Asthma mumbwa

Bronchial asthma mu imbwa chirwere chisingaperi chinoputika chekufema, izvo, zvinosuruvarisa, zviri kuwedzera kuwanda mumbwa gore negore. Asthma muimbwa inoratidzwa nezvikamu zvekufema kwakasimba kunoperekedzwa nekukosora uye/kana kukachidzwa kurwiswa nekuda kwekutetepa kwenzira yekufema. Zvinosuruvarisa, kazhinji varidzi havateereri zviratidzo zvekutanga zvechirwere uye vanoenda kukiriniki nemhuka yakatorwara zvakanyanya. Nepo pazvinenge zvaonekwa mumatanho ekutanga uye nekuraira kurapwa kwakakodzera, varidzi vazhinji vanokwanisa kuwana kudzora kwakadzikama pamusoro pechirwere chemhuka uye kuchengetedza hupenyu hunogutsa hweimbwa dzinofambidzana, uye dzekushanda nembwa dzebasa - kugona kushanda.

Muchikamu chino, tichaongorora zvikonzero, zviratidzo, kuongororwa, kurapwa uye kufungidzira mumbwa dzine bronchial asthma.

Zvinokonzera Asthma

Asthma mu imbwa chirwere chisingaperi che allergic. Pane zvikonzero zvakawanda zvinogona kukonzera chirwere ichi, asi, zvinosuruvarisa, chikonzero chaicho hachigoni kutsanangurwa.

Chero zvazvingava, kana chipfuwo chako chaonekwa kuti chine asthma, unofanirwa kutarisisa kune zvinotevera zvinhu zvekuchengeta chipfuwo:

• makemikari emumba (floor cleaners, air fresheners, aerosols akasiyana-siyana, deodorants);
• washing powders, ayo anoshandiswa kugeza mubhedha painorara imbwa, hovhorosi yake (nemibhedha yako, kana imbwa yakavata newe);
• guruva ndiro allergen ane simba;
• utsi hwefodya;
• maruva emiti yeimba;
• zvimwe zvinogona kusvibisa mweya.

Zvinotendwa kuti allergies inogona kuitika kune minhenga, murwi wekapeti, vhudzi kubva kune dzimwe mhuka dzemhuka, nezvimwewo. Hazvishamisi kuti asima iwedzere panguva yekugadziriswa kwefurati.

Nekuda kwechiito cheiyo allergen, kudzokorora kuzvimba kwemhepo kunowedzera. Kuzvimba kazhinji kunoperekedzwa nekuchinja kwe epithelium yemadziro e trachea uye bronchi. Kuwedzera kugadzirwa kwemachubu. Mhedzisiro ndeyekuvharwa kwemhepo, kuwedzera pulmonary kuramba, uye kuderedzwa kwemhepo inofemerwa, uye imbwa inoratidza zviratidzo zvekiriniki zveasthma. Chikonzero chekurwiswa kweasthma mumbwa ndiko kutadza kufema kwakanyanya.

Asi nei asima ichikura mukupindura kuita kweaallergen chete muchikamu chidiki chembwa, nepo dzimwe mhuka dzinovaraidza, zvimwe zvinhu zvakaenzana, hazvitange kurwara? Hapasati paine mhinduro kumubvunzo uyu. Zvinotendwa kuti genetic factor ine basa. Zera uye murume kana mukadzi hazvisi zvinokonzeresa. Zvisinei, mhuka duku dzinowanzoita zvirwere zvekufema, zvichikonzera kuratidzwa kwechirwere chekare chisati chavapo. Kazhinji zviratidzo zvinoonekwa mumbwa dzepakati nepakati uye dzakakura.

Zvinofanira kucherechedzwa kuti njodzi yekukura kwechirwere ichi zvinosanganisira kudzokororwa kwehutachiona hwehutachiona, inhalation yenguva refu yezvinogumbura, uye kurema kwakanyanya.

Zviratidzo zveAsma muImbwa

Chiratidzo chikuru cheasthma mumbwa chikosoro chinomboitika. Chikosoro chinowanzooma, uye mushure mekukosora kurutsa kunoratidzawo asthma. Zvimwe zviratidzo mumbwa zvinogona kusanganisira:

• kuneta;
• asthma kurwisa;
• kutsumwaira;
• kuvapo kwekufema;
• kuda kurutsa;
• kusashivirira kune basa remuviri;
• Dzimwe mhuka dzinovaraidza dzinogona kupera simba.

Zviratidzo zvekiriniki zviri pamusoro zvakakonzerwa nekukanganiswa kwemhepo patency nekuda kwekuoma kwezvinhu: kuwedzera kwekugadzirwa kwemucus, mucosal edema uye spasm yebronchial smooth muscles. Zvakare, chikonzero chekukosora chinogona kunge chiri kutsamwiswa kwekufema turakiti receptors nekuda kwekuzvimba kana spasm. Mukuwedzera kune kuratidzwa kukuru kweasthma pachayo, chirwere, nekuda kwekushayikwa kweokisijeni kumuviri, chinogona kutungamirira kumatambudziko nenzira yekushaya simba kwemwoyo, iyo inogona kuratidzwa nekupfupika kwekufema, tachycardia, cyanosis ye. mucous membranes uye yakanyanya pet lethargy.

Chinhu chakasiyana cheasthma mumbwa inyaya yekuti panogona kunge pasina zviratidzo pakuzorora. Zvakare, mune dzimwe mhuka dzinovaraidza, yakataurwa mwaka yechirwere ichicherechedzwa.

Diagnostics

Asthma mumbwa inogona kutanga kufungidzirwa nezviratidzo zvehunhu: kukosora kwenguva yakareba, nepo kugara zvakanaka kwechipfuyo kunowanzo kuve kwakanaka, uye hapana kuwedzera kwekushisa kwemuviri. Zvakare, varidzi vanogona kucherechedza kuneta kwembwa, kuderera kwekuita muviri, kupfupika kwekufema, kufema, zvikamu zvekufenda, kurwisa asima. Pakutanga kwechirwere, muridzi anoteerera anogona kutarisisa kune chaiyo kuzununguka kwemadziro emimba pakupera kwekufema uye kufema.

Palpation yetrachea inowanzokonzera kukosora kunokodzera, iyo inosanganiswa nekuwedzera kwekunzwa kwetrachea.

Kuita kuongororwa kwakaringana uye kusabvisa zvirwere zvinosangana (somuenzaniso, asima inogona kuitika pamwe chete nebronchitis yebhakitiriya etiology!) Zvinodikanwa kuita kuongororwa kwakadzama, kusanganisira:

• auscultation;
• x-ray chifuva;
• kuongororwa kweropa (munyaya iyi, ndiko kuongororwa kweropa kunoratidza);
• echo uye electrocardiography;
• bronchoscopy.

Kuongororwa kweAsma kunoitwa chete mushure mekuregererwa kwezvimwe zvikonzero zvinogona kukonzera chikosoro - pneumonia, chirwere cheparasitic, neoplasms muchipfuva chechipfuva, kupinda kwemuviri wekunze mumhepo yekufema, chirwere chemwoyo.

Chokutanga pane zvose, pakugadzwa, chiremba achaita auscultation inhanho yakakosha mukusiyana kwechirwere chepulmonary uye kusagadzikana kwemoyo. Mukuwedzera kune ruzha rwemhando, chiremba achanyatsoverenga chiyero chemoyo - nekushaya simba kwemoyo, kuwedzera kwemoyo (tachycardia) kuchava unhu, uye ne asthma, sekutonga, kushaya mwoyo kuchava kwakajairika.

On kuongororwa ropa rose kazhinji kuwedzera kwenhamba ye eosinophils inowanikwa - mukupedzisa ichanyorwa pamusoro pehama kana kuti zvachose eosinophilia. Zvisinei, zvinofanira kucherechedzwa kuti chiratidzo ichi chinogonawo kuva mune zvimwe zvirwere zvisingabatanidzi neallergic process, somuenzaniso, ne helminthic invasion. Naizvozvo, muzviitiko zvese zvekuona kuwedzera eosinophils muropa remhuka, chiremba anozonyatso nyora antiparasitic kurapwa. Asi iyo yakajairika nhamba eosinophils muropa haisanganisi kuvapo kweasthma!

X-ray kuongororwa ye thoracic cavity ndicho chishandiso chikuru mukuongororwa. X-rays inofanira kuitwa muzvikamu zvitatu kuti isabatanidze zvigadzirwa uye zvakavanzika pathologies - chipfuyo chinotorwa mifananidzo kubva kurutivi kuruboshwe, kurudyi uye fungidziro yakananga inoitwa. Pa x-ray yembwa dzine asima, murapi anogona kuona kuwedzera kujeka kwemapapu, kuwedzera kwemapapu maitiro nekuda kwekuzvimba shanduko mubronchi, uye flattening uye caudal kutamiswa kwediaphragm semugumisiro wekuwedzera kwemapapu nekuda kwekuvhara.

Zvakare, mune zvimwe zviitiko, kunyanya kusabvisa iyo bundu maitiro, kuwedzera kune x-rays, zvingave zvakakosha kuita. CT - computed tomography - inova chiyero chegoridhe chekusasanganisa kuvapo kwemaoplasms.

Kusabvisa chirwere chemoyo, chinogona kunge chiri chese chiri chikonzero chikuru chekukosora (kusagadzikana kwemoyo kutadza) uye chinetso chinokonzerwa nekutadza kufema kwenguva refu (inonzi cor pulmonale), zvinokurudzirwa kuita. electrocardiography (ECG) uye echocardiography (ultrasound yemwoyo).

Chimwe chezvikamu zvakakosha zvekuongororwa, izvo, zvinosuruvarisa, zvinowanzoregeredzwa nevaridzi nekuda kwekudiwa kwekupa pet anesthesia, ndeye. bronchoscopy nebronchoalveolar lavage kuwana swabs kubva mutrachea uye bronchi. Iyo yakawanikwa swabs inofanirwa kuongororwa kwe cytological uye microflora inoculation nekutsunga kwekunzwa kweantibacterial. Cytology inoitwa kuti isabatanidze allergic process (ine asthma, yakawedzera nhamba eosinophils ichawanikwa) kubva kuhutachiona uye fungal zvirwere (yakawedzera nhamba yeneutrophils ichawanikwa). Zvinosuruvarisa, zvinofanira kurangarirwa kuti nhamba huru ye eosinophils uye / kana neutrophils inogonawo kuwanikwa muhupo hwebundu. Izvo zvakare zvinodiwa kuita huwandu hwehuwandu hwemasero ehutachiona kusiyanisa kusvibiswa kweyakajairika microflora kubva kune chaiyo yekufema turakiti chirwere, pamwe nekuita PCR diagnostics yekuvapo kweMycoplasma (Mycoplasma) uye Bordetella (Bordetella bronchiseptica).

Kurapa Asthma muImbwa

Kurapa asima mumbwa kunoda nzira yakakwana. Mukuwedzera pakugadzwa kwemishonga chaiyo, unofanirwa kudzora kuchena kwezvakatipoteredza, uremu hwechipfuwo, pamwe nekuvapo kwemigumisiro kubva pane zvakatemwa kurapwa.

Kazhinji hapana chikonzero chekurapwa kwevarwere, kunze kwekunge apo kurapa kweokisijeni, mishonga yeropa, uye mamwe maitiro anodiwa kuti varidzi havagone kuita kumba.

Kana pane zviratidzo zvekudzikira kwemhepo nekuda kwekuita maekisesaizi, inofanira kuganhurwa. Nekudaro, kurovedza muviri zvine mwero kunogona kubatsira kana zvichidikanwa kufambisa mafambiro ebronchial secretions uye kuderedza uremu hwemuviri muhuremu hwemhuka. Mutemo mukuru ndewekuti mutoro unofanirwa kuderedzwa kusvika pamwero wakadaro kuti kushanda kwemuviri hakukonzeri kukosora.

Zvipfuyo zvehuremu zvinokurudzirwa kudya kwakaderera-koriori, nekuti zvakaratidzwa kuti uremu hwakawandisa hunokanganisa maitiro echirwere. Zvakakosha kuti vatenzi vanzwisise kuti kurasikirwa kwehuremu chinhu chinokosha chekurapa, kuderedza zviratidzo zvechirwere, izvo zvisingawanzoporeswa zvachose.

Nheyo yekurapa kwenguva refu ndeye hormonal drugs (glucocorticoids). Chiyero chekutanga chemushonga chinogona kusarudzwa chete nachiremba. Sezvo kuoma kwezviratidzo kunopera, muyero uye nhamba yemishonga inoderedzwa zvishoma nezvishoma pamusoro pemwedzi 2-4. Muzviitiko zvakawanda, iyo yakaderera inoshanda yedhijitari inotarwa kuti irambe ichishandiswa, zvisinei, kusarudzwa kwedosi kunoitwa zvakanyanya pamunhu. Zvinosuruvarisa, zvinofanira kutakurwa mupfungwa kuti kushandiswa kwenguva refu kwemishonga yehomoni kunogona kutungamirira mukuvandudzika kwehuwandu hwematambudziko. Mhuka dzinofarirwa dzinogona kuita chirwere cheshuga, congestive heart failure, weti, iatrogenic hyperadenocorticism (Cushing’s syndrome). Panyaya iyi, varwere vanowana kurapwa kwehomoni vanofanira kuongororwa nguva dzose nachiremba uye kutora kuongororwa ropa (general uye biochemistry) kutarisa kukura kwematambudziko.

Mishonga inorwisa mabhakitiriya inoshandiswa mukuparadzanisa microflora kubva pakubuda kwechirwere chekufema. Nzira yekurapa ndeye 10-14 mazuva maererano nemigumisiro yetsika ye sputum yakawanikwa semugumisiro webronchoscopy, kuti uone kunzwisiswa kwe microflora. Kana antimicrobial susceptibility tsika isingagoneki, maantimicrobial antimicrobial ane high bioavailability uye mashoma huturu (semuenzaniso, synulox) anosarudzwa.

Pamwe chete nehomoni uye antibacterial therapy, chiremba anogona kupa bronchodilators - kureva, zvinodhaka zvinobatsira kuwedzera mhepo, kuvandudza diaphragm kufamba, uye kuderedza kudzvinyirira mumapapu emapapu. Sezvo mutemo, mishonga iyi inorayirwa nenzira ye inhalations.

Mune zvimwe zviitiko, pamberi penguva refu, yakaoma, chifukidziro chinokanganisa, antitussive mishonga inorayirwa.

kushurudzira

Kufanotaura kweasthma yakasimbiswa mumbwa kunoenderana nekuoma kwechirwere, kuoma kwezviratidzo, kushivirira kwekurapa, kupindura kumishonga, uye kuvapo kwecomorbidities.

Zvakakosha kuti muridzi wacho anzwisise kuti bronchial asthma inowanzoenderera mberi nekufamba kwenguva uye kurapa kwakakwana hakuwanzoitiki (chete kana chikonzero chechirwere chinogona kuonekwa uye kubviswa). Zvinokwanisika kuderedza kuwanda kwekurwiswa, asi hazvigone kubviswa zvachose.

Imbwa dzinofanirwa kuongororwa mwedzi yese ye3-6 kuti ione zviratidzo zvekuora panguva yakakodzera. Pakangotanga zviratidzo zvekufema kana zvimwe zviratidzo zvekufema, muridzi anofanira kubata chiremba wemhuka.

Chinyorwa hachisi kudana kuita!

Kuti uwane ruzivo rwakadzama rwedambudziko, tinokurudzira kubata nyanzvi.

Bvunza chiremba wemhuka

16 September 2020

Yakagadziridzwa: Kukadzi 13, 2021