Hnoos qeev: hom phiaj thiab txoj kev

Hnoos qeev daim card yog tso tawm thaum lub sij hawm o ntawm lub raj cua, bronchi thiab lub ntsws. Nws tsos cim tsis tau tsuas yog nrog lub yeej ntawm lub pa system, tab sis kuj rau lub plawv thiab leeg tshav ntshawv siab. Txoj kev hnoos qeev koom nrog macroscopic, me me thiab tshuaj txhais ntawm nws tus yam ntxwv.

Analysis qhia hais tias

Hnoos qeev ua rau nws tau mus ntes kab mob ua rau tus kab mob tus txheej txheem, xaiv lub xub ntiag ntawm Mycobacterium tuberculosis, qhia hais tias yuav mob hlwb, ntshav thiab purulent impurities, thiab kuj los mus txiav txim cov kab mob kuj yuav tshuaj tua kab mob.

Nyob rau hauv dab tsi tej yam kev mob yog muaj tsom xam

Hnoos qeev nyob rau hauv lub zuag qhia tag nrho kev soj ntsuam ua raws li nram qab no:

• hnoos;
• o ntawm lub ntsws;
• o ntawm lub bronchi;
• mob ntsws rwj;
• tuberculosis;
• bronchiectasis;
• pulmonary gangrene;
• mob ntsws mob;
• ntsws nyob rau hauv ib tug mob daim ntawv;
• mob ntsws;
• nyob rau hauv mob tonsillitis;
• tuberculosis;
• hnoos;
• silicosis;
• mob hauv daim ntawv ntawm obstructive ntsws;
• o ntawm lub ntsws;
• anthrax.

Daim ntawv ntsuam xyuas Kev npaj

Slime yuav zoo dua faib, yog tias nyob rau hauv lub tswv yim ua ntej lub swb coj tus tsom xam lub cuab tam rau expectoration, los yog haus loj nyiaj ntawm sov dej qab zib. Ua ntej muab khaws tseg pom zoo kom ntxuav cov hniav thiab lub qhov ncauj kab noj hniav, muab yaug nws nrog dej sov hau.

Basic kev cai rau sau

Sau hnoos qeev rau bacteriological xeem yog qhov kev kawm los tsim nyob rau hauv thaum sawv ntxov (nws sau rau hmo ua ntej noj mov) nyob rau hauv ib tug menyuam tsis taus thawv, uas yog muab los ntawm cov kev kuaj. Rau lub tsom xam ntawm txaus tus nqi ntawm 5 ml. Analysis ntawm secretion yog ua tsis pub tshaj li 2 teev tom qab lawv sau. Kom txog rau thaum lub sij hawm ntawm xa mus kawm tus txheem ntawm lub thawv yuav tsum tau khaws cia kaw nyob rau hauv lub tub yees.

Tus nqi ntawm cov hnoos qeev nyob rau hauv ntau yam kab mob

Number faib secretion txawv nyob ntawm seb qhov xwm ntawm tus pathological txheej txheem. Feem ntau, nws mas nws txawv los ntawm ib tug ob peb nto qaub ncaug rau mus rau 1 liter ib hnub twg. Ib tug me me npaum li cas yog tso tawm thaum lub sij hawm lub o ntawm lub bronchi, txhaws dab pib nrog lub ntsws thiab bronchial hawb pob nce siab. Thaum lub kawg ntawm tus nres volume qab. Nws yuav ua tau mus 0.5 liv, thiab sawv ntsug nyob rau hauv loj tus xov tooj, yog hais tias muaj yog pulmonary edema.

Ntau hnoos qeev yog tso tawm ntawm ib tug purulent txheej txheem nyob rau hauv lub ntsws thaum kev sib txuas lus nrog rau cov bronchi, nrog festering, bronchiectasis thiab gangrene.

TB hnoos qeev ntsws cov ntaub so ntswg qhia tau hais tias lwj. Nyob rau hauv kev, xws li ib tug txheej txheem provokes ib tug kab noj hniav uas communicates nrog lub bronchi.

Los ntawm tej yam tau tshwm sim los ib tug txo los yog nce nyob rau hauv secretion rho tawm

Nce feem secretion tej zaum yuav txuam nrog ib tug deterioration mob ntawm tus neeg mob thiab saib xyuas thaum lub sij hawm exacerbation. Qhov nce tej zaum kuj xa mus rau qhov zoo muaj zog ntawm txoj kev loj hlob ntawm tus kab mob.

Txo tus nqi ntawm cov secreted hnoos qeev yuav qhia regression mob los yog ua txhaum nyob rau hauv kua kab noj hniav uas muaj cov kua paug. Nyob rau hauv cov ntaub ntawv no, lub deterioration ntawm tus neeg mob noj qab haus huv.

xwm ntawm lub paug

Txheej secretion stands rau ntsws nyob rau hauv mob los yog mob hauv daim ntawv ntawm bronchial hawb pob, mob ntsws, mob cancer, hlav ntawm lub ntsws, bronchiectasis, pulmonary hydatid cyst, nrog suppuration, actinomycosis.

Hnoos qeev nrog ib tug admixture ntawm kua paug yog cai nyob rau hauv lub ntsws rwj, bronchiectasis thiab echinococcosis.

Hnoos qeev tov nrog cov ntshav los yog muaj nkaus ntawm cov ntshav cov yam ntxwv ntawm tus kab mob ntsws. Cov tsos ntawm cov ntshav muaj peev xwm qhia cov muaj mob cancer, bronchiectasis, mob ntsws festering. Tsis tas li ntawd, xws li ib tug tshwm sim yog pom nyob rau hauv nruab nrab lobe syndrome, heart attack myocardial infarction nyob rau hauv lub ntsws, kev poob plig, actinomycosis thiab syphilitic txhab. Ntshav tej zaum yuav raug rho tawm thiab lobar thiab focal mob ntsws, txhaws dab, mob hawb pob thiab pulmonary edema.

Serous hnoos qeev yog cai nyob rau hauv pulmonary edema.

hnoos qeev xim

Hnoos qeev xeem qhia nws txawv xim. Txheej thiab serous paug tsis muaj ib yam xim los yog muaj ib tug whitish Hawj txawm.

Pub ntxiv tshaj kua paug muab cog qoob loo greenish Hawj txawm hais tias characterizes lub pathological dab xws li mob ntsws rwj, gangrene, bronchiectasis, mob ntsws actinomycosis.

Xaiv nrog ib tug kov ntawm xeb los yog xim av xim qhia tau hais tias lawv muaj tsis muaj tshiab cov ntshav, thiab nws cov hniav lwj khoom - hematin. Qhov no tsis pub leejtwg paub yuav muab tso tawm nrog lobar mob ntsws, kab mob anthrax, pulmonary infarction.

Greenish xim nrog ib tug kov ntawm daj av los yog zais cia pov thawj ntawm ua pa kab mob nyob rau hauv ua ke nrog nrog daj ntseg.

Lub kaj daj xim ntawm hnoos qeev yog tsuas nrog eosinophilic mob ntsws dej.

Hnoos qeev ochre tshwm sim nyob rau hauv siderosis yooj yim.

Blackish los yog grayish daim card sau tseg hauv lub xub ntiag ntawm thee hmoov av impurities. Thaum koj muaj teebmeem kev edema serous hnoos qeev cai nyob rau hauv loj naj npawb. Raws li ib tug txoj cai, nws yog pleev xim rau uniformly liab xim vim muaj cov ntshav liab. Tej kua sib cais zoo li cranberry kua txiv.

Pleev xim rau daim card tau thiab ib co tshuaj. Piv txwv li, tshuaj tua kab mob "Rifampicin" yuav muab nws ib tug liab xim.

tsw

Qhov xwm ntawm tus pathological kev nyob rau hauv lub ua pa ib ntsuj av tau tej zaum yuav qhia secretion thiab tsis hnov tsw. Hnoos qeev muab tsis hnov tsw ntawm rot nrog gangrene ntawm lub ntsws los yog bronchus putrid txhab, mob cancer, hlav, necrosis complicating bronchiectasis.

Lub xub ntiag ntawm khaubncaws sab nraud povtseg

Feem ntau txoj kev tshawb no qhia lub xub ntiag ntawm kua khaubncaws sab nraud povtseg. Thaum teev phlegm nrog ib tug admixture ntawm kua paug yog cai nrog festering mob ntsws thiab bronchiectasis.

Cov pub leejtwg mus rau rot admixture muaj peb khaubncaws sab nraud povtseg. Lub sab saum toj txheej yog zoo li foam serous nruab nrab, thiab cov sab doped nrog kua paug. Xws li ib tug muaj pes tsawg leeg yog yus muaj los ntawm gangrene ntsws.

impurities

Admixture ntawm khoom noj khoom haus yuav tsum muaj cai nyob rau hauv lub xub ntiag ntawm ib tug kab mob qog hlav ntawm cov hlab pas rau nws sib txuas lus nrog cov bronchi thiab lub raj cua. Tom qab kev sib cuag nrog tapeworm nyob rau hauv lub bronchi nyob rau hauv qhov hnoos qeev yuav yuav ntes tau los yog scolex hooks tus kab mob. Heev tsis tshua pom cov laus ntawm Ascaris uas txeem tau cov pa system nyob rau hauv immunocompromised neeg.

mob ntsws fluke qe hlwv tshwm nyob rau ntawm so uas yog tsim nyob rau hauv lub ntsws nyob rau hauv lub xub ntiag ntawm cab.

Gangrene thiab mob ntsws rwj ua cov tsos ntawm daim ntsws necrosis. Thaum hlav yuav tsum tam sim no nyob rau hauv tsis muaj kua tawg tsam ntawd.

Convolution muaj fibrin yog pom nyob rau hauv cov neeg mob uas fibrinous bronchitis, mob ntsws thiab mob ntsws muaj dej.

Rice plab hlaub lens los yog Koch xam qhovkev tuberculosis.

Stoppers Dietrich, xws li decomposition khoom ntawm cov kab mob thiab mob ntsws cov ntaub so ntswg hlwb fatty acids, tshwm sim nyob rau hauv putrid ntsws los yog gangrene ntsws.

Mob tonsillitis daim ntawv yuav sib cais los ntawm tonsils qub zoo xws li cov stoppers Dietrich.

Cov tshuaj txoj kev

Hnoos qeev tshuaj txoj kev yuav txiav txim:

• protein index, uas yuav pab tau nyob rau hauv lub differential mob ntawm tus mob hauv daim ntawv ntawm ntsws thiab tuberculosis. Mob ntsws mob daim ntawv cim daim card ib co kua nplaum uas muaj protein ntau, thiab yuav tsum tau ntau dua nyob rau hauv tubercular txhab ntawm tus nqi ntawm cov protein nyob rau hauv cov hnoos, thiab nws tej zaum yuav qhia los ntawm tus xov tooj (mus txog 100-120 g / l).
• Kua tsib pigments. Lawv muaj nyob rau hauv qhov hnoos qeev nyob rau hauv lub yeej ntawm lub pa system nyob rau hauv ua ke nrog nrog tus kab mob siab. Nyob rau hauv rooj plaub no tus siab communicates nrog lub ntsws. Kua tsib pigments yog xam qhovkev mob ntsws uas yog tshwm sim los ntawm lub cev qhuav dej ntawm lub ntsws hauv lub erythrocytes thiab lub tom ntej hloov nyob rau hauv hemoglobin.

Cytological daim card kev tshawb fawb txoj kev

Rau cov differential mob ntawm tuberculosis thiab ntau lwm yam mob ntsws txhab nws yog siv lug Pap txoj kev, uas muaj ob theem: kev soj ntsuam thiab tsom ntawm hnoos qeev.

Soj ntsuam kev tshawb fawb yuav pab txiav txim seb txoj kev yuav tsum tau sau cov ntaub ntawv uas kom tau qhov tseeb tshwm sim ntawm tus tsom xam.

Muaj ob lub ntsiab hom ntawm cov khoom, uas yuav tsum tau cov me me kev soj ntsuam ntawm cov hnoos: txawj thiab txo. Qhov thib ob hom secretion yog tau tus ntawm ntau yam stimuli (rau expectoration agents, inhalations thiab cov zoo li. D.).

Material tau los ntawm ib rab koob me

Cytological kev soj ntsuam ntawm hnoos qeev yuav kawm txog cov macroscopic thiab tsom ntawm nws hlwb.

Feem ntau ntawm cov ntaub ntawv rau cytological tsom xam ntawm hnoos qeev tau noj nyob rau hauv thaum sawv ntxov nyob rau ib npliag plab. Ua ntej rau txoj kev tshawb nws yuav tsum tau muab cia rau tsis muaj ntau tshaj li 4 teev.

• Nyob rau hauv cov hnoos tshwm sim squamous epithelial hlwb, uas yog kawm microscopically. Tab sis rau cov mob, lawv tsis muaj lub ntsiab lus. columnar epithelial hlwb - niam hluas thiab nyob rau hauv cov pab pawg neeg - yuav tsum tau cai nyob rau hauv cov kab mob xws li bronchial hawb pob, ntsws thiab mob ntsws cancer. Nco ntsoov tias lub columnar epithelium zaum yuav tshwm sim vim cov allergic ntawm lub qhov ntswg hnoos qeev.
• Alveolar macrophages yog reticuloendothelial hlwb. Macrophages yog pom nyob rau hauv lub cytoplasm (plua tshauv hais los yog phagocytic hlwb) yuav muaj nyob rau hauv cov neeg mob uas muaj ntev-lub sij hawm hmoov av nqus tau pa.
• Macrophages protoplasm (tsim los ntawm lub neej puas hemoglobin) lub plawv kho raws hu ua hlwb. Lawv muaj peev xwm tshwm sim thaum lub sij hawm teev dab nyob rau hauv lub ntsws, mitral valve stenosis, pulmonary infarction.

• Ib tug me me muaj pes tsawg tus ntawm leukocytes muaj nyob rau hauv tej hnoos qeev. Lawv siab cov ntsiab lus ntawm sau tseg nyob rau hauv admixture nrog kua paug pa.
• Eosinophils. Tej hlwb nplua nuj hnoos qeev nyob rau hauv asthmatics. Hlwb yuav tsum khij nrog rau hauv daim ntawv ntawm eosinophilic mob ntsws txhab helminths kab mob, tus kab mob ntsws thiab pulmonary infarction.
• Erythrocytes. Cov ntshav liab tsis tso saib hauv daim duab ntawm tus kab mob. Lub rov tshwm sim ntawm ib tug muaj zog npaum li cas ntawm cov pov thawj ntawm lub xub ntiag ntawm los ntshav nyob rau hauv lub ntsws. Cov tshiab cov ntshav erythrocytes txiav txim qhov. Yog hais tias muaj yog ib tug admixture ntawm cov ntshav, uas stagnated nyob rau hauv lub ntsws rau ib ntev lub sij hawm, pom leached erythrocytes.
• Cancer hlwb. Lawv muaj peev xwm yuav nrhiav tau nyob rau hauv pub leejtwg pab pawg. Lawv qhia tias cov muaj ib tug mob. Thaum twg koj muaj ib cell yog feem ntau qhov teeb meem nyob rau hauv mob. Nyob rau hauv xws li mob, ib tug re-tsom xam ntawm hnoos qeev.
• Elastic fibers, uas nws tsos yog tshwm sim los ntawm lub cev qhuav dej ntawm lub ntsws ntaub so ntswg, tuberculosis provoked, rwj, gangrene, qog. Gangrene xws hlwb yeej tsis yus li vim qhov kev txiav txim ntawm enzymes, uas yog pub leej twg paub, lawv yuav tsum tau yaj.
• Kurshmana kauv. Qhov no tshwj xeeb lub cev, zoo ib yam li lub raj. Lawv muaj nyob rau hauv txoj kev tshawb no nyob rau hauv lub tshuab kuaj kab mob. Tej zaum hnov thiab qhov muag. Feem ntau Helix xam qhovkev kab mob xws li bronchial hawb pob, pulmonary tuberculosis thiab mob ntsws muaj dej.
• Charcot-Leyden muaju yog pom nyob rau hauv qhov hnoos qeev nrog ib tug high school cov ntsiab lus ntawm eosinophils nyob rau hauv cov qhov txhab, raws li bronchial hawb pob, eosinophilic mob ntsws dej. Kuaj lub cev uas tau tuag tuberculosis mas nyob rau hauv lub lumen ntawm lub bronchi tej zaum yuav tsiag ntawv los ntawm muaj nyob rau hauv lub tso pa tawm ntawm elastic fibers cholesterol muaju, thiab amorphous txiv qaub MBT (lub thiaj-hu ua tetrad Ehrlich) - 100%.

Kev siv cov microscopy

Sau los ntawm hnoos qeev smear microscopy rau txoj kev tshawb no ntawm txoj kev yuav tus tsom xam ntawm kua rau kom paub tias ntawm ib tug Mycobacterium hais rau tuberculosis. Lawv yog cov uas zoo sib xws rau cov nyias nyias, tuab rau lub sab los yog rau hauv nruab nrab curves nrog sib txawv ntawm cov lengths, uas yog pov tseg ob leeg singly thiab nyob rau hauv pab pawg.

Nov ntawm Mycobacterium tuberculosis yog tsis yog ib tug tseem ceeb feature rau cov mob thiab yuav tsum tau paub los ntawm bacteriological txoj kev. Mycobacterium tuberculosis ntawm tus nqi ntawm ib tug pub leejtwg tsis tau kuaj.

Lub hauv paus rau lub tsom xam yog purulent hais yog npaum li cas tawm ntawm plaub caug rau cheeb tsam sib txawv thiab triturated kom txog thaum tus ob panes. Tom ntej no, lawv yog qhuav nyob rau hauv huab cua thiab tsau los ntawm cov burner nplaim taws.

Bacteriological kev soj ntsuam ntawm cov hnoos Ziehl-Nielsen uas tseg tau qhia nws nyob rau hauv liab. Nyob rau hauv cov ntaub ntawv no, tag nrho cov secrets ntawm lub particle, nrog rau cov kev zam ntawm mycobacteria, yuav tinged nrog xiav, thiab mycobacteria ua liab.

Thaum tuberculosis kab mob xav tias lesion tom qab peb cov kev tshawb fawb rau lub xub ntiag ntawm mycobacteria nrog ib tug tsis zoo teb muaj resorted mus rau qhov kev siv ntawm cov flotation qauv (tsom xam Pottenger).

Cov niaj zaus txoj kev kawm tsuas smear MTB muab ib tug zoo tshwm sim tsuas yog thaum lub xov tooj ntawm MTB kawg 50 000 units ib 1 ml ntawm cov hnoos. Raws li cov xov tooj ntawm Mycobacterium tuberculosis los txiav txim muaj tsis yooj yim sua.

Bacterioscopy cov neeg mob uas nonspecific ntsws kab mob

Kuaj cov kev tshawb fawb ntawm cov hnoos nyob rau hauv lub xub ntiag ntawm uas tsis yog-kev mob ntsws kab mob los ntawm microscopy yuav qhia cov nram qab no cov kab mob:

• Thaum o ntawm lub ntsws - pneumococci, diplococci Frenkel, Friedlander cov kab mob, streptococci, staphylococci (100%).
• Thaum gangrene teeb yuav yuav ntes tau ntxaiv pas nrig nyob rau hauv ua ke nrog nrog spirochaete Vincent (80%).
• Poov xab fungi (70%), los mus txiav txim lub hom uas yuav tsum tau ib daim card noob.
• Drusen actinomycete (100%) nyob rau hauv actinomycosis.

Lub volume ntawm secretion nyob rau hauv cov neeg noj qab

Xaav ntawm hnoos qeev secreted lub raj cua thiab bronchi nyob rau hauv tib neeg tsis raug kev txom nyem ib yam pathologies, xws li los ntawm 10 mus rau 100 ml / hnub.

Feem ntau tsawg ntawm leucocytes, ib txoj kev kawm rau tsuas smear mycobacteria muab ib tug tsis zoo tshwm sim.