Meningoencephalitis (cututtukan mutumingitis): haddasawa, alamar cututtuka, ganewar asali da magani

Ciwon kwakwalwa na meningitis shine cututtukan hoto, cututtuka ko cuta na kwayan cuta wanda ke nunawa ta hanyar ƙonewa daga ƙwayoyin kwakwalwa da ƙwararre. Zai iya haifar da mutuwa idan baza ku ɗauki maganin gaggawa da maganin gaggawa ba.

Tarihi

Akwai ra'ayi cewa a lokacin Hippocrates da Avicenna sun sani game da wanzuwar wannan cuta. Za su iya warkar da ita? Maimakon haka, babu a'a, domin a cikin zamani na zamani, ba koyaushe yana iya ƙayyade matsala a lokaci ba kuma ya amsa da shi. An rubuta rubutun farko a cikin Scotland a shekara ta 1768, amma kuma haɗin kai da pathogen ba a bayyane yake ba. Wannan annoba ya fara magana a farkon karni na sha tara a Geneva, kuma kodayake ya gudanar da jimrewa, ba a karshe ba. A cikin shekarun da suka gabata kuma kafin karni na ƙarshe, ƙwaƙwalwar ƙwayar cuta ta mace ta bayyana a Afirka, Turai da kuma Amurka.

Har zuwa ƙarshen karni na ashirin, mace-mace daga maningitis ta kai kimanin kashi dari, amma bayan an samu nasarar amfani da penicillin a kan wannan cuta a 1944, yawan rayukan rayuka sun fara karuwa. Alurar rigakafi da kwayoyin cututtuka da kwayoyin cuta, da kuma sababbin kwayoyi glucocorticoid, sun taimaka.

Dalilin

Bisa ga alamar ilimin ilimin halitta, wannan cuta za a iya raba kashi uku:

- cututtuka (haɗari da wani pathogen);
- Sashin jiki mai cututtuka (cututtukan kwakwalwa na kwakwalwa na kwakwalwa don magance kamuwa da cuta, maganin alurar riga kafi ko cutar rheumatic);
- mai guba (daukan hotuna zuwa irritating abubuwa da ke haifar da kumburi).

Akwai kuma meningitis na farko da sakandare na biyu. Kamar yadda kake tsammani, ana kiran cutar ta farko, lokacin da kamuwa da kamuwa da cuta ke tsaye a kwakwalwa. Wannan yana faruwa tare da ciwo na ciki (bruises, bruises), cututtuka ko cututtuka. Maganar sakandare ya bayyana a matsayin mai wahala, misali, otitis, sinusitis, tarin fuka ko syphilis.

Epidemiology

A baya can, saboda yawancin mutane, rashin kula da tsabta da tsabtace jiki da rashin abinci mai gina jiki, yawancin maza da yara ke nunawa a cikin yara fiye da shekaru biyar. Amma yanzu irin waɗannan lokuta suna da wuya saboda ci gaba da magani da inganta yanayin rayuwa.

Mafi sau da yawa suna rashin lafiya a karshen hunturu ko farkon spring. A wannan lokaci, avitaminosis da rage rigakafi suna bayyana, da kuma canjin canji a zazzabi da zafi. Har ila yau ana taimakawa ta hanyar tsayawa a lokacin rufewa, ɗakunan da ba su da kyau.

Ciwon kwakwalwa mazaingitis yana da yawa, amma mafi sau da yawa yakan faru a kasashen Afirka. A Rasha, farkon cutar ta faru kafin yakin yakin duniya na biyu, na biyu a cikin shekaru 80 na karni na karshe, kuma na ƙarshe a shekarar 1997.

Causal wakili

Mafi yawancin su ne meningococcal da pneumococcal encephalitic meningitis. Streptococcus pneumoniae yana da fiye da tamanin antigenic nau'in. Jikin jikin kanta ba shi da lalacewa, ya fi son sararin samaniya, amma a yanayi mai tsanani zai iya ba da izinin oxygen na dan lokaci. Tsarin kwayoyin yana da kyau, tare da diamita kasa da micrometer, yana da lalata, ba shi da haɗi. Yana tasowa sosai akan jini a zafin jiki na jikin mutum. Hanyar kwakwalwa ta hanyar ƙwaƙwalwa ta hanyar ƙwaƙwalwa ta hanyar kwantar da hankali daga mutum mai rashin lafiya ko mutum mai kwakwalwa. Tsarin microorganism yana da matukar damuwa ga sakamakon kwayoyi, ciki har da maganin rigakafi.

Binciken

Kwayar ta fara tare da gaskiyar cewa pathogen ya shiga fili na numfashi na sama kuma an gyara shi zuwa ga mucosa na hanci ko oropharynx. Ka'idodin cuta da ke da pneumococcus (capsule, acidic teichoic, abu C) ya karfafa aikin samar da prostaglandins, kunna tsarin ci gaba da neutrophilic leukocytes. Duk wannan ba tare da haifar da meningitis ba. Dalilin da ya fito da shi ya fi zurfi. Inda magungunan suka wanke mucosa, mummunar tasowa a cikin hanyar otitis, maxillary sinusitis, frontal sinusitis, ko tonsillitis. Bacteria ninka, ƙwayoyin su yana ciwo da tsarin jiki na jiki, kuma tare da jini yana gudana cikin jiki, yana shafar zuciya, zane kuma, a tsakanin sauran abubuwa, harsashi na kwakwalwa.

Clinic

A cikin asibiti, siffofin uku sun bambanta, wanda ke ɗauke da ciwon ƙwayar cuta na meningitis:

- m, tare da adrenal insufficiency , kuma sau da yawa ne m.
- wanzuwa, lokacin da bayyanar cututtuka ta karu da hankali;
- maimaitawa, tare da ƙananan lokaci.

Ga mummunan nau'i, kwatsam na cikakkiyar jin daɗin rayuwa tare da tsayi mai kaifi a cikin zazzabi zuwa lambobi pyretic (kashi 39-40) halayya ce. Akwai alamar jiki, yalwa, cyanosis, yiwuwar hasara na sani da kuma cramps, kazalika da paresis na tsoka gashin ido. A cikin jariri da jarirai, tashin hankali yana nuna kansa a cikin wata murya marar ɗitawa. By kara intracranial matsa lamba na iya zama wani, sãɓã wa jũnamai sutures na kwanyar da bulging fontanelle. A rana ta biyu na rashin lafiya akwai halayyar meningeal bayyanar cututtuka, kamar m wuyansa tsokoki. Bayan kwana uku zuwa hudu, mai haƙuri ya fada cikin haɗari, da kuma cigaba da edema (saboda mummunan motsawa) yana haifar da ƙarancin kwakwalwa.

Meningeal bayyanar cututtuka

Wadannan alamomi ne wadanda ke da halayyar ƙonewa daga cikin kwakwalwa. Suna bayyana kansu a cikin sa'o'i na farko bayan da cutar ta fara da kuma taimakawa wajen gano asali.

1. Matsayin kare (shugaban da aka mayar da shi, ƙwayoyin da ke jikinsa).
2. Ƙunƙarar wuyan wuyansa da kuma occiput (baza a iya kwantar da kansa ga likita ba saboda yiwuwar ƙarar daɗaɗɗen tsoka).
3. Alama Kernig (likita bends da kafa na daga cikin haƙuri a da kwantangwalo da gwiwa, amma a lokacin da ka yi kokarin daidaita shi hadu da juriya).
4. Hakanan mafi girma na Brudzinsky (tare da kunnen kansa yana da jawo kafafu zuwa ga akwati).
5. Average alama Brudzinskogo (kafar lankwashewa a latsa a suprapubic yankin).
6. Ƙananan bayyanar Brudzinsky (tare da musawa na kafa ɗaya na biyu kuma an kawo shi ciki).
7. Sakamakon ƙananan abu (ƙuƙasa yaro, yana tallafawa gajerun, yayin da ƙafafuwansa suna gugawa akan jiki).
8. Symptom of Mondonzi (matsa lamba mai zafi a kan eyesballs).
9. Symptom of Bechterew (ciwo yayin da yake tafe tare da zygomatic baka).
10. Hannun kamuwa da kamuwa da fuska, haske da sauti.

Yara

Domin ya fara tasawa yana da wuya a canja wurin irin waxannan cututtuka kamar encephalitis meningitis. Sakamakon a yara za su iya zama ma fi ban tausayi saboda sun wuya koka da cuta, cizon kwari ba su lura, kuma suna da rage rigakafi. Yara suna rashin lafiya fiye da 'yan mata, kuma cutar ta fi wuya.

Don kare yaronka, kana buƙatar yin ado da shi a cikin bazara da lokacin kaka, lokacin da za ka ga likita a wata alamar ƙwayar cuta da kowane sa'o'i biyu don duba shi a kan titi a lokacin rani don cin nama da sauran ƙwayoyin cutar jini.

Diagnostics

Da farko, yana da mahimmanci ga likita don tabbatar da ganewar asali na "meningitis". Shin marar lahani? Tabbas. Saboda haka, dole ne a sanya mai haƙuri a cikin wani akwati dabam ko kuma a cikin sashin cutar, bayan gudanar da bincike na annoba. Sa'an nan kuma akwai buƙatar ka tattara kayan aikin rayuwa da lafiyarka, koyi gunaguni. Binciken jiki yana kunshe da duba abubuwan alamomi da auna yawan zafin jiki. Don gwaje-gwajen gwaje-gwaje, ana ɗaukar jini da giya.

A cikin cikakken nazarin jini akwai karuwa a cikin matakin leukocytes tare da yawancin siffofin ƙwayoyin cuta, da rashin eosinophils kuma ya karu da ESR har kusan sittin miliyon kowace awa. Rashin ruwa zai zama damuwa, tsalle, tare da tinge. Tsarin tsaka-tsalle da furotin suna rinjaye shi, kuma yawan glucose an rage. Don ƙayyade wakili mai tasowa, jini, sputum ko gurasar ganye suna shuka a kan ƙwayar mai gina jiki.

Jiyya

Idan likita ko gaggawa dakin shiga da ake zargi meningitis encephalitis, da mãsu haƙuri asibiti nan da nan a cikin wani neurological asibiti. Jiyya yana farawa a lokaci guda, ba tare da jiran dakatar da gwaje-gwaje akan ganewar asali ba. Nuna tare da babban gado barci, high-kalori rage cin abinci.

Fara da bayyanar cututtuka da farfadowa na pathogenetic. Da farko, kana buƙatar tsarkake jikin toxins, wanda ke haifar da kwayoyin cuta, da kuma rage matsa lamba intracranial da jinin jini. Saboda wannan, mai haɗin gwiwa an yi masa inji tare da saline da glucose da diuretics. Saboda cikewar ambaliyar jiki mai tsanani zai iya haifar da mummunar ƙwaƙwalwar ƙwaƙwalwa da kuma mutuwar nan take. Bugu da kari, kwayoyi don inganta microcirculation, vasodilators da nootropics suna goyan bayan aikin kwakwalwa.

Ilimin ilimin halitta yana kunshe da maganin kwayoyin cutar (benzylpenicillins, fluoroquinolones, cephalosporins).

Sakamakon

Dukkan ya dogara ne akan yadda sauri da nasara ya fara maganin meningitis encephalitic. Sakamakon zai iya zama maras amfani idan an bayar da taimako a lokaci mai dacewa. Kuma a lokaci guda, tare da tsananin mummunan yanayin cuta, lethality ya kai kashi arba'in. Dalilin da wannan zai iya zama da yawa:

- edema na kwakwalwa da kwashe shi;
- insufficiency cardiopulmonary;
- sepsis;
- DIC-ciwo.

Rigakafin

Za a iya hana ƙananan ƙwaƙwalwa ta mutum ta hanyar maganin yara daga yara biyu zuwa biyar a cikin wadanda ke hadarin. An kuma bada shawara ga mutane bayan shekaru sittin da biyar. Wannan maganin rigakafi ne na sashen maganin alurar rigakafin WHO wanda ke amfani da shi a mafi yawan ƙasashe na duniya.

A halin yanzu a kasashe uku na duniya kasashen duniya suna jin tsoro game da ganewar asali na "meningitis encephalitic". Za a warkar da shi? Haka ne, hakika. Amma nasara ya dogara da yadda aka ba da taimako da sauri kuma ta yaya.