Pamusoro pechirwere chakavanzika .. meningitis, marudzi ayo, zviratidzo

Meningitis chirwere chinoputika chinokanganisa mucous membranes yakakomberedza uropi uye musana wemusana, unokonzerwa nehutachiona hwehutachiona kana hwehutachiona.

Bacterial meningitis:

Prognosis: Pane mukana wakanaka wekupora pasina kukuvadzwa kwechibvumirano, uye mikana yekupora zvachose, maererano neongororo yekurapa, yakafungidzirwa pa90%, chero kurapwa kunoitwa padanho rekutanga. Zvikonzero zvinogona kukanganisa mikana yekupora zvakanyanya kurwara kwemurwere, kunonoka kutanga kurapwa, kana utachiona hwehukasha hwakanyanya kupfuura nguva dzose.

Aseptic meningitis:

Vatsvakurudzi havasati vabudirira pakuziva chikonzero cherudzi urwu rwekuputika, mukuedza kwavo kusimudza mutsika, mushure mekutora sampuli yemvura yemuviri - kubva pano, zita racho rakafuridzirwa (asi kune dzimwe nzira dzinobatsira kuziva chikonzero. yekuzvimba).

Zvingangodaro, chinokonzera chirwere chetachiona (munyaya iyi, hutachiona hunokonzerwa nehutachiona), asi mune nhamba shomanana yezviitiko, chimwe chikonzero chetachiona, semaparasite, chinotaurwa.

Viral meningitis (kuzvimba kwe membrane kunokonzerwa nehutachiona):

Mavhairasi anonyanya kushandiswa kukonzera meningitis ndee enteroviruses. Zvimwe zvinowanzokonzera hutachiona ndeye arbovirus, oral herpes simplex type 2 uye human immunodeficiency virus (HIV). Zvirwere zvinokonzerwa ne enteroviruses uye arthropod virus ndezvemwaka, uye kuwanda kwavo kunowedzera zvakanyanya muzhizha.

Chiratidzo: Chirwere chacho hachina kunaka, fivha nomusoro zvinopera mukati mevhiki imwe chete, uye kunze kwezvimwe zvisingawanzoitiki, kupora kunopedzwa muzviitiko zvakawanda.

Zviratidzo zve meningitis

Zviratidzo zvemeningitis Chiratidzo chinonyanyozivikanwa pakuongororwa kunetsa kufambisa mutsipa
(Izwi rekuti “meningeal signs” rinoreva zviitiko zvinonzwikwa uye zvinotsanangurwa nemurwere, nepo izwi rekuti “chiratidzo” richireva zvinhu zvinoonekwa nachiremba panguva yekuongororwa.) Zviratidzo zvemeningitis zvinogona kuonekwa: musoro, photophobia; Zviratidzo zvinotevera zvinoonekwa: Kupisa, kuoma paunenge uchifambisa mutsipa mu ndege ye anterior-posterior (chiratidzo ichi hachigone kuonekwa muvana nevakwegura).

Zvinogoneka zvimwe zviratidzo zvechirwere: Shanduko muchiyero chekuziva, kusvotwa uye kurutsa, pfari (pfari), cranial neuropathy, uye zvinotevera zvimwe zviratidzo zvinogona kuoneka muvacheche nevana: Kunyanya kushatirwa, kusagadzikana uye kukanganisa mukudya.

Zviratidzo nezviratidzo zveaseptic meningitis: Zviratidzo zvinowanzoitika kutemwa nemusoro, kusvotwa, kupera simba zvachose, uye chiratidzo chinonyanyozivikanwa pakuongororwa kuomerwa nekufamba kwemutsipa (kuoma kwemuviri). Mufananidzo wechirwere kazhinji hauna kukweretwa kupfuura mufananidzo wakasiyana webhakitiriya meningitis.

Zvikonzero uye njodzi dzeMeningitis

Iyo inonyanya kurwisa-kuzvimba ndeye pneumococci - inokonzeresa inosvika hafu yezviitiko, uye inoonekwa seyo honzeri yehuwandu hwekufa), meningococci - iyo dzimwe nguva inoratidzika seyakapararira rash, inosanganisira ane mukurumbira madotsi epepuru), uye ( Hemofilus - huwandu hwehutachiona nehutachiona uhu hwave huchiderera zvishoma nezvishoma kubva pakatanga kugamuchirwa, uye kunyange kukurudzirwa kuvana). Utachiona neutachiona hutatu uhwu hunoita chikamu che80% chezviitiko zvese zvehutachiona hwehutachiona.

Vanhu vari panjodzi yekubatwa nechirwere ichi iboka revanhu vanotapukirwa nenzvimbo yakasvibiswa inoshingaira, yakadai sehutachiona hwemukati nzeve, sinusitis muchiso (Sinusitis), mabayo uye endocarditis;
Zvimwe zvinokonzerwa nengozi zvinosanganisira: cirrhosis, kudhakwa, chirwere chakashata chesero reropa, kusagadzikana kwekudzivirira muviri, uye kukuvara kwemusoro kwakakonzera kubuda kwecerebrospinal fluid pedyo nenguva yehutachiona.
Utachiona hushoma hunowanzoitika ndeye Streptococcus B. Vanhu vazhinji vanobatwa neutachiona uhu vana vari pasi pemwedzi mumwe chete, Listeria, izvo zvinokonzeresa chirwere pakati pevacheche nevakwegura, Staphylococcus, chakonzera utachiona pakati pevanhu nekukuvara kwekupinda mumusoro kana pakati pevanhu vanenge vaita invasive medical operation yemusoro.

kurapwa kwe meningitis

Zvinotevedzwa pakarepo kurapa kutanga meningitis nemishonga inorwisa mabhakitiriya, kupiwa ngozi hunhu chirwere, kazhinji pakarepo pashure lumbar puncture (mushure mepuncture pane pamberi payo kudzivirira masking, sezvo kurapwa kunokonzera kukurumidza kuchinja cerebrospinal fluid values; uye zvino zvakaoma kunyatsoona chirwere uye pathogen) uye tisati tasarudza kuzivikanwa kwechirwere chacho. Mushonga unorwisa mabhakitiriya unoshandiswa pakurapa ceftriaxone, unopihwa nekupinda mutsinga, pachiyero che4 gramu pazuva. Imwe kurapa kwakajairika ndeye cefotaxime nekupinza mutsinga yemagiramu gumi nemaviri pazuva.

Kune vana nevakuru, penicillin inowanzowedzerwa ne intravenous infusion, pamwero we 12 gramu pazuva. Vancomycin inowedzerwa pachiyero che 2 gramu pazuva, muzviitiko zvekuzvimba kunotevera kukuvara kwemusoro kana kutevera nzira dzekurapa dzinopinda mumusoro.

Munguva pfupi yapfuura, zvakaonekwa kuti kuwedzera kwecorticosteroid yerudzi rweDexamethasone kunoderedza huwandu hwekufa uye njodzi yekuremara zvachose, pakati pevakuru vane emphysema yehuropi tishu, ine yakakwira intracranial pressure, uye nechirwere chinotyisa. (Kurapa ne corticosteroid-type dexamethasone yaingowanzoshandiswa pakati pevana, kusvikira kwete kare kare, uye yakawanikwa ichibatsira zvakanyanya kuderedza dambudziko rekunetseka, kunyanya, kupera kwemvura muvarwere vakakonzerwa neHaemophilus influenzae. Sezvambotaurwa, iyo yakatenderwa kushandiswa muvakuru Zvakare). Kusarudza pathogen uye kufungidzira kunzwisiswa kwayo kumishonga yakasiyana-siyana kunogonesa kuenderera mberi kwekurapa nemushonga wakakwana.

Kurapa kweaseptic meningitis: Kurapa kunowanzo kutsigira (sekurapwa nezvinobvisa marwadzo uye mvura inoiswa mutsinga) uye kunoenderana nezviratidzo zvemurwere.