Extrapulmonary isifo sephepha: Oonobangela, Iimpawu and Treatment

tuberculosis Extrapulmonary - igama ngalo lonke iqela kwezifo oludibeneyo echaphazela iinkqubo ilungu ezahlukeneyo nasesikhumbeni namathambo kunye nesiphelo inkqubo kunye nkovu ezalathelwe luvo. Ezi zifo ayingozi ngokuyintloko ngenxa yokuba ukuxilongwa kwexesha, sele nqanaba kuphuhliso iingxaki.

Kakade ke, abantu abaninzi abanomdla inkcazelo engakumbi ngezi zifo. Yenza TB extrapulmonary esosulelayo? Nawuphi omzimba zingachaphazela indlela usuleleko? Ziziphi iimpawu zihambisana umkhuhlane? Iimpendulo zale mibuzo kuya kuba luncedo kubafundi abaninzi.

izilonda nesifo Extrapulmonary noonobangela bazo

tuberculosis Extrapulmonary - sisifo esosulelayo ezinxulumene kwii le mycobacteria yomzimba womntu. Ezichaphazela iinkqubo omzimba ezahlukeneyo, kuquka amathambo, amathumbu, isisu, ulusu, amehlo, izintso njalo njalo. D. Ngokutsho kwizifundo zamanani, iifomu extrapulmonary, njengokuba Ngumthetho, izifo aphakamileyo kunye nokuphuhlisa kwi imvelaphi ngokubonakalayo elibaleka tuberculosis miphungeni. Noko ke, maxa wambi izigulane kwafunyaniswa ukuba izitshanguba kuphela extrapulmonary.

Ukuba sithethe ngayo ngokosuleleka umzimba womntu, oko malunga ne-90% njengearhente causative izenzo Mycobacterium tuberculosis (tubercle eletha). Kakhulu okuba ukuphuhlisa TB kwintshayelelo ngasemva nokukotshwa esebenzayo Mycobacterium bovis - igciwane, ngasendleleni, nako kuchaphazela abameli iinkomo. Kumazwe yimvula, uhlobo olufanayo pathogen - M.africanum.

Kuthiwa ukuba iintsholongwane nzima kakhulu. Emanzini, bayakwazi ukugcina ikhono ubuchule ukuze siphile ngokuvisisana iinyanga ezintlanu. Xa abilayo mycobacteria zamanzi asinde imizuzu 5-45. Kwelinye icala, iintsholongwane ze-TB-ethe kakhulu yelanga.

Uyakwazi na ukufumana isifo sephepha extrapulmonary?

Kakade ke, isifo sephepha extrapulmonary, kwakunye nefom pulmonary esi sifo sisasazwa kumntu ogulayo ephile. Iarhente causative uyakhululwa kokusingqongileyo kunye yencindi ngexesha ukukhohlela, uthimla, njalo njalo. D. Ngoko, kwi qela ophezulu olusemngciphekweni ngabantu abahlala basebenzisane ngokusondeleyo kunye nezigulane TB.

Kodwa izinto akukho zilula kakhulu. Abantu abaninzi, kwanasemva ngaphezu kwesinye kweminyaka yokuphila phantsi kophahla efanayo njengoko isigulane ayisuleleki. Ngaphezu koko, lo usulelo akuthethi sifo. Kukholelwa ukuba phantse isinye kwisithathu sabemi behlabathi - abathwali Goch lesifo. Noko ke, asingabo bonke bephela ngokwenene baphethwe sisifo sephepha.

abathwali abangenwa na ezosulelayo kwaye baphile ngaphandle kokuba uyazi ukuba kukho usulelo. Noko ke, kukho ingozi yokuba esi sifo. Ukusebenza mycobacteria lwenzeka ngokuchasene nentsukaphi ukuhla esomelela sifo, ukugula ngoko, izinto umngcipheko ziquka iyoluka, izifo ezondeleyo ukudumba ukuba deplete nje umzimba, kwakunye noxinzelelo rhoqo, uxinzelelo emzimbeni, ukuphazamiseka kwamadlala, ukungondleki, ngamafutshane, zonke izinto ezichaphazela ukusebenza mzimba system.

Ucalulo kunye nefomu sifo

Kukho iinkqubo zokuhlela ezininzi kwezi ezimbi. Umzekelo, aziwayo kakhulu zezona ntlobo zilandelayo sephepha extrapulmonary:

• yendawo - elinye iziko ibekwe kwelinye iziko ochaphazelekayo (okanye ingxenye xa kuziwa, umzekelo, kwalapho);
• eziqhelekileyo - kwenye kwaye organ efanayo nakujoliso olutsha ezininzi;
• izilonda multiple - ukuthetha ngaye xa kunokwenzeka ukuba isifo sephepha kuchaphazela yimibutho eyahlukeneyo inkqubo efanayo;
• uphethwe "sochetannyj isifo sephepha" obekwe kwi kunjalo, ukuba kukho ilahleko kwemizimba eziliqela iinkqubo ezahlukeneyo (oko, ukuhlanganiswa 'pulmonary / nesifo extrapulmonary "kunokwenzeka).

Ngexesha sifo, yaye sinikela ingqalelo iqondo umsebenzi izifo:

• uhlobo elikhutheleyo sifo (ngcembe, relapsing, kwebhola kwakhona);
• engasebenziyo nesifo sephepha extrapulmonary (iinguqu ezithile nomonde kumalungu walondoloza uphawu isifo sephepha, ubukho nakujoliso olutsha encinane mathumba okanye loloyiko, kodwa iimvavanyo elebhu zibonisa akukho lutshintsho vetshe).

Kuba lokufunyaniswa nkqubo kubalulekile kwaye kukho iingxaki. Ukuba kungabelwana (umz, immunodeficiency zasesekondari, amalungu oyityhefu komzimba ababesifa, amyloidosis, systemic ezimbi values) kunye yasekuhlaleni (ezinxulumene ngqo ne-organ okanye inkqubo ezichaphazelekayo).

Isifo amathambo kunye namalungu

tuberculosis Extrapulmonary amathambo kunye namalungu - sisifo eqhelekileyo noko esinganyangekiyo ukuba lukhatshwa izitshanguba kwiindawo ezahlukeneyo kwinkqubo musculoskeletal. Ngokuchasene imvelaphi yomsebenzi ezincinane yayintsholongwane eyosulela, ukuyilwa granulomas ezithile, kwakunye ukutshatyalaliswa okuqhubekayo esiqwini ithambo, obuquka ngokwemvelo na utshintsho yokwakheka kodwa kuphela esebenza kuphahla.

Ngokutsho manani, uninzi lwezigulane kunye nale unesifo - abadala. Malunga nama-60% amatyala esi sifo sihlasela yomqolo, zikhokelela nokukhubazeka. Drives, spondylitis kunye coxitis - oku ke iintshukumo zokwaphulwa kwemithetho ixhaphakileyo, nto leyo sikhatshwa tuberculosis extrapulmonary. Iimpawu ngenkankulu kwenzeka nisaqala zesi sifo.

Ngamanye amaxesha, izigulane ingxelo intlungu inxalenye uchaphazelekayo womGaqo-nkqubo musculoskeletal. Ukuba isifo iphuhlisa uhlobo samathambo, kunokuba ukungakhululeki kuphawuliwe, ukudumba kwamalungu amancinci, intshukumo encinane. Xa kuziwa sisilonda esidumbileyoesingaphakathi spinal, lo granuloma ezikhula rhoqo Oluma iingcambu luvo, nto leyo sikhatshwa ezahlukeneyo ukuphazamiseka luvo.

Ezi mpawu ziquka utshintsho ngokuthe ngcembe kokuma. Izihlunu aqala ukulahlekelwa ilizwi labo, ngenxa yoko umntu kunzima ukuhamba.

Ngelishwa, abantu baye kugqirha kwi zigaba kamva, xa sele iingxaki ezikhoyo ezifana nesifo sephepha extrapulmonary, njengoko amathumba, sengozini enganyangekiyo skeletal, fistulas. Lokufunyaniswa sifo ezinxulumene nobunzima, ngokuba umfanekiso lwezonyango norhatyazo kakhulu. Kwiimeko ezininzi, wachitha nasemva ngokuchanekileyo sengozini bone unyango kuhlala.

Umonakalo luvo

tuberculosis Extrapulmonary le meninges ithathwa le ndlela kakhulu kwesi sifo. Ukugula senzeka ngokukhawuleza kwaye kungekho unyango kukhokelela umonakalo ongenakulungiseka luvo, kwaye maxa wambi nokufa. Noko ke, ukuza kuthi ga ngoku, amatyala sifo irekhodwa kungeyonto ayenza rhoqo.

Ngelo xesha, inkoliso ngokuqhelekileyo bene efanayo extrapulmonary isifo sephepha ebantwaneni. Ukunciphisa izifo ezinxulumene ukwanda okukhulu ethwele BCG ugonyo kwiintsana. Le mbono ixhaswa yi kukuba ukuza kuthi ga ngoku, tuberculous meningitis olukhoyo phakathi kwabantwana ngaphandle kogonyo.

yintloko zexesha elifutshane, ifiva kancinane, ubuthathaka kunye oluthile - ngoko nesifo extrapulmonary iqala. Iimpawu kuvela kuphuhliso meningitis. Headache kuvela njalo ngakumbi kwaye abe namandla kakhulu. lobushushu emzimbeni lisingisa degrees 39-40. excitability Ukwanda, iphuhlise uvakalelo ukukhanya. Uphawu Uphawu na ukuvela uneanorexia ngokukhawuleza umzimba. Ukuba lunganyangwa, ukufa isigulane uyeza kwiveki 3-5, apho wayanyaniswe ukushwabana zemiphunga okanye iziko vasomotor ebuchotsheni.

tuberculosis esiswini

Kubalulekile ukuphawula ukuba izilonda esiswini zinqabile yaye akhawunti ye% 2-3 kuphela zonke iimeko zesifo sephepha extrapulmonary. Ngokuqhelekileyo, inkqubo yokuqala zophendlo lwezifo ibandakanya iindawo nkovu kunye nesithuba zabryushinnoogo mesenteric kwaye kuphela koko izilonda tubercular yandisa ukuba amalungu esiswini.

Kuthiwa maxa wambi isifo singaqhubela ukuze kuvuleke iminxunya. Kwiimeko ezinjalo kukho ixesha iindonga zizilonda esophageal tube, lo Taper de stenosis ngokupheleleyo. Malunga indlela efanayo uyaqapheleka izitshanguba esiswini - kummandla pyloric kwaye ugobile enkulu ukwenza izilonda ezincinane, kodwa ke ezininzi unpainful.

umonakalo isisu angaludlulisa salo appendix. Maxa wambi isifo sephepha unesifo, kwaye emathunjini amancinci kwizigulana. Ngelishwa, ukuphawulwa nesifo sephepha extrapulmonary kule meko yinkqubo enzima. Iimpawu zesi sifo azikho kakhulu zomlomo wakhe, kunye nomfanekiso lwezonyango idla kufana enteritis ezingapheliyo, appendicitis kunye nezinye izifo kwinkqubo yokwetyisa.

iintlobo eyingozi sephepha ibhekisela mesadenitis. Sisifo enjalo kuchaphazela iimpahla emithanjeni le peritoneum, kodwa inkqubo uyemka ngcembe wesibeleko kunye zamaqanda. Fibrosing ukudumba uhlelo zokuzala uba ngunobangela iinkunzi kwabasetyhini.

kolusu TB

eletha Goch kaThixo idla yenzelwe nolusu nezihlunu ongama, ebangela iintlobo zezifo.

• chancre Tuberculous - ke ukubunjwa ubunjwe ngaphakathi apho kwenzeka iinkqubo ubovu. Ngokuqhelekileyo, izakhiwo ezinjalo akhiwa esiludumbo nkovu. Yezilonda badla kuvulwa, eshiya fistula.
• Lupus - sisifo luphawulwa imbonakalo yabangxamayo ethile apha esikhumbeni. Mlilo na amaqhina ashinyeneyo, ngokuthe ngcembe bahlanganisane kunye ukuze ibe kwintsunguzi, infiltrate flat. iqokobhe layo kudla wayifulela izilonda okanye fistulas.
• Kollikvativny lupus - kwisigulo, nto leyo luphawulwa ukuyilwa kwentsunguzi ngobubanzi yesikhumba node elincinane 1-3 cm Le ukudumba yalula, into leyo eyaye fistulas ezininzi ..
• uhlobo amade lwesifo sephepha ulusu kunye ukubonakala eluswini lamatywina, nto leyo ezimile papilloma. Noko ke, kukho umahluko. Ngokukodwa, ukuyilwa esithe jize kukho ukudumba nesikhumba kule ndawo kuba nombala cyanotic. Oku ngoyena ngokuqhelekileyo kwafunyaniswa uhlobo sifo izigulane kunye uhlobo evulekileyo sephepha yemiphunga, kuba ulusu ngexesha ukukhohlela rhoqo ufumana phlegm. Iqela risk kuquka oogqirha abasebenza kunye nezigulane TB, kwakunye bezilwanyana.
• tuberculosis Miliary sikhatshwa kukuvela amancinci papular kwamaqhakuvana pink. Bavame abekiwe jikelele orifices, nangona kunokwenzeka zawutwabulula kwezinye iindawo esikhumbeni. Njengoko esi sifo papules kwakhiwa isilonda elincinane ziko, nto leyo ke wambu uqweqwe. embhedeni lunganyangwa imimandla baba nakujoliso olutsha of necrosis.

Kungakhathaliseki uhlobo lwesifo sephepha cutaneous uphawuleka ngababuthuntu phezu ngaphandle ukudumba ezibalulekileyo okanye bomzimba. Amaxesha kuxolelwe indawo exacerbations, nto leyo edla iwela entwasahlobo nasekwindla.

tuberculosis enzala

Xa kufikelelwa kwesi sifo nesifo sephepha extrapulmonary, malunga nama-37% amatyala usulelo luchaphazela amalungu yenkqubo excretory. Ngokutsho manani, amadoda, kwaye usulelo kwanwenwa uhlelo zokuzala, lo gama phakathi kwabafazi Kwiimeko ezinjalo anqabe kakhulu.

Amaninzi ubunzima ngenxa yezifo zezintso. Lo mfanekiso yinto ungapheleli kakhulu. Iimpawu Okokuqala yaye akazange abonakale. Ngophuhliso sifo angavela kancinane, iqaqamba intlungu emva asezantsi. Ndandisoloko nokuxilonga sezintso ingozi sisifo sephepha, ngexesha uvavanyo umchamo epheleleyo, uzingela mycoplasma in iisampulu.

Ukuba isigulana akanaye unyango kuyimfuneko, kukho umngcipheko abanesigulo kunye hydronephrosis.

Kwiimeko apho usulelo kwanwenwa amalungu kwenkqubo sokuzala ebantwini kakhulu echaphazela le ndlala wendlala. Ngaphezu koko ukuphuhlisa iingxaki ezifana usulelo amasende, le Umbobho yobudoda kunye nentambo spermatic.

Isifo sephepha nodes nkovu

Lolona hlobo luqhelekileyo na isifo sephepha extracellular, ethi ichaphazele ezalathelwe nkovu peripheral. Ngokutsho manani, okubangela uhlezi malunga-50% yazo zonke iintlobo zezifo iintlobo extracellular. Ngaphezu koko, njengoko umthetho, ukuba kudityaniswe umonakalo imiphunga kunye namanye amaziko esifubeni.

Xa yesilungu, amatyala lymphadenitis tuberculous asekuhlaleni abhalwe rhoqo. Usulelo kuchaphazela kuphela iqela ezalathelwe nkovu, kwaye mhlawumbi ukubandezeleka wesibeleko kunye submandibular. Ngokuqhelekileyo, usulelo ingena ezalathelwe nkovu inguinal kunye axillary. Ukongeza, uhlobo kunokwenzeka ngokubanzi isifo apho abachaphazelekayo amaqela amathathu ngaphezulu ezalathelwe nkovu ngaxeshanye.

Iimpawu sephepha extrapulmonary kule ityala alisonjululwanga kugqame kakhulu. Kumanqanaba okuqala yokwanda kwiindawo nkovu. Ba ilastiki, ithambile ukuya ngaphandle kwebala, luyaguquguquka kwaye ekuqaleni elula. Tshintsha ubungakanani kwabo akunanto yakwenza njengomkhuhlane okanye nezifo phecana eliphezulu zemiphunga.

Eyona Uphawu luhlobo lymphadenitis tuberculous na ukubandakanyeka kwinkqubo sifo ezingqonge izicwili ethambileyo, kwakunye nesifo - ezingqongileyo iindawo nkovu. Ngoko ke bakha ukufukuka enkulu kangangoko. Kwixesha elizayo, xa embindini nethumba kubonakala site athambileyo. Kweli nqanaba phezu isikhumba ochaphazelekayo yi-engile ukubhitya, ngamanye amaxesha iba ithinti ebomvu okanye oluhlaza.

Ukuba lunganyangwa, kukho uqhekeko izicwili, nto leyo fistula apho iphuma imixholo ukuvumelana obufana. Ngelaphu egcwele izilonda, ukopha ezinokwenzeka. Le fistula ukuze coalesce, yaye kumphezulu wayo zezilwanya amanxeba rough. Ngelishwa, ithishu ukuphiliswa buphele - ukuphinda, apho fistula ivulwe kwakhona.

Kwezinye iimeko, umntu gabalala yenkqubo zophendlo lwezifo ichaphazela namanye amaqela nodes nkovu. Ezi ziphumo eziyingozi oonobangela tuberculosis extrapulmonary. Uxilongo oluqhutywa kulo mzekelo ngu biopsy kunye iisampulu zovavanyo kwilebhu elandelayo ifunyenwe.

Indlela ukuxilonga isifo sephepha extrapulmonary?

Njengoko ubona, kukho iimpawu ezininzi iingxaki, ezikhokelela kuphuhliso lwesifo sephepha extrapulmonary. Uxilongo ezi zifo, ngelishwa, ngokuxhomekeke kwiingxaki ezithile, ekubeni baqonde ukuba umfanekiso lwezonyango lee kwimeko nganye. Ngaphezu koko, uninzi lwezigulane abafunyenwe kakade sesihambe sephepha.

Ngokwendalo, ngokuba ekufumanekeni esi sifo kuyimfuneko yokuqhuba uphando. Oku kuqala Mantoux kunye ngeedosi ezahlukeneyo tuberculin. Olu vavanyo kunceda ukuqinisekisa ukuba isigulane bobabo kwiqela lomngcipheko. Ukongeza, inyathelo elibalulekileyo uphethwe ray kunye fluoroscopy ngokuba sisifo extrapulmonary ngokuqhelekileyo ukuphuhlisa ngokuchasene nesifo miphungeni. Nokuba ezincinane, sisilonda esidumbileyoesingaphakathi eyintsalela pulmonary unako ukuqinisekisa ubukho zokugula njengesigulane abo okanye ezinye izigqeba.

Kwixesha elizayo, izifundo ezongezelelweyo eziqhutywa kwaye, ingakumbi, ultrasound, livakale Imagnethi yomhlaba kunye Itomography computer, biopsy kunye noviwo kwilebhu izicwili ubukho Mycobacterium tuberculosis.

Unyango lwesifo sephepha extrapulmonary kunye awohluke yayo

Kakade, esi sifo kuyingozi, kodwa ngenxa kwindawo yokuqala izilangazelelo izigulane bubukho kukho iinkqubo ezisebenzayo nezinyangayo. Unyango lwesifo sephepha extrapulmonary - ende kunye nezintsonkothileyo, kunye nezigaba yayo ephambili lingqamane inkqubo unyango ngenxa iintlobo pulmonary kwesi sifo.

Ngelishwa, unyango zintsholongwane kunqabile isebenza. Isibakala sokuba mycobacteria ukuphuhlisa ngokukhawuleza ukuxhathisa phantse kuzo zonke iintlobo-ntsholongwane, ngoko la machiza zidla zisetyenziswa njengabancedisi.

Oku kucingwa ukuba ichemotherapy kakhulu ngempumelelo. Namhlanje, kukho izikimu ezininzi impatho enjalo. Amaninzi ukuba wayeqhuba kwanonyango kane ebizwa ngokuba yi-equka ukusetyenziswa rifampicin, streptomycin, isoniazid kunye pyrazinamide. Ezinye iikliniki abucala usebenzisa scheme pyatikomponentuyu okuqhubekayo ngakumbi, esongeza kuluhlu lwe iziyobisi, amanye amachiza besizukulwana esitsha. Kakuhle ukuhlanganiswa okhethiweyo inceda kutshabalalisa amagciwane sephepha, kodwa, ngelishwa, ayipheli unyango apho.

Ngenxa chemotherapy isifo sephepha kuchaphazela umzimba, kukho hepatoprotectors ezahlukeneyo, kwakunye namachiza, nokukhawulezisa inkqubo ekususeni ubuthi emzimbeni (kuthetha equka acetylcysteine, reosorbilakt). Ukongeza, yinxalenye ebalulekileyo unyango obuyiyo immunostimulants, kuquka glutoksim, xymedon, galavit.

Ngamanye amaxesha, irejimeni yonyango iquka iivithamini kwiqela A ukuze iyaluthintela uphuhliso neuropathies yoluvo. Kwezinye iimeko, uqhaqho kuyimfuneko. Ngokukodwa, umsebenzi kumiselwe kwimeko granuloma uluhlu emqolo, njengoko le kuphela kwendlela eya kuthintela umonakalo omkhulu ukuze iingcambu luvo kunye umnqonqo.

Kwanasemva kokuba onke amanyathelo zonyango imithetho okumele ilawule isigulane. Kwibakala ebalulekileyo kwakhona umzimba esinempilo yokuphila nokutya efanelekileyo. Yokudla kufuneka ibandakanye izondlo, kwakunye yonke entsonkothileyo iivithamini kunye neeminerali. Kubalulekile ukuba ukubuyisela ubunzima bomzimba eqhelekileyo. Kunye nesifo sephepha (pulmonary kwaye extrapulmonary) kubopha na unyango kwisibhedlele rhoqo.