Obstructive bronchitis - ua rau, kev kho mob thiab tseem ceeb ntawm tus kab mob

Bronchitis yog ib qho kab mob rau cov kab mob uas muaj cov kab mob ntawm cov phab ntsa ntawm cov bronchial uas muaj feem xyuam rau cov kab mob pathological. Yog tias obstructive bronchitis tau kuaj pom, qhov no txhais tau hais tias qhov mob yog nrog lub bronchial obstruction syndrome, uas yog, txoj hlua ntawm lub lumen ntawm lub bronchi tau pom, uas ua rau cov pa tawm ntawm huab cua.

Mechanism ntawm bronchial rhuav tshem

Bronchi yog ib qho khoom ua ke ntawm cov kab mob hauv lub cev, anatomically saib zoo li lub qhov ncauj ntawm lub trachea mus rau ob qhov chaw, ntawm qhov twg ob ceg cegs (bronchial ntoo) khiav tawm. Qhov tsawg tshaj plaws bronchial ceg yog txuas nrog cov kev kawm ntawm alveolar, ntawm qhov xaus ntawm lub alveoli nyob - kab npuas formations ntawm lub ntsws, los ntawm kev siv roj pauv qhov chaw. Lub plhaub tseem ceeb ntawm cov hlab ntsws yog kom tuav cov cua thaum lub sij hawm muaj kev tshoov siab nrog tib lub sij hawm ua kom zoo, ua kom sov thiab cua sov, thiab tshem tawm thaum siv exhalation.

Tiv thaiv kom tsis txhob muaj kev ywj pheej ntawm kev loj hlob ntawm kev loj hlob ntawm bronchi nyob rau hauv kev cuam tshuam ntawm irritating yam, muaj ib tug txo nyob rau hauv lub zos kev tiv thaiv, tus tiv thaiv system ntawm bronchi ceases kom tiv nrog nws functions. Hauv cov nqaij ntawm qhov mucosa, cov kev hloov hauv cov qauv hauv lub cev yog txuam nrog hypertrophy ntawm cov qog uas ua rau lub ntsws ntsws thiab ua rau lub hlwb ntawm cov clamated epithelium uas ua rau phlegm mus rau hauv cov hnoos qias-ua goblet hlwb. Raws li ib tug tshwm sim, ib tug thiaj li hu pathogenetic triad yog tsim:

• nce ntsws cov hlab ntsws;
• deterioration ntawm outflow ntawm hnoos qeev los ntawm lawv;
• ncua thiab tsub zuj zuj ntawm inflammatory secretions.

Cov txheej txheem no ua rau kev tso tawm ntawm cov tswv yim ntawm cov hlab ntsha bronchial, sib txawv ntawm cov neeg uas tshwm sim los ntawm cov kab mob uas tsis yog obstructive. Cov kws paub txog tias bronchial obstruction yog tsim los ntawm cov kev hloov kho thiab tsis ywj pheej. Cov thawj sawv daws yog:

• qauj ntawm lub lumen ntawm lub bronchi vim muaj cov nqaij mob contraction (bronchospasm);
• o ua mob nrog o ntawm mucous thiab submucosa bronchi;
• txhaws ntawm lub tsob ntoo bronchial nrog tuab, tsis zoo draining mucus masses.

Nyob rau hauv lub neej yav tom ntej, cov mechanisms no hloov los ntawm irreversible:

• stenosis ntawm lub bronchi, nrog los ntawm lub overgrowth ntawm nws lumen connective cov ntaub so ntswg;
• txo qis nyob rau hauv cov hluav taws xob tawm ntawm cov ceg me me ntawm bronchi;
• prolapse ntawm membrane phab ntsa ntawm cov loj bronchi thiab trachea nrog protrusion mus rau hauv lub lumen ntawm cov airways.

Ua rau obstructive bronchitis

Hauv cov neeg laus cov neeg mob, obstructive bronchitis feem ntau tshwm sim los ntawm kev cuam tshuam ntawm cov nram qab no:

• kev haus luam yeeb, uas cov hlab ntsws tuaj yeem txuam nrog cov tshuaj uas ua rau cov kab mob tsis zoo, cuam tshuam ntawm cov kaus txheej uas muaj teeb meem ntawm cov pa luam yeeb;
• teeb meem ua hauj lwm muaj feem xyuam nrog kev nqus tau pa, uas muaj hmoov av, tshuaj chiv keeb;
• ntau cov kab mob ua pa, weakening cov mechanisms tiv thaiv kev ua pa;
• caj ces - ib qho ua txhaum ntawm cov khoom muaj protein ntau α1-antitrypsin, ua rau kev puas tsuaj ntawm lub ntsws.

Muaj ob peb degrees ntawm txo nyob rau hauv lub lumen ntawm bronchi:

1. Yooj yim yooj yim - tsis ua rau muaj kev puas tsuaj loj hauv kev ua pa thiab kev hloov pauv.
2. Ntsig cov teeb meem ntawm lub bronchi - thaum lub lumen ntawm lub bronchi yog blocked los ntawm tsawg tshaj 50%.
3. Kev puas tsuaj nyuab heev - kev lumen ntawm lub lumen ntawm bronchi yog txo qis, uas ua rau txo cov pa oxygen nyob rau hauv cov ntshav thiab lub zuj zus hauv kev ua haujlwm ntawm txhua lub cev thiab lub tshuab.

Mob hnyav ua pob txha

Hlwb bronchitis nyob rau hauv cov ntawv tseem ceeb feem ntau tshwm sim hauv thaum yau thaum kis mob viral pathogens, nrog rau cov kab mob ntawm cov kab mob los yog los ntawm kev tsis haum tshuaj. Predisposed mus rau tus kab mob yog cov me nyuam uas tsis muaj zog tiv thaiv, muaj ib qho kev ua xua, qhov kev paub txog caj ces. Nyob rau hauv dav dav, me me thiab medium-qhov loj me ceg muaj cuam tshuam, thiab kev cuam tshuam ntawm loj bronchi yog tsawg.

Chronic obstructive bronchitis

Nyob hauv cov txheej txheem ntev, muaj ntau cov kev so thiab exacerbation ntev, uas yog cov yam ntxwv ntawm lawv cov kev tshwm sim. Tshaj tawm rau daim ntawv ntawm tus kab mob no feem ntau yog txiv neej, raws li qhov tshwm sim ntawm kev ua rau lawv muaj teeb meem ua rau muaj kev puas tsuaj (kev haus luam yeeb, kev muaj mob muaj nkeeg) ntau dua. Nyob rau hauv cov ntaub ntawv no, tej zaum yuav muaj kev cuam tshuam ntawm lub me me bronchi, thiab ib tug txo nyob rau hauv lumen ntawm loj thiab medium bronchi, thiab qee zaus inflammation ntawm cov ntaub so ntswg alveolar.

Obstructive bronchitis - cov tsos mob

Mob ntsws mob hnyav nrog obstruction, lub sijhawm tsis dhau ntau tshaj peb lub lis piam, nrog rau kev kos duab:

• ntxiv zog kub cev;
• hnoos qhuav los yog ua tsis tau zoo (feem ntau cov kab mob tuag tes, mob loj dua thaum sawv ntxov thiab yav sawv ntxov);
• nce nyob rau hauv qhov zaus ntawm cov pa taw kom txog li 18 zaug ib feeb twg;
• cov tsos ntawm tus hawb hnoos hawbpob nrog cov pa, uas tuaj yeem pom qhov chaw nyob ib puag ncig txawm tias nyob deb, uas muaj zog rau qhov chaw ua haujlwm.

Kev mob ntsws los ntawm tus mob ob leeg, uas muaj tus kab mob rov qab tshwm sim dua 3 zaug los sis ntau tshaj ib xyoo, nws tus kheej tshwm sim nrog cov nram qab no:

• nquag mob taub hau;
• hnyav heev;
• tawm hws;
• txog kev ua tsis taus pa;
• "Khaus" hnoos nrog hnyav cais hnoos qeev, qee zaum yellowish xim av, nrog rau kev pleev ntawm ntshav;
• hawb pob, xuav caj pas thaum ua pa;
• tsis qab los noj mov.

Lub sij hawm ntawm kev sib zog, pib, sib haum mus rau lub caij ntuj no thiab raug tsom tawm tsam cov keeb kwm mob kab mob los yog mob hypothyroidism. Hauv qhov no, lub cev kub tau tuaj yeem ua tau, nws yuav muaj zog dua thiab ua rau mob qhov hnoos thiab mob hnyav, muaj teeb meem ua pa nyuaj. Txoj kev mob huam tuaj mus li 2-3 lub lis piam.

Hnoos nrog obstructive bronchitis

Qhov ntau tshaj tawm ntawm cov hnoos qeev, pob txha hnoos nyob hauv lub bronchi, provokes ib obsessive hnoos nrog obstructive bronchitis, uas yog nyob rau hauv qhov chaw siab. Cov lus ceeb toom tau pom thiab ntev ntev tau pom thaum hmo ntuj thiab tom qab sawv ntxov sawv los lawm. Lub ntsev ntsev tsis muaj zog yog tsis muaj zog, nws muaj peev xwm kis tau tus cwj pwm ua purulent, thiab qhov no nws yog kev saib raws li kev rov mob ntawm tus kab mob. Kev hnoos yog ib txwm nrog nws ua pa luv. Distal obstruction ntawm bronchi, uas tuaj yeem ua rau mob ntsws tsis muaj paug, yog muaj kev sib sib zog nqus thiab npau taws ntawm daim tawv nqaij.

Kub nrog obstructive bronchitis

Feem ntau, cov neeg mob uas xav tias muaj tus kab mob, yog txhawj xeeb txog seb puas muaj kub nrog obstructive bronchitis. Nws yog tsim nyog paub tias nrog cov kab mob no tsis tshua mob heev thiab tsis tshua pom muaj cov cim siab (feem ntau tsis siab dua 38 ° C). Lub febrile xeev muaj ntau raug rau cov kab mob ntawm tus kab mob, thiab mob ntev obstructive bronchitis hauv feem ntau tshwm sim rau cov tom qab ntawm qhov kub thiab txias.

Obstructive bronchitis - kev kho mob

Txhawm rau txiav txim siab yuav ua li cas kho ob yam kabmob ntswj (obstructive bronchitis), tus kws kho mob tau qhia txog ntau cov txheej txheem kuaj mob, uas ua rau nws paub txog qhov ua rau ntawm lub chaw kuaj mob thiab qhov nws paub ntau npaum li cas. Cov txheej txheem muaj xws li:

• auscultation thiab percussion ntawm lub ntsws;
• Radiography (nrog rau kev qhia txog cov khoom nruab nrab);
• spirography ;
• tsom iav thiab cov kab mob bacteriological ntawm hnoos qeev;
• kuaj ntshav (feem ntau, biochemistry);
• immunological tests thiab thiaj li nyob rau.

Cov mob hnyav heev hauv tsev kho mob loj yog nyob hauv tsev kho mob. Mob ntsws thiab mob ntsws nrog mob hnyav, nrog rau kev kub ntxhov, tshwj xeeb yog yuav tsum tau pw so. Tom qab ua kom txhua tus neeg mob, cov neeg mob yuav tsum tau mus ua kom taug kev hauv huab cua ntshiab, tshwj xeeb tshaj yog thaum sawv ntxov. Ntxiv rau, cov neeg mob yuav tsum ua raws li cov tswv yim nram no:

1. Kev tsis kam haus luam yeeb (fencing ntawm passive smoking).
2. Sov nti thiab plentiful dej haus (lub niaj zaus cai ntawm kev haus yuav tsum tau nce 1.5-2 lub sij hawm).
3. Noj zaub mov zoo nrog kev cais tawm ntawm cov nyom, khaus, zaub mov kib.
4. Cov huab cua hauv chav nyob uas tus neeg mob nyob yuav tsum huv, ntub dej.

Txoj kev kho mob loj:

• tshuaj kho mob;
• cov txheej txheem physiotherapeutic (percussion thiab vibrating massage, electrophoresis, inhalation);
• pa, hnoos qoj ib ce.

Obstructive bronchitis - xub pab neeg

Cov neeg uas tau tsim cov pob txha hnyuv ntses, kev khomob xwmtxheej ceev tuaj yeem yuav tsum tau lub sijhawm twg los tau, vim hais tias qhov kev zuaj siab ntawm kev zawm nws tuaj yeem tsim sai thiab tsis zoo. Cov tsos mob uas qhia tau hais tias muaj kev phom sij yog: kev sib cav zaum uas zaum ntawm ntug ntawm lub rooj zaum nrog ob txhais ceg sib nrug, hnoos qhuav hnoos nrog hawb pob thiab xuav, xiav daim di ncauj thiab lub qhov ntswg, siab. Hauv qhov no, koj yuav tsum hu rau lub tsheb thauj neeg mob.

Ua ntej tuaj txog ntawm cov kws kho mob, koj yuav tsum tau:

1. Npaj tus neeg mob nrog airflow.
2. Tshem cov khaub ncaws uas txwv tsis pub ua pa.
3. Thov ib lub tshuaj txau-aerosol nrog ib lub bronchodilator, yog tias yav dhau los nws tau xaiv ib tus kws kho mob.
4. Siv cov txheej txheem txo lub thawv ntawm lub bronchi, uas ua rau ua pa ntawm cov roj nplua nuj - khiav tawm thiab nqus pa, nruj nias lub hau rau tus neeg.

Obstructive bronchitis - siv yeeb siv tshuaj

Cov neeg mob uas muaj cov tshuaj "obstructive bronchitis" tuaj yeem kho cov nram qab no:

• bronchodilators ( Salbutamol , Atrovent, Serevent);
• mucolytics (Ambroxol, Trypsin, Acetylcysteine);
• tshuaj tua kab mob rau obstructive bronchitis (Azithromycin, Cefuroxime, Clarithromycin);
• glucocorticosteroids (Prednisolone, Fluticasone);
• non-steroidal anti-inflammatory (Ibuprofen, Paracetamol, Nimesulide).

Txhaws pa nrog obstructive bronchitis

Thaum kev kho pob txha ntawm cov pob txha yuav tsum tau muaj, ib qho ntawm txoj kev khiav haujlwm zoo tshaj plaws yog nqus cov pa roj ntsha. Cov tshuaj nquag siv ntawm cov neeg siv tau raug xa tuaj hauv ib lub sij hawm luv luv rau cov kev tshuaj xyuas kab mob pathological, uas tshem tawm cov tshuaj tua kab mob, txo qhov mob, thiab thim phlegm. Peb sau cov tshuaj yeeb dawb rau nqus:

• Berodual ;
• Atrovent;
• Berotek;
• Ventolin;
• Lazolvan;
• Budesonid thiab lwm tus.

Obstructive bronchitis - pej xeem txoj kev kho mob

Kev kho mob ntawm obstructive bronchitis nrog pej xeem tshuaj yog qhov tau txais tom qab kev pom zoo nrog tus kws kho mob, thiab cov neeg noj zaub mov tsuas tuaj yeem pab rau txoj kev kho kom yooj yim. Feem ntau, cov neeg kho mob pom zoo noj cov kua txiv hmab txiv ntoo ntawm cov tshuaj ntsuab thiab cov tshuaj tiv thaiv uas ua rau qog ib tus expectorant thiab cov nyom ua rau me nyuam yaus (niam-thiab-niam, tus txiv hmab txiv ntoo licorice, thyme).

Pib daim ntawv qhia raws li dos

Cov khoom xyaw:

• dos - 500 g;
• piam thaj - 400 g;
• zib mu - 50 g;
• dej - 1 liter.

Npaj thiab siv

1. Tev thiab chop lub dos.
2. Sib tov nrog piam thaj, zib mu, ntxiv dej.
3. Boil on tsawg cua sov rau peb teev, txias, ntws.
4. Siv ib tablespoon 4-6 zaug ib hnub twg.

Obstructive bronchitis - teeb meem

Mob nyhav nyhav los ntawm cov hnyuv txhaws feem ntau muaj li nram qab no:

• emphysema ntawm lub ntsws ;
• ua pa tsis txaus;
• pulmonary lub plawv ;
• bronchiectasis;
• theem nrab ntsig txog ntshav siab.