Usulelo lwe-Infection ludluliselwa ngamaconsi aphuma emanzini ngamacontsk of mucus kunye namathe xa ukukhwehlela. Isizathu esibalulekileyo sokuphuhliswa kweempawu ze-pertussis ziyi-toxins ezikhutshwe yi-pertussis. I-pathogen ngokwayo igcinwe kwi-membrane ye-mucous yephepha lokuphefumula. Zonke iinkcukacha malunga nesi sifo oza kuzifumana kwinqaku ngesihloko esithi "Ukukhwehlela okukhuphayo: iimpawu, iimpawu, unyango".
Ukuzaliswa kweebhaktheriya
Usulelo luhamba kunye nokuveliswa kwe-hyperproduction ye-mucus kunye nokuvuvukala kwebhulethi ye-mucous yephepha lokuphefumula. Njengokuphindaphinda kweebhaktheriya, ezi ziqhamo ziyaqhubeka. Ukunyuka okukrakra kwi-mucus kunokukhokelela ekukhutsheni kwi-lumen ye-bronchi kunye nokuwa kweemiphunga. Ukongezelela, malunga nemvelaphi ye-pertussis inokuphuhlisa intsholongwane yesibini ngokuqala kwe-pneumonia.
Epidemiology
I-Pertussis isasazeka kwihlabathi lonke. Iziganeko zeso sifo zibhalwa rhoqo, kodwa zingathatha uhlobo lwesifo sengculazi. Ixesha lokuxubusha liqhelekile malunga neentsuku ezingama-7 ukususela ngexesha losulelo. Kwiindawo apho abantu bahlala khona kwindawo ehambelanayo, umngcipheko wokubambisana nabantu abanomdla uphezulu kakhulu. Emva kweMfazwe Yehlabathi II, kwakukho ukunciphisa okukhulu kwiimeko ze-pertussis kumazwe aseNtshona ngenxa yeenguqu kwi-socio-sector and, emva koko, ukugonywa komzimba.
Kukho amanyathelo amathathu ekuphuhlisweni kwesifo:
- i-catarrhal - ihlala malunga neveki kwaye ibonakaliswe ngubushushu obuncinci, ukuxininiseka kwendoda kunye nokukrazula. Iimpawu ezibonwe ngeli xesha azifani naziphi na iimpawu zokubanda;
- i-paroxysmal - ihlala kwiiveki ezi-2 ukuya kwii-4 kwaye ibonakala ngokuhlaselwa komkhuhlane odibeneyo, ongapheli ukuya kumasekhondi angu-20 ukuya ku-30. Ngethuba lokuhlaselwa komntwana akanalo ixesha lokuphefumula, ngoko ekupheleni kwaloo mpawu yokuphefumula (ukuphindaphinda) kuyava;
- kwinqanaba le-convalescence - lingadlulela iiveki eziliqela, ngexesha apho izikhwama zokukhwehlela ziphela. Ixesha elide lokukhwehlela eliqhubekayo lichaza igama lesi sifo eChina - "ukukhwehlela kwelanga elikhulu".
Inkqubo enzima kakhulu yokukhwehlela ibhokhwe ibonakala kubantwana abancinci. Zihlala zibhedlele kwizibhedlele. Kwiintsana, umfanekiso weklinikhi we-pertussis ungahluka kwi-classical one. Ukuhlaselwa ngokukhawuleza kaninzi kungahambisani nokuphindaphindiweyo, okubonakaliswe ngamaxesha okuphefumula (ukuphefumula ukuyeka ukuyeka) kunye nokukhawula. Abantwana besisu abanomkhuhlane oqhekezayo bafuna ixesha lokutya. I-Pertussis idla ngokubangela iingxaki ezinzulu, ngakumbi kubantwana kwiinyanga zokuqala zobomi.
I-pneumonia yinkxalabo eqhelekileyo yokukhwehlela okubangelwa yi-pertussis okanye isifo se-bacteria yesibini. Ukutshatyalaliswa kwengqondo - iimeko eziqhubekayo eziphazamisayo ziphuhliswa ngenxa yokunyuswa kwengcinezelo enganyanzelekanga kunye ne-hypoxia ngexesha lokuhlaselwa ukukhwehlela. Bangabonakalisa njenge-spasm okanye ukuvuvukala kwengqondo (encephalitis). Ixesha elide liquka ukukhubazeka, ukuphazamiseka kwegazi kunye nokukhubazeka kokuva, kunye nokunciphisa amandla okufunda. Ukuqhathaniswa kwesisu - ukwanda kweengcinezelo ze-intrathoracic xa ukukhwehlela kungakhokelela ekuphukeni kwemithambo encinane yegazi kwiso. Ukuphuma kwamanzi - kuhambelana nokugqithwa kweempahla ezincinci kwisigxina somsi. I-lesion yemiphunga - i-pneumonia yangexesha elide, eliye laphuhliswa ngokumelene ne-pertussis, lingakhokelela kwi-bronchiectasis (ukwanda kwentsholongwane ye-airways). Ukukhwehlela ukukhwehlela kubonakala ngokunyuka okuthe kratya kwinqanaba le-lymphocytes ekuhlolweni kwegazi jikelele, kodwa oku kuphawulwa kuyo nayiphi na intsholongwane kwaye ayikho uphawu oluthile. I-diagnostic ngokuchanekileyo yenziwe ngesiseko senkcubeko ye-pathogen evela kwi-nasopharynx.
Ukuchongwa kwe-pathogen
Ubunzima belolu hlobo lokuxilongwa kukuba i-result result is often found in early (catarrhal) yesigaba sesifo, xa umfanekiso weklinikhi ungaboni ukuba ukhonkxa nge-pertussis. Ngethuba ixesha lokusola libonakala ngakumbi, amathuba okuchonga i-pathogen ingaphantsi kwama-50%. Ukongezelela, i-smear ifanele ithathwe kwi-nasopharynx (kwaye ingekho kwisigxina se-nasal) kwaye ihanjiswe kwibhubhoratri ngokukhawuleza, mhlawumbi i-microorganisms equlethwe kuyo ingafa. Ukuzimisela kwe-DNA ukulandelelana kwe-pertussis ne-PCR (i-polymerase chain reaction) yindlela evelele ngakumbi kunokuba yodwa ibhaktheriya ephilayo. Uvavanyo olulolo hlobo lunokuba ngumgangatho oqhelekileyo wokufumanisa ukukhwehlela ukukhwehlela esikhathini esizayo.
Ulwaphulo lwe-antibiotics aluchaphazeli iimpawu zeklinikhi ze-pertussis, kuba zibangelwa yi-bhakteriya ngokwabo, kodwa zibangelwa yi-toxins. Nangona kunjalo, i-erythromycin yezifundo inceda ukunciphisa ixesha apho isigulane sithintela kwabanye. Ngoxilongo oluqinisekisiweyo lokukhwehlela, umntu wonke odibene nesigulane (ngakumbi abantwana bonyaka wokuqala wokuphila) uboniswa inkqubo yokukhusela i-erythromycin.
Unyango oluxhasa
Amanyathelo aqhelekileyo axhasayo ayenziwa, umzekelo, ukuqinisekisa ukutya okuqhelekileyo. Ukufumanisa iziqendu ze-apnea okanye i-oxygen deaguration (ukunciphisa amanqanaba e-oxygen), ukuqwalasela ngokucophelela ukuphefumla kuyimfuneko. Xa abantwana abane-pertussis bebhedlele, ukupheliswa kokuphefumula kunikezelwa. Ukuba ukhutshelwe ukusuleleka kwintsholongwane yesibini, ikhosi eqhubekayo ye-antibiotics efanelekileyo imiselweyo. Ukugonywa kwabantwana abancinci abakwazi ukunciphisa kakhulu iziganeko. Kwamazwe amaninzi, ugonyo lwe-pertussis luyingxenye yesigxina se-DTP esihlangeneyo (ngokumelene ne-pertussis, i-diphtheria kunye ne-tetanus) elawulwa kathathu. Kwafunyaniswa ukuba inxalenye ye-anticoagulant yale gonti ingabangela iziphumo zecala (ukusuka kwi-moderation ukuya kwi-severe). Iingxaki zogqithiso lweposi emva kokugonywa ziyahlukahluka kwi-subfebrile kunye ne-hypermia kwisiza sokungenwa kwintsholongwane. Ngama-1970, ukwesaba malunga neengozi ezinokwenzeka zokugonywa kwabangela ukukhishwa okukhulu kwezigulane. Ngexesha elifanayo, kwabakho ukwanda kwimeko yezikhubekiso ezinobunzima kubantwana abanokunyuka okulinganayo kwiziganeko zeengxaki ezibangelwa yiyo. Ngoku siyazi ukuba i-pertussis, iimpawu, iimpawu, unyango lwesi sifo.