Mukati
Chii chinonzi opisthorchiasis?
Opisthorchiasis inokonzerwa nehelminths (hepatic trematodes) inokanganisa chiropa uye pancreas. Maererano nehuwandu, nhamba yevanhu vane utachiona pasi rose inenge mamiriyoni makumi maviri nerimwe evanhu, uye zvikamu zviviri kubva muzvitatu zvevarwere vose vanorwara ne opisthorchiasis vanogara muRussia. Dambudziko rinokurumidzira rekutakura helminth riri munharaunda yeDnieper uye munharaunda yeSiberia (kuMadokero neEastern Siberia).
Zvikonzero zve opisthorchiasis
Chikonzero chekuonekwa kwe opisthorchiasis muvanhu ikati, kana Siberia, fluke (Opisthorchis felineus). The causative agent yechirwere parasitizes muchiropa, gallbladder uye ducts ayo, uyewo pancreas yevanhu, katsi nembwa. Kunobva utachiona munhu kana mhuka inorwara. Mazai eparasite, pamwe chete netsvina yemutakuri wehutachiona, inopinda mumvura, iyo inomedzwa nehozhwa. Mumuviri wehozhwa, makonye anoonekwa kubva kumazai uye anoberekana. Ipapo mhute muchimiro checercariae inopinda mumvura, nekuyerera kwemvura inopinda mukati memuviri we cyprinids. Kutapukirwa kwevanhu nemhuka dzine opisthorchiasis kunoitika kana uchidya hove, iyo nyama iyo isina kubatwa zvakakwana kupisa kupisa, ine munyu zvishoma kana isina kuomeswa. Hove dzakadai dzinogona kunge dziine makonye anokanganisa hutano kuvanhu uye kune dzimwe mhuka dzinoyamwisa. Mukutarisa kweiyo endemic, hutachiona hunowanzoitika kana uchishandisa midziyo yekucheka isina kugezwa ine zvimedu zvehove, kana uchibika kana kucheka zvigadzirwa izvo pasina kumwe kupisa kunopihwa (chingwa, michero, nezvimwewo).
Mudumbu remunhu kana mhuka, metacercariae capsule inoparadzwa, gonye rinopwanya iyo yakaonda hyaline membrane pachayo, yatova muduodenum, mushure mezvo maparasite anopinda mu gallbladder uye madhamu ayo uye pancreas. Paunenge uchiita maitiro ekuongorora, opisthorchia inowanikwa mumatope mukati mechiropa uye mu bile ducts mu100% yevarwere, utachiona hunoonekwa mu gallbladder mu 60% yevakapinda, mupancreas - mu 36% yevarwere. Metacercariae iyo yakapinda muhepatobiliary system uye pancreas inokura pabonde mushure memavhiki 3-4 uye inotanga kukandira mazai. Nokudaro, kutenderera kwakazara kwekukura kwezvipembenene kunotora kubva pamwedzi mina kusvika kumwedzi mina nehafu uye kunosanganisira matanho ose ekukura kwepathogen - kubva pazai kusvika kune munhu akura, mushure mokunge helminths yakakura inotanga kuisa mazai. Mumuviri wevanhu nemhuka, izvo zvinoonekwa seanopedzisira mauto emaparasite, kuwedzera kwekupinda kunogona kuitika chete mushure mekutapukirwa zvakare. Hupenyu hunotarisirwa hwehutachiona ndeye 20-25 makore.
Zviratidzo zve opisthorchiasis
Zviratidzo zve opisthorchiasis zvinoenderana nehunhu hwemunhu, kusimba kwehutachiona uye nguva yadarika kubva murwere abatwa. Chirwere chacho chakaoma kana chisingaperi. Muchikamu chakaoma, chirwere chinotora mavhiki 4-8, mune dzimwe nguva chirwere chinoramba chiripo kwenguva yakareba. Chronic opisthorchiasis inogara kwemakore: 15-25 makore kana kupfuura.
Muchikamu chakaoma, varwere vanocherechedza zviratidzo zvinotevera: fivha, mapundu eganda senge urticaria, kurwadza kwemhasuru nemajoini. Mushure menguva yakati, varwere vanotanga kunetseka pamusoro pekurwadziwa mu hypochondrium yakarurama, kuongorora kunoratidza kuwedzera kwechiropa uye gallbladder. Ipapo marwadzo munharaunda ye epigastric, kusvotwa, kurutsa, kupisa kwemoyo kunobatanidza kuratidzwa kweiyo pathology, chigaro chevarwere chinova kazhinji uye mvura, flatulence inooneka, uye kudya kunoderera. Apo fibrogastroscopic kuongorora kwakaratidza erosive gastroduodenitis, yakaratidza maronda emudumbu mucosa uye duodenum. Mune zvimwe zviitiko, opisthorchiasis inoitika nezviratidzo izvo zvinoratidzira zvemapapu zvinyama zvirwere zveallergic mavambo, zvinoti, asthmatic bronchitis.
Mune chirwere chisingaperi chechirwere, zviratidzo zve opisthorchiasis zvine zvakawanda zvakafanana nekuratidzwa kwechigarire cholecystitis, gastroduodenitis, pancreatitis, hepatitis: murwere anonyunyuta nekurwadziwa nguva dzose mu hypochondrium yakarurama, iyo paroxysmal mune zvakasikwa uye yakafanana nebiliary colic mu. kusimba kwavo, nepo marwadzo anogona kutamira kurudyi chipfuva. Uyewo, chirwere chacho chinoratidzwa ne: dyspeptic syndrome, kurwadziwa panguva yekuputika mu gallbladder, dyskinesia ye gallbladder. Nokufamba kwenguva, mudumbu uye ura zvinobatanidzwa mune pathological process, iyo inoperekedzwa nezviratidzo zvinowanikwa mugastroduodenitis, pancreatitis uye kukanganiswa kwemaitiro akajairika eura.
Kupinda kunokonzeresawo kusagadzikana kwepakati tsinga system, iyo inoratidzwa mukunyunyuta kwakajairika kwevarwere nezve kuderera kwekuita, kushatirwa, kukanganisa kurara, kutemwa nemusoro uye dzungu. Panewo kudedera kwemaziso, rurimi, zvigunwe pamaoko. Mamiriro eAsthenic anowanzo kuperekedzwa nehutera huzhinji, kukurumidza kuneta kwemuviri uye mupfungwa. Mune zvimwe zviitiko, kukanganisa kwehutano hwemagetsi kunogona kuuya mberi, varwere vakadaro vanowanzoonekwa kuti vane neurocirculatory dystonia kana autonomic neurosis.
Chronic opisthorchiasis, inoperekedzwa neallergic syndrome, inoratidzwa nekukwenya kweganda, urticaria, Quincke's edema, arthralgia, kusagadzikana kwekudya. Iyo chaiyo yekusingaperi opisthorchiasis iri mukuti mushure mekubviswa zvachose kwezvipembenene, murwere ane shanduko isingachinjiki munhengo dzemukati. Varwere vane chisingaperi hepatitis, cholangitis, cholecystitis, gastritis, zvirwere zvekudzivirira zvirwere. Kune varwere vakadai, maitiro ehutano akakosha zvikuru mushure mekupedzwa kwekosi yakazara yekurapa, yakanangana nekuvandudza kushanda kwe gallbladder, kuvandudza chiropa, uye normalizing digestion maitiro.
Nekuda kwekuora kwehutachiona, kuburitswa kwezvigadzirwa zvavo zvemetabolism, uye zvakare semhedzisiro yenecrosis yemuviri wega tishu, kudhakwa kunoitika, uko kunoperekedzwa neallergic reaction. Mukuwedzera, helminths (vaduku kusvika pamwero muduku, vanhu vakakura kusvika pamwero mukuru) vanokuvadza epithelium ye bile uye pancreatic ducts, apo inokonzera nzira ye hyperplastic tissue regeneration. Pakati pemigumisiro yechirwere, panewo kazhinji kukanganiswa kwemagetsi kwekubuda kwe bile uye pancreatic juice nekuda kwekuunganidza kwezvipembenene, mazai ezvirwere, mucus, uye epithelial masero mumadhaka.
Matambudziko akanyanya e opisthorchiasis ndeye biliary peritonitis, abscess, cirrhosis kana yepakutanga kenza yechiropa, mamwe mamiriro epathological epancreas, akadai seacute inoparadza pancreatitis, pancreatic cancer, inoitika muzviitiko zvisingawanzo.
mabatiro
Pakutanga (yekugadzirira) nhanho yekurapa opisthorchiasis, matanho anotorwa kumisa kusawirirana, kubvisa kuzvimba kwebiliary turakiti uye gastrointestinal turakiti, kuve nechokwadi chekubuda kwebile uye pancreatic muto, kuvandudza kushanda kwehepatocytes, kubvisa kudhakwa, kuchenesa. ura.
Kubudirira kwechikamu chechipiri chekurapa kwechirwere kunonyanya kuenderana nekuti danho rekugadzirira rakaitwa sei. Panguva yekurapa, varwere vanoda kutevera kudya kwakakosha: chete zvokudya zvakaderera-mafuta zvinofanira kuiswa mukudya kwavo. Pakati pemishonga inorayirwa antihistamines, sorbents. Mune zvimwe zviitiko, varwere vanofanira kutora prokinetics, antispasmodics, probiotics uye enzymes.
Muchikamu chekuregererwa mune chirwere chisingaperi chechirwere, nzira yekugadzirira kurapa inenge mavhiki maviri, kana murwere ane zviratidzo zvecholangitis, pancreatitis kana hepatitis, ipapo nzira yekurapa inotora mavhiki 2-3.
Pachikamu chechipiri chekurapa, Broad-spectrum anthelmintic therapy inoitwa, iyo inobatsira kubvisa yakawanda trematodes uye cystodes. Pamusana pemigumisiro yakakomba, nzira yekurapa nemishonga iyi inokurudzirwa kuti iitwe muchipatara, pasi pekutarisirwa kwechiremba.
Padanho rechitatu (rehabilitation), motokari uye mabasa epachivande enhengo dzomukati dzakabatwa ne helminthic invasion dzinodzorerwa. Tubage inoitwa ne xylitol, sorbitol, magnesium sulfate, mineral water, laxatives inogona kurongerwa kune mamwe matumbu ekuchenesa. Kurapa kwakaoma kunowedzerwa ne hepatoprotectors, choleretic herbal remedies.
Matanho ekudzivirira anoderedzwa pakudya hove dzaive patembiricha pazasi -40 ° C kwemaawa manomwe kana tembiricha iri pazasi -7 ° C kwemaawa makumi matatu nemaviri, yakarungwa mumunyu neine density ye28 g / l pa32 °. C kwemazuva 1,2-2 (nguva yekuonekwa inoenderana nehuwandu hwehove), yakabikwa kwemaminitsi makumi maviri kubva panguva iyo muto wakabikwa kana kubikwa kwemaminitsi makumi maviri mumudziyo wakavharwa.