I pathogenesis isifo sofuba. Etiology isifo sofuba. Izimpawu kanye izimpawu isifo sofuba

Mayelana nesifo sofuba wezwa ngabaningi, kodwa bambalwa abantu baqaphele ingozi yangempela yilesi sifo esesabekayo. Kwaphela iminyaka eminingi, odokotela emhlabeni wonke abaye bahlola izici ezibangela ukuthuthukiswa ukutheleleka, izimpawu eziyinhloko zesifo. Phakathi nalesi sikhathi, kwatholakala ukuthi zisandakuqala sofuba yamaphaphu kanye nezinye izitho kungavuka ifomu asymptomatic, kanye nokuntuleka ukwelashwa kuholela sengozini yokuthola izifo.

lwati lolufinyetiwe isifo

Kuze kube manje, lo pathogenesis sofuba wafunda ngokugcwele. Lesi isifo esiyingozi futhi esithathelanayo kakhulu kubangelwa izinto ezithwala izifo kusukela uhlobo lwe Mycobacterium.

Kunezinhlobo eziningana nezilwanyana ezincane ukuthi kumkhathaze izifo kubantu. Lezi zihlanganisa:

• womuntu, kwenzeka kaningi kakhulu, lokulandisa 92% azo zonke izigameko;
• sezinkomo, imiphumela isifo kakhulu kancane, they jeza nga-5%;
• Lesisemkhatsini, ikakhulu basakaza eNingizimu Afrika, eRussia lesi sifo sitholakale 3% eziguli;
• igundane kanye inyoni, itholakala kuphela abantu nge immunodeficiency uthi emlandweni.

Bambalwa abantu bazi ukuthi anatomy umgudu wokuphefumula akugcini sofuba. Imbewu eletha nayo eshaya:

• amathambo;
• pheshana emathunjini;
• uhlelo genitourinary;
• ingqondo.

Kungakhathaliseki indawo, ukugula kuyingozi kakhulu futhi nakanjani kuyoholela ekufeni uma ingelashwa.

Lesi sifo unesikhathi bayashintshana ekufukameleni eside. Izimpawu zokuqala zingavela ngemuva kwezinyanga 3 - 1 unyaka emva kusungulwa agent ezithathelwanayo.

izibalo

Bezempilo emhlabeni wonke Sikhatsateke kakhulu ekusakazekeni ngokushesha lesi sifo. Russia ohlwini lamazwe senzeka 22th.

Ngaphambili, omningi walo abanalesi sifo abangu idonsa izigwebo zayo ejele. Kodwa kusukela ekuqaleni kwawo-90-yalolucwaningo waqala kwaqubuka, futhi imbewu eletha ukusabalala okukhulu.

Daily kutholakala ukuthi uphethwe yini amacala amasha sofuba phakathi emikhayeni ekhomba ngophakathi, iningi lezingane babevela iziguli.

Enhlanganweni ukunakekelwa kwezempilo, leli qiniso kwakuhambisana nezinga eliphansi ukwehla lokube nawo ezingeni lekuphila yezakhamuzi, owayesanda nje kubonakala ngesikhathi futhi kwabangelwa ushintsho ezisebenzini zalo zezombusazwe kuleli zwe.

Kwaphela iminyaka eminingi lokhu Ochwepheshe ubhubhane imikhawulo iqoqo izinyathelo zokuvimbela ezivumela kancane ekulinganiseni isimo, ukunciphisa yokugula kwabantu kanye nokushona. Lezi zihlanganisa:

• Ukugonywa ezinsaneni esibhedlela;
• ngomkhondo amacala amasha usebenzisa isivivinyo Mantoux (izingane), kanye x-ray (e abadala).

Isifo sofuba imbewu eletha linamandla kakhulu nokushintsha kwendawo ezungezile, ngakho isikhathi eside siyagcinwa isimo iphila emanzini, umhlaba njalo njalo. N. Ngokuba non-ngokuvumelana nemithetho eyisisekelo kwenhlanzeko ingozi siqu yokuthola ngempela eliphezulu.

izimpawu isici

Isisekelo eyinhloko pathogenesis kuyinto Ukungena sezinsaba pathogenic emzimbeni. Abantu abanjalo ngokushesha ukugula, ngokufanele, azikho izikhalo.

Nge buthakathaka amasosha omzimba ezingase ziphakame:

• ukukhuphuka okuncane nje kwamazinga okushisa umzimba;
• kwenhliziyo;
• ukujuluka ezinzima ebusuku;
• othi awube kuhlangene ezingezona ezemvelo isikhumba pallor;
• ubuthakathaka, isiyezi;
• ukukhwehlela;
• isikhwehlela okuxutshwe negazi.

Ukuwohloka kwesimiso jikelele uphakanyiswa amagciwane ubuthi ubuthi. Lapho inombolo izimpawu ngaphezulu evelele.

Izimpawu zokuqala sofuba in iziguli uhlelo sihlale siphilile kungenzeka ongaphakeme noma ngingekho ngokuphelele.

Kuwa Yiqiniso futhi ngokushesha inchubekelembili is ebonwe abantu nezinkinga zempilo.

Uma lesi silwanyana lishaywa:

• Bone - kukhona ubuhlungu oqinile wonke amalunga nokuqina.
• Brain - kukhona isicanucanu, ukuhlanza, ubuhlungu bekhanda futhi ubuhlungu bemisipha.
• uhlelo urinary - isiguli njalo azizwa ukuchichima esinyeni. Isigaba eziseqophelweni ukubukeka igazi umchamo.
• pheshana emathunjini (Git) - kukhona njalo ukungakhululeki besisu, isicanucanu, streaks ebomvu kuso.
• Skin - surface kwakhiwa Izigaxana kugcwele ubomvu, okuyinto ezembulwa esifanele.

Ngaphansi kwesimo inkambo eside sofuba kukhona uhlobo ukuvuvukala granulomatous yenqubo ukuthi kungabonakala nasemkhakheni kabi noma isiphi isitho ethintekile. Ukukhomba ukusetshenziswa kwalo yezindlela zesimanje uphethwe.

amaqembu ingozi

Sekuyisikhathi eside Medicine kuboniswa ukuthi pathogenesis sofuba incike esimweni yesimiso sokuzivikela somzimba.

Kusukela zokuthelela sonke sibhekana, kodwa kweliphezulu ingozi iqembu kuhlanganisa abantu:

• HIV ne-AIDS;
• naseziboshweni;
• abaphethwe yizifo ngezifo okungamahlalakhona (izilonda wokugaya ukudla, isifo sikashukela, njll ...);
• babe imikhuba emibi;
• abasebasha;
• ukunganakwa imithetho komuntu;
• athinte lomuntu onegciwane;
• ngesikhathi sokukhulelwa;
• bacindezelekile njalo;
• ongawamukeli amavithamini ezidingekayo kanye namaminerali;
• abahlala ezindaweni imvelo amathuba phambilini;
• abavela emindenini enemali engenayo ephansi;
• akukho fixed nendawo yokuhlala.

Lapho ocushiwe, inqubo sokugembula, le pathogenesis sofuba libhekene anda ezithathelwanayo.

ukuma

Uhlobo ukutheleleka kuncike isikhathi sokwelashwa, isibikezelo Amathuba zokuthelela abanye abantu. Ukwabela esigabeni esilandelayo sofuba:

1. Vula. Kubonakala izilonda kwamaphaphu. Uma kwenziwe isikhwehlela ukuhlaziywa iye yaqinisekisa ukuba khona kwamagciwane kuwo, lo muntu iyathelelwana.
2. Kuvaliwe. Nge yalokho negative, isiguli akuyona inkampani yenethiwekhi lesi sifo.

Uma induku kuqala wangena emzimbeni ukuphakamisa ifomu eyinhloko, esimweni okuphambene secondary.

Ngaphezu kwalokho, lesi sifo ziyahlukahluka imvelo ekubhujisweni:

• miliary;
• eqonda;
• infiltrative;
• elinganiselwe;
• nokunjengoshizi;
• fibrocavernous;
• tuberkulemny;
• cavernous;
• cirrhotic;
• pleurisy tuberculous.

Inkambo isifo beseyizingane, kwathi ngesikhathi sokukhulelwa

Etiology sofuba kusikisela ukuthi cishe kunazo itheleleke abantu izinhlelo ababuthakathaka mzimba. ukuhlukumeza okunjalo kungase kube azalwa naso, kodwa ngokuvamile iningi livela inqubo wokuphila, ngaphansi kwethonya izici ezihlukahlukene.

Esengumntwana uhlelo wokuvikelwa ungakhishwa bakheké ngokuphelele, ngakho ingozi yokutheleleka luyanda ngokulingana ephambene yobudala kwengane. E. Than ingaphansi, izinduku ezinonya maningi amathuba.

Ngemva ukutheleleka, ukugula kwenzeka ngendlela efanayo njengoba abadala, kodwa ifomu kakhulu. umehluko Specific azinandaba.

TB ngesikhathi sokukhulelwa akuyona isizathu ekunqanyulweni wakhe.

Inguquko esigabeni asebenzayo kungabonakala senyanga yokuqala noma ngemuva kokubeletha. Ngezinye izikhathi lingandile. Lokhu kungenxa yomsebenzi kwesimiso somzimba sokuzivikela ezifweni, futhi ukushintsha kwama-hormone emzimbeni.

Ukutheleleka umbungu akuyona njalo saphawula. Ngokuyisisekelo ejwayelekile amafomu alandelayo:

• fibrocavernous;
• ezinzima elimazayo;
• eqonda.

Amagciwane anjalo kalula ukuwela isithiyo esinomhlapho, okubangela thuthuva ezinzima ku-fetus.

Uma uhlelo ukusazi ngokunembile isifo esikuphethe isiguli ngaphansi kokulawulwa wezifo zabesifazane neSifo Sofuba.

Ukwelashwa iqala ngokushesha, nemikhiqizo ezikhethiwe ukuthi libe nethonya okungenani omubi umntwana ongakazalwa.

Uma lesi sifo sitholakale ngesikhathi, onalesi sifo ngoba owesifazane icwecwe, kodwa zikhona ezehlukile. Ngezinye izikhathi isisu namanje Kunconywa.

inhlolovo

Ngemva ukubonakala izimpawu zokuqala iziguli osolisayo akuvamile uvakashele udokotela, kodwa kwanhlanga zimuka nomoya. Ngemuva imaskhi ukukhathala ayinangozi ingafihla sofuba nje kuphela kodwa futhi ezinye izifo ezimbi.

Ngisho ziwohloke kancane impilo kungekho izimpawu zokutheleleka sibi zokuphefumula, kodwa imfiva kufanele kube isikhathi ukuvakashela udokotela.

Kokuqala wokuhlola Udokotela owayezama uyilalela yonke izikhalazo, ngeke acabangele etiology isifo sofuba kanye bayaqondisa uvivinyo ezivamile (egazi noma omchamo), kanye nezinye izifundo ezidingekayo, kungaba:

• Fluorography. 1 esasiba khona minyaka yonke kusukela ngineminyaka engu-15. It ikuvumela ukuba abone isifo sofuba yamaphaphu kanye nezinye izifo zokuphefumula. Afakwe uhlu survey kuphoqelekile umsebenzi, ngaphambi kokuya ibutho, njalo njalo. N. Uma umphumela x-reyi kuyinto debatable, ezengeziwe X-ray ukukwenza.
• ukuhlolwa Mantoux. Abantu abaningi ngephutha ukudida ngayo milisa. Lona uhlobo olukhethekile uphethwe isifo sofuba. It Kwenziwa zonke izingane yobudala kusukela ngonyaka 1 kuya 14 - 15 iminyaka, ngezinye izikhathi kuze 17. Inalidi encane sifakwe ngaphansi kwesikhumba into - tuberculin. Ngo oyiyo liqukethe imikhiqizo imfucuza sezinsaba pathogenic. "A inkinobho" ukuvela ngemva ukuxhumana okunjalo. Ngokuba Chile kokuhlaziywa kulinganiswa ubukhulu bayo.
• Linked Assay immunosorbent (ELISA). It ikuvumela ukuba kutholakale khona nezilwanyana ezincane ezingabonakali igazi ngesikhathi esifundweni.
• Isikhwehlela ukuhlaziywa Ziehl-Neelsen. Kwenziwe zonke iziguli ezine-ukukhwehlela isikhathi eside. Isikhwehlela is ingcoliswe isixazululo ekhethekile, okuvumela ukuba sithole khona bacilli pathogenic.
• sowings bacteriological. It kukuvumela ukwazi ukuthi hlobo luni induku wayithukuthelisa isifo. Zokuhlwanyela ukuvuthwa ezinyangeni 1-2, kodvwa lisiniketa ticondziso Imiphumela olunembile kakhulu, ikuvumela ukuthi ukhethe yokwelapha ngempumelelo.

Ukuze sofuba esolwa nezinye izitho kwalokho kwenziwe:

• X-ray;
• MRI noma CT scan indawo ethintekayo;
• encephalogram m. p.

I pathogenesis sofuba inezici ezithi azifane nezinye izifo eziningi, ezifana nomdlavuza, ngakho ngaso sonke isikhathi ukuthi usola kuye ngokushesha.

ukwelashwa

Ukukhethwa yokwelapha ikakhulu incike pathogenesis ne-TB emitholampilo. It wenziwa ngaphansi kokulawula Ochwepheshe TB futhi kuthatha isikhathi eside. Ezimweni eziningi, kuba iminyaka engu-2 ubudala, kancane kancane 3-4.

Kukhethwa izidakamizwa isikimu kuxhomeke ezicini eziningi. Ngokuvamile, udokotela ethatha isinqumo esinjalo ngesisekelo:

• ngezimo zesiguli;
• yobudala kanye ocansini;
• imiphumela yokuhlolwa, nokunye. n.

I imigomo eyinhloko yokwelashwa:

• ukwenza nesineke non-esithathelanayo;
• sikhuthaze ukuphulukisa kwezicubu ezilimele;
• ubuyisele impilo.

imiphumela emihle ingatholakala ngosizo izidakamizwa ezilandelayo:

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

Ikakhulu esetshenziswa 3, 4, nobe 5 izingxenye kanyekanye.

Qinisekisa ukuthi usebenzisa nokwelashwa ngamakhemikhali, ubude kanye Isikali kunqunywa ngamunye.

Ngemuva kokufaka isicelo nolaka imithi izicubu ukuvuselelwa nqubo ihamba kancane futhi akamuhle kunesidingo, ngakho-ke, ukuze izicubu yemvelo ukulungisa inqubo phthisiatricians evame ukunikezwa ukwelashwa pathogenetic. Lokhu kuhlanganisa lahlukene imisebenzi ukuze zithole imiphumela emihle. Lezi zihlanganisa i-reception:

• ejenti eqeda ukuvuvukala;
• immunomodulators;
• enzyme;
• B amavithamini;
• sorbents;
• izidakamizwa sokuvikelwa kanye nokubuyiselwa isibindi (hepatic);
• glutamic acid;
• anticoagulants;
• antikininov;
• Ama-anabolic steroid;
• ejenti antiallergic nabanye.

ukusebenza

Ngokuvamile, ifomu sokuqala lesi sifo angadingi ukwelashwa kuhlinzwa. Ezimweni ethuthukile ngaphandle izindlela ezinjalo ongakwazi ukuzenza. Uma sithinta emaphashini Kwenziwa:

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

Uma ucabangela pathogenesis ka extrapulmonary sofuba nalokho kungabuye ukuhlinzwa isicelo.

Lapho izinkinga pheshana emathunjini i ebekiwe okwejwayelekile noma eziphuthumayo ukuhlinzwa itheleleke ukususa imiphumela.

Isifo sofuba CNS iphathwa izindlela ikakhulukazi olandelanayo. Uma bengakuqondi ukusiza, uqhubekele ukususwa izilonda. Lena inqubo eyinkimbinkimbi kakhulu, okungaholela nemiphumela engelapheki.

Ubovu isikhumba granulomas kungabuye siqhutshwa.

Injongo eyinhloko izenzo ezinjalo - ukuze aqede imiphumela sifo futhi mhlawumbe ukubuyisela izinhlelo abathintekayo.

Yini okufanele ukwenze ukuze ungatholi

Naphezu kokuhlaselwa okukhulu ushikashikeka ngesifo sofuba yezokwelapha, zokugula namanje ovamile kakhulu sabantu, ngakho yilutho ukwazi ukuthi kufanele uzivikele kanjani wena nomndeni wakho:

• Ukugonywa. Yenza le lokugoma abazali babo, kodwa musa ziwushiye. It ikuvumela ukuthuthukisa amasosha omzimba enamandla ingane ezifweni, okuyinto iba namandla kakhulu sifikile unyaka 1. Ngenxa yalokho, le ngane akuyona waphathwa isifo sofuba, noma ukuyiphatha ngendlela elula.
• Ukuhlolwa avamile. It ikuvumela ukuba abone isifo zisaqala, futhi afeze ukwelashwa okuphumelelayo ukuvimbela ukutheleleka ngegciwane inqwaba abantu. Lokhu kufaka Mantoux test nasesifubeni ze-X ray.

Amanye amaqembu iziguli ziboniswa nokwelashwa ngamakhemikhali ukukhalima, nazo:

• Ukuba buthaka izivikeli mzimba noma nesifo samaphaphu, pheshana emathunjini, isimiso sezinzwa esiyinhloko.
• Ukuhlala egumbini elilodwa nomuntu onegciwane.
• Ukuba ushintsho ipheshana zokuphefumula ngokumelene isizinda ukuhlupheka sofuba.
• Ebuntwaneni imiphumela abampofu Mantoux test.

Ngaphezu ukungenelela yezokwelapha, kukhona eziningi izincomo ukuthi kunganciphisa ingozi yokuba lesi sifo. Ukuze wenze lokhu:

• umzimba njalo;
• udle ukudla okunempilo;
• ulwa eziluthayo;
• geza izandla ngokuphelele ngaphambi kokudla nangemuva kokuya ezindaweni zomphakathi;
• ekuvimbeleni ukuthintana nomuntu ogulayo;
• disinfected kahle egumbini elimhlophe lapho ungenwa;
• ukuthatha njalo amavithamini kanye amalungiselelo equkethe okunamafutha polyunsaturated acid omega-3.

Zonke-TB Ochwepheshe, odokotela bayazi imfihlo kancane sendlela ukuze kuncishiswe ingozi yokuthola isifo sofuba. Ukuze wenze lokhu, kumele ube sokudla ekuseni futhi ugweme izikhathi ezinde indlala emini (ikakhulukazi uma isidingo ukusebenzisa izithuthi zomphakathi). Kukholakala ukuthi kusukela imbewu eletha has cishe akukho ithuba ukungena emzimbeni.

yezinkinga

Imiphumela emibi sofuba ephawulwe ngobuso babo, uyephuza Ukuvakashela udokotela kanye nokunganakwa ukuhlola. Running ifomu zingayisongela ukuba abantu:

• inhliziyo nokuvaleka kwemigudu yokuphefumula;
• ngopha izitho abathintekayo;
• ulceration, fistula;
• kahle umsebenzi so-renal kanye isibindi;
• ukuthuthukiswa granulomas wonke umzimba;
• amyloidosis;
• pneumothorax;
• Ukuwohloka motor umsebenzi;
• ukukhubazeka;
• sepsis;
• esibhibhayo;
• necrosis;
• ikhoma;
• ebulalayo.

Lapho kuvela izinkinga, ukubikezelwa kwesifo kuyingozi kakhulu.

Kuzo zonke ezingenhla, singaphetha ngokuthi lesi sifo senza izimpawu ezihlukahlukene. Izibonakaliso zokuqala zesifo sofuba se-pulmonary zingabonakaliswa ukukhwehlela isikhathi eside, hhayi ukukhishwa izidakamizwa ezingekho emzimbeni. Lokhu kufanele uqaphele isiguli bese umenze axoxe nodokotela. Kubalulekile ukukhumbula ukuthi lesi sifo siyaphathwa kahle ngokuphathwa ngesikhatsi esifanele, futhi uma kwenzeka ukuguqula isimo esinqatshiwe, ingozi yezinkinga ezingaholela ekufeni okubuhlungu kuphakeme.