Tuberculosis pulmonary zikwi: Iimpawu and Treatment

zingambi kakhulu, kwaye ebulalayo nesifo sephepha nezifo ikhona on Earth zeminyaka, njengoko oko kungqinwa ngabembi ezininzi ngezakudala kunye namaxwebhu zembali. Kweli hlabathi lanamhlanje nyaka ngamnye kuthatha ezintlwini amaxhoba abantu abamalunga 10 million,-25% kubo bafe.

Ifom ezingemnandi isifo - isifo sephepha yemiphunga nezisasaziweyo, nto leyo ethetha ezininzi, "" phezu bonke lula. Sithathe le usulelo kulula kakhulu, njengoko indlela nangokusulela kwayo elula ngokungaqhelekanga, nemiqondiso usaqala phantse ezingabonakaliyo. Enyanisweni, ingozi yokosulelwa ngamnye kuthi ubethwa yonke imihla, kodwa ngethamsanqa, asizizo zonke umzimba okwazi yokuvela isifo sephepha. Ukuba usafuna ubeke uxilongo eyoyikekayo, musa ukuphelelwa lithemba, kuba ngoku inzululwazi iye izame kangangoko ukunyanga ngokupheleleyo nokuba ziyithumele TB yemiphunga nezengekho kunokwenzeka. Akuyomfuneko ukuba soyike uhlolo rhoqo kwaye ukuba bathobele Nigcina yi ukumphatha specialist TB. Bathi ukwazi ukomelela kunye nobuthathaka utshaba - yiloo 50% uloyiso. Ngoko ke, makhe sibone ukuba yintoni na isifo sephepha, apho uvela khona nendlela ukulwa nayo.

tubercle eletha

tuberculosis zisasazwe emiphungeni ezibangelwa eziphila, ebizwa mycobacteria. Bona ezikhona kule planethi kwizigidi zeminyaka, kodwa bafumanisa kuphela ngo-1882 yi gqirha-nzulu Goch, endihleli imbeko igama ngoko them - Goch lesifo. Zonke mycobacteria izifo (olufinyeziweyo njengoko MKB), kukho iintlobo-74, 6 apho kunokubangela isifo sephepha ebantwini nasezilwanyaneni. Ngezinti babizwa ngenxa inkangeleko, ngokwenene intonga-ezimise. Ezinye mycobacteria zihambelana ngokugqibeleleyo, ezinye egosogoso kancinane, kwaye bobabini babe ubude micrometers ukusuka ku-1 ukuya kwi-10, yaye ububanzi - malunga 0.5 microns.

Eyona unique kubo ubume kweendonga zawo, okanye imifinya. Ngaphandle kokuba zibe iinkcukacha, siphawula ukuba kwi yeentsasa Goch ivumela ukuba lokuziguqula inani engenasiphelo ngamaxesha, ukuze bazikhusele kwizihlava ezibulalayo kwezinye izilwa-buhlungu kusebenza kwaye nakuqwalasela sixhathise bume engentle. Bade bacteriophages esetyenziswa ngempumelelo, nto leyo raison d'être - ukukhusela umzimba nxamnye amagciwane olwaye lwamfimfitha. Bagxile, eletha Goch akuthethi kufa, uze ulungise macrophage ukuze lula ukuzala kwaye oku kungenza ingakwaizi kufumaneka iinkqubo zokhuseleko abo banabo. Ngamanye amazwi, eletha Goch xa usebenzisa wokhuselo zeselula yomzimba wethu ukuphumeza kakuhle.

Kanye emiphungeni zomntu esempilweni, ezi zilwanyana benza nakujoliso olutsha lokuqala olunye (tuberculosis eziziiprayimari), kodwa emva kokuba igazi kunye / okanye nkovu zasasazwa ngaphezu indawo enkulu elinye okanye zombini imiphunga kunye nezinye zemiphunga ngaleyo ndlela ziyithumele tuberculosis miphungeni. Phantsi kweemeko ezithile elo nxeba nasemva kokuba isifo sephepha zaseprayimari ngayo, njengoko eletha Goch kaThixo ngohlobo opholileyo kuhlala emzimbeni iminyaka emininzi.

Iindlela zosulelo

isifo sephepha yemiphunga kubantu kubangela iintlobo ezintathu iintsholongwane - M. tuberculosis (zenyathi oluntu), M. africanum (zenyathi intermediate) kunye M. bovis (a zenyathi isilwanyana). Le yokugqibela yi iinkomo egula ngakumbi, yaye loo mntu isasazeka ukusuka ubisi unpasteurized.

Abaninzi banomdla, zasasazwa TB yemiphunga siyasulela okanye hayi. Impendulo ilula: oko siyasulela kakhulu, ukuba zabanjwa kunye nokukhululwa izinti Koha (tubercle bacilli).

Bavela umntu ogulayo ephile kodwa ilula gqitha:

- ukuba imuncwe emoyeni;

- ngamathe (umz, ngokuthi ukukhohlela, ukwanga);

- ngokusebenzisa izixhobo sisigulane;

- ngokusebenzisa izinto zasekhaya;

- ukusuka kumama - mbungu;

- xa usebenzisa ngokwaneleyo zintsholongwane izixhobo zonyango.

Njengoko ubona, ungafumana TB kuphi: kwizithuthi zikawonke-wonke, kwiindawo zoluntu, ezikolweni, emsebenzini kunye njalo njalo.

Kubalulekile: Goch eletha kumnandi ukunamathela. Bona bagcine iimpawu zazo eziyingozi ngaphandle komzimba womntu ixesha elide. Nantsi imizekelo embalwa yendlela inegciwane Goch bahlala kwiindawo esijamelana nazo yonke imihla:

- kwindawo emnyama ngaphandle kwelanga - ukuya kutsho kwiminyaka 7;

- in isikhohlela nomonde womisa (ekhohlo kuzo zonke izifundo) - ukuya kunyaka-1;

- eluthulini kwisitrato - ukuya kwiintsuku ezingama-60;

- amaqhosha kwiintlelo nakubuchule - ukuya kutsho kwiinyanga ezi-3;

- amanzi - malunga 150 iintsuku;

- ngobisi unboiled - malunga neentsuku ezili-14;

- in lo sisi (oyile) - ukuya kunyaka.

Ngaba kunokwenzeka ukuba uphendule kakubi umbuzo ziyithumele sephepha yemiphunga siyasulela okanye hayi? Mhlawumbi Goch inegciwane ekhoyo kokusingqongileyo, kulula ukuba atshabalalise? Ngelishwa, le mycobacteria zicwadi kunzima kakhulu ukuba bambulale. Ngenxa udonga yawo eyodwa iseli, ukuba ngenkankulu abachatshazelwa kwelanga, imitha yelanga, utywala, acetone, ii-asidi, alkalis, izibulali ezininzi, dihydrate, yaye xa ebilisiweyo izifundo zesikhohlela abosulelwe ayifanga imizuzu njengoko 5. Ukuba eletha Goch kaThixo ongaba nawo umzimba nawuphi na umntu, isifo sephepha bekuya kuba buhlungu bonke abemi uMhlaba.

amaqela ingozi

Phambi kokuba isikolo, abantwana abaninzi pick up iinkuni Goch, kodwa zasasazwa isifo yemiphunga okanye nayiphi na enye uvela kuphela ababuthathaka, abantwana nabayimilwelwe. Kukwakho iqela lomngcipheko luquka:

- bantu ngokusisigxina ukunxibelelana izigulane TB;

- Abantu abane okukwazi eliphantsi;

- ezosulelwe yi-HIV;

- immunosuppressants ethatha;

- abantwana abafikisayo kunye nabantu eliqina kwixesha lotshintsho hormone;

- silambile;

- abaphethwe tuberculosis ulusu kunye nezinye izigqeba;

- ziye zidluliselwe izifo ezosulelayo;

- bolevshie isifo sephepha lokuqala yemiphunga nezengekho ngayo;

- ukwandisa ezinye iinkqubo physiotherapeutic elide (umz, zwi).

ngezigaba

tuberculosis pulmonary ungakwazi nokuphuhlisa zisasazwe ngezi ndlela zilandelayo:

1. yegazi (hematogenous). Kulo mzekelo, zombini imiphunga ayachaphazeleka. Ngenisa yegazi iintsholongwane kwenziwa kwiindawo nkovu, eYangon nepokotho, entliziyweni ekunene kwaye Kusenjalo nezengekho miphungeni.

2. nkovu (lymphogenous). Kulo mzekelo, kwemiphunga enye abachaphazelekayo.

3. Limfogematogenny.

Ngu uhlobo sifo ukwahlula tuberculosis yemiphunga olunikezelwa ezi fom zilandelayo:

- etsolo (miliary);

- subacute;

- ezingapheliyo;

- ngokubanzi. Ngale ndlela esi sifo uthi xa, ngenxa yaso nasiphi na isizathu, imithambo yegazi kwenzeka imixholo kwizixekoapho i ochaphazelekayo nkovu node Mycobacterium, ubume apho loo obufana (caseous). Kulo mzekelo, ngexesha elifanayo isixa esikhulu yegazi kwi izinti Goch. Ngethamsanqa, oku kwenzeka ngamaxesha athile.

Ifom nokoyika sephepha

Isifo iqala wavele, ngesiquphe, iimpawu eziqaqambileyo kakhulu, azifane pneumonia. Uxilongo isekelwe phezu hardware of wemiphunga ekuzakuqalwa uhlalutyo lwe isikhohlela. Acute esasaziweyo TB yemiphunga luphawulwa ubukho kwi inwebu imiphunga of hillocks ezininzi ezincinci (malunga millimitha) efana amazimba okuziinkozo. Ngenxa yoko, igama yesibini - "miliary (milae in Latin lithetha" amazimba ") isifo sephepha." Isigulana zatshintsha yokuqala isakhiwo capillary apho collagen ibhuqiwe, yaye iindonga legkopronitsaemymi, nto leyo ekhokelela kwii-mycobacteria igazi flow ukuya emiphungeni. Iimpawu le ziquka:

- Jump ebukhali kobushushu inamanqaku 39,5-40 ° C;

- ubuthathaka, ukudinwa, ukudinwa phezulu;

- ukubetha rapid;

- ukungabi namdla;

- Imivumbo imilebe neminwe;

- yellowness kwesikhumba;

- isicaphucaphu ku ukugabha;

- intloko ebuhlungu;

- ukhohlokhohlo ezomileyo okanye imveliso isikhohlela, nto leyo ukongeza yencindi yomlomo kunye ubofu zizinto wachuba iindawo igazi;

- bamba umphefumlo.

Maxa wambi kukho isifo kusasa ngokukhawuleza, wada andabikho zingqondweni.

uhlobo Subacute sephepha

Oku kwenzeka xa sifo ezityeni ezinkulu yegazi (imithambo yegazi intralobular interlobular). Kulo mzekelo, kubonakele izilonda ukuya ku-1 cm ubukhulu. Bona ikakhulu kwi iinxalenye emiphungeni, apho uninzi emithanjeni nempahla nkovu. Ngu uhlobo ezitshangubeni proliferative, inflammations kunye nangezilonda ngaphandle, kodwa kunokukhokelela ukudumba kwi pleura visceral.

Iimpawu kweefom subacute-TB ukuze sifane nezinye izifo ezininzi ukuba nzima uxilongo lwezonyango. Phakathi langoku eziphambili zezi zilandelayo:

- ukudinwa, buthathaka;

- lobushushu kwinqanaba-38 ° C;

- a ukukhohlela kunye isikhohlela.

isifo sephepha esinganyangekiyo

Olu hlobo esi sifo lwenzeka xa isigulane eso sinyangekile ngokupheleleyo ephambili (fresh) tuberculosis. Kwiimeko ezinjalo, Mycobacterium ngokuphindaphindiweyo nge yegazi okanye nkovu evela nakujoliso olutsha lokuqala eyele amacandelo ezintsha kwemiphunga, nto leyo ke kukho nakujoliso olutsha ezininzi ezohlukeneyo ngobukhulu (ukusuka amancinci kakhulu mikhulu) iimilo ezahlukeneyo kunye neepatheni. Bangafika calcified omnandi kakhulu, kunye nomfanekiso eqaqambileyo arhabaxa. nezilonda ibonakele zombini emiphungeni. picture kwezinye wongezelela emphysema, abanesigulo izicwili ezahlukeneyo emiphungeni, loloyiko pleural. Kunjalo, ezingapheliyo sisifo sephepha zasasazwa pulmonary ithi akuthethi ukuzibonakalisa, ngokunxulumene kuso amaninzi afumaneka ngexesha fluoroscopy. Symptomatology kwefom ezingapheliyo sephepha ngolu hlobo lulandelayo:

- nokudinwa;

- ukulahlekelwa emnyama;

- emaciation;

- ikhanda njalo;

- ukunyuka ngqiqweni lobushushu (episodically);

- khohlo.

tuberculosis eqonda: Isigaba

Kuqala wacinga ukuba isigaba usuleleko I kwenzeka esithinzini aphezulu emiphungeni, II - embindini, kunye III, kwaye sele eze ukwehlisa. Kamva oluhlobo eyaziwayo ezingachanekanga, ukususela kwisigaba kwesi sifo zenzeka ngokulinganayo kuzo zonke iinxalenye kwemiphunga. Ukuza kuthi ga ngoku, eyenza zigaba zilandelayo sephepha pulmonary:

- Alopecia;

- nokungena;

- kuwa;

- Office + (uhlobo open of tuberculosis);

- MBT- (closed).

isifo sephepha zikwi-kwisigaba nokungena MBT + kuthetha ikhosi isifo kunye kwakhululwa kokusingqongileyo mycobacteria. The main uphawu - a ukukhohlela kunye nemveliso yesikhohlela, ingakumbi xa iqulethe ububomvu kunye negazi.

Alopecia isigaba ikakhulu uphawu sephepha lokuqala okanye ezintsha. Lubonakala kukuba sichaphazele isibini okanye ingxenye eyodwa. Kule milinganiselo gumbi amancinci (ukuya kwi-1 cm ubukhulu). Esi sigaba lwenzeka ngaphandle iimpawu kunye elibhaqiweyo, ngokokuqhelekileyo kunye nzima ukufunda ukukhanya (x-reyi, fluoroscopy).

tuberculosis esasaziweyo: isigaba nokungena kunye nokucazululwa

Loo umlinganiswa sifo ifunyenwe by uzingela ezelwe lingekabi lilixa layo (isigulane uyakuphepha inyanzelekile fluorography abenza ngonyaka, akuziva oogqirha xa iimpawu zokuqala ixhala, baxoxa self-medicate okanye usebenzisa amayeza abahlala jikelele ngokwaneleyo olusebenzayo njengoko unyango lokuqala). sigaba lokubola kuthetha ukuba morphology of emathunjini lung wafikelela kwinqanaba apho inyama waqalisa iba, kusekwe umngxuma ngokoqobo. Iingceba inyama ukudilika abosulelekileyo bekhohlela phandle. Bona Zinokuxutywa yencindi ububomvu kunye negazi. Kwakhona, ezi zahlulo kweyela kodwa baboniswa isifo amacandelo kwemiphunga, nto leyo imboni olukhawulezileyo mycobacteria. Izigulane unesifo ziyithumele lwesifo sephepha yemiphunga kwisigaba ekungafuneki, i umthombo eziyingozi osulelo kwabanye, kwaye kuxhomekeke esibhedlele enyanzelekileyo. Unyango esibhedlele zibe elide, ukuya kutsho kwiinyanga ezintandathu. Ngenxa yoko, yaphela izilonda Philisa (calcined).

Isigaba nokungena nalo iqatshelwe ikhondo ngcembe sifo, kodwa kule meko ukukhanya kungekho kwawa emzimbeni kwenzeka. Ngokubanzi nokungena - inxalenye (centre), apho kukho komtshiso oko. Loo ndawo uhambisa ezininzi leukocytes lymphocyte, kwaye iimpawu sifunda i inyumoniya ebukhali. Esasaziweyo tuberculosis yemiphunga isigaba nokungena unalo mpawu zilandelayo:

- ukunyuka okukhulu lobushushu ukuya ukuphakama phezulu;

- ubuthathaka, nokudinwa;

- iintlungu esifubeni;

- khohlo;

- Iimpawu yetyhefu;

- intloko ebuhlungu;

- ngamanye amaxesha buthathaka sezingqondweni.

Ngaphandle unyango quick yaqalwa e kwisiza esiqwini nokungena waqala iba. Isigulane ekhohlela ngaphandle okanye inkqubo ukhohlela lihamba ekukhanyeni yesibini, nto leyo ngokukhawuleza kakhulu bayosuleleka owayesakuba ephilile. Isifo sephepha kwi izigaba ekuweni idibane hayi nje kwakugcwele basengozini enkulu yosulelo lwe-kwabanye, kodwa ezibulalayo umguli.

ekuxilongweni

Akusoloko kulula ukuseka nangoko umguli kunye tuberculosis zahanjiswa. Uxilongo kunzima kuba iimpawu zesi sifo kunye nenyumoniya, SARS, nokuba umhlaza kuwenza ziyafana kakhulu. Xa ufowunela isigulane ukuya ekliniki yokutyholwa ukudinwa, ukhohlokhohlo, umqala obuhlungu, ukutyhafa, ukuphelelwa umoya ugqirha linyanzelekile ukuba ahlole ulusu ubukho loloyiko ukuze zihlale ukusuka ithumba engabalulekanga edlulileyo, lymphadenitis. Kwakhona bahlola wolingano apha esifubeni (ayikho, ukuba TB senzeka kwi lung omnye), zitshekishwe intlungu izihlunu imimoya umbhinqo emagxeni. Xa ndiphulaphule yeSkrini ibonisa lung, nokuba ukutswina kukuthi, yintoni indawo yabo nesimilo. Kunyanzelekile ukuba enze kwilebhu iimviwo isikhohlela ubukho mycobacteria. Kwezinye iimeko, izigulane ezithatha isifundo ezinjengeentlambo inyumoniya, okanye isisu amanzi (ngokuqhelekileyo ebantwaneni). Ukongeza, iimvavanyo elebhu ukuze ziquka:

- bronchoscopy;

- isikhohlela smear microscopy;

- biopsy le pleura;

- thoracoscopy;

- okuhlatywa pleural.

I zisetyenziswa kakhulu yaye ichaneke luphononongo fluoroscopic.

Treatment nabanye abantu abane

Ukuba ugqirha uye wafunyaniswa "ziyithumele isifo sephepha yemiphunga", unyango iya kuba elide kunye ezininzi. I-ALS kuxhomekeke kwisigaba apho esi sifo elibhaqiweyo, kwaye isigulane yenza amayeza kagqirha njani kakuhle. Xa naluphi uhlobo kwisigaba yemiphunga + kwi MWT isigulane esibhedlele. Esibhedlele becala wenziwa unyango ngamachiza (ichemotherapy) eyenziwa zamachiza anti-tuberculosis, impilo yomzimba, iivithamini, uqinisa nezifo.

Chemotherapy kwizigulane ezisanda kwafunyaniswa kwisigaba olumandla unyango lwenziwa zilandelayo amachiza alwa i-TB, "Iziniazidom", "rifampicin", "pyrazinamide" yaye "ethambutol", kwaye kwisigaba ukuqhubeka unyango - "isoniazid" yaye "rifampicin" okanye "isoniazid" and "ethambutol ".

Xa yondele tuberculosis olunikezelwa ibonisa ukusetyenziswa corticosteroids kunye immunomodulators. Eyona emiselweyo rhoqo "prednisolone" (15-20 mg / imihla iiveki 6-8).

Ubude bonyango - ukuya kwiinyanga ezi-6. Ukuba emva kweenyanga ezintathu akukho mkhwa wokuphucula, kunye nenani lezinye izibonakaliso, ukungenelela kokuphaphaza okubandakanya ukususwa kwesigaba esisodwa seplmonta okanye umphunga ngokubanzi.

Ngoku indlela entsha yokunyanga kwesifo sofuba, ebizwa ngokuthi "i-valve bronchial blocking", okanye nje "bronhoblokatsiya", eyona ndlela yindlela yokuhlinzwa, isetyenziswa.

Thintelo

Isifo sofuba semiphunga sithathwa njengesifo senhlalakahle, ukusasazwa okuxhomekeke kakhulu kumgangatho wobomi babantu (iimeko zokuhlala, ukufuduka, ukukhonza izigwebo entolongweni, njl.). Njengamanyathelo okukhusela, ngokukodwa ukusabalaliswa kwesifo sofuba se-pulmonary, sinokuthi:

Inqumaniso yebhayibrama;

- ukwenza amanyathelo okulwa neengcipheko;

- vaccination BCG;

Ukunikezelwa kwendlela yokunyanga izigulane ezineesifo sofuba;

- ukuqhuba ukusebenza (ukudlala ezemidlalo), indlela yokuphila enempilo;

- isigcaziso sezigulane ezizaliswe ngexesha lokunyangwa kwesifo sofuba.