Bacillus TB: kuchuluka kwa anthu, monga momwe? TB ndi chiyani?

Chifuwa chachikulu - matenda sioneka kuti zimakhudza akuluakulu komanso ana. Kuti chifukwa ntchito matenda mycobacteria (Koch a Bacillus) mu thupi la munthu. Mankhwalawa pathologies ntchito multicomponent Morning, zomwe ukhoza mpaka miyezi isanu ndi umodzi kapena kuposerapo. 50% milandu, kusowa chithandizo, matenda itha imfa. Kodi tubercle Bacillus wa Koch, momwe izo zifika ku thupi ndi momwe mungapewere chitukuko cha matenda - mafunso awa idzayankha m'nkhani ino.

Lingaliro la mycobacteria

Chifuwa chachikulu - matenda chifukwa cha magulu Mycobacterium ndi Mycobacterium TB (MBT). Mtundu wa mabakiteriya limatchedwa tubercle Bacillus - ndi dzina la German wasayansi Roberta Koha. Science amadziwa za 74 mitundu mycobacteria zopezeka mu nthaka, madzi, nyama ndi anthu. Ine ndiyenera kunena kuti tizilombo ta TB chifukwa cha mitundu yosiyanasiyana ya mycobacteria amasiyana Chrixitu.

Tubercle Bacillus ali wapadera m'chimake zoteteza, amene amathandiza mabakiteriya kupulumuka mu chilengedwe. MTB yoongoka kapena mawonekedwe pang'ono yokhota kumapeto, mapulani ndipamene palibe spores kapena makapisozi, pang'onopang'ono propagates ndi kugawira pulayimale m'zipinda awiri, gulu mkombero wa maola 14-18. Monga ulamuliro, kubalana kumachitika m'njira ziwiri - by ikuphukira, kupatula nthambi.

Mycobacterium negligible miyeso: awiri zimasiyanasiyana pakati 0.2-0.6 m, kutalika - 1-10 microns. Tubercle Bacillus wa bowa chifukwa kufanana awo zikusonyezedwa mowa chomwecho oxygen. MTB njuchi pang'onopang'ono (mwa masiku 34-55) kukula pa sing'anga olimba, ndi pamwamba akhakula, ofooka inki - pinki-lalanje kapena yamkaka.

Kapangidwe ka maselo MTB

maselo mabakiteriya tubercle Bacillus zigwirizana zinthu zotsatirazi:

• selo khoma - popangidwa ndi zigawo zingapo, Mycobacterium kuteteza ndi kuukira makina ndi mankhwala; Imakhala ndi kukula nthawi zonse ndi maonekedwe a maselo (by njira, gawo la containment ndi zizindikiro waxy, mafuta mankhwala);
• bakiteriya cytoplasm ndi inclusions granular;
• cytoplasmic nembanemba;
• mankhwala nyukiliya, mkati limene DNA zozungulira.

MBT kugonjetsedwa kwambiri zinthu zachilengedwe ndi yaitali lofotokozabe viability ake. Kodi miyoyo yambiri tubercle Bacillus? Mycobacteria pakhale: zaka 7 mu malo yonyowa ndi mdima pa kutentha 23 ° C; mpaka miyezi 12 mu mdima ndi youma; mpaka miyezi 6 m'nthaka; kwa miyezi 5 madzi; mpaka miyezi 3 m'mabuku; mpaka miyezi 2 fumbi msewu; kwa masabata 2 tchizi mkaka; mpaka chaka mafuta ndi tchizi. Mycobacterium TB musawope njira ya kuvunda ndi miyezi ingapo angathe kukhala m'manda mu matupi nthaka. Komabe, kuwala mwachindunji dzuwa kuwononga ILO ndi theka, kuwala ultraviolet - mu maminiti pang'ono. disinfectors Chlorinated kupirira Bacillus kwa maola 5. Mycobacteria komanso tcheru hydrogen peroxide. Aphedwa tubercle Bacillus ndi Kutentha: Mphindi 20 pa 60 ° C ndi kwa mphindi 5 - pa 70 ° C.

MBT angayambitse matenda patapita zaka ziwiri kapena zitatu aliko ndi asymptomatic kwa nthawi yaitali mu thupi zoyambitsa odana ndi TB chitetezo chokwanira.

TB ndi chiyani?

Monga momwe taonera kale, TB - matenda chifukwa cha ntchito Mycobacterium. Ambiri mwa matenda kufalikira ndi matenda droplet kwa munthu amene ali ndi kukhudzana wathanzi (kutsokomola, sneezing, kukambirana). Nthawi zina matenda akhoza kukhala chikhalidwe cha chakudya (mkaka yaiwisi).

Pachiopsezo - anthu akukhala m'madera zinthu zosafunika ukhondo - ndende, kunyumba kwa osowa pokhala. Izi zikuphatikizapo odwala ndi kachitidwe wofooka m'thupi (anthu ndi HIV, odwala khansa). odwala matenda ashuga; makanda; okalamba; achibale akudwala chifuwa chachikulu; osuta; Anthu ndi zakudya m'thupi - siyana awa a anthu nthawi zambiri limatsutsa tubercle Bacillus. mphamvu njira amafuna kuvomerezedwa kudya mavitamini ndi mchere pothandiza kubwezeretsa ntchito m'thupi yafupika.

Kuchuluka kwa TB amayamba ndi makhalidwe munthu wa chamoyo, komanso mwachindunji zokhudzana ndi boma maganizo a munthu. Malinga ndi Choyenereza zaka chimakhala chogwidwa ndi gulu la anthu zaka 18-26.

The peculiarity wa matenda ndi kuti TB Bacillus mofulumira kukhala kusamva mankhwala, choncho mankhwala njira zimaphatikizapo kugwiritsa ntchito mankhwala angapo pa nthawi yomweyo.

Malinga WHO ziwerengero pafupifupi hafu ya anthu onse padziko lapansi kachilombo ndi tubercle Bacillus, koma thupi lathanzi salola Office kuchulukana. The kudwala amapezeka mu thupi yekha m'mikhalidwe nyengo ino - adatchithisira chitetezo chokwanira. Chaka ku matenda a TB imapha anthu pafupifupi mamiliyoni atatu anthu dziko. Tsiku TB World umachitika March 24.

TB kufala njira

Pali njira zinayi zikuluzikulu zimene TB kufalikira ndodo:

• airborne pamene mycobacteria kulowa mpweya ndi m'malovu pamene kutsokomola, sneezing wodwalayo;
• alimentary - matenda kumachitika mwa mundawo m'mimba;
• kukhudzana - matenda limapezeka mwa maso a conjunctiva ndi (matenda a pakhungu ndi chodabwitsa osowa);
• utero - akutsogoleredwa ndi latuluka matenda pa kubadwa kwa mayi kupita kwa mwana.

Mu dongosolo thupi la thanzi kupuma kutetezedwa motsutsa malowedwe a mycobacteria ntchofu, amene anamasulidwa ndi maselo apadera. Komabe, ndi kutukusira kwa dongosolo kupuma, komanso mchikakamizo cha poizoni "chitetezo" sachiza. Mwina matenda mwa alimentary amadalira mkhalidwe wa pakhoma matumbo, mayamwidwe mphamvu.

Popeza tubercle Bacillus ili kunja kwa chipinda ndipo wachulukitsa pang'onopang'ono minofu kwa nthawi yaitali kusunga dongosolo lawo bwino, Mycobacterium nthawi zina kulowa otaya lymph lymph mfundo ndi kufalikira thupi lonse. The yabwino kwambiri mycobacteria matupi ndi olemera microvasculature (m'mapapo, kotekisi aimpso, m'madipatimenti chiberekero). Atangomva Office kudutsa mkati maselo, iwo anayamba kuwononga matabwa ake ndi kugawana.

kudwala thunthu

Ziwalo matenda anakhudzidwa kumachitika "ozizira" kutupa imbaenda kuna mapangidwe granulomas kuchuluka - hillocks sachedwa kudzitsitsa. Zimene thupi zikusonyezedwa milungu ingapo matenda. chitetezo chokwanira ma aumbike pambuyo miyezi iwiri. Gawo lotsatira la chitukuko cha ndondomeko pathological amakhala ndi wosakwiya kukula Office, yankho yotupa atayika Komabe, causative wothandizila za cholinga yotupa si kwathunthu inathetsedwa.

Tubercle Bacillus mu thupi kusungidwa kwa nthawi yaitali, ndipo munthu akhoza kukhala chotengera cha ILO moyo. Ndi chifooke chitetezo chokwanira otsala anthu a Office adzakhala mwachangu kugawana, kuchititsa mwapang'onopang'ono TB. The kudwala matenda mwa munthu woyamba kachilombo ndi 10% kwa zaka ziwiri pambuyo matenda. Ndi ndime ya nthawi ndichepe mosavuta matenda.

Pamene chitetezo chokwanira wofooka wa chamoyo sangathe kulimbana ndi kafalitsidwe maselo mabakiteriya amenewa amapezeka exponentially. Moyo anapanga MTB wapadera malo abwino amene granulomas Kopanda ophatikizidwa mu buku wamba, motero kuti matenda chachikulu anapeza kuti gawo TB matenda. Kutupa kufalikira zina kudutsa dongosolo zinchito.

Maonekedwe ndi mitundu TB

Pambuyo matenda kudwala amakhala zobisika mawonekedwe, mwachitsanzo. E. ambiri zambiri asymptomatic. munthu mmodzi yekha pa milandu khumi, akupita mu gawo yogwira. Coli TB makamaka amakhudza mapapo koma zingakhudze machitidwe ena a m'thupi.

Kusiyanitsa mitundu iwiri ya TB:

• lotseguka,
• chatsekedwa.

Pamene pamaso pa mawonekedwe lotsegula la tubercle Bacillus mosavuta wapezeka mu sputum kapena secretions zina wodwala (mkodzo, ndowe). Kulephera kusunga kusamalitsa ukhondo mu mawonekedwe zimenezi zingayambitse matenda a ena. Mu chatsekedwa mawonekedwe mycobacteria si wapezeka, ndi odwala osati loopsa kwa ena.

Malinga mtundu wa dongosolo zinchito poyera kwa tubercle Bacillus, kudwala wachinsinsi motere:

• TB m'mapapo mwanga,
• extrapulmonary TB.

Malinga ndi mmene kudwala yafalikira thupi, amadziŵika:

• zobisika TB,
• mwiniwakeyo TB,
• focal TB,
• caseous chibayo,
• timabamputimabampu
• fibro-cavernous TB,
• cirrhotic TB,
• pleural TB, m'phuno kapena trachea - chodabwitsa yosowa kwambiri.

Extrapulmonary TB amakhudza thupi ina, limene kudwala ndi zimagawidwa m'magulu:

• TB CNS ndi meninges - matendawa amakhudza chingwe msana ndi ubongo, chipolopolo wosautsa;
• m'mimba dongosolo, imene nthawi zambiri zimakhudza woonda ndi caecum;
• TB ya dera urogenital amakhudza impso, mkodzo thirakiti, Ziwalo zoberekera;
• nyumba fupa;
• lupus;
• TB maso.

Mawonetseredwe matenda a matenda. TB ya chapakati mantha dongosolo

Monga ndanenera kale, chifukwa chakuti tubercle Bacillus ukugawa pang'onopang'ono, waipeza pa nthawi oyambirira zotheka. Choncho kudwala angathe yaitali kuonekera, ndipo kenako anatulukira mwangozi pa mayesero fluoroscopy kapena tuberculin. Komanso, zizindikiro zenizeni za matenda zoona, kulibe. Popeza kuti thupi ndi kuledzera, zingasonyeze pallor, kutopa, kapena kugona, mphwayi, pang'ono kuchuluka kwa thupi kutentha (pafupifupi 37 ° C), kuchulukitsidwa thukuta, kuwonda, kukulitsa a mwanabele.

Laboratory kusanthula magazi a odwala TB detects akusowa chitsulo, kuchepetsa chiwerengero cha maselo oyera. Kenako, pamene matenda umalowa gawo ntchito kwambiri, kuti agwirizane zizindikiro pamwamba zizindikiro bwino kudwala wa limba akhudzidwa.

Ngati Mycobacterium amakhudza chapakati mantha dongosolo, wodwalayo zimawonedwa, kuwonjezera pa kutentha, vuto la kugona, waukali, mutu kwambiri, kusanza. Kumapeto kwa mlungu chachiwiri cha isanayambike zizindikiro loyamba kusintha zimachitika mu ubongo Kakhungu nyumba, amene yodziwika ndi mavuto minofu khosi ndi kulephera kuti akanikizire chibwano chanu m'chifuwa chanu, kutambasula miyendo yanu ngati kuli kotheka. Zoni chiopsezo matenda ashuga kapena onyamula immunodeficiency virus. Si zachilendo yatsoka ndi maziko a kudwala ichi matenda a m'maganizo komanso mkhutu kutsitsimuka, tilinazo, kayendedwe ka eyeballs lapansi.

Mosiyana ndi matenda wamkulu anthu tubercle Bacillus ana mwinamwake chimayambitsa matenda mofulumira kwambiri ndi kwambiri, nthawi zina imfa. N'chofunikira chitetezo makamaka underdeveloped mwanayo. Polimbana ndi matenda zambiri kuposa ana amene ali mu zikhalidwe za uve zakudya m'thupi, zonse chintchito chambiri. Tubercle Bacillus ana amachititsa thupi zizindikiro zenizeni, choncho makolo ayenera Atchule kusanza, kutopa mwana, yafupika tcheru, kusafuna kudya, kuwonda, kutentha thupi.

Chifuwa chachikulu cha machitidwe ena zinchito

Kuwonjezera maselo m'mapapo ndi chapakati mantha dongosolo kudwala akhoza kuukira ziwalo zina mu thupi, monga dongosolo kupuma. Choncho, tuberculous pleurisy - kugonjetsedwa kwa pleura Kakhungu okuta mapapo. kudwala Zimenezi zingakhale ndi matenda palokha, kapena zimachitika chifukwa cha dongosolo zovuta m'mapapo mwanga TB. Vuto lina TB m'mapapo mwanga akhoza kukhala TB chapamwamba kupuma thirakiti, kumene mu ndondomeko yotupa ikukhudza pharynx ndi m'phuno. Zizindikiro za matenda amenewa kuwonjezera zatchulidwazi ndi hoarseness kapena vuto kumeza.

Kugonjetsedwa kwa tubercle Bacillus amatchedwa lymph mfundo TB lymphadenitis. Nthawi zambiri pansi kuukira supraclavicular kapena khomo lachiberekero lymph mfundo zimene zikuluzikulu koma sabweretsa chisoni.

MTB kungakhudzenso ziwalo dongosolo urogenital. matenda akuwonetseredwa ndi ululu lakuthwa mu m'chiuno kapena kumbuyo, ndi kutentha thupi. Pamene pokodza n'zotheka zoonera. The kudwala amapezeka ndalama ofanana akazi ndi amuna onse.

TB ya fupa minofu yodziwika ndi fractures pafupipafupi, kupweteka kwambiri ndi dera lomwe linakhudzidwa, kulephera kusuntha bwinobwino. Akuthamanga mitundu ina kudwala nthawi zambiri amatha kufa.

Matendawa ndi mankhwala

Mu matenda a TB yogwira ndi njira yotchuka kwambiri ya sputum kuipitsa mbiri wamamamayikirosikopu ndi X-ray. Analysis kuipitsa mbiri Komabe, kukhala njira yolondola ndi odalirika, kuyambira magawo oyambirira a matenda, komanso milandu matenda kuphunzira ana amapereka chifukwa negative.

X-ray njira yodziwira zimathandiza makamaka matenda patsogolo. Kuwonjezera njira izi matenda Mankhwalawa amagwiritsidwa ntchito tuberculin khungu mayeso, amene atchedwa wamba Mantoux anachita.

Cholinga chachikulu posankha chithandizo cha dera mtima ndiyo kuphunzira mankhwala kukana, mwachitsanzo. E. The tilinazo chikhalidwe mycobacteria wamkulu zasayansi, kuti kukonzekera medicamentous.

Masiku ano, njira yaikulu ya mankhwala a chifuwa chachikulu mu mtima wa mankhwala TB, omwe ndi multicomponent. Kusiyanitsa ternary, quaternary ndi chithandizo quinary chakudya.

Ternary chithunzi adzatenge ntchito mankhwala zitatu - "Streptomycin" "INH" ndi Para-aminosalicylic asidi (Pasi). chiwembu Izi tingachipeze powerenga Komabe, kawirikawiri ntchito lero chifukwa cha kawopsedwe mkulu wa pas. Ndondomeko ntchito chetyrohkomponentnoy "Rifampicin" ( "Rifabutin") "INH" "pyrazinamide wokhala" "Ethambutol". malo ambiri mankhwala ntchito kwambiri patsogolo njira - zisanu chiwembu kuti, kuwonjezera pa pamwamba mankhwala anayi ntchito "Ciprofloxacin".

Ine ndiyenera kunena kuti chifuwa chachikulu - matenda sioneka, umene chitukuko ndi tubercle Bacillus amachititsa mu thupi la munthu. Chithandizo akhale mwamsanga ndi yolondola, chifukwa sitili imfa mankhwala matenda Wamaliza 50% ya milandu. Woopsa zotsatira chimachitika mu zaka pang'ono kuchokera pa chiyambi cha gawo yogwira matenda. Otsala 50% milandu zotsatira mu mawonekedwe aakulu a matenda. Komanso, wodwala, amene anasonyeza TB aakulu ndi ngozi ena, monga mfundo zazikulu za mycobacteria chilengedwe.

kupewa

zodzitetezera ndi TB lero akhoza zimachitika mwina katemera BCG amene mogwira amateteza imodzi mwa njira yoopsa kwambiri ya TB - tuberculous meninjaitisi. Malinga ndi National Katemera Ndandanda, katemera mwana m'chipatala pa masiku 3-7 moyo. Kenako pa 7 ndi 14, ikuchitika pansi pa chikhalidwe chilimbikitso zoipa Mantoux anachita ndiponso kusapezeka kwa contraindications.

BCG (Bacillus Calmette-Zherena) akuwonetsa zotsatira zabwino, koma katemera kuvomerezedwa ndi TB sakuvomereza m'mayiko onse a dziko, izo zidalira pa mlingo wa TB m'chigawochi. Patapita miyezi ingapo kuchokera katemera pa jekeseni malo khungu anachita limapezeka - chisindikizo yaing'ono.

Katemera mwana contraindicated milandu zotsatirazi:

• atabadwa matenda immunodeficiency, komanso mu banja ali ndi mwana nkhope, matenda awa;
• abale ndi alongo matendawo wakhanda uka pambuyo katemera otero;
• mwanayo, pali kobadwa nako zopindika wa chapakati mantha dongosolo.

Katemera ayenera mtsogolo ngati:

• mwana si donoshen,
• anapeza matenda alionse opatsirana,
• mayi ndi mwana ali osiyana RH china.

Nkofunika kukumbukira kuti matenda Osamva amachititsa tubercle Bacillus. Kudya mtima anthu mu mankhwala liyenera kukhala wathanzi ndiponso olondola. Pewani kumwa kwambiri zakudya mafuta. The kuloŵerera chakudya odwala TB ndi zovuta. Ichi ndi chifukwa kapangidwe anatomical maselo MTB - chipolopolo muli zambiri mafuta. Munthu ndi kudwala ayenera chakudya wolemera mu mapuloteni, chakudya, mavitamini ndi microelements.

Kuchepetsa mosavuta matenda chachikulu kunyumba, m'pofunika kukhala wabwino munthu ukhondo, nthawi yambiri panja, popachika mapeyala thonje mankhwala dzuwa.