Shifoxonadan tashqari pnevmoniyaning kattalarga uchraydigan klinik xususiyati
Keywords:
shifoxonadan tashqari pnevmoniya, pnevmokokklar, T - va B-limfotsitlar, mikrobiologik va immunologik parametrlarniAbstract
Shifoxonadan tashqari zotiljamgagi usullarda klinik ko’rinish haqida zamonaviy g’oyalar va uning tashxisini ta’kidlash kerakki, pnevmoniya kasallik yuzaga kelgan sharoitlarga qarab ikki turga bo’linadi. Zamonaviy qo’llanmalar "atipik pnevmoniya" atamasidan uzoqlashishni va "atipik patogenlar oqibatida pnevmoniya" tushunchasini qo’llashni taklif qiladi, chunki shifoxonadan tashqari pnevmoniyaning tabiatini to’liq aniqlash mumkin emas. Pnevmoniyaning klinik ko’rinishi yaxshi o’rganilgan va odatda febril va subfebril raqamlarga, yo’talga, balg’am mahsulotlariga harorat ko’tarilishi kabi xususiyatlardan iborat. Nonspesifik klinik ko’rinishlarga umumiy simptomlari umumiy darmonsizlik, adinamiya, bosh og’rig’i, miyalgiya, ishtahani yo’qotish, ko’ngil aynishi, terlash kabi umumiy intoksikatsion sindrom kiradi. Ko’pincha bu sindrom kasallikning og’irligini ko’rsatadi va bemorda yiringli yoki septik asoratlar paydo bo’lganda kuchayadi. Quyidagicha immunitet tanqisligi bo’lgan bemorlarda alohida pnevmoniyani ajratish davlatlar. Ushbu yondashuvning haqiqiyligi boshqacha pnevmoniya sabablari va antimikrobiyal kemoterapi tanlash uchun turli yondashuvlar. Yaqinda tibbiy yordam bilan bog’liq pnevmoniya (healthcare-associated pneumonia) tobora ko’proq izolyatsiya qilingan. Ushbu turkumda qariyalar uylarida yoki boshqa uzoq muddatli parvarishlash muassasalarida bo’lgan shaxslarda pnevmoniyani o’z ichiga oladi; so’nggi uch oy ichida oldingi antimikrobiyal terapiya tarixi yoki so’nggi 90 kun ichida ikki kundan ortiq kasalxonaga yotqizilganda. Kelib chiqish shartlariga ko’ra, bunday pnevmoniya shifoxona sifatida qaraladi. Biroq, ular patogenlarning tarkibi va ularning antibiotik qarshiligi profilida farq qilishi mumkin.
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