Na huhu da tarin fuka ya watsa: Bayyanar cututtuka da kuma Jiyya

Very m, kuma m cuta da tarin fuka ya wanzu a duniya millennia, kamar yadda evidenced yawa archaeological tono da kuma tarihi takardun. A yau duniya a kowace shekara yana daukan cikin sahu na fama da game da 10 da mutane miliyan, 25% wanda ya mutu.

A mafi m nau'i na cutar - na huhu da tarin fuka ya watsa, wanda ke nufin multifocal, "zubo" a kan dukkan sauki. Karba da kamuwa da cuta ne mai sauqi, kamar yadda hanyar ta watsa dada sauki, da kuma cututtuka a farkon matakai ne kusan ganuwa. A gaskiya ma, cikin hadarin ƙulla kowannenmu fallasa su kowace rana, amma sa'a, ba kowane jiki ne iya tasowa da tarin fuka. Idan har yanzu kana sa da mummunan ganewar asali, kada ka yi baƙin, saboda yanzu kimiyya ya tako zuwa yanzu kamar yadda gaba daya ya warkar ko ya watsa shi na huhu da tarin fuka mai yiwuwa ne. Yana ba ya bukatar jin kunya daga na yau da kullum dubawa da kuma kunã madawwama scrupulously ta zalunta tarin fuka gwani. Suka ce cewa ilmi daga karfi da kuma kasawan da makiya - shi ke 50% nasara. Saboda haka bari mu ga abin da shi ne da tarin fuka, inda ta fito da kuma yadda za ku yi yãƙi da shi.

tubercle bacillus

Watsa tarin fuka da huhu ya sa ta microscopic kwayoyin, ya kira mycobacteria. Sun zama a wannan duniyar tamu ga miliyoyin shekaru, amma aka kawai gano a 1882 da wani likita, kuma masanin kimiyya Koch, a cikin wanda girmamawa da kuma ambace su da su don haka - da Koch bacillus. All pathogenic mycobacteria (rage tsawon as MKB), akwai 74 jinsunan, 6 da abin da zai iya sa da tarin fuka a cikin mutane da kuma dabbobi. Yan sanduna na cin abinci da aka kira saboda bayyanar, da gaske sanda-siffa. Wasu mycobacteria suna daidai masu hada kai, wasu dan kadan mai lankwasa, kuma su duka biyu da tsawon na daga 1 zuwa 10 micrometers, da kuma fadin - game 0.5 microns.

A musamman alama na su ne tsarin da ganuwar, ko membranes. Ba tare da faruwa a cikin cikakken bayani, za mu lura cewa shi ne a cikin sandunansu Koch damar da su zuwa mutate iyaka yawan sau, su kare kansu daga m parasites ga sauran antibodies aiki da kuma haquri da tsayayya da maƙiya yanayi. Su ma bacteriophages amfani da nasara, wanda shine raison d'être - don kare jiki da parasitic kwayoyin. Ana tunawa, Koch ta bacillus bã Ya mutuwa, kuma gyaggyara macrophages sabõda haka sũ, sauƙi haifa da haka ba zai zama samuwa ga tsaro tsarin na mai shi. A wasu kalmomin, Koch ta bacillus yin amfani da salon salula tsaro na jikin mu da su aiwatar da shi da kyau.

Da zarar a cikin huhu da lafiya mutum, wadannan parasites samar da wata farko guda foci (primary da tarin fuka), amma bayan da jini da kuma / ko Lymph rarraba kan ya fi girma yankin na daya ko biyu huhu da sauran numfashi haka tasowa watsa na huhu da tarin fuka. A karkashin wani yanayi da zai iya ci gaba har bayan bi da farko da tarin fuka, kamar yadda Koch ta bacillus a wani m nau'i kasance a cikin jiki domin shekaru masu yawa.

Hanyoyi kamuwa da cuta

Na huhu da tarin fuka a cikin mutane sa iri uku kwayoyin - M. tarin fuka (mutum subspecies), M. africanum (subspecies matsakaici) da kuma M. bovis (a subspecies na dabba). A karshen ne mafi rashin lafiya dabbõbi, da kuma zuwa ga mutum shi ne daukar kwayar cutar daga unpasteurized madara.

Mutane da yawa suna sha'awar, watsa na huhu da tarin fuka ne m, ko ba. Amsar mai sauki ce: yana da matukar m, idan aka gudanar da a saki Koha sandunansu (tubercle bacilli).

Sun zo daga rashin lafiya mutum zuwa da lafiya tukuna remarkably sauki:

- za su iya a inhaled daga cikin iska.

- da yau (msl, ta tari, sumba).

- ta hanyar kayayyakin amfani da mãsu haƙuri.

- ta hanyar iyali abubuwa.

- daga uwar - tayin.

- a lokacin da yin amfani da arancinsu haifuwa likita kida.

Kamar yadda ka gani, za ka iya samun tarin fuka ko ina: a harkar sufuri ta gwamnati, a wuraren da jama'a, a makarantu, a wurin aiki da sauransu.

Muhimmi: Koch bacillus dama tenacious. Sun riƙe su m kaddarorin waje da jikin mutum na dogon lokaci. Ga 'yan misalai na yadda da Koch bacillus rayuwa a muhallin da muke fuskanta a kowace rana:

- a wani duhu wuri ba tare da hasken rana - har zuwa shekaru 7;

- a bushe haƙuri sputum (hagu a kan dukkan batutuwa) - har zuwa shekara 1;

- a cikin turɓãya a kan titi - har zuwa kwanaki 60.

- a kan guda na typographic bugu - har zuwa watanni 3.

- ruwa - game da 150 days.

- a unboiled madara - game da 14 days.

- a cikin cuku (mai) - to a shekara.

Shin yana yiwuwa a barnatar da amsa tambaya na watsa na huhu da tarin fuka ne m, ko ba haka ba? Zai yiwu Koch bacillus ba a cikin yanayi, da sauki halaka? Abin baƙin ciki, wadannan mycobacteria ne quite wuya a kashe. Godiya ta zuwa ga na musamman cell bango, suna da wuya ta shafa hasken rana, ultraviolet radiation, barasa, acetone, acid, alkalis, da yawa disinfectants, dihydrate, da kuma lokacin da Boiled da batutuwa kamu sputum bai mutu kamar yadda 5 da minti. Idan Koch ta bacillus iya ci gaba a cikin jikin wani mutum, da tarin fuka zai cuce dukan mazaunan duniya duniya.

hadarin kungiyoyin

Kafin makaranta shekaru, mafi yara karba sandunansu Koch, amma watsa na huhu da tarin fuka ko wani tasowa kawai rauni, sickly yara. Akwai kuma hadarin kungiyar hada da:

- mutane ne har abada a kusa lamba tare da majinyatan tarin fuka.

- Mutane da low rigakafi.

- Cutar HIV.

- karɓarsu ga immunosuppressants.

- matasa da kuma tsakiyar-shekaru mutane a cikin tsawon hormonal canje-canje.

- yunwa.

- fama da tarin fuka da fata da kuma sauran gabobin.

- canjawa wuri cututtuka.

- bolevshie farko na huhu da tarin fuka da bi.

- mikawa wasu dogon physiotherapeutic hanyoyin (msl, ma'adini).

rarrabuwa

Na huhu da tarin fuka zai iya ci gaba watsa a cikin wadannan hanyoyi:

1. jini (hematogenous). A wannan yanayin, duka biyu huhu da bala'in ya shafa. Shigar da jini da kwayoyin cuta na iya zama ta hanyar da Lymph nodes, gon Aljihuna, ta hanyar da dama zuciya da kuma huhu jannayẽnsa.

2. Lymph (lymphogenous). A wannan yanayin, da shafa daya huhu.

3. Limfogematogenny.

By yanayin da cutar rarrabe na huhu da tarin fuka ya watsa da wadannan siffofin:

- m (miliary).

- subacute.

- kullum.

- jimlace. Game da wannan nau'i na cutar cewa lokacin da, ga abin da dalilai, da jini ya auku nasara abinda ke ciki na shafa Lymph kumburi Mycobacterium, tsarin yana da cheesy (caseous). A wannan yanayin, a daidai wannan lokaci ne mai babbar adadin jini a cikin sandunansu Koch. Abin farin, shi ya faru infrequently.

A m nau'i na da tarin fuka

Haka kuma cutar ta fara abruptly, ba zato ba tsammani, da cututtuka su ne sosai haske, a bit kamar ciwon huhu. Ganewar asali dogara ne a kan hardware na huhu da kuma microbiological bincike na sputum. M watsa na huhu da tarin fuka ne halin da kasancewar a cikin huhu nama na da yawa kananan (game da wani millimeter) hillocks kama gero hatsi. Saboda haka, na biyu sunan - "miliary (milae a Latin yana nufin" gero ") da tarin fuka." A haƙuri canza farko capillary tsarin a cikin abin da collagen da aka halakar, da ganuwar ne legkopronitsaemymi, wadda take kaiwa zuwa shigar azzakari cikin farji na mycobacteria daga jini ya kwarara a cikin huhu. Alamun wannan sun hada da:

- kaifi Jump a zafin jiki zuwa 39,5-40 ° C da alãmarsu;

- wani rauni, gajiya, high gajiya.

- m bugun jini.

- rashin ci.

- blueness na lebe da kuma yatsunsu.

- yellowness da fata.

- tashin zuciya ga amai.

- ciwon kai.

- bushe tari ko sputum samar, wanda a Bugu da kari ga gamsai ne da ruɓaɓɓen jini ne na jini zane.

- shortness na numfashi.

Wani lokaci akwai wani pronounced safe cuta, har sai da ya rasa sani.

Subacute nau'i na da tarin fuka

Yana faruwa a lokacin da cutar bazuwa zuwa cikin manyan jini (jijiyoyinmu da intralobular interlobular arteries). A wannan yanayin, gano raunuka har zuwa 1 cm a diamita. Suna located, yafi a cikin segments na huhu, inda da yawa daga cikin capillaries da kuma Lymph tasoshin. By da yanayin da proliferative raunuka, inflammations da marurai ba tare da, amma ba za su iya kai wa ga kumburi a visceral pleura.

Alamun subacute siffofin tarin fuka iya kama mutane da yawa da sauran cututtuka da cewa wahalad da na asibiti ganewar asali. Daga cikin babban yanzu su ne kamar haka:

- gajiya, wani rauni.

- zafin jiki a matakin 38 ° C;

- wani tari da sputum.

kullum da tarin fuka

Wannan nau'i na cutar faruwa a lokacin da haƙuri ne gaba daya warke primary (sabo) da tarin fuka. A irin haka ne, Mycobacterium akai-akai via cikin jini, ko Lymph daga farko foci fada cikin sabon sako na cikin huhu, sakamakon su akwai mahara foci na daban-daban masu girma dabam (daga sosai kananan zuwa quite manyan) na daban-daban siffofi da kuma alamu. Suna iya zama calcified da sosai sabo, tare da haske mai kumburi hoto. Gano raunuka a duka huhu. M hoto kara emphysema, fibrosis na daban-daban kyallen takarda a cikin huhu, pleural scarring. Duk da haka, na kullum watsa na huhu da tarin fuka iya zahiri ba bayyana kanta, dangane da abin da aka fi sau da yawa samu a lokacin fluoroscopy. Symptomatology na kullum nau'i na da tarin fuka ne kamar haka:

- gajiya.

- asarar ci.

- emaciation.

- m ciwon kai.

- m Yunƙurin na zazzabi (episodically).

- tari.

Watsa tarin fuka: lokaci

A baya can an yi tunanin cewa da kamuwa da cuta lokaci na faruwa a cikin sama lobes daga cikin huhu, II - a tsakiyar, da kuma III, da kuma riga zo su runtse. Daga bisani wannan rarrabuwa gane ba daidai ba, tun da lokaci na wannan cuta na iya daidai faruwa a kowane sako na huhu. Don kwanan wata, ya bambanta da wadannan bulan na huhu da tarin fuka:

- alopecia.

- infiltration.

- rushewar.

- Office + (bude nau'i na da tarin fuka).

- MBT- (rufe).

Watsa tarin fuka a lokaci infiltration MBT + yana nufin cutar hanya tare da saki a cikin yanayi na mycobacteria. Babban alama - wani tari da sputum samar, musamman idan ta ƙunshi ruɓaɓɓen jini da kuma jini.

Alopecia lokaci, yafi halayyar farko ko sabo ne da tarin fuka. An halin da cewa shafa kawai kamar wata ko daya kashi. A wannan karamin masallaci girma (har zuwa 1 cm a diamita). Wannan lokaci na faruwa ba tare da bayyanar cututtuka da kuma gano, yawanci tare da wuya nazari haske (x-ray, fluoroscopy).

Watsa tarin fuka: lokaci na infiltration da bazuwar

Irin wannan hali na cutar da ake samu ta hanyar ganowa ta untimely (haƙuri zai kawar m shekara-shekara Yin fluorography, ba kõma zuwa likitoci a lokacin da na farko bayyanar cututtuka na tashin hankali, tsunduma kai-medicate ko yana amfani da jama'a magunguna ne kullum arancinsu tasiri a matsayin farko magani). Lalacewar lokaci yana nufin cewa ilimin halittar jiki na raunuka a huhu kai wani batu a da nama fara rarrabu, kafa sosai real rami. Da wani ɓaɓɓake daga rududdugaggun nama tare da tari tafi a waje. Suna cike da koyaswa gamsai ruɓaɓɓen jini da kuma jini. Har ila yau, wadannan guda fada cikin ba tukuna fallasa da cuta daga huhu segments, sakamakon nan da nan seeding na mycobacteria. Marasa lafiya tare da ganewar asali na watsa na huhu da tarin fuka a wani lokaci na rarrabuwa, suna da wani m tushen kamuwa da cuta ga wasu, kuma su ne batun wajibi asibiti. Magani a wani asibiti suna da dogon, har zuwa watanni shida. A sakamakon haka, rududdugaggu raunuka warkar (calcined).

infiltration lokaci ne kuma lura a cikin m hanya da cuta, amma a wannan yanayin haske ba auka daga cikin kyallen takarda ya auku. Kullum infiltration - wani rabo (a tsakiya), a cikin abin da akwai kumburi. Irin wannan wuri ne motsi mai yawa leukocytes da lymphocytes, da kuma cututtuka reminiscent wani m ciwon huhu. Watsa na huhu da tarin fuka a cikin lokaci na infiltration yana da wadannan cututtuka:

- wani kaifi Yunƙurin a yawan zafin jiki zuwa high elevations.

- wani rauni, gajiya.

- ciwon kirji.

- tari.

- ãyõyin yawan guba.

- ciwon kai.

- wani lokacin da weakening na sani.

Ba tare da m magani qaddamar a shafin na nama infiltration fara hargitse. A haƙuri coughs su fita ko a aiwatar da tari motsa zuwa na biyu haske, wanda aka sosai da sauri samun kamuwa na da lafiya nama. Da tarin fuka a cikin bulan na rushewar infiltration na ba kawai fraught tare da babban hadarin kamuwa da cuta ga wasu, amma kuma m ga mãsu haƙuri.

bincikowa da

Shi ne ba ko da yaushe sauki nan da nan kafa haƙuri tare da watsa shi da tarin fuka. Ganewar asali ne wuya saboda bayyanar cututtuka da wannan cuta da kuma ciwon huhu, SARS, ko da metastatic ciwon daji suna kama. A lokacin da ka kira da mãsu haƙuri ga asibitin gunaguni da gajiya, tari, ciwon makogwaro, wani rauni, shortness na numfashi likita zamar masa dole ya duba fata ga gaban scarring cewa za ta iya zama daga baya na tsokar ƙurji, lymphadenitis. Har ila yau, yayi nazari da fasali daga cikin kirji (shi ke ba, idan tarin fuka tasowa a daya huhu), bari zafi da tsoka tashin hankali a kafada abin ɗamararsa. Lokacin da sauraron wani stethoscope bayyana huhu, ko wheezing ne, abin da wuri da kuma hali. Shi ne m zuwa yi awon jarrabawa na sputum for gaban mycobacteria. A wasu lokuta, marasa lafiya shan nazarin Bronchial wanke-wanke, ko ciki na ruwa (yawanci a cikin yara). Bugu da kari, dakin gwaje-gwaje gwaje-gwaje na iya sun hada da:

- bronchoscopy.

- sputum shafa bincike da madubin likita.

- biopsy na pleura.

- thoracoscopy.

- pleural huda.

A mafi yadu amfani da m ne fluoroscopic karatu.

Magani da kuma hangen nesa

Idan likita ya kamu "watsa na huhu da tarin fuka", da magani zai zama dogon da multifaceted. A hangen nesa dogara a kan lokaci a cikin abin da cutar da aka gano, da kuma yadda kyau da haƙuri aikin likita ta sayen magani. A wani irin na huhu lokaci + a MWT haƙuri aka kwantar. A wani asibiti yafi kwashe miyagun ƙwayoyi far (jiyyar cutar sankara) wanda ya kunshi anti-tarin fuka da kwayoyi, jiki far, bitamin, reinforcing rigakafi.

Jiyyar cutar sankara a sabon kamu marasa lafiya a cikin m lokaci na magani ne da za'ayi wadannan anti-magungunan, "Iziniazidom", "rifampicin", "pyrazinamide" da "ethambutol", da kuma a ci gaba lokaci na magani - "isoniazid" da "Rifampicin" ko "isoniazid" da "ethambutol ".

A m watsa tarin fuka ya nuna da yin amfani da corticosteroids da immunomodulators. A mafi akai-akai wajabta "prednisolone" (15-20 MG / rana don 6-8 makonni).

Duration na lura - har zuwa 6 watanni. Idan a cikin watanni 3 na ba ganin wani Trend don kyautata, kazalika da dama sauran alamomi iya amfani da tiyata shafi kau da guda huhu kashi ko haske a general.

Wanda yayi amfani da latest jiyya ga tarin fuka, da ake kira "bawul bronchoblocation", ko kuma kawai "bronchoblocation", wanda yake shi ne madadin zuwa tiyata.

rigakafin

Na huhu da tarin fuka ne dauke da wani zaman jama'a cuta, da yaduwar wanda shi ne sun fi mayar dogara a kan ingancin rayuwa (rai yanayi, hijirarsa, bauta masa magana a kurkuku, da sauransu). Kamar yadda m matakan, musamman ga watsa na huhu da tarin fuka, za a iya kira:

- wajibi nassi na x-haskoki.

- dauke da fitar kula da matakan.

- BCG lamba;

- da kasafi na jihar kudi domin lura da marasa lafiya da tarin fuka.

- kula da wani aiki (wasanni), lafiya salon.

- nassi na marasa lafiya da cikakken magani daga mai da hankali da tarin fuka.