Khawv koob hauv me nyuam. Cov tsos mob thiab kev kho mob ntawm croup nyob rau hauv cov me nyuam

2024 Tus sau: Priscilla Miln | [email protected]. Kawg hloov kho: 2024-02-18 01:57

Ib kab mob ntawm txoj hlab ntsws uas ua rau lub ntsws stenosis yog hu ua croup hauv kev kho mob science. Tus kab mob no yog nrog los ntawm cov tsos mob nram qab no: ua tsis taus pa luv, hoarseness, "barking" hnoos, ua tsis taus pa luv. Croup nyob rau hauv ib tug me nyuam yog tsis tshua muaj. Raws li txoj cai, nws tshwm sim tawm tsam keeb kwm ntawm ntau yam kab mob sib kis. Hauv tsab xov xwm no, peb yuav ua tib zoo saib cov ntsiab lus tseem ceeb hais txog qhov teeb meem xws li croup hauv menyuam yaus.

Yog vim li cas

Cov kab mob uas tau hais ntau zaus tshwm sim nyob rau hauv ntau yam kab mob xws li qhua pias, mob khaub thuas, kab mob khaub thuas, tuberculosis, typhoid fever, syphilis. Txawm hais tias tus kab mob banal mob ua pa tuaj yeem ua rau tus kab mob no. Feem ntau, croup tshwm sim raws li qhov teeb meem ntawm diphtheria. Qee zaum, herpes yooj yim tuaj yeem ua rau tus kab mob. Nyob rau hauv cov ntaub ntawv no, nrog rau o ntawm mucous daim nyias nyias ntawm lub larynx thiab hyperemia, ib tug pob liab liab yuav tshwm sim. Ua ntej, cov no yuav tsum tau dotted papules, thiab tom qab ntawd - yaig, npog nrog ib zaj duab xis daj-dawb nyias. Koj yuav tsum tsis txhob txo qis xws li ecology tsis zoo, huab cua dependence, nrog rau huab cua. Feem ntau, tus kab mob no tau kuaj pom hauv cov menyuam yaus nyob hauv thaj chaw muaj kev lag luam (kev qias neeg),ib yam li nyob ze cov kev loj uas qias neeg. Lub luag haujlwm tseem ceeb hauv qhov tshwm sim ntawm pathology yog ua si los ntawm kev hloov pauv hauv kev ua haujlwm ntawm tus menyuam lub cev. Yog vim li cas rau qhov no yog ntau yam para- thiab malnutrition, encephalopathy, rickets, thymic-lymphatic xwm txheej, exudative diathesis, pneumonia thiab neurological pathologies. Qee cov menyuam yaus uas muaj croup muaj keeb kwm ntawm kev ua xua los yog khoom noj khoom haus, ua xua, lossis hawb pob.

Leej twg txaus ntshai?

Cov kab mob kis tau ntau tshaj plaws hauv cov menyuam yaus hnub nyoog qis dua peb xyoos. Qhov no yog vim lub anatomical thiab physiological qauv ntawm lub pa system ntawm cov me nyuam mos. Hauv cov menyuam yaus ntawm pawg hnub nyoog no, lub lumen ntawm lub larynx yog qhov nqaim ntau, thiab cov ntaub so ntswg pob txha yog ntau pliable thiab sib tw tshaj li cov neeg laus. Cov suab lus luv luv. Cov txheej submucosal muaj cov ntaub so ntswg xoob xoob. Yog vim li cas, nrog rau qee qhov chaw ntawm txoj hlab pa, edema feem ntau tshwm sim, ua rau lub lumen ntawm lub larynx.

Pathogenesis

Lub larynx hauv tus menyuam lub cev ua lub suab tsim, ua pa thiab tiv thaiv kev ua haujlwm. Ib qho kev nqaim ntawm nws tuaj yeem ua rau muaj kev ua txhaum ntawm patency ntawm lub siab ua pa, nrog rau cov pa oxygen tshaib plab ntawm lub cev tseem ceeb (lub plawv, hlwb, ob lub raum, thiab lwm yam). Croup nyob rau hauv ib tug me nyuam yog tshwm sim ntawm o. Cov kab mob, edema, necrosis, superficial yaig, ua rau lub mucosa, ua rau ib tug reflex spasm ntawm cov leeg ntawm lub larynx. Nrog rau stenosis, oxygen deficiency feem ntau tshwm sim, hom kev ua pa ntawm huab cua ntawm sab sauv yog cuam tshuam.kab mob ua pa. Tom qab ntawd muaj metabolic thiab ua pa acidosis, hypoxemia, cerebral edema. Cov kab mob no ua rau nyuaj rau kev mob stenosis.

Croup hauv me nyuam: cov tsos mob

thawj qhov tsos mob tshwm sim thaum hmo ntuj. Lawv cov tsos mob tshwm sim los ntawm anatomical thiab physiological yam tseem ceeb: nyob rau lub sij hawm no, muaj lub suab nrov ntawm lub paj hlwb parasympathetic, nyob rau hauv ib txoj hauj lwm kab rov tav, raws li txoj cai, lub ntsws ntws tawm zuj zus. Feem ntau, croup hauv tus me nyuam pib kub taub hau (txog 39 degrees).

Nws kuj tau los ntswg. Tsis pub dhau kaum ob mus rau plaub caug yim teev muaj ib tug "barking" hnoos ntxhib, reminiscent ntawm nto qaub ncaug. Feem ntau nws yog nrog los ntawm kev ua pa ntxiv, retraction ntawm intercostal qhov chaw, stridor. Nyob rau tib lub sijhawm, thaum quaj, hnoos tsuas yog intensifies. Hauv kev kuaj mob, tus kws kho mob sau tseg qhov nqaim ntawm lub ntsws thiab lub ntsws. Qhov no ua rau cov tsos ntawm lub suab nrov ua pa, nyob rau hauv uas nws yog ib qho nyuaj heev rau tus me nyuam ua tsis taus pa, nrog rau hoarseness thiab hoarseness. Thaum raug huab cua txias thiab ntub dej, cov tsos mob tau zoo.

Cim kab mob diphtheria croup

Cov tsos mob tseem ceeb yog maj mam nce hauv stenosis, ua rau muaj kev pheej hmoo ntawm qhov mob hnyav. Cov cim qhia kuj yog "tshuaj lom" pallor ntawm daim tawv nqaij, hoarse, thiab tom qab ntawd ntsiag to hnoos. Los ntawm lub qhov ntswg, vim paresis ntawm palate, kua yuav ntws. Croup nyob rau hauv cov me nyuam, cov tsos mob ntawm uas yog heev unpleasant, yog yus muaj los ntawm tsim ib tug grey-qhuav txheej ntawm lub tonsils. Nyob rau hauv cov ntaub ntawv no, ib tug putrefactive tsw feem ntau yog los ntawm lub qhov ncauj. Nws yuav tsum tau muab sau tseg tias thaum hmo ntuj, ib tug sai deterioration nyob rau hauv tus mob yog ua tau, ua rau ib tug tsis tshua muaj heev tshwm sim, mus txog rau ib tug tuag taus tshwm sim. Yog li ntawd, yog tias kuaj pom cov tsos mob tshwm sim, lub tsheb thauj neeg mob yuav tsum raug hu tam sim.

Diagnosis

Nws tuaj yeem txheeb xyuas qhov mob, qhov laj thawj tseem ceeb ntawm cov kab mob kis, hauv cov menyuam yaus siv txoj hauv kev endoscopic. Thaum kuaj lub larynx, lub mucous membrane zoo li o, hyperemic, yooj yim raug mob. Nyob rau tib lub sijhawm, edematous rollers yog pom nyob rau hauv qhov chaw subglottic. Cov contours ntawm bronchial thiab tracheal rings yog smoothed. Mucopurulent exudate yog nyob rau hauv qee kis scanty thiab kua, tab sis ntau zaus nws yog tuab thiab khov. Heev feem ntau fibrous thiab necrotic imposings yog tsim. Tom qab tshem tawm cov plaque thiab cam khwb cia, lub lumen ntawm trachea ua dav. Txawm li cas los xij, nws cov phab ntsa yog qhov txhab los ntshav tas li. Inflammatory o ntawm lub mucosa ua rau lub qhov ncauj ntawm lub bronchi ua slit-zoo li, thiab hnoos qeev (purulent) tawm ntawm qhov tob.

Tests

Hnub no, txoj kev kuaj mob serological ntawm croup tau txais qhov tseem ceeb heev. Nws yog raws li kev siv cov tshuaj tiv thaiv kab mob rau qee yam kab mob thiab kab mob. Txoj kev PCR (polymerase saw cov tshuaj tiv thaiv) kuj tau siv dav. Txawm li cas los xij, txoj kev no yuav siv tau tsuas yog yog tias cov khoom siv biomaterial raug coj los ntawm oropharynx thaum ntxov (hauv lub sijhawm mob). Nrog kev pab los ntawm kev kuaj ntshav, cov kev hloov pauv tsis tshwj xeeb tuaj yeem kuaj pom. Yog li, nrog cov kab mob croup, leukocytosis tau pom, nrog cov kab mob croup - leukopenia. Rau kev kuaj pom tseeb dua, nrog rau hauv rooj plaub ntawm kev ua xyem xyav ntawmqhov tshwm sim ntawm cov teeb meem, X-ray txoj kev yog siv (duab ntawm lub ncauj tsev menyuam cheeb tsam, paranasal sinuses, hauv siab, thiab lwm yam). Lwm txoj kev yog kev kuaj mob sib txawv. Ntawm no lub luag haujlwm tseem ceeb yog ua los ntawm cov duab kho mob ntawm tus kab mob. Lub xub ntiag ntawm cov kab mob yav dhau los uas tuaj yeem ua rau qhov teeb meem no kuj raug coj mus rau hauv tus account.

Txoj Kev Kho Mob

Nws pom zoo kom coj tus menyuam mus rau tus kws kho mob sai li sai tau. Kev kho mob ntawm croup nyob rau hauv cov me nyuam yuav tsum yog feem ntau yog aimed ntawm relieving o ntawm txoj hlab pas. Niaj hnub no, kev npaj tshuaj hormonal yog siv rau cov laj thawj no. Nws raug nquahu kom noj lossis dej rau tus menyuam kom ntau li ntau tau kom tsis txhob muaj dej. Koj tuaj yeem txo qhov kub thiab txo qhov mob nrog ibuprofen lossis paracetamol. Nyob rau hauv rooj plaub no, koj yuav tsum ua tib zoo nyeem cov lus qhia hais txog kev noj ntau npaum li cas lossis nrog tus kws kho mob txog qhov no. Koj tuaj yeem siv cov tshuaj antispasmodics, xws li Baralgin, Maksigan, Snazgan, thiab lwm yam. Nyob rau tib lub sijhawm, nws raug nquahu kom muab crumbs mus txog rau ib xyoos 1/3 ntawm ib ntsiav tshuaj, thiab cov menyuam loj - 1/2. Cov tshuaj decongestants thiab antitussive tshuaj yuav tsis pab kho croup nyob rau hauv ib tug me nyuam, tab sis lawv yuav zoo heev alleviate tus mob ntawm tus me nyuam. Nov yog thawj kauj ruam uas koj tuaj yeem ua ua ntej tus kws kho mob tuaj txog. Koj yuav tsum xyuas kom meej tias huab cua txias nkag rau hauv chav.

kho mob hauv tsev

Nyob rau theem resuscitation, lub hom phiaj yog los kho cov pa patency thiab tiv thaiv toxicosis los ntawm tus kab mob sib kis. Rau cov noLub hom phiaj, txoj kev ntawm nasotracheal intubation yog siv. Cov lus qhia rau nws siv yog cov hlab plawv thiab ua pa tsis ua haujlwm los ntawm stenosis ntawm lub larynx 2, 3 thiab 4 degrees, nrog rau kev nce hypoxia thiab hypercapnia.

Intubation yog ua raws li kev tshuaj loog. Txawm li cas los xij, txoj kev no kuj muaj nws qhov tsis zoo. Ua ntej tshaj plaws, cov no yog postintubation chondroperichondritis ntawm trachea thiab larynx, ua rau cicatricial stenosis. Txhawm rau tiv thaiv cov teeb meem zoo li no, nws raug nquahu kom siv cov raj thermoplastic tshwj xeeb. Tsis tas li ntawd, kev kho mob ntawm croup hauv cov menyuam yaus yog qhov xav tsis thoob yog tias tsis muaj kev kho tshuaj tua kab mob txaus, uas yog kws kho mob tau sau tseg, raws li tus neeg mob tus yam ntxwv ntawm tus menyuam. Nrog rau tus kab mob no, raws li txoj cai, cov tshuaj hormonal raug sau tseg uas ua rau kom sai sai ntawm stenosis tshwm sim los ntawm qhov o ntawm cov mucous daim nyias nyias ntawm lub larynx. Qee zaum, cov neeg mob tau txais cov tshuaj glucocorticoid. Yog tias thawj ob teev tom qab noj cov tshuaj hormones lawv cov txiaj ntsig tsis pom, kev siv cov tshuaj ntxiv no tsis pom zoo. Hauv kev sib ntaus tawm tsam toxicosis, infusion kho yog siv.

Kev kho mob rov tshwm sim

Hauv tus kab mob no, siv cov tshuaj bronchodilators, mucolytics, etiotropic thiab tshuaj tiv thaiv kab mob. Metered dose inhalers muaj txiaj ntsig. Kev saib xyuas tshwj xeeb yuav tsum tau them rau kev tshem tawm ntawm edema uas provokes spasms. Cov tshuaj mucolytic yuav pab ua kom lub cev ua haujlwm ntawm lub ntsws. Secretolytics ("Ambroxol" thiab "Bromhexine") pab txhawb rauliquefaction ntawm hnoos qeev, txhawb kev tsim ntawm surfactant nyob rau hauv lub ntsws. As

Cov tshuaj tiv thaiv kab mob, feem ntau yog siv cov tshuaj cromolyn. Tom qab tso tseg qhov mob tshwm sim ntawm croup, txhawm rau tiv thaiv kom tsis txhob muaj lub bronchi thiab cov hlab ntaws, nws yog ib qho tsim nyog yuav tsum tau ua kev kho mob ntev (kwv yees li ob lub hlis) nrog H1 receptor blockers (cov tshuaj "Cetirizine"). Thaum lub sij hawm ntawm convalescence, cov tshuaj immunostimulating yog muab. Lawv txoj kev xaiv nyob ntawm lub hnub nyoog ntawm tus menyuam, muaj cov kab mob etiotropic, qhov tshwm sim ntawm cov txheej txheem inflammatory. Cov tshuaj no suav nrog "Bronchommunal" thiab interferon npaj. Tib lub sijhawm, kev kho mob tom qab tso tawm hauv tsev kho mob yuav tsum yog tsawg kawg ib hlis.

Kev tiv thaiv ntawm croup

Qhov tseem ceeb yuav tsum tau them rau kev ua kom tus menyuam tawv. Koj yuav tsum nquag taug kev nrog tus menyuam hauv huab cua ntshiab. Qhov no yuav pab txhim kho kev ua haujlwm ntawm kev ua pa sab saud thiab ntxiv dag zog rau lub cev tiv thaiv kab mob. Koj tuaj yeem ua kom tawv nqaij ntawm caj pas. Ua li no, yaug nws txhua hnub nrog dej txias, maj mam txo qhov kub ntawm cov kua. Txawm li cas los xij, hauv qhov no, tsis txhob maj. Txoj kev hloov kho yuav tsum siv sijhawm tsawg kawg yog ob lub hlis. Hauv qhov kawg version, dej kub yog li 14-15 degrees. Rau cov menyuam yaus, cov dej khov resorption tuaj yeem siv los ua kom tawv. Dej yog qhov zoo tshaj plaws khov rau hauv ib daim ntawv nrog cov hlwb me, tom qab sib tov nrog kua txiv qaub. Tus me nyuam tuaj yeem muab tau ib lub thawv rau ib hnub.

Kev tiv thaiv kab mob kis rau menyuam yaus yog ua raws li cov hauv paus ntsiab lus ntawm kev noj zaub mov kom raug thiab siv cov vitamins. Qhov no yuav pab ntxiv dag zog rau lub cev tiv thaiv thiab yuav pab txhawb kev loj hlob ntawm tus menyuam kom raug thiab noj qab nyob zoo. Nws yog qhov tseem ceeb heev kom noj zaub tshiab thiab txiv hmab txiv ntoo, haus tshuaj ntsuab tshuaj yej thiab decoctions. Lawv yuav tsis tsuas yog ntxiv dag zog rau lub cev tiv thaiv kab mob, tab sis kuj tseem pab tiv thaiv kev kis kab mob thaum ntxov thiab cov kab mob uas tau tshwm sim. Nws raug nquahu kom muab cov khoom noj uas muaj vitamin C thiab A rau koj tus menyuam noj fermented mis nyuj noj qab nyob zoo, tshwj xeeb tshaj yog nyob kefir.

Nws yog ib qho tseem ceeb uas huab cua hauv chav tsev sov thiab tshiab. Nyob rau tib lub sijhawm, ib qho av noo yuav tsum tau khaws cia. Tsis txhob hnov qab txog cov cai ntawm kev nyiam huv. Thiab kev haus luam yeeb ze ntawm tus menyuam yog txwv tsis pub. Nws tseem tsis pom zoo kom siv cov roj tsw qab, tswm ciab, thiab lwm yam hauv chav uas tus menyuam nyob, lawv tuaj yeem ua rau ua pa hnyav.