Pneumocystis pneumonia yog ib yam kab mob inflammatory nyob rau hauv cov ntsws uas yog tshwm sim los ntawm cov kabmob xws li cov kabmob Pneumocystis jirovecii (pneumocysts). Kev kis mob tuaj yeem tshwm sim los ntawm cov kab mob plav. Cov cab no muaj nyob rau hauv lub ntsws ntawm ntau tus neeg noj qab haus huv, tab sis ua rau pathology nkaus xwb nyob rau hauv cov neeg tsis muaj mob.
Cov qaug zog ntawm kev tiv thaiv tej zaum yuav yog vim muaj li nram no:
- txom nyem noj haus;
- tshuaj tua kab mob;
- cov kws kho mob chem;
- cov kab mob ntshav;
- cev xeeb tub;
- kev txais tos ntawm kev siv tshuaj tua kabmob (piv txwv, nrog rau kev hloov ntshav), thiab lwm yam.
Txawm li cas los xij, feem ntau tus kab mob no muaj nyob hauv cov neeg uas tsis muaj zog tiv thaiv kab mob, los ntawm kev mob HIV (AIDS). Pneumocystis pneumonia muaj npe hauv 70% ntawm cov neeg muaj kab mob HIV.
Pneumocystis ntsws li cas?
Cov kab mob kis nkag mus rau hauv tib neeg lub cev los ntawm txoj hlab ntsws. Ncav lub lumen ntawm me me bronchi thiab alveoli, lawv pib multiply nquag. Thaum lub sijhawm no, cov hnoos qeev tau pib nyob rau hauv txoj hlab pas, uas hinders cov kev kawm ntawm huab cua.
Cov metabolites tsim thaum lub sij hawm tsim cov pneumocysts nkag rau hauv cov hlab ntsha thiab ua kom muaj cov tshuaj tua kab mob. Qhov no ua rau mob ntawm cov phab ntsa ntawm lub alveoli ntawm lub ntsws, uas kuj ua rau tsis ua pa. Kev vam meej ntawm qhov txheej txheem ua rau cov ntsig txog qog nqaij hlav ntsig, mob ntsws ntsws hauv lub ntsws , kaw pneumothorax tuaj yeem tsim tau. Feem ntau, pneumocysts txeeb lwm yam kabmob (nplooj siab, mob raum, paj).
Cov tsos mob ntawm Pneumocystis mob ntsws
Qhov pib ntawm tus kab mob no feem ntau yog mob, thiab yog tshwm sim los ntawm cov nram qab no tshwm sim:
- ntsis nce hauv lub cev kub;
- mob taub hau;
- mob dyspnoea nrog kev siv lub cev;
- kev tsis muaj zog;
- nce tawm hws;
- mob hauv siab;
- hnoos (ntau zaus qhuav, qhov ntswg, feem ntau tsawg dua - nrog rau kev tso cov kua qaub nplaum foamy).
Tom qab ib lossis ob lub lim piam, cov tsos mob nram qab no yuav tshwm sim:
- kub cev;
- dyspnea ntawm so;
- nce hnoos;
- cyanosis ntawm daim duab peb sab (nasolabial triangle);
- acrocyanosis;
- retraction ntawm intercostal chaw.
Hauv cov neeg muaj mob HIV, tus kab mob no qeeb qeeb, qhia cov tsos mob ntawm tus kab mob no tsuas yog tshwm sim tom qab 4-12 lub asthiv. Cov neeg mob siab li no, pneumocystic pneumonia yog feem ntau ua ke nrog lwm cov kev kis mob, yog li kev qaug zog zoo nkaus li nyob rau hauv qhov kev ploj tuag hauv daim duab mob.
Kev kuaj ntawm PCP
Tus kab mob yog raws li cov duab hluav taws xob lossis cov tom tsev kawm ntawv. Txheeb xyuas tus neeg raug mob ntawm tus kab mob no yog tau los ntawm qhov kev ntsuam xyuas keeb kwm ntawm cov hlab ntsws bronchoalveolar lavage thiab transbronchial biopsies, uas yog siv los ntawm txoj kev kuaj fibrobronchoscopy.
Kev kho ntawm PCP
Cov neeg mob nrog ib daim duab raug mob ntawm tus kab mob yog pw hauv tsev kho mob, kev kho mob ntawm PCP nrog HIV kuj muaj nyob rau hauv qhov chaw kho mob. Kev kho tshuaj kho mob,
- anti-inflammatory tshuaj;
- expectorant , mucolytics;
- immunomodulators, thiab lwm yam.
Cov tshuaj loj uas cuam tshuam rau pneumocyst yog trimethoprim-sulfamethoxazole thiab pentamidine isothionate. Cov neeg mob AIDS feem ntau tau kho alpha-difluoromethylornithine. Oxygen deficiency yog pom zoo rau cov pa oxygen.