Amoebic manyoka: nayo utachiona, zviratidzo, kurapwa

Intestinal Zvirwere ndivo guru boka zvirwere kuti rinobatanidza kukundwa pamusoro nemudumbu uye maitiro zvekuchipatara zviratidzo zvakadai kuda kurutsa, kurutsa, manyoka (pamwe madzihwa uye neropa) kana kupatira. Causative vamiririri venyika chakasimba intestinal zvirwere zvinogona kuita utachiona, nemavhairasi, majemusi uye helminths. Izvi zvinoita zvakaoma rokuongorora uye kunoda kazhinji syndromic kurapwa.

tsananguro

Amoebiasis (amoebic manyoka) - nayo anthroponotic chirwere pamwe fecal-nomumukanwa mashandiro kuti hutachiwana. Kuratidza Its inokosha ndivo chirwere relapsing colitis uye extraintestinal kuratidzwa zvakadai chiropa abscesses, maronda uye nevamwe. Kakawanda, izwi iri raireva amoebiasis amoebic nemanyoka, izvo anokonzerwa chisvetasimba Entamoeba histolytica.

Zvimwewo amebiasis dzoga amoebic keratitis uye encephalitis. Maererano neWorld Health Organization, vanenge gumi muzana vepasi vari utachiwana hweHIV ichi, uye ndiyo imwe vaitungamirira zvinokonzera rufu kubva parasitic zvirwere. Extra-intestinal kuratidzwa zvakaoma chaizvo kuziva, saka rokuongorora uye kurapa amoebiasis hazvibviri nguva dzose.

epidemiology

Munyika dzose inopisa uye ine uma okunze kwakakurumbira amoebic nemanyoka. Zviratidzo zviri chirwere kazhinji dzinogona kuwanikwa vanhu hanya utano uye utsanana mitemo. Endemic kune nayo utachiona vari Central neSouth America, kunyanya Mexico, uye India.

Dzimwe nguva panomuka makuru intestinal zvirwere vakanyorwa mune pfupi shoroma nyika, dzakadai muna 1933, panguva World Expo, iyo yakaitwa Chicago. Pari, vakawanda uye apo neapo zviitiko kuitika munzvimbo vatama kubva endemic kumatunhu. Kakawanda, utachiona kunooneka pachayo iri inodziya mwaka.

Panobva chirwere ndiye munhu anorwara kana keriya majemusi. Chirwere kunoitika chete kuburikidza tsvina nemaoko, zvokudya uye mvura. Uyewo, chirwere chinogona kuburikidza usina kuzvidzivirira ngochani kuonana. Zvinozivikanwa kuti cystic chimiro notupukanana vanogona kupararira makumbo uye mapapiro nezvipembenene.

exciter

Sei pane amoebic nemanyoka? Utachiona hwakakura rinoreva nyore, izvo zvinogona kuvapo muna zvitatu zvakasiyana siyana:

- zvinyama (inowanikwa chete varwere dzevanhu);

- luminal;

- cystic.

Okupedzisira maviri zvinowanika vatakuri chirwere. Zviri saizi 40 micrometers, ine panozogadzirika uye yakawanda vacuoles muchitokisi. Kufamba ari mumuviri womunhu anoshandisa rutsoka venhema. To kuvapa yakakodzera utachiona, notumwe tupukanana zvokudya zvacho. Amoebic nemanyoka anokonzerwa ino chaiyo chimiro.

Chikofu rakatenderera kana denderedzwa Sero kukura micrometers 30. Zvingava nuclei akawanda (maviri ina), izvozvo zvinoenderana padariro pakukura.

Ichitanga amoeba upenyu

Chikofu anopinda duku ura kuburikidza nemaoko evanhu rakasviba, mvura, kana mashizha. Ikoko chikofu goko yaparadzwa, uye muviri lumen mhiri vakura mubereki amoeba. Ichi chimiro kutanga kugoverana. Somugumisiro izvi yakabereka itsva chete-Musimboti utachiona masere. Amoebic nemanyoka anotanga panguva ino. Panguva confluence pakati akanaka ezvinhu mumuviri uye zvakakwana chete chinoumba vegetative siyana ane amoeba kuramba kuwanda uye kutama zvakare kupinda ura.

Mukuita kwavo upenyu nyore secrete zvinhu kuti muchetura vanhu uye kukonzera hwokufananidzira zviratidzo intestinal noutachiona. With mutsvina yadzo vegetative uye cystic siyana kuwira kwokunze kwezvakatipoteredza. Apo vanogona kuramba kwenguva yakareba. Uyewo, ivo husingakwanisi mishonga yokuuraya utachiona.

pathogenesis

Sei dzichiri zvirwere zvakadai nemanyoka, amoebic? Chirwere kunotanga kudya asina kushambwa zvokudya. Nokuti amoeba kupinda bofu uye vachikwira muura, iyo ingava nguva refu kuoneka. Asi yaivhuvhuta ezvinhu evanhu (kupera muviri, murombo muviri, dysbiosis) cysts kuteura goko kwayo, uye kune luminal chimiro notupukanana.

Achibatsirwa yavo cytolytic uye proteolytic makemikari ose nayo utachiona chinopinda pakukora zvinyama, kukonzera kuzvimba uye paumbwe nemaronda uye munzvimbo duku necrosis. Mune zvimwe zviitiko, amoeba kupinda ropa midziyo uye kuerera emura vanowira dzimwe nhengo, pova ipapo abscesses.

Mugore intestinal chimiro chirwere chokutsva kunosvika ari pasi mirayiridzo kubva cecum kusvika mutsetse. Mucous edematous muviri, pamusoro rinooneka hyperemia nodules diki uye maronda ane necrotic masarasara uye vegetative siyana amoebae. Nokufamba kwenguva, mashoko nodules vaparadzwa, ndokusiya panzvimbo yayo imwe nemaronda itsva kusvika masendimita maviri nehafu dhayamita. Deep kuremara pasi akafukidzwa pus. Kana munhu anoongorora biopsy ari urikanwi porusvingo, uchaona notupukanana.

Zvirwere pamwe paumbwe cysts, polyps, uye amoebae. Izvi bundu inotungamirwa, iyo ine granulation rinenge fibroblasts uye eosinophils.

extraintestinal chimiro

Amoebic manyoka ane zvose dyspeptic zviratidzo, uye somatic. Kana vegetative siyana amoebae kupinda mumba pakukora ari intestinal rusvingo, vapinde systemic riparadzirwe. Izvi zvinotungamirira pakuparadzirwa nayo utachiona nomuviri. Maererano negadziriro yaJehovha portal tsinga amoeba kupinda chiropa parenchyma.

The Nhengo anogona kuva maronda kunosiyana inosiyana zvakaoma kwazvo, kubva puroteni kana kuratidza steatosis kuzvimba chiropa uye chiropa pute, raiva pasi rising diaphragm. Dzimwe zviri anonziwo chokoreti cysts nokuda dzakananga ruvara pus. Kana kuzvimba usina kurapwa, kunouya kwatangwa kuvhurika ane pute iri abdominal mhango pamwe kukura peritonitis. Kana chikofu anogona kupaza diaphragm mumapapu, mediastinum kana pericardium, kukonzera unoenderana matambudziko. Kuwedzera chiropa, pomutumwa anokwanisa kuparadza uropi, ganda uye dzimwe nhengo.

kiriniki

The incubation kumwedzi kunotora inenge vhiki, pashure iyo anoratidza amoebic nemanyoka. Zviratidzo kutanga vakawanda simba, kurwadziwa iliac nharaunda uye agomuka kupisa muviri. Gumi muzana zviitiko chirwere anotora fulminant kosi. It kunoratidzwa kunonyengedza manyoka neropa uye madzihwa, izvo zvinokonzera zvikuru kupera mvura mumuviri uye rufu. Hwepakati chetatu varwere nefivha pavanoparidza akawedzera chiropa. Kuzvimba kumavambo hosha simba, saka ari mukuru kuongorora ropa haina kuchengetwa noruzhinji kuchinja.

Mune dzimwe kuratidzwa extraintestinal akaperekedza nemanyoka. Chiratidzo kuti aigona kunzi pathognomonic, muchiitiko ichi vasipo. Amebiasis substantially kwete unooneka mumuviri kusvikira vaunganidza kusvikira yakaoma guru pomutumwa.

Kana musingadi kutora chero chinhu panyaya pakurapa chirwere, shure kwechinguva utachiona anotora chirwere hunhu. Zvishoma nezvishoma, kupererwa neropa uye cachexia. Rezasi ari kurwisa womuviri, iyo nokukurumidza iyo intestinal chimiro zvinoenda extraintestinal. Ngozi chikamu zvinosanganisira vana vaduku, vakadzi vakwegura, pamuviri uye varwere vachitora immunosuppressants.

Diagnostics

By Inzirai isingachinji chirwere kuti "nemanyoka"? Chirwere uye kurapwa chirwere ichi chakabatana zvikuru upenyu kutenderera majemusi. Kuti kujekesa etiology kuti manyoka, chiremba anotora chitsiko yokuenzanisira, umo zvinyama mhando notupukanana. Kana faeces vari cysts kana translucent chimiro, ichi rinoratidza ngoro uye haagoni kushanda nokusimbisa nechirwere.

Sezvo muviri sechinhu conditionally pathogenic kasvisto uchitova mhando inoverengeka notupukanana, nechirwere chingava kwakamuomera. Zvisiri chirwere kunogona kuonekwa pamwe Entamoeba dispar. Hazvina dzisiri pathogenic amoeba, iyo hakukuvadzi chose vanhu, asi ndiyo morphologically chaizvo rakafanana nemanyoka.

Kuti asimbise nechirwere uye kushandiswa polymerase Chain kuita uye serological nemiedzo. Kuziva extraintestinal siyana amoebiasis, zvakafanira kuti kuitisa X-ray ongororo, Ultrasound uye computed tomography. Kusiyanisa amoebic chirwere pamwe shigellosis, salmonellosis uye nonspecific maronda colitis.

mabatiro

Mabatirwo amoebic nemanyoka chinotanga cytotoxic zvinodhaka zvakadai metronidazole kana tinidazole. Kana murwere asina zviratidzo, ndiko kubvisa tupukanana inogona kushandiswa yodohinod kana paromomycin.

Zvingagadziriswa wokutanga pamusoro amoebiasis waiva emetine, iyo mined kuSouth America of Ipecac. Zvino rinoshandiswa kashoma, sezvo kwazvo chepfu uye kwete inoshanda zvakakwana. By ichi zvinoreva rokukwirira chete chiitiko munhu aibuda nguva refu, muna nemishonga siyana uye chisimbwa kuti metronidazole.

Nokuti pakurapa mamwe-intestinal siyana vari metronidazole pamwe yatrenom, doydohinom, meksaformom uye zvimwe zvinodhaka. Mune zvimwe zviitiko kushandisa kuvhiyiwa.

yematambudziko

Amoebic nemanyoka kwevanhu anokwanisa kuva kwakaoma nokuda perforation yacho bowel rusvingo. Izvi zvinoitika panguva paumbwe kuremara zvokutadza yakadzika. Kana perforation intestinal zviri munzvimbo abdominal mhango uye kombera nayo. Iva zvinotevera matambudziko - peritonitis. Kuti aponese upenyu murwere, zvakakodzera kushandisa kuvhiya hanya: Ita midline laparotomy uye abdominal zvomukati kuita chinhu odhita.

Chimwe kuomesa chakakomba - intestinal kubuda ropa. Uyewo ikabuda nedanho inotungamirwa nemaronda. Zvakamuzorodza zvichiita achatora vose kuchinja uye kushanda nzira. Kurapa maronda inokonzerwa paumbwe vanga rinenge wakamanikana lumen, nokuputsa saka ndima zvokudya.

dziviriro

Amoebic nemanyoka - intestinal chirwere, saka kurudzivisa, anofanira nenguva decontaminated manyuko utachiona hwakakura: unyengeri mumadziva, reservoirs nezvimwe kuparadzira mvura hurongwa.

Uyezve, tinofanira kutora matanho kuziva vatakuri uye sporovydeliteley, uyewo kurapa varwere vane chakasimba siyana zvaidiwa Anti-dambudziko matanho. Convalescent vanhu uye motokari hapana nyaya havafaniri kubvumirwa kushanda Eenhede.

Imwe nzira yokuderedza uwandu vanayo vanhu kusimudzira utsanana uye zvakakodzera Mabatiro zvokudya pamberi rinodyiwa. Mushure yakapfuura chirwere ari munhu anofanira kugara mugore kwakacherechedzwa kudzidza zvinotapukira. Yakanga chete pashure Analyses mukati mitatu achava akaipa nokuda amoebiasis, murwere ichakurukurwa sezvo pakupedzisira utano.