Izimpawu uvendle ezinganeni nakubantu abadala

Uvendle - ngegciwane acute viral ukuthi kwenzeka ikakhulukazi ezithinta empunga ndaba zobuchopho, elibangela ukuthuthukiswa paresis kanye nokukhubazeka. Izimpawu uvendle kungatholakala nezingane ezineminyaka engaphansi kweminyaka eyi-7, kodwa esengozini yokungenwa yigciwane le kubo, ngaphansi kwezimo ezithile, inakekelwa kanye nabantu abadala.

Umlando omncane

Uvendle libhekene isifo ngokujulile umgogodla nentambo ubuchopho stem okuholela ukuthuthukiswa paresis kanye nokukhubazeka, bulbar iziyaluyalu. Izifo uvendle, izimpawu zazo bebelokhu baziwa isikhathi eside, ziyasatshalalaiswa kule XIX, ekuqaleni XX leminyaka. Phakathi nale nkathi, ke waloba ubhubhane omkhulu we ukutheleleka Melika naseYurophu. Uvendle wavulwa e Vienna ngo-1908, E. futhi K. Popper Landštejn, futhi wadala A. noJ Seybinom bukhoma. Salk yokugoma inactivated evunyelwe neminyaka engu-50 leminyaka elidlule, ukuze kakhulu ukunciphisa inani amacala lapho izimpawu zitholiwe uvendle ezinganeni.

Dynamics Positive ekulweni le ukutheleleka uyaqhubeka ngokusebenzisa yokugoma asebenzayo, izimpawu kaningi uvendle zigcinwa kuphela emazweni nekotoroyh - Pakistan, Afghanistan, Nigeria, eNdiya, eSiriya - ngesikhathi 1988 Inombolo yabo safinyelela 125 Inani lamacala ngalesi kwehle kusuka amacala 350 000 (zazo ayizinkulungwane 17.5 nokufa) ukuze amacala 406 zikhonjwe 2013. ENtshonalanga Yurophu, elaseRussia nelase-Nyakatfo Melika Nobe namuhla endaweni khulula lesi sifo kanye nezimpawu uvendle abonakala lapha kuphela njengoba amacala oqabukelayo.

exciter

Uvendle - isifo ezibangelwa amagciwane. Isizathu kuba poliovirus, okuhlobene enteroviruses. Chaza igciwane izinhlobo ezintathu (I, II, III). Ukuze izinhlobo womuntu kanye inkawu pathogenic mina III. II kungathinta ezinye namagundane. RNA igciwane liqukethe, usayizi salo 12 NM. • Inhlalo engenayo inxushunxushu imvelo - emanzini, kungashiwo abekelwe izinsuku 100 ubisi - izinyanga 3, izinyanga 6 - uketshezi nesineke. des Ezivamile. kusho ingaphumeleli, kodwa igciwane ngokushesha neutralized ngu autoclaving, abilayo, ukuchayeka ekukhanyeni ultraviolet. Lapho sishisiswe 50 ° C igciwane emizuzwini engemingaki 30. Lapho itheleleke ngesikhathi bayashintshana ekufukameleni kungatholakala egazini, ezinsukwini zokuqala 10 isifo - a swabs pharyngeal futhi kakhulu kuyaqabukela - e i-cerebrospinal fluid.

I ukuhamba indlela

Umthombo ukutheleleka e poliomyelitis kungaba njengoba umuntu ogulayo, futhi asymptomatic igciwane yenethiwekhi (kwezinye izimo, esiphathiswa ingagcinwa emithathu - emva kwezinyanga eziyisihlanu yokutakula). Igciwane adedelwa imvelo ne indle isiguli kanye isikhwehlela nasopharyngeal. Uvendle efanele elandelayo indlela:

• pin;

• sisemoyeni;

• fecal-ngomlomo.

Izindlela ezivame kakhulu yokudlulisela iyona fecal-temlomo - igciwane lingena emzimbeni ingcoliswe izandla, izitsha, ukudla, amanzi. Futhi esiyingozi iyona isikhwehlela ukhululeka iziguli nasopharynx nge 2 izinsuku lesi sifo phakathi nezinsuku zokuqala 2 amaviki.

I ezifweni we virus 0.2-1%, iningi amacala abantwana abangaphansi kweminyaka 7. Kuvamisile isiqongo kwenzeka ehlobo nokuwa.

engcupheni

Sezici ezaba nomthelela ukusabalala ukutheleleka kungabandakanya:

• yokuntuleka imikhuba yokuhlanzeka wengane;

• ukwanda kwabantu;

• nezimo ezimbi enelanga, kuhlanganise ukwephulwa kombuso sanitary izikhungo;

• isifo njalo (angaphezu kuka-4 izikhathi ngonyaka) wengane;

• immunodeficiency;

• Izinga eliphansi ngokugoma.

ngezigaba

Uvendle libhekwa ngokuvumelana nohlobo isimiso sezinzwa:

• ifomu nonparalytic - ezenzeka ngaphandle izilonda abalulekile isimiso sezinzwa - meningeal, ayahluleka (visceral) inapparatnaya (asymptomatic futhi virus, okungase kuphela kunqunywa laboratory) ukuma;

• ifomu kofé uhlangothi.

Ngakwelinye ihlangothi, ifomu kofé uhlangothi libhekwa by indawo lesion. avelele:

• umumo umgogodla - libhekene ukukhubazeka flaccid kwamalungu omzimba, isiqu, diaphragm, intamo;

• Pontina ukuma - ukuqhutshwa yl ephelele ukulahlekelwa esinqunyiwe sobuso, nokuwohloka ekhoneni emlonyeni ohlangothini ebusweni, lagophthalmos;

• bulbar - libhekene inkulumo kahle, ukugwinya, iziyaluyalu ukuphefumula nomsebenzi inhliziyo;

• Encephalitis - futhi izimpawu ebalulekile cerebral;

• ifomu okuxubile - pontospinalnaya, myasthenia, bulbopontospinalnaya.

Olwandle ukuhlukanisa phakathi izinhlobo imnene, ngokulinganisela, ezinzima futhi subclinical.

bayashintshana ekufukameleni inkathi

Bayashintshana ekufukameleni inkathi, lapho izimpawu zokuqala azikakabi wabonakaliswa uvendle, Uthatha kwezinsuku 2 kuya 35. Ngokuvamile, isikhathi salo izinsuku 10-12, kuye ngokuthi izici wengane ngabanye umzimba. Ngalesi sikhathi, ngamasango emnyango (zingabantu pharynx kanye ipheshana wokugaya ukudla) igciwane singena emathunjini lymph node, lapho kukhona ukukhiqizwa kabusha yayo. Ngemva kwalokho, lingena egazini futhi iqala esiteji viremia lapho ukutheleleka okudlulela wonke umzimba futhi sithinta izingxenye ezingavikelekile kakhulu zalo ke. Endabeni uvendle kuyinto phambi uphondo emgogodleni amaseli esivimba amanzi.

Izimpawu ifomu meningeal

amafomu Meningeal futhi ayahluleka kukhona izinhlobo uvendle non-kofé uhlangothi. Izimpawu zokuqala uvendle e izingane ifomu meningeal avele abukhali njalo. Izinga lokushisa amahora ambalwa antante 38-39 °. Thuthukisa izimpawu nobuntu umkhuhlane - ukukhwehlela, lwamafinyila noma serous acinene khulula. Uma kubhekwa emphinjeni ephawulwe hyperemia, amalaka futhi palatal izibambo kungenzeka uqweqwe. Ngesikhathi ukuphakama lokushisa kungaba ukucanuzela kwenhliziyo, ukuhlanza. Ngemva kwalokho, amathonsi lokushisa, futhi izinsuku ezimbili noma ezintathu, isimo somntwana uhlaliseke.

Kulandele imfiva okuphindaphindiwe, kanye nezimpawu uvendle zihlukile ngaphezulu - kukhona ukozela, ukudideka, ukucobeka, ikhanda, ukuhlanza. Kukhona izimpawu meningeal: uphawu omuhle ukuhlelwa (elele ngemuva isiguli umlenze izimisele ngesikhathi nedolo hip ngokuhlanganyela i-engela 90 °, nokuthi ngenxa imisipha ukungezwani kuba akukwazeki qondanisa kwedolo), imisipha Intamo yayo iqina (ukungabi nakwenzeka kwento elele emhlane wakhe ukufinyelela kwesilevu esifubeni ).

ifomu ayahluleka

Izimpawu uvendle e izingane ifomu ayahluleka futhi ziqala ukuvela sina. Against lokushisa eliphezulu (37,5-38 °) waphawula ukucobeka ukucobeka, owenqenayo ikhanda. Kukhona encane catarrhal imihlola - ukukhwehlela, amakhala yisisu, ububomvu womphimbo kungenzeka ubuhlungu besisu, nokuhlanza. Ngemva kwalokho-ke angagcina catarrhal angina, enterocolitis noma Gastroenteritis. Lokho kubonakaliswa emathunjini ukuhlukanisa poliomyelitis zikhipha isisu. Izimpawu zalesi sifo izingane, kuleli cala avame basesimweni wawubona toxemia emathunjini ngokuvumelana uhlobo uhudo noma ikholera. ukubonakaliswa Neurologic yaleli fomu uvendle.

uvendle kofé uhlangothi

Leli fomu uvendle kwenzeka amafomu ngoyisiwula kusinda kakhulu yokuphathwa ngenhla futhi zimbi kakhulu. Izimpawu zokuqala zezinzwa uvendle ziqala ukuvela izinsuku 4-10 ngemva kokungenwa igciwane, kwezinye izimo, le nkathi singase siwathole amasonto 5.

In the isinyathelo intuthuko elandelayo lesi sifo isehlane.

• Preparaliticheskaya. Libhekene ngokuvusa lokushisa kuze kufinyelele 38,5-39,5 °, ikhanda elibuhlungu, ukukhwehlela, amakhala yisisu nohudo, ukucanuzela kwenhliziyo, ukuhlanza. izinsuku ezingu-2-3 esimeni esejwayelekile, kodwa ke ukunyuka entsha e lokushisa iqala ukuba 39 - 40 °. Ngenxa yalokhu kukhona onamandla ikhanda kanye muscle ubuhlungu, jerking imisipha ukuthi kuyabonakala noma zibukeke, ukwazi kahle. Le nkathi luthatha izinsuku 4-5.

• Ukuze isigaba kofé uhlangothi libhekene ukuthuthukiswa ukukhubazeka. Batfutfukisa ngokuzumayo futhi eshiwo ku engekho ukunyakaza asebenzayo. Kuye ukuma ekuthuthukiseni esitho ukukhubazeka (ngokuvamile imilenze), isiqu, entanyeni, kodwa ukuzwela ngokuvamile ayiphazamiseki. Isikhathi esiteji kofé uhlangothi kuhluka 1 2 amaviki.

• Isinyathelo ukunciphisa ngesikhathi yokwelapha ngempumelelo libhekene wokwehla okhubazekile imisipha umsebenzi. Okokuqala, le nqubo kwenzeka ngokushesha kakhulu, kodwa ke Tempo is ehlile. Le nkathi ingahlala kusuka unyaka kuya kwemithathu.

• Ngo isinyathelo asalile imihlola abathintekayo imisipha yoma, contractures akhiwa futhi athuthukiswe deformations ezihlukahlukene esiqwini futhi emikhawulweni, kanjalo eyaziwa kanye nezimpawu uvendle ezinganeni. Izithombe okwethulwa kulesi Ukubuyekeza sifanekise lesi sinyathelo Kucacile.

ifomu umgogodla

It libhekene ukuqala acute (izinga lokushisa likhuphuka 40 ° futhi, ngokungafani nezinye izinhlobo kungokwaphakade). Ingane ucobekile, adynamic, bayozela, kodwa kungenzeka futhi hyperexcitability (njengoba umthetho, izimpawu evelele ezinganeni ezincane kakhulu), Ukudlikizela. Kukhona ubuhlungu sebengavela wemikhawulo aphansi, kubi uma ushintsha isikhundla komzimba, ubuhlungu emuva nentamo imisipha. On luhlolo, kwembule izimpawu Ukucinana kwemigudu yomoya emaphashini, pharyngitis, rhinitis. Kukhona izimpawu palsy, hypersensitivity (kwenyuke yokusabela kuya ezihlukahlukene Amagciwane). Ngokuchofoza nomgogodla, esikhundleni projection kwenzeka nerve iziqu ubuhlungu obuhlabayo.

Ngezinye izinsuku 2-4 kusukela ekuqaleni kwalesi sifo zenzeke ukukhubazeka. Lapho uvendle, banayo izici ezilandelayo:

• asymmetry - ukunqotshwa maqembu ngohlobo isandla sobunxele - unyawo lwesokudla;

• KaMose - alithintwa imisipha esitho;

• ukusebenza kungancipha noma ngingekho ikhaliphe umsipha;

• wehlise ezicutshini ithoni kuze kube atony, kodwa ukuzwela is hhayi kahle.

Esitho ethintekile ukuphaphatheka, cyanotic, abandayo uma uyithinta. Ubuhlungu syndrome kuholela yokuthi ingane kuthatha isimo bephoqeleka, okuyinto yena, iba imbangela contractures ekuseni.

Yokutakula motor imisebenzi uqale nge 2 amaviki lesi sifo, kodwa le nqubo iyaqhubeka eside futhi engalingani. izilonda Sikuveze izicubu trophism, ubambezela esitho, deformity ngokuhlanganyela, yoma ijwabu ithambo. Izifo ihlala iminyaka 2-3.

ifomu bulbar

ifomu Bulbar libhekene i ukuqala acute kakhulu. Preparaliticheskaya esiteji yena iyivelakancane. Against isizinda umphimbo obuhlungu, ngokungazelelwe wasukuma ukuze izinombolo okusezingeni eliphezulu (39-49 °) zikhona izimpawu zokungasebenzi kahle kwemizwa:

• ukukhubazeka laryngeal - ukuhlukumeza ukugwinya kanye phonation;

• iziyaluyalu zokuphefumula;

• ukunyakaza iziyaluyalu we zamehlo - futhi ovundlile nystagmus rotarny.

Lesi sifo kungaba nzima-pneumonia, atelectasis, myocarditis. Kungenzeka futhi ukuthuthukiswa ukopha emathunjini, isimiso emathunjini.

ifomu Pontin

ifomu Pontina kwenzeka ngenxa uvendle igciwane ebusweni lesion, khulula, futhi ngezinye izikhathi imizwa ka trigeminal (V, VI, VII, namabhuzu izinzwa cranial). Lokhu kuholela ukukhubazeka kwemisipha obhekene nesimo sobuso, futhi kwezinye izimo, futhi imisipha masticatory. Emtholampilo ke sivezwe kula asymmetry we imisipha yobuso, ahlelembe emphethweni Nasolabial, ukungabi imibimbi ovundlile emabunzini, ptosis (sawo) ye-engeli emlonyeni noma ibe ikhulu Ukuvalwa yayo ayiphelele. Izimpawu lacaca kakhudlwana uma uzama smile, vala amehlo akho noma kufuthwe izihlathi.

ukwelashwa

umuthi othile wokwelapha uvendle ukhona. Uma kusethwa sitholakele isiguli ungeniswe ukutheleleka esibhedlela, lapho ihlinzeka ukuphumula ngokomzimba nangokwengqondo. Ezinkathini preparalitichesky futhi kofé uhlangothi esetshenziswa analgesic futhi isisu, ngokuvumelana izinkomba unikezwa imithi ethile eqeda ukuvuvukala, noma corticosteroids. Lapho singagwinyi umsebenzi disorder - tube yokudla, ayephuli ukuphefumula - le mpilo. Isikhathi yokutakula kuboniswe umsebenzi yokwelapha, massage, Physiotherapy, amavithamini kanye nootropics, ukwelashwa kulesi sibhedlela.

zokuvimbela

Uvendle ungomunye walabo izifo ukuthi kukhona kulula ukuvimbela kunokuba ikhambi. Lokhu kungenziwa ngezindlela yokugoma. ERussia, zonke izinsana eniyenzayo umjovo. Ukugonywa Kwenziwa ngezigaba eziningana - 3 4.5 izinyanga umntwana zigonywe nge umjovo inactivated. Ngezinye 6, 18, 20 izinyanga, inqubo iyaphindwa usebenzisa wokugoma bukhoma. lokugoma Kugcine wenziwa eminyakeni engu-14. Futhi ungaphuthelwa ke, ngoba, naphezu kweqiniso lokuthi kunenkolelo uvendle kuyingozi ngoba izingane kuphela, lokhu akunjalo, njengoba kwaba njalo endabeni ka-polio izimpawu sifo abadala evelele kakhulu futhi iyingozi.

Ekukhombeni ekuvimbeleni izifo iyincenye lebalulekile okufika ngesikhathi nesineke ngabodwa, ukwahlukaniswa ngenxa yesifo kanye nokuqondisa amasonto 3 iqembu contact, ukuhambisana inhlanzeko yomuntu siqu.

Ngakho, esixoxe imininingwane eyanele yini izimpawu uvendle lapho, futhi yini okufanele uyenze ukuze ugweme lesi sifo.