Njovhera mutauro: Zviratidzo neMarapirwo

Njovhera kufamba famba nyika emakore, uye ari kutozivikanwa kunzwisiswa. To musi, yakatanga itsva nzira nechirwere uye kurapwa, asi achiri nhamba yevanhu iri kukura. Chete muna Russia muna wokupedzisira chikamu zana, nhamba yavo yakawedzera ka7.

Njovhera parurimi mumuromo rinowanika zvishoma kazhinji pane pamusoro sikarudzi, asi hapana zvishoma ngozi. The chikuru chinoratidza chimiro ichi ndechokuti mumuromo mucosa uye mutauro zviri nyore kuvhiringidzika ane zvachose chisingakuvadzi zvirwere, ndokusaka varwere vakawanda rikasakurumidza chiremba, uye mubasa kuzvidzora medicate uye Muzvare nguva. Asi njovhera kuporeswa fungidziro kunobva zvachose vachinyatsoziva kurapwa.

Funga kuti njovhera kunoratidzwa muna mutauro, sei kubata navo, sei nengozi kune vamwe, uye raikura ayo nzira kurapwa.

Portrait ane utachiona hwakakura

Njovhera kunokonzera nemaziso microbe - ". Treponema rakachenuruka" anaerobic, ane zita riri Hapana kumutumidza nokuti Romanovsky-Giemsa siyana yava pingi rakachenuruka. muviri wayo roga rine chimiro nhete zononoka rwakavakwa miromo uye 12-ndipo kana 14-vakasuwa 8-ndipo kazhinji curls. tupukanana ava Mobile chaizvo, asi kwete chaizvo akaoma musoro. Ndivo kupikisa nharaunda pamwe T = 55 ° C 15 chete kwemaminitsi uye pasi reflux, i.e. panguva t = 100 ° C uye kumusoro, vanourayiwa pakarepo. Uyewo nyore kwavari kuti aparadze chero disinfecting mhinduro, kunyange mumwe munhuwo sipo. Naizvozvo, kuti varege kubata njovhera nerurimi kuburikidza zuva nezuva, tinofanira chete tinofanira kuchengeta utsanana. A pachena kuchiitwa treponemes kuti zvakanaka chete noushamwari uye nyoro runyararo. In nechando, uyewo pasi pokudzora vamwe mishonga, vanogona kuumba cysts uye vakamirira pamapapiro kwemakore. Pakupisa, kunyanya pasina samadonhwe mwando, Vanofa sezvo kuomesa kwakaita nyoro substrate. Treponema zviwande kubudikidza nyore kupesana, uye, zvisanduke. Kazhinji, kubereka ane utachiona hutsva Zvinotora maawa 32. chinhu ichi chinobata nguva yose incubation nguva.

Nzira chirwere

Makarasika anofunga kuti mutauro njovhera zvinogona vakanonga chete panguva nomumukanwa zvepabonde kuvimbika naye. Maererano WHO nenhamba, saka noutachiona chirwere ichi, vanenge hafu varwere. The Vakasara utachiwana Treponema pallidum mumuromo mune dzimwe nzira:

• ndimbondotsvoda pamwe njovhera (zvinorwadza, udzamu);
• kuisirwa unscreened ropa;
• Vaona zvisina chiremba wemazino anoshanda unsterile zviridzwa;
• achiita majekiseni kuti vanhu vakawanda vane imwe sirinji (zvikurukuru pamusoro muropa nezvinodhaka);
• kushandisa chikwesheso, chipunu, mukombe, pashure murwere chete njovhera;
• treponem kutapukirwa kubva amai Fetus (vachiberekwa njovhera);
• vacheche utachiona paanenge achiyamwa;
• chirwere vashandi zvoutano.

mashandiro chirwere

Mutauro kuratidzwa njovhera zvinokwanisika, kana Treponema pallidum akakwanisa zvinopfuura mucous membranes ari nomumukanwa mhango. Oral pabonde kutapukirwa mashandiro ari nyore. Treponema nguva dzose massively aripo ari urume murwere, kunyange kana zviri nemaziso sikarudzi havana zviratidzo chirwere.

Kamwe mumuromo nedambudziko idzva, utachiona vanoedza zvinopfuura mucosal tishu. Kunyanya zvakanaka kune chisvetasimba, kana vane maronda. Panyaya iyi, utachiona kunoitika ne 100% mukana. In nemate ane mwoyo murefu njovhera treponema padzakacherechedza chete kana muromo wake ane hunhu mapundu. It anosarudza kuti chikamu mukana chirwere nokutsvoda.

Ivepo kupinda extracellular kwenguva nyama kuti mabhakitiriya anobatsira zononoka chimiro miviri yavo, ivo kuitira kuti "Volt" sezvinoita kokusikuruu, uye kamwe mukati, vanotanga bereka. The rokuzvidzivirira anorayira akatambudzwa atadza antibodies, macrophages, lymphocytes. Kana munhu zvirwere yakasimba kwazvo, uye kuonana murwere aiva mumwe-nguva uye pfupi, zvichida nokusunga chirwere. Asi vakawanda vaishandira zvirwere havagoni kukurira varwi rakapinda muMutumbi tupukanana vane uyewo kudzivirira Kamudzira muviri akafukidzwa nebhitumini. pakutanga Treponema Kuwanziridzwa achizadza pakakoromoka node, node kubva 0.1 chete% oxygen. Next, vanopinda muropa uye vanotanga kuenda kuburikidza nomuviri, bata nedzimwe nhengo.

kupatsanura

Munyika tsika, tinoshandisa inotevera kupatsanura pakati njovhera:

• chikuru
• yechipiri (mangwanani uye mushakabvu);
• vachiberekwa.

Mumwe nemumwe siyana idzi dzakaona zviratidzo zvavo mutauro njovhera.

Aiwanzoshandisa nyore kupatsanura:

• mangwanani njovhera (nyore chirwere, zvakawanda chinotapuriranwa, zvingaratidza kunyangarika, vachisiya pasina zvisaririra);
• Late njovhera (nevanhu miviri zvose, kunyange zvazvo aigona kutanga pamuromo).

In mushonga, pane dzakasiyana kupatsanura pakati njovhera:

• zvepuraimari (seropositive uye seronegative);
• yechipiri (yakachena, hwakavigwa, idzokororo);
• Tertiary (rakavhurika, akavanda);
• vachiberekwa (mangwanani uye mushakabvu);
• visceral.

Muitiro hosha rakakamurwa muzvikamu zvina:

• incubation;
• chikuru
• yechipiri;
• Tertiary.

Ngationgororei navo zvizere.

incubation nguva

Zviratidzo njovhera mumutauro pakutanga chirwere hatisi. Ichi Isimba rakadini rinogona kubudiswa Danho, huchavapo kubva nguva iri mucosal kupinda microbe uye kutangira kuona chiratidzo.

Panguva ino, Treponema kuwedzera nhamba dzavo uye zvishoma nezvishoma kupararira aibuda node kuburikidza nomuviri. The rokuzvidzivirira achiri kugona varambe vachishingaira mukurwa, achidzikisa zvikuru nhamba yavo. Murume ane haisati anonzwa kuti vakabatwa, kunyange vamwe zviri kuva nengozi. Ramba incubation nguva zvingava mazuva 15 kusvika 60. Avhareji izwi mazuva 20-21 zvaiona kuzivikanwa. Nokukurumidza zviratidzo kuoneka mune vanhu simba nezvimwe zvirwere (TB, AIDS, kudhakwa). Kunonoka zvingaratidza kuitika kana murwere ari nenguva njovhera iri kutora mishonga nokubata angina, mwandabvu nezvimwe chokuita zvirwere.

chikuru nguva

Iye kunotanga pakuonekwa chancre, uye rinopera Kutsakatika ake uye pakuonekwa mapundu. Shoko "chancre" mushanduro kubva Old French rinoreva "kwazvo." inotungamirwa Izvi zvinowanzoita nyarara, gobvu, rinowanika munzvimbo okusuma treponemes mu tishu. On pemvura chancre anogona dzinongoda haana kununura marwadzo Kuparara. Saizvozvowo, unoratidzwa chikuru nguva njovhera mumutauro. Photo unoratidza chancre parurimi pamusoro. Anoenda kuburikidza wandei zvokukura kukura, achitanga duku dzvuku nzvimbo. Mukati maviri kana matatu mazuva panguva yayo pakati pane chisimbiso, iyo zvishoma nezvishoma chinowedzera mu dhayamita. Parallel izvi, pakati chinokosha nekrotiruetsya chancre panosvika tsvuku (nyama) ruvara.

Kana kubva nzvimbo kutora tichibvisa, izvozvo acharatidza zviuru treponemes. Dzimwe nguva, maronda ari nechepakati chancre rinofukidza whitish unhani. Nechepakati nzvimbo munzvimbo mutauro matanga mune vamwe vanhu vakacherechedza crevice Kuparara. Kana papi seri rurimi, kazhinji tumiti panze pamusoro pemvura.

Chimwe chinokosha ndiko lymphadenitis romunharaunda (wakakurisa node nodes). Kana njovhera dzakatangira pamuromo, node nodes pasi shaya kunowedzera chirebvu, uye dzimwe nguva zviri mumutsipa.

Features chinonyanya kumwedzi

Nemaronda parurimi mu njovhera, kana kwete mumwe chirwere zviratidzo (zvakawanda zvive, fivha, nomusoro, etc.), varwere vakawanda tora chinhu (semuenzaniso, stomatitis), asi kwete zvirwere zvinotapuriranwa pabonde. Izvi zvinoshandawo kunyanya kuvanhu, kwete kuita dzisina pabonde uye utachiona neimba. Saka vanotanga kurapa maronda avo rinses, sear navo ayodhini. Treponem nzira dzakadaro Usauraya, asi munhu ane chancre parurimi kana zvimwe zvikamu muromo (musi matadza, miromo) anova zvikuru dzaitapuriranwa nokuti kwemabhakitiriya maronda nguva dzose kupinda mate. Zvisinei, kana vangakosora kana sneezing njovhera isina inoparadzirwa chete kuburikidza kutsvoda, mudzanga ndiro.

Analysis RW (Wassermann maitiro) rokutanga Danho vangava kunaka (seronegative chimiro) mana inopinza akanaka pluses (seropositive fomu).

Second kumwedzi

Kunoratidza Kutsakatika pamusoro chancre, kuti vanhu vazhinji vakaona sechinhu "kupora kubva stomatitis." Munguva chekare njovhera Panguva iyi, mumwe mapundu pamusoro nezvanza zvamaoko ake, tsoka, muviri wose. Uyezve, pane zvave kukuvara tsinga. Around chete zviratidzo zvaizobatsira njovhera nerurimi. Photo rinoratidza Zvinoonekwa rozeolnye mavara zvinogona kuonekwa pamwe papules (plaques). Kana ivo aonekwa nzvimbo papillae vari zvakanaka akaratidza, kuti protrude pamusoro akapoteredza munyama muchimiro grayish foci pamwe zvakajeka kana ndiEzekieri, kuenzana kumicheto. Asi kazhinji nenguva nzvimbo kukundwa yacho papillae hatisi, zvadaro papule rava kupenyerera, pinkish-rinokwanisa kucheneruka, iri nechepazasi pedyo zvikamu. Language saka anotanga akafanana raiiswa ochadhi unoparadzanisa zvidimbu.

Vamwe varwere pakutanga yechipiri nguva pane utera, nemusoro, fivha, iro kunonzwisiswa sezvo zvishoma kuchitonhora. Izvi "chirwere" varwere vakazvigadzirira zvikuru chivimbo, kana vanoshandisa confluent tsvuku makwapa pamusoro tonsils uye pahuro, kufanana chiduku angina. Musiyano mukuru iri chokwadi kuti njovhera hapana marwadzo kana pakuparadza.

Second kumwedzi kunotanga anenge 9-10 mavhiki pashure neutachiona uye 6 7 - pashure wokutanga chancre, uye kunotora makore maviri kana kupfuura. Panguva iyi, pane systemic kukundikana nhengo dzomukati, uye rashes uye makwapa parurimi mu njovhera vangave kutsakatika zvachose, ipapo kuzodzosera kuoneka.

tertiary

Vachingotya kuregeredza chirwere kunoitika kukundwa vazhinji zvomukati (pfupa, chiropa, mwoyo, chirwatata). The rokuzvidzivirira simba uye murwere irege yekudyidzana kukanganisa nzira chirwere. Zvisinei, exacerbation uye kuregererwa panguva tertiary Danho kunogona kurondwa. Chikonzero kwavari kukuvara, kushushikana, kushaya zvokudya zvinovaka muviri, zvimwe zvirwere, Somuenzaniso, zvokuvamba pachando.

Classically Tertiary kumwedzi kunotanga pashure pemakore 4.5-5.0 pashure chirwere, asi pane zviitiko zvakawanda kwakatanga makore 10 kana kupfuura. The huru chiratidzo ndicho chimiro chake kutanga gummas - raiva pedyo nebundu rinenge yekudyidzana deforming miviri. Language anooneka njovhera Tertiary tsvarakadenga zvakajairika, saka haagoni kuva kururama kuti chepabonde ane chando kana ihosha huro.

Gunma mumutauro kunogona kukonzera nodular kana diffuse glossitis. Yokupedzisira ichaongororwa wakakura zvikuru kuomesa kwakaita njovhera pamuromo. Language murwere nokuda diffuse infiltration richikora, kunova denser, riri kusununguka naye mataurirwo mazwi. Pashure, pamusoro-nzvimbo infiltration ngapaonekwe vanga rinenge mutauro hunowedzera gobvu namabukira ndokudzora pamusoro ndiye gogonera, uye unoratidza zvinorwadza makatsemuka uye maronda, izvo zvinogona kukonzera nyanyisa anomera. Pasinei zvisingafadzi zviratidzo izvi, murwere Low njodzi kune vamwe, sapamazuva Gunma treponem inenge ikoko.

Diagnostics

Njovhera mumutauro chiremba ane ruzivo anogona kuona nokuda zvokunze kuratidzwa, asi kazhinji murwere ushandiswe wandei Analyses. Vanhuwo zvikuru, asi zvikuru kururama - nayo RW. On the serological pachikuva, anogona kupa kunaka kunounza murwere kwevanhu uye utano yakanaka ezvinhu akadai:

• pamuviri;
• tiibhii;
• marariya;
• zvirwere ropa;
• pashure yokutindivadza;
• panguva yekutevera.

PCR ndiye ongororo neyakarurama, asi anopa mhinduro yakarurama chete kune nesekondari zvokukura njovhera kukura. Uyezve, Maitiro akadaro inoshandiswa Detective Treponema: RIBT, Rif, TPHA, RHS, RPR, RNC.

Hapana nzira idzi hakusi yakarurama pa 100%, saka kuti vawane zvakarurama mugumisiro wacho yemanyorero akaita Analyses maviri. Nokuti mufambiro wavo murwere kurasikirwa ropa kubva tsinga usina chawadya. The pakati assays kuti njovhera mhando yechipiri ngaarayire kubva chancre, mapundu, papules uye nodules, asi rezultativen chete nesekondari nzendo chirwere.

A akanaka mugumisiro anoratidza "++++" kana "+++". Izvi zvinoda mumwe muedzo confirmatory.

zvabuda mibvunzo akasarudzwa "++" kana "+". Panyaya iyi, nechirwere inodzokororwa pashure pemazuva 10-12.

Mabatirwo njovhera mumutauro

Sezvo pallidum zvikuru nehanya nemekiyuri nokuda njovhera vasati pekubatira kubvisa zvinodhaka anoritsanangura. With kuwanikwa kuti penicillin, iyo pallidum kuri nehanya chaizvo, tsika ichi chinhu chekare. Kwemakumi emakore kuti mishonga njovhera kushandisa kuti penicillin zvinodhaka. kana chete murwere ane chisimbwa kwavari, ivo ne "Erythromycin", "Cephalosporin" "Tetracycline". Dzimwe nguva kushandisa aminoglikozity, vari achigonawo tunodzivisa kukura treponemes, asi vanofanira kubatwa mu kukwirira mishonga, Hazvina kunaka kuti murwere.

Kuwedzera kurapwa vanhu nechirwere njovhera, kuti chirwere uye, kana zvakakodzera, kurapa anofanira vose vave uchikurukura naye.

mataridzikiro

The nesekondari zvokukura mutauro njovhera zvakakodzera kurapwa arapwa anenge 100%, asi kunofanira kurangarirwa kuti Treponema anokwanisa kudzivirira pamusoro kuitwa zvinodhaka. Kana mamiriro ezvinhu ave nezvemurume Ivo matsime dutu kwebasa, chimiro cysts uye kutanga kumirira. Kamwe aiona munhu chinoitika chichiburutswa kutapata, ivo zvakare kuumba dzose helical chimiro uye kutanga zvichiberekana. Naizvozvo, pashure pokupedza yokurapa ose 3 months, varwere rasai bvunzo ivhu. Rinotora makore 2. Zvadaro rimwe gore miedzo vachava kamwe ose 6 mwedzi. Pashure rakakwana kuzviongorora murwere, nemigumisiro zvakanaka rinobviswa mazita.

The tertiary pavaipfuura njovhera iri zvino kurapwa, asi akatanga kudzvinyirira mutauro hakuchisina akapora. Uyewo, regai kunyangarika rakadzika stellate mavanga vasara pashure gummas.