuzu, kukho waphazamiseka), insufficiency oluqhubekayo yokuphefumla, kwaye iyabonakala kwi x-reyi afunxwe ngokubanzi emiphungeni, kusenokwenzeka ukuba ukuphuhlisa iingxaki ezahlukeneyo.

Yiyiphi imithi eyenzelwe izigulane nge-PCP?

Ngokungathandabuzekiyo, ukwazi indlela yokumelana ne-pneumonia yinto enkulu enkulu kubo bonke abantu. Nangona kunjalo, oku akunako. Asikho oogqirha kwaye asinakukwazi ukubonelela ngokuchanekileyo. Akukho luhlobo olulodwa lwe-pneumonia, kunye ne-side-side okanye i-pneumonia-side side, i-pneumocystis kunye nezinye iindlela zokugula azikwazi ukuchongwa ngumntu oza kuluhlu. Ngoko ke, ukuzinyango akukwazi ukuhamba ngaphandle kwentetho. Into ephambili ayikulibaziseka nokuthembela oogqirha. Emva kokuphumeza yonke uphando oluyimfuneko, ugqirha uya kuba nakho ukwenza isigqibo esicacileyo malunga nokuba i-PCP yimbangela yesifo esibi segulane. Utyando luqeshwe kuphela emva kokuqinisekiswa kokuxilongwa kwaye luquka ukuqhuba amanyathelo enkqubo kunye nonyango kunye nonyango lweziyobisi.

Amanyathelo-mbutho karhulumente afaka i-hospital hospital mandatory. Esibhedlele, isiguli siyafumana amayeza kwaye sigcina ukutya okuphakanyiswe ngugqirha.

Unyango lwamayeza luqulethwe nge-etiotropic, i-pathogenetic kunye neyonyango. Izigulane zivame ukumiselwa izidakamizwa "i-Pentamidine", "Furazolidon", "Trichopolum", "Biseptol", kwakunye neziyobisi ezahlukeneyo ezichasayo, amayeza anceda ukutshiza kunye nokuququzelela i-expectoration, i-mucolytics.

"I-Biseptol" ilawulwa ngomlomo okanye nge-intravenously. Isilwanyana sinyamezeleke kwaye sikhethwa "kwi-Pentamidine" xa sinolawulo lwezigulane ezingenayo i-AIDS. "I-Pentamidine" ilawulwa nge-intramuscularly or intravenously.

Izigulane ezinegciwane lesandulela ngculaza, phakathi kwezinye izinto, zifumana unyango lwe-antiretroviral, kuba bane-pneumocystis pneumonia ngenxa yesistim sokuzivikela. Ukuze unyango lwe-pneumocystisis kwizigulane ze-AIDS, i-alpha-difluoromethylornithine (i-DFMO) isetyenziswe ngokukhawuleza kungekudala.

Thintelo

Ukuthintela i-pneumocystosis kuqukwa nemisebenzi emininzi, ekufuneka kuthethwe oku kulandelayo:

1. Ukungabandakanyi ukusuleleka kumaziko ezobonyango abantwana, kwizibhedlele apho izigulane ze-oncology kunye ne-hematology ziphathwa ngayo, bonke abasebenzi, ngaphandle kokunye, kufuneka bahlolisiswe rhoqo ukusuleleka.
2. Amachiza prophylaxis yabantu abasengozini. Olu thintelo luhlobo lweentlobo ezimbini: eziphambili (ngaphambi kokuba isifo sifumane ukuphuhlisa) kunye nesibini (isithintelo emva kokubuyiselwa ngokupheleleyo ukuze ukhusele ukubuyela kwakhona).
3. Ukufumanisa ngokukhawuleza kwe-PCP kunye nokwahlukana ngokukhawuleza kwesigulane.
4. Ukukhubazeka rhoqo kwiindawo apho kubonakala khona ukuqhuma kwe-pneumocystosis. Ukwenza oku, yenza ukucoca okumanzi, usebenzisa isisombululo se-5% ye-chloramine.