Ukuze ukwazi ukubona izibonakaliso ze-meningitis ezinganeni kufanele bonke abazali, ngoba ingozi yokugula ingamaphesenti angu-10 ephakeme ebuntwaneni. Uma ingane inganikeza usizo lwezokwelapha ngesikhathi esifanele, imiphumela ingaba yingozi, ngisho nasemphumela obulalayo.
I-agent causative of meningitis
I-Meningitis iyiqembu lezifo lapho ukuvuvukala kwezingqimba zobuchopho noma intambo yomgogodla kwenzeka. Ukuvuvukala kwe-webs esithambile noma yesicabucabu kubizwa ngokuthi i-leptomeningitis, amagobolondo aqinile - i-pachymeningitis. Ngaphambi kokusungulwa kwemigomo nemithi elwa namagciwane ekuqaleni kwekhulu lama-20, ukufa kwabantu ekutholeni i-meningitis ye-purulent ezinganeni kwakungaba ngu-90%. Kuze kube manje, emazweni aseNtshonalanga Afrika (indawo "ye-meningitis belt") ukuqhuma kwalesi sifo kuvele nezinkulungwane ezithathelelekile.
I-Meningitis iyisifo esizimele (i-meningitis eyinhloko) kanye nesimo sezinkinga (i-meningitis yesibili). Ukutheleleka kungenziwa ngamaconsi amancane, ngezandla ezingcolile, ukudla, amanzi. Ukungena emzimbeni wesifo singakwazi futhi nangamahlumela avulekile, ama-catheters angama-venous. Ngokuvamile, ukutheleleka nge-agent causative ye-meningitis kwenzeka ngokumelene nesizinda sokuzivikela okunciphise noma izifo ezikhona kakade zesimiso sezinzwa ezisemkhatsini - ukukhubazeka kwesibindi, ama-cysts ebuchosheni.
Ama-causative agents of meningitis yilokhu:
- ama-virus;
- amabhaktheriya;
- isikhunta;
- i-spirochaetes;
- i-plasmide ye-malaria ne- toxoplasma .
Izimbangela ze-meningitis ezinganeni
I-meningitis ye-viral inzingane ivame kakhulu kunezinye izinhlobo. Ama-virus ayimbangela ye-meningitis:
- ama-enteroviruses, kufaka phakathi i- Coxsackie ;
- amagciwane omkhuhlane, inkukhu yezinkukhu, ama-shingles;
- Ama-arbovirus, kuhlanganise ne-encephalitis virus,
- i-herpes virus ye-1 st no-2 izinhlobo;
- i-mumps virus;
- i-cytomegalovirus .
I-meningitis yebhaktheriya ebantwaneni nasebuntwini ibangela:
- i-meningococcus ;
- i-pneumococcus;
- i-staphylococcus aureus;
- Listeria (nge-immunity ebuthakathaka nasebekhulile);
- i-tubercle bacillus (ibangela i-meningitis yesibili);
- E. coli (imbangela evamile yokungena kwamantombazane ezinsana);
- I-Haemophilus influenzae .
Kusuka ku-fungi kubangele ukuvimbela i-meningitis ezinganeni:
- i-cryptococci;
- Abafundi.
Ama-spirochaetes abangela i-meningitis yilezi:
- i-treponema ephukile, ebangela ukuphikisa;
- Borrelia, obangela isifo seLyme;
- Leptospira.
Indlela yokubona i-meningitis - izimpawu ezinganeni
Ukuze wazi ukuthi i-meningitis iqala kanjani ezinganeni, kubalulekile ukuthi ufunde izibonakaliso eziyinhloko zesifo, ezihlanganisa:
- i-fever ephezulu kanye nezikhukhula;
- ikhanda;
- ubuhlungu emisipha yentamo;
- ukulala, ukungazi;
- ukuhlanza;
- i-photophobia;
- intamo eqinile.
Izimpawu zezinye izinhlobo ze-meningitis ezinganeni:
- ukuphuza esikhumbeni;
- ukuxubha;
- ukukhathazeka;
- ukukhuphuka okukhulu;
- ukuphazamiseka kwengqondo.
Isikhathi sokugxilwa kwe-meningitis ezinganeni
Uma lesi sifo singumama we-meningitis ezinganeni, izimpawu nezibonakaliso zizibonakalisa ngokushesha, kodwa zivame ukufana nezibonakaliso kwezinye izifo. Phakathi naleso sikhathi, ingozi ye-meningitis idinga ukunakekelwa ngokushesha esibhedlela, futhi ngokushesha lokhu kwenzeka, ukubikezela okuhle kuzoba ngcono. Ubude benkathi yokufakelwa kweso sifo kuxhomeke ezintweni eziningi, kuhlanganise nesimo somzimba wamasosha omzimba, futhi singahluka ezinsukwini ezimbili kuya kwezingu-10. Ukuqala kwalesi sifo kunzima.
Izimpawu zokuqala ze-meningitis ezinganeni
Isibonakaliso esiyinhloko se-meningitis yizinsizwa, okufundwa kusukela ezinsukwini zokuqala zalesi sifo futhi siqhubeka siphinde siphumelele. Ngokuvamile ikhanda lihambisana nokuhlanza "ukuqhuma" ngaphandle kwesiqhwaga, esingenzi ukukhulula isiguli. Ukutholakala kwendawo ebuhlungu buhlukile - ikakhulukazi ebunzini noma entanyeni, ngezinye izikhathi ubuhlungu buyahlukahluka. Ubukhulu be-syndrome lobuhlungu buyahlukahluka, kodwa okubi kunayo yonke inhlanzi e-meningitis ene-tuberculous. Kusuka umsindo nokukhanya, ubuhlungu be-syndrome buyanda njalo.
Uphawu lokuqala lwe-meningitis ezinganeni eziningi zamacala yi-fever high. Nge-meningitis ehlanzekile, izinga lokushisa likhuphukela ezimisweni ezibucayi - 40-41ºС, nge-serous meningitis kanye nezinye izinhlobo zesifo, izinga lokushisa liphakanyiswa kancane, futhi nge-syphilitic meningitis izinga lokushisa livamile. Ama-chills kule sifo kwenzeka uma izinga lokushisa lesikhumba liyancipha ekushiseni komzimba okuphakeme - lokhu kwenzeka nge-meningitis nakho kungaba uphawu lokuqala lwesifo.
Rash nge-meningitis ezinganeni
Ukuqhuma okuvamile nge-meningitis kubonakala cishe ngamacala ama-quarter of the disease futhi cishe njalo kuyisibonakaliso sohlobo lwe-meningococcal yesifo. Ngalolu hlobo lwesifo, amabhaktheriya awonakalisa izindonga zendimbi, futhi amahora angu-14-20 ngemva kokuqala kwesifo, ukuqubuka kwesisu (ukubola kwesisu) kuvela. Rash nge-meningitis ezinganeni - izithombe nezibonakaliso zezici:
- umbala obomvu noma obomvu-violet;
- ifomu elithi "stellate" elingavamile, ukuthambekela kokuhlanganisa amabala;
- uma ucindezela esikhumbeni ngodonga lwengilazi, ukuqhuma akukhenyi futhi ingilazi ye-birch ibonakala (lena ingenye yezindlela zokuxilonga);
- indawo yangakini - emlenzeni nasezinhlangothini, ukubonakala kokushisa ebusweni kuyisimpawu esibi kakhulu.
Ama-syndromes e-Meningeal
Phendule ngokuqondile umbuzo wokuthi ungabona kanjani ukuthi i-meningitis enganeni iyasiza izibonakaliso ezibonakalayo kuphela zalesi sifo. I-Meningeal syndrome ihlanganisa izimpawu ezinjalo:
- Ubunzima bemisipha yentamo. Lapho ehlola lesi sifo, udokotela ucela ukubeka ingane ngemuva kwakhe, ngesandla esisodwa esicindezela ngesifuba esifubeni sakhe, kanti enye - igoba ikhanda esifubeni sayo. Ngenxa yokuqina kwemisipha, lokhu kuhamba kuyabuhlungu ingane.
- I-Reflex muscle tension. Le syndrome ingabonwa enganeni elele esithatha indawo engavumelekanga "yeqhude elikhiphekile" - umzimba uguqulwa, ikhanda liphonswa emuva, izandla zicindezelwa esifubeni, imilenze - esiswini.
- Isibonakaliso seBrudzinsky. Ukufakwa esikhwameni se-supine ngemuva - uma ingane iphakamisa ikhanda, imilenze yakhe emagqumeni nasezintweni ziyocabangela. Njengoba ukugoqa okungahambi kahle komlenze owodwa emagqabeni nasezintweni zamadolo, elinye lizocatshangelwa ngokucophelela.
- I-Kerning Symptom. Hlola amanga ngemuva - uma ingane igoba umlenze ngezinyosi zezinyosi namadolo, bese uzama ukuqondisa idolo - le senzo ngeke isebenze.
- Isibonakaliso se-Lesage. Uma ingane iphakanyiswa ngokubamba izimpumputhe, imilenze yakhe izodonsa esiswini.
- I-Symptom Flatau. Ngokukhulisa ngokubheke phambili kwekhanda lomntwana phambili kusuka esimweni esithandwayo, umfundi uzokhula. Ngale ndlela, izibonakaliso ze-meningitis ezinganeni zihlolwe ikakhulu ezinganeni.
Imfanelo ye-meningitis yilezi:
- ukuhlukunyezwa - uhlobo lwesibhukela noma uhlobo lokuthuthumela okuncane;
- ukulala (kubonwe ngamacala angu-70%) - kuqala ngenxa yokuvimbela imisebenzi yobuchopho, ngaphezu kwalokho - kukhona ukucindezeleka kwezikhungo ezibalulekile futhi isiguli senza i-dyspnea, yehlisa ukucindezelwa kwegazi;
- ukukhathazeka - kungabonwa lapho kuqala lesi sifo, kodwa kaningi - kuqala ngosuku lwesine-5, kuhambisane nokudideka;
- ukukhohliswa, ukucabangela, ukwesaba - izimpawu ze-psychosis ziyahlukahluka ngezinhlobo ezahlukene zokutheleleka, ngokuvamile ziqinisa ngokushisa okukhulayo.
I-Meningitis - izimpawu ezinganeni ezingaphansi konyaka owodwa ubudala
Kungenakwenzeka ukuhlolisisa i-meningitis ezinganeni ezingaphansi kwezimpawu zikaBrudzinsky, uKerning noLesage ngoba zinamazwi ajwayelekile, ngakho-ke odokotela abanokusola nge-meningitis ezinganeni ezingaphansi kweminyaka yobudala bahlole isimo seFlautau. Ngaphezu kwalokho, odokotela bahlola i-fontanel enkulu yezingane ezisanda kuzalwa - nge-meningitis, ihlupha kakhulu, ivuvukala. Esinye isibonakaliso sokuthi i-meningitis emntwaneni wonyaka wokuqala wokuphila yikhala lokukhipha i-hydrocephalic (ukuklabalaza okubukhali phakathi kokungazi kahle noma ukungadideki). Ingane egulayo inga:
- ukukhala;
- thuthumela;
- Ukulala okuningi;
- isikhumba sakhe sibaleka;
- ekhanda kusobala ukuthi i-setochka enobuhlungu.
I-Meningitis ezinganeni - ukuxilongwa
Ukuxilongwa okunzima kwe-meningitis kuhlanganisa ucwaningo, izifundo zelabhutri kanye nezinsimbi, ukuhlolwa kwegazi. Ngesikhathi sokubuza, udokotela uthola izifo ezikhona noma ezisanda kuhanjiswa, ngokucacile ukuthi ukutholakala kwezifo ezifana nesifo sofuba, i-rheumatism, i-syphilis. Kubalulekile ukwazisa udokotela uma ingane isanda kugula, isifo se-otitis, sinusitis, sinusitis, pneumonia, pharyngitis, sithola ukungenelela kokuhlinzwa, salimala, sahamba kwelinye izwe, sathola imithi yokulwa namagciwane noma imithi yokulwa negciwane.
Ukuhlolwa kwe-neurologic kuvumela ukwembulwa izici ezibonisa ukuthi i-meningitis inabantwana. Okokuqala, udokotela uhlola izimpawu zikaBrudzinsky, Kerning, Lesage, Flatau, ubukeka, kungakhathaliseki ukuthi kunezinkinga zomzimba. Ngaphezu kwalokho, ukukhathazeka nokuzwela kuyaphenywa - kwanda nge-meningitis. Kuphoqelekile ukuba udokotela enze ukuhlolwa kwezinzwa ze-cranial, ezonakaliswe ngesikhathi se-meningitis.
Ucwaningo lwe-Instrumental lokuthola izimpawu ze-meningitis ezinganeni kuhlanganisa i-electroencephalogram kanye ne-tomography ye-computed. Inani lezivivinyo ze-laboratory zihlanganisa ukuhlolwa kwegazi jikelele kanye nokuhlolwa kwegazi, i-PCR noma i-latex test, i-cerebrospinal puncture, ukuhlaziywa kwe-cerebrospinal fluid. Izinhlobo ze-meningitis ku-morphological pathological of fluid cerebrospinal:
- i-serous meningitis ezinganeni - inani lama-lymphocytes e-cerebrospinal fluid landa, i-membranes yobuchopho igubha;
- i-meningitis ye-purulent ezinganeni - ku-fluide cerebrospinal okuqukethwe okuphezulu kwe-neutrophils, okuqukethwe okuphezulu kwamaprotheni, ama-envelope ebuchopho - ama-purulent, ahlanganiswe.
I-Meningitis enganeni - ukwelashwa
Uma lolu cwaningo lwembula izimpawu ze-meningitis ezinganeni, isiguli sinikezwa ukwelashwa okuphuthumayo esibhedlela. Njengoba ukwelashwa okuzimele kwe-meningitis ezinganeni kungaholela emiphumeleni enhle yempilo, udokotela oqeqeshiwe kufanele anikeze imithi. Ukwelashwa kwe-Meningitis kuhlanganisa ukwelashwa okuhlosiwe:
- ukubhujiswa kwebhaktheriya, i-viral noma enye ukutheleleka;
- ukuqeda i-edema ye-cerebral nokucindezela okungekho emthethweni;
- ukuqeda izimpawu ezithile zempilo - ukubuyiswa kwezinga lemanzi, ukunciphisa izinga lokushisa, ubuhlungu kanye nokuqothulwa, ukuqedwa kwe-oksijeni yindlala.
Imiphumela ye-meningitis ezinganeni
Imiphumela emibi ye-meningitis uma kungabikho ukwelashwa okwanele kungaba yingozi. Izingane zingase zibe nezinkinga ezingqondweni, zokuziphendulela, izinkinga zokukhuluma, ukuhlukunyezwa kwegazi, i-hydrocephalus, ukulimala kwesibindi somzimba, kanye nokucindezeleka okunzima ngendlela yokukhubazeka noma i-paresis, isithulu, ubumpumputhe, ukuphazamiseka kwengqondo. Ngokuvamile ngemuva kokuba i-meningitis idlulile, ingane inenkinga nokunyuka kwengcindezi, ukuthuthukiswa kwengqondo nokuqondiswa kwengqondo kubambezelekile, i-strabismus, i-ptosis (ukucindezeleka kwe-ijwayela le-eyelid), isifo somzimba se-asymmetry singakhula.
Ukuvimbela i-meningitis ezinganeni
Izinyathelo zokuzivikela ngokumelene ne-meningitis zihlukaniswe ngamaqembu amabili - okucacile nokungabonakali. Isigaba sokuqala sifaka ukugoma:
- Ukugonywa kwe-Meningococcal - i-inoculation ngokumelene ne-meningitis ezinganeni ezineminyaka engu-10-12 ihlinzeka ngokuvikeleka ezinhlobonhlobo zezinambuzane ezincane ze-pathogenic, futhi kunconywa ngaphezu kwabantu abavakashela amanye amazwe, abafundi, abaqashiwe.
- Umgomo ovela eHaemophilus influenzae B unikezwa izingane ezineminyaka engu-2-5 izinyanga.
- Umgomo wokugoma i-pneumococcal - kunezinhlobo ezimbili: izingane ezineminyaka engaphansi kweminyaka emibili kanye nabadala.
- Ukugonywa ngokumelene nesimungumungwane, ama-mumps, inkukhu ye-chickenpox, i-rubella yesimungumzimba kwenziwa ukuze unciphise ingozi ye-meningitis ngemuva kwalesi sifo.
Ukuvimbela okungenasiphakamiso kwe-meningitis kuhlanganisa:
- ukuqinisa ukuzivikela;
- ukunamathela emithethweni yokuhlanzeka;
- ukujwayelekile komsoco;
- ukunciphisa amathuba okutheleleka ezindaweni ezigcwele;
- ukuvikelwa ezinambuzaneni ezingathwala ukutheleleka;
- ukugeza kuphela emzimbeni wamanzi aqinisekisiwe;
- ukugoma ngesikhathi esifanele lapho uya eholidini;
- ukwelashwa okufika ngesikhathi futhi okuphelele kwezifo ezibandayo nezifo.