Extrapulmonary TB: Zoyambitsa, Zizindikiro ndi Chithandizo

Extrapulmonary TB - dzina limene gulu lonse la matenda ophatikizana zokhudza machitidwe osiyanasiyana limba pa khungu ndi mafupa ndi kutha mantha dongosolo ndi lymph mfundo. Matendawa ndi oopsa makamaka chifukwa amapezeka mochedwa kwambiri, kale pa siteji ya chitukuko cha matendawo.

Kumene, anthu ambiri amachita chidwi ndi nkhani zambiri za matenda amenewa. Kodi TB extrapulmonary Amapatsirana? dongosolo lililonse limba zingakhudze matenda? Kodi zizindikiro ndi limodzi mwa malaise? Mayankho a mafunso amenewa kukhala zothandiza owerenga ambiri.

zotupa Extrapulmonary TB ndi zimene

Extrapulmonary TB - ndi nthenda kugwirizana ndi malowedwe a thupi la munthu mycobacteria. Iwo akhoza bwanji machitidwe osiyana limba, kuphatikizapo mafupa, matumbo, m'mimba, khungu, maso, impso ndi zina zotero. D. Malinga ndi maphunziro zowerengera, mitundu extrapulmonary, monga ulamuliro, ndi matenda sekondale ndi kukhala pa maziko a mwachangu loyenda TB m'mapapo mwanga. Komabe, nthawi zina odwala matenda zotupa yekha extrapulmonary.

Ngati ife kulankhula za matenda a thupi, ndi 90% monga nthumwi causative amachita Mycobacterium TB (tubercle Bacillus). Kuli angayambe TB chapansipansi oyamba ndi yogwira kubalana Mycobacterium bovis - bakiteriya, ndi njira, akhoza kusokoneza anthu a ng'ombe. M'mayiko otentha, tizilombo wamba tizilomboto wa - M.africanum.

Akuti ndi kugonjetsedwa kwambiri tizilombo. Mu madzi, iwo amatha kusunga luso ndi luso kukhala miyezi isanu. Mu otentha madzi mycobacteria kupulumuka mphindi 5-45. Komano, majeremusi TB ali tcheru kwambiri cheza ultraviolet.

Kodi inu kupeza extrapulmonary TB?

Kumene, extrapulmonary TB, komanso mawonekedwe m'mapapo mwanga cha matenda imafalikira kwa munthu wodwala wathanzi. Nthumwi causative adzamasulidwa ku chilengedwe pamodzi ndi ntchofu pa kutsokomola, sneezing, ndi zina zotero. D. Choncho, gulu yayenda anthu amenewa amakhala ndi kucheza kwambiri ndi odwala TB.

Koma zinthu siziri mophweka. Anthu ambiri, ngakhale pambuyo pa zaka khumi kuposa wina wa amoyo m'nyumba imodzi monga wodwala si matenda. Komanso, matenda sizikutanthauza matenda. Akukhulupirira kuti pafupifupi theka la anthu onse padziko lapansi - onyamula Koch Bacillus. Komabe, osati onse a iwo kwenikweni akudwala TB.

matenda onyamula si opatsirana ndi moyo popanda kuzindikira pamaso pa matenda. Komabe, pali kudwala matenda a. Kutsegula wa mycobacteria amapezeka ndi maziko a kuchepa amphamvu chitetezo chokwanira Choncho, zinthu pangozi yaitali matenda aakulu yotupa matenda chabe kuchepetseratu thupi, komanso maganizo pafupipafupi, nkhawa thupi, matenda m'thupi, kutupikana Mwachidule, zonse zimene zingakhudze ntchito kwa chitetezo dongosolo.

Gawo ndi maonekedwe a matenda

Pali zingapo machitidwe gulu kuti pathologies izi. Mwachitsanzo, ambiri mitundu zotsatirazi extrapulmonary TB:

• m'dera - mmodzi pakati ili mu akhudzidwa chiwalo chimodzi (kapena gawo pankhani Mwachitsanzo, msana);
• wamba - mu umodzi ndi limba yomweyo foci angapo;
• zotupa angapo - za iye kukachitika kuti TB amakhudza ziwalo angapo a dongosolo yemweyo;
• matenda "sochetannyj TB" aikidwa mu choncho, ngati pali imfa ya matupi angapo machitidwe osiyana (Motero, kuphatikiza kwa "m'mapapo mwanga / extrapulmonary TB" n'zotheka).

Pa nthawi ya matenda, ndipo kulabadira kwa mlingo wa ntchito matenda:

• yogwira mawonekedwe a matenda (mwapang'onopang'ono, relapsing, kuchokamo kachiwiri);
• anafooka extrapulmonary TB (mtima kusintha yeniyeni ziwalo anasunga khalidwe chifuwachi, pamaso pa foci ka abscesses kapena amamuyambitsa timabala, koma mayesero zasayansi alibe kusintha zina).

Kwa matenda a ndondomeko n'kofunika ndi kukhalapo matendawo. Iwo akhoza kugawidwa (mwachitsanzo, sekondale immunodeficiency, poizoni ndi matupi awo sagwirizana matenda ziwalo, amyloidosis, zokhudza zonse pathologies mfundo) ndi m'deralo (mwachindunji ndi limba akhudzidwa kapena dongosolo).

Chifuwa chachikulu mafupa ndi zimfundo

Extrapulmonary TB mafupa ndi mfundo - ndi zimakhalanso wamba aakulu matenda limodzi ndi zotupa mu madera osiyana a dongosolo minofu ndi mafupa. Against maziko a ntchito za tizilombo toyambitsa matenda, mapangidwe granulomas zenizeni, komanso kuwonongedwa pang'onopang'ono kwa fupa minofu yomwe mwachibadwa kumatanthauza osati anatomical komanso kusintha zinchito mu mafupa a.

Malinga ndi kafukufuku, anthu ambiri odwala matenda ichi - okalamba. Pafupifupi 60% a milandu matendawa amakhudza msana, zikubweretsa chilema. Abulusa, spondylitis ndi coxitis - ichi ndi kuyan'anila ambiri, amene anatsagana ndi extrapulmonary TB. Zizindikiro nkomwe zimachitika mu magawo oyambirira a matenda.

Nthawi zina, odwala lipoti ululu mu gawo akhudzidwa a dongosolo minofu ndi mafupa. Ngati matenda akufotokozera nyamakazi mtundu, zingakhale wodziwika kusapeza, kutupa mu mafupa ang'ono zochepa kuyenda. Pankhani chotupa msana, ndi granuloma kukula zambiri compresses mizu ubongo, zomwe limodzi ndi zosiyanasiyana matenda a ubongo.

Zizindikiro ingakhale monga kusintha kwa kaimidwe. Minofu anayamba kutaya kamvekedwe awo, chifukwa cha zimene munthu n'zovuta kusuntha.

Mwatsoka, anthu kupita kwa dokotala mu magawo ina ndi kale mavuto amenewa extrapulmonary TB, monga abscesses, kugonjetsedwa chigoba deformities, fistulas. Matenda a matenda akhoza kugwirizana ndi movutikira, chifukwa chithunzi matenda amaona kwambiri. Nthawi zambiri, ngakhale pambuyo molondola anakhala chithandizo fupa deformities kukhala.

Kuwonongeka kwa wamanjenje dongosolo

Extrapulmonary TB ya meninges ndi imatengedwa ovuta kwambiri mtundu wa matenda. Matenda akufotokozera mofulumira ndi pakalibe mankhwala kumabweretsa kuwonongeka chosachiritsika wamanjenje dongosolo, ndi zina imfa. Komabe, kwa tsiku, milandu matenda zalembedwa infrequently.

Panthawiyo, zofala kwambiri matenda ofanana extrapulmonary TB ana. Kuchepetsa matenda kugwirizana ndi kuchuluka chachikulu onyamula BCG katemera makanda. Chiphunzitsochi imayendetsedwa ndi chakuti chibwenzi, kakhosi tuberculous zikuchitika pakati pa ana popanda katemera.

Yochepa mutu, pang'ono malungo, kufooka ndi malaise - kotero extrapulmonary TB imayamba. Zizindikiro kuoneka ngati chitukuko cha matenda oumitsa khosi. Mutu limapezeka kawirikawiri ndi kukhala kwambiri. Thupi kutentha limatuluka digiri 39-40. Kuchuluka excitability, akufotokozera kudziwa kuwala. Mbali khalidwe ndi zikamera wa anorexia imfa mofulumira kulemera. Ngati Popanda kuchitapo kanthu, imfa ya munthu wodwala adza kwa sabata 3-5, omwe amagwirizana ndi ziwalo za m'mapapo kapena vasomotor pakati ubongo.

TB ya m'mimba

Dziwani kuti zotupa m'mimba n'zochepa ndi mlandu% okha 2-3 milandu onse extrapulmonary TB. Childs, woyamba pathological ndondomeko ikukhudza lymph mfundo ndi mesenteric zabryushinnoogo danga kenako okha zotupa chifuwa chachikulu athandize ziwalo m'mimba.

Akuti nthawi zina matenda mwina patsogolo kwa kholingo. Zikatero pali pang'onopang'ono esophageal ulceration makoma a chubu, ndi taper mpaka stenosis mokwanira. Za chitsanzo zimawonedwa mu zotupa m'mimba - m'dera pyloric ndi kupindika wamkulu kupanga yaing'ono, koma angapo zilonda unpainful.

kuwononga matumbo adutse pa nsalu ya kumapeto. Nthawi zina TB ndi matenda, ndi intestine yaing'ono odwala. Mwatsoka, chizindikiritso cha extrapulmonary TB mu nkhani iyi ndi njira yovuta. Zizindikiro za matenda si chitaperekedwa ndi chithunzi matenda zambiri akufanana enteritis aakulu appendicitis ndi matenda ena a dongosolo m'mimba.

mitundu woopsawo TB amatanthauza mesadenitis. Matenda amenewa amakhudza ziwiya lymphatic wa peritoneum, koma ndondomeko akupitiriza pang'onopang'ono chiberekero ndi thumba losunga mazira. Fibrosing kutupa cha ziwalo zoberekera chimakhala chifukwa cha osabereka mu akazi.

zotupa TB khungu

Bacillus Koch a kawirikawiri isanafalikire khungu ndipo zimakhala subcutaneous, kuchititsa zosiyanasiyana matenda.

• Tuberculous chancre - ndi ting'onoting'ono basi mapangidwe mkati zimachitika njira purulent. Childs, nyumba chotero anapanga mu mfundo lymph. Zilonda zambiri atsegulidwa, kusiya fistula.
• Lupus - matenda amene amakhala ndi maonekedwe a zotupa enieni a khungu. Kuphulika ndi wandiweyani mfundo zomwe pang'onopang'ono kuphatikiza pamodzi kupanga wandiweyani, kuphwa adzalowerera. chigoba chake kawirikawiri yokutidwa ndi zilonda kapena fistulas.
• Kollikvativny lupus - matenda, amene amakhala ndi mapangidwe yaing'ono wandiweyani diameters khungu mfundo za 1-3 masentimita Izi kutupa sabweretsa chisoni, komwe kunasonyeza fistulas angapo ..
• Warty mawonekedwe a chifuwa chachikulu wa khungu limodzi ndi maonekedwe a khungu la zisindikizo, amene kumaoneka ngati papilloma. Komabe, pali kusiyana. Makamaka, mapangidwe padziko felemu lija kuti pali yotupa ndi khungu m'dera amakhala cyanotic hue. Izi zambiri matenda mawonekedwe a matenda odwala ndi mawonekedwe lotseguka TB m'mapapo mwanga, chifukwa khungu pa kutsokomola zonse afika phlegm. Gulu chiopsezo zikuphatikizapo madokotala ntchito ndi odwala TB, komanso veterinarians.
• Miliary TB limodzi ndi maonekedwe a ang'ono papular totupa pinki. Nthaŵi zambiri isanafalikire padziko orifices, ngakhale n'zotheka adayala m'madera ena apakhungu. Monga matenda ili m'kati anapanga papules chilonda kakang'ono pakati, umene unali ndi kutumphuka. Popanda kuchitapo kanthu ulcerations mabacteria kukhala foci wa necrosis.

Kaya mawonekedwe a cutaneous TB yodziwika ndi waulesi popanda kutupa kwambiri kapena soreness. Nthawi chikhululukiro m'malo exacerbations, zomwe kawirikawiri imagwera pa kasupe ndi yophukira.

urogenital TB

Pankhani matenda monga extrapulmonary TB, pafupifupi 37% ya milandu matenda amakhudza ziwalo za dongosolo excretory. Malinga ndi kafukufuku, anthu, ndi matenda kufalikira kwa ziwalo zoberekera, pamene pakati pa akazi Zikatero ndi n'kukhala kwambiri.

Nthawi zambiri amadwala matenda a impso. Chithunzi matenda ndi chachilengulengu kwambiri. Zizindikiro Choyamba ndi chiyani siziwoneka. Ndi chitukuko cha matenda angaoneke pang'ono, kupweteka ululu kumbuyo m'munsi. Nthawi zambiri ine ama ngozi TB aimpso, pa wathunthu mayeso mkodzo, kupeza mycoplasma mu zitsanzo.

Ngati wodwala alibe chisamaliro zofunika mankhwala, pali chiopsezo fibrosis ndi hydronephrosis.

Pa nthawi imene matenda kufalikira kwa ziwalo cha ziwalo zoberekera za amuna kwenikweni zimakhudza prostate. Komanso kukhala mavuto monga matenda a machende, ndi deferens vas ndi chingwe spermatic.

TB ya mwanabele

The yofala kwambiri ndi chifuwa chachikulu extracellular, izi zimakhudza zotumphukira lymph mfundo. Malinga ndi kafukufuku, chimachititsa crouches mozungulira 50% a mitundu yonse mitundu matenda extracellular. Komanso, monga ulamuliro, ndi pamodzi ndi kuwonongeka kwa mapapo ndi ziwalo zina za chifuwa.

Mu mankhwala amakono, milandu m'dera lymphadenitis tuberculous analemba zambiri. Infection amakhudza gulu limodzi lokha la mwanabele, ndi ambiri amavutika khomo lachiberekero ndi submandibular. Pasanathe ambiri, nthenda likulowerera inguinal ndi axillary lymph mfundo. Komanso nkutheka zowombetsa mkota mawonekedwe a matenda omwe anakhudzidwa magulu atatu ena a mwanabele imodzi.

Zizindikiro za extrapulmonary TB mu nkhani iyi si kwambiri kulitchula. Mu masiteji koyamba kuwonjezeka mu mwanabele. Iwo zotanuka, wofewa kwambiri, kugawa poyamba sabweretsa chisoni. Kusintha kukula ziribe kanthu kochita ndi chimfine kapena matenda pa mundawo chapamwamba kupuma.

Mbali khalidwe ndi tuberculous lymphadenitis mawonekedwe ndi okhudzidwa mu ndondomeko matenda ozungulira zimakhala zofewa, komanso matenda - ndi ozungulira lymph mfundo. Choncho anapanga kutupa mwachilungamo lalikulu. M'tsogolo, pakati pa chotupa pamaoneka olimbikitsa malo. Apa pa khungu zimadalira n'kakang'ono kumathandiza kupeza ngodya zabwino, nthawi zina amakhala ofiira kapena bluish kulocha.

Ngati Popanda kuchitapo kanthu, pali anawononga wa zimakhala, chifukwa mu fistula kudzera amene akutuluka nkhani wowumitsa kugwirizana. Nsalu yokutidwa ndi zilonda, magazi ndi zotheka. The fistula mwina coalesce, ndipo pamwamba pake zipsera akhakula anapanga. Mwatsoka, minofu machiritso suchedwa kutha - ndi zisadzachitikenso, imene fistula tidutse kachiwiri.

Mu zina, generalization za ndondomeko pathological amakhudza magulu ena a mwanabele. Izi kuopsa zimayambitsa extrapulmonary TB. Matenda ikuchitika mu nkhani iyi ndi biopsy ndi zitsanzo wotsatira zasayansi mayeso analandira.

Kodi matenda extrapulmonary TB?

Monga mukuonera, pali zizindikiro zambiri ndi mavuto, zimene zimachititsa kuti pakhale extrapulmonary TB. Matenda a matenda awa, mwatsoka, nkhani mavuto ena, kuyambira kuzindikira chithunzi matenda ali kutali lililonse. Komanso, ambiri odwala matenda kale mu magawo patsogolo TB.

Mwachibadwa, chifukwa kudziwika matenda m'pofunika kuchita kafukufuku. Izi makamaka mayeso Mantoux ndi mlingo wosiyana wa tuberculin. Kuyeza kumeneku kumathandiza kudziwa ngati wodwalayo anali m'gulu pangozi. Komanso, chinthu chofunikira ku matenda ndi radiography ndi fluoroscopy monga matenda extrapulmonary zambiri kukhala ndi TB m'mapapo mwanga. Ngakhale ang'ono, yotsalira m'mapapo mwanga chotupa otsimikiza pamaso pa matenda mu mtima mwa anthu kapena ziwalo zina.

M'tsogolo, maphunziro imachitika ndi, makamaka ultrasound, maginito kumveka ndi kompyuta tomography, biopsy ndi zasayansi Kupenda zimakhala pamaso pa Mycobacterium TB.

Chithandizo cha TB extrapulmonary ndi peculiarities ake

Ndithudi, izi ndi matenda oopsa, koma chifukwa mu malo oyamba zofuna za odwala ndi kukhalapo kwa wogwira mtima njira achire. Chithandizo cha extrapulmonary TB - yaitali ndi zovuta, ndipo magawo waukulu lifanane ndi chiwembu cha mankhwala likamanena m'mapapo mwanga matendawa.

Mwatsoka, mankhwala opha tizilombo kawirikawiri ntchito. chakuti mycobacteria mofulumira kukhala kukana pafupifupi mitundu yonse ya mankhwala, choncho mankhwala zambiri ntchito ngati auxiliaries.

Amaona kuti kukhala Morning yabwino kwambiri. Masiku ano, pali masikimu angapo chithandizo chotere. Nthawi zambiri izo anachita otchedwa quadruple mankhwala womwenso ntchito rifampicin, streptomycin, isoniazid ndi pyrazinamide. Ena zipatala payekha ntchito zambiri mwapang'onopang'ono pyatikomponentuyu chiwembu, kuwonjezera pa mndandanda wa mankhwala, mankhwala ena a mbadwo watsopano. Bwino osankhidwa kuphatikiza amathandiza kuononga tizilombo toyambitsa matenda a TB, koma, mwatsoka, mankhwala si zokhazo.

Chifukwa chithandizo cha mankhwala TB limakhudza anthu thupi, pali hepatoprotectors zosiyanasiyana, komanso mankhwala, mofulumira ndondomeko kuchotsa poizoni m'thupi (njira kupanga acetylcysteine, reosorbilakt). Komanso, mbali yofunika ya mankhwala ndi utsogoleli wa immunostimulants, kuphatikizapo glutoksim, xymedon, galavit.

Nthawi zina, chithandizo chakudya zikuphatikizapo mavitamini a gulu A pofuna kupewa chitukuko cha neuropathies zotumphukira. Nthawi zina, opaleshoni m'pofunika. Makamaka opaleshoni Kwalamulidwa ngati granuloma lomenyera msana, monga iyi ndi njira yokhayo kupewa kuwononga kwambiri mizu mitsempha ndi msana.

Ngakhale pambuyo zinthu zonse achire ndi malamulo amene ayenera kutsogolera wodwalayo. An sitepe yofunika kuchira ya thupi ndi moyo wathanzi komanso kudya bwino. The zakudya pazikhalanso zakudya, komanso lonse zovuta mavitamini ndi mchere. Nkofunika kuti abwezeretse kulemera yachibadwa thupi. TB (m'mapapo mwanga ndi extrapulmonary) chikugwirabe ndi zonse chipatala chaching'ono chithandizo.