Le Pathogenesis lwesifo sephepha. Le umyalezo lwesifo sephepha. Iimpawu kunye zimpawu nesifo

Abantu abaninzi baye bakuva ngesifo sofuba, kodwa bambalwa babona ingozi eyona yeso sifo. Kwiminyaka emininzi, oogqirha emhlabeni jikelele baye bafunda izinto ezibangela ukuphuhliswa kosulelo, iimpawu eziphambili kunye nokubonakaliswa. Ngeli xesha kwafunyaniswa ukuba isigaba sokuqala sesifo sofuba semiphunga kunye nezinye izitho zingaqhubeka ngendlela engabonakaliyo, kwaye ukungabikho kwonyango kubangela iingxaki ezinzulu.

Ulwazi olufutshane malunga nesifo

Kuza kube yimhla, i-pathogenesis yesifo sofuba iye yafundiswa ngokupheleleyo. Esi sifo esiyingozi kwaye esichengeni kakhulu esibangelwa yi-agent echaphazelekayo evela kwi-mycobacterium.

Kukho iintlobo zeentlobo ezincinci ezikhupha izifo kubantu. Ezi ziquka:

• Uluntu, lwenzeka ngokuqhelekileyo, libalelwa kwi-92% yazo zonke iimeko ezirekhodiweyo;
• I-Bull, ekhokelela kwisi sifo kuncinci, bayagula malunga ne-5%;
• Ephakathi, ngokusasazwa eMzantsi Afrika, eRussia, isifo sifumaneka kwi-3% yezigulane;
• Imouse kunye ne-avian, ivela kuphela kubantu abaneemimode ezifanelekileyo kwi-anamnesis.

Bambalwa abantu bayazi ukuba isifo sokuphefumula sesifo sofuba asiphelelanga. I-bacillus ibetha kwakhona:

• Amathambo;
• Iphepheni yesisu;
• Inkqubo yeGenitourinary;
• Ingqondo.

Kungakhathaliseki ukuba yindawo yokuhlala, ukugula kuyingozi kakhulu kwaye kungenakwenzeka ukuba kukhokelela ekufeni ngaphandle kokunyanga.

Isi sifo sinexesha elide lokuxubusha. Impawu zokuqala zingabonakala emva kweenyanga ezi-3-1 unyaka emva kokusungulwa kwe-arhente esebenzayo.

Izibalo

Iingcali zezokwelapha emhlabeni wonke zixhalabele ngokukhawuleza kweso sifo. IRashiya ngowama-22 kuluhlu lwamanye amazwe.

Ngaphambili, uninzi lwaba sulelekileyo lwabantu babekhonza izivakalisi zabo kwiindawo zokulahla inkululeko. Kodwa ukususela ekuqaleni kwee-1990 ukuqhambuka kwesi sifo saqala, kwaye i-bacillus yaqala ukusasazeka.

Nsuku zonke iintsholongwane ezintsha zesifo sofuba zafunyaniswa kwiintsapho ezizinzileyo, ezininzi ziimeko zazingabantwana.

Kwintlangano yolondolozo lwempilo, eli qiniso lidibene nokuhla kwezinga lokuphila kwabemi, okwakubonwa ngaloo xesha kwaye kubangelwa ukulungiswa kwezopolitiko kwilizwe.

Kwiminyaka emininzi yesifo esikhoyo, iingcali ziye zaqalisa isicwangciso seendlela zokukhusela ezivumela ukuba kubekho ukuzinza kwimeko, ukunciphisa ukubulawa komzimba nokufa. Ezi ziquka:

• Ukugonywa kwabantwana abatsha esibhedlele;
• Ukubeka esweni izifo ezitsha ngokusabela kweMantoux (kubantwana) kunye ne-fluorography (kubantu abadala).

Intonga yesifo sofuba inqabile kakhulu kwiinguqu kwiimeko, ngoko ke, ihlala ixesha elide kummandla osebenzayo kumanzi, umhlaba, njl. Ukuba imithetho yokuqala yokucoceka kobuqu ingazalisekanga, ingozi yokugula iyaphakama.

Iinkalo zobunjani

Kwintliziyo ye-pathogenesis eyona nto kukungena kwe-pathogen emzimbeni. Abantu abanjalo abagulayo kanye, ngoko, akukho zikhalazo.

Ngobuthathaka obunokukhuseleka lunokwenzeka:

• Ukunyuka okunyuka kwiqondo lokushisa komzimba;
• Ukongeza kwenani lentliziyo;
• Ukukhupha ngamandla ebusuku;
• Ukuqhafaza ngokubambisana ne-pallor engavamile yesikhumba;
• Ubuthathaka, utywala;
• Isiqhamo;
• Ukwahlukana kwe-sputum kunye nokudibanisa kwegazi.

Ukutshatyalaliswa kwemeko jikelele kubangelwa imvelaphi yetyhefu ngamathambo e-microbes. Ikhudlwana inamba, ivakaliswe ngakumbi iimpawu.

Iimpawu zokuqala zesifo sofuba kwizigulane ezineenkqubo ezikhuselekileyo zokuzivikela komzimba zingabalulekanga okanye zingekho ngokupheleleyo.

Inkqubo enzima kakhulu kunye nokuqhubela phambili ngokukhawuleza kubonakala kubantu abaneengxaki zempilo.

Ukuba i-microorganism yabetha:

• Izicubu zethambo - kukho intlungu enamandla kuwo onke amaqela kunye nokuqina kohambo.
• Ingqondo - kukho isicasuleko, ukuhlanza, intloko enzima kunye nentlungu yomzimba.
• I-urinary system - isigulane sivakalelwa rhoqo. Kwimigangatho yesibini, ukubonakala kwegazi kumchamo.
• I-traitastinal tract (GIT) - kukho ukuphazamiseka okuqhubekayo kwisisu, isicupunu, imifuno elubomvu kwisitulo.
• Ulusu - phezu kwendawo lwayo lwakha ama-nodules, luzaliswe ngumbhobho, ekugqibeleni luvulekile.

Ngokuchasene nemvelaphi yexesha elide lesifo sesifo sofuba, inqubo yokuvuvukala yolu hlobo lwe-granulomatous yenzeke, enokuthi ibonwe kwinqanaba elichaphazelekayo. Ukukufumanisa, iindlela zokuxilongwa zanamhlanje ziyasetyenziswa.

Amaqela engozi

Sekude kusetyenzwa ngonyango ukuba i-pathogenesis yesifo sofuba ixhomekeke ngqo kwimeko yomzimba wokhuseleko lomzimba.

Akukho mntu uhlaselwe ngomshukela, kodwa iqela elijongene nobungozi kakhulu libandakanya abantu:

• I-HIV ne-AIDS;
• I ntolongo;
• Ukubandezeleka kwezifo ezahlukileyo (izilonda zesistim sokutya, isifo sikashukela, njl njl);
• Ukuba nemikhwa emibi;
• Umncinane ubudala;
• Ukungayithobeli imithetho yokucoceka kobuqu;
• Ukuqhagamshelana rhoqo nesifo;
• Ngexesha lokukhulelwa;
• Ukufumana uxinzelelo oluqhubekayo;
• Iimvithamini ezinganeleyo kunye neemaminerali;
• Ukuhlala kwimimandla engalungileyo;
• Ukususela kwiintsapho ezifumana umvuzo ophantsi;
• Ngaphandle kwendawo ethile yokuhlala.

Ngokusebenza kwenkqubo ye-pathological, i-pathogenesis yesifo sofuba ibonakala ngokusuleleka kwintsholongwane.

IiFom

Uhlobo lokusuleleka luxhomekeke kubude bonyango, amathuba okusulelwa kwabanye abantu. Izigaba ezilandelayo zesifo sofuba ziyahluka:

1. Vula. Kuyabonakala xa imiphunga ichaphazelekayo. Ukuba uhlalutyo lwe-sputum olwenziwe luqinisekisile ukuba khona kwezilwanyana-zifo kuyo, umntu uphathekayo.
2. Valiwe. Ngenxa yempembelelo engalunganga, isigulane asiyithathi yesifo.

Ukuba u-wand wangena emzimbeni uthetha ngefom yeprayimari, kwimeko echaseneyo malunga nesibini.

Ukongeza, isifo singahluka kwiimeko zesilonda:

• Milliary;
• Sasazwa;
• Ukungenelela;
• Umncinci;
• Ebuhlungu;
• I-cavernous e-Fibrous;
• Isifo sofuba;
• Cavernous;
• I-Cirrhotic;
• Pleurisy.

Inkambo yesi sifo ebuntwaneni nangesikhathi sokukhulelwa

I-etiology yesifo sofuba ibonisa ukuba abantu abane-immune system bathathaka kakhulu kwintsholongwane. Ingxaki enjalo inokuba yintsholongwane, kodwa idla ngokubonakalayo kwinkqubo yobomi, phantsi kwefuthe leemeko ezahlukeneyo.

Ngomntwana, inkqubo yokukhusela ayilwanga ngokupheleleyo, ngoko umngcipheko wokusuleleka kwintsholongwane ukhula ngokungafani nonyaka wengane. Oko kukuthi, omncinci yena, ulunge ngakumbi ukungena kwilungu elibi.

Emva kokusuleleka, isifo sifana ngendlela efanayo nakubantu abadala, kodwa kwimeko enzima kakhulu. Ulwahlulo oluthile alukwazi.

Isifo sofuba ngexesha lokukhulelwa akusisizathu sokuphazamiseka kwayo.

Utshintsho kwisigaba esisebenzayo singabonwa kwi-trimester yokuqala okanye emva kokunikezelwa. Eli lonke ixesha aliqhelekanga. Oku kungenxa yomsebenzi wamasosha omzimba kunye noshintsho lwe-hormones kumzimba.

Usulelo lwe-fetus alisoloko lugcinwa. Ngokwenene, oku kufaneka kule fomu elandelayo:

• I-cavernous e-Fibrous;
• Ukubhubhisa kakhulu;
• Sasazwa.

Ezi zifo-mzimba zincinci ngokukhawuleza isithintelo se-placental, zikhokelela kwiintlungu ezinzima kumntwana.

Emva kokuxilongwa, isigulane singaphantsi kolawulo lwe-gynecologist ne-phthisiatrician.

Unyango luqala ngokukhawuleza, ngelixa izidakamizwa ezinempembelelo encinci kumntwana ongakazalwa zikhethiweyo.

Ukuba isifo sifumaneka ngexesha, isalathiso salo mfazi kunye nosana luyakuthandeka, kodwa kukho ukungafani. Ngamanye amaxesha isisu sisicetyiswa.

Uviwo

Emva kokubonakala kweempawu zokuqala ezinokukrokra, izigulane azivakalisi kangangoko ugqirha, kodwa ngeze. Emva kwesigqubuthelo sokukhathala okungenakubungozi, kungekhona nje isifo sofuba, kodwa ezinye izifo ezibi ziyakusitheka.

Nangona kungonakaliswa kancinci kwintlalo ngaphandle kwempawu zesifo esiphumayo, kodwa ngokunyusa izinga lokushisa lomzimba kufuneka kube sisihlandlo sokutyelela ugqirha.

Uviwo lokuqala luya kwenziwa ngumgqirha oza kuphulaphula izikhalazo zonke, ziqwalasele i-etiology yesifo sofuba kwaye unikele izikhokelo kumvavanyo jikelele (igazi kunye nomchamo) kunye nezinye izifundo ezifunekayo, kunoku:

• Fluorography. Kuqhutywa kanye ngonyaka, ukususela kwiminyaka eyi-15. Ivumela ukufumana isifo sesifo sofuba kunye nezinye izifo zokuphefumula. Kuqukwa kuluhlu lweemviwo ezigunyazayo xa ufaka isicelo somsebenzi, ngaphambi kokushiya umkhosi, njl. Ukuba isiphumo sokukhupha i-fluorography ingquzulwano, ngoko kwandisa ii-X-rays.
• Ukuphendula kweMantoux. Abaninzi bayiphambanisa ngokugonywa. Olu luhlobo olukhethekileyo lokuxilongwa kwesifo sofuba. Ilawulwa kuzo zonke iintsana ezineminyaka eli-1 kuya kweyesi-14 ukuya kwe-15, ngamanye amaxesha ukuya kwi-17. Inaliti encinane phantsi kwesikhumba ifakwe inkunkuma ebizwa ngokuba yi-tuberculin. Iqulethe iimveliso zomsebenzi obalulekileyo wezilwanyana eziphilayo. Emva koqhagamshelwano olunjalo, "iqhosha" kufuneka livele. Ukulinganisa umphumo, lilinganisa ububanzi balo.
• Uhlalutyo lwe-Immunoenzyme (ELISA). Ivumela ukucacisa ubukho be-microorganism egazini ngexesha lokufunda.
• Uhlalutyo lwe-sputum ngokutsho kweTsiol-Nielsen. Ilawulwa kuzo zonke izigulane ezinomkhuhlane ode. I-Sputum idutywe ngesisombululo esisodwa, esivumela ukucacisa ubukho be-bacilli pathogenic.
• Kutyalwa kwe-bacteriological. Ikuvumela ukuba ufumane ukuba yiyiphi intonga ebangela isifo. Ukuhlwayela izivuno malunga neenyanga ezi-1-2, kodwa kunika umphumo ochanileyo, ukuvumela ukuba ukhethe unyango olusebenzayo.

Xa ukrokra isifo sofuba sezinye izitho, ukongezelela:

• X-ray;
• I-MRI okanye i-CT yendawo echaphazelekayo;
• Encephalogram, kunye nezinye.

I-pathogenesis yesifo sofuba inempawu ezifanayo kakhulu kwezinye izifo ezininzi, ezinjengomhlaza, ngoko akunakwenzeka ukuba unokukrokra ngokukhawuleza.

Unyango

Ukukhetha unyango, ngokuxhomekeke kwi-pathogenesis kunye neklinikhi yesifo sofuba. Kuqhutyelwa phantsi kolawulo lwabaphthiti-ntathu kwaye kuthatha ixesha elide. Kwiimeko ezininzi le minyaka emi-2, ngaphantsi kwe-3-4.

Ukukhethwa kwerimenki yeziyobisi kuxhomekeke kwizinto ezininzi. Njengomthetho, ugqirha wenza eso sigqibo ngesiseko se:

• Imeko yomonde;
• Ubudala bakhe kunye nesondo;
• Iziphumo zophando, njalo njalo.

Iinjongo eziphambili zonyango:

• Yenza isigulane singenasifo;
• Ukukhuthaza ukuphulukiswa kwezicubu ezinobungozi;
• Buyisela impilo.

Isiphumo esihle sinokufezekiswa ngoncedo lwezi zi yobisi zilandelayo:

• I-Paraaminosalicylic acid.
• "Streptomycin."
• "Kanamycin".
• Rifampicin.
• "Ftivazide."
• "Pyrazinamide."
• "Ethionamide".

Ngokuyinxalenye, izinto ezi-3, 4 okanye ezi-5 zisetyenziswe ngexesha elifanayo.

Kufuneka ukuba isebenzise izifundo ze-chemotherapy, ubude kunye nomyinge owenziwe ngokwawo.

Emva kokusetyenziswa kwamachiza enkathazo, inkqubo yokuhlaziywa kwezicubu ihamba ngokukhawuleza kwaye kungeyona nto imele iyenze, ngoko i-phtisiatricians zihlala zibeka unyango oluthileyo lwendalo kwinkqubo yokulungisa izicubu. Oku kubandakanya lonke uluhlu lwemisebenzi eyenza ukwazi ukuphumeza iziphumo ezilungileyo. Ezi ziquka ukufumana:

• Iziyobisi ezichasayo;
• Immunomodulators;
• Enzymes;
• IiVithamini zeqela B;
• Izibilini;
• Ukulungiselela ukukhuselwa nokubuyiselwa kwesibindi (i-hepatoprotectors);
• I-Glutamic acid;
• Anticoagulants;
• Antikinins;
• Anabolic;
• Izidakamizwa zeAnticergergic, njl

Ukusebenza

Ngokuqhelekileyo, iifom zokuqala zesifo azidingi unyango otyando. Kwiimeko eziphambili ngaphandle kwezi ndlela azikwazi ukwenza. Xa izilonda zamaphaphu zenziwa:

• Lobectomy.
• UkuHlelwa.
• Bilobectomy.
• Pulmonectomy.
• Cavernectomy.
• Pneumothorax.

Ukuqwalasela i-pathogenesis yesifo sofuba esifanelekileyo , ukungenelela kwindlela yokuphanda kungasetyenziselwa kuyo.

Xa kuvela iingxaki kwi-tract stinal tract tract, isicwangciso esicwangcisiweyo okanye esiphuthumayo sicwangciswa ukususa imiphumo.

Isifo sesifo se-central central nervous system siphethwe ngokukodwa ngeendlela ezilondolozayo. Ukuba abancedi, baqala ukususa i-pathological foci. Ezi nkqubo zinzima kakhulu ezingakhokelela kwimiphumo engapheliyo.

I-granulomas yesikhumba ekhuselweyo inokusetyenziswa kwakhona.

Injongo ephambili yale nyathelo ukuphelisa iziphumo zesifo kwaye, ukuba kunokwenzeka, ukubuyisela umsebenzi weenkqubo ezichaphazelekayo.

Yintoni enokuyenza ukuze ungenwasuleleka

Nangona ulwabalazo olunzima lwabagqirha abaneesifo sofuba, ukukhubazeka kusekhona ngokuqhelekileyo phakathi koluntu, ngoko akunakulungela ukwazi indlela yokuzikhusela kunye nabathandekayo bakho:

• Ukugonywa. Yenza oku kugonywa ngabazali, kodwa ungayishiyi. Ukwenza kube lula ukukhusela umkhuhlane ozinzileyo ngokusuleleka kumntwana, oba ngowona mandla kakhulu emva kokufikelela kwiminyaka eli-1. Ngenxa yoko, umntwana akagula ngesifo sofuba okanye uyayithumela kwifom elula.
• Uviwo rhoqo. Ivumela ukufumanisa eso sifo kwinqanaba lokuqala, ukuphumeza unyango olufanelekileyo kunye nokuthintela ukusulelwa kwintsholongwane yabantu. Oku kubandakanya uvavanyo lweMantoux kunye ne-fluorography.

Amanye amaqela ezigulane abonisa izifundo zokukhusela i-chemotherapy, ezi zilandelayo:

• Bafumana izifo ezikhuselekanga kunye nezifo ezingapheliyo zemiphunga, umzila wesisu, inqubo yesantya ephakathi.
• Ukuhlala kwelinye igumbi nomntu ogulayo.
• Utshintshe kwi-airways ngokusuka kwimvelaphi yesifo sofuba.
• Ubuntwana abaneempembelelo zeMantoux ezihluphekileyo.

Ukongeza kwimisebenzi yonyango, kukho iincomo ezinokunciphisa umngcipheko wokuphuhlisa eso sifo. Kule nto ufuna:

• Ukuzivocavoca rhoqo;
• Ukutya ukutya okunempilo;
• Ukulwa nemida;
• Geza izandla kakuhle phambi kokutya nangemva kokuhambela iindawo zoluntu;
• Nciphisa umnxibelelwano nomntu ogulayo;
• Kukulungele ukuhlaziya i-disinfect ukukhanya kwamagumbi apho umntu onentsholongwane;
• Ukuthatha rhoqo amavithamini kunye namalungiselelo aqukethe i-Omega-3 acids ye-polyunsaturated.

Bonke oogqirha be-TB bayazi enye imfihlo encinci yokunciphisa ingozi yokufumana isifo sofuba. Ngenxa yoko kuyimfuneko ukufumana isidlo sakusasa ekuseni kwaye ungavumeli izikhala ezilambileyo ngexesha lomhla (ngakumbi xa kukho imfuneko yokusebenzisa izithuthi zikawonkewonke). Kukholelwa ukuba i-bacillus ayinalo ithuba lokungena emzimbeni.

Iingxaki

Imiphumo engebiyo yesifo sofuba ibonakala ngabantu abaye bebambezela ukutyelela ugqirha nokunyanzela ukuxilongwa. Ifomu elimiselweyo lingasongela umntu:

• I-cardiac kunye nokungakwazi ukuphefumula;
• Ukuhlamba okuvela kwizitho ezichaphazelekayo;
• Ukwakhiwa kwezilonda, i-fistula;
• Umsebenzi wezintso ezinobungozi kunye nesibindi;
• Ukuphuhliswa kwama-granulomas kuwo wonke umzimba;
• Amyloidosis;
• Pneumothorax;
• Ukukhubazeka komsebenzi wemoto;
• Ukukhubazeka;
• Sepsis;
• Gangrene;
• Necrosis;
• Coma;
• Isiphumo se-Lethal.

Xa kuvela inkxalabo, ukugxekwa kwesi sifo kuyingozi kakhulu.

Kuzo zonke ezi ngasentla, sinokugqiba ekubeni eso sifo senza iimpawu ezahlukahlukeneyo. Iimpawu zokuqala zesifo sofuba se-pulmonary sifo singabonakaliswa ngumkhuhlane ohlala ixesha elingapheliyo, kungabikho ukuxhatshazwa kweziyobisi. Oku kufuneka kuqaphele isigulane kwaye menze adibane nodokotela. Kufanelekile ukukhumbula ukuba isifo siyaphathwa kakuhle nangonyango olufike ngexesha, kwaye xa kwenzeka utshintsho kwifomu ehoxisiwe, umngcipheko weengxaki ezinokuthi zikhokelela ekufeni okubuhlungu ziphezulu.