Isikhohlela: iinjongo kunye neendlela

Isikhohlela ngasese usebenze ngexesha ukudumba uqhoqhoqho, bronchi kunye nemiphunga. inkangeleko wakhe awayethe nje kuphela ngokoyiswa isixokelelwano sokuphefumla, kodwa intliziyo nokuphazamiseka nemithambo. Ndlela zesikhohlela zibandakanya definition ongatshintshiyo, esasinokubonwa imichiza iimpawu zayo.

Analysis ityhila ukuba

Isikhohlela kwenza kube lula ukufumanisa Cya ezibangela inkqubo izifo, Zimiseleni ubukho Mycobacterium tuberculosis, ukuba ukuchonga iiseli umhlaza, igazi kunye ubovu ukungcola, kunye nokujonga kwakhona ukumelana yintsholongwane elwa.

Phantsi Uhlalutyo oko iimeko kuboniswa

Isikhohlela kuhlalutyo iyonke eyenziwa phantsi kwale miqathango ilandelayo:

• ukukhohlela;
• ukukrala kwemiphunga;
• ukudumba bronchi;
• ithumba lung;
• tuberculosis;
• bronchiectasis;
• nezilonda pulmonary;
• Ithumba lung;
• bronchitis ngohlobo yayiyazi;
• kwemigudu yomoya;
• e tonsils ezingapheliyo;
• tuberculosis;
• unkonkonko;
• silicosis;
• uhlobo nokoyika bronchitis obstructive;
• ukukrala kwemiphunga;
• anthrax.

Survey Ukulungiselela

Ngebhitumene uya kunikwa ngcono, ukuba ngosuku olwandulela phambi kokuba uzinikele ukuthatha isixhobo ngohlalutyo expectoration, okanye umthamo omkhulu yeziselo ezishushu. Ngaphambi Ukuqokelela Kucetyiswa ukuba ukucoca emazinyweni kwisisu ngomlomo, ngamanzi ngamanzi ashushu abilayo.

imithetho engundoqo yokuqokelela

Qokelela isikhohlela lokubhalela uviwo bacteriological ayinqwenelayo uvelise kusasa (yena uqokelela ebusuku ngaphambi kokuba kudliwe) kwisingxobo okungenazintsholongwane, elikhutshwa elabhoratri. Kuba uhlahlelo imali ngokwaneleyo ml-5. Uhlalutyo secretion yenziwa kwiiyure ezingama-2 emva kokuba ingqokelela yazo. De kube mzuzu yokuthumela ukuba bafunde imixholo kwisikhongozeli kufuneka igcinwe esekhusini efrijini.

Isixa isikhohlela kwindawo zizifo ezahlukahlukeneyo

Inani secretion eyabelwe kuyahlukana nedlela yohlobo lwenkqubo yezifo. Ngokuqhelekileyo, oko iyahluka ukusuka nasekutshicelweni ezimbalwa kwilitha 1 ngosuku. A kukhutshwa amancinci ngexesha le ukudumba bronchi, iinkqubo congestive aqala imiphunga kunye ahlaselwe sisifo sombefu inyumoniya. Ekupheleni kwale ukunyuka ukuhlasela umthamo. Kusenokuba ukuya kwiilitha 0.5, kwaye beme amanani amakhulu, ukuba kukho nokudumba miphungeni.

yencindi Kuninzi akhululwe inkqubo ubovu emiphungeni xa unxibelelwano kunye bronchi, kunye ubukrakra, bronchiectasis ukubola.

TB isikhohlela lung inyama ubonisa ukubola. Ingakumbi, inkqubo enjalo evusa umngxuma leyo enxibelelana bronchi.

Ukususela oko kuye kwabangela ukuncipha okanye ukunyuka secretion bodwa

Ukwanda kukhuthaza secretion esinxulunyaniswa umqathango kukwehla kumguli esweni ngexesha exacerbation. Ukwanda Kungenzeka kubhekisele nemiba ezintle yophuhliso yesi sifo.

Ukunciphisa inani yencindi secreted ingabonisa ukuhlehla of yokukrala okanye ukuhlukunyezwa kwi kwisisu semibhobho ezaliswe ubomvu. Kulo mzekelo, ngokonakala yempilo yomguli.

uhlobo yokumpompoza

secretion uxakaxa omela bronchitis uhlobo oyingozi okanye engapheliyo besi sifo inyumoniya, inyumoniya, umhlaza, nangezilonda kwemiphunga, bronchiectasis, cyst yemiphunga hydatid, ephelekwa suppuration, actinomycosis.

Isikhohlela kunye admixture of ubofu uyaqapheleka lung ithumba, bronchiectasis kunye echinococcosis.

Yencindi exutywe ngegazi okanye equlathe ngokupheleleyo igazi Uphawu lwesifo sephepha. Imbonakalo negazi azinako kubonisa ubukho umhlaza, bronchiectasis, lung iyabhiqiza. Kwakhona, into enjalo iqatshelwe syndrome lobe eliphakathi, iposi engabalulekanga kwi kwemiphunga, umothuko, actinomycosis kunye izilonda syphilitic. Igazi ibe inyumoniya ekwanti kunye lobar kunye focal, iinkqubo congestive, isifuba ezesifuba nokudumba nezengekho miphungeni.

isikhohlela Serous uyaqapheleka nokudumba miphungeni.

isikhohlela umbala

iimviwo isikhohlela utyhila ngendlela eyahlukileyo umbala. Amanzi uxakaxa kwaye serous akanaye umbala omnye okanye abe nombala ezimhlophe.

Ukujoyina ubomvu unika ukuzithemba umbala oluhlaza oluphawula iinkqubo zophendlo lwezifo ezifana ithumba lung, njengesilonda, bronchiectasis, lung actinomycosis.

Ukhetho ngokundibamba nerusi okanye umbala omdaka ibonisa ukuba ziqulathe akukho igazi elitsha, kunye neemveliso zayo ukubola - hematin. Le mfihlelo kukhululwa kunye lobar pneumonia, anthrax, iposi miphungeni.

umbala oluhlaza ngokundibamba ubumdaka emthubi okanye ubungqina ofihlakeleyo izifo zemiphunga ile senyongo.

Umbala eliqaqambileyo emthubi isikhohlela wabenza ne pneumonia eosinophilic.

Yencindi imbola yenzeka siderosis lula.

imfihlo omnyama okanye nombala waqaphela ubukho ubumdaka amalahle uthuli. Xa pulmonary nokudumba isikhohlela serous iqatshelwe amanani amakhulu. Ngokuqhelekileyo, oko ipeyintiweyo umbala ngokufanayo elipinki ngenxa yobukho iiseli ezibomvu zegazi. Ezo ukwahlukana ulwelo ezifana juice cranberry.

Beqabe mfihlo kunye nezinye iziyobisi. Umzekelo, zintsholongwane "rifampicin" umnikeze umbala obomvu.

iphunga

Indlela emi ngayo inkqubo zophendlo lwezifo kwisiqwenga sokuphefumla isenokubonisa secretion kunye nevumba. Isikhohlela unika ivumba kubola kunye njengesilonda kwemiphunga okanye bronchus amanxeba angcolile, umhlaza, nangezilonda, necrosis nzima bronchiectasis.

Ubukho lamanqanaba

Ngokufuthi uhlolisiso lubonisa ubukho netuwa zikhabane. Xa phlegm amileyo kunye admixture of ubofu nto yabonakala iyabhiqiza wemiphunga bronchiectasis.

Imfihlelo ibole admixture iqulethe ngeengcamba ezintathu. Umaleko phezulu kuyafana amagwebu medium serous, kwaye doped asezantsi ubomvu. Loo sisincoko luphawulwa njengesilonda semiphunga.

elimsulwa

Admixture lokutya ibonakala kukho ithumba eli kuvuleke iminxunya kuqhagamshelwano yayo kunye bronchi kunye noqhoqhoqho. Emva wadibana tapeworm kwi bronchi kwi isikhohlela kungabonwa okanye amagwegwe scolex ezimfimfitha igazi. kunqabile kakhulu wafumana abadala of Ascaris engena isixokelelwano sokuphefumla kubantu immunocompromised.

lung iqanda Iphiko cysts kuvela kwi lekhefu ezikhandelwa kwi kwemiphunga phambi gazi.

Ekuboleni ithumba kwemiphunga ukuba ukuvela kumaqhekeza necrosis semiphunga. Xa yamathumba ekhona yincindi iziqwenga zayo.

NgokwenqanawaComment equlethe fibrin zifumaneka izigulane bronchitis fibrinous, isifo sephepha kunye nenyumoniya.

Rice ithole lens okanye Goch tuberculosis azalwa.

Ukuvimba eDietrich, kuquka iimveliso yokubola iintsholongwane kunye neeseli nemiphunga lolwabo okunamafutha acid, kwenzeka iphika elinukayo okanye njengesilonda semiphunga.

ifomu tonsils Chronic lubandakanya yokwahlukana tonsils Imigudu ezifana bavimbe eDietrich.

Indlela khemikhali

imithi yesikhohlela kubandakanya ukuqonda:

• index protein, nto leyo enokusinceda xa umahluko lokufunyaniswa uhlobo ezingapheliyo yomoya kunye nesifo sephepha. ifomu kwemigudu yomoya iphawulwe imizila ezifihlakeleyo iiprothini, yaye uya kuba phezulu kakhulu amanxeba tubercular ye isixa iiprothini isikhohlela, kwaye oko kuboniswa amanani (ukuya ku 100-120 g / l).
• zombala enyongweni. Bona afumaneka isikhohlela kwi ngokoyiswa isixokelelwano sokuphefumla xa zidityaniswe ne-hepatitis. Kulo mzekelo isibindi enxibelelana emiphungeni. ngombala yenyongo na inyumoniya semvelo okubangelwe ekuweni kwemiphunga ngaphakathi erythrocytes kunye utshintsho kwamva nje mpilo.

Cytological indlela uphando ngasese

Kuba umahluko isifo sephepha kunye nezinye izitshanguba zemiphunga oko Pap ndlela isetyenziswa ngokubanzi, equka izigaba ezimbini: kuxilonga aze ezincinane of isikhohlela.

Uphando lwezonyango kunceda ukuqonda ukuba yiyiphi indlela kufuneka iqokelelwe izinto ukufumana iziphumo ezichanekileyo zohlalutyo.

Kukho iindidi ezimbini eziphambili eziphathekayo, nto leyo ifuna uviwo ezincane of isikhohlela: ezizenzekelayo lincitshiswe. Uhlobo lwesibini secretion ifunyenwe impembelelo zizinto ezahlukeneyo (ngokuba agents expectoration, inhalations kunye ezifana. D.).

Amanqaku afunyenwe biopsy inaliti

Uviwo Cytological of isikhohlela kubandakanya ukufunda iimviwo ongatshintshiyo kunye ezincinane weeseli yayo.

Uninzi ulwazi uhlalutyo cytological of isikhohlela uye kusasa ungatyanga. Phambi kokuba phando kufuneka igcinwe akukho iiyure ezingaphezu kwama-4.

• Xa isikhohlela zenzeka iiseli carcinomas epithelial, apho bafunda microscopically. Kodwa ngenxa uxilongo, abanawo intsingiselo. iiseli columnar epithelial - zombini single kwaye kwi qela - ibonakala izifo ezifana isifuba inyumoniya, iphika kunye umhlaza wemiphunga. Qaphela ukuba epithelium columnar unakho ngenxa kwii le yencindi ngeempumlo abonakale.
• macrophage Alveolar iiseli reticuloendothelial. Macrophage zifumaneka kukho icytoplasm (amasuntswana othuli okanye iiseli phagocytic) enokufunyanwa izigulane abo uthuli ixesha elide ukurhogele.
• Macrophage protoplasm (akhiwa yokuwa haemoglobin) Intliziyo siphene ekuthiwa ziiseli. Bayakwazi zenzeke ngexesha iinkqubo amile emiphungeni, mitral vana stenosis, iposi miphungeni.

• A Inani elincinane leukocytes equlethwe kuwo nawuphi na isikhohlela. umxholo wazo eliphezulu kubonisiwe admixture ubomvu secretion.
• Eosinophils. iiseli ezinjalo yencindi zizityebi amaxhoba kunganganynzeleki. Iiseli kusenokubakho kunye uhlobo izitshanguba yinyumoniya eosinophilic ephilayo helminths, isifo sephepha kunye iqhosha nezengekho miphungeni.
• Erythrocytes. Ngamnye iiseli ezibomvu igazi musa ukubonisa umfanekiso sifo. Ukuvela isixa elingakumbi ubungqina phambi ukopha emiphungeni. Le erythrocytes igazi elitsha wayezimisele rhoqo. Ukuba kukho admixture igazi, leyo ndawo emiphungeni ixesha elide, wafumana erythrocytes leached.
• iiseli zomhlaza. Ukuba inokufumaneka kumaqela emfihlekweni. Zibonisa ukuba kukho ithumba. Xa awutshatanga iseli kudla ubunzima ekufumaniseni. Kwiimeko ezinjalo, kwakhona analysis of isikhohlela.
• okuzenzela ilastiki, ibangelwa ukuwa esiqwini lung, isifo sephepha nicaphukile, ithumba, babe ithumba ogama imbonakalo. Njengesilonda ezinjalo iiseli azisoloko kwachazwa ngokuthi ngenxa intshukumo enqanda, ezo ziyimfihlo, ukuze ipheliswe.
• Kurshmana zikhula. Lo mzimba ezithile, ezifana ityhubhu. Bona afumaneka isifundo phantsi ngemicroscope. Ngamanye amaxesha buqapheleke amehlo. Ngokuqhelekileyo Helix izifo ezingundoqo ezifana isifuba inyumoniya, isifo sephepha yemiphunga kunye nenyumoniya.
• Charcot-Leyden ziikristale zifumaneka isikhohlela ezinomthamo aphezulu eosinophils kwezi izilonda, njengoko isifuba inyumoniya, inyumoniya eosinophilic. Kwesidumbu tuberculosis Uqhambuko mithambo ye bronchi ukuze kubalulwa phambi kwesi secretion ngelasitiki ziikristale imicu cholesterol, kwaye amorphous MBT lime (ekuthiwa-tetrad Ehrlich) - 100%.

Ukusetyenziswa microscopy

Ukuqokelelwa isikhohlela smear microscopy isifundo le ndlela ibandakanya uhlalutyo netuwa ukuba efumanise Mycobacterium ethile tuberculosis. Bafana ukuya ezicekethekileyo, ubukhulu emacaleni okanye phakathi amagophe izinti ezibude, ezo zilahlwa zombini zibangele kunye namaqela.

Efumanise Mycobacterium tuberculosis asiyonto phawu lubalaseleyo ukwenzela iziphumo zokuxilonga kunye ufuna nangokungqinwa indlela bacteriological. Mycobacterium tuberculosis kwi linganiselo mfihlelo ayikwazi ukuba andibhaqwa.

Isiseko uhlalutyo amasuntswana ubovu zithathwa ngaphandle kwiindawo ezahlukeneyo mane anesithandathu kwaye triturated de egudileyo Izahlulo ezimbini. Okulandelayo, atshe umoya elibekwa nelangatye sokukhuphela.

iimviwo bacteriological of isikhohlela Ziehl-Nielsen bala icebisa ukuba ngombala obomvu. Kulo mzekelo, zonke iimfihlelo kwisuntswana, ngaphandle mycobacteria, uba tinged kunye nemisonto, kunye mycobacteria babe ebomvu.

Xa tuberculosis ephilayo okusolwayo sisilonda esidumbileyoesingaphakathi emva izifundo ezithathu ubukho mycobacteria nabantu abangenamdla asebenzise ukusetyenziswa indlela ayinto (uhlalutyo Pottenger).

Indlela eqhelekileyo ukufunda nebala smear MTB unika iziphumo ezidibanisayo kuphela xa inani MTB nama-50 iiyunithi 000 nganye 1 ml isikhohlela. Ngokutsho inani Mycobacterium tuberculosis ukuba ubukho akunakwenzeka kugweba.

izigulane Bacterioscopy kunye zizifo zamaphaphu nonspecific

izifundo zeLebhu of isikhohlela phambi yezifo ezingezizo ezithile umphunga yi microscopy onokuchaza iintsholongwane zilandelayo:

• Xa ukukrala kwemiphunga - pneumococci, diplococci Frenkel, Friedlander iintsholongwane, streptococci, staphylococci (100%).
• Xa kungabonwa njengesilonda ukukhanya intonga yokuluka nodibaniso spirochaete Vincent (80%).
• fungi igwele (70%), ukwenzela ukuqinisekisa ukuba hlobo esifuna imbewu ngasese.
• actinomycete Drusen (100%), e actinomycosis.

Umthamo secretion kubantu abasempilweni

Ukubana yencindi secreted uqhoqhoqho kunye bronchi ebantwini ungasivumeli ukuba naziphi ezimbi, ukusukela nge-10 ukuya kwi-100 ml / ngosuku.

Ngesiqhelo amaqondo aphantsi leucocytes, uphando kwi efafazwe smear mycobacteria unika isiphumo esibi.