Ukutheleleka kudluliselwa ngamaconsi angena emanzini ngamaconsi emisipha namathe uma ekhwehlela. Isizathu esiyinhloko sokuthuthukiswa kwezibonakaliso ze-pertussis yizidakamizwa ezikhishwe yi-pertussis. I-pathogen ngokwayo igcinwa embranini yomsindo wephefumula. Yonke imininingwane mayelana nalesi sifo uzothola esihlokweni esihlokweni esithi "Ukukhwehlela: izimpawu, izimpawu, ukwelashwa".
Ukukhiqizwa kwamabhaktheriya
Ukutheleleka kuhambisane nokukhiqizwa kwe-hyperproduction ye-mucus nokuvuvukala kwebhande elimangcwaba lephefumula. Njengoba ukuphindaphinda kwamagciwane, lezi zenzakalo ziqhubeka. Ukwanda okunamandla kumasiki kungaholela ekuvinjweni ku-lumen ye-bronchi nokuwa kwamaphaphu. Ngaphezu kwalokho, ngokumelene nesizinda se-pertussis kungase kube nokutheleleka kwesibili ngokuqala kwe-pneumonia.
Epidemiology
I-Pertussis isakazeka kabanzi kuwo wonke umhlaba. Amacala omuntu ngamunye wale sifo aqoshiwe njalo, kodwa angathatha uhlobo lwezifo eziwumshayabhuqe. Isikhathi sokukhushulwa ngokuvamile siba nezinsuku ezingu-7 kusukela ngesikhathi sokutheleleka. Ezindaweni lapho abantu bahlala khona endaweni ehambelanayo, ingozi yokuthola abantu abahlukumezayo iphezulu kakhulu. Ngemuva kweMpi Yezwe II, kwaba nokunciphisa okukhulu emiphakathini ye-pertussis emazweni aseNtshonalanga ngenxa yezinguquko emkhakheni wezenhlalo kanye, kamuva, ukugoma okukhulu.
Kunezigaba ezintathu ekuthuthukiseni ukutheleleka:
- i-catarrhal - ihlala cishe ngesonto futhi ibonakaliswa ngokushisa okuncane, ukuxubana komzimba kanye nokweqa. Izimpawu ezigcinwe kule nkathi azifani nezezimpawu zanoma yikuphi ukubandayo;
- i-paroxysmal - ihlala emasontweni amabili kuya kwangu-4 futhi ibhekene nokuhlaselwa kokukhwehlela okuxubile, okungahlala kuze kube semaminithi angu-20-30. Ngesikhathi sokuhlaselwa ingane ingenaso isikhathi sokuphefumula, ngakho-ke ekugcineni kwayo umoya wokuxuba (ukuphindaphinda) uzwakala;
- isiteji se-convalescence - singadlulela amasonto ambalwa, lapho iziqephu zokukhwehlela ziphela kancane kancane. Isikhathi eside sokukhwehlela okuphikisanayo kuchaza igama lesi sifo eChina - "ukukhwehlela kwezinsuku eziyikhulu".
Inkambo enzima kunazo zonke yokukhwehlela ikhwehlela ibonakala ezinganeni ezincane. Zivame ukungena esibhedlela ngenxa yalesi sifo. Ezinganeni, isithombe somtholampilo se-pertussis singase siqhathaniswe nesigaba esiyingqayizivele. Ukuhlaselwa okukhukhulayo ngokuvamile akuhambisani nokuphindaphindiwe, okubonakala ngezikhathi ze-apnea (ukuyeka ukuphefumula isikhashana) nokuchofoza. Izingane zomama ezinomkhuhlane okhwehlelayo ngokuvamile zidinga ukudla kwesondlo. I-Pertussis ivame ukubangela izinkinga ezinkulu, ikakhulukazi ezinganeni ezinyangeni zokuqala zokuphila.
I-pneumonia iyinkimbinkimbi evame kakhulu yokukhwehlela okukhwehlela okubangelwa i-pertussis noma ukutheleleka kokubili kwebhaktheriya. Ukunciphisa ubuchopho - ukucindezeleka okukhulu okuphikisanayo kuthuthuka ngenxa yokunyuka kwengcindezi engathandana nokuhlangana ne-hypoxia ngesikhathi kuhlaselwa ukukhwehlela. Bangabonakalisa njenge-spasm noma ukuvuvukala kobuchopho (encephalitis). Imithelela yesikhathi eside ihlanganisa ukukhubazeka, ukukhubazeka okubonwayo nokuzwa kokuzwa, nokunciphisa ikhono lokufunda. Ukwehla kwesisu - ukunyuka kwengcindezi ye-intrathoracic lapho ukukhwehlela kungabangela ukuqhuma kwemithambo encane yegazi iso. Ukuphuma kwegazi - okuhambisana nokuqhekeka kwezikebhe ezincane emgodini wezintambo. I-lesion yamapayipi - i-pneumonia yesikhathi eside, eyakhiwe ngokumelene ne-pertussis, ingaholela ku-bronchiectasis (ukukhula kwe-pathological of the airways). Ngokuba ukukhwehlela ukukhwehlela kubonakala ngokunyuka okubukhali ezingeni lama-lymphocytes ekuvivinyeni kwegazi jikelele, kodwa lokhu kubonakala cishe noma yikuphi ukutheleleka futhi akusona uphawu oluthile. Ukuxilongwa okuqondile kuyenziwa ngesisekelo somuthi we-pathogen kusuka ku-nasopharynx.
Ukubona kwe-pathogen
Ubunzima balolu hlobo lokuxilongwa ukuthi umphumela omuhle ungatholwa kuphela ekuqaleni kwesigaba (lesi catarrhal) sesifo, lapho isithombe somtholampilo singekho isizathu sokusola i-pertussis. Ngenkathi ukusola kubonakala ngokwengeziwe, amathuba okuthola i-pathogen angaphansi kwama-50%. Ngaphezu kwalokho, i-smear kufanele ithathwe kusukela ku-nasopharynx (hhayi kusuka emgodini wamanzi) futhi ihanjiswe ebhokisithri ngokushesha ngangokunokwenzeka, ngaphandle kwalokho izinambuzane eziqukethwe kuyo zingase zife. Ukunqunywa kwe-DNA ukulandelana kwe-pertussis ne-PCR (i-polymerase chain response) kuyindlela ezwela kakhulu kunokuhlukaniswa kwamabhaktheriya aphilayo. Uhlolo olunjalo lungaba yindlela ejwayelekile yokuthola ukukhwehlela okukhipha esikhathini esizayo.
Ukwelashwa kwama-antibiotic akuthinti izimpawu zomtholampilo ze-pertussis, ngoba azibangelwa yi-bacteria ngokwabo, kodwa yizifo ezibukhululayo. Kodwa-ke, inkambo ye-erythromycin isiza ukunciphisa isikhathi lapho isiguli sithinteka kwabanye. Ngokuthola ukuxilongwa okuqinisekisiwe kokukhwehlela, wonke umuntu oxhumana nesiguli (ikakhulukazi izingane zonyaka wokuqala wokuphila) uboniswa inkambo yokuvimbela i-erythromycin.
Ukwelashwa okusekelayo
Izindlela ezijwayelekile zokusekela zenziwa, isibonelo, ukuqinisekisa ukudla okunomsoco. Ukuthola iziqephu ze-apnea noma i-oxygen deaguration (ukunciphisa amazinga e-oksijeni egazi), ukuqapha ngokucophelela kokuphefumula kuyadingeka. Lapho izingane ezine-pertussis sezibhedlela, ukuqedwa kokuphefumula kunikeziwe. Uma kukhishwa ukutheleleka kwesibili, inkambo eyengeziwe ye-antibiotic efanelekile inqunywe. Ukugonywa okusebenzayo kwezingane ezincane kunganciphisa kakhulu izigameko. Emazweni amaningi, ukugoma i-pertussis kuyingxenye yokugonywa kwe-DTP kathathu (ngokumelene ne-pertussis, i-diphtheria ne-tetanus) ephethwe izikhathi ezintathu. Kutholakale ukuthi ingxenye ye-anticoagulant yale mithi yokugoma ingabangela imiphumela emibi (kusukela ngokulinganayo kuze kube nzima). Izimo zokugoma emva kokugoma zingahlukahluka kusuka kwi-subfebrile ne-hyperemia endaweni yokujova ukubhekana nokulimala okukhulu kwe-neurologic nokulimala kobuchopho (ezimweni ezingavamile). Ngomnyaka we-1970, ukwesaba ngeengozi zokugoma kwaholela ekwenzeni ukugoma okukhulu. Ngesikhathi esifanayo, kwaba khona ukwanda kwezikhwehlela zokukhwehlela ezinganeni ezinyuka ngokulinganayo ekuhlanganiseni kwezinkinga ezibangelwa yilo. Manje siyazi ukuthi yiziphi i-pertussis, izimpawu, izimpawu, ukwelashwa kwalesi sifo.