I-TB-cavernous tuberculosis: iimpawu kunye nonyango. Ukuthintela kunye neengcebiso ezincedo

Isifo sofuba se-Fibrous-cavernous isifo esiyingozi, into ephawulekayo yokuba kukho ubude bodwa emiphakeni. Kwimichiza, yayibizwa ngokuba yi "cavern". Isifo sisigaba sokuqhubela isifo sesifo sofuba. Ngokuqhelekileyo, ikliniki ye-pathology efanayo ifana nomntu ocolileyo.

Izifo zesifo

Njengomthetho, i-fibro-cavernous tuberculosis ibonakala kwizigulane zabantu abadala. Xa ubuntwaneni, ukubonakaliswa kwe-TB yesifo esiyintloko kubunqabile.

I-Cavernous pathology yenza njengesiphumo sesifo sesifo sofuba, kodwa kwenzeka ukuba intlobo yesifo esasasazwayo, okanye i-focal.

Ifom ye-Fibrous-cavernous ifunyenwe kwi-5% yeziganeko zesifo sofuba.

I-Cavernous tuberculosis njengenyathelo ekujoliseni ekuphuhliseni i-fibrous-cavernous pathology

Isibonakaliso sokubonakalisa i-cavernous tuberculosis esichaphazelekayo kubonakala ukuba kukho ukungena kwesibindi esisodwa, ukungabikho kwesibindi kunye noshintsho lwe-fibrotic kwindawo ye-tubon bronchial, izitya ze-lymphatic kunye nezicubu eziseduze. Esi sifo asihlali ngaphezu kweminyaka emi-2.

Ukuphulukiswa kwamagalebhu kwenzeka ngokusekwa kwe:

• Rumen;
• Isifo sofuba;
• Ingqwalasela enye yeso sifo;
• Umgudu ongezantsi.

Xa kungabikho unyango olufanelekileyo, ifomu le-cavernous liya kwi-tuberous-Cavernous tuberculosis, ebonakalayo ngokubamba iindonga ze-cavern kunye ne-pulmonary parenchyma. Kukho neendawo ezininzi zokusasazwa.

Isibonakaliso sesi sifo

Njengomthetho, i-fibrous-cavernous tuberculosis yindawo emaphakeni. Ukuphuhliswa kwesi sifo kubakho kwiinyanga eziyi-3-4 zonyango olungenakusebenza kolunye uhlobo lwesifo sofuba. Ukubonakaliswa kwesi sifo kubangelwa ngokukodwa kwisigaba sokubola.

Iimpawu eziphambili zesifo zingabalwa:

• Asthenia;
• Ukunciphisa ukutya;
• Isikhwehlela esinamandla kunye ne-phlegm;
• Ukuxilongwa kwegazi;
• Ukuhlamba;
• Imiba emanzi kwindawo yokubola.

Emva kokubunjwa kwe-cavern, iimpawu ziba zimbalwa, zingabonakaliyo kwaye zingabonakali. Isigulana sinokukhalaza ngobuthakathaka obuninzi, ukukhathala okuqhubekayo, ukulahleka kwesisindo kunye nobukho beqondo lokushisa.

Ukuphuhliswa kwesimo esifumanekayo sesifo sesifo sofuba singaboniswa ngokuphuma kumaphaphu, okwenzeka ngaphandle kwesizathu.

I-Anamnesis yezigulane ezithinteka yi-fibro-cavernous tuberculosis, ithatha i-wavy course. Ixesha eliphakathi kwexesha elibi kunye nokuxolelwa lunokude lide okanye, ngokuchaseneyo, isigaba esiqatha singabonakalisa ngokuqhelekileyo.

Ifom ye-Fibrous-Cavernous yeesifo sofuba ineempawu ezahlukeneyo zeklinikhi. Yibangelwa yinkqubo yesifo, kunye neengxaki ezihambelanayo.

Kukho iintlobo ezimbini zekhosi yezifo: ezilinganiselwe okanye ezizinzileyo, apho phantsi kwefuthe le-chemotherapy liza ukuzinza kwesimo somguli kunye nokuxolelwa, okuhlala iminyaka emininzi.

Ngexesha elimangalisayo kukho ukunyuka kokushisa nokuphuhliswa kwenkqubo yokuvuvukala ecaleni kwendawo. Iqondo lokushisa linokufikelela kumaxabiso aphezulu xa usulelo lwesibini luhlangene nesifo esiphezulu.

Ukutshatyalaliswa kwe-bronchi kuhambelana nokukhwehlela okubuhlungu, apho i-sputum equkethe i-muscus ne-pus ihlukanisa ubunzima.

Isigulane esinesifo sofuba sisifo se-cavernous, silahlekelwa ngamandla. Unesikhumba esomileyo, esingaba lula ukumelana. Izihlunu zesigulane zithinteka. Injongo yeprogram ye-pathological is a belt belt, back and area between the nbsp.

Izigulane zithobela ukuxilwa rhoqo. Ngenxa yokuxhatshazwa kwesi sifo, ukungaphumeleli kokuphefumula kwe-1 ne-2 degrees kukhula. Kwixesha elizayo, kunokubakho ukwanda kwimiqulu yesibindi. Kukho ukuvuvukala.

Xa eso sifo siqhubeka, iilryx kunye nezilonda zamathumbu ziyabonakala, ezikhokelela ekutheni amandla omzimba omzimba athathaka. Ngo-kahesia, i-amyloid nephrosis kunye nesifo senhliziyo, ukuxelwa kwesifo akubi.

Izizathu zesifo

Ukutshatyalaliswa kunokushukunyiswa naluphi uhlobo lweklinikhi yesifo sofuba. I-provoker yentuthuko ingabonakali. I-Mycobacteria kufuneka ihlelwe njengezilwanyana. Kuzo zonke ii-74 amagama. Baye kwi-genco Mycobacterium. Nangona kunjalo, isifo sofuba ebantwini sishukunyiswa ngumhlobo otyunjwe ngokomqathango, othiwa yi- Mycobacterium isifo sofuba.

Izinto ezikhuselekileyo ekuphuhlisweni kwezifo zi:

• Ukwandisa izinga lokukhuthaza;
• Utshintsho kwi-reactivity yendalo;
• Izifo zamalungu angaphakathi;
• Imikhwa emibi.

Izigaba eziphambili zesifo

Yamkelekile ukuhlukanisa ezi zilandelayo zigaba ze-tuberous-cavernous tuberculosis:

• Ukungena. Ithatha ubukho bokugxotha.
• Ukubola. Kugxininiso lokuvuvukala i-cavity, ezaliswe yindlela ekhethekileyo yezicubu zesifo somzimba - ubunzima obubi. Okubomileyo kwinto ekhulayo kwaye ngokukhawuleza kuhlanjululwe kwi-bronchus. Endaweni yalo ihlala isigxina. Kwixesha elizayo, liqala ukuzalisa umoya, kwaye ukuba kukho ukuphulwa komjelo kwi-bronchi, kuba ngumbane.
• Ukuqulunqwa kwamabala. Uqeqesho luyilwe ngesisombululo sokuqhaqhazela kunye ne-fibrosis. Udonga lwe-anomaly luqulethe ezintathu. Uluhlu lwangaphakathi lumelelwe ubunzima obubi (uluhlu lwe-polygen). Phakathi nendawo igobolulation granulation ihlanganiswe ngamaseli amakhulu epithelium. Ukusuka kwingxenyana yangaphandle yesigxina ihlanganiswe ne-capsule yezicubu ezinxibelelwano.
• Insemination. Kule nqubo, ubukhulu bendawo yokunyuka, kunye nokujikeleza kwayo kubonakala ukungena ngaphakathi, okanye ukuhluma. Inkqubo ibandakanya ukuphuhliswa kwe-foci evulekileyo kwi-cavernous tuberculosis. Yile ndlela uhlobo lwe-fibrous-cavernous lwesifo lukhula ngayo.

Iingxaki eziqhelekileyo

Iingxaki ezilandelayo ze-fibrous-cavernous tuberculosis ziyahluka:

• Hemoptysis.
• Ukuhlamba kumphunga.
• Ubuninzi beengqungquthela. Ibonakaliswa ngokunciphisa isandi kwimimandla ye-pleura kunye ne-fibrosis.
• Ukuphulaphula ukuphefumula obuthathaka kwimimandla yokunyuka kwe-pleura. Kwakhona, ukuphefumula okumanzi kunye nokuphefumla komzimba kubonakala . Iingqinamba ezinjalo ziyafunyanwa phambi kweendawo ezinkulu. Ngaphezulu kweenkomfa ezincinci, izandi ziyahlukahlula ngesandi esincinci.

Iindlela zokuxilonga

I-TB-cavernous tuberculosis ifunyanwe njani? Imbali yesi sifo ngexesha lokuxilongwa, njengommiselo, sele iqulethe ulwazi malunga nokusuleleka kwesifo sofuba esisasazeka ngaphambili.

Kufuneka kuqatshelwe ukuba iimpawu ezixhasayo zineenkcukacha ezincinane. Uviwo olongezelelweyo nge-X-ray lubonisa ubukho beemithunzi ezibunjiweyo kunye nesilungiselelo seperiyali ngesimo se-oval okanye isangqa. Emva kwedatha efunyenwe yi-X-ray diffraction, ukuxilongwa ngokungafaniyo kunye ne-pathology efana nekhefu lomphunga, umdlavuza wendawo yomhlaba, i-bullous emphysema, i-pneumothorax, i-echinococcosis, okanye i-pleurisy efunyenweyo iyadingeka.

Iindlela zokuxilongwa ngoncedo ziyi-laboratory kunye neendlela zokugcina.

Uhlalutyo lwe-sputum lubonisa izinga eliphezulu le-MTB. Kwi-laboratory ukuhlola iqondo eliphezulu lokwabiwa kwe-bacilli libonakalisiwe. Ngamanye amaxesha inkqubo ikhula. I-fibers elastic elastically

Xa kungabikho i-sputum, i-bronchoscopy ibonisiwe. Ivumela ukuchonga i-foci ye-inflammation kwimiphunga kunye ne-bronchi, ekhusela ukuvalwa kwesigxina.

Uvavanyo lwegazi. Kwizigulane nge-TB-cavernous tuberculosis kukho i-lymphopenia kunye nenani elikhawulezileyo le-ESR ukuya kuma-30-40 mm / h.

Ngokusuleleka kwintsholongwane, kukho ukwanda kwinqanaba le-leukocytes ukuya kwixabiso le-19 000-20 000, kunye nokwanda kwinqanaba le-neutrophils.

Kukho umlinganiselo weprotheni ephezulu kumchamo.

Iimigaqo zonyango

I- TB -cavernous tuberculosis ipheliswe njani ? Unyango luqhutyelwa esibhedlele kwizabelo ze-TB.

Isicwangciso sonyango sisekelwe ekusebenziseni ngexesha elifanayo ezintathu okanye ezine izilwanyana ezibhekiselele ekuphuhlisweni kwezilwanyana. Njengomthetho, "Izoniazid", "Etambutol", "Rifampicin" kunye ne "Streptomycin" zisetyenziselwa. Iziyobisi zingeniswa ngaphakathi kwangaphakathi okanye ngokuthe ngqo kwisigxina sendawo.

Kwakhona wasebenzisa i-tuberculin unyango, i-gymnastics yokuphefumula, iinkqubo ze-physiotherapy, unyango lwe-laser, i-ultrasound kunye ne-inductothermy.

Ukuqhuba ikhemotherapy

Yintoni enye inokupheliswa kwesifo sofuba se-fibro-cavernous pulmonary? Unyango luquka ukhemotherapy. Iinkqubo zinikezelwa ngamnye ngokuhambelana nezibonakaliso zentsholongwane zamachiza.

Njengomthetho, phambi koxhathiso kwizinto ezinqamlekileyo ezibhekiselele kwisifo sofuba, unyango luqhutywa ngokuhambelana ne-regimen yesine ye-chemotherapy. Utyando lubandakanya ukusetyenziswa okudibeneyo kwezidakamizwa njenge "Kanamycin", "Prothionamide", "Cycloserin", "PASK" kunye ne "Fluoroquinolone." Ubude be-chemotherapy abukho ngaphantsi kweenyanga ezi-15-18.

Izigulane ezine-TB-cavernous tuberculosis ziboniswa unyango lwe-pathogenetic, olujoliswe ekulungiseni imisebenzi ephazamisekileyo yemzimba. Iimpawu ze-metabolizing, kunye neziyobisi zokubuyisela isimiso somzimba kunye nama-hormone asetyenziswayo.

Ngendlela efanelekileyo yokunyanga, emva kwesigamu sonyaka, umgangatho omuhle uyagcinwa. Kukho ukwehla ekukhululweni kwe-bacilli, kwakunye nokunciphisa nokuvalwa kwe-cavern.

Ukungenelela kokusebenza

Ukuphulukiswa kwee-caverns ezinamafutha zihlala ziphuza. Ukuba ngexesha lekhankanywe ngasentla alinakwenzeka ukuphumeza iziphumo ezintle, i-fibro-cavernous pulmatic tuberculosis ipheliswa ngongenelelo olunyango. Kule meko, ukuthengiswa komgca omnye komgca kubonisiwe. Usebenziso lwenziwe kwakhona kwinkqubo yomhlaba. Kwakhona ifaka iqondo eliphezulu lokusebenza kakuhle kwaye ikuvumela ukuba ugcine isigunyaziso sokusebenza. Ukulindela ubomi komntu ogulayo kukude kakhulu. Ukuxhoma kwe-mycobacteria kuyayeka.

Olunye uhlobo lokungenelela ngophulo olwenziwe ngugqirha, olubandakanya ukufakwa kwe-pneumothorax.

Emva kwonyango kwiimeko zesibhedlele, ukunyanzeliswa kokuhlala kwindlu yokuhlaliswa kwezilwanyana, unyango lwangegulane kunye nokuhlolwa kweliso kwi-dispensary kuyadingeka.

Ukugxekwa kwesi sifo

Kwinkoliso eninzi ye-fibrous-caverous tuberculosis ixhomekeke kwiyeza. Iifumba ezincinci zivaliwe kwaye zinqabile. Uqeqesho kunye nobukho beendonga eziqinileyo kunye nexesha lizaliswe ngento enobunzima, obangela ukuba uphuhliso lwe-pseudotuberculoma.

Ukuqokelela kwe-pus, ubukho be-aspergillosis, inkqubela yesifo sofuba ayinqabile kakhulu.

Amanyathelo okukhusela

I-TB-cavernous pulmonary tuberculosis yilezi zifo zezifo ezibangelwa zizinto ezingenakulungeleluntu zentlalo. Ngokuqhelekileyo, imbangela ebalulekileyo yonakaliswa kwimilinganiselo yokuphila yabemi.

Ngokwezibalo, amadoda ayagula kathathu ngokuphindaphindiweyo kunabesifazane. Ngokubanzi, i-pathology igxininiswe kwiminyaka engama-20 ukuya kwe-39.

Ngenjongo yokuthintela, le mithetho ilandelwayo:

• Ukuqhuba amanyathelo okukhusela afanelekileyo;
• Ukufumanisa kwangaphambili abantu abachaphazelekayo ngesifo;
• Ukunikezelwa kwemali nguRhulumente kumayeza;
• Ukuphunyezwa kweemviwo zokuqala zonyango xa ufaka umsebenzi kwimfuyo yeefama;
• Ukwanda kwendawo yokuhlala yokuhlala kwizigulane ezifunyaniswe ngesifo sofuba;
• Ukuhanjiswa kwexesha ngokukhawuleza kweentsana ezisandul 'ukuzalwa kwinyanga yokuqala emva kokuzalwa.

Isiphelo

Isifo sofuba se-Fibrous-cavernous (isifo esiyingozi kwimeko yezempilo) sisifo esingapheliyo. Njengomthetho, ucatshulwa yi-cavernous tuberculosis. Isifo sinokuba sesinye salo okanye sesibini.

Ukuba kunzima ukuphatha unyango lwangaphambili, ngoko ngoku unyango luluhlu lweendlela ezahlukeneyo zokwelapha ezivumela ukufumana ukuxolelwa okuzinzileyo kwiminyaka emininzi. Ukwelashwa ngokukhawuleza kukuvumela ukuba ugcine isigunyaziso sokusebenza.