Iimbangela ze-bronchitis. Iintlobo ze-bronchitis, iimpawu kunye nokunyanga kubantu abadala

Ubuntwaneni, sasisoloko sixelelwa ngabazali: musa ukusela kubanda - uya kubamba ubanda, ungahambi kunye ne-caps - ufumane i-pneumonia, ungamisi imilenze yakho - umqala wakho uyabetha. Kodwa asizange sithobele kwaye sigula. Ekubeni inkani, okanye ngenxa yomdla wophando, sihlolisise umzimba wethu ngamandla. Ngoko, emva koko, yintoni i-bronchitis kwaye yintoni na?

Bronchitis

I-brronchitis isifo esibangelisayo sephepha lokuphefumula elingaphansi, kunye neempawu eziqhelekileyo abantu abaninzi emhlabeni jikelele baya esibhedlele. Iimbangela ze-bronchitis zinokuhluka kakhulu: iibhaktheriya, ii-virus okanye iprotozoa.

Kule meko, umonakalo wesikhumba semiphunga awunakwenzeka, kwaye inkqubo yokuvuvukala yindawo ehlala kuyo kuphela emthini we-bronchial.

Zikhona iindidi ezilandelayo ze-bronchitis :

- esicacile, xa umthamo we-secretary bronchial ukwandisa kwaye ukukhwehlela okugqithisileyo kubonakala;
Engapheliyo, xa kumgangatho wamaselula kukho utshintsho kwi-membrane, eholele ekukhutshweni kwe-hypersecretion kunye nokuphulwa komoya.

Etiology

Njengoko sele sele khankanywe ngasentla, izimbangela ze-bronchitis zingafani kakhulu. Ukusuka kwi-bacterial spectrum, ii-pathogens eziqhelekileyo zi-streptococci, i-mycoplasmas, i-chlamydia, i-anaerobic flora. I-etiology egqirha i-viral etiology iboniswa ngumkhuhlane, i-parainfluenza kunye ne-rhinovirus.

I-brronchitis eyabangelwa yimichiza okanye iziphumo ezinobungozi emzimbeni ungaphantsi kakhulu. Kodwa kule meko, ukongezwa kokusuleleka kwintsholongwane yesibini kuya kuphepheka. Ngokwe-International Classification of Diseases ye-revision yeshumi, i-bronchitis enomdla obangelwa zizifo eziphilayo kunye ne-bronchitis engacacisiwe.

Ubungakanani baleso sifo bubonakala:
- esisisigxina (ukuya kwiiveki ezintathu);
- Ubuninzi (ngaphezu kwenyanga).

I-bronchitis ebonakalayo inokuthi iyenze njengokuba i-bronchial spasm, kwaye ngaphandle kwayo. Ngokweendawo, kunokwenzeka ukuhlukanisa phakathi kwe-tracheobronchitis, xa utshintsho oluvuthayo lujoliswe kwingxenyana ye-bronchial tree, kunye ne-bronchiolitis (inkqubo ye-pathological affects small bronchioles and alveoli). Ngokwemvelo ye-exudate ikwahlula i-purulent, i-catarrhal ne-necrotic bronchitis.

Pathophysiology

I-bronchitis ikhula njani? Iimpawu kunye nokunyanga kubantu abadala kuxhomekeke ngqo kwinkqubo yokuqala kwesi sifo, ekubeni unyango lujoliswe ngokuchanekileyo kwiinkcukacha zenkqubo ye-pathological process.

Izinto ze-Etiological zonakalisa ngandlela-thile iiseli ze-mucosa ze-bronchial kwaye zibangele i-necrosis. Ezi "zikhefu" ekukhuseleni zidala iimeko zokungena kwi-pathogen. Ukuba intsholongwane yayiqale ikholoni ye-epithelium, emva kweentsuku ezimbalwa okanye ezimbini naziphi na iibhaktiriya, njengomthetho, i-pneumococcus, iya kujoyina.

Izimpembelelo zesikhumba ezivuthayo (i-edema, ubomvu, ukunyuka kwamaqondo okusebenza kwendawo, kunye nokukhubazeka komsebenzi) kubangela ukuphazamiseka kwegazi kumbhedla we-capillary, ukunyanzeliswa kweziphetho zentsholongwane kunye nokwakhiwa kwe-thrombi.

Ukuba i-dynamics yenkqubo ilungile kwaye unyango luhlelwe ngexesha, emva kokuba ukutshayalala kuphelile, i-mucosa ibuyiselwa kwiinyanga ezimbalwa. Kodwa ipesenti yezigulane azenzi. Emva koko eso sifo sidlulela kwisimo esingapheliyo. Ukuba utshintsho luchaphazela kuphela i-membrane ye-mucous, oko akuyi kubachaphazela kakhulu ubomi bomntu. Kodwa ukutshatyalaliswa kwazo zonke iziqendu ze-bronchus kungabangela ukubola kweengxenyeni zamaphaphu, kunye nokucaza i-sputum ngegazi.

I klinikhi

Izimbangela ze-bronchitis eziphazamisayo, ezinjengebhaktheriya okanye iintsholongwane, zibangela izibonakaliso zeklinikhi. Ngethuba lexesha elidlulayo kukho ukwanda kwindlubhiso yomzimba ukuya kumanani amanani, ubuthathaka, ukulala, ukulahleka kwesidlo, intloko, ukujuluka, ukuphalaza.

Izigulane zichaza ukuvakalelwa kwazo njengengxangqa okanye ukukhathazeka emqaleni nasemva kwe-sternum, ezikhuliswa ngumoya womoya obandayo. Ukongezelela, baphazamiseka ngumkhuhlane oqhawulayo ongenakuzondla. Emva kweentsuku ezimbini okanye ezintathu, izigulane zifumana i-sputum eninzi kwi-mucus okanye ipus. Isikhumba sinokuhamba kunye nentlungu engxenyeni engaphantsi kwesifuba. Oku kubangelwa ukugqithisa izidumbu ze-pectoral.

Ngethuba loviwo oluqhelekileyo, ingqwalasela ibhekiswe kumswakama ogqithiseleyo wesikhumba, ubomvu obunomgca wemilomo ye-cyanotic. Imisipha kunye nokuphefumlelwa ngalunye kukhatywayo kwiindawo ezingaphakathi, ngokuphefumula, isilumkiso esincedisayo.

Ngokuqhelekileyo i-bronchitis engazinzileyo ihlala malunga neveki ezimbini kwaye iphelela ngokuzifumana ngokupheleleyo.

Diagnostics

Iimbangela ze-bronchitis zichongwa ngokulula ukuba ziyi-diagnostic ezisetyenziswa kakuhle. Emva kokuvavanywa kwembonakalo, kubalulekile ukuqhuba iindlela zokuphanda, ezifana ne-palpation, i-percussion kunye ne-auscultation. Ukuziva kunye nokuthelela kulo mzekelo akuyi kubonisa nantoni na engavamile, kodwa apha kwi-phonendoscope unokuva ukuphefumla kanzima, kuhamba kunye nokujikeleza. Xa i-sputum ibonakala, i-wheyzing iyanamanzi ngamabhulu amakhulu.

Kuvavanyo jikelele lwegazi, kuya kubakho ukwanda kwenani lama-leukocytes kunye nokwanda kwinqanaba le-erythrocyte sedimentation (ESR). Kuhlalutyo lomchamo, njengomthetho, akukho tshintsho, kodwa ekuphakameni komkhuhlane, ukubonakala kwiprothini kunokwenzeka. Uhlalutyo lwegazi lwegazi lukuvumela ukuba ubone ukubonakala kweprotheyini esebenzayo yeC kunye nokwandisa i-fraction-alpha yeproteins. Kwi-sputum, i-fibrin, i-leukocytes, i-epithelium ye-bronchial kunye ne-erythrocytes ekhoyo. Ukongeza, i-laboratory yenza ukuba kufakelwe i-bronchi ukuba ibekho kubakteria kunye neentsholongwane.

Kwi-roentgenogram akuyi kuba neenguqu ezithile, ngaphandle kokuba kuphuculwe iphethini yepmonta. Ukuqhuba i-spirogram iya kuhlola ubukho kunye nobukhulu bokhuselo.

Unyango

Iimbangela ze-bronchitis zikhetha ukhetho lwezonyango zonyango kwimeko nganye. Ngokuxhomekeke kubuqili benkqubo ye-pathological, i-bronchitis enamandla ingaphathwa ngokugqithiseleyo kwaye ngokusisigxina, phantsi kweliso loogqirha malunga newashi.

Ulwaphulo kufuneka lubandakanye i-antitiviral okanye i-antibacterial component, kunye neziyobisi ezandisa i-bronchi. Ukongezelela, kubalulekile ukuqeda iimeko eziza kubangela ukuqhubela phambili kosulelo. Inkqubo yokonyango kufuneka ifike ekupheleni, kungakhathaliseki ukuba impawu ziyaqhubeka okanye cha.

Okwangokunje, oogqirha ba ndakanya ngokunyanga kwi-physiotherapy, ukusilalisa, ukuvocavoca. Oku kunceda ukukhutshwa okugqithiseleyo kokufihlakelelwa kwi-bronchi, kwaye kukuvumela ukuba utshintshe indlela ojoza ngayo iziyobisi emzimbeni.

Bronchitis

Isizathu esibalulekileyo se-bronchitis sinomonakalo kwi-epithelium ye-mucosa yephepha eliphantsi lokuphefumula. Ukuthetha nge-bronchitis engapheliyo kunokuba neveki ezine emva kokuqala kwesi sifo, phantsi kokugcinwa komfanekiso wekliniki kunye nokuguquka kwamathambo kwimiphunga.

Le meko ibonakala ngesilonda esivela kwindonga ye-bronchi, edibene nenkqubo yokuvuvukala eqhubekayo ekhokelela ekubhubheni kwezicubu. I-device ye-secretary ye-bronchi ifana neenguqu ezininzi kwaye ijongene nokuveliswa kwemveliso ye-mucus.

Ukwahlula

Kukho izigaba ezininzi zeklinikhi ze-bronchitis engapheliyo. Ezi zilandelayo zifom ye-kliniki zesifo ziyabonakala:
- elula (okanye i-catarrhal);
- purulent engenziyo;
- ifomu elula kunye nokuphulwa komoya;
- isithintelo esilungileyo;
- okhethekileyo, umzekelo, i-fibrous or hemorrhagic.

Kwinqanaba lezilonda, i-bronchitis ye-bronchi enkulu kunye encinci iyahlula. Cinga ubukho bokuba sisifo se-asthmatic complex and complexity. Ngokwemeko yekhosi, njengezinye izifo ezivuthayo, i-bronchitis ifikelelekile, ngezinto ezinqabileyo, kwaye zihlala ziqhubeka.

Iingxaki emva kwe-bronchitis engapheliyo:
- emphysema;
- hemoptysis;
- ukwakheka kwesifo sokuphefumula;
Intliziyo yepilmonari engapheliyo.

Izizathu

Inkqubo engapheliyo ilandelwa yi-bronchitis enzima. Izizathu zolu hlobo zingagxininiswa ngaphakathi ngaphakathi kwimizimba nangaphandle kwayo. Okokuqala, umntu makangacingisise ukulungeleka komzimba. Ukuba unamandla okanye unobuthakathaka kakhulu, kunokubangela ukuvuvukala ixesha elide kunye nomonakalo womzimba. Ukongezelela, ukukhuseleka kwe-immunity kuyotshabalalisa zonke ii-colonies ezintsha kunye neentsholongwane, ngoko ke isifo siya kubakho kwakhona.

Ukongezelela, ixesha elide, ngaphezu kweminyaka, ukucaphukiswa komcosa we-bronchial kunye nomoya owomileyo obandayo, ukutshaya ucuba, uthuli, i-carbon monoxide kunye nezinye iikhemikhali ezitholakala kwamashishini athile, zinokuchaphazela kakhulu isi sifo.

Kukho iingxelo ukuba ezinye izifo zofuzo zingakwazi nokuba negalelo lokuvuvukala okungapheli kwimiphunga.

Pathogenesis

Iimbangela ze-bronchitis zihambelana ngqo neendlela zokwakha izifo. Okokuqala, ukukhuselwa kwe-bronchopulmonary yendawo iyancipha, oku: ukucotha i-epillium epithelium, i-lysozyme, i-interferon kunye ne-immunoglobulin A, iindidi ezahlukeneyo zeeseli kunye ne-alveolar macrophages.

Okwesibini, i-pathogenetic triad ivela kwi-bronchi:
- hyperfunction ye-gonchial glancer (i-hypercrinia);
Ukwandisa i-viscosity ye-sputum (discrinia);
- stasis yemfihlo kwi-bronchi (mucostasis).

Kwaye okwesithathu, ukuphuhliswa kokwenza utyholongwane kunye nokuguqulwa kwamanzi kunye neeseli zomzimba wazo. Ezi ngongoma zintathu ziqinisekisa ukugcinwa kokuvuvukala ngaphezu kweeveki ezine.

Iimpawu

Esi sifo sibonakaliswe ngumkhuhlane oqinileyo kunye nokuhlukana kwe-sputum ukuya kuma-milliliters ayikhulu namashumi amahlanu ngosuku, ngokuqhelekileyo kusasa. Ngexesha lokuxhatshazwa kweempendulo ezivuthayo, kunokubakho ukushisa okukhulayo, ukuthuthumela kunye nobuthathaka.

Ngokuqhubela phambili kokuphefumula kunye nentliziyo, ukunyuka kwama-phalanges eminwe ("iinqwelo") kunye nokuxinwa kwamacwecwe ekhonkwane ("ijonga lokubukela") liyaqhubeka. Ubunzima bubuhlungu buya kwenzeka kuphela ukuba umbane we-pleural ubandakanyeka kwinkqubo yokuvuvukala okanye ukuba i-musculature iqine kakhulu ngexesha lokukhwehlela ixesha elide.

ILebhu kunye nophando olusebenzayo

Ukuxilonga "i-bronchitis" kubonakala ngokusekelwe kwizifundo zebhubhoratri nezixhobo. Ukuhlalutya ngokubanzi kwegazi, kukho ukunyuka kwama-leukocyte, ukutshintshwa kwefomula ye-leukocyte ngakwesobunxele, ukwanda kwinqanaba le-sedimentation ye-erythrocyte. I-biochemically, inani le-sialic acids, seromucoids, i-alpha kunye ne-gamma globulins linyuka egazini, iprotheni esebenzayo e-C ibonakala. I-sputum i-mucous okanye i-purulent, ingaba ne-streaks blood. Iqukethe iiseli ze-epithelial, i-erythrocyte kunye neutrophils.

Ukuqinisekiswa kwe-morphological diagnostic, i-bronchoscopy yenziwa. Kwi-roentgenogram, ukuphuculwa kwendlela yokuphammoni kunye nefuthe layo, kunye nemiqondiso ye-emphysema, ibonakala. I-Spirography inceda ukuqhelisa ugqirha malunga nokuba khona okanye ukungabikho kwempawu zokhuselo olushushu.

Unyango

Yintoni enokuyenza emva kokuxilongwa "kwe-bronchitis engapheli"? Iimpawu kunye nokunyanga kubantu abadala akufani kakhulu nakwezinye iifom. Ngokuqhelekileyo, ugqirha uchaza idibaniselwano ezininzi zamachiza ngethemba lokuthintela i-etiological factor of reaction inflammatory. Ukuba oku kungaphumeleli, ngoko kuyimfuneko ukuzinzisa imeko yesigulane. Ukwenza oku, sebenzisa la maqela alandelayo:
- antibiotics;
- expectorants;
- bronchodilators;
- antihistamines;
- inhalation kunye ne-physiotherapy.