Вумбилдинг в Уфе

- Медицинская Справочная Уфы

Муковисцидоз


Муковисцидоз_2.jpgМуковисцидоз представляет собой системное наследственное заболевание, при котором поражаются экзокринные железы. Причиной муковисцидоза является генная мутация, передающаяся по аутосомно – рециссивному типу.

Выделяют следующие основные формы муковисцидоза:

- смешанная (легочно-кишечная, 75-80%)

- респираторная (15-20%)

- кишечная (5%).

Причины

При развитии муковисцидоза основными являются три основных момента: поражение желез внешней секреции, изменения со стороны соединительной ткани, водно-электролитные нарушения. Причиной муковисцидоза служит генная мутация, в результате которой нарушается строение и функции белка МВТР (трансмембранного регулятора муковисцидоза), участвующего в водно-электролитном обмене эпителия, выстилающего бронхопульмональную систему, поджелудочную железу, печень, желудочно-кишечный тракт, органы репродуктивной системы.

При муковисцидозе изменяются физико-химические свойства секрета экзокринных желез (слизи, слезной жидкости, пота): он становится густым, с повышенным содержанием электролитов и белка, практически не эвакуируется из выводных протоков. Задержка вязкого секрета в протоках вызывает их расширение и формирование мелких кист, в наибольшей степени бронхолегочной и пищеварительной системах.

Муковисцидоз_3.jpg

Электролитные нарушения связаны с высокой концентрацией кальция, натрия и хлора в секретах. Застой слизи приводит к атрофии (усыханию) железистой ткани и прогрессирующему фиброзу (постепенному замещению ткани железы - соединительной тканью), раннему появлению склеротических изменений в органах. Осложняет положение развитие гнойного воспаления в случае вторичного инфицирования.

Поражение бронхолегочной системы при муковисцидозе происходит вследствие затруднения отхождения мокроты (вязкая слизь, нарушение функции мерцательного эпителия), развития мукостаза (застоя слизи) и хронического воспаления. Нарушение проходимости мелких бронхов и бронхиол лежит в основе патологических изменений органов дыхания при муковисцидозе. Бронхиальные железы со слизисто – гнойным содержимым, увеличиваясь в размерах, выпячиваются и перекрывают просвет бронхов. Формируются мешотчатые, цилиндрические и «каплевидные» бронхоэктазы, образуются эмфизематозные участки легкого, при полной обтурации бронхов мокротой – зоны ателектаза, склеротические изменения ткани легкого (диффузный пневмосклероз). При муковисцидозе патологические изменения в бронхах и легких осложняются присоединением бактериальной инфекции (золотистого стафилококка, синегнойной палочки), абсцедированием, развитием деструктивных изменений. Это связано с нарушениями в системе местного иммунитета (снижение уровня антител, интерферона, фагоцитарной активности, изменение функционального состояния эпителия бронхов).

Кроме бронхолегочной системы при муковисцидозе отмечается поражение желудка, кишечника, поджелудочной железы, печени.

Лечение

Для стимуляции роста эндогенной микрофлоры целесообразно назначать пробиотики - препараты, содержащие живые микробы (моно- или комбинированные), и пребиотики - препараты, не содержащие живых организмов, а только их метаболиты, стимулирующие рост нормальной микрофлоры.

Среди метаболитов следует особенно выделить лактулозу - синтетический дисахарид, не встречающийся в природе.

Лактулоза попадает в толстый кишечник в неизмененном виде, становится питательным веществом для сахаролитических бактерий и снижает кислотность содержимого толстой кишки. Также применение лактулозы понижает проходимость пищевых масс, что ведет к задержке жидкости в просвете кишки и усилению ее перистальтики. Лактулоза - источник углеводов и энергии, ее использование приводит к увеличению бактериальной массы, активной утилизации аммиака и азота аминокислот. Эти изменения в конечном итоге и обеспечивают профилактический и терапевтический эффекты. Особенно важна лактулоза при запорах, портосистемной энцефалопатии, энтеритах и сахарном диабете.

Лактулоза применяется для терапии больных муковисцидозом уже в течение 5 лет и зарекомендовала себя как эффективное и безопасное средство. 



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تحتاج ربات البيوت شغالات بالساعة خصوصاََ عند الكثير من ربات البيوت المشغولات كثيراََ بالأطفال والعمل و الدراسة لتوفر على نفسها الوقت والجهد، وقد تلجأ ا?مهات لشغالات تعملشغالات بالساعه المدينة المنورة لتنظف أجزاء مختلفة بالمنزل

تبحث كل ربة منزل على خادمات للتنازل ممتازين حتى يستطيعوا إتمام أي مهمة ولا بد من توافر الأمانة العالية وا?خلاق الحميدة، ويمكن الإتفاق مع الكثير من الشركات التي تختص في توظيف شغالات بعدة أنظمة ويكون من ضمنها نظام شغالات بالشهر وذلك ?رضاء كافة العملاء، أيضاََ تقوم شغالات بالساعه بالدمام شركات كثيرة على توفير الشغالات ذات الأعمار المختلفة لتلبية كافة إحتياجات العملاء في أي وقت.

الفارق في الأمر هو وجود مربية اطفال بالرياض ترفع سعر الشغالات كثيراََ بالرغم من لجوء العملاء لهذا النوع من الخدمة بسبب تكلفتها القليلة، وعند توظيف مفتشات جوالات شغالات بالساعة يجب الحرص على إختيار شركة مناسبة بأسعار مناسبة وبالمقابل شغالات بالساعه بجدة خدمة ممتازة و أن تكون الخدمة موفرة أحسن جودة للعملاء و تتحلي الشغالة بخلق عالي جداََ وتجيد العمل بصورة صحيحة وبكل أمانة، توفر شركتنا أفضل أنواع الشغالات ذات الأخلاق الحسنة و بأفضل الأسعار.

يوجد في هذا المجال مساج الرياض الكثير من الشركات التي تقدم خدمة مساج منزلى بالرياض شغالات بالساعة ولكن تختلف مستويات الخدمة التي تقدم من شركة إلى شركة أخرى فمثلاََ يوجد الكثير من الشركات التي تقدم لك مساج جدةشغالات بالساعة مختصة في مجال واحد فقط أي تكون متخصصة في مساج منزلى جدة تنظيف حمامات السباحة أو حتى المطابخ والغرف وهكذا، بالطبع هذا النوع من الشركات لديه نوع معين من مساج الدمام العملاء وذلك بسبب وجود فئة كبيرة جداََ من العملاء يفضلون وجود مساج منزلى الدمام الشغالات التي تقوم بأي عمل ويوجد سبب اخر وهو وجود الكثير من الشركات التي ترفع الأسعار مقابل هذه الخدمات.

إختيار شركة متخصصة في توظيف شغالات بالساعة أمر لابد من أن يكون بصورة محترفة حتى لا تضر حملات عمرة بالرياض بالعميل الذي اعتمد على الشركة حتى يحصل على الخدمة التي تريدها ، يجب أن تحرص الشركة التي تقدم الخدمة على التحقق الجيد من الشغالات الموجودين عن طريق طلب جميع الأوراق الرسمية الموجودة في الدولة أو السفارات المختلفة إذا كانت الشغالات من دول أجنبية كذلك و
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