Elephantiasis inoratidzwa nekuzvimba kwemakumbo, kazhinji makumbo, ayo dzimwe nguva anokanganisawo nhengo dzepabonde. Icho chinobva kune ichi chinoshamisa, kupa makumbo ezasi emunhu akabatwa chitarisiko chakafanana nemakumbo enzou, iyo elephantiasis inowana zita rayo. Iyi pathology inogona kuva nemavambo maviri akasiyana. Chinonyanya kuzivikanwa chirwere cheparasitic, chiri kunyanya muAfrica neAsia: chinokonzerwa nefiriform parasite, inonziwo lymphatic filariasis. Imwe fomu, yedu elephantiasis warts, inyaya yakasarudzika yakabatana nekuvharika kwemidziyo ye lymphatic.

Tsanangudzo yeelephantiasis

Elephantiasis inoratidzwa nekuzvimba kwemakumbo ezasi anoita semakumbo enzou. Zvitsva zvekare zvechirwere ichi zvakawanikwa zvakadzokera kune makore anopfuura 2000 BC Saka, chifananidzo chaFarao Mentuhotep II chakamiririrwa negumbo rakazvimba, chimiro cheelephantiasis, icho chiri chiratidzo chechirwere chakakomba chinonziwo. lymphatic filariasis. Ichi chirwere cheparasite, chiripo muAsia neAfrica, hachipo zvachose muEurope.

Imwe nzira yeelephantiasis, inonzi Yedu warty elephantiasis, iyo inogona kuwanikwa muFrance, inokonzerwa nekuvharwa kwemidziyo ye lymphatic, nekuda kana kwete nehutachiona hwehutachiona. Inoramba ichishamisa zvikuru.

Zvikonzero zve elephantiasis

Elephantiasis chinhu chakanyanyisa che lymphatic filariasis: chirwere chinokonzerwa nediki diki, kana filaria, inogara muropa revanhu uye tishu, uye inoparadzirwa neumhutu, vector yavo. Makonye aya ane 90% Wuchereria Bancrofti, mamwe marudzi ari kunyanya Bruges Malaya et Brugia anotya. Makonye ma<em>microfilariae, anogara muropa. Pavanenge vakura, zvipembenene izvi zvinowanikwa mu lymphatic system, iyo yose zvivako uye midziyo inoita basa rinokosha mukudzivirira zvirwere. Iyi filaria inogara mumitsipa ye lymphatic inodzika uye inovavharira, zvichikonzera kuzvimba kweimwe kana akawanda nhengo. Izvi zvinonyanya kunetseka nemidziyo ye lymphatic muchikamu chezasi chemuviri, semuenzaniso mugodzi, nhengo dzesikarudzi uye zvidya.

Nezve yedu verrucous elephantiasis, saka kwete kukonzerwa nehutachiona, mavambo e-lymphedemas akabatanidzwa nekuvharidzirwa kwemidziyo ye lymphatic, iyo inogona kana kuti isingaiti yebhakitiriya. Lymphedema yaizobva yabatanidzwa kune chisingaperi mamiriro ekuzvimba.

Mamwe mamiriro ezvinhu anogona kuramba achikonzera elephantiasis: zvirwere zvinonzi leishmaniasis, kudzokorora streptococcal infections, zvinogonawo kuva migumisiro yekubviswa kwemalymph nodes (kazhinji nechinangwa chekudzivirira kukura kwekenza), kana kuti ichiri kubatanidzwa nehurema hwekuzvarwa.

chirwere

Chirwere chekiriniki chinofanira kuitwa kana pane gumbo rezasi rakazvimba, kana kuzvimba kwacho kuchinyanya kuoneka pane imwe nhengo pane imwe. Nhanho yekutanga yekuongorora lymphatic filiarosis ndeyekutanga nhoroondo yekusangana neparasite munzvimbo dzine nharaunda. Ipapo bvunzo dze laboratory dzinogona kusimbisa kuongororwa.

• Bvunzo idzi dzinobva pakuonekwa kwemasoja ekudzivirira chirwere.
• Ganda biopsy rinogonawo kubatsira kuziva microfilariae. 
• Kune zvakare nzira yakavakirwa paultrasound, rudzi rwevascular ultrasound inogona kutsvaga nekuona mafambiro eparasite yevakuru.
• Nzira dzekuona dzakaita sePCR bvunzo dzinoita kuti zvikwanise kuratidza kuvepo kweDNA yeparasite, muvanhu pamwe nemuumhutu.
• Lymphoscintigraphy, nzira yekuongorora midziyo ye lymphatic, yakaratidza kuti kunyangwe mumatanho ekutanga uye ekiriniki asymptomatic, lymphatic abnormalities inogona kuonekwa mumapapu evanhu vane utachiona.
• Immunochromatographic bvunzo dzakanyanya kunzwisiswa uye yakanangana nekuongororwa kweW. Bancrofti hutachiona.

Nezve iyo isingawanzoitiki elephantiasis nostras verrucosa, kuongororwa kunogona kuitwa nephlebologist. Anozvizivisa kukiriniki kwake.

Vanhu vane hanya

• 120 mamiriyoni evanhu pasi rose vanobatwa, 40 mamiriyoni avo vanotambura nemhando dzakakomba dzine zviratidzo zvekliniki zve lymphatic filariasis: lymphedemas, elephantiasis uye hydrocele.
• Chirwere ichi chinonyanya kubata vanhu muAfrica neAsia, uye kumadokero kwePacific. The pathology iripo asi haina kujairika muAmerica nekumabvazuva kweMediterranean, uye haisipo zvachose muEurope.
• Vakuru, kunyanya pakati pemakore makumi matatu nemakumi mana, vane hanya zvikuru kupfuura vana, nokuti kunyange zvazvo chirwere ichi chinowanzotanga muhuduku, zviri muvanhu vakuru kuti filariasis inova yakakosha, nekuda kwechivharo chinopfuurira. lymphatic midziyo.
• Nyaya dzeelephantiasis muFrance dzinogona kukonzeresa zvichitevera kubviswa kwemalymph nodes, semuenzaniso kutevera gomarara.

Zvinhu zvinotyisa

Kutapurirwa utachiona munharaunda iri panjodzi yakawedzera kana hutsanana husina kunaka.

Chiratidzo chikuru cheelephantiasis kuzvimba, unilateral kana bilateral, yemakumbo ezasi. Kuzvimba uku kwakapfava uye kunodzikisika mumatanho ekutanga, asi kunova kwakaoma, kana kusimba pakubata, mumaronda ekare.

Muvarwere vechirume, lymphatic filiariasis inogonawo kuzviratidza sekuzvimba kwescrotum kana hydrocele (bhegi rakazara nemvura muscrotum). Muvakadzi, panogona kuve nekuzvimba kwemboro, kwete kunyorova kunze kwekunge paine acute kupinda.

Panogonawo kunge paine maoze, ayo anonhuwa.

Zvimwe zviratidzo panguva yakaoma chikamu

• Kupindwa nechando.
• Kurwadza kwenhengo ine utachiona.
• Tsvuku uye inonzwisa tsitsi.
• Kusagadzikana.

zviratidzoyedu warty elephantiasis vari padyo, nekugara kuvepo kwenhengo yemuviri yakazvimba, ivo zvakare vanoonekwa newarts paganda.

Mhando dzinoverengeka dzekurapa dziripo pakurapa elephantiasis dzakabatanidzwa nemaparasite:

• Kurapa kwezvinodhaka: ivermectin uye suramin, mebendazole uye flubendazole, kana kunyange diethylcarmazine, uye albendazole.
• Mishonga yekuvhiya: Hydrocele inogona kurapwa nekuvhiya maitiro, sekubvisa. Nhengo ine utachiona hunogonawo kurapwa nekuvhiyiwa, kuburikidza nekugerwa kwemvura kana kuchekwa.
• Kurapa kwekupisa: VaChinese vakabudirira kuedza nzira itsva mukurapa lymphedema, iyo inoshandura kupisa uye kutonhora.
• Mishonga yemishonga: mishonga yakawanda yakarongerwa kwemazana emakore mukurapa elephantiasis: Vitex negundo L. (midzi), Butea monosperma L. (midzi nemashizha), Ricinus communis L. (mashizha), Aegle marmellos (mashizha), Canthium mannii (rubiacées), Boerhaavia diffusa L. (chirimwa chose).

Mazano akati wandei aripo ekurapa elephantiasis yeasina-parasitic chikonzero, izvo zvichiri kunetsa kurapa:

• Massages, mabhandeji, compression.
• Utsanana hweganda.
• Kubviswa kwetishu kuburikidza nekuvhiya debridement.
• Abblative carbon dioxide laser, nzira itsva ichangobva kuedzwa zvakabudirira.

Kudzivirira zvinodhaka zve filariasis

Zvirongwa zvakakura zvikuru zvekutonga zvinodhaka mumakore gumi nematatu apfuura, sekureva kweWorld Health Organisation (WHO), zvakadzivirira kana kurapa vanhu vanopfuura mamirioni makumi mapfumbamwe nematanhatu. Kubvisa iyi lymphatic filariasis zvinogoneka nekukanganisa kutenderera kwekutapurirana kweparasite.

• Muchokwadi, kupa kurapa pamwero mukuru kunharaunda dzese uko hutachiona hwehutachiona hunogona kubatsira kumisa kupararira kwehutachiona. Iri zano, rinova rekudzivirira kurapa kwezvinodhaka, rinosanganisira kupa muyero wakasanganiswa wemishonga miviri pagore kune vanhu vari panjodzi.
• Nokudaro, albendazole (400 mg) inopiwa panguva imwechete ne invermectin (150 kusvika 200 mg / kg) kana ne diethylcarbamazine citrate (6 mg / kg). Mishonga iyi, ine mhedzisiro shoma pazvipembenene zvevanhu vakuru, zvinobudirira kuderedza huwandu hwemicrofilariae muropa, kana maparasite. Vanodzivirira kupararira uye kukura kune umhutu. Zvimiro zvevakuru zveparasite zvinogona kuramba zviri zvipenyu kwemakore.
• Munyika dzine imwe utachiona, inonzi Loa loa, iripo, nzira iyi yekudzivirira inofanira kupiwa kaviri pagore.

Egypt ndiyo nyika yekutanga pasi rose kuzivisa kupedzwa kwakazara kwe lymphatic filariasis, maererano neWHO.

Kudzora kwevector mosquito

Kudzora kwechirwere chevector, mosquito, kunogona kuwedzera kuedza kubvisa, kuderedza kuwanda kweumhutu, nekudzivirira kusangana pakati pevanhu neumhutu. Mapindiro ekudzora marariya, neaerosols uye zvipembenene, ane anobatsira collateral mhedzisiro nekuderedza zvakare kutapurirana kwelymphatic filariasis.

Kudzivirira kweyedu warty elephantiasis

Mukutaura kweelephantiasis isingabatanidzi neparasite, inofanira kuonekwa, kazhinji, kudzivirira kurwisana nekufutisa, iyo ndiyo imwe yezvinokonzera.

Mukupedzisa

Kubva muna 1997 matanho ese aya akatangwa mukubvisa lymphatic filariasis sedambudziko guru rehutano hweveruzhinji. Uye muna 2000, WHO yakatanga chirongwa chepasi rose chekubvisa uku, nezvikamu zviviri:

• kumisa kupararira kwehutachiona (nekukanganisa kutapurirana).
• kusunungura kutambura kwevanhu vakabatwa (nekudzora kurwara), nenzira yeprotocol yekurapa, kusanganisira kuvhiyiwa, utsanana hwakanaka uye kuchengetwa kweganda, kuitira kudzivirira bhakitiriya superinfection.