Ukuxilongwa ngokuchanekileyo akuzange kube lula kwi-aspergillosis, kodwa izixhobo zanamhlanje ziphuhliswa ngokukhawuleza kwaye ngoku ziphucula isantya kunye nokuchaneka kokuxilongwa. Isigulana esiza ekliniki siya kucelwa kuqala ukuba sinike imbali yeempawu esizibonileyo. Ngokuxhomekeke kule mbali inani leemvavanyo lingacelwa kolu luhlu lulandelayo:
- Uvavanyo lwegazi
- I-X-ray okanye i-CT scan yesifuba
- Uvavanyo lwesikhumba lokulinganisa ubuntununtunu kwiAspergillus allergener
- Inkcubeko kunye nohlalutyo lwesampulu yesikhohlela (mucus).
- Inkcubeko yolwelo lwethishu umz. ulwelo lwemiphunga (olubizwa ngokuba yiBAL)
- I-bronchoscopy - apho ityhubhu eguquguqukayo idluliselwa emiphungeni ngelixa iphantsi kwe-sedation.
- Isampulu okanye i-biopsy yobunzima bethishu (ukuba ikhona) kumngxuma wemiphunga
Zibonisa ntoni iimvavanyo?
Ukuhlolwa kwegazi: Amajoni achaseneyo I-Aspergillus Iiproteni zinokulinganiswa egazini lesigulana kwaye oku kubonisa ukuba isigulana sinokuba nalo I-Aspergillus usulelo – oku kwenziwa kusetyenziswa i uvavanyo lwe-immunosorbent (ELISA), njenge-ImmunoCAP® Uvavanyo lweGazi lwe-IgE oluthe ngqo.. Isiphumo esihle sithetha ukuba izilwa-buhlungu zokungunda zifunyenwe. Iziphumo zovavanyo oluqinisekileyo zikwaluphawu oluluncedo kuthelekiso lwamva ukuvavanya ukusebenza kakuhle konyango. Ngamanye amaxesha iziphumo zobuxoki zinokuthi zenzeke yiyo loo nto uninzi lweemvavanyo ezahlukeneyo zisetyenziselwa ukuxilongwa kwe-aspergillosis. Ngamanye amaxesha iimpawu zokwaliwa I-Aspergillus ziqinisekile egazini. Uvavanyo lwemolekyuli ethile yokungunda ngamanye amaxesha ifumaneka egazini - ebizwa ngokuba yi uvavanyo galactomannan inokuqhutywa kwakhona kwisampulu yegazi.
Ezinye iimvavanyo ziquka inani legazi, i-plasma viscosity kwaye Iproteni esebenzayo, enokuthi ibonise ukuvuvukala - abamakishi abanjalo ngokuqhelekileyo baphucula unyango ngoko inqanaba elisisiseko liyanceda. Iimvavanyo zesibindi kunye nezintso zibalulekile njengoko ukusebenza kwesibindi kunokungaqhelekanga kumachiza e-antifungal. Kwakhona, ezinye izigulana ze-aspergillosis zinokuba namazinga aphantsi ento ebizwa ngokuba yi-aspergillosis Imannose ebopha i-lectin (MBL) kwaye ibonise imfuza engaqhelekanga yale proteni.
A X-reyi yesifuba ivumela ukubonwa kwengaphakathi lemiphunga kwaye inokuchonga into engaqhelekanga efana nayo nayiphi na imingxuma emiphungeni - eyenziwe ngenxa yesinye isifo esisisiseko okanye usulelo, okanye ukuba Ibhola lomngundo (aspergilloma) ikhona. Kusenokufuneka umfanekiso ongaphezulu wecandelo elinqamlezileyo lemiphunga, apho ke kunokwenzeka i-computer tomography (CT) kunokuba yimfuneko. Inkqubo ixhomekeke kwiX-reyi ukuvelisa umfanekiso oneenkcukacha. Kuya kufuneka ulale ungashukumi kwitafile emxinwa, etyibilika kumbindi we-CT scanner apho iiX-reyi zijikeleza ngakuwe. Ukuskena ngokuqhelekileyo kuthatha imizuzu embalwa kuphela.
A uvavanyo lolusu apho inaliti encinci isetyenziselwa ukukrwela umphezulu wolusu ingasetyenziselwa ukubona ukuba isigulana sinezilwa-buhlungu ze-IgE ezijikelezayo. I-Aspergillus. Olu luvavanyo oluxhaphake ngakumbi ukuba unesifuba okanye i-ABPA. Isiphumo esihle sibonisa ukuba isigulana siyathuthuzelwa I-Aspergillus. Jonga amajoni omzimba.
A isampuli yesikhohlela, olunye ulwelo lwethishu okanye iithishu biopsies zinokuthunyelwa elabhoratri ukuze zikhuliswe, ukuze kubonwe ukuba kunokwenzeka ukukhula. I-Aspergillus ukusuka kwisampulu. Izazinzulu zisebenzisa ipleyiti yenkcubeko ekhethekileyo ukukhulisa ukungunda, kwaye ukuba kukho nakuphi na okukhulayo zisebenzisa imakroskopu ukuqinisekisa uhlobo lokungunda. Enye indlela yokuqonda I-Aspergillus inendlela yovavanyo lwemolekyuli enovakalelo.
A ibronchoscopy yinkqubo apho ityhubhu eguquguqukayo idluliselwa emiphungeni ukujonga imiphunga kunye neendlela zomoya - isigulane sihlaliswa ngexesha lenkqubo. Iisampulu zethishu yemiphunga okanye ulwelo lunokwenziwa nge-biopsied nge-bronchoscope ukuze luhlolwe elabhoratri ngovavanyo lwenkcubeko kunye ne-molecular, ukuba kuyimfuneko. bona ngaphezulu.
Izinto eziphilayo ziisampulu ezincinci zeethishu ezithathwe kwiindawo ezosulelekileyo (umzekelo, imiphunga, i-sinus) ezisikwe kancinci, zinebala kwaye zihlolwe phantsi kwemakroskopu, okanye zibekwe kwimithombo yezondlo ezivumela ukuba nakuphi na ukungunda okukhoyo kukhule - umngundo unokuchongwa.
Iziphumo zolu vavanyo lungentla ziqwalaselwe kunye kwaye ukuba i-aspergillosis iqinisekisiwe unyango olufanelekileyo luya kuqaliswa.
Iimpawu:
Iimpawu zinokwahluka ngokubanzi ngokuxhomekeke kuhlobo lwe-aspergillosis esinokuba nalo umguli. Umzekelo, esinye isigulana esine-aspergilloma sinokuba neempawu ezimbalwa okanye ukhohlokhohlo, esinye sinokukhohlela igazi elininzi (i-haemoptysis) kwaye sifune unyango olungxamisekileyo. kukho umahluko omkhulu phakathi kwezigulane.
- ukuhla ukusinda
- ukukhathala
- umkhuhlane
- ukhohlokhohlo
- ukukhohlela igazi (hemoptysis)
- ukuphefumla
Isigulana esinezinye zezi mpawu sisenokungabi nayo i-aspergillosis – eneneni ayinakwenzeka loo nto, ngaphandle kokuba umntu lowo unenkqubo yokuzikhusela ebuthathaka (umz. ukulandela unyango lomhlaza, uqhaqho-fakelo lwamalungu). Ukuba umntu akakaphenduli kwiidosi ezininzi zamayeza okubulala iintsholongwane kwaye unenkqubo yomzimba yokuzikhusela ebuthathaka ngoko uvavanyo lwe-aspergillosis kufuneka luqwalaselwe.