Sputum: zvinangwa uye nzira

Sputum chakavanzika asunungurwa panguva kuzvimba trachea, principales uye nemapapu. Chitarisiko wake Kunoonekwa kwete chete chete kukundwa ari kufema system asiwo mwoyo uye vascular zvirwere. Nzira sputum kunosanganisira macroscopic, nemaziso uye makemikari tsanangudzo zvachiri.

Analysis kunoratidza kuti

Sputum zvinoita kuti tikwanise kuziva tusingaoneki kuti anokonzera chirwere kwacho, kunan'anura kuvapo Mycobacterium tibhii, kuziva masero kenza, ropa uye purulent netsvina, uye kuona kusakuvadzwa nemishonga kuti nemishonga.

Under chii ezvinhu kunoratidzwa ongororo

Sputum ari hombe kuongorora anoitwa pasi zvinotevera ezvinhu:

• kukosora;
• kuzvimba mumapapu;
• kuzvimba principales;
• bapu pute;
• tiibhii;
• bronchiectasis;
• pulmonary neronda rinonyenga;
• bapu mota;
• bronchitis iri rikwanise muchimiro;
• chisingaperi bronchitis;
• mu chisingaperi tonsillitis;
• tiibhii;
• whooping chikosoro;
• silicosis;
• chenjera chimiro obstructive bronchitis;
• kuzvimba mumapapu;
• nechigwadara.

Survey Preparation

Nebhitumini achange dzinounzwa nani, kana pamusoro avaida pamberi kusarenda kutora kuongorora chishandiso expectoration, kana uparadze yakawanda inodziya zvinwiwa. Asati nekunhonga yakarumbidza kuchenesa mazino uye dzaiita mhango, rinsing nemvura inodziya abika.

Basic mitemo kuti muunganidzwa

Unganidza sputum kuongororwa bacteriological kunodiwa kubudisa mangwanani (iye anounganidza usiku pamberi kudya) ari chena mudziyo, izvo nekanzuru murabhoritari. Nokuti kuongorora zvakakwana uwandu 5 Rine mamiririta. Analysis pamusoro secretion hauna papera pane 2 maawa pashure muunganidzwa kwavo. Kusvikira nguva nokutuma kudzidza zviri mudziyo zvinofanira kuchengetwa namahwindo mufiriji.

Uwandu sputum mu nezvirwere zvakasiyana-siyana

Number dzinounzwa secretion zvinosiyana zvichienderana yezvakaita pathological muitiro. Kazhinji, izvozvo zvichisiyana mashoma nekusvipirwa 1 fő pazuva. A zvishoma ukasunungurwa panguva yacho kuzvimba principales, congestive pezvakaitwa kutanga nemapapu uye Árbol asima kurwiswa. Panoperera kurwisa vhoriyamu inowedzerawo. Zvinogona kusvika 0.5 litres, uye mumire vazhinji, kana pane pulmonary edema.

madzihwa Zvakawanda anosunungurwa panguva purulent kwacho mumapapu kana kutaurirana pamwe principales, pamwe chinoda kugadziriswa, bronchiectasis uye neronda rinonyenga.

TB sputum zvemapapu rinenge kunoratidza kuora. Kunyanya, akadaro muitiro chinokurwadzai ane mhango iyo anotaura nemashoko principales.

Kubva chii chakaita vasanyanye kana nokuwedzera secretion voga

Inosimudzira excretion secretion vangava kusonganirana kudzikira ezvinhu omurwere uye kuongororwa panguva exacerbation. The kuwedzera kunogona kureva zvakanaka rinomutsa okukura chirwere chacho.

Kuderedza uwandu secreted madzihwa anogona kuratidza regression kuti kuzvimba kana kukanganisa mu abudise mhango akazadzwa pus. Panyaya iyi, kuderera murwere utano.

hunhu zvinoyerera

Mucous secretion anomirira bronchitis mu chakasimba kana chirwere chimiro Árbol asima, mabayo, kenza, namamota ari zvemapapu, bronchiectasis, pulmonary hydatid chikofu, achiperekedzwa suppuration, actinomycosis.

Sputum ane admixture pamusoro pus iri kuchengetwa zvemapapu pute, bronchiectasis uye echinococcosis.

Madzihwa hwakakanyiwa ropa kana wakaumbwa zvachose ropa chinoratidza tibhii. Chimiro ropa anogona kuratidza kuvapo kenza, bronchiectasis, zvemapapu chinoda kugadziriswa. Uyewo, kwakadaro chiri kurangarirwa mukati akafukidza chirwere, myocardial infarction ari zvemapapu, kunotevera, actinomycosis uye syphilitic maronda. Ropa angava voga uye lobar uye muzinda nemabayo, congestive urongwa, cardiac asima uye pulmonary edema.

Serous sputum ari kuchengetwa pulmonary edema.

sputum ruvara

Sputum ongororo inoratidza izvozvo zvakasiyana mavara. Mucous uye serous buditsa haana chete ruvara kana vane whitish Hue.

Ndakabatana pus anopa chivimbo greenish Hue kuti kuratidza pathological pezvakaitwa akadai zvemapapu pute, neronda rinonyenga, bronchiectasis, zvemapapu actinomycosis.

Selection ane Kumubata ngura kana shava ruvara kunoratidza kuti dzine hapana ropa yakachena, uye ayo kuora zvigadzirwa - hematin. chakavanzika ichi chinogona kusunungurwa pamwe lobar nemabayo, hwechigwadara, pulmonary infarction.

Greenish ruvara ane kubatwa yellow tsvina kana zvakavanzika uchapupu zvirwere zvokufema akabatana jaundice.

The inopenya yero ruvara sputum rinamakwapa eosinophilic nemabayo.

Madzihwa ocher kunoitika muna siderosis nyore.

Blackish kana grayish chakavanzika akaona kuvapo marasha guruva netsvina. Kana pulmonary edema serous sputum aona vazhinji. Kazhinji, zvinonzi kupendwa noruvara vaaleanpunainen ruvara nokuda pamberi masero matsvuku eropa. Kwakadaro mvura Kuparadzana akafanana cranberry muto.

Akapendwa muchivande zvinogona uye zvimwe zvinodhaka. Somuenzaniso, asingaurayiwi "Rifampicin" anogona kuripa yakatsvuka.

munhuhwi

Yezvakaita pathological kwacho kufema turakiti zvingaratidza secretion uye kunhuwidza. Sputum anopa munhuwi kuora pamwe neronda rinonyenga pamusoro zvemapapu kana bronchus chinonyangadza maronda, kenza, namamota, necrosis complicating bronchiectasis.

Kuvapo akaturikidzana

Kazhinji kuongorora kunoratidza kuvapo secretions akaturikidzana. Kana mira phlegm ane admixture pamusoro pus iri akaona chinoda kugadziriswa zvemapapu uye bronchiectasis.

Chakavanzika kuora admixture rine zvitatu akaturikidzana. The pamusoro rukoko zvakafanana foam serous unosvikirwa, uye rezasi doped pamwe pus. mumwe sezvamunoita kwakadaro kunoratidzwa neronda rinonyenga yemapapu.

marara

Admixture zvokudya zvinogona kuonekwa pamberi akaipa nebundu rimwe yegurokuro pakukurukurirana dzaro principales uye trachea. Pashure kuonana tapeworm ari principales ari sputum anogona kuonekwa kana scolex nezvikorekedzo kuti chisvetasimba. Very kashoma kuwana vakuru pakati Ascaris kuti zvinopfuura kufema wemuTesitamende immunocompromised vanhu.

bapu fluke zai cysts ngavauye panguva yokumbozorora inopfurwa muna zvemapapu pamberi tupukanana.

Neronda rinonyenga uye zvemapapu pute kuti chitarisiko zvezvimedu zvemapapu necrosis. Kana mapundu chinogona kuvapo secretions zvimedu dzayo.

Convolution rine fibrin zvinowanika varwere fibrinous bronchitis, tiibhii uye mabayo.

Rice mhuru gogorosi kana Koch yokusafa tibhii.

Kuparidzirwa Dietrich, kusanganisira manyowa zvibereko utachiona uye zvemapapu rinenge masero mafuta acids, kuitika chinonyangadza bronchitis kana neronda rinonyenga yemapapu.

Chirwere tonsillitis chimiro kunosanganisira kuparadzana tonsils plugs akafanana kuparidzirwa Dietrich.

The mushonga nzira

Sputum makemikari nzira kunosanganisira kuona:

• mapuroteni indekisi, zvinogona kubatsira vari differential zvokuongorora pamusoro pemamiriro chimiro bronchitis uye TB. Bronchitis chisingaperi chimiro akacherekedza muchivande zvisaririra mapuroteni, uye achava yepamusoro zvikuru tubercular maronda uwandu mapuroteni muna sputum, uye kungaratidzwa nhamba (kusvika 100-120 g / l).
• Bile pigments. Ivo anowanikwa sputum ari kukundwa ari kufema ezvinhu akabatana nehepatitis. Panyaya iyi chiropa anokurukura nemapapu. Bile pigments vari yokusafa nemabayo kuti zviri kukonzerwa pokuwa zvemapapu mukati erythrocytes uye haizopereri vachinja hemoglobin.

Cytological chakavanzika tsvakurudzo nzira

Nokuti differential zvokuongorora kuti tibhii uye zvemapapu nezvimwe maronda zviri zvikuru kushandiswa pap nzira, iyo ine muzvikamu zviviri: kurapwa uye nemaziso kuongorora sputum.

Clinical tsvakurudzo kunobatsira kuona izvo nzira anofanira ndaitora zvinhu kuwana akarurama pamusana kuongorora.

Pane mhando mbiri chikuru zvinhu, izvo zvinoda nemaziso kuongorora sputum: kwatangwa uye kuderedzwa. The mhando secretion chechipiri inotengwa kufurirwa mikana yakawanda yokukurudzira siyana (nokuti expectoration nevasori, inhalations uye zvakafanana. D.).

Material yaunganidzwa tsono biopsy

Cytological Kuongorora sputum hunosanganisira kudzidza macroscopic uye nemaziso kuongorora masero ayo.

Vazhinji mashoko cytological kuongorora sputum atora mangwanani usina chawadya. Risati kudzidza rinofanira kuchengetwa hapana zvinopfuura 4 maawa.

• In sputum kuitika squamous masero epithelial, izvo akadzidza microscopically. Asi nokuti chirwere, havana zvaanoreva. columnar masero epithelial - Single uye muboka - zvinogona kuonekwa zvirwere zvakadai Árbol asima, bronchitis uye kenza yemapapu. Cherechedza kuti columnar epithelium kuonekwe nokuda kupinda ari nasal madzihwa.
• Alveolar macrophages muri masero reticuloendothelial. Macrophages anowanikwa cytoplasm (seguruva kana masero phagocytic) inogona kuwanikwa varwere vane refu guruva inhaled.
• Macrophages protoplasm (inoumbwa Kuparara Chizenga) mwoyo kuremara inonzi masero. Vanogona kuitika panguva mira pezvakaitwa mumapapu, mitral vharafu stenosis, pulmonary infarction.

• A vashoma leukocytes zviri chero sputum. yakakwirira kugutsikana kwavo munyaya admixture pamwe pus secretion.
• Eosinophils. masero kwakadaro akapfuma madzihwa ari asthmatics. Masero anogona anozivikanwa ne wechinhu eosinophilic nemabayo maronda helminths Muviri, tiibhii uye pulmonary infarction.
• Erythrocytes. Individual masero matsvuku eropa regai kuratidza mufananidzo chirwere. The kwaita yakawanda uchapupu pamberi ropa mumapapu. The matsva erythrocytes ropa tsunga kuramba. Kana pane admixture ropa, iro kuora mumapapu kwenguva refu, akawana leached erythrocytes.
• Masero Cancer. Vanogona kuwanikwa mumapoka muchivande. Inoratidza kuvapo bundu. Kana usina kuroora kana kuroorwa Sero kazhinji kuoma iri kuongorora chirwere. Muzviitiko zvakadaro, murume akanga apiwa kuongorora sputum.
• Kwakavharwa nenyama fibers, ane chitarisiko anokonzerwa akoromoke zvemapapu rinenge tiibhii makatsamwisa, pute, neronda rinonyenga, bundu. Neronda rinonyenga masero kwakadaro hakusi yoku sezvo nokuda kuitwa makemikari, izvo zvakavanzika, vanogona yakanyauka.
• Kurshmana zononoka. Ichi muviri chaiwo, akafanana chubhu. Ivo anowanikwa kudzidza pasi maikorosikopu. Dzimwe nguva kuoneka uye ziso. Yemanyorero Helix yokusafa zvirwere zvakadai Árbol asima, pulmonary tibhii uye nemabayo.
• Charcot-Leyden crystals anowanikwa sputum rurefu zviri eosinophils mu maronda aya, sezvo Árbol asima, eosinophilic mabayo. Kuvhuya chitunha tiibhii yatanga muna lumen pakati principales anogona dzinoratidzwa kuvapo ari secretion pakati kwakavharwa nenyama fibers remafuta akawandisa crystals, uye amorphous madota MBT (anonzi tetrad Ehrlich) - 100%.

Kushandiswa microscopy

Collection pakati sputum zodzera microscopy kuti kudzidza nzira anewo kuongorora secretions kuti vasabatwa munhu Mycobacterium wakananga tibhii. Vakafanana akafanana dzakaonda, nemvumi panhivi kana pakati makakombama tsotso akasiyana urefu, izvo dzinongoda zvose singly uye mumapoka.

Kuziva miedzo Mycobacterium tiibhii haisi hukuru chepfungwa nokuti chirwere uye kunoda nokusimbisa nomuromo bacteriological nzira. Mycobacterium tiibhii pamwero ane chakavanzika haagoni kuonekwa.

Hwaro nokuti kuongorora zviri purulent nezvimedu vanobviswa makumi mana nezvitanhatu munzvimbo dzakasiyana uye triturated kusvikira mvere panes maviri. Next, ivo aoma mumhepo uye yakatarwa burner womoto.

Bacteriological kuongorora sputum Ziehl-Nielsen staining zvinoratidza nawo dzvuku. Panyaya iyi, zvose zvakavanzika PARTICIPLE, kunze mycobacteria, yava tinged yebhuruu, uye mycobacteria kuva dzvuku.

Kana tiibhii muviri vanofungidzirwa lesion pashure zvidzidzo zvitatu kuvapo mycobacteria pamwe zvisina kunaka kunge akarwawo kushandisa flotation nzira (ongororo Pottenger).

Zvatinosiita nzira kudzidza Stained zodzera MTB anopa yakanaka mugumisiro chete kana uwandu MTB kuvaduku 50 000 inokwana zviyero por 1 ml sputum. Maererano nenhamba Mycobacterium tiibhii kutonga pamberi hazviiti.

Varwere Bacterioscopy nezvirwere nonspecific bapu

Laboratory zvidzidzo zviri sputum pamberi non-zvimwe zvirwere yemapapu microscopy anogona kuzivisa zvinotevera utachiona:

• Kana kuzvimba mumapapu - pneumococci, diplococci Frenkel, Friedlander utachiona, streptococci, staphylococci (100%).
• Kana neronda rinonyenga chiedza anogona kuonekwa chokurukisa tsvimbo akabatana spirochaete Vincent (80%).
• Mbiriso notumwe (70%), kuziva mhando kunoda muchivande mbeu.
• Drusen actinomycete (100%) pa actinomycosis.

Bhuku secretion muvanhu hwakanaka

Musha kuti madzihwa secreted trachea uye principales muvanhu kwete kutambura chero pathologies, kubvira 10 kusvika 100 ml / zuva.

Kazhinji yakaderera kwevari leucocytes, kudzidza pamusoro yakasvibiswa zodzera mycobacteria anopa zvakaipa mugumisiro.