- 12 Kirschner doc noi tuy
HOAI THlTSINH HO
1. DAI CUONG
Hoai thu sinh hdi la benh do n h ilm khu&n yem khi, thuoc Gr (-)■ Benh chiem ty le khoang 14,4% trong tong so nhiem khuan yem khi noi chung.
Benh dtfdc mo ta nam 1864 bdi Pirogoff, ong cho d in g no lien quan tdi vet thUdng chien tranh gay thUdng ton chu yeu d to chtfc cd va tien trien rat diJ doi.
1.1. Nguyen nhan
Pasteur va Jouber nam 1877 phat hien ra Clostridium septicum vi chu ng gay nhiem trung mau. Sau nay cac nha khoa hoc da phat hien ra them cac loai Cl.Perfringens va Cl.Novyi.
1.2. Tinh chat vi sinh vat cua vi khuan gay hoai thu sinh hdi
Cac vi khuan nay co nhieu typ huyet thanh khac nhau nhtfng giong nhau ve hinh the, tinh chat sinh vat va kha nang sinh ngoai doc to. Do la doc to" typ A.
• a Toxin gay phan hoa kieu ldxitinaze, pha huy te bao co ldxitin: hon g C&U, to chtfc phan mem.
•0 Toxin pha huy nhanh to chtfc neu d moi trUdng ky khi hoac it oxy ttf do - Tan hong c lu
- Hoai tu to chtfc - Gay liet cd tim
• K Toxin pha huy to chtfc keo
• fi Toxin phan huy acid hyaluronic gay tan ra stf lien ket te bao
Hau qua la hoai thu sinh hdi tao nen nam hien ttfdng chinh:
Hien ttfdng thoi rtfa: la hien ttfdng co sdm, ttf to chtfc hoai thu boc m ui thoi giong nhu mui chuot chet.
Hien ttfdng tao hdi: xay ra do tac dong vi khuan len to chtfc cd, la to chiic co nhieu dtfdng va de len men. Hdi tao ra lai boc tach cac kh oang te bao lam cho n h ilm khuan lan rong, khi an vao vung bi thtfdng co cam giac lao xao dtfdi tay.
Hien ttfdng n h ilm doc: rat nhanh chong lan ra toan than, l&m ch o h on g d iu bi tan, do toan mau tang. Nhiem doc la do stf phan huy cac ch£t thoi riia tai vet
thtfdng va do doc to cua vi khuan.
Hien ttfdng hoai ttf cac cd cung r&'t ro ret: cd phu ne, tit d6 chuyen sang T»m
Hien ttfdng phu ne la phan tfng cua cd the. Dich phu lam tach cac khoang te bao tao dieu kien de benh lan rong.
1.3. Nguon lay benh
- Vi khuan d dat, phan, xac chet, da ngtfdi (dac biet d chi dtfdi)
- Vi khuan yem khi co mat d vet thtfdng chien tranh khoang 80% va gay nhiem trung yem khi khoang 1%
- Dieu kien thuan ldi de vi khuan phat trien
Vet thtfdng dap nat, gay xtfdng hd nang, stfc de khang kem (ngtfdi gia, tre em, ngtfdi nghien ma tuy...), xii ly cua thay thuoc (cat loc vet thtfdng ph&n mem) khong
dung cach, khong kip thdi... tao nen to chtfc chet, ttf do vi khuan yem khi phat trien.
M ot so' trtfdng hdp dat garo voi va gay nen thieu dinh dtfdng d vet thtfdng cung tao thuan ldi cho vi khuan phat trien.
Vi khuan can moi trtfdng co dtfdng: cd bi giap nat la nguon cung cap dtfdng; d cac vung co nhieu cd nhtf mong, dui, b&p chan, khi bi ton thtfdng lai co kem ca vet thtfdng mach mau se la moi trtfdng thich hdp cho hoai thtf sinh hdi phat trien.
Co stf phoi hdp gitfa cac vi khuan ky khi vdi nhau hoac vi khuan ky khi vdi vi khuan tfa khi. Stf phoi hdp te hai nhat la gitfa Cl.perfringens vdi lien cau khuan lam cho qua trinh hoai thtf tien trien nhanh va nguy hiem.