I-pneumonia ichaphazela izigidi zabantu ngonyaka. Ngokutsho kwamaZiko okuLawulwa kweNtsholongwane kunye nokuVikela (CDC), abantu abangaphezu kwama-400,000 bafuna ukuvavanywa kunye nonyango kwisebe elingxamisekileyo kwaye abantu abangaphezu kwama-50,000 bafa ngesifo. Kodwa iingxaki zinokuthintelwa! Ukufumanisa ukuba une-pneumonia yinyathelo lokuqala, ngoko ufunda uhlobo luni lwe-pneumonia onayo- ibhakteria , i- viral , okanye i- fungal -yimfuneko yokonyango olufanelekileyo.
Uvavanyo lweMvelo
Umkhuhlane, ukukhwehlela kunye nokuphefumula ukuphefumula kungabonakalisa ukuba une-pneumonia. Ugqirha wakho uqale uvavanyo ngokujonga iimpawu zakho ezibalulekileyo.
Uya kukulinganisa izinga lokushisa, uxinzelelo lwegazi, izinga lentliziyo, kunye neqondo lokuphefumula, kwaye uya kuhlola izinga lakho le-oxygen usebenzisa i- pulse oximetry . Oku kwenziwa ngokubeka ifowuni encinci ngomnwe ukuba uqikelele ipesenteji ye-oksijini egazini lakho. Amanqanaba aphantsi e-oksijini ayenxulumene kwaye ithetha ukuba kufuneka ubeke oksijini.
Ukusebenzisa i-stethoscope, ugqirha uya kuphulaphula imiphunga yakho. Bakhangele ukuva izandi okanye ukuvutha . Izandi eziphantsi kwelinye indawo zingathetha ukuba i-pneumonia yenzeke khona. Ukubamba emva kwakho kwinqanaba kunokuncedisa ukuba ngaba kukho ukuqokelela kwamanzi okanye ukuhlanganiswa. Ungamangaliswa ukuba ucelwa ukuba uthethe ileta "E" ngokuvakalayo. Ukuba unomphunga emiphakeni yakho, kuya kuzwakala ngathi "A" xa uphulaphule nge stethoscope.
IiLabs kunye novavanyo
Nangona uvavanyo lomzimba lungakhulisa ukusola nge-pneumonia, ukuxilongwa kunokuxinwa ngokusebenzisa iimvavanyo ezahlukeneyo. Ugqirha wakho unako okanye angasebenzisi le mivavanyo elandelayo. Yazi ukuba ezininzi zilula kwaye zichanekile kwicala lakho-i-drawn draw yegazi okanye isampuli yokuqokelela, ngokukhawuleza nangentlungu.
Gcwalisa Igalelo leGazi
Inani elipheleleyo legazi luvavanyo olulula nolusabizi. Inani legazi elimhlophe lenye yexabiso legazi elilinganiselwayo. Ukuba ithe yaphakanyiswa, ukusuleleka okanye ukuvuvukala kukho. Akukuvumeli ngokukodwa ukuba une-pneumonia.
Procalcitonin
I-Procalcitonin yi-precursor ye-calcitonin, iprotheni ekhishwa ngamaseli ekuphenduleni i-toxins. Ilinganiswa ngokuhlolwa kwegazi. Okuthakazelisayo, amanqanaba akhula ekuphenduleni kwiintsholongwane zebhaktheriya kodwa kuncipha kwiintsholongwane. Iziphumo zivame ukungena kwisithuba seeyure ezingama-4 zokusuleleka kwintsholongwane kunye nokuphakama kweeyure ezili-12 ukuya kuma-48. Nangona akukuvumeli ukuba uluphi uhlobo lwebhaktheriya olukhoyo, lubonisa ukuba unyango lwe-antibiotics lunokuba luyimfuneko.
I-Sputum Culture kunye ne-Gram Stain
Umgangatho wegolide wokufumanisa ukusuleleka kwebhaktheriya yinkcubeko. Ngelishwa, ukuqokelela isampuli se-sputum enobungakanani kunzima, ngakumbi ukuba umntu unomkhuhlane omile. Ngokuqhelekileyo ihlambuluke neebhaktheriya eziqhelekileyo ezihlala kwiphepha lokuphefumula.
Isampuli kufuneka iqokelelwe ngaphambi kokuba uphathwe ngamayeza. Uyakucelwa ukuba uhlambele i-sputum, kunye ne-saliva encinane ngangokunokwenzeka. Ukuba unenkathazo yokwenza njalo, ugqirha unokusebenzisa ifowuni ngekhamera encinane kunye encinane ibekwe phantsi komqala wakho.
Uya kukunceda ukhulule ngemithi ngexesha le nkqubo, kwaye kukho imiphumo embalwa engaphandle kwimeko embi yengqondo.
Xa sele iqokelelwe, i- Gram stain isetyenziswe kwinxalenye yesikimu kwaye ihlolwe phantsi kwe-microscope. Isampuli ye-sputum ephezulu iya kubonisa iiseli zamhlophe zegazi ezimhlophe kodwa zimbalwa zeeseli ze-epithelial. Ibhaktheriya iya kubonakala ibomvu okanye i-violet kwaye, ngokusekelwe kwindlela yokubonakala kwayo, ingafakwa ngokwezigaba ezimbini zeebhaktheriya. Ukunciphisa i-diagnostic yenza kube lula ukukhetha i-antibiotic efanelekileyo.
Ukuze ufumane ukuba yiyiphi ibhaktheriya ethile ebangela ukugula kwakho, isampuli yakho iya kuhlonyelwa kwiitya zePetri.
Xa ibhaktheriya okanye isikhunta zikhula, ziyavavanywa kumayeza ahlukeneyo ukuze zibone ukuba zeziphi unyango oluza kusebenza kakhulu.
Ingxaki kukuba kuthatha iintsuku ukufumana isiphumo senkcubeko ecacileyo. Kwakhona, ezinye iintsholongwane ezifana ne- S. pneumoniae zinzima ukukhula kwaye inkcubeko inokunika iziphumo ezingamanga. Ngenxa yemingeni ekufumaneni isampuli enemgangathweni, olu vavanyo luyasetyenziswa ngokuqhelekileyo kubantu esibhedlele kunokuba bahlala kuluntu.
Uvavanyo lwe-Urine Antigen
I-bacterium pneumonia ebangelwa yiS S. pneumoniae kunye neentlobo zeLegionella zineziganeko eziphezulu zeengxaki. Ama-antigens avela kula ma-bhaktiriya aphethwe emcini. Uvavanyo olulula lomchamo lufumaneka ukujonga ezi antigen.
Iziphumo zifumaneka ngokukhawuleza kwaye izifundo zibonise ukuba zichanekile ngakumbi kuneCraam okanye inkcubeko. Enye inzuzo yolu vavanyo kukuba unyango ngamayeza anokuthi aluyi kuguqula iziphumo.
Ingxaki kukuba iimvavanyo ze-antigen ezingamanzi zichanekile kangangoko kwiimeko ezinzima zesifo se-pneumonia. Kwakhona kuphela iimvavanyo kwi-serotype enye yeLegionella nangona kukho iintlobo ezininzi. Kananjalo, ngokungafani nenkcubeko, ayikho indlela yokusebenzisa iziphumo ukufumanisa ukuba zeziphi i antibiotics eza kusebenza kakhulu kunyango.
Serology
Ezinye iibhaktheriya kunzima ukukhula kwenkcubeko kwaye awunalo umchamo we-antigen okhoyo uvavanyo lokuhlola. I-Chlamydia , i- Mycoplasma , kunye neentlobo ezithile zeLegionella ziyi-bacteria ye-atypical ewela kulolu hlobo.
Kukhona iimvavanyo zegazi ze-serologic ezinokukwazi ukugqiba nini na ukuba unesifo. I-Serology yenza amanyathelo okulwa neengqungquthela ezenziwe malunga ne-pathogen ethile. Ama-antibodies ase-IgM abonisa intsholongwane entsha kodwa i-IgG antibodies ibonisa ukuba sele unesifo kwixesha elidlulileyo. Ngamanye amaxesha kunzima ukukwazi ukuba i-anti-gig antibodies i-IgM ishintshelwe kwi-anti-gig.
I-PCR ne-Enzyme Immunoassays
Kunokuba nzima ukwenza inkcubeko intsholongwane. Kunoko, izifo zentsholongwane zivame ukuxilongwa ngokusebenzisa i-polymerase chain reaction (PCR) kunye ne-enzyme immunoassays.
I-PCR ngumvavanyo okhangela ukubonakala kwe-DNA okanye i-DNA yebhaktheriya kwisampuli. Enye indlela yokusebenzisa i-serology ukukhangela ibhaktheriya ye-atypical. Nangona iziphumo zihlala zifumaneka kwiiyure eziyi-1 ukuya kwezi-6, i-PCR ayikwazi ukuyenza kwisayithi. Kufuneka iqhutywe yibhubhoratri.
Nangona kunjalo, i-enzyme immunoassays, ingaba yenziwa yinjongo yokunyamekela ngeziphumo ezifumaneka kwimizuzu eyi-15 ukuya kwiyure. Ezi zi-immunoassay zisebenzisa i-antibodies ukuze zibone ubukho be-antigen antigens kwaye zingakwazi ukukhenkcelela iintsholongwane ezininzi ngexesha elinye.
Ukucinga
Izifundo zokucinga zenziwa rhoqo phambi kweemvavanyo zebhubhoratri. Ukuba unonophelo, ugqirha unokukuphatha ngempumoniya ngokusekelwe ekuhloleni ngokomzimba kunye nezifundo zokucinga.
X-Ray
Ukuba i-pneumonia ikhunjulwa ngokusekelwe kwimpawu kunye nokuhlolwa komzimba, umgangatho wokunyamekela ukufumana i- x-ray esifubeni . I-x-ray yesifuba ingabonisa ukungena ngaphakathi, okuyiqoqo le-pus, igazi, okanye iprotheni kwimisipha yomphunga. Ingabonakalisa nezinye iimpawu zesifo semiphunga njengemigxobhozo kunye neengqungquthela ze-pulmonary .
Ugqirha wakho akakwazi ukuhlula phakathi kweentsholongwane ze-bacterial and viral based based on imaging alone. Nangona kunjalo, ukungena ngaphakathi okuzalisa konke okanye ubuninzi bodwa okanye ngaphezulu kwe-lobes yemiphunga kungenzeka ukuba yi-bacterium pneumonia ebangelwa yi- S . pneumoniae .
CT Scan
Kungenzeka ukuba i-x-ray yesifuba ingaphuthelwa ukuxilongwa. Ukuba ugqirha wakho usenokusola okukhulu ngenxa yempumoniya emva kwesiphumo esibi, unokukhetha ukuqinisekisa ukuba uhlalutyo lwe-CT . Ngokuqhelekileyo, i-CT scan ichanekile ngakumbi kune-x-ray yesifuba nangona ixabisa ngakumbi kwaye ikubonisa ukuba iqondo eliphezulu leemitha.
Uvavanyo luqhutyelwa ngokubeka iplani kumatshini owenziwe ngombono othabatha imifanekiso. Isifundo asibuhlungu yaye sigqityiwe ngemizuzu, kodwa kubalulekile ukulala kwakhona ngexesha lokuvavanya ukufumana imifanekiso emihle.
Bronchoscopy
Kwiimeko ezinzima ezingaphenduliyo unyango, ugqirha wakho unokuphinda acinge ngokucinga ngezinye izizathu. Olu vavanyo lunokubandakanya i- bronchoscopy , apho ikhamera elincinci likhokelwa ngempumlo yakho okanye emlonyeni emiphakeni yakho.
Ngaloo ndlela, ugqirha wakho uyakwazi ukubona ngokucacileyo ngaphakathi ngaphakathi kwemiphunga. Iintlobo kunye ne-biopsies zingathathwa njengoko zifunekayo. Ungaxhalabi. Uya kudityaniswa kwenkqubo.
Ukuxilongwa ngokungafani
Kukho ezinye iimeko ezinokuba neempawu ezifana ne-pneumonia, njenge- bronchitis okanye ukuhluleka kwentliziyo . Ukuba umntu unesifo se- asthma , i- bronchiectasis , okanye isifo se-pulmary disease (COPD) esingapheliyo, sinokuba sisifo se-lung disease. Kwiimeko ezinzima kakhulu, kunokuba ngumqondiso wesilumkiso somhlaza wamaphaphu .
Nangona kunjalo, ungakhathazeki ngala manqaku. Into engcono kakhulu ukuba uyenze, utyelele ugqirha wakho ukuze ufumane ukuxilonga. Kwiimeko ezininzi, xa sele kufunyanwe ukuba, i-pneumonia inokunyamekelwa.
> Imithombo:
> Bartlett JG. Indlela yokuxilongwa kwi-Pneumonia esebenzayo yoluntu kubantu abadala. Ku: Bond S. (ed), UpToDate [Intanethi] , Waltham, MA. Ukuhlaziywa ngoFebruwari 2018.
> Caliendo AM. I-Multiplex PCR kunye ne-Technologies Emerging for Detection of Pathogens. Iiklinikhi ezingenayo. Ngo-Meyi ka-2011; 52 I-Suppl 4: S326-30. i-doi: 10.1093 / cid / cir047.
> Harris AM, Beekmann SE, Polgreen PM, Moore MR. Uvavanyo lwe-Antigen olukhawulezayo kwi-Streptococcus pneumoniae kubantu abadala abakwi-Community-Acquired Pneumonia: I-Clinical Use and Barriers. Diagn Microbiol Disfect Dis. 2014 Aug; 79 (4): 454-7. i-doi: 10.1016 / j.diagmicrobio.2014.05.008.
> Pneumonia. I-Heart Heart, i-Lung, ne-Bood Institute. https://www.nhlbi.nih.gov/health-topics/pneumonia.
> I-Rodrigues CMC, iGroves H. I-Pneumonia esebenzayo yoluntu kwi-Children: iMingeni ye-Microbiological Diagnosis. J Clin Microbiol. 2018 Feb 22; 56 (3). pii: e01318-17. i-doi: 10.1128 / JCM.01318-17.