Isifo sesibetho, esinobudlelwane bendoda engama-1,500 kwiminyaka edlulileyo, kwangaphambili kubangele ukuqubuka okukhulu kobuthathaka, kuthatha amashumi kunye namakhulu ezigidi zabantu. Imbali ayayazi ukusuleleka kobuhlungu kunye nokuphazamiseka, kwaye ngoku kude kube ngoku, nangona uphuhliso lweyeza, kwakungenakwenzeka ngokupheleleyo ukuhlangabezana nayo.
Yintoni i sibetho?
Isibetho siyisifo kubantu, esiyinkalo echaphazelekayo yendalo, kwiimeko ezininzi kuphelela kwisiphumo esibulalayo. Le yintsholongwane echaphazelekayo, kwaye ukukhuselwa kwinto yonke. Emva kokuba idluliselwe kwaye iphilwe isifo, ukukhuseleka okuzinzileyo kungabonakali, oko kukuthi, kukho umngcipheko wokusuleleka kwintsholongwane (kodwa okwesibini isi sifo silula).
Imvelaphi ngqo yegama lesi sifo ayilunganga, ngelixa igama elithi "isibetho" ekuguquleleni ukusuka eTurkey lithetha "ukujikeleza, i-cone", ukusuka kwisiGrike - "shaft", ukusuka kwisiLatini - "hit, inxeba". Kwimithombo yezenzululwazi yasendulo neyenamhlanje, umntu unokufumana inkcazo enjalo njengesifo sesibetho se-bubonic. Oku kubangelwa kukuba enye yeempawu ezibonakalisa isifo yi-bubo - ukuvuvukala okujikelezayo kwindawo ye- lymph node evuliwe. Kule meko, kukho ezinye iintlobo zentsholongwane, ngaphandle kokubunjwa kwama-buboes.
Isibetho yi-agent agent
Kwangexesha elide akuzange kucacise oko kubangela i sibetho se-bubonic, i-agent causative yafunyanwa kwaye idibene nesifo kuphela ekupheleni kwekhulu le-XIX. Baye baba yi-bacam-negative negative from family enterobacteria - i-plaque (Yersinia pestis). I-pathogen ifundwa kakuhle, iiprospecies zayo ezininzi zityhilwa kwaye ezi zinto zilandelayo zenziwe:
- unokufumana ifomu eyahlukileyo - ukusuka kwi-filiform ukuya kwi-spherical;
- Ukulondolozwa kwexesha elide lokuphila kubantu abahlukileyo abagulayo;
- ukunyamezela kakuhle kweqondo lokushisa okuphantsi, ukuqhwala;
- ukuvakalelwa okukhulu kwiintsholongwane, ukukhanya kwelanga, ukuphendulwa kwe-acid kwimeko, ukushisa okuphezulu;
- iqulethe malunga nezakhiwo ezingamashumi amathathu ze-antigenic, ifihla i-endo- exotoxins.
Inkxalabo - iindlela zokungena kweebhaktheriya emzimbeni womntu
Kubalulekile ukwazi ukuba isibetho sithunyelwa njani kumntu kumntu, kunye nakwezinye izinto eziphilayo. I-Plagiarum ijikeleza kwiindawo eziphathekayo ezithintekayo kwizidalwa zezilwanyana ezibandakanyekayo, ezibandakanya izilwanyana zasendle (i-squirrels, i-groundhogs, i-voles), amagundane amnyama kunye namnyama, amagundane endlu, iikati, i-lagiformes, iikamela. Abathwali (abafakeliyo) bezilwanyana-zifo ziintlobo zeentlobo ezahlukeneyo kunye neendidi ezininzi zeengxube zegazi ezikhuselwe yi-agent e causative xa ukondla izilwanyana ezigulayo ezinezibetho egazini.
Ukwahlula ukuhanjiswa kwe-pathogen ngokusebenzisa iifleas eziphathekayo zezilwanyana kubantu nakubantu. Sisebenzisa uluhlu lweendlela zokungena kwi sibetho emzimbeni womntu:
- Ukugqithiswa - ukungena kwigazi emva kokulunywa kwesilwanyana esisifo.
- Uqha ga mshelwano - xa unxibelelana nomntu onesikhumba okanye embran membrane ye-microtrauma, kunye nezidumbu zezilwanyana ezisulelekileyo (umzekelo, xa usika izidumbu, ukucoca izifihla).
- Utywala - ngokusebenzisa i-mucosa yesondlo sesisu xa udla inyama yezilwanyana ezigulayo ezingazange zithole unyango olwaneleyo, okanye ezinye iimveliso zembewu.
- Uqhagamshelwano -khaya - kwindawo yokuthintela umntu ogulayo, udibanisa kunye nezixhobo zakhe eziphilayo, usebenzisa izitya, izinto zokuhlambulula umntu kunye nezinto ezinjalo.
- I-Aerosol isuka kumntu ukuya kumntu ngeempawu zokuphefumula xa ukhahlela, udibanisa, ingxoxo esondeleyo.
Isibetho - iimpawu kubantu
Ukusuka kwindawo yokusungulwa kwe-pathogen kuxhomekeke kwiphi uhlobo lesifo esiza kuphuhliswa, kunye nomonakalo weziko, kunye naluphi ukubonakaliswa. Ezi zilandelayo ziseko zesisibetho somntu zimelele:
- bubonic;
- pulmonari;
- septic;
- emathunjini.
Ukongezelela, zikhona iintlobo ezinqabileyo zokukhubazeka njenge-skin, pharyngeal, meningeal, asymptomatic, avortive. Isifo sesibetho sinexesha lokutshatyalaliswa kweentsuku ezi-3 ukuya kwezi-6, ngezinye ii-1-2 iintsuku (kunye nefomimari okanye ipopsi ye-septic) okanye iintsuku ezingama-7-9 (kwiigulane okanye ezigulayo. Kuba zonke iifom zibonakaliswa ngokukhawuleza kunye neempawu ezinzima kunye nesifo sokuxhatshazwa, ukubonakaliswa kwezi zinto zilandelayo:
- izinga lokushisa lomzimba;
- ukuphosa;
- intloko;
- intlungu yomculo;
- isicefe
- ukuhlanza;
- ubuthathaka obunamandla.
Njengoko isifo sifana, ukubonakala kwesigulane kuyatshintsha: ubuso buba bukhukhumele, i-hypermic, abagcini bamhlophe bavuke, umlomo kunye nolwimi luba ngumile, imibala ebumnyama ibonakale phantsi kwamehlo, ubuso bubonisa ukwesaba, ukuphazamiseka ("isibetho sesifo"). Kwixesha elizayo, isigulane siphazamiseka ngokuqonda, intetho ingabikho mthethweni, ukulungelelaniswa kwemfudu kuphazamiseka, ukukhohlisa nokuhlaziywa. Ukongezelela, izilonda ezithile zikhula, kuxhomekeke kwifom yesibetho.
Isibetho se-Bubonic - iimpawu
Izibalo zibonisa ukuba isibetho se-bubonic sisona sifo esiqhelekileyo sesifo esiphuma kuma-80% abo bachaswe ngokungena kwi-membrane kunye nesikhumba. Kule meko, intsholongwane isasazeka kwi-lymphatic system, eyenza umonakalo kwi-lymph nodes, engamaqabana - i-axillary okanye yomlomo wesibeleko. Iibbobo ezibangelwayo zingatshatanga kwaye zininzi, ubungakanani bazo bunokuhluka ukusuka kwi-3 kuya kwi-10 cm, kwaye ekuphuhliseni kwabo bahlala behamba ngezigaba eziliqela:
- ukwandisa, ukuqina nokunyameka kweempawu zeclimph - iintsuku ezimbalwa emva kokuqala kwesifo sokuxhatshazwa (kwisifo se-bubonic isifo kwisigulane esinama-buboes angamaqhina);
- Ukunciphisa i-bubo - ngomhla wesine wesi sifo;
- ukutshatyalaliswa ngokukhawuleza, ukwakheka kwesilonda okanye indawo ye-necrosis - ngomhla we-10 wesibetho.
Isibetho sePulmonary
Le fomu ifunyanwe kwi-5-10% yezigulane, nesifo sesibetho esakhulayo emva kokusuleleka kwe-aerogenic (primary) okanye njengengxaki ye-bubonic (ngasese). Olu luhlu oluyingozi kakhulu, kwaye iimpawu ezithile zesibetho kubantu kulo mzekelo ziphawulwe malunga nomhla 2-3, emva kokuqala kweempawu zokuxilisa. I-agent causative ichaphazela iindonga ze-alveoli ye-pulmonary, ezibangela iziganeko ezibangelwa yi-necrotic. Ukubonakaliswa okuhlukileyo kukuba:
- ukuphefumula ngokukhawuleza, ukuphefumula okufutshane;
- ukukhwehlela;
- ukukhulelwa kwe-sputum - ekuqaleni kwe-frothy, evulekileyo, ngoko-kunye nemivilini yegazi;
- intlungu esifuba;
- tachycardia;
- behla kwixinzelelo legazi.
Ifomu yeSeptic yesibetho
Ifom yokuqala-septic yesibetho, eqhubekayo xa i-dose enkulu ye-microbes ingena kwigazi, ayinqabile, kodwa kunzima kakhulu. Izibonakaliso ezinxilisayo zibonakala zizibane ngokukhawuleza, njengoko i-pathogen isasazeka kuzo zonke iziko. Kukho amaninzi amanxeba ekhumbeni kunye nezicubu ezinamaqabunga, i-conjunctiva, emathunjini kunye nokuphuma kwegazi, ukuphuthuma ngokukhawuleza kokutshatyalaliswa kweso sifo . Ngamanye amaxesha le fom iqhubeka njengenkcaso yesibini yezinye iintlobo zesibetho, esibonakaliswe ngokubunjwa kweebhobho zesibini.
Ifomestinal ifom yesibetho
Akunabo bonke abayingcali abahlula iintlobo zeembilini zesibetho ngokwahlukileyo, ukuyiphatha njengenye yembonakalo yefom ye-septic. Xa isibetho sesisu sisenza izibonakaliso zesifo kubantu abachasene nesimo sokuxhatshazwa kunye nomkhuhlane, oku kubhaliweyo:
- intlungu yesisu;
- ukuhlanza okuninzi ngegazi;
- isifo sohudo kunye nesigxina;
- isisulu esinzima sokukhupha amathumbu.
Inkxalabo - Ukuchonga
Inendima ebalulekileyo edlalwa ukuxilongwa "kwesifo" sokuxilongwa kwebhubhoratri, eqhutywa yiendlela ezilandelayo:
- serological;
- i-bacteriological;
- microscopic.
Ukuze uphando uthathe igazi, i-punctate kwi-buboes, izilonda ezihlukeneyo, i-phlegm, i-oropharynx ehlukileyo, ukuhlanza. Ukuhlolisisa ubukho be-pathogen, izinto ezikhethiweyo zingakhula kwiimfuno ezizodwa zemidiya. Ukongeza, i-X-ray ye-lymph nodes kunye nemiphunga yenziwa. Kubalulekile ukumisa inyaniso yokuluma kwezilwanyana, ukudibanisa nezilwanyana ezigulayo okanye abantu, ukutyelela imimandla yokuphela kwesibetho.
Inkxwaleko - unyango
Ukuba isifo sikhankanywe okanye siyifumene, isigulane siyasibhedlele ngokukhawuleza esibhedlele esichengayo kwibhokisi elikude, apho ngaphandle kokuphuma komoya okungafaki. Ukunyangwa kwesibetho ebantwini kusekelwe kwimisebenzi enjalo:
- ukwamkelwa kwee-antibiotics, kuxhomekeke kwifom yesifo ( Levomycetin , Tetracycline, Streptomycin);
- ukuxilongwa kwe-antioxidants (Albumin, Reopoliglyukin, Gemodez);
- ukusetyenziswa kweziyobisi ukuphucula i-microcirculation kunye nokulungiswa (iTrental, Solcoseryl , Pikamilon);
- unyango lwe-antipyretic kunye nolwazi;
- unyango lokulondolozwa (iivithamini, iziyobisi zenyama);
- i-plasmapheresis - ne-septic lesion.
Ngethuba lexesha lomkhuhlane isiguli kufuneka sithobele ukuphumla kombhede. Ulwaphulo lwe-antibiotics luyenzelwa iintsuku ezi-7 ukuya kwe-14, emva koko uphando olwenziweyo lolawulo lwee-biomaterial. Isigulana sikhululwa emva kokuphulukana okupheleleyo, njengoko kuboniswe ngempumelelo yesithathu. Impumelelo yonyango ixhomekeka kumlinganiselo omkhulu ekufikeleleni kweso sifo.
Amanyathelo okukhusela isifo emzimbeni womntu
Ukuthintela ukusasazeka kwentsholongwane, kwenziwa amanyathelo okukhusela angabalulekanga, kuquka:
- Uhlalutyo lwengcaciso malunga neemeko zesibetho emazweni ahlukeneyo;
- ukuchongwa, ukuhlukaniswa kunye nokunyangwa kwabantu abanomdla wokukhunjulwa;
- Ukukhutshwa kancinci kwezithuthi ezivela kwimimandla engasebenziyo malunga nesibetho.
Ukongezelela, umsebenzi uqhutyelwa rhoqo kwi-foci yendalo: ngokuqwalasela inani lamagundane asendle, ukuphanda kwabo ukufumanisa ibhaktheriya yesifo, ukubhubhisa abantu abanegciwane, ukulwa neentambo. Ngokuchongwa kweso sigulane esisodwa kwiindawo zokuhlala, ezinjalo izenzo zokulwa nobulwelwe zenziwa:
- ukufakwa kwesigxina kunye nokuthintela ukungena nokuphuma kwabantu iintsuku eziliqela;
- ukwahlukana kwabantu abadibana nezigulane zezibetho;
- ukukhutshwa kwesiphene kwi-foci yesifo.
Abantu abadibana nesifo esiyingozi, ngenxa yeenjongo zokukhusela, balawulwa yi-serum yesifo sengxaki kunye ne-antibiotic. Ukugonywa kwesibetho kumntu osisifo sokugonywa kwesigulane kufakwe kwiimeko ezinjalo:
- xa kwintsikelelo yendalo yesifo okanye ekuphumeni okuzayo kwindawo engasebenzi;
- emsebenzini, ezinxulumene nokufumaneka kwimiba yesifo;
- xa kuninzi ukusasazeka kweentsholongwane phakathi kwezilwanyana kwiindawo zokuhlala.
Inkcazo yezobunzima
Ndiyabulela ukuphuhliswa kweyeza kunye nokugcinwa kwamanyathelo okukhusela phakathi, isifo sesibetho asiqhelanga ngokukhawuleza. Kwixesha la mandulo, xa kungekho nkunkuma eyakhelwe le ntsholongwane, ukufa kwaba malunga neepesenti ezilikhulu. Ngoku ezi zibalo azidluli kwi-5-10%. Ngelo xesha, bangaphi abantu abafa kwisibetho ehlabathini kumaxesha adlulileyo, abanokhathazeka.
Inkxwaleko kwimbali yoluntu
Isibetho kwimbali yoluntu sishiye umkhondo owonakalisayo. Eyona nto ixhaphakileyo yilezi zifo:
- "I-Justinian Plague" (551-580 gg.), Eyayiqala eYiputa, apho abantu abangaphezu kwezigidi ezili-100 bafa;
- ubhubhane "lokufa okumnyama" (i-XIV inkulungwane) eYurophu, wehliswa evela eMpuma yeTshayina, eyayibangele abantu abayizigidi ezingama-40;
- isibetho kwiRashiya (1654-1655 gg.) - malunga namawaka angama-700 abantu abafa;
- isibetho eMarseilles (1720-1722) - abantu abayi-100 000 bafa;
- isifo sesibetho (ekupheleni kwekhulu le-XIX) e-Asia - abantu abangaphezu kwezigidi ezi-5 bafa.
Isibetho kwiintsuku zethu
Isibetho se-bubonic namhlanje senzeke kuwo onke amazwekazi, ngaphandle kwe-Australia kunye ne-Antarctica. Ngethuba lokusukela ngo-2010 ukuya ku-2015, iziganeko ezingaphezu kwama-3 ezi sifo zafunyaniswa, kunye nesiphumo esibulalayo sabonwa ngo-584 one-HIV. Amaninzi amaninzi abhaliswe eMadagascar (ngaphezulu kwe-2 amawaka). I-foci yesibetho sele iphawulwe kumazwe afana neBolivia, i-USA, iPeru, iKyrgyzstan, iKazakhstan, iRashiya nabanye. Ubunzima kwimimandla yesifo seRashiya yi: i-Altai, i-Urals yaseMpuma, iStvropol, iTransbaikalia, i-Caspian lowland.