Elephantiasis imadziwika ndi kutupa kwa miyendo, nthawi zambiri miyendo, yomwe nthawi zina imakhudzanso maliseche. Ndi chifukwa chapadera ichi, kupatsa miyendo yapansi ya munthu wokhudzidwayo mawonekedwe ofanana ndi a njovu, kuti elephantiasis amatenga dzina lake. Matendawa amatha kukhala ndi magawo awiri osiyana kwambiri. Chofala kwambiri ndi matenda a parasitic, omwe amapezeka makamaka ku Africa ndi Asia: chifukwa cha filiform parasite, amatchedwanso lymphatic filariasis. Fomu ina, elephantiasis nostras verrucosa, ndi vuto lapadera kwambiri lomwe limagwirizanitsidwa ndi kutsekeka kwa mitsempha ya lymphatic.

Tanthauzo la elephantiasis

Elephantiasis imadziwika ndi kutupa kwa miyendo ya m'munsi yomwe imawoneka ngati miyendo ya njovu. Zakale kwambiri za matendawa zomwe zapezeka zaka zoposa 2000 BC Choncho, fano la farao Mentuhotep II linkaimiridwa ndi mwendo wotupa, khalidwe la elephantiasis, lomwe ndilo chizindikiro cha matenda aakulu omwe amatchedwanso. lymphatic filariasis. Matenda a parasitic awa, omwe amapezeka ku Asia ndi Africa, palibe ku Europe konse.

Mtundu wina wa elephantiasis, womwe umatchedwa Warty elephantiasis yathu, yomwe imapezeka ku France, chifukwa cha kutsekeka kwa mitsempha ya mitsempha, chifukwa cha matenda a bakiteriya kapena ayi. Zimakhala zachilendo kwambiri.

Zifukwa za elephantiasis

Elephantiasis ndi gawo lalikulu la lymphatic filariasis: matenda oyambitsidwa ndi tizilombo tating'onoting'ono, kapena filaria, zomwe timakhala m'magazi a anthu ndi minofu, ndipo zimafalitsidwa ndi udzudzu, vector yawo. Mphutsi izi ndi 90% Wuchereria Bancrofti, mitundu ina ndiyo makamaka Brugia Malayi et Brugia amawopa. Mphutsi ndi microfilariae, zomwe zimakhala m'magazi. Akakula, majeremusiwa amapezeka mu lymphatic system, yomwe ndizitsulo zonse ndi ziwiya zomwe zimathandiza kwambiri chitetezo cha mthupi. Mafilaria omwe amakhala m'mitsempha yamagazi amatambasuka ndi kuwatsekereza, zomwe zimapangitsa kutupa kwa nthambi imodzi kapena zingapo. Izi makamaka zimakhudza zotengera zamitsempha m'munsi mwa thupi, mwachitsanzo mu groin, kumaliseche ndi ntchafu.

Za verrucous elephantiasis, choncho osati chifukwa cha tizilombo toyambitsa matenda, chiyambi cha lymphedemas chikugwirizana ndi kutsekeka kwa mitsempha ya lymphatic, yomwe ingakhale yochokera ku bakiteriya kapena ayi. Lymphedema ndiye kuti imalumikizidwa ndi kutupa kosatha.

Zochitika zina zimatha kuyambitsa njovu: matenda otchedwa leishmaniasis, matenda obwerezabwereza a streptococcal, amathanso kukhala zotsatira za kuchotsedwa kwa ma lymph nodes (nthawi zambiri ndi cholinga choletsa kukula kwa khansa), kapena kulumikizidwabe ndi chilema chobadwa nacho.

matenda

Chidziwitso chachipatala chiyenera kuchitidwa ngati pali chotupa cham'munsi chotupa, kapena ngati kutupa kumawonekera kwambiri pa mwendo umodzi kusiyana ndi wina. Njira yoyamba yodziwira matenda a lymphatic filiarosis ndikukhazikitsa mbiri yokhudzana ndi tizilombo toyambitsa matenda m'madera omwe alipo. Ndiye mayeso a labotale amatha kutsimikizira matenda.

• Mayesowa amatengera kuzindikira kwa ma antibodies.
• Kufufuza khungu kungathandizenso kuzindikira microfilariae. 
• Palinso njira yozikidwa pa ultrasound, mtundu wa ultrasound vascular ultrasound yomwe ingathe kupeza ndikuwona momwe majeremusi akuluakulu akuyendera.
• Njira zodziwira monga kuyesa kwa PCR zimapangitsa kuti ziwonetsere kukhalapo kwa DNA ya tiziromboti, mwa anthu komanso mu udzudzu.
• Lymphoscintigraphy, njira yowunikira mitsempha yamagazi, yawonetsa kuti ngakhale m'magawo oyambilira komanso opanda zizindikiro, zofooka zam'mimba zimatha kupezeka m'mapapu a anthu omwe ali ndi kachilomboka.
• Mayesero a Immunochromatographic ndi ovuta kwambiri komanso enieni kuti adziwe matenda a W. Bancrofti.

Ponena za osowa kwambiri elephantiasis nostras verrucosa, matenda akhoza kupangidwa ndi phlebologist. Amadzizindikiritsa ku chipatala chake.

Anthu okhudzidwa

• Anthu 120 miliyoni padziko lonse lapansi amakhudzidwa, 40 miliyoni omwe ali ndi mawonekedwe owopsa omwe ali ndi mawonetseredwe amthupi a lymphatic filariasis: lymphedemas, elephantiasis ndi hydrocele.
• Matendawa amakhudza makamaka anthu a ku Africa ndi Asia, komanso kumadzulo kwa Pacific. Matendawa alipo koma sapezeka ku America ndi kum'mawa kwa Mediterranean, ndipo ku Europe kulibe konse.
• Akuluakulu, makamaka azaka zapakati pa 30 ndi 40, amakhudzidwa kwambiri kuposa ana, chifukwa ngakhale kuti matendawa amayamba nthawi zambiri ali mwana, ndi akuluakulu omwe filariasis amakhala ofunika, chifukwa cha kutsekeka kwapang'onopang'ono. mitsempha ya lymphatic.
• Milandu ya elephantiasis ku France imatha kukhala ndi zotsatira zoyipa pambuyo pochotsa ma lymph nodes, mwachitsanzo kutsatira khansa.

Zowopsa

Kufala kwa tizilombo toyambitsa matenda mdera lanu kumakhala pachiwopsezo chowonjezereka ngati ukhondo suli bwino.

Chizindikiro chodziwika kwambiri cha elephantiasis ndi kutupa, unilateral kapena mbali ziwiri, za m'munsi miyendo. Kutupa kumeneku kumakhala kofewa komanso kocheperako koyambirira, koma kumakhala kolimba, kapena kolimba kukhudza, mu zotupa zakale.

Odwala amuna, lymphatic filiariasis angadziwonetsere ngati kutupa kwa scrotum kapena hydrocele (thumba lodzaza ndi madzi mu scrotum). Kwa amayi, pangakhale kutupa kwa maliseche, osati kupwetekedwa, pokhapokha ngati mukukumana ndi vuto lalikulu.

Pakhoza kukhalanso zotulutsa, zomwe zimakhala zonunkha.

Zizindikiro zina pa pachimake gawo

• Malungo.
• Ululu m'manja omwe ali ndi kachilomboka.
• Zofiira komanso zowoneka bwino.
• Zosasangalatsa.

Zizindikiro zawarty elephantiasis ali pafupi, ndi nthawi zonse kukhalapo kwa thupi membala kutupa, iwo Komanso yodziwika ndi njerewere pa khungu.

Pali mitundu ingapo yamankhwala ochizira elephantiasis yolumikizidwa ndi tiziromboti:

• Mankhwala mankhwala: ivermectin ndi suramin, mebendazole ndi flubendazole, kapena ngakhale diethylcarmazine, ndi albendazole.
• Chithandizo cha Opaleshoni: Hydrocele imatha kuthandizidwa ndi maopaleshoni, monga kudulidwa. Chiwalo chomwe chili ndi kachilombo chingathenso kuchitidwa opaleshoni, pochotsa ngalande kapena kudula.
• Kutentha mankhwala: The Chinese bwinobwino kuyesa njira yatsopano yochizira lymphedema, amene alternates otentha ndi ozizira.
• Mankhwala azitsamba: Zitsamba zingapo zakhala zikugwiritsidwa ntchito kwazaka zambiri pochiza elephantiasis: Vitex negundo L. (mizu), Butea monosperma L. (mizu ndi masamba), Ricinus communis L. (mapepala), Aegle marmellos (mapepala), Canthium mannii (ma rubiacées), Boerhaavia diffusa L. (chomera chonse).

Pali njira zingapo zochizira matenda a elephantiasis omwe si a parasitic, omwe ndi ovuta kwambiri kuchiza:

• Massage, bandeji, compression.
• Ukhondo wapakhungu.
• Kuchotsa minofu ndi kuwononga opaleshoni.
• Ablative carbon dioxide laser, njira yatsopano yomwe yayesedwa bwino posachedwa.

Mankhwala kupewa filariasis

Mapulogalamu akuluakulu oyendetsa mankhwala m'zaka khumi ndi zitatu zapitazi, malinga ndi World Health Organization (WHO), alepheretsa kapena kuchiza anthu oposa 96 miliyoni. Kuthetsa izi mitsempha yodutsitsa madzi filariasis n'zotheka mwa kusokoneza mkombero kufala kwa tiziromboti.

• Ndipotu, kupereka chithandizo pamlingo waukulu kumadera onse kumene matenda a tizilombo toyambitsa matenda alipo kungathandize kuthetsa kufalikira kwa matenda. Njira imeneyi, yomwe ndi njira yopewera mankhwala, imakhala yophatikiza mankhwala awiri pachaka kwa anthu omwe ali pachiwopsezo.
• Chifukwa chake, albendazole (400 mg) imaperekedwa limodzi ndi invermectin (150 mpaka 200 mg / kg) kapena ndi diethylcarbamazine citrate (6 mg / kg). Mankhwalawa, okhala ndi zotsatira zochepa pa majeremusi akuluakulu, amachepetsa bwino chiwerengero cha microfilariae m'magazi, kapena mphutsi za parasite. Amalepheretsa kufalikira ndi chitukuko cha udzudzu. Mitundu yayikulu ya tizilomboto imatha kukhalabe ndi moyo kwa zaka zambiri.
• M'mayiko omwe tizilombo toyambitsa matenda timatchedwa Loa loa, njira yodzitetezera iyenera kuperekedwa kawiri pachaka.

Egypt ndi dziko loyamba padziko lonse lapansi kulengeza kuthetsa kwathunthu kwa ma lymphatic filariasis, malinga ndi WHO.

Kuwongolera udzudzu wa vector

Kuwongolera tizilombo toyambitsa matenda, udzudzu, kumatha kukulitsa kuyesetsa kuthetsa, kuchepetsa kuchuluka kwa udzudzu, ndikuletsa kukhudzana pakati pa anthu ndi udzudzu. Njira zothana ndi malungo, pogwiritsa ntchito aerosols ndi mankhwala ophera tizilombo, zimakhala ndi zotsatira zopindulitsa pochepetsanso kufala kwa ma lymphatic filariasis.

Kupewa kwawarty elephantiasis

Pankhani ya elephantiasis yosagwirizana ndi tizilombo toyambitsa matenda, ziyenera kukumbukiridwa, makamaka, kupewa kunenepa kwambiri, chomwe ndi chimodzi mwa zifukwa zomwe zimayambitsa chiopsezo.

Pomaliza

Kuchokera mu 1997 kuti njira zonsezi zakhazikitsidwa pofuna kuthetsa matenda a lymphatic filariasis monga vuto lalikulu la thanzi la anthu. Ndipo mu 2000, WHO idakhazikitsa pulogalamu yapadziko lonse yothetsa izi, yokhala ndi zigawo ziwiri:

• kuletsa kufalikira kwa matenda (posokoneza kufalitsa).
• kuthetsa kuvutika kwa anthu omwe akhudzidwa (poletsa kudwala), pogwiritsa ntchito ndondomeko ya chithandizo, kuphatikizapo opaleshoni, ukhondo wabwino ndi chisamaliro cha khungu, kuti apewe kufalikira kwa mabakiteriya.