Calaamadaha cudurka dabeysha ee carruurta iyo dadka waaweyn

Polio - caabuq ba'an viral in dhacdaa inta badan saameeya arrinta cawlan ee maskaxda, taasoo keenta horumarinta paresis iyo curyaannimo. Calaamadaha cudurka dabeysha waxaa lagu ogaan karaa in caruurta da'doodu ka yar tahay 7 sano, laakiin halista ah ee iyaga qandaraas, xaaladaha qaarkood, la hayo iyo dadka waaweyn.

A yar oo taariikh

Polio waxa lagu gartaa caabuq ba'an ee stem xadhig iyo maskaxda lafdhabarta keentay in horumarinta paresis oo curyaannimo, xanuunada bulbar. polio Disease, calaamadaha taas oo lagu yaqaano muddo dheer, si weyn loo faafin XIX ah, laga bilaabo qarnigii XX. Muddadan, waxa ay diiwaan faafa weyn ee cudurka ee America iyo Europe. Polio waxaa la furay sanadkii 1908 Vienna, E. iyo K. Popper Landštejn, iyo abuuray A. iyo Salk J. Seybinom live. Tallaalka fayruska aan nooleyn ee oggol yahay 50-ka sano ee qarnigii la soo dhaafay, si ay si weyn u yareeyo tirada xaaladaha markii calaamooyinkaasu ayaa la ogaan karo cudurka dabeysha ee carruurta.

dhaqdhaqaaqa wanaagsan in dagaalka ka dhanka ah cudurka tani sii socoto iyada oo tallaalka firfircoon, calaamado badan ee polio ku kaydsan yihiin oo kaliya dalalka nekotoroyh - Pakistan, Afgaanistaan, Nigeria, India, Suuriya - halka sannadkii 1988 ay tirada gaaray 125. Tirada xaaladaha muddo ka hoos 350 000 xaaladood (kuwaas oo 17.5 kun dhimashada) si ay 406 xaaladood oo lagu tilmaamay 2013. Western Europe, Russia iyo North America maanta waa meesha free of cudurka iyo calaamadaha cudurka dabeysha halkan lagu tilmaamay oo keliya xaaladaha goosgoos ah.

exciter

Polio - cudur fayras keeno. Sababta waxa uu noqonayaa mid dabeysha, taasoo la xiriirta enteroviruses ah. Qeex saddex nooc oo fayraska (I, II, III). Waayo, nooc aadanaha iyo daanyeer pathogenic aniga iyo III. II saamayn kartaa jiirka qaar ka mid ah. virus RNA ku jira, oo ay size waa 12 nm. Deggan deegaanka - biyo, waxaa la soo kaydin karaa 100 maalmood oo caano - 3 bilood, 6 bilood - ka dheecaanka bukaanka. Caadiga ah des. macnaheedu waa natiijo la'aan, laakiin fayraska si degdeg ah Kipury by autoclaving, karaya, gaadhista iftiinka ultraviolet. Marka kululaynta ilaa 50 ° C virus dhiman 30 daqiiqo gudahood. Marka cudurka inta lagu guda jiro Xilliga cudurku ee lagu ogaan karaa in dhiigga, 10 maalmood ee ugu horeeya ee cudurka - a dheecaanka pharyngeal iyo aad u dhif ah - in dheecaanka lafdhabarka.

farsamo gudbinta

halka uu cudurka ku dabeysha noqon kartaa sida nin buka, iyo side virus astaamo (xaaladaha qaarkood, side la hayn karaa muddo saddex - shan bilood ka dib markii dib u soo kabashada). Fayraska waxaa laga sii daayay deegaanka la saxarada oo ka mid ah bukaanka iyo xab ilaa dhuunta. Waayo, polio dariiqa socda ee khuseeya:

• pin;

• hawada,

• saxaarada-afka.

hab ugu badan ee la isugu gudbiyo waa saxaarada-afka - virus jidhka ka gala meel wasakhaysan gacmaha, maacuunta, cuntada, biyaha. Sidoo kale khatar ah waa xab ka bukaan bacaraarka 2 maalmood cudurka sii daayay inta lagu guda jiro 2 toddobaad ee ugu horreeya.

nuglaato ee virus waa 0.2-1%, inta badan kiisaska ay yihiin carruurta ka yar 7 sano. dhacdooyinka ugu xumaa dhacdaa xagaaga iyo dayrta.

sababaha halista

Sababaha ka qeyb faafidda cudurka waxa ka mid noqon kara:

• la'aanta caadooyinka nadaafad ilmaha;

• mugga dadweynaha;

• xaaladaha nadaafadda saboolka ah, oo ay ku jiraan xad gudub ku ah nidaam fayadhowr in hay'adaha;

• cudurka soo noqnoqda (in ka badan 4 jeer sanadkii) ee ilmaha;

• difaaca,

• heerka u hooseeya ee tallaalka.

kala soocidda

Polio waxa lagu tilmaamay sida uu dabiiciga ah ee habka dareemayaasha:

• foomka nonparalytic - dhaca oo aan lesions weyn ee habka dareemayaasha - meningeal, abortive (visceral) inapparatnaya (astaamo iyo waa virus, kaas oo kaliya la go'aamin karaa by shaybaarka) qaab;

• foomka curyaanka.

Taa baddalkeeda, foomka curyaanka lagu tilmaamay inay by meesha dhaawaca. distinguished:

• qaabka spinal - gartaa curyaannimo flaccid of adimada, jirridda, diaphragm, qoorta,

• Pontina qaab - baxa yl la complete khasaaraha qayb ka mid ah wajiga, geeska dhula afka dhinaca wajiga, lagophthalmos;

• bulbar - waxa lagu gartaa hadalka oo yaraada, liqidda, neefsashada xanuunada iyo dhaqdhaqaaqa wadnaha,

• Encephalitis - iyo astaamaha cerebral focal;

• foomka isku qasan - pontospinalnaya, daweeyay, bulbopontospinalnaya.

Ka dambeysa kala saaro noocyada khafiif ah, dhexdhexaad ah, daran iyo subclinical.

xilliga cudurku

Xilliga cudurku, marka calaamadaha ugu horeeya oo aanan weli la muujiyey polio, waxay qaadataa 2 ilaa 35 maalmood. Inta badan, muddada waa 10-12 maalmood, taas oo ku xidhan astaamaha ilmaha gaarka ah ee u shaqeeyo. Wakhtigan, irdaha laga galo iyada oo loo marayo (ay yihiin dalqada iyo shiidka) virus helo gelin qanjidhada caloosha, halkaas oo ay jiraan oo ay faafin. Ka dib markii in, waxa uu galo dhiigga iyo billowdo wareegga of viremia inta lagu guda jiro kaas oo caabuq ku fidaa jirka oo dhan iyo saameeyaa qaybaha ugu nugul waxaa ka mid ah. In the case of polio waa gees hore ee laf-dhabarta iyo unugyada myocardial.

Calaamadaha foomka meningeal

Foomamka Meningeal iyo abortive jira noocyo of polio non-curyaanka. Calaamadaha ugu horeeya ee cudurka dabeysha ee carruurta leh qaab meningeal mar walba ka muuqan af badan. Heerkulka dhowr saacadood gaartay 38-39 °. In la sameeyo calaamado caan ku hargab caadi ah - qufac, dheecaan-axaleedka ama nabarrada sanka. Marka viewed ka cunaha sida calaamad oo hyperemia, qumanka iyo gacanka palatal laga yaabaa huurada. At height of heerkulka noqon kartaa lallabo, matag. Ka dibna, dhibcood heerkulka, iyo laba ama saddex maalmood, xaaladda ilmaha ay degto.

waxaa la qabsi, jahawareer, feejignaan xumo, madax-xanuun, matag - raacay by qandho soo noqnoqda, iyo astaamaha cudurka dabaysha ayaa ka badan oo kala duwan. Waxaa jira calaamado meningeal: calaamad wanaagsan kerning (been on dambe ee bukaanka waa lugta laaban at wadajir jilibka iyo misigta xagal 90 ° ah, iyo in ay sabab u tahay kacsanaanta muruq uu noqdo wax aan macquul aheyn in ay toosi jilibka), muruqyada qoorta adag (adagtahay ee isagoo Jiifa dib si ay u gaaraan gar in ay xabadka ).

foomka abortive

Calaamadaha cudurka dabeysha ee carruurta leh qaab abortive sidoo kale ay bilaabaan in ay u muuqdaan khatar ah. Against heerkulka sare (37,5-38 °) arkay qidmeyntiibulshada, feejignaan xumo, debcin madax xanuun. Waxaa jira ifafaale yar catarrhal - qufac, sanka oo dareera, guduudasho cunaha laga yaabaa in calool xanuun, iyo matag. Ka dibna waxaa laga yaabaa in angina catarrhal, enterocolitis ama caloosha. In daliilka xiidmaha kala saaro dabeysha abortive. Calaamadaha cudurka carruurta, kiiskan inta badan waa in toxemia ku calaamadeysan mindhicirka sida uu nooca dabadhiig qaba ama daacuun. daliilka dareemayaasha ee foomkan of polio.

polio curyaanka

Qaabkan polio dhacdaa noocyo badan oo culus ee daaweynta ee kor ku xusan iyo mid aad u xun. Calaamadaha ugu horeeya ee dareemayaasha polio bilaabaan in ay u muuqdaan 4-10 maalmood ka dib marka uu fayruska soo, xaaladaha qaarkood, muddo this laga soo kordhin karaa ilaa 5 todobaad.

In horumarka Tallaabada ku xigta ee cudurka waxaa go'doonsan.

• Preparaliticheskaya. Lagu gartaa kor heerkulka ilaa 38,5-39,5 °, madax-xanuun, qufac, sanka oo dareera, shuban, lallabo, matag. 2-3 maalmood gobolka caadi ah, laakiin markaas u kaca cusub ee heerkulka bilaabo inuu 39 - 40 °. Against asalka this waxaa jira madax-xanuun iyo murqo xanuun xoog badan, gundhin muruqyada in loo arki karaa xitaa aragga, miyir oo yaraada. Xilligan waxa ku dhammaataa 4-5 maalmood.

• Waayo, stage curyaanka lagu gartaa horumarinta curyaannimo. Waxay si lama filaan ah u horumariyaan oo ay muujiyeen in maqnaanshaha dhaqdhaqaaqyo firfircoon. Iyada oo ku xidhan qaab reer horumarinta curyaannimo ee addinka (badanaa lugaha), jirridda, qoorta, laakiin dareen waxaa sida caadiga ah ma saameeyeen. Muddada stage curyaanka kala duwan tahay 1 ilaa 2 todobaad.

• Tallaabada ugu hoos at therapy guul lagu gartaa yareynta shaqo muruqa curyaanka. First, habka ay taasi dhacdo aad u degdeg ah, laakiin markaas Isbadalo la hoos. Xilligan waxa uu socon karaa hal ilaa saddex sano.

• In ifafaale saameeyeen haraaga ah tallaabo muruqyada atrophy, contractures loo sameeyay iyo in la horumariyo deformations kala duwan oo ka mid ah jirrid iyo jirka, waxaa si fiican u yaqaan sida calaamadaha cudurka dabeysha ee carruurta. Photos soo bandhigay in dib u eegis this lagu muujiyo tallaabada ay tani tahay arrin cad.

foomka spinal

Waxaa lagu gartaa bilawga ba'an (heerkulka ka soo baxdo ilaa 40 ° iyo, in la barbardhigo noocyo kale waa joogto ah). Child itaal darnaadaa, adynamic, hurdo, laakiin waxaa suurto gal ah iyo hyperexcitability waa (sida caadiga ah, calaamado u yihiin inta badan sameysa ee caruurta aadka u yaryar), qalal. Waxaa jira xanuun lama filaan ah ee jirka hoose, ka xun marka beddelidda booska ee jirka, xanuun muruqyada dhabarka iyo qoorta. On baaritaan, ayaa muujinaya in astaamaha boronkiitada, pharyngitis, rhinitt. Waxaa jira calaamado cerebral, diidmo (reaction kordhay in noocyo kala duwan oo wareer ah). By gujinaya dhabarta, ama meel ka mid ah qiyaas ugu dhacdaa dogob dareemayaasha xanuunka af badan.

At 2-4 maalmood laga bilaabo bilowga ah ee cudurka dhici curyaannimo. Marka polio, waxay leeyihiin sifooyinka soo socda:

• kaqabto - guuldaradii of baas nooca gacanta bidix - cagtiisa midig,

• humaag - ma saamayn muruqyada addinka,

• hummaag seed dhimay ama ka maqan;

• hoos qarsan ee muruqyada ilaa atony, laakiin dareen aan loo kala dhantaalan.

The addinka saameysey caddaan, CYNOTIC, qabow marka la taabto. Xanuun syndrome keenaysaa in xaqiiqda ah in ilmuhu qaato xaalad khasabka, taas oo, ee jeedo, ayaa noqonaya Jidka contractures hore.

Recovery of hawlaha motor bilowdo 2 toddobaad cudurka, laakiin habka tani sii dheer oo aan sinnayn. lesions muujiyay trophism unugyada, addinka korid, qaloocsan si wadajir ah, atrophy unugyada lafta. Cudurka socdaa 2-3 sano.

foomka bulbar

foomka Bulbar waxa lagu gartaa bilawga ah mid aad u ba'an. stage Preparaliticheskaya iyadu waa ku dhawaad maqan. Against asalka ah cune xanuun, iyo si lama filaan ah u kacay inuu u tiro badan (39-49 °) waxaa jira calaamado dareemayaasha:

• curyaannimo doobta - xadgudub ku ah liqidda iyo phonation;

• xanuunada neefsashada;

• xanuunada dhaqdhaqaaqa jallo - iyo rotarny nystagmus siman.

Cudurku wuxuu keeni kartaa pneumonia, atelectasis, myocarditis. Waxa kale oo suuragal horumarinta dhiig caloosha, xiidmaha xirma.

foomka Pontin

foomka Pontina dhacaa sabab u tahay dhaawaca wajiga fayraska cudurka dabaysha, dheecaan, iyo mararka qaarkood dareemayaasha ee trigeminal (V, VI, VII, lammaane oo dareemayaasha cranial). Tani waxay keenaysaa in curyaannimo muruqyada mas'uul ka ah wajiga, iyo xaaladaha qaarkood, iyo muruqyada masticatory. Caafimaad ahaan waxaa la muujiyay in kaqabto oo ka mid ah muruqyada wejiga, yeeesha laalaabka nasolabial, la'aanta laalaabkii siman on foodda, ptosis (kaa dhaga) ee xagal ee afka ama qarni ah, ay dhamaystirnayn la xiro. Calaamadaha ka sii muuqata marka aad isku daydo in aad iftiimisid, indhahaaga xir ama ka badbadinin dhabanka.

daaweynta

daawayn gaar u ah cudurka dabeyshu ka jiro. Marka dejinta cudurka ee bukaanka loo oggolaaday in cudurka isbitaalka, halkaas oo ay bixisaa inta kale jirka iyo maskaxda. In muddo preparalitichesky iyo curyaanka isticmaalo xanuunka iyo diuretics, sida ay tilmaamo siin daawooyinka anti-bararka, ama corticosteroids. Marka liqidda disorder function - quudinta tuubo, xadgudub ku ah neefsashada - neefsashada. Muddada kabashada muujiyay therapy jimicsi, massage, daaweynta dabiiciga ah, fitamiin iyo nootropics, daaweynta sanatorium.

ka hortagga

Polio waa mid ka mid ah kuwa cudurro si sahlan si looga hortago in ka badan in ay daawo. Taas waxaa la samayn karaa iyadoo qofka la tallaalay. In Russia, dhammaan carruurta iminka dhalatay samaynayaan tallaalkan. Tallaalka waxaa lagu fuliyaa in dhowr marxaladood - 3 iyo 4.5 bilood ilmaha la tallaalo tallaalka fayruska aan nooleyn ee ah. At 6, 18, 20 bilood, habka lagu celceliyo oo isticmaalaya a tallaalka nool. tallaalka la soo dhaafay waxaa lagu fuliyaa ee 14 sano. Oo ha ka maqnaan, maxaa yeelay, inkastoo xaqiiqda ah in la aaminsan yahay in cudurka dabeysha uu yahay khatar ah oo keliya carruurta, tani ma aha sidaas waa, sida kiiska ee calaamadaha cudurka dabaysha ee dadka waaweyn waa mid aad u fahmayaan oo khatar ah.

In la aqoonsado hortagga cudurka waa shey muhiim ah in lagu takooro bukaanka waqtiga, karantiil iyo kormeerka muddo 3 isbuuc ah koox xiriir ah, waafaqsan nadaafadda shakhsiga.

Sidaas darteed, waxaan ka fikiray si faahfaahsan ku filan waxa calaamadaha cudurka dabeysha waxaa, iyo waxa la sameeyo si looga fogaado in cudurka this.