Genitourinary TB: zizindikiro, matenda, njira kachilombo

Matenda a dongosolo mkodzo ndi zofala. Iwo akhoza bwanji impso thirakiti mkodzo, chikhodzodzo. Matenda onse ndi kupereka ndi kuganizira genitourinary TB. About matenda, muyenera kudziwa munthu aliyense, chifukwa cha matenda palibe amene sangayesedwe.

Werengani zambiri za chifuwa chachikulu, napasula dongosolo mkodzo

Mwina si wotero, amene sanamve za chifuwa chachikulu. Ndi matenda amene mabakiteriya otchedwa Bacillus, bwanji mapapo. Komabe, osati ziwalo zimenezi akhoza moyo tizilombo otchedwa. Anthu aluso kudziwika extrapulmonary mitundu ya matenda. Choyamba mwa awa ndi TB genitourinary.

Kodi matenda? The mkodzo dongosolo Koch Bacillus kugwa hematogenous njira. Pa mfundo imeneyi, tinganene kuti munthu woyamba ndi kachilombo matendawo wodwala mwachizolowezi, kumasuka ku malo kwa tizilombo toyambitsa matenda. Kenako Koch Bacillus asalowe dongosolo mkodzo kwa mtsinje wa magazi. Choncho, njira ya matenda - woyamba airborne kenako hematogenous.

TB ya dongosolo urogenital amuna ndi akazi akuyamba ndi vuto la impso. Awa, ndondomeko opatsirana ndi kugawidwa ndi tubules ndi aimpso, Mitsempha mu mafupa a chiuno ndi aimpso. Ndiye amakhudza ureters, chikhodzodzo mkodzo. Foci TB zimachitika mu impso ziwiri, koma, mu kuchita, patsogolo ndondomeko pathological imodzi yokha ya nsapato ziwalo.

Monga matenda akufotokozera? Bacillus Koch pamene anagunda mu impso bwanji kotekisi ndi medulla. Mu thupi pali tokhala. Kenako ulcerate, pali wowumitsa kuwonongeka. Chifukwa, cavities anapanga. Owazungulira akupanga njira yotupa, pali tokhala. Zonsezi zingachititse kuti chiwonongeko chotheratu cha impso kupanga pyonephrosis.

Ndi pofuna TB genitourinary pakati pa akazi ndi amuna amakhudza fibrotic ndi adipose kapisozi mkati limba. The tokhala ndi zilonda kuoneka pa mafupa a chiuno aimpso, ureter. Wall chifukwa cha thicken, amakhala walowerera, edematous. Zilonda zarubtsovyvayutsya kenako anapanga dongosolo kuteteza ndi outflow wa mkodzo.

Popeza mankhwala okwanira pamatenda amapatsirana impso ndi chikhodzodzo. The ndondomeko pathological chiyambira mu dera kumene ureters mofatsa. Mu mkati limba mucosa zimachitika timabamputimabampu. Iwo pansi azingokhala zina. Mu malo awo anapanga zilonda, mabala. Kenako chikhodzodzo amakhala makwinya chifukwa chakuti khoma mkati mwa chiwalo anakhudzidwa m'malo minofu sclerotic.

TB ya dongosolo genitourinary: a gulu mwachidule matenda

Akatswiri mu kuchita ntchito gulu chimene chimasiyanitsa pamisinkhu angapo matenda:

• Chifukwa gawo loyamba la matenda amakhala ndi impso infiltrative TB, T. E. Non-zowononga.
• Mu Chinthu chachiwiri kuwononga koyamba zimawonedwa, mwachitsanzo. E. Single M'mimbamo kuoneka ang'ono. Awiri, iwo ali zosakwana 1 centimeter.
• Mu gawo lachitatu pali chiwonongeko zochepa. Limodzi la zigawo za impso kuoneka cavern lalikulu kapena polikavernozny TB.
• Pakuti gawo lachinayi yodziwika ndi chiwonongeko kapena subtotal.

The matenda chithunzi cha matenda

Genitourinary TB kungaonekere m'njira zosiyanasiyana. Nzosadabwitsa matendawa mu mabuku mankhwala mmodzi wa ambiri "mystifies" mwa matenda a m'chikhodzodzo, impso ndi kapepala mkodzo. Pa maonekedwe a TB zambiri mavuto zokhudza anagwirizana. Izi zikhoza kukhala pyelonephritis, aakulu aimpso kulephera.

Zizindikiro za TB aimpso anawagawa m'magulu 2:

• zizindikiro zosonyeza kuti zidzachitika pamene inu kusintha chikhalidwe wamkulu wa munthu wodwalayo;
• Zizindikiro m'deralo, lophatikizana ndi ubwamunalo linagawanika iwonso pa zotengera malingaliridwe (amene amaona) ndi cholinga (wapezeka ndi akatswiri pa kafukufukuyu).

Zizindikiro Common TB ya mapeto a njira ya mkodzo

Pamene matenda 20-30% ya anthu chinawonjezeka kutentha thupi. Ndichachidziwikire kuti ranges ku madigiri 37-38. Mu ena odwala matenda zina, mavuto anati kutentha wofanana madigiri 38-39, kuzizira akuwonekera.

Pafupifupi anawona oopsa (kuthamanga magazi) mu 5-18% ya anthu odwala. Poyamba, akatswiri amakhulupirira kuti chizindikiro ichi ndi chifukwa acceding pyelonephritis. Tsopano izo imatsimikizirika kuti matenda oopsa - ndi chizindikiro zimene zikusonyeza impso TB. Tikumbukenso kuti zochitika za chizindikiro ichi zimadalira chikhalidwe cha matenda. Mwachitsanzo:

• TB aimpso parenchymal oopsa kumakhudza pafupifupi 1.1% ya anthu odwala;
• TB aimpso papilla - 3.2%;
• tuberculous pyonephrosis polikavernoznom ndi TB - 18,3%.

Zizindikiro Local zotengera malingaliridwe

Nthawi zambiri anthu amafunsa kuti, "Zizindikiro, ngati pali TB genitourinary, kodi?" Poganiza kuti angayambe - ndi zopweteka pafupipafupi pokodza. Akatswiri mu 50-60-ntchentche Mu zaka zapitazo anaulula khalidwe limeneli mwa anthu onse. Anayamba chizolowezi kuchepa pafupipafupi mankhwala. Mu 60-70-ntchentche,% 48 okha a anthu anadandaula za kuphwanya pokodza ndi zaka 80 - 43 okha% odwala. M'zaka zaposachedwapa, chizindikiro, si anthu wamba. kuchepa amenewa anafotokoza chifukwa pafupipafupi zotupa za Kakhungu mucous a chikhodzodzo.

Nthawi zambiri pali zizindikiro - ululu m'dera lumbar akuwuka pamene wayamba kukhala genitourinary TB. Zizindikiro zonsezi zikuloza pafupifupi theka la odwala anthu. Zimamupweteka amakhala mmodzi ndiye amaganiza. About zomverera zosasangalatsa isanafalikire mbali zonse, kulengeza% 15-20 okha a anthu odwala.

Ndi chikhalidwe chake, zowawa ndi pachimake, ofanana colic aimpso. Vutolo limachitika chifukwa kuphwanya kugwira ntchito excretory chifukwa blockage wa kuundana ureter magazi, purulent Nkhata Bay, kutupa nembanemba mucous. Aimpso colic - chizindikiro kuti zimawonedwa osati TB ya dongosolo mkodzo. Iye ali achilendo, ndipo matenda ena. Mmodzi wa iwo - urolithiasis. Kuti matenda molondola anachita Kupenda Urological.

Local umboni cholinga

Tatchulawa mbali, amene ali ndi chifuwa chachikulu cha dongosolo genitourinary - zizindikiro ndi zotengera malingaliridwe. Zizindikiro cholinga monga pyuria. Mawu amenewa amatanthauza chinawonjezeka chiwerengero cha leukocytes mu mkodzo. Leucocyturia - chizindikiro oyambirira a matenda. Pankhaniyi, si kuvomerezedwa. Ngati mu nthawi ya kusanthula mkodzo maselo oyera si wapezeka, izo si umboni chosowa matenda.

Zizindikiro za TB monga eritrotsiturii dongosolo urogenital. Mu mankhwala, mawu akunena kwa msinkhu okwera maselo a magazi mu mkodzo. M'zaka zaposachedwapa, chikhalidwe ichi chavumbulutsidwa zambiri - pafupifupi 70-75% ya anthu odwala. Kuchuluka kwa maselo ofiira magazi kugwirizana ndi kukula kwa ndondomeko zowononga impso ndi.

Kumayambiriro cholinga chizindikiro cha TB - proteinuria (mapuloteni kudziwika mu kusanthula mkodzo). Iwo amawapeza mu 85-95% ya anthu odwala. Pa zosayembekezereka ya proteinuria ndi maganizo ochepa:

1. Akatswiri ena amakhulupirira kuti si kugwirizana ndi chifuwa chachikulu cha dongosolo la mkodzo. gwero la mapuloteni, mu maganizo awo, ndi maselo ofiira.
2. Akatswiri ena amanena kuti protoinuriya chifukwa cha kusintha osachiritsika mu tubules ndi glomeruli a impso.

Chaka chilichonse zambiri madokotala kupeza chizindikiro china cha TB. Ndi za bacteriuria nonspecific. The matenda tingaone pamisinkhu zonse za matendawa. nthawi zambiri zimasonyeza pa mitundu ya cavernous. Tizilombo toyambitsa matenda nonspecific mkodzo matenda zosiyana. Kuzindikiritsidwa ndi Escherichia coli, ndi Staphylococcus, ndi Streptococcus, ndi timitengo buluu wobiriwira mafinya. Sizachilendo ndi zomera losanganikirana.

The chizindikiro yodalirika ya matenda - chizindikiritso cha Koch amakhala mu mkodzo. Komabe, akatswiri si nthawi zonse kusamalira kupeza waukulu causative wothandizila matendawa. Ngakhale masiku ano njira mayesero bacteriological sititenga. chakuti anthu ena kutenga mankhwala zotchulidwa dokotala ku matenda alipo kapena kumwa mankhwala, kuchita kudzipatsa medicate. Chifukwa, Mycobacterium TB kutaya luso lawo kubereka ndi kukula. Mutabzala, iwo, kumene, pa chifukwa chimenechi sangathe wapezeka. N'zovuta kudziwa tizilomboto mu thupi la munthu wodwalayo.

Makamaka chifuwa chachikulu cha dongosolo la mkodzo ana ndi okalamba

matenda amakhudza akulu makamaka. Ana, kuli matenda mu genitourinary TB. Pafupipafupi ndi oyambirira chizindikiro akuwuka kwa iwo - izi ndi polyuria, mwachitsanzo, ndi kuwonjezera mphamvu ya mkodzo ... Pali zizindikiro zina, koma iwo amaganizira matenda ena. Mbali ina yofunika ya TB ana ndi kuti atsikana ambiri mawonekedwe a matenda si zowononga, ndipo anyamata - zowononga.

TB ya mapeto a njira ya mkodzo zimakhudza anthu ambiri achikulire. Ichi ndi chifukwa kuchepa chitetezo cha m'thupi, zikamera wa matenda osiyanasiyana. Pa zizindikiro za TB zokhudza zothangatira ndi matenda Urological. Zikuphatikizapo: .. BP, matenda pa mundawo m'mimba, impso matenda, nonspecific pyelonephritis, etc. Chifukwa cha ichi, TB ya mapeto a njira ya mkodzo si nthawi zonse wapezeka. zizindikiro zake ndi masked ndi zizindikiro za matenda pamwambapa.

Features wa panopa matenda a amuna ndi akazi

Kuchokera pansi zimadalira m'mene kuwonetseredwa genitourinary TB. Mu akazi, zizindikiro monga ululu zochepa kwambiri. Mu Amuna amphamvu. Iwo nthawi zambiri amakhala kukhala TB, ziwalo zoberekera. Kafukufuku amasonyeza kuti kupitilira izi akazi kumachitika kokha 7% milandu, pamene amuna - 31%.

Poganizira genitourinary TB anthu, ndi zizindikiro za matenda, ndi Dziwani kuti loyamba la Koch Bacillus anagunda Prostate (Prostate). Mu ndondomeko pathological nawo kenako mbali zina za dongosolo dongosolo ubereki: seminal vesicle, testis, epididymis. Nthawi zina, mbolo anakhudzidwa. Zikuoneka matenda chilonda amakhudza zotumphukira lymph mfundo. Zizindikiro amenewa anaona pa mbolo, amafuna masiyanidwe matenda a khansa.

Genitourinary TB: matenda

Pamene matenda a njira yachipatala ntchito choyamba. Iwo salola kuti molondola kudziwa munthu ali TB kapena ayi. Komabe, akatswiri kudziwa zizindikiro Muzisamala chiyamiko cha kwa iwo. njira kafukufuku pa chipatala monga kafukufuku wa munthu odwala, akuchita anayendera, palpation malo Chowawa.

Yofunika kwambiri matenda a njira kusewera zasayansi:

1. Odwala mayeso magazi. Iye sanaulule zinthu zapadera chibadidwe TB ya mapeto a njira ya mkodzo, koma tingasonyeze leukocytosis ndi kuwonjezera erythrocyte mlingo sedimentation. Izi zisonyeza pamaso kutupa mu thupi.
2. Kuikidwa ndi mkodzo. Izi ndi njira yaikulu ya matenda a zasayansi TB. Mu mkodzo matenda anapeza Koch Bacillus, matenda ena (ngati aliyense, kapena chitukuko cha mavuto). Kafukufuku angasonyeze proteinuria, pyuria, eritrotsiturii.

Akatswiri amanena kugwiritsa ntchito njira zonse zotheka wa kufufuza, ma awo ndi ntchito angapo.

Mndandanda wa njira yodziwira zikuphatikizapo tuberculin. Kwenikweni umenewu chagona mu ulamuliro subcutaneous wa wapadera unakhuthala sing'anga. Iyo imatchedwa tuberculin. Tuberculin Tili zizindikiro ndi contraindications. Mwa zizindikiro ndi monga: a kukayikirana TB ya dongosolo genitourinary, adziwe amadza ikuchitika ndi mankhwala enieni, ndondomeko kulamulira zochitika. Contraindications amachita mbali yapadera.

Pamene matenda a TB akhoza kugwiritsa ntchito njira endoscopic wa kufufuza:

1. Mmodzi wa iwo - ndi cystoscopy. Mu njira imeneyi, ndi endoscope, umene ndi catheter ndi zounikira ndi machitidwe kuwala, ali anaikapo mwa mkodzo mu chikhodzodzo. Zizindikiro Nonspecific TB mutuluka akakufunsani kapena mogwirizana hyperemia ankaona eni limba mucosa. Zizindikiro zenizeni yachititsa cystoscopy - timabamputimabampu, mabala, zilonda unakhazikitsidwa pa malopo.
2. Nthawi zina, pamene n'zosatheka kuti apange matenda molondola ndipo pali zinthu zina zokhudza unachitika endovezikalnaya biopsy. Pamene ikuchitika nkhani mpanda kafukufuku. The chifukwa otsimikiza pamaso pa chifuwa ndi chikhodzodzo kansa. Ndi chifukwa zoipa si kukusalani TB.

Monga njira kafukufuku wothandiza ntchito radiography zomveka tomography. Ndi njira izi akatswiri kufufuza tiphunzira za magawo impso, boma perinephric mafuta, awulule calcifications ndi malo ossification cha ziwalo mkodzo dongosolo, lymph mfundo, retroperitoneal danga. Zona pa chifuwa chachikulu angiography aimpso. Ndi udalowa kusintha zowononga impso, aimpso mtima mamangidwe a kuphunzira, kupeza mphamvu ya kuchita kusamala opaleshoni ndi impso minofu buku kuti resected.

Nthawi imene ultrasound jambulani. Izi njira si olanda za kafukufuku. Ultrasound kupenda dongosolo pyelocaliceal, oyambirira kudziwika miyala impso, kusintha sclerotic, calcifications matumba, mphako, cysts. Pa nthawi yomweyo Ehostruktura zotupa n'zosatheka kuti ndi matenda zolondola. Kuona zotsatira za ultrasound zitha akusonyeza pamaso pa chifuwa.

Chithandizo regimens matenda

Chithandizo cha TB ya dongosolo genitourinary akapatsidwa malingana siteji:

• Mu masiteji koyamba mankhwala ntchito. Odwala amapatsidwa mankhwala tuberculostatic osakaniza macrolides ndi fluoroquinolones, immunomodulators, proteolytic michere. Kusankha mankhwala ndi madokotala, kutenga nkhani tilinazo wa kudziwika M. TB ndi mphamvu ya mankhwala ntchito.
• Pa nthawi III matenda mankhwala pamodzi yosalekerera opaleshoni. Wodwala kapena tsankho nephrectomy kavernotomiya awerenge (kutsegula M'mimbamo a).
• Pa gawo lotsiriza la nthenda ndi anagwira mankhwala ndi nephrectomy (kuchotsa impso anakhudzidwa).

Nephrectomy mwa milandu TB dongosolo mkodzo ndi mwachilungamo zambiri. Ichi ndi chifukwa Buku mochedwa aluso chithandizo kusalankhula muyezo chithandizo. Pambuyo nephrectomy, zosokonezeka postoperative n'zotheka, koma iwo n'zochepa kwambiri. Zikuphatikizapo hematoma, abscess subcutaneous mafuta, mafinya ndi yaitali kuchiritsa fistulas, hernias.

TB ya dongosolo urogenital anthu, ndicho kumaliseche, kovuta kuchiza. Iye ndi woipa amenable mankhwala ndiwofatsa. Mankhwala amaikidwa ndi yeniyeni mankhwala odana ndi TB mu mlingo chomwecho monga chifuwa chachikulu cha dongosolo mkodzo. Komanso, pamene matenda kumaonekeranso immobilization kudzera scrotal mwamphamvu pafupi heats ntchito novocaine blockades spermatic chingwe (molumikizana ndi streptomycin). TB ya dongosolo wamwamuna urogenital amaliona 2 kapena 3 miyezi. Ngati zotsatira zake sizikhala zogwira mtima, ndiye ikuchitika resection wa epididymis kapena epididymectomy. Pamene kugonjetsedwa okwana testis anatenga opareshoni kuchotsa izo. Ngati TB amakhudza prostate ndi vesicles umuna, kenako mankhwala mankhwala ndiwofatsa.

Pomaliza, ndi Dziwani kuti genitourinary TB akufotokozera m'ma 10-15 zaka pambuyo isanayambike m'mapapo mwanga kapena osteoarticular TB. Zizindikiro bwino kupempha thandizo ku luso osati kuzengereza Ulendo chifukwa chifukwa Kukula kwa matendawa m'tsogolo kungafune kuchotsa impso. Mu magawo oyambirira amenewa ndi zotsatira angathe kupewedwa.