I-Salmonellosis lusulelo olubukhali lwamathumbu oluvela kubantwana nakubantu abadala. Iimpawu zeempawu zesi sifo kukuxiliswa ngokubanzi komzimba, ukuphuhliswa kweenkqubo ezivuthayo kwizitho zokugaya. Amaxesha amaninzi, usulelo lwenzeka ngokutya.
Idatha yembali kwi-salmonellosis
Imbali yokufunda imvelaphi yesifo i-salmonellosis yaqala ngo-1876. Bollinger, owahlalutya ubudlelwane phakathi kwezifo ze-septicopyemic zezilwanyana zasekhaya kunye neemeko zetyhefu ebantwini emva kokutya inyama engcolileyo. Ngowe-1885 Oogqirha bezilwanyana baseMelika uSalmon kunye noSmith baye bakhetha into ebangela esi sifo ebizwa ngokuba yi S. Cholerae suis kumalungu eehagu ezichaphazelekayo. Ngowe-1888 Isazinzulu saseJamani uGaertner wakwazi ukufumana intsholongwane efanayo kwinyama yenkomo kunye nodaka lomntu osweleke emva kokutya le nyama. Le microorganism yayibizwa ngokuba yiB. enteritidis Gartneri (S. enteritidis).
Ngowe-1892 ULeffler wafumana i-microorganism B. typhimurium (S, typhimurium), eyaxhokonxa ukufa kweempuku. Igama elithi Salmonella lamkelwa ngowe-1934. ngembeko yomvunzi weSalmon.
I-Etiology kunye ne-epidemiology yesi sifo
Ii-causative agents zesifo zivela kwi-genus Salmonella, intsapho ye-Enterobacteriacea. Sisifo esinjani esi? Salmonella - iintonga 1-3 microns ubude, 0,5-0,8 microns ububanzi. Zihamba ngokubulela kwi-flagella, ziyi-facultative anaerobes (ekwazi ukukhula kunye nokuzala phambi kwe-oksijini okanye ngaphandle kwayo). I-Salmonella i-gram-negative (i-causative agents of purulent-inflammatory izifo), musa ukwenza i-spores okanye i-capsules. Ukukhula kunokwenzeka kwindawo eqhelekileyo kwiqondo lokushisa le-8-44 ° C (37 ° C libhekwa njengelona lifanelekileyo).
I-Salmonella ixhathisa kakhulu kwiimpembelelo zendalo. Zingahlala kumadama kangangeenyanga ezi-4, kwilindle lezilwanyana ukuya kutsho kwiminyaka emi-3, ebisini malunga neeveki ezi-3 (kubushushu obuyi-6-8°C), kumaqanda entaka ukuya kutsho kunyaka. Kwiqondo lokushisa eliphantsi, i-salmonella inokuphindaphinda. Umzekelo, iibhaktheriya zihlala enyameni kwi-0 ° C kangangeentsuku ezingama-140. Inani elikhulu lee-microorganisms ezinjalo zichasene ne-antibiotics, kodwa kwangaxeshanye zivakalelwa kakhulu kwii-disinfectants (i-bleach, i-chloramine, njl.).
Imithombo ephambili yosulelo yizolimo, izilwanyana zasendle, iintaka (ingakumbi iintaka zamanzi). Izilwanyana zinokuchitha iintsholongwane kwindawo engqongileyo kangangeminyaka ngomchamo, ilindle, ubisi, imifinya yeempumlo, namathe. Umthombo wesifo ngumntu osuleleke nge-salmonellosis, umthwali weebhaktheriya.
Esi sifo sisasazwa kwiimeko ezininzi ngokusebenzisa i-fecal-oral route, kaninzi ngokudibana nekhaya. Ukuqala kwesi sifo kunokwenzeka emva kokutya iimveliso ezingcolileyo: inyama yezilwanyana kunye neenkukhu, intlanzi, ukutya kwaselwandle, ukutya okulungiselelwe (okungekho phantsi kwonyango lobushushu), iziqhamo, i-confectionery, amaqanda, ubisi, amanzi. Usulelo lokunxibelelana nekhaya lwenzeka ngexesha lokhathalelo lwezigulane, kwiindawo apho inani elikhulu labantu lihlangana khona. Ibangelwa yi-S. Typhimurium, isasazeka ngokukhawuleza, iphikelela ixesha elide, kwaye ineemeko ezininzi ezinzima.
Abantwana abangaphantsi konyaka omnye basengozini kakhulu kwi-salmonellosis. Ngokukhula, ukuchaphazeleka kwesi sifo kuncipha. Iimeko ezininzi ze-salmonellosis zenzeka ehlotyeni nasekwindla, nangona unokusuleleka nangaliphi na ixesha lonyaka.
I-Pathogenesis kunye ne-pathomorphology yesi sifo
I-Salmonellosis liqela lezifo ezosulelayo zamathumbu. Usulelo ludla ngokubakho ngomjelo wokwetyisa.
Inkqubo yophuhliso lwesifo:
- Ibhaktiriya ihamba kumzila wesisu isebenzisa i-flagella.
- I-microorganism inamathele kwi-membrane ye-mucous yezitho zokugaya.
- I-pathogen iyaphindaphindeka kwaye iikoloni ezininzi zenza.
- Ukungena kwebhaktheriya nge-membrane yeseli, ngenxa yoko umgca wangaphakathi wezicubu uvutha.
Iibhaktheriya zeSalmonella zineqokobhe elomeleleyo; ziphila nasemva kokuba zifunxwe yimacrophage. Ukukwazi ukuphindaphinda kwiiseli eziveliswa ngumzimba ukutshatyalaliswa kwazo. Emva kwexesha elithile, ezi ntlobo zosulelekileyo zigqithiselwa ngegazi kwiindawo ezikufutshane.
I-Salmonella iyaxhathisa kwiqhwa ixesha elide kwaye ihlala isebenza xa ishushu kwi-100°C. Ukubilisa ixesha elide kuphela kunokutshabalalisa igobolondo le-microorganism.
Iibhaktheriya ze-Salmonella zinyamezela ngokulula ukukhanya kwe-ultraviolet. Unokuzisusa kuphela ngokuhlala uphatha igumbi nge-disinfectants.
Iimpawu zekhosi ye-salmonellosis
Xa i-Salmonella ingena emathunjini amancinci, inamathele kwi-epithelium yeeseli kwaye iqala ukuvelisa i-exotoxins (ubushushu-labile, ubushushu obuzinzile). Kwiindawo ezichaphazelekayo, ukutshatyalaliswa kwenzeka kwaye ukubonakala kweenguqu ze-microvilli. Amajoni omzimba avelisa i-macrophages kunye ne-T-lymphocytes ukulwa neebhaktheriya. Ekubeni iSalmonella ixhathisa kwi-macrophages, iingxaki zesi sifo zivela.
Ii-Microorganisms zikhupha inani elikhulu leetyhefu ezingena egazini kwaye zisasazeke kuwo wonke umzimba. Ukuxiliswa okukrakra kwenzeka kwaye ukuphelelwa ngamanzi emzimbeni kukhula. Isigulane sifumana ukuhlanza kunye nesifo sohudo, ngenxa yoko umzimba ulahlekelwa ngamaminerali asebenzayo, ngaphandle kokuba ukusebenza okuqhelekileyo kwamalungu kunye neenkqubo akunakwenzeka. Ukuvuvukala kwezicubu zobuchopho kwenzeka, umonakalo kwi-tubules yezintso, uxinzelelo lwegazi olunokwenzeka, i-arrhythmia.
Izintso zifumana owona mthwalo mkhulu ngexesha lokugula. Umthamo wegazi elihluziweyo kunye nokuchama uyanda. Ngenxa yokungabikho kwamanzi, inani lomchamo liyanda, elikhokelela ekubekweni kweetyuwa.
Nge-salmonellosis, umthamo womchamo okhutshwayo ngosuku uyancipha ngamaxesha ama-3 okanye ngaphezulu. Kukho amaxesha apho akukho kuchama kwaphela.
Isifo se-salmonellosis sikhokelela ekutshintsheni okuguquguqukayo kwi-membrane ye-mucous yamathumbu amancinci. I-Vascular hemorrhage kunye nokudumba kwezicubu nazo zinokwenzeka.
Ungasulelwa njani yi-salmonellosis?
Abathwali besifo se-salmonellosis zizilwanyana zasefama. Unokosuleleka ngelixa ukhathalela izilwanyana, xa usika izidumbu, ngexesha lokupakisha, kwaye ulungiselela iimveliso ezigqityiweyo.
Ukuba imigangatho yococeko iyaphulwa kwiifama zeenkukhu, ubhubhani usasazeka ngenxa yokusetyenziswa kwamaqanda angcolileyo.
Iindlela zokudluliselwa kwe-agent causative ye-salmonellosis:
- I-Fecal-oral - ukusuka kumntu ukuya kumntu ngezandla ezingcolileyo emva kokutyelela indlu yangasese, kwisigulane esosulelekileyo.
- Amanzi – xa usela amanzi akrwada.
- Indlu - ngexesha lokuxhawula izandla, xa usebenzisa izinto zomntu zesigulane.
- Uthuli olusemoyeni - xa uphefumla umoya oqulethe amasuntswana enkunkuma enemicroorganisms.
Ukuthintela usulelo, kuyacetyiswa ukuba utye ukutya okuthe kwaphathwa ngobushushu kwaye uthobele imithetho yococeko lomntu kubantu abadala kunye nabantwana.
Iimpawu ze-salmonellosis
Emva kokutya iimveliso ezingcolileyo, iimpawu zokuqala ze-salmonellosis zivela kwiiyure ezimbalwa. Ngendlela yasekhaya yokusuleleka - emva kweentsuku ezimbalwa. Ukuqina kweempawu kuxhomekeke kwi-immunity, ubudala besigulane, ubukho be-pathologies ehlukeneyo, kunye nohlobo lwe-ejenti esosulelayo.
Abanye abantu banokuchasana neebhaktheriya ze-salmonella, ngoko akukho zimpawu zetyhefu.
Kukho iindlela ezininzi zophuhliso lwenkqubo yokusuleleka, ukumisela ukuba ngabaphi abasebenzi bezonyango abaqhuba ukuxilongwa kwangaphambili kwesigulane.
Iintlobo ezahlukeneyo ze-salmonellosis zineempawu zazo.
Ifom yesisu. Iimpawu zokuqala zesifo zibonakala kwiiyure ezimbalwa emva kokusuleleka. Iimpawu zeempawu: ukwanda kobushushu bomzimba, umkhuhlane, ukugodola, intloko ebuhlungu, ukungcangcazela kwamalungu omzimba, ukuqaqamba komzimba, ukuwohloka kwe-tactile ne-reflexes yezihlunu, isicaphucaphu, ukugabha. Emva kweyure, urhudo oluxutywe ne-mucus kunye negazi lunokwenzeka. Kule meko, isitulo sinamagwebu, sinamanzi, kwaye siluhlaza ngombala. I-nasolabial fold ithatha i-tint bluish. Isigulana siba nemvakalelo yokuqunjelwa. Ngenxa yoxinzelelo lwegazi oluphantsi, kukho ubuthathaka, ukozela, ukutyhafa, kunye nokubetha kwentliziyo ngokukhawuleza.
Ifom yeGastroenterocolitis. Iimpawu ziyafana nezo zefom ye-gastroenteric. Emva kweentsuku ezi-2, inani lokuhamba kwamathumbu liyancipha. Kukho ithoni eyongeziweyo yamathumbu amakhulu kunye neentlungu ezibuhlungu zenzeka. Kungenzeka ukuba ubushushu bomzimba wakho bunokwenyuka amaxesha amaninzi ngemini. Ngexesha lokuhlanjululwa, umntu ufumana ukungahambi kakuhle kunye neentlungu.
Ifom yesisu se-salmonellosis ayiqhelekanga kunezo zangaphambili. Xa inkqubo yokuvuvukala kwenzeka, ixhoba lihlala liziva ligula, lihlanza, kunye neentlungu zesisu ziqala. Kule meko, i-intestinal motility ayiphazamiseki. Ngexesha elibukhali lesi sifo, ukubandayo, ukulahlekelwa ngumdla, ukukhathala, ukukhathala, intloko (kwiitempile, emva kwentloko) kunokwenzeka. Ubushushu bomzimba abunyuki ngaphezu kwe-37,5°C. Le meko inzima ngenxa yokuncipha komthamo womchamo ngosuku kunye nokuqina kwayo. Kule meko, ukutyhelwa kwegazi kunokwenzeka.
Ifomu efana netyphoid. Iimpawu zayo zifana ne-gastroenteritis enzima (ukubonakala kwe-foci yosulelo kwi-mucosa yesisu phantsi kwefuthe le-microbes). Kukho ezi mpawu zilandelayo: umkhuhlane, ukugabha, ilindle elinogwebu, iintlungu zesisu, isiyezi, ukozela, ukozela. Ubushushu bomzimba bunokunyuka bufike kuma-40°C, ukunyuka ukubila nokugodola kwenzeka. Ngenxa yokugula, iingxaki zokulala kunye nokucaphuka kubonakala. I-Rashes inokwenzeka kwisifuba kunye nesisu, ulusu lwexhoba lomile, lubala, i-nasolabial fold is blue blue. Emva kweentsuku ezimbalwa, isibindi kunye ne-spleen kwandisa ubukhulu, kwaye intlungu ivela kwicala lasekunene phantsi kwembambo. Kukho ukuhla okubukhali kwi-renal kunye noxinzelelo lwegazi, ukusebenza kwemithambo yegazi kunye nentliziyo iphazamisekile. Kwiimeko ezinzima, ukungcangcazela kwamalungu kunye nokuncipha kwe-tactile kunye ne-tendon reflexes kubonwa.
Ifomu ye-septic ye-salmonellosis ibonakaliswe ngokunyuka kweqondo lokushisa lomzimba ngaphakathi kwe-37-38 ° C, umkhuhlane, ukunyuka ukujuluka, intlungu ye-muscle, i-tachycardia, i-chills, i-mucous membranes eyomileyo. Ukusebenza kweeseli zesibindi kuncipha ngenxa yokuphazamiseka kwemetabolism. Umntu ubandezeleka ngenxa yeentlungu zamalungu kunye neentlungu.
Kwifom ye-septic, i-purulent foci ibonakala kwisibindi, izintso, kunye nemiphunga. Umguli uba nenyumoniya, ukudumba kwezihlunu zentliziyo. Olu hlobo lwe-salmonellosis lubonakaliswa ngokuncipha kokuchama okanye ukungabikho ngokupheleleyo. Xa ukhupha i-bladder, ixhoba lifumana ukutshisa, ukukrazula, kunye neentlungu ezibuhlungu kwingingqi ye-lumbar kunye nesisu esisezantsi.
I-salmonellosis engapheliyo (i-bacterium carriage) ayinayo impawu kwaye ingenayo imiphumo. Iibhaktheriya azikho yingozi kubathuthi beebhaktheriya nokuba kuncitshisiwe ukuzikhusela. Ekubeni ii-microorganisms zikhutshwa kwindle kwiinyanga ezininzi, ukusuleleka kwabantu abazungezile kunokwenzeka.
Ukuxilongwa kwentsholongwane yamathumbu
Ukuchonga isifo se-salmonellosis, kuyimfuneko ukuphumeza ukuxilongwa ngokuhlukileyo. Iimpawu zokusuleleka emathunjini zingabangelwa usulelo kunye nezinye iibhaktheriya (umzekelo, i-shigella, i-staphylococcus, i-protozoa).
Ukuqinisekisa isifo, kuyimfuneko ukuhlalutya isitulo, umchamo, igazi kunye nokuhlanza. Kwakhona kuyimfuneko ukumisela umthombo wesi sifo. Uthintelo losulelo phakathi kwabantu abajikeleze ixhoba luyenziwa.
Uphawu oluphawulekayo lwe-salmonellosis yintlungu ejikeleze inkaba, kwisisu, nakwindawo ye-ileocecal (umda phakathi kwamathumbu amancinci namakhulu).
Ukuxilongwa ngokuchanekileyo kwenziwa emva kokumisela uhlobo lwe-arhente esosulelayo.
Unyango lwe-salmonellosis
I-Salmonellosis sisifo sebhaktheriya. Amachiza okulwa neentsholongwane asetyenziselwa unyango. Emva kokufumana iziphumo zovavanyo lwesigulane, ugqirha uchaza irejimeni yonyango. Kwiintlobo ezincinci zesifo, unyango lunokwenziwa ekhaya. Kwezinye iimeko, esibhedlele phantsi kweliso labasebenzi bezonyango.
Ngexesha lokunyangwa kwesi sifo, oku kulandelayo kumiselwe:
- ii-enterosorbents, ii-adsorbents;
- izisombululo ze-saline;
- kuthetha ukunciphisa intlungu, ukukhulula i-spasms;
- amalungiselelo enzymatic;
- ii-antacids;
- amayeza okuphelisa ubutyhefu;
- iifluoroquinolones.
Ukwandisa ukuchasana komzimba womntu kwizifo zamathumbu, ikhosi ye-immunostimulants, i-immunomodulators, iivithamini kunye ne-microelements iyanconywa. Kwimeko yeengxaki, izitho ezichaphazelekayo ziphathwa.
Ukuba kukho ukuhlanza okanye umkhuhlane, kufuneka kunikezelwe ngoncedo lokuqala. Kucetyiswa ukuba uhlambe isisu ngesisombululo esibuthathaka se-potassium permanganate kwaye ubize i-ambulensi, kuba akunakwenzeka ukuxilonga i-salmonellosis ekhaya; usulelo lwamathumbu luyabulala abantu.
Iingcali ezinamava kuphela zinokwenza ukuxilongwa ngokuchanekileyo kunye nokumisela unyango oluyimfuneko kwisifo. Ukuba iimpawu ezincinci ze-overdose zenzeka, kufuneka ufune uncedo lwezonyango.
Shiya iMpendulo