Bronchial asthma pathogenesis ndi etiology

Bronchial asthma ndi matenda aakulu ndipo, monga lamulo, episodic. Imeneyi ndiyo njira yowopsya kwambiri. Kutupa kwambiri kumabweretsa kuwonjezeka kwamphamvu kwa bronchi kuti zikhale ndi zosiyana za chilengedwe.

Matendawa angakhale obadwa kapena opezeka. Tidzakambirana za chifuwa cha mphumu - pathogenesis, kuchipatala, kuchiza matendawa. Zonsezi ndi zofunika kwambiri kudziwa ndi kuphunzira bwino ngati pali munthu m'banja yemwe akudwala matendawa.

Mfundo zazikulu

Ichi ndi matenda aakulu omwe amalepheretsa kupuma bwinobwino chifukwa cha njira zochepa zopita kumapapo. Mipikisano ikhoza kudutsa mwachindunji, koma pamunda wovuta kwambiri, mankhwala okha ndi othandiza. Kodi pathogenesis ndi chifuwa chachikulu cha mphumu? Chiwopsezo cha matendawa ndi chakuti, chifukwa cha kuchuluka kwa ntchentche zomwe zimatulutsa, kutupa kwa mpweya ndi kutupa kumapangitsa makoma a bronchus, ndipo kusiyana pakati pawo kumakhala kochepa. Chotsatira chake, mpweya sungaperekedwe mokwanira, zomwe zimayambitsa kuzunzidwa mwatsatanetsatane wa kufooka, kukhwima, kuwomba ndi zizindikiro zina zowala za mphumu.

Kuchokera ku matendawa, malinga ndi chiŵerengero, 5% mwa anthu a ku Ulaya, achinyamata omwe amavutika kwambiri. Monga lamulo, awa ndi ana osakwana zaka khumi. Ngakhale kuti mankhwala akufufuza nthawi zonse za matendawa, omwe amachititsa chitukuko chake, chithandizo chake ndi chitetezo sichimvetsetsedwe. Kafukufuku wamatsenga ndi tizilombo toyambitsa matenda a mphumu yowonongeka nthawi zambiri amapanga asayansi pamapeto. Koma kodi matendawa amakula bwanji?

Pathogenesis wa bronchial mphumu

Pathogenesis - njira ya chitukuko cha matenda - ili ndi magawo awiri:

• Immunological. Pomwe chitetezo cha chitetezo chimalowa mu chitetezo cha mthupi, kutupa kwa mucous memphane kumapezeka.
• Pathophysiological. Zochitika zachilengedwe zowonongeka kwa njira yotupa yomwe imapezeka mu thupi.

Mmene mawonekedwe a bronchospasm amawonekera motere: Nthawi yayitali mu mucosa wa mtengo wa bronchial umakhudzidwa ndi chikoka. Kutupa koopsa, ndipo pali hypersecretion, yomwe imayambitsa kugwedezeka. Kodi chimachitika n'chiyani ku thupi mukukula kwa mphumu yakufa?

Pathogenesis ikuphatikiza ndi mavuto otsatirawa:

• Hyperestrogenemia, zomwe zimachititsa kuti chiwerengero cha α-adrenergic receptors chiwonjezereke komanso kuchepa kwa opaleshoni ya β-adrenergic. Ndi zochitika zakunja za allergen yomweyo ndi njirazi, bronchospasm ikukula.
• Kulephera kwa glucocorticosteroid kumawonjezera kuchuluka kwa mbiri ya histamine ndi bronchus tone, yomwe imakhala yovuta kukhumudwitsa.
• Hyperthyroidism. Matendawa akuwonjezeka ndipo akukula mwamsanga mwa anthu omwe awonjezera kuchuluka kwa mahomoni a chithokomiro.

Pathogenesis ya kupwetekedwa kwa mphutsi yodziwika ndi matenda a chidziwitso. Kusintha kumene kumachitika m'thupi kungakhale mkati ndi kunja. Zinthu zakunja zomwe zimakhudza chitukuko cha matenda:

• Chikhalidwe chaumoyo;
• Kusokonezeka;
• Zochita zathupi;
• Kuwonetsedwa kwa zoletsedwa;
• Chikoka cha mankhwala osokoneza bongo;
• Nyengo yoipa.

Zowonjezera:

• Kusokonezeka mu dongosolo la endocrine;
• Kufooketsa chitetezo chochepa;
• Kutentha kwambiri.

Dothi lapanyanja ndi limodzi la anthu opondereza kwambiri, omwe amatsogolera ku mphumu. Lili ndi tizilombo ting'onoting'ono, zomwe zimakhala zovuta kwambiri.

Kukhwima Kwambiri

Ngakhale kuti pathogenesis ya chifuwa chachikulu cha mphumu ndi matenda, ndizofunika kuti mutengepo kanthu mwamsanga. Kuukira kungakhale kochepa kapena kumatha kwa maola angapo. Pambuyo pake, wodwalayo amakhala bwino, ndipo zikuwoneka kuti akuchiritsidwa.

Zonse zimatengera gawo la matendawa. Munthu akhoza kulepheretsedwa pang'ono ndi ndege. Gawo lalikulu likhoza kudziwonetsera lokha mkati mwa masiku angapo ndikupita masabata angapo. Fomu iyi imatchedwa asthmatic status. Kuphulika kotereku ndi koopsa ndipo kungayambitse zotsatira zake.

Kwa mtundu uliwonse wa pathogenesis, pali njira zowonongeka. Mwachidziwikire, tingathe kusiyanitsa kusintha kwa reactivity ndi kukhudzidwa kwa bronchi, kuyesedwa pogwiritsa ntchito thupi kapena mankhwala.

Pamene chifukwa chake ndi chibadwidwe

Munthu wokhala ndi chibadwa cha mphumu ndi mphumu sangamve kuti ndiwonekera, kapena izi zidzamveketsa pa msinkhu uliwonse:

• 50% - zaka za ana (mpaka zaka 10);
• 30% - mpaka zaka 40;
• 20% pambuyo pa zaka 50.

Choloŵa choloŵa ndicho chomwe chimayambitsa chitukukochi. Ngati makolowa akudwala mphumu, ndiye kuti nthendayi imatha kuperekedwa kwa mwanayo ndi 30%. Komabe, matenda okhaokha sangathe kuwonetseredwa, ayenera kukhumudwa ndi chinachake.

Izi zikutanthauza kuti, kuphatikizapo mkati, zowonjezera ndi zowonongeka, chiopsezo choyambitsa matenda opatsirana chimakula pang'onopang'ono.

Zochititsa mantha za mphumu

Njira za kupuma kwa anthu omwe akudwala mphumu yowonongeka ndizovuta kwambiri. Zinthu zowononga zomwe zimayambitsa kupweteka zimatchedwa oyambitsa m'njira ina:

• Zinthu zakuthambo;
• Chilengedwe;
• Nyama, nkhungu, bowa;
• Zosokoneza mtima;
• Kuchita masewera olimbitsa thupi;
• Kusuta, utsi wa fodya;
• Mankhwala;
• Zakudya zakudya;
• Zipangizo za nyumba;
• Nyama.

Munthu aliyense amakhala ndi pathogenesis yosiyana ya mphumu yowonongeka, kupweteka kungayambitsidwe ndi chinthu chimodzi kapena zambiri.

Zotsatira za kunja

Kawirikawiri, mphumu ndi zifukwa zingapo zomwe zimagwira nthawi imodzi pathupi. Iwo amagawidwa m'magulu angapo:

• Kutengera;
• Allergens;
• Zosokoneza makina ndi mankhwala;
• Zinthu zakuthambo;
• Mankhwala.

Zonsezi zimaphatikizapo fumbi la nyumba, mungu wa zomera, chakudya, mankhwala, tizilombo, nyama. Tizilombo toyambitsa matenda: mabakiteriya, mavairasi, bowa. Mankhwala ndi mankhwala osakaniza: phulusa kapena silicate fumbi, utsi, nthunzi za alkali ndi acids. Zomwe zimapangitsa kuti nyengo isinthe komanso kusokonekera kwa nyengo.

Kuthamangitsa asthma kungayambe b-adrenoblockers, yogwiritsidwa ntchito polimbana ndi matenda oopsa kwambiri, mankhwala opangira mphamvu komanso anti-inflammatory drugs. Ndilimbana ndi matendawa, zimayambitsa kusintha.

Pamene vuto liri mkati

Kukula mphumu yowonongeka kungatheke chifukwa cha kusokonezeka kwa chitetezo chokwanira, chitetezo cha endocrine, kagayidwe ka shuga, kuwonjezereka kwa ntchito za mapuloteni mu bronchial mucosa, zopweteka mu dongosolo la mitsempha. Zizindikiro zonsezi ndi zotsatira za njira yolakwika ya moyo, matenda opatsirana omwe amachititsa kuti akhale ndi matenda opatsirana.

Etiology ya chifuwa chachikulu cha mphumu

Mankhwala a etiology ndi tizilombo toyambitsa matenda a mphumu yowonongeka ndi yakuti matendawa ndi osagwirizana ndipo amagwirizanitsa ndi matenda ndi matenda omwe amachititsa kuti matendawa asokonezeke. Komabe, ndikofunika kuzindikira kuti kusiyana kumeneku kumakhala kochititsa chidwi komanso kumakhudza magulu a anthu.

Ponena za msinkhu wa maselo, pathogenesis ya mphumu yowonongeka ndi ya mitundu iwiri: yowopsya komanso yapadera. Yoyamba, monga lamulo, ikukhudzana ndi mbiri ya banja ya matenda otere:

• Eczema;
• Rhinitis;
• Zotsatira za mapepala a erythematous;
• Urticaria.

Kuwonetsa koyamba kwa matendawa kungakhale limodzi ndi zizindikiro zofanana ndi chimfine, koma patatha masiku ochepa pamakhala mpweya wochepa, kulira mluzu, kuwomba ndi zizindikiro zina za mphumu yakuda.

Zizindikiro

Malingana ndi mlingo wa kuuma ndi mawonekedwe, mphumu yowonongeka ili ndi zizindikiro zosiyana. Etiology, pathogenesis, mndandanda amapangidwa ndi zizindikiro zotchulidwa ngati chifuwa chaching'ono, kupuma, kupuma pang'ono, kupweteka pamtima kapena kupweteka . Ndi zizindikiro zomalizazi, kuyeza kwa dokotala ndi njira yofunikira komanso yofunika kwambiri.

Mukamaliza kukambirana ndikupeza kuti matendawa amapangidwa, kawirikawiri inhaler imatchulidwa. Koma pazochitikazi, pamene ntchito yake imagwiritsidwa ntchito mobwerezabwereza kuposa momwe adalembedwera, m'pofunika kuti nthawi yomweyo mupeze thandizo kwa dokotala yemwe akuyang'anira.

Ngati zizindikiro sizidutsa mkati mwa masiku 1-2, ndipo inhaler sizithandiza, kuchipatala kudzafunika. Panthawi yovutitsidwa ndi kuyankhula ndi mavuto, ambulansi imatchedwa.

Zizindikiro Zogwirizana

Panthawi ya kuwonjezereka, wodwalayo ali ndi kuchuluka kwa momwe amachitira ndi zofukiza zonunkhira ndi kusintha kwa kutentha. Izi zikusonyeza njira yotupa ndi kuyambitsa mankhwala. Chimodzi mwa zizindikiro zochititsa chidwi kwambiri ndi kusintha kwa matendawa pogwiritsa ntchito antihistamines ("Zirtek", "Tsetrin", ndi zina zotero). Zizindikiro zina:

• Umaliseche, kumutu;
• General malaise ndi kufooka;
• Tachycardia (kugunda kwa mtima mwamsanga);
• Kuphulika kwa khungu;
• Zizindikiro za emphysema.

Thandizo lachikhalidwe silingathe kuchotsa chikhalidwe cha asthmatic, kuukira kumeneku kumaphatikizapo kufooka kwanthaŵi yaitali ndi kukhumudwa. Matendawa amatha kufa.

Kuyankha kwa asthmatic kuwonjezereka kwa chiwonongeko choyipa kwa allergen kungakhale kumayambiriro kapena mochedwa. Pachiyambi choyamba, kugunda kumayamba pambuyo pa mphindi 1-2 ndikutha pambuyo pa mphindi 20. Nthawi yonse ya chikhalidwe cha asthmatic ikhoza kutha kwa maola awiri. Gawo lakumapeto limayambitsa matenda osokoneza bongo pambuyo pa maola 4-6, kumapeto kwake kumachitika maola 8. Nthawi ya chiwonongeko ndi maola 12.

Zovuta:

• Matenda a m'mphysematous m'mapapu;
• Kulephera kupuma bwino ;
• Pamene mpweya umalowa mkati, pneumothorax imayamba.

Pali mitundu yambiri ya mphumu pa etiology:

• Zosakanikirana (zovutitsidwa ndi chifuwa chachikulu);
• Zosasokonezeka (zokhumudwitsa ndi matenda);
• Mixed genesis.

Kawirikawiri ndi mphumu yowonongeka ya mawonekedwe a atopic , omwe amachokera ku zamoyo zomwe zimayambitsa zamoyo kuti zichitike.

Chofunika kudziwa

Chinthu choyamba chimene muyenera kuchita ndi kukaonana ndi dokotala, kufufuza bwinobwino, kukhazikitsa chidziwitso cholondola ndikupeza malangizo othandizira. Dokotala yekha amadziwa matenda omwe amachititsa kuti matenda a asthma, etiology, pathogenesis, chipatala, chithandizo. Ndikofunika kuti wodwala yekhayo ndi okondedwa ake nthawi zonse akonzekere kutsogolo kwatsopano ndikudziwa momwe angathandizire.

Kuti mupereke chithandizo choyenera, muyenera kudziwa zambiri zokhudza zizindikiro, magawo ndi mitundu ya matenda. Ndikofunika kudziwa zomwe tizilombo toyambitsa matenda timene timakhalapo ndi chifuwa chachikulu. Mwachidule, wina akhoza kulangiza izi: Ndondomeko yowonetsera bwino iyenera kukhazikitsidwa ndi malangizo omwe akufotokoza zomwe angachite ngati akuzunza kwambiri. Palibe ndondomeko, uphungu kapena kusankhidwa kwa dokotala kungathe kunyalanyazidwa, kungathe kuwononga moyo wa wodwalayo. Mankhwala amatengedwa mosamalitsa malinga ndi mankhwala, pokhapokha pa mlingo woyenera komanso nthawi zina.

Pafupi, kulikonse kumene wodwala ali, iye ndi okondedwa ake ayenera nthawi zonse kukhala ndi mankhwala oyenera, thandizo loyamba ndi inhaler. Ndikofunika kulemba diary ya zizindikiro, kukonza kusintha kwawo, ndi kuzindikira zowopsya zomwe zimakhudza chikhalidwe cha munthu. Ndikofunika kuti musamachite mantha panthawi yoyamba, koma kuti muchite zinthu molingana ndi dongosolo.

Madokotala akupitirizabe kuphunzira mosamalitsa chifuwa cha mphumu. Etiology, tizilombo toyambitsa matenda, tizilombo toyambitsa matenda, timatha kuzindikira bwino ndikusankha mankhwala oyenera. Monga lamulo, dokotala amalemba kuti inhalers, aerosols, ndipo ngati pali matenda, ma antibayotiki amauzidwa. Monga chiyeso chochitetezera, malangizowo ofunikira kwambiri ndi otsalira pazifukwa zomwe zimayambitsa kugwedezeka. Kuti muchite izi, muyenera kuyang'anitsitsa ukhondo wa nyumba, kupewa malo owonongeka a zachilengedwe, kusiya kusuta komanso kumwa mankhwala onse.