Isifo sephepha lweendawo nkovu intrathoracic, uxilongo, iintlobo isifo

Isifo sephepha lweendawo nkovu intrathoracic - luhlobo esi sifo, nto leyo zihlelwe ngokupheleleyo. Abanye bakholelwa ukuba bangathunyelwa ngesifo ezimeleyo, abanye bakholelwa ukuba kufuneka kusala enezakhiwo tuberculosis zaseprayimari. Esi sifo iza kuxutyushwa kweli nqaku. Esiza kuxubusha ngayo ngokweenkcukacha oonobangela zesi sifo, iifomu zawo, iindlela isifo kwaye afumane unyango iindlela, kwakunye iingxaki kunokwenzeka kunye amanyathelo othintelo.

Yintoni na?

Isifo sephepha lweendawo nkovu intrathoracic (VGLU) - sisifo liphawulwa ziinkqubo ukudumba ekuqaleni nodes ibekwe kwiingcambu zemiphunga. Phephezela ngezifo Mycobacterium tuberculosis. I-arhente causative yosulela ezigulayo.

VGLU Isifo sephepha ivame abantwana, ulutsha kunye nabantu abadala ukuya kwiminyaka engama-25. Ngenxa ubhubhane ugonyo ngobuninzi phantse akukho amatyala losulelo zinqabile yaye kwenzeka kuphela sifo ephantsi. Le ngezifo iphawulwa ikhosi esinganyangekiyo zethuba yesenzo yenkqubo sisiba mandundu. 70% ye iingxaki sifo kwenzeka abantwana abangaphantsi kweminyaka emithathu.

indlela usulelo

Zonke iintlobo nesifo lweendawo nkovu intrathoracic ebantwini okubangelwa tuberculosis igciwane Mycobacterium.

Usulelo lwenzeka ngezi ndlela zilandelayo:

• Ngenxa ukusetyenziswa kokutya ezivela isigulane zezilwanyana (umz, ubisi lwenkomo).
• Ngokuphefumelelana evela lesifo okanye isilwanyana.
• Esebenzisa izinto zemihla ngemihla kunye nokutya ezingcolisekileyo kunye iintsholongwane.
• Ngokusebenzisa amanxeba esikhumbeni.
• Kokuba idluliselwe ukusuka kumama ukuya emntwaneni ngexesha lokukhulelwa (ngokusebenzisa ngumkhaya) kunye lokwaphusa (milk).

Oku ke kungenzeka bayosuleleka iphecana sokuphefumla. Umntu ne-TB, ukukhohlela rhoqo kwaye bethetha exhales kulo phlegm emoyeni equlathe iintsholongwane ezinobutshaba. Bona bayakwazi ukwandisa ukuya kumgama oziimitha ezimbini nokuhlala emoyeni kuba ngaphezu kweyure. Bona ke ahlale phantsi kunye oxutywe nothuli, kunye nokusebenza kwabo igcinwa ukuya kwiinyanga ezintandathu.

Nto leyo eyandisa amathuba osulelo?

Imizimba yokuphefumla kwabantu bephilile akhuselwe kusulelo TB, kodwa izifo ukutshaya kunye bronchopulmonary kunganciphisa nezifo. Ngowe-95% amatyala ngexesha yomfowunelwa wokuqala igciwane tuberculosis usuleleko kwenzeka.

Imiba ezandisa amathuba osulelo:

• ukutya engaphelelanga ingafanelekanga.
• contact elide kunye tuberculosis ezosulelekileyo.
• iimeko zokuhlala Poor.
• Ubukho lwezifo ezingapheliyo.
• kuxinezeleko emzimbeni nasengqondweni.

Ngokuqhelekileyo igciwane enye kwezi zinto, kwaye nkqu ezimbalwa kuquka imbali yezonyango. Isifo sephepha lweendawo nkovu intrathoracic ngoko kuchaphazela abantu imikhwa emibi abaphethwe chronic fatigue, kwakunye abantwana abavela kwiintsapho ezihlelelekileyo. Usulelo cishe kungenakwenzeka ukuba agcine, ukuze umzimba ofanayo usempilweni nangoko uqalisa ukwakha umzimba zendalo. Apho mna isiguli ngenye imini thatha abantu abambalwa, kodwa ukubamba umzimba mnye kuphela eya alilunganga ukuzikhusela ngokwabo. Olusemngciphekweni abantwana kunye nabantu abadala ezingakhange zigonywe, kwakunye izigulane ezine-HIV kunye nabantu iinkqubo eziyekeyeke omzimba.

Isifo

Kukho ezi fom zilandelayo sephepha lweendawo nkovu intrathoracic:

• Ithumba.
• Infiltrative.
• Small.

Ithumba uhlobo bronhoadenita enzima. Idla kwenzeka kubantwana abancinane ukwanda ngamandla kwiindawo nkovu (ubukhulu yabo ukufikelela ukuya ku-5 cm) kunye tubinfitsirovanii enkulu. Amaxesha amaninzi amacandelo nababandakanyekayo welding, ukuba ibe nabaphathi enye.

ifomu Infiltrative ebangela ukunyuka okungephi kwiindawo nkovu, ngaloo ndlela perinodulyarnoe ukudumba olubalaseleyo.

ifomu emfutshane

uhlobo Small sephepha lweendawo nkovu intrathoracic kunzima ukubona, kwaye kuchaphazela ngakumbi abantwana. diagnosis ezifike emva kwexesha okanye uhola ukuba bangaboni loloyiko le mediastinum, ethi ichaphazele eqhelekileyo yokusebenza capillary pulmonary ukuhamba kwegazi. Kwakhona ngezifo kunokukhokelela ukuvela ifomu embi kakhulu kwaye iyingozi sephepha.

Ukwenza ukuxilongwa echanekileyo ukuchonga isifo, oko kuyimfuneko ukuze bakuthathele ingqalelo yonke oluntsonkothileyo data zeradiyoloji kunye endoscopic, kufuneka kwakhona ukuchitha Itomography le mediastinum.

ukufumanisa iingxaki abanazo ifomu amancinci

Nkqu kwisigaba esebenzayo sephepha elincinane nodes nkovu intrathoracic 1-2 luphawulwa izitshanguba ze kwiindawo nkovu kunye nokwanda elincinane (1.5 cm). Ezi ziimpawu kungabonwa kwi x-reyi.

Iimpawu lwezonyango siswele kakhulu. Thaca idla kuphela fever ephantsi-grade kunye ukunxila syndrome. Xa elivisayo, isikhalazo iphambili DYSTONIA. Ngenxa yoko, izigulane ziye zithunyelwe makancinwe koogqirha ezinye iinkangeleko. Kule fomu encinci sephepha kuyingozi kuba isifo kunokubangela amanye amalungu zangaphakathi.

iimpawu

Isifo sephepha lweendawo nkovu intrathoracic ine mpawu zilandelayo:

• lobushushu emzimbeni lisingisa degrees 39.
• Ebusuku, akukho ukubila ngokucacileyo, ukuba ayibangelwa bubushushu.
• Ukwehla imnyama.
• Ukhohlokhohlo luqala ngathi lowo uvela unkonkonko.
• pallor ezimandundu esikhumba ukuya nombala oluhlaza.

Nangona kunjalo, ezi mpawu kakubi kuchazwa, ngoko ukuxilongwa phezu kwabo kuya kuba nzima kakhulu. Kodwa ke ezinye iinkalo kuchongwa kwinkqubo Ukuhlolwa:

• Visual. inethiwekhi neuropathy lwemithambo enkulu kakhulu kwisithuba intercostal yokuqala neyesibini. Phakathi vanes iimpahla ezincinci kunabela izabelo eliphezulu.
• Ngokucofa. Livela ubuhlungu noxinzelelo kwi kwiinkqubo spinous ngayo amalungu omqolo thoracic (ukusuka kwi-3 ukuya 7).

Ezibalulekileyo uxilongo lwesifo sephepha yi eluviweni X-ray. Kuliwa 'ukubakho ngo uqikelelo osecaleni Antero-ngomva, t. K. A umthunzi iindawo nkovu zinokufihlwa amalungu mediastinal kunye nokuqaqamba intliziyo. Kubalulekile kwakhona ukuba aqhube krwaqula zomthi tracheobronchial. Kodwa malunga loo ntetho elandelayo.

ekuxilongweni

Kunzima kakhulu ukwahlula kwezinye ezimbi TB efanayo ezalathelwe nkovu intrathoracic. uphethwe umahluko ayimfuneko njengoko phantsi omnye komnye sifo.

Ngoko ke, ukuqala njani isifo?

Inyathelo lokuqala kukwazi ukubona ubukho Mycobacterium tuberculosis emzimbeni. iintsholongwane ze-TB lula inokufumaneka ekuhlanjweni amanzi isisu. Amaninzi zifumaneka ekuhlanjweni amanzi bronchi, isikhohlela.

Okulandelayo inyanzelekile iimviwo radiology. Ingasetyenziswa nje kuphela ukuba ngaba umntu wosulelwe, kodwa ukuqonda uye losulelwe elide kangakanani. Kwakhona umfanekiso elungileyo ubuchule evumela ukuba ukuhlalutya isakhiwo kwiindawo nkovu eququzelela oogqirha kakhulu umngeni ekufumaniseni.

Enye indlela ebalulekileyo diagnostic test Mantoux. Ngenxa yoko entle, ikwabizwa ngokuba "ithuba." Kulo mzekelo, indlela ezazinesifo ukwenza ngenaliti i kulandelayo - inaliti yandiswa kakhulu ngaphezulu kwe-5 mm. "Virage" banesifo kwezi meko zilandelayo:

• Papule (uphawu isithuba) lube lukhulu kwe-0.5 cm.
• Iba kakhulu ngakumbi xa kuthelekiswa iziphumo elidlulileyo.
• Kudlulwe eqhelekileyo nge-17 mm ngaphandle komda ugonyo odlulileyo.
• Emva kweminyaka 3 yobukhulu balo mkhulu kwe-12 mm.

Noko ke, akusoloko eyakhayo Mantoux uthetha malunga usulelo. Kukho kungenzeka ukuba isizathu sokuba ukusabela ngaleyo inokuba izifo komzimba okanye zidluliselwe ngaphambili. Kwakhona Akusoloko uvavanyo-minus libonise ukuba ukungabikho kosulelo. iziphumo False ezimbi ezinokubangelwa immunodeficiency okanye kukuba ukususela mzuzu losulelo akakaphumezi kwiiveki ezili-10.

Nangona kunjalo, i "begoba" isizathu eyaneleyo ukuqhubeka uvavanyo olunye.

Kwakhona, wenze uvavanyo igazi njengenxalenye iinkqubo zonyango. Xa isixa-mali MTB ukusulelwa leukocytes, lymphocyte, neutrophils, eosinophils ziya kwandiswa kancinci.

uxilongo mahluko sephepha lweendawo nkovu intrathoracic

Xa isifo sephepha VGLU kaninzi kuye kufuneke ukuba ingafani kwezinye ezimbi tuberculosis. Ukuze benze oku, ugqirha kufuneka balujongisise ngenyameko imbali, ukuchonga amathuba obekudibene nezigulana bacillary, ukuhlalutya uvavanyo tuberculin, uhlolisise zonke izifo kwiCEMIS ngaphambili ukuba zinokunxulumana kusuleleko.

Ngaphandle kokuba ukwazi mazingabhidaniswa omnye VGLU tuberculosis Isifo imboniselo, akukho kusenokwenzeka ukuba kulahlula kwizifo iindawo nkovu intrathoracic.

Unako ukudida ngezifo ne Ukudlulela evela ngokoyiswa umhlaza wemiphunga lymphosarcoma. Noko ke, kungenzeka enjalo ibonakala kuphela kwizigulane abadala.

ayini

Isifo sephepha nodes nkovu intrathoracic abantwana kunye nabantu abadala kwenzeka phantse ngokulinganayo, ngoko uthomalaliso emiselweyo umahluko engephi.

Unyango olu hlobo lwesifo sephepha elide ngokwaneleyo. Kwi-avareji, unyango ingathatha naphi na ukusuka kwiinyanga ezili-10 ukuya konyaka onesiqingatha. Kulo mzekelo, kwiinyanga zokuqala 2-3, isigulane kufuneka esibhedlele isifo sephepha. Okokuqala, ukuze ukuba ukosulela abanye. Okwesibini, ukuba unyango olusebenzayo ngakumbi.

Lonke eli xesha le unyango enzima, equka iziyobisi nxamnye sephepha, gepatoprotektory, iivitamini, kwakunye immunomodulators.

Kwakhona kwiiveki zokuqala ezimbalwa zikumanqanaba elichubekileyo sifo wenziwe ichemotherapy. Noko ke, 'yesitshixo sele inikezelwe iinkqubo ezahlukeneyo depuration. Umzekelo, efakwa laser zokukhanya okanye igazi plasmapheresis.

unyango VGLU TB yahlulwe nezigaba ezibini. Ngexesha unyango olunzulu yenziwa kuqala, olujoliswe yokonakalisa Ofisi, ukufunyanwa ezonakeleyo esiqwini emiphungeni ngokuhamba kwexesha kunye nokuthintelwa kubunzima izifo. Therapy-TB lubandakanya indibanisela amachiza eziliqela abakwaziyo kutshabalalisa zonke iintlobo MBT. Inqanaba lesibini ayikho nje kakhulu. Apha into engundoqo - ukuthintela kwakhona uphuhliso ngezifo, ukukhuthaza izihlunu impiliso, ukubulala naziphi mycobacteria eziyingozi eseleyo nokomeleza inkqubo yomzimba yokuzikhusela.

Ngexesha unyango yonke Kucetyiswa ukuba balandele ngokutya izinto ezikhethekileyo, nto leyo eya kunceda ekunciphiseni ubungozi umzimba nokwandisa ukuxhathisa kusuleleko. Yokudla usoloko iquka ukutya kunye protein eninzi sesalathiso (amaqanda, inyama, iimveliso zobisi), ibhotolo kunye neminquma neoli, nobusi, ukutya okuziinkozo, iziqhamo kunye nemifuno kunye omninzi ivithamin C

ukungenelela kuhlinzwa

Isifo sephepha lweendawo nkovu intrathoracic kunqabile kukhokelela imfuneko kotyando, njengoko sifo ubaleka cwaka kakhulu, phantse nazimpawu.

Xa iyonke kukho izizathu ezibini eziphambili kutyando:

• Qala ukwakha tuberculoma ezalathelwe nkovu.
• Ukunqongophala naziphi na iziphumo ezintle unyango, eyaziswa ngaphezulu kweenyanga ezintandathu eyadlulayo.

iingxaki kunokwenzeka

Sibala iingxaki nesifo lweendawo nkovu intrathoracic okunokwenzeka:

• Formation of fistulas yentsimbi-inyumoniya ngenxa woyiswa elinzima bronchi.
• Ngenxa ukuhlukumeza epheleleyo kwimiqobo inyumoniya, olwenzeka xa kwimibhobho inyumoniya acudisiweyo ngokuthi i setyana nkovu omkhulu okanye ukuvaleka nobunzina obufana, ntonje ngokuwa isabelo, atelectasis kwemiphunga eme ngaphezu uxinzelelo kwegumbi okanye ukuvaleka.
• Total okanye focal atelectasis (inxalenye spadenie okanye nomhlehlo kwemiphunga).

amanyathelo othintelo

Isifo sephepha lweendawo nkovu intrathoracic, lokufunyaniswa apho kwaxoxwa ngazo iinkcukacha ngathi ilapha ngasentla isebenza, kwakunye nazo zonke ezinye iintlobo sephepha, ukuba "isifo ekuhlaleni." Oko kukuthi, imbonakalo yayo ixhomekeke iimeko zokuphila kunye nomgangatho wempumelelo. ERashiya, oonobangela ngulo bhubhane kakubi esi sifo luthathwa ngokuba ukonakala elibukhali kwi imigangatho yokuphila, ukunciphisa umgangatho iimeko zentlalo noqoqosho, ukukhula ngokukhawuleza kwenani labantu abangenamakhaya, kwakunye kut- iinkqubo yokufuduka esebenzayo.