Botulism Yana da rare kuma mai tsanani guba wanda ya haifar da toxin botulinum, wani neurotoxin wanda ke toshe sakin acetylcholine a mahadar neuromuscular da kuma haddasawa m innaBakteriya ne ke samar da ita Clostridium botulinumAnaerobic spore-forming microorganism wanda ke cikin ƙasa, ƙura, koguna da tekuna. Ba a yaɗuwa daga mutum zuwa mutum, amma yana iya tasowa daga gurɓataccen abinci, raunuka, mamayewar hanji da kuma, musamman, daga hanyoyin likita ko shakar guba.
Menene botulism da nau'ikansa?
Akwai daban-daban na botulism dangane da yadda gubar ke shiga jiki: alimentary (ciwon abinci mai ɗauke da guba a cikin mahalli mara ƙarancin iskar oxygen, kamar abincin da aka kiyaye gida), saboda raunuka (spores suna mamaye rauni kuma suna haifar da guba); yaro ko daga jariri (spores germinate a cikin baby's balagagge hanji), iatrogenic (saboda wuce kima alluran guba don dalilai na likita / ado) da ta hanyar inhalation (mai wuya sosai kuma yana haɗuwa da toxin aerosols). Spores suna mai tsananin zafi, yayin da guba yake mara aiki tare da ci gaba da tafasa.
Alamun ta nau'in da alamun gargadi
en el botulism na abinci Alamun yawanci suna farawa tsakanin Awanni 12 da 36 bayan an sha (daga 'yan sa'o'i zuwa kwanaki da yawa dangane da kashi): bushe baki, hangen nesa ko biyu, faduwar fatar ido, wahalar magana da hadiyewa, kasa mai ma'ana rauni, damuwa na numfashi, baya ga tashin zuciya, amai y Colic. A cikin rauni botulism bayyanar cututtuka sun bayyana a ~10 kwana kuma suna kama da haka, ba tare da buƙatar yin ja ko kumbura ba. A cikin jariri Alamar farko da aka saba ita ce maƙarƙashiya, biye hypotonia (motsi-tsitsi), tsotsa mai rauni, fatar ido ptosis, zubarwa, haushi y parálisis. A cikin iatrogenic akwai iya zama ciwon kai, rauni o Shanyewar fuska. da inhalation botulism gudu bayan 1-3 kwanaki tare da irin wannan bayyanar cututtuka.
Wasu alamomi yawanci rashin halarta a cikin botulism: zazzabi, alamar tachycardia o Ƙara hawan jini. Nemi kulawar gaggawa Idan akwai tuhuma: magani na farko yana inganta rayuwa kuma yana ba da damar sa ido kan lafiyar jama'a don kunna.
Janar alamomin nau'ikan nau'ikan botulism 3:
- Riƙewa mai narkewa.
- Paralysis na tsarin juyayi.
- Cututtukan numfashi.
- Shanyewar tsokoki na kai.
- Wahalar magana da hadiyewa.
- Raunin jijiyoyi.
- Sumewa.
- Bushewar baki da harshe.
- Rage hawan jini.
- Burin gani.
- Dizziness
Dalilai, abinci da mahallin haɗari
La kwayoyin cuta botulinum girma a ciki ƙananan yanayin oxygen da sharuɗɗa masu kyau don da zazzabi, pH y Sal. Ba ya haifar da guba a ciki pH <4,6An danganta guba da low-acid gwangwani kayan lambu (koren wake, alayyahu, namomin kaza, beets), kifi (fermented, salted, smoked ko vacuum-cushe; nau'in E na iya haifar da guba ko da a ~ 3 ° C), warkewar nama y gasa dankali a nannade cikin tsare. Su ma sun shiga hannu man da aka zuba tafarnuwa y barkono. Dandano ko kamshi ba kullum suke cin amana ba da guba.
da spores tsira dogon dafaffe, amma an lalata su da magunguna 121 ° C a cikin marufi mai matsa lamba. The toxin eh ba a kunna shi ta tafasa a >85 ° C na minti ≥5 kuma za'a iya ragewa ta hanyar sake dumama da kyau kafin amfani. A cikin jarirai, tushen na iya zama miel ko ƙura/ƙasa. A cikin raunuka, rauni ko amfani da miyagun ƙwayoyi na allura (misali, baƙar fata irin tabar heroin).
Bayyanar cututtuka da magani
Sakamakon ganewar asali shine asibiti kuma an tabbatar dashi gano guba a cikin jini, stool ko abinci, ko al'adar botulinum a cikin feces/rauni. The electromyography yana goyan bayan ganewar asali kuma yakamata a cire shi bugun jini, Guillain-Barré ciwo y myasthenia gravis. Idan ana zargin aerosol yana da haɗari. cire tufafin, jaka shi kuma yi shawa/shafewa.
An ba mutanen da aka gano suna da botulism a magani tare da antibodies (botulinum antitoxin) cewa neutralizes zagayawa guba amma ba ya juyar da lalacewar da aka riga aka kafa, don haka dole ne a fara da wuri-wuriYa danganta da tsananin lamarin. enemas da / ko lavage na ciki don hana sha da guba a cikin tsarin narkewa. A cikin raunin botulism, maganin rigakafi kuma mai yiwuwa lalata; a jarirai, ana amfani da shi musamman immunoglobulinYawancin marasa lafiya suna buƙata inji iska y farfadowaAkwai maganin rigakafi, amma amfaninsa yana da iyaka.
Matsaloli da tsinkaya
Barazana nan take ita ce gazawar numfashi saboda shanyewar tsokoki na numfashi. Yawan lokuta sun haɗa da matsala hadiye, kasadar ciwon huhu da kuma rauni mai tsawoTare da kulawa mai zurfi da farkon antitoxin hasashen yana inganta sosai, kodayake farfadowa na iya buƙata makonni ko watanni.
Rigakafin abinci da aminci
Mahimman matakan sun haɗa da: bakara kiyayewa karkashin matsin lamba ~ 121 ° C lokacin da ya dace dangane da abinci (minti 20-100), tafasa minti 10 kafin yin hidima, firiji bayan budewa, jefar da marufi kumbura ko tare da wari mara kyau, cinye dankali a aluminum zafi ko sanyaya su ba tare da nannade ba, kuma a ajiye zuba mai cikin sanyi ki watsar dasu 4 kwanakin. kiyaye raunuka masu tsabta da gujewa magungunan allura. Kada ku bayar zuma ga yara 'yan kasa da watanni 12. Don hanyoyin tare da toxin botulinum, je zuwa ƙwararrun masana. Barkewar cutar ba kasafai ba ne, amma ana bukata sanarwa da sa ido hadewa.
Botox da iatrogenic botulism
Botox yana da amfani Botulinum toxin type A sosai tsarkake a allurai kadan kadan don dalilai na ado da kuma hanyoyin warkewa (migraine, spasticity, blepharospasm, hyperhidrosis). A hannun kwararru shi ne lafiya, ko da yake yana iya haifar da da wuya rauni ko yanayin da ya dace da iatrogenic botulism.
A cikin yanayi na abubuwan da ba a saba gani ba ba tare da sanin haɗin gwiwa a cikin ɗan gajeren lokaci ba, hasashe na fallasa da gangan, wanda shine dalilin da ya sa daidaitawa tare da lafiyar jama'a yana da mahimmanci.
Wani nau'in botulism da ba kasafai ba zai iya faruwa daga inhalation na gubobi, tare da bayyanar cututtuka bayan kwanaki 1-3; idan ana zargin, guje wa ƙarin bayyanarwa kuma yi ƙazanta na asali.
fahimtar da hanyoyin fallasa, don ganewa farkon bayyanar cututtuka kuma amfani matakan tsaro a gida yana rage haɗari; don ƙarin koyo game da yadda za a hana shi, a cikin yanayin kowane zato, kulawar likita na farko yana haifar da bambanci.
