Sputum: whāinga me ngā tikanga

tukua sputum ngaro te i roto i mumura o te pukorokoro, bronchi me pūkahukahu. Tona ahua tohua ki te hinga o te pūnaha romahā kore anake, engari ano hoki mo te ngakau me disorders iaia. Methods sputum ngā macroscopic, mōkitokito, me te matū whakamāramatanga o ona āhuatanga.

heheu Tātaritanga e

hanga sputum taea reira ki te kitea microorganisms e meinga tukanga mate, tautapa i te aroaro o te Mycobacterium kohi, ki te tāutu i ngā pūtau mate pukupuku, poke toto me te purulent, a hoki ana ki te whakatau i ātete kitakita ki paturopi.

I raro i te tātari aha whakaaturia tikanga te

Sputum i roto i te tātari whānui whakamana i raro i nga tikanga e whai ake nei:

• mare;
• mumura o nga pūkahukahu;
• mumura o nga bronchi;
• pūkahukahu whēwhē;
• kohi;
• bronchiectasis;
• kikohangatia pūkahukahu;
• pūkahukahu puku;
• Bronchitis i roto i te puka whakapeka;
• Bronchitis;
• i roto i te tonsillitis ma'i;
• kohi;
• mare;
• silicosis;
• puka whakapeka o Bronchitis taunutia;
• mumura o nga pūkahukahu;
• mua.

takanga Survey

Uku ka kia pai tohaina, ki te i runga i te mahana i mua i te tukunga ki te tango i te taputapu tātari mo expectoration, ranei pau nui o inu mahana. I mua i te kohikohi tūtohutia ki te horoi i te niho, me te kōhao-waha, i horoia te reira ki te wai mahana kohuatia.

ture Basic mō te kohinga

Kohikohi sputum hoki e hiahiatia ana whakamātautau bacteriological te ki te whakaputa i roto i te ata (kohikohi ia te po i mua i te kai) i roto i te ipu horomata, puta nei i te taiwhanga. Hoki te tātaritanga o te nui nui o 5 ml. hanga Tātaritanga o secretion te kore i muri i te 2 haora i muri i to ratou kohinga. Tae noa kia pupuri i kati te kau o te tuku ki te ako i te tirotiro o te ipu i te pouaka.

Ko te nui o te sputum i tini o nga mate

rerekē Tau secretion tohaina i runga i te āhua o te tukanga pathological rānei. Tikanga, rerekē te reira i te kei tuwhaina torutoru ki te 1 rita ia ra. tukua te nui iti te i roto i te mumura o te bronchi, ngā tukanga congestive timata ki te pūkahukahu, me te whakaeke huangō arahau. I te mutunga o nga piki rōrahi whakaeke. E nehenehe te reira ki runga ki te 0.5 rita, ka tu i roto i tau nui, ki te reira he edema pūkahukahu.

tukua nui hūpē te i te tukanga purulent i roto i te pūkahukahu, ka kōrero ki te bronchi, ki pukupuku, bronchiectasis me te kikohangatia.

E whakaatu ana TB sputum pūkahukahu kiko pirau. I roto i ngā, e whakaoho ana i te tukanga taua he kōhao e fetu'utaki ki te bronchi.

Mai te mea kua meinga he hekenga hua ranei i roto i te secretion wehe

kia secretion papī nui ake kia pā ana ki te huru ino o te manawanui, me te aroturuki i roto i exacerbation. kia hoki te hua tirohia ki te akiaki pai o te whanaketanga o te mate.

Whakaiti i te nui o hūpē huna ana e taea tohu inenga o te mumura ofatiraa ranei i roto i te kōhao pana ki tonu i te pirau. I roto i tenei take, te ino o te hauora manawanui.

āhua o te rere

tu secretion mucous mō te Bronchitis i roto i te puka whakapeka ma'i ranei o huangō arahau, kakā, mate pukupuku, te pukupuku o te pūkahukahu, bronchiectasis, pūkahukahu whēwhē hydatid, haere tahi i te suppuration, actinomycosis.

kitea sputum ki te hawhekaihe o te pirau te i roto i te pukapuka whēwhē, bronchiectasis me echinococcosis.

i konatunatua hūpē ki te toto ranei arā, katoa o te toto āhuatanga o te mate kohi. Ko te ahua o te toto e taea tohu i te aroaro o te mate pukupuku, bronchiectasis, pūkahukahu pukupuku e tupu. Ano, kitea te tītohunga taua e i roto i te syndrome taupa waenganui, infarction myocardial i te pūkahukahu, whētuki, actinomycosis me pāpaka syphilitic. kia Toto kakā taratahi me te lobar me rahi, ngā tukanga congestive, huangō cardiac me te edema pūkahukahu.

kitea sputum Serous te i roto i te edema pūkahukahu.

tae sputum

heheu sputum whakamātautau reira rerekē tae. e kore e rere mucous me serous i te tae kotahi ranei i te hue repa.

Hono pirau homai whakawhirinaki hue puwhero e faaite i te tukanga pathological pērā i pūkahukahu whēwhē, kikohangatia, bronchiectasis, pūkahukahu actinomycosis.

Tīpakonga ki te pa o te waikura tae parauri ranei tohu e roto i ratou kahore toto hou, me ona hua pirau - hematin. Ka taea te tukua tenei mea ngaro ki lobar kakā, Anthrax, infarction pūkahukahu.

tae puwhero ki te pa o te paru kōwhai taunakitanga ngaro o mate romahā i roto i ngā ki jaundice ranei.

poke te tae kōwhai kanapa o te sputum te ki kakā eosinophilic.

Hūpē kōkōwai puta i roto i te siderosis ngāwari.

tuhia ngaro mangu grayish ranei te aroaro o poke waro puehu. A, no te kite pūkahukahu edema sputum serous i roto i ngā tau nui. Ka rite ki te tikanga, kua pania reira tae kaupae māwhero tika ki te aroaro o ngā pūtau toto whero. wehenga wai pērā rite karani wai.

Pania kēne ngaro me etahi taero. Hei tauira, paturopi "Rifampicin" Ka taea e hoatu a reira i te tae whero.

kakara

Ko te āhua o te tukanga pathological i roto i te wahi romahā kia tohu secretion me te kakara. Sputum homai te haunga o te pirau ki kikohangatia o te pūkahukahu ngōrahi ranei pāpaka e pirau, mate pukupuku, te pukupuku, necrosis te fifi bronchiectasis.

Ko te aroaro o paparanga

E mea pinepine te ako heheu te aroaro o secretions papa. A, no te kite maremare whakaroau ki te hawhekaihe o te pirau i te hakihaki pukapuka, me te bronchiectasis.

Ko te mea ngaro ki te pirau hawhekaihe kei toru papa. He rite ki te pahuka i reo serous, me te doped raro ki pirau te kahu o runga. āhuatanga he hanganga taua e kikohangatia pūkahukahu.

poke

Ka taea te kite hawhekaihe o kai i roto i te aroaro o te puku mārere o te pū kai i runga i tona kōrero ki te bronchi me pukorokoro. I muri i te whakapā atu ki tapeworm i roto i te bronchi i roto i te sputum taea te kitea ranei matau scolex te werau. Tino uaua kitea ngā pakeke o te Ascaris e tomo te pūnaha romahā i roto i te iwi immunocompromised.

puta pūkahukahu cysts whiore hua manu i whati i hanga e te i roto i te pūkahukahu i te aroaro o pirinoa.

Kikohangatia me pūkahukahu whēwhē meinga te ahua o nga wahi o te pūkahukahu necrosis. A, no te pea pukupuku hakari i roto i ona secretions whatiwhatinga.

E kitea Convolution kei roto pūtōtepe i roto i te tūroro ki te fibrinous Bronchitis, mate kohi me te kakā.

Rice arotahi kuao kau Koch kohi tūturu ranei.

Puru Dietrich, tae atu ki ngā hua whāwehe o huakita me ngā pūtau pukapuka kiko waikawa ngako, puta i roto i te Bronchitis e pirau kikohangatia pūkahukahu ranei.

puka tonsillitis ma'i tā wehenga i tonsils hiko rite ki puru Dietrich.

Ko te tikanga matū

tikanga matū sputum tā whakatau:

• taupū pūmua, e taea te āwhina i roto i te tātaritanga pārōnaki o te puka ma'i o te Bronchitis me te mate kohi. Bronchitis puka ma'i tohua tohu ngaro o te pūmua, a ka waiho nui teitei i roto i pāpaka tubercular o te nui o te pūmua i sputum, a kia tohu ai i ngā tau (ki runga, ki te 100-120 g / l).
• uhi ate. E kitea ratou i roto i te sputum i te hinga o te pūnaha romahā i roto i ngā ki kakā. I roto i tenei take fetu'utaki te ate ki te pūkahukahu. uhi ate he kakā tūturu meinga e te i tiango o te pūkahukahu roto nga erythrocytes me te huringa muri i roto i te pūtoto.

tikanga rangahau ngaro Cytological

Hoki te tātaritanga pārōnaki o mate kohi, me te maha atu pāpaka pūkahukahu ko reira tikanga pap whānui whakamahia, e ngā o e rua ngā wāhanga: whakamātautau haumanu, me te mōkitokito o te sputum.

tauturu rangahau Haumanu whakatau e tikanga kia kohia rauemi ki te whiwhi i te hua tika o te tātari.

E rua ngā momo matua o rauemi, e titau te whakamātautau mōkitokito o te sputum: māhorahora, me te iti. whiwhi te momo tuarua o secretion ko te mana o ngā whakaohooho (mo māngai expectoration, inhalations me te rite. D.).

Material whiwhi e te unuhanga ngira

whakamātautau Cytological o sputum tā te ako o te whakamātautau macroscopic me mōkitokito o ona pūtau.

tangohia te nuinga o te mōhiohio mō te tātari cytological o sputum kua i roto i te ata i runga i te puku kau. I mua ki te ako kia penapena reira kaua e nui ake 4 haora.

• I roto i te sputum puta pūtau epithelial squamous, e kua ako microscopically. Ko mo te tātaritanga, kahore o ratou tikanga. pūtau epithelial hanga tīwae - e rua kotahi, me te i roto i te rōpū - e taea te kitea i roto i mate pērā i huangō arahau, Bronchitis me te mate pukupuku pūkahukahu. Kia mōhio kia puta te epithelium hanga tīwae tika ki te kătahi o te hūpē nasal.
• macrophages kauae He pūtau reticuloendothelial. E kitea Macrophages i roto i te cytoplasm (matūriki puehu pūtau phagocytic ranei) e taea te kitea i roto i tūroro e whai puehu wā roa-hau.
• protoplasm Macrophages (i hanga e te rärangi o te pūtoto) koha ngakau i huaina pūtau. Ka taea e ratou puta i roto i ngā tukanga whakaroau i roto i te pūkahukahu, stenosis piha mitral, infarction pūkahukahu.

• He maha iti o leukocytes roto i roto i tetahi sputum. Ratou ihirangi tiketike o tuhia i roto i te hawhekaihe me te pirau secretion.
• Eosinophils. Taua pūtau hūpē taonga i roto i asthmatics. kia tohua Pūtau ki te ahua o pāpaka kakā eosinophilic kaiao helminths, mate kohi me te infarction pūkahukahu.
• Erythrocytes. e kore e takitahi pūtau toto whero whakaatu te pikitia o te mate. Ko te putanga o te nui nui haere o taunakitanga o te aroaro o toto i roto i te pūkahukahu. whakaritea nga erythrocytes toto hou tamau. Ki te kahore he he hawhekaihe o toto, i stagnated i te pūkahukahu mo te wa roa, kitea erythrocytes leached.
• pūtau Cancer. Ka taea te kitea ratou i roto i ngā rōpū ngaro. tohu ratou te aroaro o te puku. A, no te e kotahi koutou ko maha pūtau te uaua i roto i te tātaritanga. I roto i ngā take pēnei i, he anō-tātaritanga o sputum.
• muka rapa, kua meinga e te parariraa o te pūkahukahu kikokiko, kohi whakapataritari, whēwhē, kikohangatia, puku nei ahua. e kore e āhuatanga tonu kikohangatia taua pūtau rite tika ana ki te mahi o whākōkī, e he matatapu, kia rewa ai ratou.
• Kurshmana tōrino. Tenei tinana motuhake, rite ki te ngongo. E kitea ratou i roto i te ako i raro i te karu. I te tahi taime kite, me te kanohi. Tikanga Helix mate tūturu pērā i huangō arahau, mate kohi pūkahukahu me te kakā.
• E kitea Charcot-ka pa o tioata i roto i te sputum ki te ihirangi tiketike o eosinophils i roto i enei pāpaka, rite huangō arahau, kakā eosinophilic. pakarutanga kohi tūpāpaku i roto i te lumen o te bronchi kia āhuatanga e te aroaro i roto i te secretion o rapa tioata muka cholesterol, me MBT kotakota amorphous (te pera-ka karanga tetrad Ehrlich) - 100%.

Ko te whakamahi o te Microscopy

Kohinga o sputum pani Microscopy mo te ako o te tikanga tā te tātari o secretions mo rapunga o te Mycobacterium motuhake ki te mate kohi. He rite ki te kikokore ratou, matotoru i runga i te taha ranei te waenganui ānau rakau o roa rerekē, e kua ineine rua putawa, me i roto i ngā rōpū.

e kore te mea he āhuatanga tino mo te tātaritanga Haurapa o Mycobacterium kohi, me te titau te haamauraa i te tikanga bacteriological. e kore e taea te kitea kohi Mycobacterium i te tere o te ngaro.

Ko te pūtake mo te tātari e kua tangohia matūriki purulent i roto i o e wha tekau ono ngā wāhi rerekē, me te triturated tae noa pihanga maheni rua. Next, kua maroke ratou i roto i te rangi, ka whakaritea e te mura pūwera.

whakamātautau Bacteriological o sputum Ziehl-Nielsen poke fokotuu reira i roto i te whero. I roto i tenei take, nga mea ngaro katoa o te matūriki, me te haunga o mycobacteria, tau ana Āroha ki puru, a ka riro whero mycobacteria.

A, no te whakapae kohi kaiao lesion i muri i toru rangahau mo te aroaro o te mycobacteria ki te whakautu kino kua haere ki te whakamahi o te tikanga tēnei waka (tātari Pottenger).

Ko te ara mua ki te ako MTB pani ōpure homai he hua pai anake, no te te maha o MTB iti rawa 50 000 wae ia 1 ml o te sputum. E ai ki te maha o te Mycobacterium kohi ki te whakawa aroaro taea.

tūroro Bacterioscopy ki nonspecific mate pūkahukahu

rangahau taiwhanga o sputum i te aroaro o kore-tauwhāiti pūkahukahu mate i te Microscopy taea whakakitea te huakita e whai ake nei:

• A, no te mumura o te pūkahukahu - pneumococci, diplococci Frenkel, Friedlander huakita, streptococci, staphylococci (100%).
• A, no te taea te kitea kikohangatia marama tokotoko muka i roto i ngā ki spirochaete Vincent (80%).
• harore rewena (70%), ki te whakatau i te momo i titau i te uri ngaro.
• actinomycete Drusen (100%) i actinomycosis.

Ko te rōrahi o te secretion i roto i te iwi hauora

Displacement o hūpē huna ana te pukorokoro me bronchi i roto i te tangata e kore e te mamae tetahi pathologies, mai i te 10 ki te 100 ml / ra.

Tikanga taumata iti o leucocytes, he ako i runga i mycobacteria pani poke homai he hua kino.