Chinese fluke. Clonorchiasis: zizindikiro, chithandizo. Tizirombo wa munthu

Clonorchiasis anthu - biogelmintoz trematodozov ku gulu yodziwika ndi chotupa chachikulu pa mundawo biliary, kapamba ndi chiwindi parenchyma.

EPIDEMIOLOGY

Ndiwo matenda - munthu kachilombo klonorhami. Komanso, madzi infest agalu ndi amphaka. Chinese fluke kofala Japan, Vietnam, China, Korea North, ndi Amur beseni Obi ndi Primorye. Helminth mazira allocated ndi ndowe mu amadzimadzi sing'anga kuwameza ngale cercariae (mphutsi) anapanga mu thupi limene pafupifupi 14 masiku. Pambuyo kukhudzana ndi thupi la mphutsi za nsomba ndi nsomba zazinkhanira ku intestine, iwo ayamba kusamukira ku minofu ndi subcutaneous minofu. Choncho, metacercariae. Clonorchiasis anthu ali ndi kudya zosaphika, insufficiently kutentha ankachitira nsomba kapena nsomba zazinkhanira. Ndipo akufotokozera clonorchiasis. Odwalawa zizindikiro zambiri kuonekere pambuyo tizilomboto kulowa intestine yaing'ono.

Flukes: khalidwe

Trematodes (flukes) - mphutsi, zokhudzana ndi mtundu wa flatworm. Monga ulamuliro, iwo ndi tsamba-mphako. kukula zimasiyanasiyana pa osiyanasiyana kuchokera 0,1 mamilimita cm 15 m'litali. Chinese fluke akhoza parasitize mu chamoyo wa nyama ndi anthu. mitundu yonse ya flukes ndi parasitic moyo.

Kafukufuku wakapangidwe kazachilengedwe ndi zamoyo wa trematodes

Thupi trematode constricted malangizo dorsoventral. Cuticle pamodzi ndi wosanjikiza minofu kupanga khungu minofu sac imene ziwalo zili. Flukes ndi kuliika mwa matupi wapadera minofu - suckers. Pangakhale awiri - m'kamwa ndi m'mimba. Ziwalo zikhomo fixation akhoza amati ndi cuticle ndi maenje glandular.

dongosolo alimentary

Kutsogolo kwa thupi mukuchitika m'kamwa sucker, yomwe ili pansi pakamwa kutsegula. Pakamwa ayenera pharynx (pharynx) ndi kum'mero elongated. Matumbo chubu - awiri slepozakanchivayuschihsya thunthu. Chotulukira pa lathyathyathya mphutsi sakhala. Zotsalira unhydrolyzed chakudya kunja kudzera pakamwa. Gawo la mphamvu ya flatworms akhoza kuchitika kudzera tegument lapansi.

Mantha ndi excretory dongosolo

Mantha dongosolo limapangidwa ganglia mitsempha, ili pansi pharynx, ndipo nozzles yaitaliyo mbali zina za thupi. dongosolo Excretory ukufanizidwa ndi dongosolo kuipidwa wa tubules zomwe ndi awiri excretory ritsa.

dongosolo ubereki

Dongosolo ubereki wabwino wa trematodes bwino kwambiri anayamba. Flukes (kupatula Schistosomatata mtundu wa oimira) - hermaphroditic (bisexual cholengedwa).

dongosolo Male ubereki, monga ulamuliro, imakhala testes awiri. Achoke kwa iwo vas efferens, amene olumikiza wamba vas deferens. Nthawi zambiri unazunguliridwa mu cirrus sac (wapadera akulu sac). The mbali yomaliza ya deferens vas - cirrus (copulatory limba).

Kapangidwe ka zida wamkazi ubereki zikuphatikizapo n'kuwasanganiza, jajtceprovoda, ootype, spermatheca, Vitellaria Laurerovy njira Mehlis 'England ndipo chiberekero, limene limatha ndi kutsegula wamkazi maliseche.

etiology

The causative wothandizila ndi clonorchiasis fluke - Chinese fluke. Izi amatanthauza banja mphutsi Opisthorchidae - Clonorchis sinensis. Bot Choyamba akufotokozedwa McConnell mu 1874 fluke Chinese mu thupi la munthu akhoza parasitize kwa zaka 40. Thupi helminth mosabisa, lanceolate 10-20 mamilimita ndi m'lifupi mwake 2-4 mm. trematode mazira ndi kuwala golide mtundu, pa chimodzi cha mitengo yonyamulira ya kapu ndi kuoneka bwino. Clonorchis sinensis mu siteji wamkulu akhoza parasitize onse anthu ndi nyama zimene zimadya. Yotsirizira ndi makamu okhazikika. Monga wogwirizira ngale kuchita madzi oyera, owonjezera - madzi oyera nsomba zazinkhanira ndi carp nsomba.

Lifecycle trematodes

trematodes moyo mkombero imakhala nthawi anayi:

• embriogonii;
• partenogonii;
• tsistogonii;
• maritogonii.

Embriogoniya - pa embryonic chitukuko maselo nyongolosi mu dzira kuchokera umuna kuti trematode miracidia kuchoka. Kutalika kwa gawo lino kwa mwezi umodzi. Partenogoniya - posleembrionalny nthawi ya chitukuko cha siteji larval mu thupi la khamu wapakatikati. Anapereka gawo akuyamba ku mapangidwe sporocysts pamaso pa cercaria mu chilengedwe. Kutalika kwa nthawi imeneyi akhoza zimasiyana masabata awiri miyezi isanu.

Tsistogoniya - kutembenuka ndondomeko mu cercaria adolescaria (mu chilengedwe) kapena metacercariae (thupi zapadera khamu). Tsistogonii nthawi - kuchokera maola angapo kwa miyezi iwiri.

Maritogoniya - nthawi ya chitukuko cha flukes mu okhazikika khamu lake kukhwima kugonana (imago), limene limafotokoza mazira mu chilengedwe. Kutalika kwa nthawi imeneyi - kuyambira pa mlungu umodzi mpaka miyezi iwiri.

pathogenesis

Odwala kukhala m'madera kuderako kukhala chitetezo chokwanira kuti wadutsa kuchokera kwa mayi kupita kwa mwana ndi transplacental. Choncho, anthu matenda, ngakhale matenda, koma ali Inde wofatsa. Abweretsa chitukuko cha kudwala ndi trematode makina amadza, kugwirizana sekondale microflora, matenda neurotrophic, poizoni ndi thupi lawo siligwirizana. Komanso, klonorhi zimabweretsa kusintha cirrhotic mu chiwindi.

zizindikiro matenda

Ngati mwakhala matenda clonorchiasis, zizindikiro matenda ofanana opisthorchiasis. Mu gawo pachimake matenda a AIDS ndi Amowabu kusowa chilakolako malaise, kufooka, maonekedwe a thupi lawo siligwirizana. Ndi kupitirira kwa matenda M'magazini owonetseredwa amakhala chiwindi, kapamba, ndi kapepala biliary. Odwala akudandaula ya malungo ndi ululu isanafalikire mu hypochondrium bwino.

zosokonezeka zotheka matendawa

Zimenezi zingakhale:

• aakulu cholecystitis;
• matenda enaake;
• aakulu gastroduodenitis;
• khansa pancreatic ndi m'mimba;
• aakulu chiwindi.

kudwala diagnostics

Matendawa zachokera deta matenda ndi epizootic ndi gelmintokoprologicheskih maphunziro. Kulongosolerana matenda kubala kusanthula amuzolengedwa magazi (mapuloteni okwana shuga magazi, bilirubin, ntchito phosphatase zamchere, zipangizo aminotransferases, amylase, trypsin, ndi lipase), Kwalamulidwa (cholecystography, ultrasound mosamala ndulu, chiwindi, kapamba, fibrogastroduodenoscopy) ndi serological (kuchotsa , RIHA, PCR) njira.

mankhwala

Ngati wodwala anapezeka clonorchiasis, mankhwala ayenera kukhala zovuta:

• dietetics;
• mankhwala anthelmintic ( "biltricid", "Niklofolan", "hloksila");
• mankhwala ( "kashiamu gluconate", "loratidine," "Suprastin");
• nonsteroidal odana ndi yotupa mankhwala ( "Ibuprofen", "Nimisulid");
• michere ( "Panzinorm", "mezim", "Creon");
• Sorbents ( "Enterosgel" "ataxia", "Polysorb");
• MANKHWALA OLETSA VUTOLI ( "papaverine", "No-spa", "Mebeverin");
• macrolides ( "oleandomycin", "Spiramycin", "azithromycin", "Roxithromycin", "Fluritromitsin");
• mankhwala cholagogue ( "Xylitol" "Sorbitol", chimanga silika, immortelle, ananyamuka m'chiuno, timbewu masamba);
• gepatoprotektory ( "Essentiale", "Ursohol").