Ukusha Kwesibindi Kohlobo A: Izimpawu ezinganeni, uphethwe, ukwelashwa kanye nokuvimbela

Kubantu, isibindi uhlobo a laboratory yamakhemikhali, lapho igazi wahlanzwa eziningi ezinobuthi futhi elimazayo. Uma lokhu umzimba usebenza kahle, ke ubhekana imisebenzi yayo qualitatively, kodwa akusho ngaso sonke isikhathi kwenzeke. Kukhona izifo ezingaba nomthelela isibindi, njenge lokusha kwesibindi kohlobo A. Izimpawu ezinganeni nakubantu abadala, kubalulekile ukukhomba kusenesikhathi ukuze uqale ukwelashwa ngempumelelo. Ake sicabangele lokho kuyinto isifo ukuthi kungenzeka ligweme izinkinga ezingase zivele.

Kuyini nokohlobo A

Amafomu lesi sifo kungase kube ezimbalwa, konke izici zabo futhi izimpawu. Uma sicabanga nokohlobo A, kuba isifo esithathelanayo esithinta amaseli isibindi. Lesi sifo libhekene Yiqiniso eyindilinga abonakalisa izimpawu zokudakwa nokukhubazeka ezahlukene umsebenzi walo mzimba.

Uma ubheka i-ngezigaba international, le-hepatitis A ihlukaniswe izinhlobo eziningana:

• Hepatitis kanye ikhoma hepatic.
• Acute lokusha kwesibindi kohlobo A.
• Ngaphandle ikhoma hepatic.

ukubonakaliswa Clinical kwesibindi

isifo ngasinye yayo, i-hepatitis A has ngalezi zikhathi ezilandelayo:

1. I bayashintshana ekufukameleni. Iqala ngemva igciwane lingena emathunjini ngomlomo, bese-ke ingena phakathi kwesibindi, lapho uqala zizalela olunzulu. Isikhathi bayashintshana ekufukameleni Uthatha nokohlobo A emavikini amathathu noma amahlanu.
2. isikhathi Preicteric iqala okuvela izimpawu zokuqala zesifo - kwehle esesuthi, ukukhathala kungaba khona ubuhlungu esiswini. Ngokuvamile kukhona ukwanda lokushisa.
3. Ukubonakaliswa acacile isifo, esibonakala by isikhumba ophuzi, umchamo onombala bese indle okhanyayo. Ukusha Kwesibindi Kohlobo igciwane kubangela ukwenyuka isibindi, ubende futhi ngezinye izikhathi kwandisa.
4. In the isinyathelo esilandelayo kunciphisa kuqala, isimo lesiguli kuthuthukisa, isibindi ubuyela Ubukhulu yayo yasekuqaleni.
5. Isikhathi yokutakula, ngokuvamile okuthatha cishe 3 izinyanga. Ngalesi sikhathi, ingane namanje azizwa kwaba lokungahlaliseki kungenzeka izikhalazo.

Uyithola kanjani batheleleke nge-hepatitis

Ukusha Kwesibindi Kohlobo igciwane avame kuthinta umzimba wengane. Pathology kungenzeka ezimweni ngazinye noma ukuqubuka ezincane, lapho wonke iqembu ogulayo enkulisa noma ibanga esikoleni.

Ukusha Kwesibindi Kohlobo - isifo esithinta abantu kuphela, futhi ngenxa yalokho isakaze amagciwane kungaba indoda. Ngokuvamile lokhu indima eyadlalwa nesineke ifomu atypical kwesibindi A, lapho lesi sifo hhayi sitholakale. Umuntu kuyinto othwala igciwane, zokuthelela emhlabeni abanye.

Ukutheleleka nge-hepatitis A kwenzeka ngezindlela ezahlukene, ngokuvamile ukudla, amanzi, angadluliselwa ngokusebenzisa indle. Transmission kwesibindi sisemoyeni kungenzeki kungaba batheleleke ngesikhathi ukumpontshelwa igazi, kodwa ngenxa nokuntengantenga igciwane egazini, lokhu ingozi oluphakeme encane.

Umzimba womuntu zithandwa ukutheleleka, ngokuvamile umqedazwe oluqubuka empandleni izikhungo lapho inombolo enkulu izingane ngesikhathi esisodwa ushaya nokohlobo A (izimpawu ezinganeni, cabangela kancane kamuva). Kufanele kuqashelwe, uma umuntu ngenxa kanye empilweni yakho, ezifana izingane, savelelwa isifo, izivikeli mzimba ukhiqiza elingapheli nalapho sezikhulile.

ngezigaba

Silingane isihloko ngokuya ngohlobo, kobukhulu kanye Yiqiniso lesi sifo. Lezi zinhlobo ezilandelayo nokohlobo A:

1. Ejwayelekile, esizibonakalisa zonke izimpawu ejwayelekile lesi sifo.
2. Atypical, kube ukusulwa izibonakaliso libhekisela sibi.

Izimpawu zesifo zincike kobukhulu isifo, odokotela ihlaba umkhosi:

1. ifomu emnene okuyinto esijwayeleke kakhulu ezinganeni. Ukudakwa ibuthakathaka, isibindi kwandisa kancane. Lesi sifo has a imvelo cyclical, futhi yokutakula kwenzeka cishe inyanga.
2. Ukusha Kwesibindi Kohlobo A kobukhulu ngokulinganisela. Kube bushelelezi Yiqiniso lesi sifo, yellowness ngokulinganisela uzwakalise, kungandisa hhayi kuphela isibindi, kodwa futhi ubende. Izimpawu lokudakwa kungase kuphikelele amaviki angu-2. Buyisela umzimba okwazi izinyanga ezimbili kuphela.
3. ifomu Sinzima sitholakale kuqhathaniswa akuvamile. Izimpawu lokudakwa kakhulu ubonakalisiwe, ingane iba ucobekile, ukucobeka. Kube kufanele isiyezi, ukushaya kwenhliziyo okungajwayelekile, umongozima, ukuqubuka esikhumbeni. Isibindi luyanda kakhulu ngobukhulu, futhi kukhona ubuhlungu obukhulu ku palpation.
4. ifomu Anicteric kwenzeka eminyakeni engu-20% eziguli. Ayikho yellowing we sclera kanye isikhumba uyalandelwa. Kukhona ubuthakathaka, ukungakuthandi ukudla, kungenzeka ukuhlanza nesicanucanu. Lesi sifo bungabonakala isibindi lakhulisiwe.
5. Libuye libe ifomu subclinical lesi sifo, lapho izimpawu jikelele bengekho. Sifo zingenziwa kuphela ngemva zokwelapha. Izingane ezinjalo zisekelwa inqubo ubhubhane e collective yezingane.
6. Kungase kube cholestatic lokusha kwesibindi kohlobo A. Izimpawu ezinganeni kuyagcinwa ngesimo jaundice. Isikhumba asikwazi kuphela abe phuzi, kodwa Tint umbala ogqamile. Kubonakala isikhumba silume, inyuka isibindi kancane. Isebenzisa uhlobo eside, ungakwazi yokwelula izinyanga eziningana, kodwa ezingamahlalakhona aluphumeleli.

Inkambo isifo ezinganeni

Kanjani nokohlobo A ezinganeni, kuzoya inkambo isifo. Odokotela wazi:

1. Yiqiniso olunamandla. Litholakala isikhathi esiningi futhi, njengoba umthetho, zonke izimpawu zinyamalale emasontweni 2-3. Acute nokohlobo A ezinganeni kungathatha izinyanga 3, kodwa namanje esikhathini esithile ngemva yokutakula kungenzeka ezinye izikhalazo.
2. Yiqiniso eside ngithi uma isifo akusho ukubohla iminyaka engaphezu 3 izinyanga. Isibindi isikhathi eside angeke buya ezivamile, kodwa yokutakula kuyofika ngokushesha noma kamuva, uma wonke isincomo udokotela.
3. Pathology nge exacerbations. Lapho ezifana zamanje zandisa izimpawu zokwelashwa isifo, eziwohlokayo isibindi umsebenzi ukuhlolwa, eside egcinwe inqubo sokugembula e emangqamuzaneni omzimba.
4. Inkambo isifo, esithinta ipheshana biliary. Ngokuvamile Lokhu kwenzeka ngo ifomu ngokulinganisela. Lesi sifo kungavuka ngaphandle izimpawu ezisobala futhi kungenziwa kuphela ukutholwa izifundo laboratory.
5. Pathology ngoba ukubusa izifo intercurrent. Izifo ukuthi kunezelwa, njengoba umthetho, musa ukwandisa kobukhulu izimpawu HCV kodwa kungase kuvuse ukwanda esibindini.

Ukuxilongwa nokohlobo A

Okuyikona ngoba noma isiphi isifo iqala izifundo zokwelapha. Ukuthola kwesibindi A ezinganeni lusekelwe futhi epidemiological, laboratory kanye idatha emitholampilo.

Uma usola ukuthi lokhu zokugula thatha kokuhlahlela Ukuhlolwa lokusha kwesibindi kohlobo A. zingahlukaniswa zibe ethize, zisiza atholakala lesiguli igazi HAV RNA ngu-PCR kanye namasosha omzimba elwisana HAV JgM ngu ELISA.

Ngosizo izinkomba ze-non-ethize lungacacisa degree yokulimala isibindi, ukuhlola isifo, namandla aso kanye ongenza isibikezelo. Lapho kuthathwe igazi ukusha kwesibindi kohlobo A, qinisekisa ukuthi yokuhlola ukucacisa umsebenzi enzyme hepatocellular kanye nezinkomba sombala umzimba.

Kwaze kwaba yilapho sebeshiye uphethwe kwaleso sifo usungaqala yokwelapha.

Kodwa ngendlela efanele usaqala lesi sifo, abazali bangakhulisa sinake izimpawu zaso futhi ngokushesha afune usizo lwezokwelapha. Ake sibheke izimpawu kwesibindi A ukuthi abazali basuke bedinga ukwazi.

Symptomatology isikhathi predzheltushnogo

Ubude lesi sikhathi - kusuka 3 kuya 7 izinsuku. Siqukethe esigabeni infective futhi ubuthi yesibili. Eyokuqala libhekene ukubonakaliswa umzimba ukudakwa yengane, kubangelwa ukulimala isimiso sezinzwa. Ukuqala Kwenkathi lesi sifo ngempela abukhali, kanye zimpawu ezilandelayo:

• Ukwanda kokutheleleka kudlange kakhulu lokushisa.
• ubuthakathaka Jikelele.
• Ubuhlungu bekhanda.
• Tachycardia.
• Ezingavamile, kodwa kungenzeka ukuhlanza.
• Ubuhlungu besisu.

isikhathi ezithathelwanayo ihlala kwezinsuku ezimbalwa, bese amathonsi lokushisa, ingane ngcono. Nakwele ubuthi yesibili futhi izimpawu zaso eyobonisa ukuthuthukiswa yokwehluleka kwesibindi, izimpawu nokohlobo A kuleli cala, kancane kancane, wayevame ukuthi:

• Ukucobeka.
• Nokunganakwa.
• Ukozela.
• Mhlawumbe isiyezi.
• Kwehliswe esesuthi, kukhona ukuya ukudla okunamafutha.
• Ukucanuzela kwenhliziyo nokuhlanza.

Kulesi sigaba, isibindi kuyinto ohlangene, inyuka ngokuphawulekayo ngobukhulu, ingane ingase ubuhlungu ngakwesokudla quadrant engenhla. Uma ngalesi sikhathi ukuthatha ukuhlolwa igazi, wabe esethola ukwanda enzyme isibindi.

Iphela nenkathi preicteric of umchamo onombala bese sezinyawo ukushintsha kombala.

Izimpawu ezinganeni esikhathini icteric

Uma sisheshe nokohlobo A, izimpawu ezinganeni esikhathini icteric incike nesigaba lesi sifo. Ziyakwazi ezintathu: ukwanda izimpawu, ukuphakama isifo kanye nokwehla.

Esikhathini igazi, anda amazinga bilirubin, ngokuvamile, le nqubo ithatha izinsuku 6-8, bese iqala ukwehla, uma esihle lesi sifo. amaprotheni Kushintshwe, amafutha, umzimba carbohydrate, ukuphazamiseka kwengqondo amanzi-usawoti ibhalansi kanye umsebenzi kwesibindi uyahlabeka.

Ngokuvamile, izimpawu nokohlobo A ezinganeni ezineminyaka engu-6 ubudala kule nkathi zimi kanje:

• Temperature ingahluka discontinuously. Zonke kuncike khona ohambisana pathologies kanye nezinkinga izinqubo ukuvuvukala.
• Aphazamise uhlelo senhliziyo nemithambo yegazi.
• izinguquko sokugembula e isimiso sokugaya ukudla bungene.

Kufanele kukhunjulwe ukuthi yesisindo lesi sifo ukuthi ukusha kwesibindi kohlobo A kwenza izinguquko ukusebenza inhliziyo, okuyinto zichazwe ayephuli izinqubo umzimba e imisipha yenhliziyo.

Izenzo esikhathini poslezheltushnom

Lapho uqeda jaundice isikhathi yahlulelwe inani bilirubin egazini. Uma izibalo lehla uhla evamile, kungenzeka athi isiqongo lesi sifo ngemva.

Jaundice kuvame ukuthatha isikhathi amasonto amabili, kodwa Singase sithathe isikhathi esijana. Poslezheltushny ungase ube nobude amasonto amathathu, kodwa ezinye izingane - futhi ezinyangeni ezimbalwa. Azikho izinkomba ocacile sekupheleni kwesikhathi, ngokuvamile ukhonza njengoba umbandela esiyinhloko ukuzinza ka isibindi usayizi nokwehlisa enzyme isibindi.

Kanjani nokohlobo A ezinsaneni

isifo izinsana has izici zayo siqu. Kukhona ukuthambekela flow ifomu okuxubile (ezibangelwa amagciwane kanye ezibangelwa amagciwane) ukuthi saziwa ngesikhathi luhlolo.

Esinye isici ukuthi odokotela esibhedlela akalushongo kuqala futhi exacerbation yenqubo esicashile - azalwa naso noma abanakekela abakhulelwe.

Izifo kwenzeka ezinganeni nzima ngaphezu abadala noma izingane ezindadlana. isikhathi Preicteric kubathatha izinsuku ezimbalwa futhi akanayo ukubonakaliswa emitholampilo, zokugula kaningi neyaziwayo, lapho i-jaundice iqala.

ukuqala olunamandla kungase kudingeke zimpawu ezilandelayo ezinsaneni:

• Kwehliswe iphango.
• regurgitation njalo.
• Ukujoyina ngegciwane emathunjini.
• lokushisa okuphezulu.
• Kungase kube nezimo catarrhal umgudu wokuphefumula.
• Indle kanye nomchamo ushintsho umbala wangayizolo kwesikhathi jaundice.

Ukwelashwa kwesifo sokusha kwesibindi sohlobo B kumele kwenziwe kuphela ngaphansi kweso lwezokwelapha. Kuye kobukhulu isifo udokotela angase hospitalize omncane nesineke noma ukunikezela yokwelapha ekhaya.

Ukwelashwa kwesifo sokusha kwesibindi sohlobo A

Njengoba inkathi bayashintshana ekufukameleni ukusha kwesibindi kohlobo A ngokuvamile khona izimpawu, ngokuvamile unomdlavuza isifo kudala njengoba esiteji jaundice. On ukubonakaliswa yokuqala ngesimo ukukhathala, ukungakuthandi ukudla, abanye abazali akakwazi ukunaka. Kuphela onguchwepheshe oqeqeshiwe anikeze noma iluphi izincomo njengoba ukwelapha isifo sokusha kwesibindi kohlobo A ngokuvamile yokwelapha kuyehla kube imisebenzi elandelayo:

1. Esikhathini sibi isiguli hhayi esibhedlela, ebekiwe embhedeni ukuphumula, ngefomu ezinzima, kufanele wentiwe kute okungenani izinsuku 5.
2. Isiguli kumele kube lesifanele nengane umsoco, lapho isilinganiso amaphrotheni, amafutha kanye carbohydrate kuyoba 1: 1: 4.
3. Abazali okufanele uzihlanganise ekudleni ngaphezulu eluhlaza imifino, izithelo, amakhambi nesiphuzo.
4. Kuyadingeka ukuba kuqedwe amafutha ephezulu ukuncibilika, ngokuvamile atholakala imajarini, lard. Enginakho ukuze ingafaki ukudla okusemathinini, amasosishi okunamafutha inhlanzi nenyama. Singazuzi ukusetshenziswa izinongo hot, nososo, amaswidi namakhekhe.
5. Ngokuvamile odokotela ayibeki umncele izidakamizwa ethize ukuze silwe kwesibindi, kungenziwa ebekiwe cholagogue. Esigabeni acute lesi sifo izidakamizwa holeliticheskogo Kunconywa izenzo ezifana "Magnesium sulfate" "Berberine", futhi phakathi izinyathelo ukululama holesekretiruyuschego: "Allohol", "Holenzim".
6. Odokotela bavame linqume iziguli inkambo amavithamini iqembu B ( "Combilipen").
7. Uma kukhona at cholestasis ifomu cholestatic, ebonisa ukuthi indlela "ursosan" e isamba 10-15 mg / kg ngosuku. Ngo isikhathi okunzima impatho enjalo kungaba kusuka 3 kuya ku-6 izinyanga.
8. Uma i-hepatitis kwenzeka kakhulu, enqunyiwe yokwelapha ukumnika, okuyinto kuhlanganisa nokukhipha ukuvuza emthanjeni kanye 1.5% amandla "Reamberin" ikhambi umthamo 10 ml esisindo / kg.
9. Kuyo yonke ukwelashwa, kungakhathaliseki isifo namandla aso, le chelators enqunyiwe, njengokuthi "Enterosgel", "Enterodez".
10. Ngemva nelesithupha amaviki lapho kuqala lesi sifo Kwenziwa luhlolo lokuqala nesineke, ngemuva kwezinyanga 3 izidingo Ukuhlolwa yesibili. Uma udokotela akusho ukuxilonga ukubonakaliswa yomtholampilo, ingane ezincwadini.

Kumelwe kubhekwe: uma imishanguzo siqhutshwa e-ekhaya, isiguli abasha kumele kube ekamelweni elihlukile kanye nazo zonke izinto siqu (izinto, imikhiqizo kwenhlanzeko).

Imiphumela nokohlobo A

Kusukela igciwane lesi sifo uyakwazi ukuphazamisa ukusebenza kohlelo isibindi enzyme, kungaba bazitshela ukuthi ngeke esilimaza umsebenzi wonke umzimba wengane. Wonke umzali kudingeka aqonde lonke umthwalo yalesi sifo nemiphumela yaso, ngakho-ke ngezinye ukubonakaliswa yokuqala ngempela ubheke onguchwepheshe.

Uma yokwelapha isiqalisile ngendlela esifike ngesikhathi kuhambisana zonke izincomo udokotela, embhedeni ukuphumula, wenza izinguquko ukuze ukudla, ungakwazi ungesabi yezinkinga kungenzeka. Lapho isifo Botkin sika (owaziwa nangokuthi isifo sokusha kwesibindi kohlobo A) is hhayi ziphathwe, ngokuqinisekile ube nomthelela ongemuhle impilo yengane esikhathini esizayo. Phakathi nezinkinga ezingase kukhona ezivamile okulandelayo:

• Ukukhubazeka e kokusebenza kwesibindi.
• Izinkinga ukugaya ukudla.
• Isibindi kuyehla ngosayizi.
• Ukuthuthukisa encephalopathy.
• Ascites.
• Mhlawumbe kungcono ukuphela e yokwehluleka kwesibindi.
• Inguquko lesi sifo kwifomu ezingamahlalakhona.

Uma uqala ukwelashwa esifike ngesikhathi, lo-hepatitis A kancane kancane zivame ukufiphala, wonke amanani laboratory ukubuyela esimweni esivamile, isibindi uyalulama umsebenzi walo.

Indlela yokuvimbela ukuthuthukiswa isifo

Ukuvimbela i-hepatitis A linendima ebalulekile. Iinlinganiso ezihlukileko ukuvimbela ukusabalala igciwane kwakusho umthelela umthombo ukutheleleka, izindlela yokudlulisela kanye ezifweni ekungenweni.

Kubalulekile ukuba afeze ekuhlonzweni ke sizokwazi ukwehlukanisa isiguli kwabanye ukuvimbela ukusabalala igciwane. Uma leyo ngane izokwazi nabo isiguli, kubalulekile nsuku zonke ukuze ahlole isikhumba, amehlo sclera ukubukeka umbala i-jaundice, palpate kwesibindi.

Uma kukhona kakade Kugcwele nokohlobo A, ukukhomba amafomu atypical of ukuhlolwa laboratory njalo emavikini 2 kumele kwenziwe kuze flash ngeke ngiphume.

Ukuze ugweme ukusabalala ukutheleleka kungaba ngezindlela ezilandelayo:

• Lawula amandla komphakathi.
• Gada izinga amanzi okuphuza.
• Thobela imithetho kwenhlanzeko zomphakathi kanye siqu.
• Uma uthola ingane egulayo, kule kokugqashuka kufanele sigcwaliswe magciwane.
• Ngokuba nokuvimbela immunoglobulin evamile iphathwa emakamu eliphezulu amasosha lokusha kwesibindi kohlobo A.

Ukugoma ngokuvamile kwenziwe umsebenzi ezithile zonyaka-hepatitis C virus, kubalulekile kaningi ekupheleni ehlobo futhi ekuqaleni ekwindla.

Kodwa ngangokunokwenzeka ukuze bakwazi ukuzivikela futhi izingane zabo ngokumelene isifo kuphela ngomgomo. Odokotela Russian zisebenzisa izinhlobo ezahlukene imijovo kakhulu kulokhu okulandelayo:

• Umgomo ngokumelene nokohlobo A nge polioksidoniem "GEP-A-e-Vac-IN L", ekhiqizwa eRussia.
• "AWACS" wokugoma French.
• "Havrix" - wokugoma British ezenziwe.
• Enye wokugoma ngokumelene nokohlobo A, ekhiqizwa eRussia, - bagxila ukuhlanzwa inactivated adsorbed uketshezi "GEP-A-e-Vac".

Lezi zinhlobo ngemigomo busuka isidumbu sengane ngaphambi kokuba zifinyelele unyaka owodwa ubudala. Ngokuvamile uzenza co-nokuphathwa isifo sokusha kwesibindi kohlobo A no-B, kodwa ezingxenyeni ezihlukahlukene zomzimba. Cishe 95% izingane zigonywe ukuthuthukisa amasosha omzimba aqinile ngokumelene igciwane.

imiphumela engathandeki emva yokugoma, ngokuvamile engekho. Kungase kube ububomvu kancane, ukuvuvukala kusayithi umjovo, imfiva omnene. Le miphumela emibi akuzona zonke iziguli abasha, ikakhulukazi izingane zigonywe asibekezeleleki kahle.

Ngaphandle umsebenzi evamile isibindi akukwazi ekusebenzeni zonke ezinye izitho zezinzwa izinhlelo, ngakho iyiphi zokugula yayo kumele ihlonzwe ngendlela esifike ngesikhathi futhi kuncike yokwelapha ngempumelelo. Lokhu kusebenza ikakhulukazi ukuba seziguli ezisencane. Ukunakekela impilo yabo uwela ngqó emahlombe abazali, ngakho-ke kubalulekile ukuba banake iyiphi ngeziphambeko kusukela uthola ukuziphatha kwezingane, amagugu laboratory. Okuwukuphela kwendlela ukuvimbela ukuthuthukiswa sengozini yokuthola izifo ngaphezulu.