Tuberculous pleurisy: Mitundu, Zoyambitsa ndi mankhwala

Pali ambiri matenda zimene zingakhudze anthu kupuma dongosolo. Ena a iwo aima zambiri kuopseza thanzi, koma pali anthu amene kwambiri mavuto ndi kuchepa mu mlingo wa moyo wa wodwalayo. Mmodzi wa awa ndi pleurisy tuberculous, ndi amene tinakumana m'nkhani lero wathu. Taonani zifukwa kwa chitukuko, mitundu ndi mankhwala osavomerezeka.

Kodi wapatsidwa matenda

Mu matenda yodziwika ndi pachimake, aakulu kapena kobwereza pleural kutupa. matenda zambiri kumaonekera pambuyo kutenga TB chamoyo.

Tuberculous pleurisy zambiri zimakhudza nembanemba serous kuti apange M'mimbamo pleural ndi kuphimba m'mapapo. matenda ndi aakulu mokwanira, polimbana wakhala ukupitirira kwa zaka, koma lero musabise akadali zimachitika.

Kuopsa kwa matenda n'lakuti achuluke kwambiri pakati pa anthu, kuwonjezeka amafa. Ndinaona kuti nthawi zambiri matendawa amapezeka mwana. Pleurisy wa etiology tuberculous ndi zinadzala ndi kufala kwa tizilombo thupi lonse, imbaenda kusokoneza machitidwe onse limba, kotero mwamsanga matenda amawapeza, ndi aluso mankhwala.

zimagwirira chitukuko matenda

kudwala uyu ali njira ziwiri za chitukuko:

1. Pleural effusion wa tuberculous etiology akufotokozera ngati pleura kukhudzana ndi poizoni zinthu causative wothandizila wa matenda ndi oipa mankhwala a zimakhala. Pleural M'mimbamo Pankhaniyi lili pang'ono mabakiteriya. The pathogenesis akhoza ananena kuti nthawi zambiri kumawonjezera tilinazo lake ndi majeremusi tizilombo, kukula zimakhudza njira yapita matenda TB. Utatha bakiteriya mu pleura akuyamba ndi kudzikundikira mofulumira madzimadzi.
2. Kukula chachiwiri limagwirira - kutukusira kwa pleura ndi mapangidwe timabamputimabampu, kuyambika mabakiteriya akulowa misa cholinga mu m'mapapo kapena thoracic lymph mfundo.

Monga tizilomboto amatha kulowa mu M'mimbamo pleural

Pali njira zingapo zimene tubercle Bacillus angakhoze kulowamo M'mimbamo pleural:

1. Pin. Pankhaniyi, ingress zimachokera kwa foci mu mapapo kutayidwa pansi mthunzi.
2. njira Lymphogenous kumaphatikizapo inafikira ziwiya lymphatic.
3. Hematogenous kufala - ndi zoyendera kudzera ziwiya magazi.

Limagwirira chitukuko cha matenda ndi kutupa mu mapepala ndi pleural, kudzikundikira leukocytes ndi malowedwe a madzi kuti patsekeke pleural.

Exudate tuberculous pleurisy angakhale chikhalidwe chosiyana:

• Fibrous.
• Serous.
• Wamagazi.
• Purulent.

Ngati mankhwala si zothandiza, ndiye kenako serous effusion watsimikiza, ndi fibrous connective minofu adzabwere zinthu padziko lapansi pleura ndi mawonekedwe chilonda anakuta.

Zimayambitsa pleurisy tuberculous

M'mapapo mwanga tuberculous pleuritis amatanthauza matenda pathological kuti kukhala pa maziko a matenda kapena insufficiency m'mapapo mwanga. The etiology wa pleurisy ilipo ingapo mitundu, ndi aliyense ali yake zifukwa chitukuko.

Zimayambitsa matenda awa:

• Matenda oyamba ndi mabakiteriya, monga staphylococci, galamu alibe microflora.
• Mavairasi ndi majeremusi m'thupi, makamaka ngati kumanzere mankhwala.
• TB matenda ambiri mu mawonekedwe a timitengo.
• matenda a mafangasi: candidiasis, blastomycosis.
• Chindoko, typhoid ndi brucellosis kungakhale chitukuko cha matenda.

Mukhozanso itanani zimayambitsa si opatsirana:

• Ngati pali chotupa zilonda mu mapapo, zopangitsa mammary, mazira.
• M'mapapo mwanga infarction.
• Kapamba, khansa.

Madokotala olekanitsidwa mu gulu osiyana zimayambitsa osadziwika kuti lingachititse tuberculous pleurisy:

• Ngozi.
• Kuvulala, monga gunshot.
• Opaleshoni.

Timauza matenda ayamba zimapezeka ndi zizindikiro, koma choyamba m'pofunika kuganizira zosiyanasiyana matenda, iwonso zimapezeka mosiyana.

Gawo ndi mitundu ya kudwala

Ngati tikambirana maonekedwe a pathogenesis wa matenda, ndi akutali pleurisy TB mitundu zotsatirazi:

1. Matupi awo sagwirizana.
2. TB ya pleura.
3. Perifocal.

The zosiyanasiyana woyamba wa matenda kuonekera maziko a tcheru kwambiri ndi chamoyo. The peculiarity a mtundu umenewu pleurisy ndi pamaso pa ululu ndi kudzikundikira mofulumira madzimadzi. Koma mphamvu osiyanitsidwa monga mofulumira.

Mu nkhani ya kufalitsa ambiri malo ang'ono ndi lalikulu kukhala pleura TB. Kawirikawiri mtundu wa matenda amakhala ndi yaikulu caseous-necrotic ayankhe. Tuberculous pleurisy wa mtundu uwu imatengedwa kuti ndi kukulitsa kwambiri.

mtundu Perfokalny kuyambika kutupa kufalikira kwa mapapo kuti pleura lapansi. Exudate akhoza kudziunjikira mu yaing'ono kapena yaikulu chiwerengero cha tizilombo zimapezeka kuti si nthawi zonse, koma zimatengera mtundu uwu yaitali zambiri kobwereza.

Pa gulu la matendawa amakhudza kwambiri ndi pleural zikuchokera. Malinga kumasulidwa izi:

• Fibrinous kapena youma.
• Tuberculous pleural effusion.
• Purulent.

Woyamba chosayenerera zikachitika, monga kulamulira, m'madera ena a pleura, kumene waikamo mwawo Ulimbo. M'kupita kwa nthawi, pleura wotaya kusalala ake. mtundu uwu matenda mosavuta n'ngochiritsika ngati kuyamba nthawi yake.

Pleural effusion popenyana ndi fibrotic chiwonetsero cha malingaliro. Nthawi yomweyo akuyamba mwachangu secrete madzimadzi ndi kudziunjikira mu M'mimbamo pleural. Pali nthawi pamene onse kumayamba ndi youma mtundu, zomwe zikulumikizana ndi exudative.

Purulent kupanga khalidwe chipangizo. Pleural kumachitika chifukwa cha kukhudzana ndi ILO mlingo kapena kuphwanya cholinga subpleural.

Ngati pleurisy wa etiology tuberculous, izo akadali ogaŵikana mitundu ingapo:

• Infection. Mpatuko pambuyo kukhudzana ndi staph, pneumococcal, TB oyambitsa mu mapapo.
• Noninfectious TB pleurisy akufotokozera ndi maziko a khansa ya m'mapapo, la misempha ndipo pathologies ena.
• Idiopathic pleurisy akufotokozera chifukwa bwinobwino zifukwa.

Disease angayambe mosiyana kwambiri akutali mawonekedwe, subacute ndi aakulu. Aliyense ali yake zizindikiro.

chiwonetsero cha matenda

Pakuti mtundu uliwonse wa pleurisy amakhala ndi zizindikiro zake. Youma chifuwa chachikulu zizindikiro pleurisy ali motere:

• Izo limfatogennoe kufala kwa matenda.
• Pali ululu pachifuwa. Pamene inu pokoka mpweya kuti nakweza ndipo kungakhale sneezing, kutsokomola.
• Kuchuluka thupi kutentha.
• Cacikulu pali kufooka mu ndondomeko ya kudwala matenda.
• Kuledzela amapezeka.
• Utachepa kudya.
• Yafupika kulemera.

Zizindikiro zoyambirira sizipanga n'zotheka matenda mwamsanga, kotero ululu mpaka matenda zolondola kovuta. Ndi chitukuko cha matenda ululu umakhala wolimba, pali ngakhale milandu imfa ya chikumbumtima.

Symptomatology youma pleurisy ndi ofanana kwambiri neuralgia, kotero nkofunika kusintha zinthu zina matenda masiyanidwe. Ngati pali pleurisy youma, wodwalayo amayesetsa kunamiza kumbali inayo, koma ululu uwonjezeke.

Ngati dokotala adzamva maonekedwe a ululu, ndiye inu mumvere phokoso ku mikangano ya pleura lapansi. Matenda mtundu wa pleurisy zambiri ndi mayesero magazi amalephera.

Exudative mawonekedwe zizindikiro zotsatirazi:

• Kupuma movutikira.
• Zofooka ndi malaise.
• Kuchuluka thupi kutentha kwa madigiri 38-39.
• Chifuwa.
• Dryness pakamwa.
• ululu chifuwa ku tizilomboto kutanthauzira.

Nthawi zambiri, effusion amenewa ndi pachimake Inde, koma pali nthawi zina pamene ana kapena achinyamata matenda asymptomatic ndipo wapezeka pokhapokha mosamala thirakiti chapamwamba kupuma.

Pambuyo kudzikundikira wa madzimadzi mu M'mimbamo pleural ya zizindikiro angathe kuchepetsedwa, ikhala yekha kumbali yokoka lapansi. Chiwerengero cha exudate angafikire malita awiri. Pankhaniyi, mutu, chizungulire, ana angathe kusintha mtundu wa khungu, iwo lethargic, wotumbululuka ndi zambiri kugona mbali imodzi.

Symptomatology purulent pleurisy ali ndi mawu ofooka wodwalayo sizingasinthidwe, koma pali kuwawa mbali yake, kufupika kwa mpweya, kufooka ndi malungo. chikhalidwe kawirikawiri kulimbikitsa moti wodwala kudzuka pabedi.

Zizindikiro za subspecies pleurisy

Tapeza kuti palinso subtypes wa pleurisy, amenenso zimapezeka mosiyanasiyana.

Perifocal ali ndi zizindikiro zochepa:

• Wofatsa kupweteka pachifuwa.
• A kufooka yaing'ono.
• Ngakhale kumvetsera phokoso yaing'ono pamtima.

Izi subspecies wa pleurisy ndi yaitali ndiponso musabise kawirikawiri, ngati pali kudzikundikira madzimadzi, zizindikiro ndi kale kwambiri kutchulidwa:

• Kuchuluka thupi kutentha.
• Amphamvu thukuta.
• Mpatuko tachycardia.

Matupi awo sagwirizana pleurisy limapezeka motere:

• Kutentha limatuluka digiri makumi asanu ndi anayi.
• Tachycardia.
• Rapid kudzikundikira madzimadzi.
• Kupuma movutikira.
• Kuopsa kwa inhalation ndi ululu mbali yake.

Zizindikiro zimenezi mwamsanga kuoneka ndi kutha komanso.

Ngati anayamba TB ya pleura, ndi khalidwe la iye:

• The Kutentha kuuka kwa madigiri makumi anai.
• Kugwiritsa thukuta.
• Ululu mbali yake.
• Youma chifuwa.
• Kupititsa patsogolo dyspnea.

Ngati ndi mawonekedwe aakulu, ndi mmene chifukwa pleurisy tuberculous:

• Kumverera chosowa mpweya.
• Pa khosi kutupa mitsempha, ndi lymph mfundo.
• Cyanosis cha milomo.

Pamene zizindikiro za wodwala ayenera kuchipatala. M'pofunika kuonetsetsa kuti anthu ndi zizindikiro sanasangalale kumbuyo gudumu, ndi bwino kuitana "ambulansi" ngati inu simungakhoze kubweretsa nokha ku chipatala.

matenda

Ngati pali tuberculous pleurisy matenda ndi zovuta. Doctor kuti matenda si kofunika kudziwa mmene matenda kuonekera zosiyanasiyana, komanso kuchititsa maphunziro osiyanasiyana. Pamaziko a deta onse akhoza matenda. Matendawa zikuphatikizapo:

1. kafukufuku mtima pa nkhani ya madandaulo.
2. Kutolera mfundo za kupenta kuwonekera kwa matenda.
3. Pogwira mayesero tuberculin.
4. Radiographic Kupenda anaulula kusintha minofu ya m'mapapo.
5. A magazi limasonyeza zikuchokera leukocytes, makamaka kusintha kutchulidwa mu magazi mu mawonekedwe a purulent pleuritis.
6. Urinalysis detects kukhalapo kwa mapuloteni. Ngati zilipo, matenda ndi lodziwikiratu.
7. Bronchoscopy angazindikire TB bronchial amamuyambitsa timabala.
8. Ankafufuza exudate. Ngati pleurisy tuberculous, ndiye pali mbali ya mapuloteni, ndi shuga yafupika.
9. Mkulu chiwerengero cha oteteza titers mu zochita za IHA, IFA adzasonyeza pamaso pa chifuwa chachikulu matenda.
10. Kudzera tomography anatsimikiza etiology pleurisy.

Pokhapo zikutsimikiziridwa matenda a "tuberculous pleurisy", chithandizo Kwalamulidwa ndi dokotala wodziwa bwino.

mankhwala matenda

Kuthana ndi matenda, ndi nthawi yofunika kuti azindikire izo, ndi kuyamba chithandizo. Anthu ambiri amadzifunsa kuti: tuberculous pleurisy opatsirana kapena ayi?

Ndi matenda, ndipo ngati sputum lili tizilombo toyambitsa matenda kudwala, monga wodwala ngozi anthu ena. Therapy ayenera kuchitidwa kokha kuchipatala TB.

Therapy ayenera makamaka kulimbikitsa kutha minofu chiwonongeko ndondomeko. Kuti tichite zimenezi, tisonyezeni:

• "Rifampicin".
• "Pyrazinamide wokhala".
• "Ethambutol".

Kutalika kwa mankhwala mankhwala ndi miyezi eyiti, ngati komanso matenda TB m'mapapo mwanga, nthawi mwina idzapitirizabe mpaka zaka ziwiri.

Akatswiri akukhulupirira kuti zingakhale zothandiza polimbana ndi matenda tizilombo toyambitsa matenda corticosteroids, monga "Prednisolone".

Mosavuta kutenga mawonekedwe mwake, m'pofunika kuchita ikukoka madzimadzi kuteteza mapangidwe zigawo.

Chithandizo cha pleurisy tuberculous ndi anagwiritsanso ntchito immunostimulants, mankhwala monga "Levamisole", "Taktivin".

Ngati yaitali mankhwala mankhwala sapereka zotsatira zake, m'pofunika amachita opaleshoni.

Pa mankhwala ayenera kutsatira bedi zina ndi zakudya ayenera anamva chisoni. Mukufuna malire ntchito mchere ndi mchere zakudya, zakumwa zochepa madzimadzi, ziwonjezeke ntchito mankhwala ndi lalikulu zili zomanga thupi ndi mavitamini.

kupewa matenda

Kuti adzathe sanabwerere tuberculous pleurisy, mankhwala si lamulo, ndikofunika kutsatira njira zodzitetezera. TB ndi matenda chikhalidwe amene mwachindunji zokhudzana ndi khalidwe la moyo wa anthu. AIDS vuto chifuwachi anachititsa kuwonongeka kwa umoyo ndi zachuma zinthu, kuchepa moyo mfundo za anthu, zochita za kusamuka njira.

Akulepheretseni zotheka kuti malangizo otsatirawa malangizo:

1. Kuchititsa miyeso zonse njira ndi odana ndi mliri.
2. Posachedwapa matenda matenda odwala ndi kupereka mankhwala mankhwala.
3. Onetsetsani kuti achite mayeso zachipatala ntchito m'madera amene akumane nyama TB.
4. boma ayenera kuonetsetsa m'madera osiyana moyo wamoyo, odwala TB yogwira makamaka ngati moyo m'zipinda zogona kapena mabanja ang'onoang'ono.
5. Mokakamizidwa Katemera wa akhanda.
6. Unachitikira pachaka pachifuwa X-ray a m'mapapo.
7. Poyamba chizindikiro cha matenda chofunika kukaonana ndi adokotala.

Compliance ndi yosavuta njira zoyezera kuchepetsa kufala kwa matenda ndi thandizo kuzindikira pa adakali siteji ya chitukuko, pamene mankhwala ambiri mogwira mtima.

Munthu aliyense iye mwini udindo kwa umoyo wawo. Sikuti pa indisposition zizindikiro loyamba okha, Choncho tiyenera kulola nthumwi za "kufalikira ufulu wawo", ndi matenda ayamba patsogolo. Only dokotala oyenerera apange matenda zolondola ndi mankhwala mankhwala.