Thanzi, Matenda ndi zokwaniritsa
Zizindikiro za poliyo mu ana ndi akulu
Poliyo - ndi tizilombo matenda pachimake kuti kumachitika makamaka zokhudza nkhani imvi ubongo, zomwe zimabweretsa chitukuko cha paresis ndi ziwalo. Zizindikiro za poliyo angathe kuonedwa ana osakwana zaka zaka 7, koma angathe kutenga iwo, pa zochitika zina, anakhalabe ndi akulu.
A mbiri pang'ono
Poliyo amakhala ndi matenda pachimake kwa msana ndi ubongo tsinde chifukwa mu chitukuko cha paresis ndi ziwalo, matenda bulbar. Disease poliyo, zizindikiro zimene akhala kudziwika kwa nthawi yaitali, ambiri anayala mu XIX, chiyambi cha XX atumwi. Nthawi imeneyi, iwo analemba mliri kwakukulu kwa matenda America ndi Europe. Poliyo chinatsegulidwa ku Vienna mu 1908, E. ndi K. Popper Landštejn, ndipo analenga A. ndi J. Seybinom moyo. Salk inactivated katemera yokonzedwa ndi zaka 50 Mu zaka zapitazo, kuti kuchepetsa chiwerengero cha milandu aya anali wapezeka poliyo ana.
mphamvu zabwino polimbana ndi matenda imeneyi kudzera Katemera yogwira, zizindikiro kawirikawiri poliyo zasungidwa yekha m'mayiko nekotoroyh - Pakistan, Afghanistan, Nigeria, India, Syria - pamene mu 1988 chiwerengero chawo anafika 125. Chiwerengero cha milandu chifukwa nthawi imeneyi utachepa kuchoka Nthawi 350 000 (zomwe 17,5 zikwi imfa) milandu 406 kuzindikiridwa mu 2013. Ulaya, Russia ndi North America lero ndi dera lopanda matenda ndi zizindikiro za poliyo amadziŵika kuno monga milandu ayi.
exciter
Poliyo - matenda enaake. chifukwa amakhala poliovirus limene limafotokoza kuti enteroviruses lapansi. Kutanthauzira mitundu HIV atatu (I, II, III). Kwa mitundu anthu ndi nyani tizilombo Ine ndi III. II zingakhudze ena makoswe. RNA HIV lili, kukula kwake ndi 12 nm. Khola mu chilengedwe - mu madzi, zikhoza kusungidwa kwa masiku 100 mu mkaka - 3 months, kwa miyezi 6 - ndi secretions mtima. Ochiritsira des. zikutanthauza osamveka, koma kachilombo koyambitsa mofulumira zopanda ndi autoclaving, kuwira, kukhudzana ndi kuwala ultraviolet. Pamene usavutike 50 ° C HIV m'mphindi zochepa 30. Pamene kachilombo nthawi makulitsidwe angathe kuonedwa mu magazi, woyamba masiku 10 matenda - ndi swabs pharyngeal ndipo kawirikawiri - mu madzimadzi cerebrospinal.
Limagwirira kufala
Gwero la matenda mu poliomyelitis akhoza kukhala monga munthu wodwala, ndipo asymptomatic HIV chonyamulira (zina, chotengera akhoza asungidwe atatu - miyezi isanu pambuyo kuchira). HIV adzamasulidwa ku malo ndi ndowe za mtima ndi nasopharyngeal ntchofu. Pakuti poliyo zogwirizana zotsatirazi njira:
pini;
airborne;
fecal-m'kamwa.
Njira yofala HIV ndi fecal-m'kamwa - HIV alowa m'thupi kudzera zakhudzana manja, ziwiya, chakudya, madzi. Komanso yoopsa ndi ntchofu anamasulidwa odwala nasopharynx ndi masiku 2 matenda pa masabata oyambirira 2.
The chiwopsezo cha HIV ndi 0.2-1%, ambiri a milandu ndi ana osaposera zaka 7. Pachimake zochitika limapezeka m'chilimwe ndi kugwa.
Zina mwa zifukwa
Zinthu zimathandiza kuti kufala kwa matenda ingakhale monga iyi:
kupanda makhalidwe ukhondo wa mwanayo;
kachulukidwe anthu;
osauka zinthu ukhondo, kuphatikizapo kuphwanya boma ukhondo mu mabungwe a;
matenda kawirikawiri (kuposa maulendo 4 chaka) wa mwanayo;
immunodeficiency;
mlingo wochepa wa katemera.
Gawo
Poliyo zimagawidwa monga mwa chikhalidwe ya ubongo:
nonparalytic mawonekedwe - zikuchitika popanda zotupa kwambiri ya ubongo - meningeal, abortive (choipidwa) inapparatnaya (asymptomatic ndi HIV, amene yekha zingadziŵike ndi zasayansi) mawonekedwe;
manjenje mawonekedwe.
Nawonso mawonekedwe manjenje zimagawidwa ndi malo a chotupa cha. wolemekezeka:
msana mawonekedwe - yodziwika ndi flaccid ziwalo za miyendo, thunthu, zakulera, khosi;
Pontina mawonekedwe - yl chimaposa imfa wathunthu tsankho la nkhope, sagging ngodya ya pakamwa pa mbali ya nkhope, lagophthalmos;
bulbar - amakhala ndi kulankhula mkhutu, kumeza kupuma matenda ndi ntchito mtima;
Encephalitis - ndi zizindikiro focal oziziritsa;
wosanganiza mawonekedwe - pontospinalnaya, myasthenia, bulbopontospinalnaya.
Akazitumiza kusiyanitsa ofatsa, odziletsa, aakulu ndi subclinical mitundu.
nthawi makulitsidwe
Makulitsidwe nthawi, pamene zizindikiro woyamba siali akuwonetseredwa poliyo, chimakhala cha masiku 2 35. Nthawi zambiri, anakhala masiku 10-12, malingana ndi maonekedwe a mwanayo munthu wa chamoyo. Panthawi imeneyi, pazipata polowera (ali pharynx ndi kapepala m'mimba) HIV limalowera mu matumbo mwanabele, kumene kubereka ake. Kenako, akulowa magazi ndipo amayamba siteji ya viremia imene matenda kufalikira thupi lonse ndipo amagwira zigawo ya chiopysezo kwambiri mu izo. Pankhani ya poliyo ndi nyanga kutsogolo kwa chingwe msana ndi maselo m'mnyewa wamtima.
Zizindikiro za mtundu meningeal
Meningeal ndi abortive mitundu mitundu ya si manjenje poliyo. Zizindikiro zoyambirira za poliyo ana ndi mawonekedwe meningeal nthawi zonse amaoneka lakuthwa. Kutentha kwa maola angapo limatuluka kuti 38-39 °. Kukhala ndi zizindikiro khalidwe la chimfine - chifuwa, mucous kapena serous m'mphuno kumaliseche. Kuwaona ku mmero ikusonyezedwa hyperemia, tonsils ndi palatal amangomvera kungakhale zolengeza. Kutalika kwa kutentha kungakhale nseru, kusanza. Kenako, madontho kutentha, ndipo masiku awiri kapena atatu, chikhalidwe mwanayo ali okhazikika.
Otsatidwa ndi malungo mobwerezabwereza zizindikiro za poliyo zambiri osiyana - pali kugona, chisokonezo, ulesi, mutu, kusanza. Pali zizindikiro meningeal: zabwino chizindikiro kerning (atagona kumbuyo kwa wodwala akufunitsitsa mwendo pa bondo ndi ntchafu olowa pa ngodya 90 °, ndi kuti chifukwa imakungika kumakhala kovuta kuwongola bondo), ouma khosi minofu (ndikosatheka atagona pa nsana wake kuwafika chibwano ndi chifuwa ).
mawonekedwe abortive
Zizindikiro za poliyo ana ndi mawonekedwe abortive komanso kuonekere kwambiri. Against kutentha (37,5-38 °) anati malaise, ulesi, mutu lochedwa. Pali yaing'ono catarrhal zochitika - chifuwa, chimfine, redness kummero kungakhale ululu m'mimba, ndi kusanza. Kenako iwo angathe catarrhal angina, enterocolitis kapena gastroenteritis. Kuti mawonetseredwe matumbo kusiyanitsa abortive poliomyelitis. Zizindikiro za matenda ana, mu nkhani iyi zambiri ali Amowabu matumbo toxemia malinga ndi mtundu wa kamwazi kapena kolera. mawonetseredwe Neurologic wa mawonekedwe poliyo.
manjenje poliyo
Izi mawonekedwe a poliyo amapezeka njira zambiri olemera a mankhwala pamwamba ndi zikuipiraipirabe. Woyamba zizindikiro ubongo wa poliyo kuonekere masiku 4-10 pambuyo kukhudzana ndi HIV, zina, nthawi imeneyi akhoza anawonjezera kuti masabata 5.
Mu sitepe yotsatira chitukuko cha matenda n'kopanda.
Preparaliticheskaya. Yodziwika ndi kulera kutentha kwa 38,5-39,5 °, kupweteka kwa mutu, chifuwa, chimfine, kutsekula m'mimba, nseru, kusanza. masiku 2-3 boma wabwinobwino, koma ndiye nyamuka latsopano kutentha wayamba 39 - 40 °. Against maziko awa pali amphamvu kupweteka minofu ululu, akugwedezeka minofu kuti Tingaone ngakhale zowoneka, mkhutu kutsitsimuka. Nthawiyi kumatenga masiku 4-5.
Pakuti gawo manjenje yodziwika ndi chitukuko cha ziwalo. Kukhala mwadzidzidzi ndipo anasonyeza pakalibe kayendedwe yogwira. Malinga ndi mawonekedwe a osauka nthambi ziwalo (zambiri miyendo), thunthu, khosi, koma tilinazo nthawi si bwanji. Kutalika kwa gawo manjenje zimasiyanasiyana masabata 1 2.
Chinthu kuchepetsa pa mankhwala bwino amakhala ndi kuchepetsa wa ziwalo minofu ntchito. Choyamba, ndondomeko izi zimachitika mofulumira kwambiri, koma kenako tempo mochedwa pansi. Nthawiyi ukhoza kwa chaka chimodzi kufikira zitatu.
Mu sitepe yotsalira zochitika anakhudzidwa minofu ya manja, contractures anapanga ndipo anayamba deformations zosiyanasiyana za thunthu ndi malekezero, ndi odziwika bwino monga zizindikiro poliyo ana. Photos kuperekedwa mu ndemanga iyi ikuonetsa sitepe izi momveka bwino.
mawonekedwe msana
Iwo amakhala ndi isanayambike pachimake (kutentha limatuluka kuti ° 40, mosiyana ndi zamoyo zina wakhululuka). Mwana lethargic, adynamic, kuwodzera, koma n'zotheka ndi hyperexcitability (monga ulamuliro, zizindikiro ndi kutchulidwa zambiri ana aang'ono kwambiri), khunyu. Pali mowiriza ululu malekezero m'munsi, zoipa pamene kusintha malo a thupi, kupweteka kwa msana ndi khosi minofu. Kuzionetsetsa, awulule zizindikiro za matenda, pharyngitis, rhinitis. Pali zizindikiro oziziritsa, hypersensitivity (kuchuluka anachita zosiyanasiyana tizilombo toyambitsa matenda). Mwa kuwonekera pa nsana, kapena malo a ziyerekezo kumachitika makungwa mitsempha kupweteka kwambiri.
Pa masiku 2-4 kuyambira chiyambi cha matenda zimachitika ziwalo. Pamene poliyo, ali mbali zotsatirazi:
asymmetry - kugonjetsedwa kwa mipita mtundu wa dzanja lamanzere - phazi lolondola;
zithunzi - si bwanji nthambi minofu;
yafupika kapena kwina tendon bongo;
ndichepe mu minofu kamvekedwe kuti atony, koma tilinazo si chakhungu.
Nthambi akhudzidwa wotumbululuka, cyanotic, ozizira kukhudza. Ululu syndrome kumabweretsa mfundo yakuti mwana amatenga zinthu simuchita, amene nawonso, wobwezera chifukwa cha contractures oyambirira.
Ayambe ntchito galimoto kuyamba ndi masabata 2 matendawa, koma ndondomeko imeneyi yaitali ndi m'goli. Kulankhula zotupa minofu trophism, stunting nthambi, olowa chilema, manja a minofu fupa. Disease kumatenga zaka 2-3.
mawonekedwe bulbar
laryngeal ziwalo - kuphwanya Pomeza ndi phonation;
matenda kupuma;
matenda kayendedwe ka eyeballs - ndipo yopingasa nystagmus rotarny.
Matendawa akhoza kumva ndi chibayo, atelectasis, myocarditis. N'zothekanso chitukuko cha magazi m'mimba, matumbo kutsekeka.
mawonekedwe Pontin
Pontina mawonekedwe kumachitika chifukwa poliyo HIV nkhope chotupa, kumaliseche, ndi zina misempha ya trigeminal (V, VI, VII, awiriawiri misempha cranial). Zimenezi zimabweretsa ziwalo za minofu udindo nkhope, ndi zina, ndi akatumba masticatory. Kukomoka izo ndi zimenenso asymmetry a minofu nkhope, ndi kuwongola makutu nasolabial, kusowa makwinya yopingasa pa mphumi, ptosis (kuŵeramitsa) ya ngodya m'kamwa kapena zaka, kutsekedwa ake chosakwanira. Zizindikiro kumaonekera kwambiri pamene inu muyesera kumwetulira, kutseka maso anu kapena zingakweze masaya.
chithandizo
mankhwala enieni poliyo alipo. Pamene wakhala matenda a wodwalayo ali anavomereza kuti matenda m'chipatala, komwe amapereka thupi ndi maganizo ena onse. M'nthawi preparalitichesky ndi wodwala manjenjeyo ntchito analgesic ndi okodzetsa, malinga ndi zizindikiro anapatsidwa odana ndi yotupa mankhwala, kapena corticosteroids. Pamene Pomeza ntchito matenda - chubu kudya, kuphwanya kupuma - ndi othandizira. Nthawi kuchira wasonyeza zolimbitsa mankhwala kutikitirako physiotherapy, mavitamini ndi nootropics, chipatala chaching'ono chithandizo.
kupewa
Poliyo ndi amodzi mwa matenda amene savuta kupewa kuposa kuchiza. Izi zikhoza kuchitika kudzera mwa katemera. Mu Russia, ana onse akuchita katemera uyu. Katemera ikuchitika mu magawo angapo - mu 3 ndi 4.5 miyezi mwana katemera ndi katemera inactivated. Pa 6, 18, 20 miyezi, ndondomeko akubwerezedwa ntchito katemera moyo. Katemera Last ikuchitika zaka 14. Ndipo musaziphonye izo, chifukwa, ngakhale kuti amakhulupirira kuti poliyo ndi owopsa okha ana, izi siziri choncho, monga mmene zizindikiro matenda poliyo akuluakulu ndi kutchulidwa kwambiri ndi woopsa.
Kudziwa kupewa matenda ndi chinthu chofunika a yake mtima kudzipatula, kwaokha ndi kuyang'aniridwa kwa masabata 3 kwa gulu kukhudzana, kugwilizana ndi ukhondo.
Choncho, tafotokoza mwatsatanetsatane zokwanira zimene zizindikiro za poliyo kumeneko, ndi chochita kupewa matenda.
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