I-pneumonia ithinta izigidi zabantu minyaka yonke. Ngokusho kwamaCentral for Disease Control and Prevention (CDC), abantu abangaphezu kuka-400,000 badinga ukuhlolwa kanye nokwelashwa emnyangweni ophuthumayo kanti abantu abangaphezu kuka-50 000 bafa ngesifo. Kodwa izinkinga zingavinjelwa! Ukuthola ukuthi une-pneumonia yisinyathelo sokuqala, bese ufunda uhlobo luni lwe-pneumonia onayo- ibhaktheriya , igciwane lesandulela ngculazi noma i- fungal -balulekile ekunakekeleni okufanele.
Ukuhlolwa Kwemvelo
Ukushisa, ukukhwehlela nokuphefumula kungase kube izibonakaliso ukuthi une-pneumonia. Udokotela wakho ngokuqala ukuhlola ngokuhlola izimpawu zakho ezibalulekile.
Uyokwazi ukulinganisa izinga lokushisa, ukucindezeleka kwegazi, izinga lokushaya kwenhliziyo, kanye nesilinganiso sokuphefumula, futhi uzohlola izinga lakho le-oxygen usebenzisa i- pulse oximetry . Lokhu kwenziwa ngokufaka idivayisi encane emunwe wakho ukulinganisa iphesenti yomoya-mpilo egazini lakho. Amazinga aphansi oksijini ahlobene futhi angasho ukuthi udinga ukufakwa emoyeni.
Ukusebenzisa i-stethoscope, udokotela uzolalela amaphaphu akho. Babheka ukuzwa imisindo eqhudayo noma isondo . Ukunciphisa imisindo endaweni eyodwa kungasho ukuthi i-pneumonia yenzeke lapho. Ukubamba ngemuva kwakho kuleyo ndawo kungasiza ekunqumeni ukuthi kukhona iqoqo elihambelana namanzi noma ukuhlanganiswa. Ungamangali uma ucelwa ukuthi usho ukuthi "E" ngokuzwakalayo. Uma unamanzi emaphashini akho, kuzozwakala sengathi "A" uma ulalela nge-stethoscope.
Ama-Labs nezivivinyo
Nakuba ukuhlolwa ngokomzimba kungaholela ekusola ngenxa ye-pneumonia, ukuxilongwa kungaqiniswa ngokusebenzisa izivivinyo ezihlukahlukene. Udokotela wakho angasebenzisa noma angasebenzisi lezi zivivinyo ezilandelayo. Yazi ukuthi iningi lilula futhi liqondakala eceleni kwakho-ukudweba kwegazi okulula noma ukuqoqwa kwesampula, okusheshayo nokungenabuhlungu.
Gcwalisa i-Blood Count
Inani eliphelele legazi livivinyo elilula futhi elingabizi. Inani legazi elimhlophe lingenye yezinombolo zegazi elilinganisiwe. Uma iphakanyisiwe, ukutheleleka noma ukuvuvukala kukhona. Akukutshelisi ngokuqondile uma une-pneumonia.
Procalcitonin
I-Procalcitonin iyisandulela se-calcitonin, iphrotheni ekhishwa ngamaseli ekuphenduleni ubuthi. Ilinganiselwa nge-test test. Ngokuthakazelisayo, amazinga akhula ekuphenduleni ukutheleleka kwebhaktheriya kodwa wehla ezinyangeni eziphilayo. Imiphumela ngokuvamile ihle ngaphakathi kwamahora angu-4 wokutheleleka kwebhaktheriya nokuphakama phakathi kwamahora angu-12 kuya kwangu-48. Nakuba ingakuvumeli ukuthi uhlobo luni lwebhaktheriya olukhona, lubonisa ukuthi ukwelashwa kwama-antibiotic kungadingeka.
I-Sputum Culture ne-Gram Stain
Izinga legolide lokuthola ukutheleleka kwebhaktheriya yisiko. Ngeshwa, ukuqoqa isampuli se-sputum enhle kungaba nzima, ikakhulukazi uma othile enomkhuhlane owomile. Ngokuvamile uthola ukungcola ngamagciwane ajwayelekile ahlala emphefumulweni wokuphefumula.
Isampula kufanele iqoqwe ngaphambi kokuba uphathwe ngama-antibiotics. Uzocelwa ukukhwehlela isikhukhuni, njengamathe amancane ngangokunokwenzeka. Uma unenkinga yokwenza kanjalo, udokotela angasebenzisa idivaysi ngekhamera encane futhi encane ibekwe phansi emqaleni wakho.
Uzokusiza ekuphumule ngemithi ngenkathi inqubo, futhi kukhona nemiphumela emibi engaphandle kwekhanda elincane elingenzeka.
Uma iqoqwe, i- Gram stain isetshenziselwa ingxenye ye-specimen futhi ihlolwe ngaphansi kwe-microscope. Isampuli se-sputum enempilo izobonisa amaningana amangqamuzana egazi amhlophe kodwa ambalwa amangqamuzana e-epithelial. Ama-bacteria azovela obomvu noma ama-violet futhi, ngokusekelwe ekubukeni kwawo, angahlukaniswa njengenye yamakilasi amabili amabhaktheriya. Ukwehlisa ukuxilongwa kwenza kube lula ukukhetha i-antibiotic efanelekile.
Ukuze uthole ukuthi yiziphi amabhaktheriya athile abangela ukugula kwakho, isampuli yakho izoklonyelwa ku-Petri izitsha.
Lapho amabhaktheriya noma isikhunta sikhula, ihlolwe ngokumelene nama-antibiotic ahlukene ukuze ubone ukuthi iziphi izindlela zokwelashwa ezizophumelela kakhulu.
Inkinga yukuthi kungathatha izinsuku ukuthola umphumela wenkambiso eqondile. Futhi, amabhaktheriya athile afana ne- S. pneumoniae kunzima ukukhula futhi isiko singanikeza imiphumela engamanga. Ngenxa yezinselele zokuthola isampula lekhwalithi elihle, lolu hlelo luvame ukusetshenziswa kakhulu kubantu esibhedlela kunokuba labo abahlala emphakathini.
Ukuhlolwa kwe-Urine Antigen
I-pneumonia yebhaktheriya ebangelwa yi- S. pneumoniae neLegionella izinhlobo zinezimo ezinzima zokucindezeleka. Ama-antigens avela kulawa ma-bacteria adonswa emcinini. Ukuhlolwa okulula komchamo kuyatholakala ukuze ubuke lawa antigens.
Imiphumela iyatholakala ngokushesha futhi izifundo zibonise ukuthi zinembile kune-Gram stain noma isiko. Enye inzuzo yokuhlolwa ukuthi ukwelashwa ngama-antibiotics ngeke kuguqule imiphumela.
Inkinga yukuthi izivivinyo ze-antigen ze-urine zinembile kakhulu ezimweni ezinzima ze-pneumonia. Kubuye kuhlolwe kuphela nge-serotype eyodwa yeLegionella nakuba kunezinhlobo eziningi. Futhi, ngokungafani nesiko, ayikho indlela yokusebenzisa imiphumela ukunquma ukuthi yimiphi imithi elwa namagciwane eyophumelela kakhulu ekwelapheni.
I-Serology
Amanye amabhaktheriya kunzima ukukhula emasimini futhi awunayo i-antigen test ye-antigen etholakalayo yokuhlola. I-Chlamydia , i- Mycoplasma , nezinye izinhlobo zeLegionella ziyi-bacteria e-atypical ewela kulo mkhakha.
Kunezivivinyo zegazi ze-serologic ezingase zikwazi ukucacisa nini futhi uma usulelekile. I-Serology yenza izinyathelo zokulwa nama-antibodies ezenziwe ngokumelene ne-pathogen ethile. Ama-antibodies e-IgM akhombisa ukutheleleka okusha kodwa ama-IgG antibodies ngokuvamile abonisa ukuthi usulelekile esikhathini esidlule. Ngezinye izikhathi kungase kube nzima ukwazi ukuthi nini ama-antibodies e-IgM ashintshwe kuma-antibodies e-IgG.
I-PCR ne-Enzyme Immunoassays
Kungaba nzima ukuhlakulela igciwane. Esikhundleni salokho, izifo ezithathelwana ngegciwane zivame ukutholakala zisebenzisa i-polymerase chain reaction (PCR) ne-enzyme immunoassays.
I-PCR iyisivivinyo esibonisa ukutholakala kwe-DNA ethile yegciwane noma igciwane esampula. Kuyinto ehlukile ku-serology ukuzohlola amabhaktheriya ase-atypical. Nakuba imiphumela ivame ukutholakala emahoreni angu-1 kuya kwangu-6, i-PCR ayikwazi ukuwenziwa kusayithi. Kumele kucutshungulwe yi-laboratory.
Kodwa-ke, i-enzyme immunoassays ingenziwa njengesilingo sokuhlola ukunakekelwa ngemiphumela etholakala emaminithini angu-15 kuya ehoreni. Lezi zimpawu zokuzivikela zisebenzisa ama-antibodies ukuze zibone ukutholakala kwama-antigen anesandulela ngculazi futhi zingakwazi ukufaka ama-virus amaningi ngesikhathi esisodwa.
Ukucabanga
Ukucubungula ukucwaninga kuvame ukuqhutshwa ngaphambi kokuhlolwa kwelabhoratri. Uma unempilo enhle, udokotela angakuphatha ngempneumonia ngokusekelwe ekuhloleni ngokomzimba nokucwaninga kuphela.
I-X-Ray yekhanda
Uma kutholakala ukuthi i-pneumonia isekelwe ezimpawu nokuhlolwa ngokomzimba, izinga lokunakekela ukuthola i- x-ray yesifuba . I-x-ray yesifuba ingabonisa ukungena ngaphakathi, okuyinto iqoqo le-pus, igazi, noma amaprotheni emathangeni amaphaphu. Kungabonisa nezinye izibonakaliso zesifo samaphaphu njengama-cavitations nama -nodules we-pulmonary .
Udokotela wakho kaningi akakwazi ukuhlukanisa phakathi kwezifo ezinama-bacterial kanye nesandulela ngculazi ngokusekelwe ku-imaging yedwa. Kodwa-ke, ukungena ngaphakathi okugcwalisa konke noma ngaphezulu kweyodwa noma ngaphezulu kwe-lobes yamapayipi kungenzeka kube yi-bacneial pneumonia eyenziwe yi- S . pneumoniae .
I-CT Scan
Kungenzeka ukuthi i-x-ray yesifuba ingaphuthelwa ukuxilongwa. Uma udokotela wakho esenaso ukusola okukhulu nge-pneumonia ngemuva komphumela omubi, angase akhethe ukuqinisekisa ukuthi uhlolwe nge- CT scan . Ngokuvamile, isithwebuli se-CT sinembile kakhulu kune-x-ray yesifuba nakuba kubiza okungaphezulu futhi kukubeka emisebeni ephakeme yemisebe.
Isivivinyo senziwa ngokukubeka phansi emshinini owenziwe nge-donut othatha izithombe. Ucwaningo alubuhlungu futhi lugcwaliswa ngamaminithi, kodwa kubalulekile ukuqamba amanga ngesikhathi sokuhlolwa ukuthola izithombe ezinhle kakhulu.
I-bronchoscopy
Ezimweni ezinzima ezingaphenduli ukwelashwa, udokotela wakho angase aphishekele ukucabanga okuqhubekayo ukuze afune ezinye izimbangela. Lokhu kuhlolwa kungabandakanya i- bronchoscopy , lapho ikhamera encane iqondiswa khona emakhaleni noma emlonyeni wakho phansi emaphashini akho.
Ngale ndlela, udokotela wakho uyakwazi ukubona ngokuqondile ngaphakathi kwamaphaphu. Imvelo kanye ne-biopsies ingathathwa njengoba kudingeka. Ungakhathazeki. Uzodedelwa ngenqubo.
Ukuhlonza okuhlukile
Kunezinye izimo ezingaba nezibonakaliso ezifana ne-pneumonia, njenge- bronchitis noma ukuhluleka kwenhliziyo ye-congestive . Uma othile ene- asthma , i- bronchiectasis , noma isifo se-pulmonary chronic obstructive (COPD) , kungase kube ukuphazamiseka kwesifo sabo se-lung lungaziwa. Esimweni esinzima kunazo zonke, kungaba yisixwayiso somdlavuza wamaphaphu .
Kodwa-ke, ungakhathazeki ngalezi zindlela. Into engcono kakhulu ongayenza uvakashele udokotela wakho ukuze ahlolwe kahle. Ezimweni eziningi, uma kutholakala ukuthi, i-pneumonia ingaphathwa kahle.
> Imithombo:
> Bartlett JG. Indlela Yokuthola Ukuthola Pneumonia Yomphakathi Kubantu Abadala. Ku: Bond S. (ed), UpToDate [Inthanethi] , Waltham, MA. Kubuyekezwe ngo-February 2018.
> Caliendo AM. I-Multiplex PCR ne-Emerging Technologies yokuthola izifo ezifufusa ukuphefumula. I-Dis Infect Dis. 2011 Meyi; 52 I-Suppl 4: S326-30. doi: 10.1093 / cid / cir047.
> Harris AM, Beekmann SE, Polgreen PM, Moore MR. Ukuhlolwa kwe-Rapid Urine Antigen ye-Streptococcus pneumoniae kubantu abadala abane-Pneumonia esebenzisa umphakathi: Ukusetshenziswa kwemithi kanye nezithiyo zemitholampilo. I-Diagn Microbiol I-Disfect Infect. 2014 Aug; 79 (4): 454-7. doi: 10.1016 / j.diagmicrobio.2014.05.008.
> I-pneumonia. I-National Heart, Lung, ne-Bood Institute. https://www.nhlbi.nih.gov/health-topics/pneumonia.
> Rodrigues CMC, Grove H. Pneumonia Yomphakathi Kwabafundi: Izinselele Zokuthola Ukuhlolwa Kwemvelo. J Clin Microbiol. 2018 Feb 22; 56 (3). i-pii: e01318-17. i-doi: 10.1128 / JCM.01318-17.