Okuqukethwe
Iyini i-opisthorchiasis?
I-Opisthorchiasis ibangelwa ama-helminths (ama-hepatic trematodes) athinta isibindi namanyikwe. Ngokwezibalo, isibalo sabantu abangenwe yilesi sifo emhlabeni wonke silinganiselwa ezigidini ezingama-21, kanti izingxenye ezimbili kwezintathu zazo zonke iziguli ezine-opisthorchiasis ezihlala eRussia. Inkinga ephuthumayo kakhulu yokuthwala i-helminth isendaweni yaseDnieper nasesifundeni saseSiberia (eNtshonalanga naseMpumalanga yeSiberia).
Izinkinga ze-opisthorchiasis
Isizathu sokuvela kwe-opisthorchiasis kubantu yikati, noma i-Siberian, fluke (Opisthorchis felineus). I-agent causative yalesi sifo i-parasitizes esibindi, i-gallbladder kanye nemigudu yayo, kanye nama-pancreas abantu, amakati nezinja. Umthombo wokutheleleka kumuntu ogulayo noma isilwane. Amaqanda ezinambuzane, kanye nendle yalowo othwala isifo, angena emanzini, lapho agwinywa khona iminenke. Emzimbeni weminenke, izibungu zivela emaqandeni futhi ziyazalana. Khona-ke izibungu ngesimo se-cercariae zingena emanzini, ngokugeleza kwamanzi zingena emzimbeni we-cyprinids. Ukutheleleka kwabantu nezilwane nge-opisthorchiasis kwenzeka lapho kudla izinhlanzi, inyama engazange ithole ukwelashwa okwanele kokushisa, inosawoti omncane noma omisiwe. Izinhlanzi ezinjalo zingase zibe nezibungu ezihlaselayo ezingaba yingozi empilweni yabantu nakwezinye izilwane ezincelisayo. Ekugxileni kwe-endmic, ukutheleleka kuvame ukwenzeka lapho kusetshenziswa imishini yokusika engageziwe equkethe izinhlayiya zezicubu zezinhlanzi, lapho upheka noma usikwa imikhiqizo okungekho ukwelashwa okwengeziwe okunikezwayo (isinkwa, izithelo, njll.).
Esiswini somuntu noma isilwane, i-capsule ye-metacercariae iyabhujiswa, isibungu siphula ulwelwesi oluncane lwe-hyaline ngokwalo, kakade ku-duodenum, emva kwalokho izibungu ze-parasite zingena ku-gallbladder kanye nemigudu yayo kanye nama-pancreas. Lapho kwenziwa izinqubo zokuxilonga, i-opisthorchia itholakala emiseleni engaphakathi kwesibindi kanye ne-bile ducts ku-100% yeziguli, amagciwane atholakala ku-gallbladder ngama-60% ahlaselwe, ku-pancreas - kuma-36% eziguli. I-Metacercariae engene ohlelweni lwe-hepatobiliary kanye nama-pancreas ivuthwa ngokocansi ngemva kwamasonto angu-3-4 futhi iqala ukubeka amaqanda. Ngenxa yalokho, umjikelezo ogcwele wokuthuthukiswa kwama-parasites uthatha izinyanga ezine kuya kwezine nengxenye futhi uhlanganisa zonke izigaba zokukhula kwe-pathogen - kusukela eqandeni kuya kumuntu ovuthiwe, emva kwalokho ama-helminths avuthiwe aqala ukubeka amaqanda. Emzimbeni wabantu nezilwane, ezibhekwa njengezindishi zokugcina zezimuncagazi, ukwanda kokuhlasela kungenzeka kuphela ngemva kokutheleleka kabusha. Ubude besikhathi sokuphila kwamagciwane yiminyaka engama-20-25.
Izimpawu ze-opisthorchiasis
Izimpawu ze-opisthorchiasis zincike ezicini zomuntu ngamunye, ukuqina kokutheleleka kanye nesikhathi esidlulile kusukela isiguli sangenwa yilesi sifo. Lesi sifo sibucayi noma singamahlalakhona. Esigabeni esibucayi, lesi sifo sithatha amasonto angama-4-8, kwezinye izimo i-pathology iqhubeka isikhathi eside. I-opisthorchiasis engapheli ihlala iminyaka: iminyaka engu-15-25 noma ngaphezulu.
Esigabeni esibucayi, iziguli ziphawula lezi zimpawu ezilandelayo: imfiva, ukuqubuka kwesikhumba njenge-urticaria, imisipha ebuhlungu namalunga. Ngemva kwesikhathi esithile, iziguli ziqala ukukhathazeka ngobuhlungu ku-hypochondrium efanele, ukuhlolwa kwembula ukwanda kwesibindi ne-gallbladder. Khona-ke ubuhlungu esifundeni se-epigastric, isicanucanu, ukuhlanza, isilungulela, ukuqubuka kwenhliziyo kujoyina ukubonakaliswa kwe-pathology, isitulo seziguli siba njalo futhi siwuketshezi, kuvela i-flatulence, futhi isifiso sokudla siyancipha. Lapho ukuhlolwa fibrogastroscopic kwatholakala erosive gastroduodenitis, kwaphawulwa isilonda mucosa esiswini kanye duodenum. Kwezinye izimo, i-opisthorchiasis ivela ngezimpawu eziwuphawu lwezifo zamaphaphu ezisuka ku-allergic, okungukuthi, i-asthmatic bronchitis.
Esikhathini esingapheli salesi sifo, izimpawu ze-opisthorchiasis zifana kakhulu nokubonakaliswa kwe-cholecystitis engapheli, i-gastroduodenitis, i-pancreatitis, i-hepatitis: isiguli sikhononda ngobuhlungu obungapheli ku-hypochondrium efanele, okuyi-paroxysmal ngokwemvelo futhi efana ne-biliary colic. ukuqina kwabo, kuyilapho ubuhlungu bungathuthela esifubeni esingakwesokudla. Futhi, lesi sifo sibonakala: i-dyspeptic syndrome, ubuhlungu ngesikhathi se-palpation ku-gallbladder, i-dyskinesia ye-gallbladder. Ngokuhamba kwesikhathi, isisu namathumbu kubandakanyeka enqubweni ye-pathological, ehambisana nezimpawu ezitholakala ku-gastroduodenitis, i-pancreatitis kanye nokuphazamiseka kokusebenza okuvamile kwamathumbu.
Ukuhlasela futhi kubangela ukuphazamiseka kwesimiso sezinzwa esiyinhloko, esivezwa ezikhalazo ezivamile zeziguli mayelana nokwehla kokusebenza, ukucasuka, ukuphazamiseka kokulala, ikhanda elibuhlungu kanye nesiyezi. Kuqhaqhazela amajwabu amehlo, ulimi, iminwe ezandleni. Isimo se-asthenic ngokuvamile sihambisana nobuthakathaka obujwayelekile, ukukhathala okusheshayo ngokomzimba nangokwengqondo. Kwezinye izimo, ukuphazamiseka kwesimiso sezinzwa kungase kuvele, iziguli ezinjalo zivame ukutholakala ukuthi zine-neurocirculatory dystonia noma i-autonomic neurosis.
I-opisthorchiasis engapheli, ehambisana ne-allergic syndrome, ibonakala ngokuluma kwesikhumba, i-urticaria, i-edema ka-Quincke, i-arthralgia, i-allergies yokudla. Ukucaciswa kwe-opisthorchiasis engapheli kulele eqinisweni lokuthi ngemva kokuqedwa ngokuphelele kwama-parasite, isiguli sinezinguquko ezingenakuguqulwa ezithweni zangaphakathi. Iziguli zine-hepatitis engapheli, i-cholangitis, i-cholecystitis, i-gastritis, ukuphazamiseka kwamasosha omzimba. Ezigulini ezinjalo, izinqubo zempilo zibaluleke kakhulu ngemva kokuphothulwa kwenkambo yokwelashwa ephelele, okuhloswe ngayo ukuthuthukisa ukusebenza kwe-gallbladder, ukuthuthukisa isibindi, nokwejwayelekile izinqubo zokugaya ukudla.
Njengomphumela wokubola kwamagciwane, ukukhululwa kwemikhiqizo yabo ye-metabolic, futhi ngenxa ye-necrosis yezicubu zomzimba, ukudakwa kwenzeka, okuhambisana nokusabela komzimba. Ukwengeza, i-helminths (abancane ngokwezinga elincane, abantu abavuthiwe ngokwezinga elikhulu) balimaza i-epithelium ye-bile kanye ne-pancreatic ducts, kuyilapho iqala inqubo yokuvuselelwa kwezicubu ze-hyperplastic. Phakathi kwemiphumela yalesi sifo, kuvame ukuphulwa kwemishini kokuphuma kwe-bile kanye nejusi le-pancreatic ngenxa yokuqoqwa kwama-parasites, amaqanda amagciwane, ama-mucus namaseli e-epithelial emathanjeni.
Izinkinga ezinzima kakhulu ze-opisthorchiasis yi-biliary peritonitis, ithumba, i-cirrhosis noma umdlavuza wesibindi oyinhloko, ezinye izimo ze-pathological zamanyikwe, njenge-pancreatitis eyingozi eyingozi, umdlavuza we-pancreatic, okwenzeka ezimweni ezingavamile kakhulu.
Ukwelashwa
Esigabeni sokuqala (sokulungiselela) sokwelashwa kwe-opisthorchiasis, izinyathelo zithathwa ukumisa ukungezwani komzimba, ukukhulula ukuvuvukala kwepheshana le-biliary kanye ne-gastrointestinal tract, ukuqinisekisa ukuphuma okujwayelekile kwe-bile kanye nejusi le-pancreatic, ukuthuthukisa ukusebenza kwe-hepatocytes, ukudambisa ukudakwa, ukuhlanza. amathumbu.
Ukuphumelela kwesigaba sesibili sokwelashwa kwalesi sifo kuncike kakhulu ekutheni isigaba sokulungiselela senziwe kanjani. Ngesikhathi sokwelashwa, iziguli zidinga ukulandela ukudla okukhethekile: ukudla okunamafutha aphansi kuphela kufanele kufakwe ekudleni kwabo. Emithini enqunyelwe ama-antihistamine, ama-sorbents. Kwezinye izimo, iziguli zidinga ukuthatha ama-prokinetics, ama-antispasmodics, ama-probiotics nama-enzyme.
Esigabeni sokuxolelwa esikhathini esingamahlalakhona sesifo, inkambo yokwelapha yokulungiselela cishe amasonto amabili, uma isiguli sinezimpawu ze-cholangitis, i-pancreatitis noma i-hepatitis, khona-ke inkambo yokwelashwa ihlala amasonto angama-2-3.
Esigabeni sesibili sokwelashwa, ukwelashwa okubanzi kwe-anthelmintic kwenziwa, okusiza ukuqeda ama-trematode amaningi nama-cystodes. Ngenxa yemiphumela emibi kakhulu, inkambo yokwelashwa nalesi sidakamizwa inconywa ukuba yenziwe esibhedlela, ngaphansi kokuqondisa kukadokotela.
Esigabeni sesithathu (ukuvuselelwa), imisebenzi ye-motor kanye nemfihlo yezitho zangaphakathi ezithintekayo ekuhlaselweni kwe-helminthic zibuyiselwa. I-Tubage yenziwa nge-xylitol, i-sorbitol, i-magnesium sulfate, amanzi amaminerali, ama-laxatives anganqunywa ukuhlanzwa kwamathumbu okungeziwe. Ukwelashwa okuyinkimbinkimbi kunezelwa yi-hepatoprotectors, amakhambi e-choleretic herbal.
Izinyathelo zokuvimbela zincishiswa ekudleni inhlanzi emazingeni okushisa angaphansi -40 ° C amahora angu-7 noma izinga lokushisa elingaphansi -28 ° C amahora angu-32, lafakwa usawoti ku-brine nge-1,2 g / l ngo-2 °. C izinsuku ezingu-10-40 (isikhathi sokuchayeka sincike kubuningi bezinhlanzi), ibilisiwe okungenani imizuzu engu-20 kusukela ngesikhathi umhluzi ubilisiwe noma uthosiwe okungenani imizuzu engu-20 esitsheni esivaliwe.