Menene opisthorchiasis?
Opisthorchiasis yana haifar da helminths (hepatic trematodes) wanda ke shafar hanta da pancreas. Bisa kididdigar da aka yi, adadin wadanda suka kamu da cutar a duniya ya kai kusan mutane miliyan 21, tare da kashi biyu bisa uku na masu fama da cutar opisthorchiasis da ke zaune a Rasha. Matsala mafi gaggawa na karusar helminth yana cikin yankin Dnieper da kuma yankin Siberiya (a Yammacin Siberiya da Gabas).
Abubuwan da ke haifar da opisthorchiasis
Dalilin bayyanar opisthorchiasis a cikin mutane shine cat, ko Siberian, fluke (Opisthorchis felineus). A causative wakili na cutar parasitizes a cikin hanta, gallbladder da ducts, da kuma pancreas na mutane, kuliyoyi da karnuka. Tushen kamuwa da cuta shine mara lafiya ko dabba. Kwai masu yatsa, tare da najasar mai dauke da cutar, suna shiga cikin ruwa, inda katantanwa suka hadiye su. A cikin jikin katantanwa, larvae suna fitowa daga ƙwai kuma suna haifuwa. Sa'an nan tsutsa a cikin nau'i na cercariae sun shiga cikin ruwa, tare da kwararar ruwa suna shiga cikin jikin cyprinids. Kamuwa da cuta na mutane da dabbobi tare da opisthorchiasis yana faruwa ne lokacin cin kifi, naman da ba a yi masa isasshen maganin zafi ba, ana ɗanɗa shi gishiri ko kuma ba a bushe ba. Irin wannan kifin na iya ƙunsar tsutsa masu zazzaɓi waɗanda ke haifar da haɗari ga lafiyar ɗan adam da wasu dabbobi masu shayarwa. A cikin abin da ya fi mayar da hankali, kamuwa da cuta yana faruwa sau da yawa lokacin amfani da kayan yankan da ba a wanke ba masu ɗauke da barbashi na kifi, lokacin dafa abinci ko yankan samfuran waɗanda ba a ba da ƙarin maganin zafi ba (gurasa, 'ya'yan itace, da sauransu).
A cikin mutum ko dabba, an lalata capsule na metacercariae, tsutsa ta karya membrane na hyaline na bakin ciki da kanta, riga a cikin duodenum, bayan haka tsutsa ta shiga cikin gallbladder da ducts da pancreas. Lokacin aiwatar da hanyoyin bincike, ana samun opisthorchia a cikin ducts a cikin hanta da kuma a cikin bile ducts a cikin 100% na marasa lafiya, ana gano ƙwayoyin cuta a cikin gallbladder a cikin 60% na mamayewa, a cikin pancreas - a cikin 36% na marasa lafiya. Metacercariae wanda ya shiga cikin tsarin hanta da pancreas ya zama jima'i bayan makonni 3-4 kuma ya fara yin ƙwai. Saboda haka, cikakken sake zagayowar ci gaban parasites yana daga hudu zuwa hudu da rabi kuma ya hada da duk matakai na ci gaban pathogen - daga kwai zuwa balagagge mutum, bayan da balagagge helminths fara sa qwai. A cikin jikin mutane da dabbobi, waɗanda ake la'akari da rundunonin ƙarshe na parasites, haɓakar mamayewa na iya faruwa ne kawai bayan sake kamuwa da cuta. Tsawon rayuwa na pathogens shine shekaru 20-25.
Alamun opisthorchiasis
Alamun opisthorchiasis sun dogara ne akan halayen mutum na kwayoyin halitta, girman kamuwa da cuta da kuma lokacin da ya wuce tun lokacin da mai haƙuri ya kamu da cutar. Cutar na da tsanani ko na kullum. A cikin m mataki, cutar yana 4-8 makonni, a wasu lokuta da Pathology ci gaba na dogon lokaci. Opisthorchiasis na yau da kullun yana ɗaukar shekaru: 15-25 shekaru ko fiye.
A cikin m mataki, marasa lafiya lura da wadannan bayyanar cututtuka: zazzabi, fata rashes kamar urticaria, zafi tsokoki da gidajen abinci. Bayan wani lokaci, marasa lafiya sun fara damuwa game da ciwo a cikin hypochondrium daidai, binciken ya nuna karuwa a cikin hanta da gallbladder. Sa'an nan kuma zafi a cikin yankin epigastric, tashin zuciya, amai, ƙwannafi shiga cikin bayyanar cututtuka na Pathology, stool na marasa lafiya zama m da ruwa, flatulence ya bayyana, da ci rage cin abinci. Lokacin da fibrogastroscopic jarrabawa gano erosive gastroduodenitis, alama ulceration na ciki mucosa da duodenum. A wasu lokuta, opisthorchiasis yana faruwa tare da alamun bayyanar cututtuka na huhu na nama na rashin lafiyan asali, wato, mashako mai asthmatic.
A cikin na kullum hanya na cutar, da bayyanar cututtuka na opisthorchiasis suna da yawa a kowa tare da bayyanar cututtuka na kullum cholecystitis, gastroduodenitis, pancreatitis, hepatitis: mai haƙuri koka da m zafi a cikin dama hypochondrium, wanda su ne paroxysmal a cikin yanayi da kuma kama biliary colic. tsananin su, yayin da zafi zai iya motsawa zuwa kirjin gefen dama. Har ila yau, cutar tana da alamun: ciwo na dyspeptic, jin zafi a lokacin palpation a cikin gallbladder, dyskinesia na gallbladder. A tsawon lokaci, ciki da hanji sun shiga cikin tsarin pathological, wanda ke tare da alamun bayyanar cututtuka na gastroduodenitis, pancreatitis da rushewa na al'ada na hanji.
Har ila yau, mamayewa yana haifar da rikice-rikice na tsarin juyayi na tsakiya, wanda aka bayyana a cikin gunaguni akai-akai na marasa lafiya game da rage yawan aiki, rashin jin daɗi, damuwa barci, ciwon kai da dizziness. Har ila yau, akwai rawar jiki na fatar ido, harshe, yatsu a hannu. Yanayin asthenic yawanci yana tare da raunin gaba ɗaya, saurin gajiyar jiki da ta hankali. A wasu lokuta, rashin lafiya na tsarin juyayi na iya zuwa gaba, irin waɗannan marasa lafiya sau da yawa ana gano su da neurocirculatory dystonia ko autonomic neurosis.
Opisthorchiasis na yau da kullum, tare da rashin lafiyar jiki, yana nunawa ta hanyar itching na fata, urticaria, Quincke's edema, arthralgia, allergies abinci. Ƙayyadaddun ƙwayar opisthorchiasis na yau da kullum ya ta'allaka ne a cikin gaskiyar cewa bayan an kawar da ƙwayoyin cuta, mai haƙuri yana da canje-canjen da ba za a iya canzawa ba a cikin gabobin ciki. Marasa lafiya suna da na kullum hepatitis, cholangitis, cholecystitis, gastritis, cuta na rigakafi da tsarin. Ga irin waɗannan marasa lafiya, hanyoyin lafiya suna da matukar mahimmanci bayan kammala cikakken aikin jiyya, da nufin inganta aikin gallbladder, inganta hanta, da daidaita tsarin narkewa.
A sakamakon lalacewa na pathogens, da saki na su na rayuwa kayayyakin, da kuma a sakamakon necrosis na jiki kyallen takarda, bugu yana faruwa, wanda tare da wani rashin lafiyan dauki. Bugu da ƙari, helminths (ƙananan zuwa ƙananan ƙananan, mutane masu girma zuwa mafi girma) suna cutar da epithelium na bile da pancreatic ducts, yayin da suke haifar da tsarin farfadowa na hyperplastic nama. Daga cikin sakamakon cutar, akwai kuma sau da yawa a inji take hakkin fitar da bile da pancreatic ruwan 'ya'yan itace saboda tara parasites, qwai pathogens, gamsai, da epithelial Kwayoyin a cikin ducts.
Mafi tsanani rikitarwa na opisthorchiasis ne biliary peritonitis, ƙurji, cirrhosis ko na farko hanta ciwon daji, wasu pathological yanayi na pancreas, kamar m destructive pancreatitis, pancreatic ciwon daji, wanda faruwa a sosai rare lokuta.
Jiyya
A mataki na farko (shirdi) na jiyya na opisthorchiasis, ana daukar matakan dakatar da halayen rashin lafiyan, sauƙaƙe kumburi na biliary tract da gastrointestinal tract, tabbatar da fitowar al'ada na bile da ruwan 'ya'yan itace pancreatic, inganta aikin hepatocytes, kawar da maye, tsaftacewa. hanjin.
Amfanin mataki na biyu na maganin cutar ya dogara da yadda aka gudanar da matakin shiri sosai. A lokacin jiyya, marasa lafiya suna buƙatar bin abinci na musamman: abinci mai ƙarancin kitse kawai ya kamata a haɗa su cikin abincin su. Daga cikin kwayoyi wajabta antihistamines, sorbents. A wasu lokuta, marasa lafiya suna buƙatar ɗaukar prokinetics, antispasmodics, probiotics da enzymes.
A cikin mataki na remission a cikin na kullum hanya na cutar, hanya na shirye-shirye far ne game da makonni biyu, idan mai haƙuri yana da alamun cholangitis, pancreatitis ko hepatitis, hanya na far yana 2-3 makonni.
A mataki na biyu na jiyya an gudanar da wani m-bakan anthelmintic far, wanda taimaka wajen kawar da mafi yawan trematodes da cystodes. Saboda mummunan sakamako masu illa, ana ba da shawarar yin amfani da magani tare da wannan magani a asibiti, a ƙarƙashin kulawar likita.
A mataki na uku (gyare-gyare), aikin motsa jiki da ayyukan sirri na gabobin ciki da suka shafi mamayewar helminthic sun dawo. Ana aiwatar da Tubage tare da xylitol, sorbitol, magnesium sulfate, ruwan ma'adinai, laxatives za a iya ba da izini don ƙarin tsaftace hanji. Hadadden magani yana haɓaka ta hanyar hepatoprotectors, magungunan choleretic na ganye.
An rage matakan rigakafi zuwa cin kifi wanda yake a zafin jiki a kasa -40 ° C na tsawon sa'o'i 7 ko kuma a zafin jiki da ke ƙasa -28 ° C na sa'o'i 32, an sanya shi a cikin brine tare da yawa na 1,2 g / l a 2 °. C na kwanaki 10-40 (lokacin bayyanarwa ya dogara da yawan kifin), an tafasa shi don akalla minti 20 daga lokacin da broth ya tafasa ko soyayyen na akalla minti 20 a cikin akwati da aka rufe.