Isifo sikashukela i-mellitus senzeka ngemuva kokungasebenzi kahle kwezinqubo ze-metabolic, lapho isiguli sinoshukela wegazi ophakeme. Kunezinhlobo ezimbili ezihola phambili zalesi sifo. Esimweni sokuqala, i-pancreas ayakhiqizi i-insulin, okwesibili - kukhiqizwa i-hormone, kepha ayibonwa ngamangqamuzana omzimba.
Isimanga sesifo sikashukela ukuthi abantu abafi kulesi sifo uqobo, kodwa ngenxa yezinkinga ezibangelwa yi-hyperglycemia engapheli. Ukuthuthukiswa kwemiphumela kuxhumene nenqubo ye-microangiopathic kanye ne-glycosation yamaprotheni e-tishu. Ngenxa yokwephulwa okunjalo, amasosha omzimba awenzi imisebenzi yakhe yokuvikela.
Esikhathini sikashukela, izinguquko zenzeka futhi kuma-capillaries, amangqamuzana abomvu egazi, kanye ne-oxygen metabolism. Lokhu kwenza ukuthi umzimba uthambekele ezifweni. Kulokhu, noma yisiphi isitho noma uhlelo, kubandakanya namaphaphu, lungathinteka.
I-pneumonia kusifo sikashukela kwenzeka lapho uhlelo lokuphefumula lungenwa yileli gciwane. Imvamisa ukudluliselwa kwe-pathogen kwenziwa ngamaconsi omoya.
Izimbangela Nezingozi Zengozi
Imvamisa, inyumoniya ivela ngemuva kwesimo sokubanda noma umkhuhlane wesikhathi esithile. Kepha kunezinye izimbangela zenyumoniya kubashukela:
- i-hyperglycemia engapheli;
- ukungasebenzi komzimba okungenamandla;
- i-pulmonary microangiopathy, lapho kwenzeka khona ushintsho lwe-pathological emithanjeni yezitho zokuphefumula;
- zonke izinhlobo zezifo ezihlangene.
Njengoba ushukela ophakeme udala indawo enhle emzimbeni wesiguli ukungena kokutheleleka, abanesifo sikashukela kudingeka bazi ukuthi yimaphi ama-pathogen angadala ukuvuvukala kwamaphaphu.
Umenzeli ovame kakhulu we-pneumonia wesimo se-nosocomial kanye nomphakathi osuselwa emphakathini yiStaphylococcus aureus. Futhi i-bacterial pneumonia ku-diabetesics ibangelwa hhayi ukutheleleka nge-staphylococcal kuphela, kodwa futhi neKlebsiella pneumoniae.
Imvamisa nge-hyperglycemia engalapheki, i-pypumumonia yasesikhathini ebangelwa amagciwane kuqala ukukhula. Ngemuva kokutheleleka ngegciwane.
Ubuchopho benkambo yenqubo yokuvuvukala emaphashini onesifo sikashukela yi-hypotension kanye noshintsho esimweni sengqondo, ngenkathi ezigulini ezijwayelekile izimpawu zesifo zifana nezimpawu zokutheleleka kalula kokuphefumula. Ngaphezu kwalokho, kwabanesifo sikashukela, isithombe somtholampilo siyaphawuleka.
Futhi, ngokugula, njenge-hyperglycemia ku-mellitus yesifo sikashukela, i-pulmonary edema ivela kaningi. Lokhu kungenxa yokuthi ama-capillaries angena kakhulu, ukusebenza kwama-macrophages nama-neutrophils kuhlanekezelwa, futhi amasosha omzimba nawo abuthaka.
Kuyaphawuleka ukuthi i-pneumonia ebangelwa isikhunta (Coccidioides, Cryptococcus), staphylococcus neKlebsiella kubantu abakhiqizeka i-insulin engasebenzi kahle kunzima kakhulu kuneziguli ezingenazo izinkinga ze-metabolic. Amathuba wesifo sofuba nawo anda kakhulu.
Ngisho ukwehluleka kwe-metabolic kunomthelela omubi emasosheni omzimba. Ngenxa yalokhu, amathuba okukhula kwe-abscess yamaphaphu, i-asymptomatic bacteremia, nokufa imbala kuyanda.
ISymbomatology
Isimo somtholampilo sokuqubuka kwezinduna kushukela sikashukela sifana nezimpawu zesifo ezigulini ezijwayelekile. Kepha iziguli esezikhulile zivame ukuba namazinga okushisa, njengoba imizimba yazo ibuthakathaka kakhulu.
Izimpawu ezihamba phambili zesifo:
- amakhaza;
- ukukhwehlela okwomile, ngokuhamba kwesikhathi kuphenduka kube manzi;
- umkhuhlane, onamazinga okushisa afinyelela kuma-38 degrees;
- ukukhathala;
- ikhanda
- ukuntuleka kokudla;
- ukuphefumula
- ukungaphatheki kahle kwemisipha;
- Isiyezi
- hyperhidrosis.
Futhi, izinhlungu zingavela emaphashini athintekile, zanda ngesikhathi sokukhwehlela. Futhi kwezinye iziguli, ukuphawulwa kwamafu kanye ne-cyanosis konxantathu we-nasolabial kuyaphawulwa.
Kuyaphawuleka ukuthi ukukhwehlela kwesifo sikashukela okunezifo ezithathelanayo zephepha lokuphefumula kungenzeka kungahambi izinyanga ezingaphezu kwezimbili. Futhi izinkinga zokuphefumula zenzeka lapho i-fibrous exudate inqwabelana ku-alveoli, igcwalisa ukukhanya kwesitho futhi iphazamise ukusebenza kwayo okujwayelekile. I-Fluid emaphashini iyanqwabelana ngenxa yokuthi amaseli omzimba athunyelwa kugxile kokuvuvukala ukuvikela ukutheleleka okujwayelekile kanye nokuqeda amagciwane namagciwane.
Ku-diabetes, izingxenye zangemuva noma eziphansi zamaphaphu zithinteka kakhulu. Ngaphezu kwalokho, ezimweni eziningi, ukuvuvukala kwenzeka esithweni esifanele, esichazwa yizici zomzimba, ngoba i-pathogen kulula ukungena ngaphakathi kwe-bronchus ebanzi nefish.
I-edema ye-Pulmonary edema ihambisana ne-cyanosis, ukuphefumula kanye nomuzwa wokubumbana esifubeni. Futhi, ukugcwala koketshezi emaphashini kuyisikhathi sokuthuthuka kokuhluleka kwenhliziyo nokuvuvukala kwesikhwama senhliziyo.
Endabeni yokuqhubeka kwe-edema, izimpawu ezifana:
- i-tachycardia;
- ubunzima bokuphefumula
- hypotension;
- ukukhwehlela okunzima nobuhlungu besifuba;
- ukukhipha okukhulu kwe-mucus ne-sputum;
- ukujaha.
Ukwelashwa nokuvimbela
Isisekelo sokwelapha i-pneumonia yinkambo yokwelashwa kwe-antibacterial. Ngaphezu kwalokho, kubaluleke kakhulu ukuthi kuqediwe kuze kube sekupheleni, uma kungenjalo kungahle kwenzeke kabusha.
Uhlobo oluncane lwesifo luvame ukuphathwa ngemithi eyamukelwa kahle ngabanesifo sikashukela (Amoxicillin, Azithromycin). Kodwa-ke, ngesikhathi sokuthatha imali enjalo, kubalulekile ukubhekisisa izinkomba ze-glucose, ezizogwema ukuthuthukiswa kwezinkinga.
Izinhlobo ezinobunzima zalesi sifo ziphathwa ngama-antigciwane, kepha kufanele kukhunjulwe ukuthi inhlanganisela - isifo sikashukela ne-antibiotic, ichazwa kuphela odokotela abakhona.
Futhi, nge-pneumonia, izidakamizwa ezilandelayo zingabekwa:
- antitussive;
- ama-painkiller;
- antipyretic.
Uma kunesidingo, kudalwa imishanguzo ye-antiviral - i-Acyclovir, iGanciclovir, iRibavirin. Kubalulekile ukugcina ukuphumula kombhede, okuzovimbela ukuthuthukiswa kwezinkinga.
Uma inani elikhulu loketshezi libuthana emaphashini, kungadinga ukuthi kukhishwe. Kusetshenziselwa isixhobo sokuphefumula kanye nemaski komoya ophefumulayo ukwenza lula ukuphefumula. Ukwenza lula ukudlula kwesisu kusuka emaphashini, isiguli sidinga ukuphuza amanzi amaningi (aze afinyelela kumalitha ama-2), kepha kuphela uma kungekho hlungu lwezinso noma inhliziyo. Ividiyo ekulesi sihloko ikhuluma ngesifo sikashukela esibangelwa isifo sikashukela.
