Izimbangela ukucinana kwemigudu yokuphefumula. Izinhlobo ukucinana kwemigudu yokuphefumula, Izimpawu kanye Treatment Abadala

Ngiseyingane, sivamile abazali bathi, ungaphuzi abandayo - abandayo, ungahambi mes caps - izozuza yisishiso emaphashini, makungabi izinyawo ezimanzi - umphimbo obuhlungu. Kodwa asizange silalele iyagula. Kungakhathaliseki out yenkani noma ngenxa isithakazelo ucwaningo bahlolelwa ngamandla emzimbeni wakho. Ngakho ngemva konke lokho kwenzeka ukucinana kwemigudu yokuphefumula kanye kuyini na?

Ukucinana kwemigudu yomoya emaphashini acute

Ukucinana kwemigudu yomoya emaphashini - isifo sokuvuvukala aphansi ipheshana zokuphefumula, ne nezimpawu ezivamile kubantu emhlabeni wonke aye esibhedlela. Izimbangela ukucinana kwemigudu yokuphefumula kungaba nhlobonhlobo: amagciwane noma lenyama.

Ngesikhathi esifanayo kokunqotshwa nezicubu wamaphaphu ingekho, kanye ukuvuvukala itholakala kuphela ku isihlahla bronchial.

Hlukanisa okulandelayo izinhlobo ukucinana kwemigudu yokuphefumula :

- acute lapho nekwandzisa umtsamo uketshezi bronchial kanye livela ukukhwehlela reflex;
- amahlala khona, uma ushintsho ulwelwesi lwamafinyila kwenzeka emangqamuzaneni, okuholela hypersecretion nokushaya komoya kahle.

omsakazo

Njengoba kushiwo ngenhla, izimbangela ukucinana kwemigudu yokuphefumula zingase zishintshe kakhulu. spectrum Amagcikwane we Amagciwane njalo iningi kukhona streptococci, mycoplasma, chlamydia, anaerobic flora. A omsakazo viral uvezwa Umkhuhlane, parainfluenza futhi rhinovirus.

Kancane ukucinana kwemigudu yokuphefumula bungavami okubangwa umphumela zamakhemikhali noma enobuthi emzimbeni. Kodwa kulokhu uxhumano ongenakugwenywa igciwane yesibili. Ngokwe-International Ukwahlukanisa Diseases Ukubuyekeza Weshumi, isehlane acute ukucinana kwemigudu yokuphefumula ngenxa Amagciwane osungulwe futhi proximate ukucinana kwemigudu yokuphefumula oyingozi.

Ukuze isikhathi isifo ababonakali ngezikhundla:
- acute (amasonto amathathu);
- isikhathi isikhathi eside (esingaphezu kwenyanga).

Ukucinana kwemigudu yomoya emaphashini olunamandla kungaba ageleze kokubili kusuka spasm bronchial, futhi ngaphandle kwalo. Kwasendaweni ungakwazi ukuhlukanisa tracheobronchitis, izinguquko ukuvuvukala uma bagxila engxenyeni engenhla kwesihlahla bronchial, futhi bronchiolitis (inqubo sokugembula kuthinta bronchioles encane kanye ne-alveoli). Ngu ubunjalo ubovu exudate umehluko, necrotizing ukucinana kwemigudu yokuphefumula kanye catarrh.

pathophysiology

ingaqala kanjani ukucinana kwemigudu yokuphefumula? Izimpawu kanye nokwelashwa ngqo abadala kuncike indlela lesi sifo, njengoba ukwelashwa okuqondiswe izixhumanisi yenqubo sokugembula.

izici Etiological ngandlela-thile ilimaze bronchial mucosa amaseli bese yokubangela ukufa kwabo. Lezi "izimbobo" ekuvikeleni ukudala izimo Ukungena pathogen. Uma epithelium eyinhloko ababengaphansi kwemibuso yakwamanye amazwe igciwane ke ngemva kwezinsuku ezimbili noma ezintathu ukuze ujoyine kuye futhi abanye uhlobo lwama-bacterium, ngokuvamile Streptococcus pneumoniae.

I ukuvuvukala izicubu ukusabela (ukuvuvukala, ububomvu, kukhuphuke izinga lokushisa lendawo nokuphazamiseka okuhambisana) okubangela ukuphazamiseka ukugeleza kwegazi embhedeni capillary, kokucindezelwa ka kwalapho kuhlangana khona imizwa kanye amahlule.

Uma Dynamics omuhle yenqubo kanye nokwelashwa isabelo ngesikhathi, emva ukunyamalala ukuvuvukala ulwelwesi lwamafinyila elibuyiselwe ezinyangeni ezimbalwa. Kodwa idlanzana iziguli kanti akunjalo. Khona-ke lesi sifo kuba amahlala khona. Uma izinguquko abathintekayo kuphela mucosa, akusiyo nomthelela kakhulu ku umuntfu lakhetsa kuphila ngato. Kodwa kokunqotshwa zonke Izendlalelo bronchus ingadala ukopha nezicubu wamaphaphu igazi staining isikhwehlela.

umtholampilo

Izimbangela ukucinana kwemigudu yokuphefumula obstructive, ezifana amagciwane noma amagciwane ezibangela isici ukubonakaliswa emtholampilo. I esiteji prodromal ephawulwe ukwanda izinga lokushisa lomzimba kuya amadijithi febrile, ubuthakathaka, ukozela, ukungakuthandi ukudla, ubuhlungu bekhanda, ukujuluka, palpitations inhliziyo.

Iziguli ukuchaza emizweni yabo njengoba soreness noma umphimbo okulumayo nasesifubeni, okuyinto banezelwa ephefumula umoya abandayo. Ngaphezu kwalokho, bakhathazekile ezomile nokugenca ukukhwehlela okungahambisani abalethele impumuzo. Ngemva kwezinsuku ezimbili noma ezintathu, iziguli abe isikhwehlela obukhulu kusukela isikhwehlela noma ubomvu. Kukhwehlela kungase kuhambisane ubuhlungu engxenyeni engezansi kwesifuba. Lokhu kungenxa yokwanda kwemisipha pectoral.

Phakathi inhlolovo jikelele wahosha ukunakwa umswakama ngokweqile kwesikhumba, ububomvu ku cyanosis wakhe ngemuva sezindebe. Imisipha ngomoya ngamunye ukudonselwa intercostal izikhala, imisipha ukuphefumula asizayo esetshenziswa.

Ngokwesilinganiso ukucinana kwemigudu yokuphefumula ayinzima ihlala cishe amasonto amabili futhi iphela ukululama ephelele.

ukuhlola

Ubangela ukucinana kwemigudu yokuphefumula bakhombe uma ngokuhlakanipha wasebenzisa amathuluzi kusebenta kwahulumende. Ngemva kuhlolwe ngamehlo kuyadingeka ukuze ucwaningo izindlela Physical ezifana palpation, eshaywayo kanye auscultation. Ukuzizwa kanye eshaywayo kulokhu alibonisi yini engavamile, kodwa nakhu IselulekoSesihenqo ungezwa ukuphefumula kanzima, ephelezelwa kwesifuba zihlakazeke. Lapho kukhona phlegm, kwesifuba babe krupnopuzyrchatymi ezimanzi.

Ngokuvamile, ukuhlaziya igazi leukocyte count kuzokhulisa kanye nokwenyuka waphawula erythrocyte sedimentation isilinganiso (ESR). Esikhathini ukuhlaziya umchamo, njengoba umthetho, akukho ushintsho, kodwa ngesikhathi ibambene umkhuhlane kungadala amaprotheni. ukuhlaziywa kwamakhemikhali kwegazi ivumela ukubona ukubonakala amaprotheni kanye nokwanda C-esisheshayo-alpha-ingxenyenamba amaprotheni. Ngo isikhwehlela kukhona fibrin, leukocyte, epithelium desquamated of bronchi kanye amangqamuzana abomvu egazi. Ngaphezu kwalokho, i-laboratory ukwenza okuqukethwe kwezitshalo ze- bronchi ebukhoneni lamagciwane.

On the radiograph ngeke izinguquko ezithile, ngaphandle ongadalwa kuphela iphethini yamaphaphu. Ethwele spirogram uzohlola khona kanye degree of isimiso.

ukwelashwa

Izimbangela ukucinana kwemigudu yokuphefumula, kwenze ukukhethwa isu ukwelashwa esimweni ngasinye. Kuye kobukhulu inqubo sokugembula, ukucinana kwemigudu yokuphefumula acute kungenziwa wangalaliswa nehora inpatient waqashwa odokotela.

Ukwelashwa kufanele kufake ingxenye namagciwane noma elwa namagciwane, kanye izidakamizwa ezithuthukisa bronchi. Ngaphezu kwalokho, kubalulekile ukuqeda izici ezoholela ukuqhubeka ukutheleleka. Inkambo yokwelashwa liyadingeka sidlula, kungakhathalekile yini noma cha izimpawu isifo iqhubeka.

Okwamanje, odokotela benza izenzo ezibonisa zihlanganisa ukwelashwa Physiotherapy, massage, ejimini. Lokhu kusiza ukuba abantu baphume kangcono uketshezi bronchial, futhi ikuvumela ukuba ushintshe indlela yokuphathwa emzimbeni.

ukucinana kwemithambo yomoya emaphashini

Isizathu esikhulu ukucinana kwemigudu yokuphefumula - kuyinto ukulimala epithelium mucosal we ephansi ipheshana zokuphefumula. Khuluma mayelana ukucinana kwemithambo yomoya emaphashini kungaba emasontweni amane kusukela ekuqaleni isifo ngenkathi sigcina izinguquko emitholampilo sokugembula emaphashini.

Lesi simo elinesimo lesion ngokukhukhumala kwentamo odongeni bronchial, okuyinto lihlotshaniswa isikhathi eside ukuvuvukala okuholela izicubu sclerosis. Secretory kudivayisi bronchi sibhekana nezinguquko eziningana futhi kushintshwe umkhiqizo wawanda ka isikhwehlela.

ngezigaba

Kunezinhlobo eziningana ngeengaba basemtholampilo ukucinana kwemithambo yomoya emaphashini. Kukhona amafomu alandelayo emitholampilo ye isifo:
- Easy (noma catarrhal);
- ubovu obstructive;
- ifomu elula ephula ukupholisa;
- ubovu obstructive;
- ekhethekile, isibonelo, fibrous noma oluhambisana.

Ngu ezingeni nolokubhujiswa ukucinana kwemigudu yokuphefumula isabelo yomoya ezinkulu nezincane. Acabangele khona uphawu somoya namandla aso. Ngu ubunjalo ukugeleza, kanye nezinye izifo ukuvuvukala, ukucinana kwemigudu yokuphefumula kuthiwa esicashile nge exacerbations ngezikhathi ezithile, futhi njalo yansukuzonke.

Izinkinga ngemuva kokushaywa yisifo ukucinana kwemithambo yomoya emaphashini - kuyinto:
- emphysema;
- Ukukhwehlela igazi;
- kumiswa nokuvaleka kwemigudu yokuphefumula;
- ezingamahlalakhona inhliziyo yamaphaphu.

izizathu

Ezingalapheki, ngokuvamile kwandulelwe ukugunyazwa okwenziwe ukucinana kwemigudu yokuphefumula oyingozi. Izimbangela le nqubo sinqophisa ngaphakathi emzimbeni nangaphandle kwalo. Into yokuqala acabangele ukulungela kwesimiso somzimba sokuzivikela ezifweni. Uma sinamandla kakhulu noma ayinamandla, lokho kungase kubangele ukushisa isikhathi eside futhi umonakalo izicubu. Ngaphezu kwalokho, amasosha omzimba encishisiwe uyokhanga amakoloni amasha lamagciwane, ukuze isifo kuzokwenzeka kaningi.

Ngaphezu kwalokho, kuthatha isikhathi eside, eminyakeni, ukucasuka kuzo ngemibhobho imithambo emaphashini emoyeni elomile buyabanda, ugwayi, uthuli, i-carbon monoxide namanye amakhemikhali ihlangabezane kwezinye izimboni kungathikameza kabi inkambo isifo.

Kunobufakazi bokuthi izifo ezithile zofuzo nakho kungaba nomthelela ukuvuvukala ezingamahlalakhona emaphashini.

pathogenesis

Izimbangela ukucinana kwemigudu yokuphefumula zihlobene ngokuqondile lo mshini kumiswa isifo. Ngokuyinhloko encishisiwe Ukuvikelwa indawo bronchopulmonary, okuyilezi: epithelium ciliated we okwehlisa villi, kuncishiswe inani surfactant, lysozyme, interferon futhi immunoglobulin A, amaqembu ahlukahlukene-T cell kanye macrophage alveolar.

Okwesibili, e-bronchi eba triad pathogenic:
- hyperfunction bronchial nezindlala lwamafinyila (giperkriniya);
- kwenyuswa viscosity isikhwehlela (dyscrinia);
- yokujama tsi of uketshezi kule bronchi (mukostaz).

Futhi okwesithathu, ukuthuthukiswa sensitization ku-ejenti causative, futhi cross-ukuphendula amangqamuzana omzimba siqu. La maphuzu amathathu ukuvumela ukulondolozwa ukuvuvukala amasonto lemine.

izimpawu

Lesi sifo kubonakala ukukhwehlela eqinile ne isikhwehlela ukuze ngayikhulu namashumi ayisihlanu namamililitha ngelanga, ngokuvamile ekuseni. Ngo izikhathi acute ukusabela ukuvuvukala kungaba liyaphuma lokushisa, ukujuluka, ubuthakathaka.

Nge ukuqhubeka esingamahlalakhona zokuphefumula futhi inhliziyo eba phalanges ukuqina ( "drumsticks"), futhi ukuqina ipuleti nail ( "ihora ingilazi"). Ubuhlungu ukucinana kwemigudu yokuphefumula kwenzeke kuphela uma ukuvuvukala abathintekayo pleura noma ngesikhathi kuqhubeka isikhathi eside ukhwehlela kakhulu buhle kakhulu ezicutshini asekelayo.

ukuhlolwa Lab

Imiphumela yaloku kuhlola okungenhla "ukucinana kwemigudu yokuphefumula" kusethelwe ngesisekelo laboratory kanye izifundo wezinsimbi. Ngokuvamile, ukuhlaziya igazi siyenzeka ukwanda leukocyte shift leukocyte kwesokunxele, kukhuphuke erythrocyte sedimentation izinga. Biochemically isibalo sezikhungo acid sialic egazini, seromucoid, alpha- futhi gamma-globulin, kukhona amaprotheni C-esisheshayo. isikhwehlela lwamafinyila noma ubovu, kungenzeka ezinemishwe ngegazi. Iqukethe isikhumba amangqamuzana, amangqamuzana egazi abomvu futhi neutrophil.

Ukuze uthole isiqinisekiso morphological uphethwe eyenziwa bronchoscopy. On radiographs Okubukwe anda iphethini yamaphaphu futhi anezikhala yayo ukusonteka nezimpawu emphysema yamaphaphu. Spirography kusiza Orient udokotela mayelana nokuba khona noma ukungabi khona izimpawu isimiso bronchial.

ukwelashwa

Yini ukuthatha emva ukuxilongwa "ukucinana kwemithambo yomoya emaphashini"? Izimpawu kanye Treatment Abadala azihlukile kakhulu kusuka ukuthi ifomu oyingozi. Ngokuvamile, udokotela ekunika ezinye inhlanganisela izidakamizwa ethemba ukuthonya ejenti causative of impendulo ukuvuvukala. Uma lokho kwehluleka, khona-ke kuyadingeka ekulinganiseni isimo lesiguli. Ngenxa yale njongo, amaqembu elandelayo imikhiqizo:
- imithi elwa namagciwane;
- expectorants;
- bronchodilators;
- antihistamine;
- inhalations futhi Physiotherapy.