Iqhenqa (iqhenqa): umyalezo, Pathogenesis, iimpawu kunye neempawu unyango

Igama elithi "oneqhenqa" nkqu ngexesha lethu sinikezwe kabi kabukhali negative. Le mbono "iqhenqa" kuba abaninzi, nangona kakuhle ngokupheleleyo, kodwa ke zingambi kakhulu, kodwa ngaphambi kokuba iye zamiselwa onke yokunqakulisa, kunxunguphala. Kweli nqaku, siza kukubonisa ukuba uhlobo lwesifo - seqhenqa, yintoni iimpawu zakhe, umyalezo weimeyile, esandulwa kumiliselwa, Pathogenesis, kukho unyango, kwaye okona kubaluleke kakhulu, kufuneka ukuba woyike abantu eneqhenqa, nokuba ukubamba ngayo.

Iqhenqa okanye iqhenqa?

Kukho sisifo apho umntu uba ngeyona nokungafunekiyo, nezandla neenyawo zenziwe zimbi ngenxa yokulahlekelwa weminwe. Amagama malunga neshumi elinesibini. Kukho exotic - isifo buhlungu, izifo yaseFenike kufa ndini. Kukho ukuqapha, umzekelo, hansenoz okanye granulomatosis engapheliyo, kwaye kukho ezaziwayo-kakuhle, ezifana seqhenqa okanye seqhenqa, wazala igama eyoyikekayo "oneqhenqa." igama ngalinye igxininisa omnye okanye enye inkalo yesi sifo. Umzekelo, "hansenoz" wabonakala imbeko ISAZINZULU Hansen kuqala wafumanisa arhente causative kwesifo kunye "iqhenqa" livela kwi lepras zamaGrike, ithetha ukuba i "esikalini". Kuyabonakala ukuba, kufana ke Amahlathi amandulo amaGrike, nangokhwekhwe amanwele kwizigulane ejongene. Le nokuxubana yamandulo ngenxa yamazwi "pro" yaye "kazIt", oko kukuthi, ukutshintsha inkangeleko, ebizwa i "iqhenqa" buhlungu. Umyalezo weimeyile, Pathogenesis, kunye nonyango lwe gciwane zisabangela iingxabano, naphambi kwabantu ita wayengazi nto, ukoyika kangaka. Church wabhengeza isifo sisohlwayo ngenxa yezono kaNdikhoyo, kunye namakholwa abazange nabuganga ningathandabuzi kuyo. Lowo izono unyango kuphela zamalivanie.

Sifunda izinto eziliqela yomlando

Izazinzulu ziqhube uthotho analyses isidumbu yamandulo waza wafumanisa ukuba kwiminyaka engaphezu kwe-6000 yaziwa eluntwini kukududuzela esibizwa ngokuba liqhenqa. Umyalezo weimeyile, Pathogenesis kwezifo ochazwe yi noHippocrates, kodwa ngempazamo kwaziwe ukuba enye, kunye ukhwekhwe. Iqhenqa kucingwa indawo yokuzalwa Afrika (njengako kweminye imithombo Asia, yiyo isifo yaseFenike) usuleleko eYurophu Bazizisile "akhaliphileyo" zokholo, yaye Melika oovulindlela zayo ezihlangwini zabo. Emva kokufumana imali enkulu amaxhoba IiReggaeton ngaphandle izithintelo ngaphandle kweziphazamiso, esi sifo ngokulula ndiloyisile isiqingatha ihlabathi. Akukho namnye wayengazi, liqhenqa - yintoni na. Le umyalezo kunye Pathogenesis seqhenqa wehla yokuba abantu ngequbuliso waba ndiyingwenya na, wawa eminweni yakhe, imilenze, waza ke rots uyaphila. Abantu e yokothuka, kwaye ngandlela zonke ukuphelisa abaneqhenqa. Eyona, nje agxothwe. Kwakukho sisithethe ukuba "kungcwaba" kwengozi, ngexesha apho yafakwa ebhokisini, zibethelelwe, kwehliswa emhadini, yaye igqunywe ngomhlaba. Kanye, Noko ke, ngaphambi kokuba uphume, kodwa bonke abantu phakathi kwabaphilayo engasekho khona. Kwimeko okubi, abagulayo babulawa ngenxa yokwenene. Enoba kwalo, akwaziwa, kodwa yinto eyenzekayo - Europe ukuhlasela enye sisibetho esibulalayo, kancinane kuqala. Emva kokuba isibetho seqhenqa lombulalazwe iye kwisehlo enqabileyo apha.

liqhenqa namhlanje

Nokuba kumaXesha Aphakathi xa yoonongendi wadala ikhaya abaneqhenqa, apho bahlala de ukufa kwakhe. Sasizibiza eyayilithânga owayeneqhenqa. Ngowe-1873, isazinzulu Hansen, abasebenzi kwelinye kula maziko, kwaba kuyenzeka ukubona izinto kuthatyathwa isigulane, unangoku iintsholongwane ongabonwayo. Baye ngokuba Mycobacterium leprae. Kodwa kwathatha iminyaka emininzi phambi kokuba wafumanisa ulwalamano lwabo kwizifo ezifana iqhenqa. Umyalezo weimeyile, Pathogenesis kunye nonyango iindlela ngoku ziqondwa ngcono. Kudala-dala ehlabathini kwakukho amawaka leprosariums kuba abaneqhenqa ngoko ngaphezulu kwezigidi ezingama-20. In Russia yedwa, kwakukho 19 pieces leprosariums. Ngenxa ufumene ichiza ekupheleni kwenkulungwane yama-20, inani lezigulane ehlabathini, wawa ukuya kwizigidi ezili-12, yaye ngalo mzuzu kukho malunga nesiqingatha sesigidi. Manani, Noko ke, kwakhona zibonise ukunyuka okungephi kwenani lezigulane ngo-2015. In Russia leprosariums ngoku nje 4, kunye nezigulane 600 liqhenqa. Isambuku "abaneqhenqa" Ngoku ngokwendawo e China, India kunye namanye amazwe South Asia, kuphantse ukuba kulo Afrika, kuquka eMadagascar, Umzantsi Melika, i-Arabhu Peninsula, kwiiPhilippines, nakwiCaribbean.

Portrait lwegciwane

Le Pathogenesis seqhenqa uqalisa ndzulu eletha umzimba womntu sikaHansen. Le ntsholongwane ezincinane ukuya microns-8 elide, ububanzi of ukuya ku 0.5 microns. Oloba ziloliwe okanye uqweqwe elintlangothi wayifulela ngeengcamba ezine inwebu ashinyeneyo kakhulu, ebakhusela ezenzeka ngaphandle. Abazange aziyo imbewu ndikwandise kakhulu kade. Icandelo ye gciwane enye ithatha malunga neentsuku ezili-14. Amaqela ubambe izinti, ngoko ziyafana icuba iyona. Ngamanye amaxesha nezinambuzane zingafunyanwa kwenye. Zihlala kuphela amaxhoba leeseli, ngoko, kanye yemeko ezisingqongileyo, afe ngokukhawuleza. Mycobacterium leprae parasitize kuphela komntu, kodwa kukholelwa ukuba kokuba yosulele iimpuku, armadillos, chipmunks kunye neentlobo ezininzi monkeys. Le umyalezo kunye Pathogenesis seqhenqa (liqhenqa) sifunda nzima, kuba thanga Hansen inamathele medium lwezakha elabhoratri kukhula embi kakhulu kwaye slow - ukususela kwiiveki ezi-6 xa kuthelekiswa iiyure eziliqela ezinye iintsholongwane. Enye ubunzima - ngaphandle iseli, ukuba non-yayintsholongwane eyosulela, yaye phantse musa bendelisele iingcambu izilwanyana zovavanyo. Sekunjalo, siye safumanisa ukuba Mycobacterium leprae kunye Goch (unobangela tuberculosis) bavela bacterium enye, kodwa inkqubo zazivelela ukuyiguqula kancinane isakhiwo sayo. Kwaye ngo-2009 sazivula uhlobo olunye amagciwane ebangela iqhenqa ehlasela lepromatous.

Iindlela zosulelo

Umthombo ye gciwane liqhenqa ke ukubandezeleka kuphela kwesi sifo ngendlela esebenzayo woMntu. Kodwa ezinye iingxelo athile kunokubangela usuleleko kuba umsebenzi ngaphandle iiglavu kunye nezilwanyana ezosulela iintsholongwane sikaHansen. Njani na Pathogenesis seqhenqa eso? Izifo ezosulela yi ngamathontsi emoyeni, sisoloko ngokunamandla kakhulu kwaye bayakwazi yosulela abantu abaninzi. Kodwa kwimeko seqhenqa, oko akwenzeki ngenxa yezizathu kodwa ayaziwa. Yinto eyaziwayo nje ukuba coli Hansen ngokubonakalayo zande kwiisayithi liqumrhu siphole umoya, oko kukuthi, i-yangaphakathi ngomlomo. Ukususela yempilo yomguli, kodwa ayihambi uthimla, ezanga kakhulu, ukukhohlela, incoko ngokweemvakalelo. Ukongeza, eli gciwane zinokusasazwa kwigazi yomguli okanye xa bengena exudates, amakhalane abazizityebi; ngqo kwi eluswini boyikiswa walixhoba entsha.

amaqela ingozi

Amathuba High ukubamba abo iintsapho iqhenqa. Okokuqala, ngenxa yokuba amalungu entsapho kunzima ukuphepha ukunxulumana elide, kwaye okwesibini, ngokuba kukho yofuzo ukuya sifo. Couples abavumelekanga ukuba babe ziindlalifa. Kodwa ke kwizigulane kunye neentsana oomama bazalwa besempilweni. Ukuba aba bantwana nangoko angamvaleli solo ngokupheleleyo iqhenqa (iqhenqa). Le umyalezo kwesifo yiyo ayikacaci, kunye nezinye iindidi umngcipheko kubantu bebonke. Nangona kufunyaniswe ukuba esi sifo ngokukhutheleyo ekuphuhliseni kubantu abanamajoni omzimba buthathaka. Kukho iimeko apho abantu ukunyamekela abaneqhenqa, ahlala usempilweni, kodwa kwabagulayo nezalamane zabo, abangazange inxaxheba ukhathalelo. wazisa Doctor Daniel Danielson iminyaka emininzi kuye igazi abaneqhenqa, wayifaka exudate zabo inxeba kula maqhuqhuva emzimbeni, kodwa ke azicinywanga gciwane. Ngokubanzi, esi sifo kakhulu apho umgangatho ophantsi wokuphila.

Le Pathogenesis seqhenqa

Yezizathu, ngenxa yokuba ukukhula kade iintsholongwane Hansen luphuhlisa elide kakhulu yaye ityala seqhenqa eso. Le umyalezo kunye Pathogenesis kwesifo zezi: pathogen, ukubetha inxeba yangaphakathi okanye ingena egazini kunye nkovu, kwaye ezi ulwelo kwinkqubo luvo kunye namanye amalungu zangaphakathi. Kukho iintsholongwane ukuvelisa granulomas equlethe ezininzi macrophage. Abosulelekileyo, ukuba umntu aphile iminyaka kwaye abanalwazi ukugula kwabo. Ithuba elisuke ihlala kangangeenyanga ezintandathu, kwiminyaka engaphezu kwama-5, kwaye kwezinye iimeko, engama-20 okanye 40. Ukongeza bafukanywe, kukho ixesha efukamileyo (ixesha apho anekhono esisulelweyo nokosulela abanye). lingaphantsi thile kwe bafukanywe iqhenqa. Isigulana ngeli xesha inokuba akukho iimpawu okanye uphawula umkhuhlane elincinane, ukungabi namdla, ukudinwa kunzima, kodwa singabandakanyi isifo kakhulu, nangona oko esosulelayo.

iimpawu

Gciwane kuchaphazela kuphela imazi ibonakalisa emlonyeni, kodwa emiphungeni, yaye iiseli kwalapho (Schwann). Kunye nokuqhubekeka iintsholongwane sifo afumaneka emehlweni, esibindini, nkqu ebuchotsheni. Uphawu lokuqala kwisigulo - ukuba intlungu nzima nokunyamezeleka kwi yesiqephu, iqolo. Ngelo xesha, izigulane usenokukhalaza yobuthathaka, ukozela, ukungabi namdla, ukuphazamiseka kwesisu. Kwixesha elizayo, iintlungu indawo yakhawuleza esibuhlungu, yaye ke loo mntu ulahlekelwa yonke imvakalelo kwimimandla echaphazelekayo. Oku kubangela iingozi, nezinye izifo, yaye ekugqibeleni ukulahlekelwa iminwe, iziphene lakho ezandleni nasezinyaweni. Mycobacterium leprae ngaphakathi ngokwabo musa ndiwuhlutha yomlenze yesigulane. Xa iqhenqa iintlobo ezimbini eziphambili - liqhenqa tuberculoid kunye lepromatous. iimpawu zazo ezahlukeneyo, ngoko khangela nganye iinkcukacha ezingaphezulu.

Tuberculoid iqhenqa, umyalezo weimeyile, iimpawu, unyango

Olu hlobo isifo eso ngeendlela ezintathu:

• polar;
• umda;
• undifferentiated.

Uphawu engundoqo ngokubonakala kweqhenqa tuberculoid lolusu hypopigmented (ukukhanya) amabala ecacileyo. ifomu Undifferentiated uyakwazi self-lokuphilisa okanye bafudukele kakhulu ngakumbi. Ekuqaleni, isikhumba kwisiza nombala na ethe kakhulu, kodwa kungekudala ibala iqala ukwandisa, imiphetho uPienaar, lo gama inxalenye engundoqo, phezu koko, imiqadi. Akukho kwamadlala umbilo, iinwele iyanyamalala, isikhumba ulahlekelwa ubuntununtunu sayo. Ngaphandle amabala luvo izokhula njengoko eletha Hansen bakhule futhi yenyuse iiseli abachaphazelekayo. Usulelo lwe-luvo ebangela yoma kwezihlunu, contracture iinyawo nezandla. Xa iibhaktheriya ezichaphazela luvo kobuso izigulane nesifo iliso, ekugqibeleni kukhokelela kubumfama.

liqhenqa lepromatous

Olu hlobo sifo kakhulu ngakumbi yaye yingozi ngakumbi kubantu singqongwe sisigulane. Kukho iintlobo ezimbini:

• polar;
• umda.

Enye iimpawu eziphambili sifo nazo amabala, kodwa bona babe picture eyahlukileyo kancinci - i enkulu, amalungiselelo symmetrically malunga olunemiqathango median umgca omzimba womntu, kunye nemida olungaqondakaliyo neziko ashinyeneyo khaxa. Ukongeza ukujaduka amabala inokuba ngohlobo maqhuqhuva, umonakalo okanye papules. Bonke bephela zibizwa ngokuba leproma kwaye ziqulathe infiltrate amawaka yeentsasa sikaHansen. eziphawuleka kakhulu kwenzeka ntoni xa izigulane kunye nabantu liqhenqa. Baya kuwa ngaphandle amashiya nasemashiyini, impumlo iwela (lamva), kukho egqwethekileyo (kuba ziyatyeba) imilo ngeendlebe, ulusu phezu kobuso ( "ingonyama ubuso"), baphuke yobuso. Okunye zimpawu:

• iingxaki impumlo (ngeempumlo, ukuphefumla nzima, maxa wambi igazi liya ukusuka impumlo);
• utshintsho voice (uba icule);
• iingxaki umbono (keratitis, iridocyclitis);
• nodes nkovu zidumbileyo kwi nasemiphakathweni;
• afunxwe esikule amasende;
• imfundo kwi ndawo seqhenqa eyaphukileyo izilonda agula;
• ilungu ubuthathaka, yoma, yaye ekugqibeleni necrosis.

Kukho uhlobo exubeneyo seqhenqa, apho zombini uneempawu ze tuberculoid neefom lepromatous.

ekuxilongweni

isifo iqhenqa, lo umyalezo kunye Pathogenesis neya nangoku efundwayo, axilonge iindlela eziliqela.

1. Clinical. Kuyinto uhlolo olubonakalayo eluswini isigulane, ekuchongeni isifo non-onovakalelo kwaye ulusu.
2. Ezincane. Xa nasopharyngeal asaqhuba kakhulu (igazi phezulu) ukukrwela, ukuthatha izinto ukusuka kwindawo nkovu. Neemicroscope ibonisa isigulane ubukho mbhoxo iimpawu okanye iiseli lepra ngeenxa zonke. Smear bahlambuluka Ziehl - Nielsen, ngenxa Mycobacterium leprae endala kuba ebomvu, namatakane becala oluhlaza.
3. test komzimba (Meath-enkundleni). Phantsi kwesikhumba ephathwa lepromin (obalungiselwa kwinyama ezithathwe izigulane liqhenqa). Ukuba lo mbandela osulelwe, iye ngaphantsi kosuku eluswini kwindawo le aphakama isampula redden.
4. Lweseroloji umkhuhlane.

unyango

Liqhenqa wokususa lide kakhulu, ukuya kutsho kwiinyanga ezili-12, yaye ngamanye amaxesha neminyaka. Kuphela kwanonyango ebanzi ebandakanya ophthalmologists, orthopedists, neurologists. Amachiza Antibacterial nazo kusetyenziswa zidityaniswe. Oku "dapsone" ngokubambisana "clofazimine" yaye "rifampicin". Kuba isigulane ngasinye abafumana algorithm idosi kunye neziyobisi ngamnye. Ezinye iintlobo sifo ziphathwe ukusetyenziswa ababini kuphela olwa ngasentla ezintathu kumiselwa gqirha. Senza zokwenza uvavanyo iziyobisi "Minocycline" "Clarithromycin", "ofloxacin" njengoko ichiza nxamnye seqhenqa eso. Ngenxa yoko, izigulane sibulawa zonke iintsholongwane seqhenqa, kodwa ke umonakalo bakufikise amalungu nesikhumba (ukuba beze kule) kuhlala.

Outlook

Ukuba unyango uqalwa ngexesha, isiphumo kunokuba evumayo. Izigulane abakwazi ukuhlala eluswini akukho mkhondo. Xa sesihambe emva kwimpilo ayisekho kunokwenzeka, loo mntu uhlala ikhubaziwe ebomini, kodwa kusenokwenzeka ukuba ukubuyisa enyama yangaphakathi, nto leyo kuyolula ubomi bakhe.

Uthintelo esi sifo iquka:

• yococeko, ingakumbi xa kwiindawo apho seqhenqa elichumayo;
• isigulo kwangethuba kunye nonyango;
• iliso othintelo zonke, ngubani ixesha elide obekudibene nezigulana liqhenqa (oogqirha, usapho).