Meningitis tshwm sim thaum kis kab mob ua rau cov meninges (cov ntaub so ntswg uas ua rau lub paj hlwb thiab tus txha caj qaum) ua rau mob thiab o tuaj. Cov tsos mob hauv tus menyuam mos liab tuaj yeem suav nrog ua rau lub cev tsis zoo, ua npaws, ua pob, tawv, ua pa nrawm, tsis muaj sia thiab quaj. Yog tias koj tsis paub tseeb tias tus menyuam raug cuam tshuam los ntawm cov no lossis lwm yam tsos mob thiab koj xav tias qee yam tsis raug, mus rau chav kho mob xwm txheej tam sim.
Cov kauj ruam
Ntu 1 ntawm 4: Txheeb Xyuas Koj Tus Menyuam Rau Cov Cim
Kauj Ruam 1. Saib cov tsos mob thaum ntxov
Cov tsos mob ntxov tshaj plaws ntawm tus mob meningitis suav nrog ntuav, ua npaws, thiab mob taub hau. Nrog rau menyuam yaus, muaj ntau txoj hauv kev los txheeb xyuas cov cim thiab tsos mob ntawm tus mob meningitis vim tus menyuam tsis tuaj yeem sib tham lawv qhov mob thiab tsis xis nyob rau koj nrog cov lus. Cov tsos mob tuaj yeem tshwm sim sai ntawm 3 txog 5 hnub ntawm thawj kis. Yog li ntawd nws yog ib qho tseem ceeb kom coj koj tus menyuam mus rau kev kho mob tam sim.
Kauj Ruam 2. Tshuaj xyuas koj tus menyuam lub taub hau
Kuaj thiab maj mam hnov ib puag ncig tus menyuam lub taub hau rau qhov txhaws thiab nruj me ntsis. Cov mos mos me me feem ntau yuav tshwm rau ntawm ob sab ntawm tus menyuam lub taub hau hauv lawv thaj tsam fontanelle, uas muaj qhov khoob nyob hauv tus menyuam lub pob txha taub hau vim lawv cov cranium txuas ntxiv mus.,
-
Kev loj hlob fontanelle tsis yog ib txwm qhia txog mob qog noj ntshav. Tsis hais txog qhov ua rau tuaj yeem ua tau, qhov font loj heev yog ib txwm muaj xwm txheej ceev thiab koj yuav tsum coj koj tus menyuam mus rau chav kho mob xwm txheej tam sim. Qee qhov xwm txheej uas ua rau muaj kev thab plaub fontanelle suav nrog:
- Encephalitis, uas yog o ntawm lub hlwb, feem ntau tshwm sim los ntawm kev kis mob.
- Hydrocephalus, tshwm sim los ntawm cov kua dej hauv lub hlwb. Qhov no tuaj yeem tshwm sim vim tias muaj qhov thaiv lossis nqaim ntawm lub qhov ncauj uas pab cov kua tawm.
- Ua kom lub siab intracranial ntau ntxiv, tshwm sim los ntawm kev tsim kua dej. Qhov no tuaj yeem txwv cov ntshav ntws mus rau lub hlwb.
Kauj Ruam 3. Ntsuas koj tus menyuam qhov ntsuas kub
Siv tus pas ntsuas qhov ncauj los yog qhov quav los kuaj seb ua npaws. Tus menyuam yuav kub cev yog tias qhov kub siab tshaj 37.5ºC (99.5ºF). Qhov kub siab heev tuaj yeem yog lub cim ntawm kev kho mob xwm txheej ceev, nyob ntawm tus menyuam lub hnub nyoog:
- Hnub nyoog qis dua 3 hlis, ib txwm nrhiav kev kho mob rau qhov kub siab tshaj 38 ° C (100.4 ° F).
- 3-6 lub hlis: ib txwm nrhiav kev saib xyuas ua npaws ntau dua 39ºC (102.2ºF).
- Laus tshaj 6 lub hlis: ib txwm nrhiav kev saib xyuas ua npaws tshaj 40 ° C (104 ° F).
- Tsis txhob cia siab rau qhov kub kom qhia koj tias koj yuav tsum coj tus menyuam mus rau chav kho mob xwm txheej ceev. Cov menyuam mos uas muaj hnub nyoog qis dua peb lub hlis uas muaj tus mob meningitis feem ntau tsis ua npaws.
Kauj Ruam 4. Mloog seb tus menyuam quaj li cas
Yog tias koj tus menyuam muaj mob, nws yuav ua rau muaj kev chim siab xws li quaj, quaj, lossis tsoo. Qhov no yuav tshwm sim tshwj xeeb tshaj yog thaum koj khaws nws vim qhov mob, mob leeg thiab pob qij txha. Nws yuav nyob ntsiag to thaum nws nyob ruaj khov, tab sis nws yuav pib quaj nrov nrov thaum tuaj tos.
- Mloog kom hloov pauv tus menyuam mos quaj uas tuaj yeem qhia qhov mob lossis tsis xis nyob. Tus menyuam yuav quaj thiab quaj ntau dhau lossis tso suab quaj uas siab dua li ib txwm hauv lub suab.
- Tus menyuam kuj tseem yuav mob lossis quaj heev thaum koj rub nws lossis kov lub caj dab.
- Lub teeb ci ci kuj tseem tuaj yeem ua rau quaj vim yog photophobia.
Kauj Ruam 5. Saib xyuas cov tsos mob ntawm tus menyuam lub cev
Yog tias koj xav tias mob meningitis, tshuaj xyuas thiab saib xyuas tus menyuam kom pom tias nws khov nyob hauv nws lub cev, tshwj xeeb yog nws caj dab. Tus menyuam yuav tsis tuaj yeem kov nws lub hauv siab nrog nws lub puab tsaig, thiab nws tuaj yeem ua rau lub ntsej muag vwm, txav nrawm.
Kauj Ruam 6. Txheeb xyuas tus menyuam daim tawv nqaij kom pom xim thiab ua pob
Saib tus me nyuam daim tawv nqaij thiab tawv nqaij. Koj tuaj yeem soj ntsuam daim tawv nqaij uas tsis tshua muaj daj lossis blotchy, lossis nws yuav tsim cov xim daj.
- Saib rau qhov ua pob liab liab, liab-liab, lossis xim av lossis tsim ua pob ua pob ntawm tus pin-prick dots uas zoo ib yam nqaij tawv.
- Yog tias koj tsis paub tseeb tias qhov chaw me me ntawm tus menyuam yog pob, koj tuaj yeem txheeb xyuas tau los ntawm kev siv lub tumbler/iav kuaj. Qhov no yog ua los ntawm maj mam nias lub khob haus kom huv rau thaj tsam ntawm daim tawv nqaij. Yog tias pob khaus lossis pob liab liab tsis ploj vim lub iav raug nias rau ntawm daim tawv nqaij, tus menyuam feem ntau yuav muaj pob liab liab. Yog tias koj tuaj yeem pom pob tawm ntawm lub iav ntshiab, mus rau chav kho mob xwm txheej tam sim.
- Yog tias tus menyuam muaj lub ntsej muag tsaus, qhov ua pob yuav nyuaj rau pom. Hauv qhov no, saib ntawm thaj chaw xws li xib teg ntawm txhais tes, ib txhais taw ntawm ko taw, lub plab, lossis ze ntawm daim tawv muag. Cov cheeb tsam no kuj tseem yuav muaj qhov zoo li qhov liab teev los yog pinpricks.
Kauj Ruam 7. Txheeb xyuas tus menyuam qhov qab los noj mov
Koj tus menyuam yuav tsis tshaib plab li qub. Nws yuav tsis kam noj thaum koj sim pub zaub mov rau lawv thiab ntuav ib yam dab tsi uas lawv noj.
Kauj Ruam 8. Txheeb xyuas tus menyuam lub zog thiab qib kev ua ub no
Nrhiav cov cim ntawm kev qaug zog. Tus me nyuam yuav zoo li tsis muaj zog, tsis muaj sia nyob, thiab nkees lossis tuaj yeem tsaug zog tas li tsis hais txog qhov lawv tau txais. Qhov no tshwm sim thaum tus kab mob kis thoob plaws hauv lub cev.
Kauj Ruam 9. Mloog tus menyuam txoj kev ua pa
Soj ntsuam tus menyuam kom paub ua pa txawv txav. Tus menyuam yuav ua pa sai dua li ib txwm lossis ua pa nyuaj.
Kauj Ruam 10. Hnov tus menyuam lub cev kom txias
Soj ntsuam yog tias tus me nyuam zoo li muaj qhov hnyav heev, tshee tshee thiab tsis txias, tshwj xeeb yog ntawm nws txhais tes thiab taw.
Kauj Ruam 11. Paub tias meningitis yog dab tsi
Meningitis tshwm sim thaum kis kab mob ua rau mob meninges lossis cov nqaij mos uas ua rau koj lub paj hlwb thiab tus txha caj qaum ua rau mob thiab o tuaj. Kev kis tus kab mob feem ntau yog vim muaj kab mob lossis kis kab mob nkag mus rau hauv tus menyuam lub cev. Ua rau mob meningitis muaj xws li:
- Kab mob: Qhov no yog tus lej ua rau mob qog noj ntshav hauv ntiaj teb, thiab nws tuaj yeem daws qhov nws tus kheej. Txawm li cas los xij, tus menyuam tseem yuav tsum tau mus ntsib kws kho mob vim tias qhov cuam tshuam ntawm kev kis tus kab mob tuaj yeem ua rau tuag taus yog tias tsis muaj kev saib xyuas pab txhawb. Rau menyuam yaus thiab menyuam yaus, nws yog ib qho tseem ceeb rau niam txiv lossis tus saib xyuas ua raws txhua txoj cai txhaj tshuaj tiv thaiv kab mob. Cov niam uas tau kis tus kab mob herpes simplex lossis HSV-2 tuaj yeem kis tus kabmob mus rau lawv tus menyuam thaum lub sijhawm ua haujlwm, yog tias leej niam muaj mob qog noj ntshav.
- Kab mob: Hom no tshwm sim ntau rau cov menyuam mos thiab menyuam mos.
- Fungal: Hom kab mob meningitis no tsis tshua muaj tshwm sim thiab feem ntau cuam tshuam rau cov neeg mob AIDS nrog rau lwm tus uas muaj kev tiv thaiv kab mob tiv thaiv kab mob (piv txwv li tau txais kev hloov pauv thiab cov neeg mob tau txais tshuaj kho mob).
- Lwm yam: Lwm hom mob meningitis tuaj yeem yog tshuaj, tshuaj, ua rau mob qog noj ntshav thiab mob qog noj ntshav.
Ntu 2 ntawm 4: Tau Txais Kev Txheeb Xyuas los ntawm Tus Kws Kho Mob
Kauj Ruam 1. Qhia tus kws kho mob txog txhua yam tsos mob
Piav tag nrho cov tsos mob rau koj tus kws kho mob, suav nrog cov uas zoo li me me xws li txham lossis hnoos. Qhov no yuav pab koj tus kws kho mob paub qhov sib txawv ntawm hom mob meningitis, thiab txav mus rau qhov kev kuaj mob uas tsim nyog. Qhia tus kws kho mob txog cov tsos mob hnyav tam sim ntawd, vim tias lawv yuav xav tau kev kho mob xwm txheej ceev:
- Qaug dab peg
- Tsis nco qab
- Cov leeg tsis muaj zog
Kauj Ruam 2. Qhia koj tus kws kho mob yog tias koj tus menyuam tau kis kab mob
Muaj ob peb hom kab mob uas ua rau mob meningitis. Yog tias koj tus menyuam tau kis rau cov neeg uas muaj mob plab lossis mob ua pa, nws lossis nws tau kis rau ib yam ntawm cov kab mob no:
- Strep B: Hauv pawg no, cov kab mob feem ntau ua rau mob qog noj ntshav hauv menyuam yaus hnub nyoog qis dua 24 lub hlis yog strep agalactiae.
- E Coli
- Listeria hom
- Neisseria Meningitidis
- S. Mob ntsws
- Haemophilus Influenzae
Kauj Ruam 3. Kom koj tus menyuam mus kuaj lub cev kom tiav
Tus kws kho mob yuav coj koj tus menyuam qhov tseem ceeb nrog rau nws keeb kwm kev kho mob. Tus kws kho mob yuav ntsuas tus menyuam qhov ntsuas kub, ntshav siab, lub plawv dhia, thiab ua pa.
Kauj Ruam 4. Cia tus kws kho mob kos ntshav
Tus kws kho mob yuav kuaj ntshav los ntawm tus menyuam txhawm rau ua kom suav cov ntshav tiav. Tus kws kho mob yuav nqa ntshav los ntawm qhov paum me me rau hauv tus menyuam pob taws.
Kev suav ntshav tag yuav tshuaj xyuas cov qib electrolyte, nrog rau suav cov qe ntshav liab thiab dawb. Tus kws kho mob tseem yuav kuaj ntshav coagulation thiab yuav tshuaj xyuas cov kab mob hauv cov ntshav
Kauj Ruam 5. Nug tus kws kho mob txog kev kuaj CT
Cranial CT scan yog ntsuas hluav taws xob uas kuaj xyuas lub hauv paus ntawm lub hlwb kom pom tias cov nqaij mos tau o los yog yog tias muaj ntshav los tshwm sim. Yog tias tus neeg mob tau qaug dab peg lossis raug mob, CT tuaj yeem pab nrhiav qhov no ntxiv rau thiab qhia seb tus neeg mob tuaj yeem kuaj mob tom ntej uas yog lub lumbar puncture. Yog tias tus neeg mob muaj qhov qhia txog kev nkag siab siab vim yog ib qho ntawm cov lus qhia yav dhau los, lub lumbar puncture yuav tsis pib kom txog thaum lub siab tau qis dua.
Kauj Ruam 6. Nug seb puas tsim nyog lumbar puncture
Qhov kev ntsuam xyuas no rho tawm cov kua dej hauv plab los ntawm tus menyuam lub nraub qaum. Cov kua dej xav tau los tswj hwm qee qhov kev sim txhawm rau txiav txim siab qhov ua rau mob qog noj ntshav.
- Ceeb toom tias qhov kev xeem no mob heev. Tus kws kho mob yuav siv tshuaj pleev tshuaj pleev thiab siv rab koob loj los rub dej tawm ntawm cov pob txha ntawm tus neeg mob lub nraub qaum.
-
Yog tias muaj qee yam mob tshwm sim, tus kws kho mob yuav tsis ua lub lumbar puncture. Cov xwm txheej no yuav suav nrog:
- Ua kom lub siab nkag mus rau lub paj hlwb ntau ntxiv (cerebral herniation)
- Kev kis mob ntawm qhov chaw ntawm lub lumbar puncture
- Coma
- Qhov txawv txav ntawm tus txha nqaj qaum
- Ua pa nyuaj
-
Yog tias lub lumbar puncture yog qhov tsim nyog, tus kws kho mob yuav siv cov kua dej hauv lub paj hlwb los tswj cov kev ntsuas, uas suav nrog:
- Gram stain: Thaum cov kua dej hauv lub cev raug tshem tawm, qee qhov ntawm nws yuav raug zas nrog zas xim txhawm rau txiav txim siab hom kab mob tam sim no hauv cov kua.
- Kev soj ntsuam kab mob hauv lub cev: Qhov kev ntsuas no txheeb xyuas cov kua dej ua piv txwv rau cov cell, protein thiab piam thaj-rau-ntshav piv. Qhov no tuaj yeem pab kws kho mob kuaj pom tus mob meningitis thiab txheeb xyuas txhua hom meningitis ntawm ib leeg.
Ntu 3 ntawm 4: Tau Txais Kev Kho Mob Menyuam Yaus
Kauj Ruam 1. Kom koj tus menyuam kho tus mob meningitis
Meningitis raug kho raws li hom. Viral meningitis raug kho nyob ntawm qhov ua rau kis.
Piv txwv li, HSV-1 lossis mob khaub thuas tuaj yeem kis los ntawm leej niam mus rau menyuam thaum lub sijhawm ua haujlwm yog tias leej niam muaj mob qog noj ntshav. Kev kho mob rau tus menyuam mos tshiab uas kuaj pom tus mob herpes encephalitis yuav tsum tau kho nrog tus neeg siv tshuaj tua kab mob hauv lub cev (piv txwv li, acyclovir muab tshuaj txhaj tshuaj)
Kauj Ruam 2. Ua raws txoj kev npaj kho kab mob meningitis
Kab mob meningitis kuj tau kho raws li cov kab mob ua rau. Koj tus kws kho mob yuav txheeb xyuas qhov laj thawj no thiab muab kev kho mob rau koj tus menyuam. Ua raws koj tus kws kho mob cov lus qhia rau kev tswj hwm kev kho mob. Hauv qab no yog qee qhov kev qhia tshuaj thiab ntau npaum li cas:
- Amikacin: 15-22.5 mg/kg/hnub txhua 8-12 teev
- Ampicillin: 200-400 mg/kg/hnub txhua 6 teev
- Cefotaxime: 200 mg/kg/hnub txhua 6 teev
- Ceftriaxone: 100 mg/kg/hnub txhua 12 teev
- Chloramphenicol: 75-100 mg/kg/hnub txhua 6 teev
- Co-trimoxazole: 15 mg/kg/hnub txhua 8 teev
- Gentamicin: 7.5 mg/kg/hnub txhua 8 teev
- Nafcillin: 150-200 mg/kg/hnub txhua 4-6 teev
- Penicillin G: 300, 000-400, 000 U/kg/hnub txhua 6 teev
- Vancomycin: 45-60 mg/kg/hnub txhua 6 teev
Kauj Ruam 3. Tham nrog kws kho mob txog qhov kev kho yuav nyob ntev npaum li cas
Lub sijhawm kho mob rau koj tus menyuam mos meningitis nyob ntawm qhov ua rau mob meningitis. Nov yog qee qhov kwv yees ntev ntawm kev kho:
- Meningitides: 7 hnub
- H. Mob khaub thuas: 7 hnub
- Strep mob ntsws: 10 txog 14 hnub
- Pawg B. Strep: 14 txog 21 hnub
- Gram tsis zoo aerobic bacillus: 14 txog 21 hnub
- Listeria monocytogenes/L. meningitis: 21 hnub lossis ntau dua
Kauj Ruam 4. Muab kev zov me nyuam ntxiv rau tus me nyuam
Muab kev saib xyuas koj tus menyuam kom ntseeg tau tias nws tau txais nws cov tshuaj kom raug txhua lub sijhawm ntawm kev kho mob. Nws yuav tsum tau txhawb kom so thiab haus dej ntau. Nws zoo li yuav tau muab cov kua dej IV vim nws lub hnub nyoog hluas. Nws yuav tsum raug tiv thaiv kom tsis txhob kis tus mob meningitis mus rau lwm tus neeg hauv tsev neeg.
Ntu 4 ntawm 4: Ua Ntej Tom Qab Kev Kho Mob Menyuam Yaus
Kauj Ruam 1. Txheeb xyuas koj tus menyuam qhov kev hnov lus
Hnov tsis hnov lus yog qhov tshwm sim feem ntau ntawm cov mob meningitis. Yog li ntawd, txhua tus menyuam yuav tsum tau hnov qhov kev tshuaj xyuas tomqab kev kho mob dhau los ntawm kev hnov lub suab nthuav tawm cov kev tshawb fawb.
Kauj Ruam 2. Txheeb xyuas koj tus menyuam lub siab intracranial nrog MRI
Cov kab mob tom qab kho lossis lwm yam kab mob tuaj yeem nyob twj ywm thiab ua rau muaj teeb meem. Ib qho ntawm cov no yog nce siab intracranial los ntawm kev tsim cov kua nruab nrab ntawm qhov sib txawv ntawm lub hlwb.
Txhua tus menyuam mos yuav tsum tau mus ntsib MRI 7 txog 10 hnub tom qab kho tus mob meningitis tas lawm
Kauj Ruam 3. Txhaj tshuaj rau koj tus menyuam
Nco ntsoov tias koj tus menyuam tau txhaj tshuaj tiv thaiv kab mob tag lawm txhawm rau txo txoj hauv kev kis tus mob meningitis.
Txo txoj kev pheej hmoo ntawm cov menyuam yav tom ntej yuav mob meningitis. Yog tias koj cev xeeb tub thiab koj muaj HSV nrog qhov chaw mos ntawm qhov chaw, qhia rau koj tus kws kho mob ua ntej yug
Kauj Ruam 4. Tshem tawm kev sib cuag nrog cov neeg muaj mob lossis cov neeg muaj mob
Qee hom kab mob meningitis yog kis tau. Khaws cov menyuam yaus thiab menyuam yaus kom deb ntawm kev sib cuag nrog cov neeg kis lossis mob.
Kauj Ruam 5. Ceev faj txog kev pheej hmoo
Qee leej neeg yuav muaj kev pheej hmoo kis tus mob meningitis ntau ntxiv, nyob ntawm qee qhov xwm txheej. Qee qhov no suav nrog:
- Hnub Nyoog: Cov menyuam yaus hnub nyoog qis dua tsib xyoos tuaj yeem muaj kev pheej hmoo siab mob viral meningitis. Cov neeg laus hnub nyoog tshaj 20 xyoo yuav muaj kev pheej hmoo siab ntxiv rau cov kab mob meningitis.
- Nyob ze cov neeg nyob ze: Thaum tib neeg nyob sib ze nrog ntau tus neeg, xws li chaw pw, chaw ua tub rog, tsev kawm ntawv nce tsev thiab chaw zov menyuam, lawv yuav muaj kev pheej hmoo mob qog noj ntshav ntau ntxiv.
- Kev tiv thaiv kab mob tsawg zuj zus: Cov tib neeg uas muaj kev tiv thaiv kab mob tsis zoo yuav muaj feem yuav pheej hmoo kis tus mob qog noj ntshav. AIDS, quav dej quav cawv, ntshav qab zib, thiab siv tshuaj tiv thaiv kab mob tuaj yeem cuam tshuam kev tiv thaiv kab mob.
