Kev mob ntsws thoob zej zog hauv cov neeg laus

Lub ntsws muaj dej yog ua pa (ua pa) uas muaj tus kab mob ntsws.

Kab lus no yuav piav txog cov mob ntsws muaj nyob hauv zej zog (CAP). Hom kab mob ntsws no muaj nyob rau cov neeg uas tsis ntev los no tau pw hauv tsev khomob lossis lwm qhov chaw saib xyuas kev noj qab haus huv xws li tsev laus lossis chaw kho mob. Kev mob ntsws dej uas cuam tshuam rau tib neeg hauv cov chaw saib xyuas kev noj qab haus huv, xws li tsev kho mob, yog hu ua kev mob ntsws los ntawm tsev kho mob (lossis kev tiv thaiv kev mob ntsws uas cuam tshuam txog kev mob ntsws).

Kev mob ntsws yog ib yam mob uas cuam tshuam rau ntau lab tus tib neeg txhua xyoo hauv Asmeskas. Cov kab mob hu ua cov kab mob, kab mob thiab hu ua fungi tuaj yeem ua rau mob ntsws. Hauv cov laus, cov kab mob yog cov feem ntau ua rau mob ntsws.

Txoj kev koj tuaj yeem mob ntsws muaj xws li:

• Cov kab mob thiab kab mob nyob hauv koj lub qhov ntswg, hlab ntshav, lossis qhov ncauj yuav kis mus rau koj lub ntsws.
• Koj tuaj yeem nqus qee cov kab mob no ncaj qha mus rau hauv koj lub ntsws.
• Koj ua pa (nqus tau) khoom noj, kua, ntuav, lossis dej los ntawm lub qhov ncauj mus rau hauv koj lub ntsws (mob ntsws mob ntsws).

Kev mob ntsws tuaj yeem tshwm sim los ntawm ntau hom kab mob.

• Qhov feem ntau ntawm hom kab mob yog Kab mob ntsws dej liab (mob ntsws).
• Atypical mob ntsws, feem ntau hu ua taug kev mob ntsws, yog tshwm sim los ntawm lwm yam kab mob.
• Cov fungus hu ua Pneumocystis jiroveci tuaj yeem ua rau mob ntsws nyob rau cov neeg uas lub cev tiv thaiv kab mob tsis ua haujlwm zoo, tshwj xeeb yog cov neeg muaj tus kab mob HIV nce siab.
• Cov kab mob, zoo li tus kab mob npaws, thiab feem ntau tsis ntev los no SARS-CoV-2 (uas ua rau KEVID-19), kuj tseem ua rau mob ntsws.

Cov teeb meem pheej hmoo uas ua rau koj muaj feem ntau yuav mob ntsws muaj:

• Mob ntsws ntev (COPD, bronchiectasis, cystic fibrosis)
• Ua luam yeeb
• Dementia, mob stroke, hlwb raug mob, hlwb tuag, lossis lwm yam kev mob hlwb
• Kev tiv thaiv kab mob hauv lub cev (thaum kho mob cancer, lossis vim HIV / AIDS, hloov khoom nruab nrog, lossis lwm yam kabmob)
• Lwm yam mob hnyav ntxiv, xws li mob plawv, mob ntshav siab, lossis ntshav qab zib
• Tsis ntev los no phais lossis mob
• Kev phais mob los kho mob qog nqaij hlav ntawm qhov ncauj, caj pas, lossis caj dab

Cov tsos mob feem ntau ntawm kev mob ntsws yog:

• Hnoos (nrog rau qee qhov mob ntsws koj tuaj yeem hnoos hnoos ntsuab lossis daj, los yog hnoos qeev)
• Kub taub hau, uas tej zaum yuav mob sib khuav lossis siab
• Tuav txias txias
• Ua tsis taus pa (tej zaum tsuas yog tshwm sim thaum koj nce ntaiv lossis siv zog koj tus kheej)

Lwm cov tsos mob muaj xws li:

• Tsis meej pem, tshwj xeeb tshaj yog rau cov neeg qub
• Dhau hws thiab tawv nqaij
• Mob taub hau
• Kev poob qis, tsis muaj zog, thiab nkees
• Malaise (tsis xis nyob)
• Ntse lossis siv pob tw hnoos mob hauv lub siab thaum koj nqus pa lossis hnoos
• Ntsia dawb rau lub ntsej muag ntshav, lossis leukonychia

Tus kws saib xyuas kev noj qab haus huv yuav mloog zoo rau pob txha ntsej muag lossis ua pa txawv txawv thaum mloog koj lub hauv siab nrog lub stethoscope. Kev khawm nrog ntawm koj lub hauv siab (percussion) pab tus kws kho mob mloog thiab mloog zoo rau lub suab tsis zoo hauv koj lub hauv siab.

Yog xav tias mob ntsws yog xav tau kev pab, lub chaw zov me nyuam yuav xoo hluav taws xob xoo lub hauv siab.

Lwm yam kev xeem uas yuav raug txiav txim suav nrog:

• Arterial blood gases seb puas muaj oxygen txaus rau hauv koj cov ntshav los ntawm lub ntsws.
• Ntshav thiab hnoos qeev cov kab lis kev cai los saib rau tus kab mob uas yuav ua rau mob ntsws.
• CBC txhawm rau kuaj cov qe ntshav dawb.
• CT scan ntawm lub hauv siab.
• Bronchoscopy. Lub teeb yoog kom yooj yim nrog lub koob yees duab ntawm lub qhov kawg tso rau hauv koj lub ntsws, hauv qee kis.
• Thoracentesis. Tshem tawm cov kua dej tawm ntawm qhov chaw nruab nrab sab nrauv ntawm lub ntsws thiab lub hauv siab phab ntsa.
• Nasopharyngeal swab txhawm rau tshuaj xyuas rau cov kab mob zoo li khaub thuas thiab SARS-CoV-2.

Koj tus kws khomob yuav tsum txiav txim siab ua ntej koj yuav tsum tau nyob hauv tsev khomob. Yog koj tau mus kho mob hauv tsev khomob, koj yuav tau txais:

• Ua kua dej thiab tshuaj tua kab mob los ntawm koj cov leeg ntshav
• Kev kho mob oxygen
• Ua tsis taus pa kev kho mob (tejzaum nws)

Yog tias koj tau kuaj pom tias muaj kab mob ntsws mob ntsws, nws yog qhov tseem ceeb uas koj yuav tsum pib siv tshuaj tua kab mob sai sai tom qab koj tau txais. Yog tias koj muaj mob voos ua paug, koj yuav tsis tau txais tshuaj tua kab mob. Qhov no vim tias tshuaj tua kab mob tua tsis tau tus kab mob. Koj tuaj yeem tau txais lwm yam tshuaj, xws li cov tshuaj tiv thaiv, yog tias koj mob npaws.

Feem ntau koj yuav tau mus pw hauv tsev kho mob yog tias koj:

• Muaj lwm yam mob loj ntxiv
• Muaj cov tsos mob hnyav
• Saib xyuas tsis tau koj tus kheej hauv tsev, lossis noj tsis taus lossis haus tsis tau
• Laus dua 65 xyoos
• Tau siv tshuaj tua kab mob hauv tsev thiab tsis zoo dua

Coob leej ntau tus tuaj yeem kho hauv tsev. Yog li, koj tus kws kho mob yuav qhia koj kom noj tshuaj xws li tshuaj tua kab mob.

Thaum noj tshuaj tua kab mob:

• Tsis txhob nco cov tshuaj. Noj cov tshuaj kom txog thaum nws ploj mus, txawm tias koj pib zoo.
• Tsis txhob noj cov tshuaj hnoos lossis tshuaj txias tshwj tsis yog koj tus kws kho mob hais tias TSIS TAU. Kev hnoos yuav pab koj lub cev tshem cov hnoos qeev tawm ntawm koj lub ntsws.

Kev ua pa rau huab cua sov, ntub dej noo (ntub) yuav pab ua kom cov leeg hnoos qeev tuaj yeem ua rau koj mloog zoo li txhawm chim. Cov no yuav pab tau:

• Tso cov phuam sov, ntub dej kom xoob dhau koj lub qhov ntswg thiab qhov ncauj.
• Sau lub tshuab cua sov nrog dej sov thiab ua pa ntawm qhov yuam kev sov.
• Siv li ob peb zaug ua pa li 2 lossis 3 zaug ntawm ib teev twg. Kev nqus pa yuav pab qhib koj lub ntsws.
• Kuaj koj lub hauv siab maj mam tso ob peb zaug hauv ib hnub thaum dag nrog koj lub taub hau qis dua koj lub hauv siab. Qhov no pab coj cov hnoos qeev tawm los ntawm lub ntsws kom koj hnoos tawm.

Haus dej kom ntau, tsuav koj tus kws kho mob hais tias TSIS TAU.

• Dej haus, kua txiv, lossis tshuaj yej tsis muaj zog
• Haus tsawg kawg 6 mus rau 10 khob (1.5 txog 2.5 liv) ib hnub
• Tsis txhob haus cawv

So kom txaus thaum koj mus tsev. Yog hais tias koj muaj teeb meem tsaug zog thaum hmo ntuj, noj naps thaum nruab hnub.

Nrog rau kev kho mob, neeg feem coob yuav zoo nyob hauv 2 lub lis piam. Cov neeg laus lossis cov neeg mob hnyav heev yuav tsum tau kho ntev dua.

Cov neeg uas tej zaum yuav muaj tus mob ua pa nyuaj ntau muaj xws li:

• Cov neeg laus dua
• Cov tib neeg lub cev tiv thaiv tsis ua haujlwm zoo
• Cov neeg uas muaj lwm yam mob nhyav xws li mob ntshav qab zib lossis mob ntsws

Hauv txhua cov xwm txheej saum no, kab mob ntsws tuaj yeem ua rau tuag taus, yog tias nws hnyav.

Muaj qee zaus, cov teeb meem loj dua tuaj yeem tsim muaj, suav nrog:

• Lub neej pauv hloov hauv lub ntsws uas xav kom lub tshuab ua pa
• Dej ncig lub ntsws (pleural effusion)
• Muaj kua dej nyob ib ncig ntawm lub ntsws (empyema)
• Lub ntsws ua qog ntshav

Koj tus kws kho mob yuav yuam kom xoo hluav taws xob ntxiv. Nov yog ua kom koj lub ntsws tau pom tseeb. Tab sis nws yuav siv sij hawm ntau lub lis piam rau koj xoo hluav taws xob kom tshem. Koj yuav zoo siab dua ua ntej xoo hluav taws xob ntshiab.

Hu rau koj tus kws khomob yog koj muaj:

• Kev hnoos uas ua rau hnoos ntshav lossis xeb xau
• Ua tsis taus pa (ua pa) cov tsos mob uas heev dua
• Kev mob hauv siab mob heev dua thaum koj hnoos lossis ua pa tawm
• Ua pa ceev lossis mob heev
• Tawm fws tsaus ntuj lossis piav tsis tau ceeb thawj
• Ua tsis taus pa, tshee tshee, los yog tus kheej nquag kub taub hau
• Cov cim ntawm mob ntsws thiab lub zog tiv thaiv kab mob tsis muaj zog (piv txwv li, nrog rau HIV lossis kev siv tshuaj kho mob)
• Ua rau cov tsos mob hnyav tom qab kev txhim kho thawj zaug

Koj tuaj yeem pab tiv thaiv kom tsis txhob mob ntsws yog ua raws cov kev qhia hauv qab no.

Ntxuav koj ob txhais tes kom ntau, tshwj xeeb:

• Ua ntej npaj ua ntej thiab noj zaub mov
• Tom qab tshuab ntswg koj lub tshuab ntswg
• Tom qab mus siv chav dej
• Tom qab hloov menyuam daim pawj
• Tom qab tau ntsib nrog cov neeg muaj mob

Zam txhob nyob ze nrog cov neeg muaj mob.

Tsis txhob haus luam yeeb. Luam yeeb ua rau koj lub ntsws tsis muaj peev xwm tiv thaiv kev kis kab mob.

Cov tshuaj tiv thaiv tuaj yeem pab tiv thaiv qee yam mob ntsws. Nco ntsoov tias koj tau txais cov tshuaj tiv thaiv txuas mus ntxiv no:

• Tshuaj tiv thaiv kab mob khaub thuas tuaj yeem pab tiv thaiv kev mob ntsws uas tshwm sim los ntawm tus khaub thuas.
• Tshuaj tiv thaiv mob ntsws o pab kom koj txoj hmoo mob ntsws muaj dej ntau tuaj Kab mob ntsws dej liab.

Cov tshuaj tiv thaiv tseem tseem ceeb tshaj rau cov laus thiab cov neeg muaj ntshav qab zib, mob hawb pob, mob ntsws, mob HIV, mob cancer, cov neeg uas hloov khoom nruab nrog, lossis lwm yam mob mus ntev.

Cov hlab ntsws ntsws; Kev mob ntsws hauv zej zog; CAP

• Bronchiolitis - paug
• Mob khaub thuas thiab mob aws - yam yuav nug koj tus kws kho mob - neeg laus
• Mob khaub thuas thiab mob aws - yam yuav nug koj tus kws kho mob - menyuam
• Yuav ua li cas ua pa thaum koj tseem ua pa luv
• Cov pa oxygen kev nyab xeeb
• Kev mob ntsws tshwj xeeb hauv cov laus - kev tso tawm mus
• Kev mob ntsws ntawm cov menyuam yaus - tso tawm
• Siv cov pa oxygen hauv tsev
• Siv cov pa oxygen hauv tsev - dab tsi yuav nug koj tus kws kho mob
• Thaum koj tus menyuam lossis menyuam yaus muaj mob kub cev

• Kev ua pa system
• Mob ntsws o
• Ntsia thawv dawb

Daly JS, Ellison RT. Mob ntsws o. Hauv: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, thiab Bennett's Cov Ntsiab Cai thiab Kev Coj Ua ntawm Kab Mob KisCov. 9le ed. Philadelphia, PA: Elsevier; 2020: chap 67.

Musher DM. Txheej txheem cej luam ntawm kev mob ntsws. Hauv: Goldman L, Schafer AI, eds. Goldman-Cecil TshuajCov. 26th ed. Philadelphia, PA: Elsevier; 2020: cha 91.

Wunderunk RG. Cov txheej txheem tswj hwm kev mob ntsws rau zej zog. Clin Hauv Siab MedCov. 2018; 39 (4): 723-731. PMID: 30390744 pubmed.ncbi.nlm.nih.gov/30390744/.