Negcushuwa ulwimi: Iimpawu and Treatment

Negcushuwa ehamba ejikeleza umhlaba kangangeenkulungwane, kwaye sele kakuhle. Ukuza kuthi ga ngoku, liqulunqe iindlela ezintsha loxilongo kunye nonyango, kodwa inani lamaxhoba uyakhula. Kuphela eRussia kwikota yokugqibela yenkulungwane, inani labo banda izihlandlo 7.

Negcushuwa elwimini yaye emlonyeni kuvela alufane kwe phezu zangasese, kodwa akukho ngaphantsi yingozi. Eyona iphambili yale fom kukuba kule isifo emlonyeni kunye ulwimi ngayo edidekile lula nge izifo engeyongozi ngokupheleleyo, nto leyo esisizathu sokuba izigulane ezininzi musa ukukhawuleza kugqirha, kwaye wenza self-medicate kunye nexesha siyiphose. Kodwa abantu abane negcushuwa ukuphiliswa ixhomekeke ngokupheleleyo unyango kwangethuba.

Cinga negcushuwa kubonakala njani ngolwimi, ukubamba ngayo, ukuba kuyingozi ngayo abanye, yaye liphuhlise iindlela zalo zonyango.

Portrait lwegciwane

Negcushuwa ibangela leentsholongwane ngemikroskopu - ". Treponema sakuba" anaerobic, ogama lakhe Kuba luthuthu sikubiza ngokuba Romanovsky-Giemsa abasabela kuba sakuba. umzimba wayo obungabonakaliyo na uhlobo uwele obhityileyo kunye iziphelo etsolo kunye we-12 okanye we-14, 8-th akufane curls. Ezi zilwanyana ziphatheka kakhulu, kodwa hayi olukhuni kakhulu. Ukuba uyakwazi ukumelana okusingqongileyo kunye t = 55 ° C 15 kuphela imizuzu kunye phantsi reflux, ngamanye kwi t = 100 ° C nangaphezulu, ziyafa washona. Kulula kwakhona ukuba atshabalalise nasiphi na isisombululo magciwane, nokuba ngesepha zesiqhelo. Ngoko ke, ukuze bambambise negcushuwa ngolwimi ngenxa ngemihla, kufuneka nje ukuba bagcine nococeko. A isici esasenza treponemes ukuba kuphumelela kuphela kwiindawo ezifudumeleyo kwaye ufumile. Engqeleni, kwakunye phantsi kweempembelelo amayeza athile, ukuba bangaba cysts kunye belinde amaphiko iminyaka. Kulo ubushushu, ingakumbi ngaphandle amathontsi ukufuma, baya kufa njengoko omiswe of zeendawana ofumileyo. Treponema phinda kwiyantlukawano elula, yaye, kakhulu ngokucothayo. Ngokuqhelekileyo, inkqubo ngokuzalwa iintsholongwane ezintsha kuthatha iiyure 32. Olu phawu kuchaphazela ixesha okuthatha.

Iindlela zosulelo

Iphutha ocinga ukuba ulwimi negcushuwa inokucholwa kuphela ngexa lokwabelana ngesondo ngomlomo kunye neqabane ukungathembeki. Ngokutsho manani WHO, ngoko bosulelwe sesi sifo, malunga nesiqingatha kwizigulane. Esiseleyo zingenwe Treponema pallidum emlonyeni nangezinye iindlela:

• ukwanga kunye negcushuwa (kubuhlungu, ubunzulu);
• ukutofelwa igazi njengongahluzwanga;
• NjengeBoniweyo wamazinyo unfair esebenza izixhobo unsterile;
• ukwenza iinaliti kubantu ezininzi isirinji omnye (ubukhulu becala ngokuphathelele ngamakhoboka eziyobisi);
• ukusetyenziswa ibhrashi yamazinyo, icephe, ikomityi, emva kokuba isigulane kunye negcushuwa;
• ukudluliselwa treponem ukusuka kumama ukuya kwimveku (negcushuwa naso);
• iintsana eyosulelekileyo ngexesha lokuncancisa;
• usulelo kwazo abasebenzi bonakekelo lwezempilo.

indlela usulelo

ulwimi ngokubonakala negcushuwa lunokwenzeka, ukuba Treponema pallidum ilawulwa ndzulu kwiinwebu kwisisu ngomlomo. mechanism Oral transmission ngesondo ilula. Treponema njalo kakhulu khona kwamadlozi yomguli, nokuba abangaboniyo umthondo azinazo iimpawu zesi sifo.

Kanye emlonyeni ixhoba entsha, iibhaktheriya zama ndzulu inyama mucosal. Ingakumbi sivune sisidleleli, ukuba unezilonda. Kulo mzekelo, usulelo lwenzeka nge-100% lilonke. Ngamathe yokuba umguli kunye negcushuwa treponema ibhaqwe kuphela ukuba umlomo wakhe nerhashalala isici. Oku kugqiba ipesenti ithuba usulelo ngokumanga.

Kwangena kwisithuba extracellular izicwili ukuba iintsholongwane kunceda imilo isantya imizimba yabo, kangangokuba "ziqinisiwe" ngathi corkscrew, kwaye kanye ngaphakathi, baqale nokuzala. Amajoni omzimba uyalela ixhoba ukuya umhlaseli izilwa-buhlungu, macrophage, lymphocyte. Ukuba inkqubo yomzimba yokuzikhusela unamandla kakhulu, kwaye kumfowunelwa isigulane ixesha-nye elifutshane elide, mhlawumbi nokunqanda isifo. Kodwa ke uninzi njengabagunyaziswa amajoni omzimba abakwazi ukumelana nomkhosi eyangena umzimba lweentshulube abaye ukukhusela umzimba philisi zambethe ngebhitumene. Treponema Ekwandeni ngokuzalisa ekuqaleni nkovu umsantsa, nkovu ukususela% 0.1 kuphela oksijini. Okulandelayo, baya kungena egazini aze aqalise ukuhamba ngawo umzimba, echaphazela eminye amalungu.

ngezigaba

Ukuziqhelisa hlabathi, sisebenzisa ulwahlulohlulo zilandelayo negcushuwa:

• primary
• lesibini (phambi kwexesha nasemva kwexesha);
• bekhubazekile.

Ngalinye zezi fom baphawula iimpawu zazo lolwimi negcushuwa.

Wayedla kudidi elula:

• negcushuwa yokuqala (lula ngakumbi ngoxilongo, iyosulela kakhulu, iimpawu kungaphela, eshiya kungekho mkhondo);
• negcushuwa Ngasekupheleni (eqhelekileyo kuwo onke amaqela, nangona unokuqalisa emlonyeni).

Xa amayeza, kukho uhlobo ezininzi ezahlukeneyo negcushuwa:

• wokuqala (seropositive kunye seronegative);
• lesibini (fresh, efihliweyo, yomhla nezolo);
• Ephakamileyo (open, efihliweyo);
• naso (phambi kwexesha nasemva kwexesha);
• visceral.

Inkqubo esi sifo yahlulwe izigaba ezine:

• okuthatha;
• primary
• zamabanga;
• Ephakamileyo.

Makhe sihlolisise ngokweenkcukacha.

okuthatha

Iimpawu negcushuwa ngolwimi ekuqaleni kwesi sifo bengekho. Eli nqanaba ebhekiswe, okuhlala ukusuka mzuzu mucosal umthondo leentsholongwane kwaye phambi kokuba uphawu lokuqala ezibonwayo.

Ngeli xesha, Treponema ukwandisa amanani abo baza ngokuthe ngcembe kwalutyhutyha ukuqukuqela nkovu ngawo umzimba. Amajoni omzimba nangoku nako ukuzigcina inxaxheba ekulweni, ukunciphisa kakhulu inani labo. Le woMntu akanayo kodwa uziva ukuba anesivumelwano naye, nangona abanye kuya kuba yingozi. Qhubeka okuthatha inokuba ukusuka iintsuku ezili-15 ukuya kuma-60. Igama avareji leentsuku 20-21 zicingeleka ingqalelo. Iimpawu ngokukhawuleza kuvela abantu buthathaka zezinye izifo (TB, AIDS, butywala). mpawu Ukulibaziseka kunokwenzeka ukuba isigulana ixesha negcushuwa uthatha antibiotics ngokubaphatha angina, ukuvuza ngaphantsi kunye nezinye izifo ezinxulumene.

ixesha lokuqala

Yena Iqala imbonakalo chancre, kwaye igcina nge umkakhe kunye ukubonakala yabangxamayo. Igama elithi "chancre" kuguqulelo evela Old French lithetha "buhlungu." Le Ukwakheka ngokuqhelekileyo yalula, zamahlathi, livela endaweni ukuqaliswa treponemes kwi kwithishyu. Phezu komhlaba chancre ukuze zilahlwe ukuba umsebenzi ukhukhuliseko intlungu. Ngokufanayo, oko kuboniswa kwixesha iphambili negcushuwa kulwimi. Ifoto ibonisa chancre phezu kobuso ulwimi. Yena uya kwizigaba ezininzi zophuhliso, kuqalwa kwindawo encinane ebomvu. Kwiintsuku ezimbini okanye ezintathu kwiziko layo kukho itywina, ngokuthe ngcembe kwandisa ubukhulu. Okuhamba, xa embindini chancre ngelaphu nekrotiruetsya kwaye ufumana obomvu (inyama) umbala.

Ukuba ukusuka kwindawo ukuthatha ukukrwela, iya kubonisa up amawaka treponemes. Ngamanye amaxesha, ulcer embindini chancre iquka ukutyabeka ezimhlophe. Xa indawo yayo kummandla ulwimi nezibaya kwezinye Abantu baphawula ukhukuliseko mqolomba. Xa ibekwe ngasemva ulwimi, yena ngokuqhelekileyo iphumela ngaphezu kwamanzi.

Enye into ebalulekileyo lymphadenitis wenqila (iindawo nkovu banzi). Ukuba negcushuwa yavela emlonyeni, nkovu kwamiliselwa iiprojekthi phantsi imihlathi kwandisa kwesilevu, yaye ngamanye amaxesha entanyeni.

Iimpawu xesha lokuqala

Izilonda elwimini e negcushuwa, ukuba akukho naziphi na ezinye iimpawu usuleleko (oluthile, ifiva, intloko ebuhlungu, njalo-njalo), izigulane ezininzi kuthatha nantoni na (umzekelo, stomatitis), kodwa hayi kwizifo ezidluliselwa ngeentlobano zesini. Oku kusebenza ngakumbi ebantwini, ukuba neentlobano zesini ezithandabuzekayo wathelela nendlu. Ngoko ke qala ukunyanga yezilonda zabo ezopulayo, kubhenca kuzo nge-ayodini. Treponem ezinjalo iindlela musa ukubulala, kodwa indoda chancre elwimini okanye kwezinye iindawo emlonyeni (on iintsini, imilebe) uba siyasulela kakhulu ngenxa iintsholongwane izilonda rhoqo ukungena ngamathe. Noko ke, xa ukhohlela okanye uthimla negcushuwa ukuba ayihambi kuphela ukwanga, idosha izitya.

Uhlalutyo RW (Wassermann reaction) kwinqanaba lokuqala inokuba lingalihle (imilo seronegative) kunye pluses abane HIV elibukhali (ifom seropositive).

ixesha lesibini

Uphawula yokuduka le chancre, ukuba abantu abaninzi ukuqonda njenge "angalulama stomatitis." Kule negcushuwa classical kwesi sigaba, kwamaqhakuvana ezintendeni zezandla, iinyawo, umzimba uphela. Ngaphezu koko, kuye kubekho umonakalo luvo. Ehlabathini iimpawu ezifanayo zikho kunye negcushuwa ngolwimi. Ifoto ibonisa Imbonakalo amabala rozeolnye ukuba angavela kunye papules (umonakalo). Ukuba kuvela kwisiza apho papillae ichazwa kakuhle, ukuba ezivelileyo ngasentla ancedisana ezingqonge ngokohlobo nakujoliso olutsha nombala kunye ichazwe ngokucacileyo okanye ngokugqwethekileyo, ezinemiphetho ezitsolo. Kodwa ke amaxesha amaninzi kwisiza ngokoyiswa le papillae abangekhoyo, ngoko papule uba ecwebezelayo, ezipinki-oluhlaza, ibekwe ngezantsi kumacandelo ezikufutshane. ndlela Ulwimi uqala ukuba zifane kophahla emnandi amaqhekeza ezahlukeneyo.

Ezinye izigulane ekuqaleni kwethuba lesibini kukho bubuthathaka, intloko ebuhlungu, ifiva, nto leyo ibonwa njenge abandayo okungephi. Oku "uphethwe" izigulane Balwakha ingakumbi siqinisekile, ukuba isicelo amabala confluent abomvu kwi tonsils nasemqaleni, kakhulu ngathi angina engenamsebenzi. Umahluko ephambili iza kuxhomekeka kukuba negcushuwa akukho ntlungu xa ukuginya.

ixesha lesibini iqala iiveki nama-9-10 emva kokosuleleka kunye 6 7 - emva chancre yokuqala, yaye ihlala iminyaka emibini okanye ngaphezulu. Kweli nqanaba, kukho ukusilela lwenkqubo enyama yangaphakathi, kunye irhashalala kunye amatshatshazi ulwimi kwi negcushuwa ngoko kungaphela ngokupheleleyo, ngoko ivele kwakhona.

tertiary

Xa imo lwesifo ukungahoywa lwenzeka woyiswa uninzi enyama yangaphakathi (ithambo, isibindi, intliziyo, udakada). Amajoni omzimba aba buthathaka kwaye isigulane akufuneki kakhulu kuchaphazela ekuhambeni sifo. Nangona kunjalo, lo exacerbation kunye noxolelo kwinqanaba ephakamileyo kufumaniseka ukuba aba lolu. Cause kubo ukwenzakala, ntshikilelo, ukungondleki, ezinye izifo, umzekelo, ingqele elemental.

ixesha Classically Elesithathu luqala emva kweminyaka 4.5-5.0 emva kokosuleleka, kodwa ke kukho iimeko ezininzi xa baqalisa iminyaka eli-10 okanye ngaphezulu. Uphawu engundoqo imbonakalo gummas zakhe ekuqaleni - node izihlunu, deforming kakhulu imizimba. Ulwimi ivela negcushuwa ephakamileyo pretty eqhelekileyo, ngoko ke asikwazi ngokuphosakeleyo ezinjengezifo ezidluliselwa ngeentlobano zesini kunye yengqele okanye umqala obuhlungu.

Gunma ngolwimi kungabangela nodular okanye glossitis kwentamo. Le yokugqibela ithathwa ingxaki ngokuqatha negcushuwa emlonyeni. Ulwimi umguli ngenxa kuyenye nokungena sikhula, iba luthe, nto leyo abayithandi yokubiza izandi. Koko, on-site nokungena kuvela kukuqulungana izihlunu, ulwimi uba amathupha ashinyeneyo ngakumbi mpuluswa ngaphezulu lazo, yaye ibonisa neentanda buhlungu, nangenxa yezilonda, nto leyo enokubangela ngamathumba amabi. Nangona ezi mpawu ekhathazayo, ingozi nomonde Phantsi kwabanye, njengokuba e Gunma treponem phantse apho.

ekuxilongweni

Negcushuwa ngolwimi i ugqirha nakho ukubona xa ibonwa zangaphandle, kodwa kaninzi isigulane emiselweyo inani wohlalutyo. Eyona eqhelekileyo, kodwa ke eyona engeyizizo - it RW. Eqongeni serological, unako ukunika yoko ezigxekayo isigulana yoluntu kunye nemiqathango esempilweni zakhayo ezifana:

• nokukhulelwa;
• tuberculosis;
• imalariya;
• izifo igazi;
• emva Ukubulawa;
• esexesheni.

PCR i uhlalutyo oluchanekileyo ngakumbi, kodwa inika impendulo ekunene kuphela zigaba eziziiprayimari neziziisekondari kuphuhliso negcushuwa. Ngaphezu koko, ukusabela ezo zisetyenziselwa lokufumana Treponema: RIBT, RIF, TPHA, sisigulo, RPR, RNC.

Akukho nanye kwezi ndlela olungachanekanga kwi-100%, ngoko ukuze ufumane isiphumo echanekileyo uqobo eyenziwa cazululo ezimbini. Kuba ukuziphatha nomonde ulahlekelwa igazi ukusuka apho iphuma khona ungatyanga. Uhlobo lwesibini zePCR negcushuwa iya kokuphalwa ukusuka chancre, irhashalala, papules kunye maqhuqhuva, kodwa rezultativen kuphela zigaba eziziiprayimari neziziisekondari esi sifo.

Iziphumo ezidibanisayo eboniswe "++++" okanye "+++". Oku kufuna enye uvavanyo lwembewu.

iziphumo imibuzo ekhethwe "++" okanye "+". Kulo mzekelo, uxilongo iphindiwe emva kweentsuku 10-12.

Unyango lwe negcushuwa kulwimi

Ekubeni pallidum umkhathalele kakhulu mercury ngenxa negcushuwa phambi kokuba iziyobisi ayibulale ezisekelwe kuyo. Ngenxa kwafunyanwa penicillin, apho pallidum nayo ethe kakhulu, lo mkhwa yinto elidlulileyo. Kuba iminyaka emininzi ukuze unyango negcushuwa usebenzisa iziyobisi penicillin. Kuphela xa isigulane sine-mngundo kubo, yokuba indawo yi "Erythromycin", "Cephalosporin" "Tetracycline". isicelo Ngamanye amaxesha aminoglikozity, abakwaziyo zinqanda ukukhula treponemes kwakhona, kodwa ke kufuneka kuthathwe ngeedosi eziphezulu kakhulu, akukhuselekanga ukuba umguli.

Ukongeza ekuphatheni abantu bene kunye negcushuwa, ukuba unesifo kwaye, ukuba kuyimfuneko, unyango ukuba bonke abaye zadibana kunye naye.

Outlook

Izigaba eziziiprayimari neziziisekondari kolwimi negcushuwa kunye nonyango olufanelekileyo waphilisa phantse-100%, kodwa kufuneka kukhunjulwe ukuba Treponema nako ukuzikhusela nxamnye intshukumo iziyobisi. Ukuba imeko injani kakubi ngenxa yabo, bayeka njengesiphango umsebenzi, ifomu cysts nokuqalisa ukuba alinde. Xa ngayo umntu kuyenzeka ubuza sifo, baphinda bakha imilo rhoqo helical aze aqalise nokuzala. Ngoko ke, emva kokugqiba unyango rhoqo emva kweenyanga ezi-3, izigulane kudlule zeesampulu uvavanyo. Kuthatha iminyaka emi-2. Emva koko omnye iimvavanyo nyaka uya kuba kanye qho kwiinyanga ezi-6. Emva koko uviwo epheleleyo yesigulane, kunye neziphumo kulungile liyasuswa kwirejista.

Inqanaba ephakamileyo negcushuwa ngoku athatha, kodwa waqala zizame ulwimi engasekho wachacha. Kwakhona, musa shwaka amanxeba stellate enzulu eseleyo emva gummas.