The pathogenesis TB. The etiology TB. Zizindikiro ndi zizindikiro za chifuwa chachikulu

Za chifuwa chachikulu anamva ambiri, koma anthu ochepa kuzindikira ngozi ya matenda oopsa. Kwa zaka zambiri, madokotala padziko lonse afufuza zinthu zimathandiza kuti chitukuko cha matenda, zizindikiro zazikulu ndi zizindikiro. Panthawi imeneyi, chinapezeka kuti siteji oyambirira a chifuwachi a mapapo ndi ziwalo zina angayambe maonekedwe asymptomatic, ndi kusowa kwa mankhwala kumabweretsa mavuto aakulu.

mudziwe mwachidule za matendawa

Pakali pano, ndi pathogenesis TB anaphunzira zonse. Izi ndi oopsa ndipo kwambiri matenda opatsirana chifukwa cha wothandizila opatsirana ku mtundu Mycobacterium.

Pali mitundu yambiri ya majeremusi amene zoyambitsa matenda anthu. Njirazi ndi monga:

• anthu, limapezeka nthawi zambiri, mlandu 92% milandu polisi;
• Bovine, zotsatira matenda kwambiri zochepa, akudwala za 5%;
• wapakatikati, makamaka kufalitsidwa ku South Africa, mu Russia matenda wapezeka mu 3% odwala;
• mbewa ndi mbalame, imapezeka mu anthu ndi limati immunodeficiency mu mbiri.

anthu ochepa mukudziwa kuti thunthu la dongosolo kupuma si TB. The Bacillus amadziwikanso kuwakantha:

• mafupa;
• m'mimba thirakiti;
• genitourinary dongosolo;
• ubongo.

Kaya malo, matendawo ndi woopsa kwambiri ndipo n'kogwiritsa imfa ngati sanalandire chithandizo.

Matendawa ali ndi yaitali makulitsidwe. Zizindikiro woyamba kuonekera patatha miyezi 3 - 1 chaka kumayambiriro nthumwi opatsirana.

ziwerengero

zachipatala padziko lonse akuda nkhawa chifalikire mofulumira matendawa. Russia mu mndandanda wa mayiko chikuchitika 22th.

Poyamba, zambiri za anthu kachilombo kutumikira ziganizo m'ndende. Koma kuyambira 90 ntchentche anayamba mliri, ndi Bacillus kufala chachikulu.

Daily matenda amapezeka TB mwa mabanja olemera, ambiri mwa ana ankachokera odwala.

Mu gulu zaumoyo, mfundo imeneyi anali kugwirizana ndi kuchepa mu kakhalidwe ka moyo wa nzika, amene anali ataona pa nthawi ndi chifukwa cha kukonzanso ndale za dziko.

Kwa zaka zambiri izi mliri akatswiri kuti zagwiridwa ya zodzitetezera kuti kulola pang'ono ziziyenda zinthu, kuchepetsa odwala ndi omwalira. Njirazi ndi monga:

• Katemera wa akhanda ku chipatala;
• kutsatira amapezeka ntchito Mantoux mayeso (ana), ndi x-ray (akuluakulu).

TB Bacillus kugonjetsedwa kwambiri kusintha chilengedwe, kotero nthawi yaitali anakhalabe mu mkhalidwe yotheka mu madzi, dziko ndi zina zotero. N. Pakuti si kugwilizana ndi malamulo aukhondo chiopsezo munthu chotenga ndithu mkulu.

zizindikiro khalidwe

Maziko yaikulu ya pathogenesis ndi malowedwe a timitengo tizilombo mu thupi. Anthu oterowo safuna yomweyo adwale moyenera, pali kudandaula ayi.

Ndi chifooke chitetezo chokwanira pa angakhalepo:

• pang'ono kuwonjezeka thupi kutentha;
• chinawonjezeka kugunda kwa mtima;
• thukuta kwambiri ndi usiku;
• manyazi pamodzi zobwera khungu pallor;
• kufooka, chizungulire;
• kutsokomola;
• sputum wothira magazi.

Kuwonongeka kwa chikhalidwe ambiri ukapezeka chifukwa cha majeremusi poizoni poizoni. The zambiri chiwerengero zizindikiro zambiri kwambiri kutchulidwa.

Zizindikiro zoyambirira za TB odwala ndi dongosolo amphamvu chitetezo akhoza kukhala otsika kapena kwina palimodzi.

The aakulu Inde ndipo mofulumira kupitirira zimawonedwa mwa anthu ndi matenda.

Ngati bakiteriya ndi anakantha:

• Bone - pali ululu amphamvu mafupa onse ndi stiffness.
• Brain - pali nseru, kusanza, kupweteka kwambiri, ndipo ululu minofu.
• dongosolo mkodzo - wodwala zonse amamva zikusefukira chikhodzodzo. Mbali zapamwamba za maonekedwe a magazi mu mkodzo.
• M'mimba thirakiti (GIT) - pali zonse m'mimba kusapeza, nseru, wofiira milozo m'manyi.
• Khungu - padziko anapanga tinatake tozungulira ake wodzazidwa ndi mafinya omwe zavumbulutsidwa mu njira yake.

Motsutsa likhale njira yaitali TB pali yotupa granulomatous mtundu wa ndondomeko kuti zingaoneke mu chiwalo chilichonse akhudzidwa. Kudziwa ntchito njira zamakono za matenda.

anthu okhudzidwa

Medicine akhala wasonyeza kuti pathogenesis TB zimadalira boma ya chitetezo cha mthupi.

Ku matenda palibe amene sangayesedwe, koma Kumwambamwamba gulu chiopsezo amaphatikizapo anthu:

• HIV ndi AIDS;
• akaidi;
• kudwala matenda osiyana siyana aakulu (zilonda za dongosolo m'mimba, matenda a shuga, etc ...);
• ndi zizolowezi zoipa;
• wamng'ono;
• kunyalanyaza malamulo munthu ukhondo;
• Amakambirana ndi munthu amene ali;
• pa mimba;
• akupanikizika zonse;
• wosalandira mavitamini zofunika ndi mchere;
• akukhala mu madera zachilengedwe ovutika;
• kwa mabanja amene amapeza ndalama zochepa;
• palibe atathana malo okhala.

Pamene adamulowetsa, ndondomeko pathological, ndi pathogenesis TB amakhala ndi kuchuluka opatsirana.

mawonekedwe

Mtundu wa matenda zimadalira nthawi ya chithandizo, ndi Mapa Mwina matenda ena. Kuonetsetsa gawo zotsatirazi TB:

1. Open. Chimasonyeza zotupa za m'mapapo. Ngati ikuchitika sputum kusanthula watsimikizira kukhalapo kwa tizilombo toyambitsa matenda mu izo, munthu ali opatsirana.
2. Tatseka. Ndi chifukwa zoipa, wodwalayo si chonyamulira cha matenda.

Ngati ndodo koyamba mu thupi amati mawonekedwe chachikulu, ngati osiyana sekondale.

Komanso matenda akhoza zimasiyana mu chiwonongeko chilengedwe:

• miliary;
• mwiniwakeyo;
• infiltrative;
• zochepa;
• wowumitsa;
• fibrocavernous;
• tuberkulemny;
• cavernous;
• cirrhotic;
• tuberculous pleurisy.

Njira ya matenda a ana, ndipo pa mimba

The etiology TB zikusonyeza kuti nthawi zambiri kuti anthu ndi chitetezo ofooka kachilombo. Chotero kuphwanya angakhale kobadwa nako, koma nthawi zambiri amapezeka mu ndondomeko ya moyo, mchikakamizo cha zinthu zosiyanasiyana.

Mu ubwana dongosolo chitetezo si athanzi, kotero kusatetezeka kwambiri chifukwa malinga osiyanitsidwa ndi zaka mwanayo. E. Kuposa iye pansi, m'pamenenso njiru nkhuni.

Pambuyo matenda, matenda kumachitika chimodzimodzi monga akulu, koma ndi mawonekedwe kwambiri. kusiyana Specific ziribe kanthu.

TB pa mimba si chifukwa kuchotsa ake.

The kusintha kwa gawo yogwira Tingaone mu trimester kapena pambuyo pobereka. Nthawi zina n'kukhala. Ichi ndi chifukwa ntchito ya chitetezo cha m'thupi, ndi kusintha m'thupi mu thupi.

Matenda a mwana wosabadwayo si nthawi zonse anaona. Kwenikweni ndi mmene likamanena zotsatirazi:

• fibrocavernous;
• aakulu zowononga;
• mwiniwakeyo.

tizilombo toyambitsa matenda amenewa mosavuta kuwoloka chotchinga placental, kuchititsa chisokonezo kwambiri mwana wosabadwayo.

Kamodzi ndi matenda zolondola wodwalayo pansi pa ulamuliro wa gynecologist ndi TB.

Chithandizo akuyamba yomweyo, ndi mankhwala owerengeka amene ali wamng'ono kungasokoneze mwana osabadwa.

Ngati nthendayo wapezeka mu nthawi, kuti madokotala ananena zawo mkazi ndi mwana-wochezeka, koma pali kuchotserapo. Nthawi zina mimba akadali osavomerezeka.

kafukufuku

Pambuyo kuoneka zizindikiro woyamba odwala Muzisamala kawirikawiri kukaona dotolo, koma pachabe. Wavala chinyawu zowawa chabwinobwino adzabisale osati TB komanso matenda ena zoopsa.

Ngakhale kuwonongeka pang'ono thanzi ndi zizindikiro za matenda pachimake kupuma, koma ndi malungo akhale nthawi kukaonana ndi adokotala.

Koyamba anayendera adzakhala Dokotala amene amamva madandaulo onse, kuganizira etiology TB ndi kupereka malangizo mayesero ofanana (magazi ndi mkodzo), ndipo maphunziro zina zofunika, zingakhale:

• Fluorography. 1 chaka chilichonse kuyambira ali ndi zaka 15. Timatha kuzindikira TB m'mapapo mwanga ndi matenda ena okhudzana ndi kupuma. M'gulu mndandanda wa Kafukufuku kuvomerezedwa ntchito, asanapite ku usilikali, ndi zina zotero. N. Ngati chifukwa cha x-ray ndi zofunika kukambirana, ndi zina X-ray kuchita.
• Mantoux mayeso. Anthu ambiri molakwika kusokoneza ndi alumikize. Izi ndi mtundu wapadera wa matenda a TB. Iwo ikuchitika kuti ana onse mu m'badwo 1 chaka 14 - 15 zaka, nthawi zina 17. singano zochepa anaikapo pansi pa khungu ndi zinthu - tuberculin. Mu dongosolo lake lili muli timitengo tizilombo. "Batani A" kuonekera pambuyo kukhudzana zimenezi. Pakuti chifukwa wounikira anayeza awiri ake.
• Zogwirizana immunosorbent zofufuza (Elisa). Timatha kudziwa pamaso tizilombo m'magazi pa nthawi ya phunzirolo.
• Sputum kusanthula Ziehl-Neelsen. Ikuchitika odwala onse ndi chifuwa yaitali. Sputum ndi wodetsedwa ndi njira yapadera, amene amalola kudziwa pamaso pa oyambitsa tizilombo.
• Bacteriological sowings. Zimenezi zithandiza inu mukudziwa mtundu wa ndodo chikwiyire matenda. Fesani kukula za 1-2 miyezi, koma amapereka zotsatira zolondola kwambiri, limakupatsani kusankha mankhwala ogwira.

Pakuti amaganiziridwa TB ziwalo zina kuwonjezera ikuchitika:

• X-ray;
• Kujambula kapena CT jambulani m'dera anakhudzidwa;
• encephalogram ndi m. p.

The pathogenesis TB ndi zinthu zofanana kwambiri ndi matenda ena ambiri, monga khansa, kotero Sizotheka kuganiza pomwepo.

chithandizo

Kusankha mankhwala makamaka zimadalira pathogenesis ndi TB zipatala ndi. Iwo anachita m'manja mwa akatswiri TB ndipo zimatenga nthawi yaitali. Nthawi zambiri, ndi zaka 2, pang'ono pokha 3-4.

Kusankha chiwembu mankhwala kumatengera zifukwa zambiri. Kawirikawiri, adokotala amatenga zochita pa maziko a:

• mmene wodwalayo;
• msinkhu ndi kugonana
• Zotsatira bwinobwino ndi zina zotero. N.

Zolinga zikuluzikulu za mankhwala:

• kupanga wodwalayo si opatsirana;
• Zimachititsa machiritso a zimakhala kuonongeka;
• mwakale.

zotsatira zabwino chingapezeke ndi thandizo la mankhwala zotsatirazi:

• Para-aminosalicylic acid.
• "Streptomycin".
• "Kanamycin".
• "Rifampicin".
• "Ftivazid".
• "Pyrazinamide wokhala".
• "Ethionamide".

Zimagwiritsa ntchito 3, 4, kapena 5 zigawo imodzi.

Gwiritsirani ntchito mankhwala amphamvu, nthawi ndi mlingo anatsimikiza payekha.

Kuthira aukali mankhwala minofu kusinthika zimachitika pang'onopang'ono ndipo ndithu monga kofunikira komanso koyenera choncho, kuti masoka minofu kukonza ndondomeko zambiri zotchulidwa phthisiatricians pathogenetic chithandizo. Izi zikuphatikizapo lonse zosiyanasiyana zomwe iyende bwino. Zikuphatikizapo phwando:

• odana ndi yotupa wothandizila;
• immunomodulators;
• michere;
• mavitamini B;
• sorbents;
• mankhwala chitetezo ndi kubwezeretsa kwa chiwindi (kwa chiwindi);
• asidi glutamic;
• anticoagulants;
• antikininov;
• anabolic mankhwala;
• antiallergic wothandizila ndi ena.

opareshoni

Nthawi zambiri, mawonekedwe koyamba matenda alibe amafuna chithandizo opaleshoni. Nthawi patsogolo popanda njira zimenezi sangachite. Ngati zingamvekere mapapo ikuchitika:

• Lobectomy.
• Resection.
• Bilobektomiyu.
• Pneumonectomy.
• Kavernoektomiyu.
• Pneumothorax.

Poganizira pathogenesis wa extrapulmonary TB thereto Angagwiritsidwenso ntchito opaleshoni.

Pamene matenda thirakiti m'mimba ya kachilombo Kwalamulidwa chizolowezi kapena mwadzidzidzi opaleshoni kuti achotse zotsatira zake.

TB CNS ankachitira njira makamaka ndiwofatsa. Ngati sititenga, chitani kuchotsa zotupa. Iyi ndi ndondomeko zovuta, omwe angakhale ndi zotsatira sizingasinthe.

Purulent khungu granulomas Angagwiritsidwenso ntchito.

Cholinga chachikulu cha zimenezi - kuthetsa mavuto a matenda ndi mwina kubwezeretsa machitidwe anakhudzidwa.

Kodi kuchita kupeza

Ngakhale kulimbana wosimidwa ndi TB zachipatala, kudwala akadali wamba kwambiri anthu, choncho palibe mavuto kudziwa momwe mungadzitetezere ndi banja lanu:

• Katemera. Pangani katemera uyu ndi makolo awo, koma sasiya izo. Timatha kukhala ndi chitetezo chokwanira amphamvu mwanayo ndi matenda amene amakhala amphamvu kwambiri akafika 1 chaka. Chifukwa, mwanayo si kudwala chifuwa cha TB, kapena kunyamula mu njila yosavuta.
• Wokhazikika anayendera. Timatha kuzindikira matenda langoyamba, ndi kusunga mankhwala kuteteza matenda a ambiri anthu. Izi zikuphatikizapo Mantoux mayeso ndi chifuwa X-ray.

Magulu ena odwala amaoneka njira mankhwala amphamvu, zinalimbana:

• Kukhala ndi dongosolo ofooka m'thupi kapena aakulu matenda a m'mapapo thirakiti m'mimba, chapakati mantha dongosolo.
• Kukhala m'chipinda chimodzi ndi munthu amene ali.
• Kukhala ndi kusintha mu kapepala kupuma ndi maziko a akuvutika TB.
• Childhood ndi zotsatira osauka Mantoux mayeso.

Kuwonjezera zikunena zachipatala, pali ya malangizo amene akhoza kuchepetsa kudwala matenda a. Kuchita izi:

• masewera olimbitsa thupi;
• kudya azidya chakudya;
• amavutika ndi zizolowezi;
• sambani m'manja bwinobwino asanayambe kudya ndipo pambuyo ku malo onse;
• kucheza ndi munthu odwala;
• bwino kupopera mankhwala chipinda choyera kumene kachilombo;
• nthaŵi zonse mavitamini ndi kukonzekera munali polyunsaturated mafuta zidulo Omega-3.

Onse-TB akatswiri, madokotala kudziwa chinsinsi chaching'ono pa zochepetsera chiopsezo cha kuchepa TB. Kuti tichite zimenezi, muyenera kukhala chakudya m'mawa ndi kupewa nyengo yaitali njala masana (makamaka kufunika kogwiritsa ntchito zoyendera anthu). Akukhulupirira kuti popeza Bacillus ali pafupifupi zosatheka kudutsa thupi.

zosokonezeka

Mavuto obwera chifukwa cha TB ikusonyezedwa pa nkhope zawo, kuti akuchedwa ulendo kwa dokotala ndi kunyalanyaza diagnostics. Akuthamanga mawonekedwe ungathe kusokoneza anthu:

• mtima ndi kulephera kupuma;
• magazi kuchokera ku ziwalo bwanji;
• ulceration, fistula;
• chakhungu ntchito aimpso ndi chiwindi;
• chitukuko cha granulomas thupi lonse;
• amyloidosis;
• pneumothorax;
• kuwonongeka kwa ntchito galimoto;
• ziwalo;
• sepsis;
• chilonda;
• necrosis;
• chikomokere;
• koopsya.

Pamene mavuto a madokotala ananena zawo matenda ndi umphawi wadzaoneni.

Kuchokera pamwamba Ndizachidziwikire kuti matenda amakwiya zizindikiro zosiyanasiyana. Zizindikiro zoyambirira za TB m'mapapo mwanga akhoza kusonyeza chifuwa yaitali, musati kuthetsa mankhwala mucolytic. Izi ayenera kuchenjeza mtima ndipo iye kuwona dotolo. M'pofunikanso kukumbukira kuti matenda amalabadira mankhwala ndi chithandizo yake, ndipo mu nkhani ya kusintha kwa mtundu zapamwamba za chiopsezo cha matenda oyamba osauka, zivute zitani kudzetsa imfa chowawa.