Zifukwa za matenda opatsirana ndi malungo a Lassa. Zizindikiro, chithandizo ndi matenda

Lassa malungo ndi matenda cha gulu la matenda hemorrhagic tizilombo. Chifukwa, sukhala impso, chiwindi zikadzawonongedwa, osauka malungo kwambiri. Matendawa ali ndi makhalidwe pachimake capillary toxicosis, pamene pamodzi ndi khungu kuonongeka ndi ziwiya pamwamba ndi permeability ukuwonjezeka awo kwambiri. moyo pachiswe kwambiri matenda, imfa akupezeka 40% ya milandu. Chaka chilichonse anthu pafupifupi hafu miliyoni amadwala Lassa malungo. Matendawa amapezeka mu masabata awiri, makamaka zovuta kunyamula malungo akazi mu theka lachiwiri la mimba, mu nkhani iyi, amafa ndi pafupifupi 80%.

Geographic madera kufalikira

Mu 1969, asayansi ku Nigeria kudziwa malungo mwa anthu a m'tauni ya matenda Lassa timakumana ndi ofufuza ndi anamwino chisamaliro. A milandu asanu oyamba, atatu zinachititsa kuti kufa kwa wodwala. Microbiologists chaka chimodzi kudziwa causative wothandizira. Lassa malungo pa nthawi ino chimakwirira m'mayiko Africa West, monga :. Guinea, Mali, Nigeria, Senegal, ndipo ena kwanthawi kumbuyo mu mawu a pakhomo AIDS ndi mbali chapakati cha Africa. Nthawi zina zotupa la zimachitika ku Ulaya, Israel, USA, Japan, kumene kachilombo tizilomboto anasamutsa nzika oyendayenda.

Kufotokozera malungo tizilomboto

The causative wothandizila wa Lassa malungo ndi banja woimira tizilombo kutengera mapangidwe RNA, zomwe ziribe DNA mfundo za chibadwa ndiyotengera maunyolo imodzi kapena ziwiri RNA. Kapangidwe chikugwirizana ndi kapangidwe ka HIV Bolivia ndi Argentinean malungo tizilomboto choriomeningitis. Atamwa virion awiri a nm 80-160 wolungama, unazunguliridwa mu zamadzimadzi envelopu zozungulira amene pamwamba ali ndi ulusi. Kudzifufuza pansi simungathe kutiona limasonyeza particles tizilombo mkati ribosomes khumi woimira granules wandiweyani chabwino.

Chifukwa kukhalapo kwa particles mkati, mbewu zofanana, HIV Arenavirus amalandira dzina la banja Arenaviridae (mu Latin arenaceus amatanthauza mchenga). M'zaka khumi zapitazi asayansi wapezeka 4 subgroups, amene Lassa malungo ndi kufalitsidwa ku madera osiyanasiyana a Africa. Virus kukana kuti kusintha mu madera ozungulira ndi mphamvu yake ndi luso kukhala kukhudzana ndi magazi kapena thupi zinsinsi sanataye kwa nthawi yaitali. Kuchepetsa ntchito mwakhama ntchito chloroform ndi efa.

Magwero ndi hawkers kachilombo

Onyamula HIV amaonedwa makoswe multimammate a mu Africa, maganizo Mastomys natalensis. AIDS woopsawo m'madera chiwerengero cha anthu kachilombo ndi 14-18% ya chonse cha anthu a makoswe ndi rodent ndi HIV ndi kachilombo moyo, nthawi zina popanda zizindikiro za matenda. Gwero la matenda ndi munthu wodwala, onse zakumwa amene ali opatsirana thupi ena.

Lassa malungo matenda zinthu MUKACHULUKIDWE kufala kwa matenda kudzera mumpweya ndi m'malovu madzi pamene kutsokomola, sneezing, kupuma. The matenda opezeka mu ndowe ndi mkodzo wa makoswe, amene angathe kutenga chakudya ndi khungu anthu. Infection m'madera zakhudzana kumachitika pamene Mpweya mpweya atomized laling'ono nyama zonyansa, ntchito chinyezi asaipitsidwe kasupe ndi mavairasi ndi insufficiently kuphika nyama makoswe ambiri ankadya chakudya.

Pakati pawo makoswe kupatsira kachilombo pa kukhudzana, kumwa, kudya, kuswana. Kuyambira wodwala matenda osiyana njira munthu kukhudzana ndi kugonana. Pakati mayi apatsira HIV thupi kwa mwana. nthenda chipatala ndodo amanyamula pa matenda a magazi ndi phukusi opaleshoni, autopsies, kutumikira odwala matenda catarrhal. Mu magazi odwala pambuyo matenda, Lassa malungo masamba chitetezo, amene tapemphera kwa zaka 7, sipangakhalenso obnaruzht kafukufuku zasayansi.

The vuto AIDS

Matendawa imatengedwa kuti ndi malungo focal tizilombo. Anthu ambiri pa chiopsezo ndi anthu a dera la kumadzulo kwa Africa. Infection mofanana zikuoneka onse kumudzi mu mzinda, chifukwa ambiri omwe makoswe multimammate. Anthu oposa theka la milandu amapha.

Nthawi ya asanazolowere matenda chosatha pang'ono kuphunzira, koma Zikatero matenda zina zidzachitika, ndi chithandizo mobwerezabwereza ndi kupewa Lassa malungo sikutanthauza khama, matenda ndi mu mapapo. Pafupifupi onse magawo a Africa matenda tikaona chaka chonse, koma chiwerengero chachikulu kwambiri cha kubuka ali mu nyengo yozizira, pamene magulu a makoswe anasamukira pafupi ndi nyumba anthu.

Nthawi ya HIV kusuntha dziko ku Ulaya zikuchitika, koma pofuna kupewa kufala onse oterewa malungo matenda imvera mlandu okhwima akukhalamo padziko lonse. Anthu amuna ndi akazi Amachitanso pachiopsezo chotenga kachilombo. Kachilomboka kwambiri kwambiri kufalikira m'madera uve, osauka kuli anthu m'madera.

The pathogenesis matendawa

Nembanemba mucous thupi la munthu ndi pachipata matenda wambiri. Virus kwa ndime ya nthawi makulitsidwe, isanafalikire mu mfundo za lymph pa siteji yotsiriza pachimake febrile nthawi akuyamba ndi kufala kwa particles pa machitidwe onse thupi. Maselo a ziwalo zofunika, munali HIV, kutenga ladziko lymphocytes cytotoxic, pali Lassa malungo. Zizindikiro ndi mankhwala a matenda zikuchulukirachulukira chidwi mwa akatswiri. M'kupita kwa kukhala ndi matenda necrosis a chiwindi ndi impso, ndulu ndi kuwonongedwa kwa minofu mtima.

The kukula kwa matenda zimadalira chitetezo chokwanira wa chamoyo, choncho amapha anakonzeratu mayankho kuphwanya selo. Ngati pali febrile nthawi matenda mapangidwe chitetezo kuthetsa tizilombo inaimitsidwa ndipo anachedwa kwa - izo kumaonekera monga Lassa malungo. Photo wa wodwala anapereka m'munsimu.

Zizindikiro za matenda Lassa

Nthawi makulitsidwe kumatenga sabata imodzi kapena atatu, ndiye umayamba gawo pachimake cha matenda limodzi ndi zizindikiro khalidwe:

• boma thupi akuyamba ndi kuwonjezeka pang'ono thupi kutentha;
• owonetseredwa malaise, kumverera kufooka;
• pali myalgia, kupweteka kwa khosi pamene Pomeza;
• maso amakhudzidwa ndi conjunctivitis;
• ndi kuwonjezeka thupi kutentha kwa khalani phee kufooka nakweza;
• kuchititsa ululu kumbuyo, pamimba, chifuwa;
• zina pali nseru, kutsekula m'mimba, kupweteka;
• kukhosomola amakhala kusanza;
• wasokonezeka maganizo a danga zithunzi.

Kuphunzira mtima

Zopezeka pa anayendera kutupa kwa khosi ndi nkhope, m'dera pachifuwa, pali zotsatira hemorrhagic m'madera osiyana, palpation anati kuwonjezeka zikuluzikulu mwanabele. laryngeal mupeza zilonda, mucosal yodziwika ndi maonekedwe a mawanga woyera, harbingers zilonda wotsatira wakupatsa Lassa malungo. Zizindikiro za kupenda mtima amaoneka mu malankhulidwe Aletsedwa, bradycardia, ndipo ukuwonjezeka kapena amachepetsa magazi. Ndi njira zina za matenda kukhala myocarditis, bradycardia ndi tachycardia m'malo.

Survey ya matenda amaganiziridwa amabweretsa pa khungu la wodwala akamataya magazi ambiri, kuwonjezera pa iwo, pali yamawangamawanga, papules, roseola, nthawi zina totupa pa chikhalidwe akukumbutsa chiwonetsero cha chikuku. The mtima wakulitsidwa, wodwalayo nkhawa za kufupika kwa mpweya, chifuwa, wheezing mu mapapo yonyowa kapena youma khalidwe. M'dera mkati mwa peritoneum amene ankamva kupweteka, kugunda m'mimba m'mimba. Mu kuphunzira zikuluzikulu chiwindi. Mantha dongosolo matenda komanso kumaonekera malungo Lassa. Epidemiology anati milandu imfa ya chikumbumtima, kumva imfa, tinnitus, pali wathunthu kapena tsankho balding mutu.

Laboratory ofufuza magazi leukopenia, ndiye leukocytosis, motero ankatembenukira kwa wbc kumanzere, yodziwika ndi kupatsidwa zinthu za m'mwazi kuchuluka kuwerenga ndi utachepa prothrombin, kuchuluka ESR kwa 50-80 mamilimita / h. amachepetsa magazi clotting, kuchuluka prothrombin nthawi limapezeka. Impso kulephera zimapangitsa pakokha kudziwika zili mkulu wa urea mu magazi, kuphunzira akutha wodwalayo mkodzo ndi proteinuria cylindruria. Mkodzo lili leukocytes, erythrocytes, zosafunika mapuloteni zonenepa granular.

Popeza Lassa malungo amatanthauza focal matenda chikhalidwe ndi amaganiziridwa HIV ikuchitika mbiri AIDS, pezani preconditions kwa chiwonetsero cha matenda chifukwa cha kukhala wodwala m'madera zakhudzana. Monga ciwiya cofufuzila ntchito X-ray, FDSG, ultrasound, Kujambula kuonongeka ziwalo ndi machitidwe thupi. Pa tanthauzo la matenda, odwala malangizo a pulmonologist, cardiologist, katswiriyu, gastroenterologist.

Aakulu Inde ndi mavuto

Mu 37-52% milandu, zovuta matenda kumayambitsa zotupa choopsa cha m'mapapo (chibayo osiyanasiyana mwamphamvu), mtima (myocarditis), chiwindi (matenda enaake), impso (kulephera). Aakulu edema m'madera pleural za thupi kuwawonetsera Lassa malungo. Epidemiology, mbali matenda, kupewa sikuti kupereka Zoneneratu zabwino ndi kusokoneza umathandizanso. Anthu oposa theka la milandu kulosera imfa wodwala pambuyo masabata awiri isanayambike. matenda abwino akupitiriza kwa masabata 3, kenako amayamba kuchepa kutentha. Pochira pang'onopang'ono zizindikiro kukonzanso chionetsero nthawi pali musabise.

Zosiyanasiyana matenda ndi matenda ena

Malinga ambiri mwa zizindikiro chiwonetsero cha matenda ofanana ndi malungo hemorrhagic a mitundu ina. Nthenda yofanana ndi tayifodi, matendawa malungo, chikasu malungo, Kyasanur matenda nkhalango, West Nile, Chikungunya, Malungo kotentha, fever, kakhosi akufanana Lassa malungo. Marburg, Ebola ndi pa malo ndi zambiri zofanana ndi Tisawasale matenda anaganiza.

Malungo ndi ofanana ndi zizindikiro za Lassa kuti pamene matenda pali mkulu thupi kutentha zizindikiro, mutu, chikasu pathupi. kusiyana kwake kwagona kuti malungo si yodziwika ndi maonekedwe a zilonda necrotic mu mmero, ndiponso kuchuluka zikuluzikulu mwanabele, kawirikawiri kukhala syndrome haemorrhagic. Komanso, malungo amakhala ndi khungu wotumbululuka, thukuta zimabwezera mawonetseredwe m'goli malungo, patchy totupa.

Hemorrhagic malungo ndi matenda aimpso amakhala ndi zizindikiro zosonyeza matenda Lassa, anaonetsa zowawa za mutu ndi minofu omangana, sclerite, conjunctivitis, oliguria. Koma sayambitsa HFRS anthu mobwerezabwereza kusanza, anam'peza pharyngitis ndi kutsekula m'mimba. Mosiyana ndi matenda Lassa otaya ku tsiku loyamba la matenda kumachitika pakamwa youma, ludzu ndi kufooka kwambiri chifukwa cha minofu.

Pakuti leptospirosis khalidwe zizindikiro zokhudzana monga malungo, kupweteka kwa mutu, myalgia, conjunctivitis, scleritis, oliguria. Koma kupanda leptospirosis ndi zilonda necrotic m'kamwa chikhalidwe chimasiyanitsa izo kuchokera Lassa malungo. Ngati leptospirosis si kutsokomola, kutsekula m'mimba, retching, kupweteka m'chifuwa si wapezeka zasayansi maphunziro leukopenia, bradycardia. zizindikiro zosiyana kwambiri ndi Lassa malungo. Photos ndi matenda ali anapereka m'munsimu.

Marburg malungo ndi mipita pachimake tizilombo matenda, ndi zizindikiro zofanana ndi za matenda Lassa. A digiri yapamwamba ya imfa, chitukuko malungo, matenda hemorrhagic, zotupa choopsa cha ziwalo mkati ndi dongosolo chapakati mantha. Gwero la matenda si ndendende unakhazikitsidwa, amakhulupirira kuti HIV imafalikira kwa anthu wobiriwira nyani droplet kapena mpweya njira ndi anakumana ndi nyama.

njira achire

odwala onse amaganiziridwa chotenga kachilombo adzakhala phunziro kwa mokakamizidwa hospitalization mu zipatala wapadera. Pamene zili wodwalayo mankhwala anaona ulamuliro okhwima kudzipatula popanda zakusokonenezedwa. Kwalamulidwa yopingasa bedi malo, katundu lilibe, chithandizo umalimbana ndi kuthetsa zizindikiro za matenda zimachitika. Mu masabata loyamba zimayambitsa wotsimikiza, ndi chithandizo cha Lassa malungo mu malo oyamba ndi ntchito convalescent plasma. Izi ndi ntchito pokhapokha pa chiyambi cha matenda, popeza ntchito mankhwala kwa malungo yaitali pa amakwiya zina, kuwonongeka kwa matenda ndi mmene matendawo.

vuto la matenda amaliona ndi mankhwala amphamvu ndi corticosteroids. Mu malonda masiku ano zachipatala mankhwala etiotropic anayamba mankhwala atsopano ndi katemera. Kugwiritsa mpaka lero ntchito mankhwala mankhwalawa virazole, ribamidil, ribavirin. Iwo anatengedwa mu siteji koyamba za matenda opatsirana pakamwa, mu ndalama 1000ed patsiku. Phwando lekani kwa masiku 10. M'nsinga kutumikiridwa mankhwala zokwanira kwa masiku 4, amene amathandiza kusintha njira ya matenda ndi kuchepetsa amafa.

Kupewa matenda

imfa kwambiri a moyo ali ndi malungo Lassa. Disease kupewa ndi yofunika kwambiri m'madera AIDS chiopsezo. Pofuna kupewa malowedwe a anthu azikhalamo za HIV, siyani chida chimenechi makoswe multimammate ndi mitundu ina ya makoswe. Kawirikawiri, chakudya ndi madzi akumwa zitsime za mankhwala atsopano mosamala wobisa kuti kuthetsa ingress wa mkodzo ndi chimbudzi cha makoswe. Monga prophylaxis unazokotedwa kulikonse makoswe namtsata ndi moto mitembo.

Great njira phindu linaperekedwa patsogolo kakhalidwe ka moyo wa anthu zakwawoko African, kuwongolera chakudya cha zikamera wa okwanira chitetezo cha m'thupi la chamoyo. nkhani unachitikira ndi nkhani kumapangitsanso chikhalidwe - mlingo banja, anafotokoza kufunika kugwilizana ndi mfundo za thanzi payekha munthu aliyense.

Madokotala ndiponso zipatala zina matenda ogwira ntchito kuchipatala akuyenera kuonetsetsa njira kofunika prophylaxis munthu, monga magolovesi ndi masks kusamalira wodwalayo. Kodi aphunzitsidwe ndi kuwatumiza kwa m'dera AIDS chiopsezo m'dera madokotala kwa khalidwe labwino ndi abwino achoke ndi kuonetsetsa kuti odana ndi mliri boma.

Pogwira ntchito mu inayamba mliri yatsoka

Mwadongosolo kwaokha zochita kwenikweni chichitike, ngati m'dera lililonse pali Lassa malungo. Control miyeso akutsatiridwa mwamsanga mwamsanga. Cholinga chake bungwe la kwaokha molimbika kudzipatula wathunthu odwala matenda mu mabokosi, anthu akumeneko kuchenjeza anthu za isanayambike mliri wa. onse okhudzidwa ayenera kuvala odana ndi mliri zovala ndi zinthu zodzitetezera.

Choyenera ndi malo ogulitsira anthu omwe akudandaula kuti amakumana ndi odwala, kutentha kwa zinthu zomwe sizinthu zamtengo wapatali ndi zinthu za tsiku ndi tsiku za anthu akuluakulu komanso okhudzana ndi anthu, kutenthedwa pamoto kwa akufa, matenda osokoneza bongo m'zipinda ndi nyumba. Anthu omwe akufika kumadera "oyera" kuchokera ku mliri ali kutali ndi malo omwe akudwala matenda odwala matenda odwala matenda odwala matendawa ngati akudandaula pang'ono kuti matendawa akuyamba.

Pomaliza, ziyenera kudziŵika kuti malungo owopsa amatha, ngati chitetezo chimayendetsedwa bwino, njira zothandizira zimatengera kuchepetsa chiopsezo cha matendawa, ndipo mankhwala amayamba mwamsanga.