Pleurisy Tuberculous: Izinhlobo, Izimbangela Nezingozi Ukwelashwa

Kukhona izifo eziningi ezingaba nomthelela womuntu umgudu wokuphefumula. Ezinye zazo abalona kakhulu usongo empilweni, kodwa kukhona labo babe sengozini yokuthola izifo kanye ukwehla izinga lempilo isiguli. Omunye walena uwukuba le pleurisy tuberculous, nobani sahlangana esihlokweni namuhla yethu. Cabangela izizathu ngendlela, izinhlobonhlobo kanye zokwelapha abazitusayo.

Yini kunikezwa isifo

Kulesi sifo libhekene i-acute, esingelapheki noma yansukuzonke ukuvuvukala pleural. isifo ngokuvamile kubonakala emva igciwane sofuba umzimba.

pleurisy Tuberculous ngokuvamile kuthinta ulwelwesi serous ukuthi zakha ingaphakathi pleural bayigubungele emaphashini. Lesi sifo kuyingozi ngokwanele, ukulwa ke sekuqhubeke zeminyaka, kodwa namuhla umuntu uyahluleka uma elwa namanje.

Ingozi yalesi sifo iwukuthi kungakwenza zanda ngokushesha phakathi abantu, okwandisa izinga lokufa. Ngaqaphela ukuthi kaningi lesi sifo kwenzeka eminyakeni yobungane. Pleurisy of omsakazo tuberculous igcwele ukusabalala amabhaktheriya wonke umzimba, okuholela ukuphazamiseka zonke izinhlelo isitho, ngakho ngokushesha lesi sifo sitholakale umuntu ukuphathwa ngempumelelo ngaphezulu.

izindlela zokuthuthukiswa isifo

Lokhu zokugula has izindlela ezimbili yentuthuko:

1. Exudative pleuritis omsakazo tuberculous eba uma pleura kuthinte ezinobuthi ejenti causative nemikhiqizo noqhekeko ihlule. ingaphakathi Pleural kulokhu iqukethe esincane amagciwane. I pathogenesis kungenziwa kuphawulwe ukuthi ukuzwela kwandisa ngokuphindaphindiwe umzimba ukuze igciwane pathogenic, ukukhula kuthonywa esandulele ukugeleza sofuba ukutheleleka. Ngemuva kokungena kwegciwane pleura iqala olwenzeka okusheshayo uketshezi.
2. Eyesibili ukuthuthukiswa indlela - yisishiso pleura kumiswa tubercles, eba lapho amagciwane engena nenqwaba umnqopho iphaphu noma thoracic zamanzi.

Njengoba lwegciwane ukungena ngaphakathi komgodi pleural

Kunezindlela eziningana lapho imbewu eletha tubercle angangena ngaphakathi komgodi pleural:

1. Pin. Kulokhu, ingress evela foci emaphashini ngokufanele ngaphansi igobolondo.
2. indlela Lymphogenous kuhilela kwafikela kwemigudu ye-lymph.
3. ukusabalala Hematogenous - izithuthi ngokusebenzisa imithambo yegazi.

Mechanism yentuthuko isifo ukuvuvukala kule amashidi pleural, ukunqwabelana leukocyte kanye Ukungena uketshezi ingaphakathi pleural.

Exudate pleurisy tuberculous kungaba bemvelo ezahlukene:

• Fibrous.
• Serous.
• Bloody.
• Ubovu.

Uma yokwelapha alusebenti ke effusion ekugcineni serous kuxazululwa, nezicubu fibrous zezinzwa lihlasela izakhi phezu kobuso pleura futhi ifomu isibanda okubekwe ngaphezulu.

Izimbangela pleurisy tuberculous

Yamaphaphu pleuritis tuberculous libhekisela iziyaluyalu sokugembula ukuthi ukuthuthukisa ngesisekelo unesifo noma esingamahlalakhona yamaphaphu. Etiology ka pleurisy kuyinto ngezinhlobo eziningi, futhi ngalinye linomsebenzi izizathu ayo wentuthuko.

Izimbangela lengculaza:

• Izifo ezibangelwa amagciwane, ezifana staphylococci, amalutshwana-negative microflora.
• Amagciwane nezimbungulu emzimbeni, ikakhulukazi uma kwesokunxele yokwelapha.
• Isifo sofuba kwezifo kusho ogxile ngesimo izinti.
• izifo fungal: candidiasis, blastomycosis.
• Ugcunsula, typhoid brucellosis kungaba avuse ukuthuthukiswa isifo.

Ungase futhi ushayele yokungabibikho kwezimbangela ezithathelwanayo:

• Uma kukhona isimila esibulalayo esikhula emaphashini, nezindlala mammary, amaqanda.
• infarction yamaphaphu.
• Pancreatitis, ene-leukemia.

Odokotela behlukaniswe iqembu elihlukile izimbangela ezingaziwa engabangela pleurisy tuberculous:

• Ukulimala.
• Ukulimala, ezifana isibhamu.
• Surgery.

Kuye imbangela isifo uqale ubonise ngokwabo kanye nezimpawu, kodwa kuqala kubalulekile cabanga ezihlukahlukene lesi sifo, futhi azibonakali ehlukile.

Ukwahlukanisa futhi izinhlobo zokugula

Uma sicabangela izici pathogenesis lesi sifo, kuba angawodwa pleurisy sofuba lezi zinhlobo ezilandelayo:

1. Nomzimba.
2. Isifo sofuba ka pleura.
3. Perifocal.

Izinhlobonhlobo wokuqala lesi sifo ukuzibonakalisa isizinda ukuzwela eqinile umzimba. I engavamile yalolu hlobo pleurisy kuba phambi ubuhlungu kanye ukunqwabelana ngokushesha uketshezi. Kodwa Dynamics ephambene ezifana okusheshayo.

Endabeni ka ukusakazwa inqwaba izikhungo ezincane nezinkulu ekuthuthukiseni sofuba pleura. Ngokuvamile lolu hlobo isifo libhekene impendulo olunzulu caseous-necrotic. pleurisy Tuberculous yalolu hlobo ubhekwa le ngodlame kakhulu.

uhlobo Perfokalny eba lapho ukuvuvukala zibhebhetheka kusuka emaphashini kuze pleura. Exudate angase buthelela inombolo encane noma enkulu-bacterium atholakala kuwo akuzona njalo, kodwa kuthatha lolu hlobo eside futhi ngokuvamile yansukuzonke.

On Ukwahlukaniswa lesi sifo sihlasela Ukwakheka kakhudlwana futhi pleural. Kuye lokhu kukhululwa:

• Fibrinous noma ezomile.
• Tuberculous effusion pleural.
• Ubovu.

I angahlangani lokuqala kwenzeka, njengoba umthetho, kwezinye izindawo pleura, lapho imali zingu fibrin. Ngokuhamba kwesikhathi, pleura ilahlekelwa olubushelelezi yayo. Lolu hlobo isifo ngempela kalula esilaphekayo uma sekufakwe ngesikhathi sako.

effusion Pleural kuyinto okuphambene ukubonakaliswa fibrotic kwengqondo. Cishe ngokushesha uqala ngenkuthalo secrete uketshezi buthelela ngaphakathi komgodi pleural. Kunezikhathi lapho konke iqala nge uhlobo ezomile, okuyinto eyenza ihlangana ne exudative.

Ubovu akha uhlamvu eyinkimbinkimbi. Pleura kwenzeka ngenxa ukunqotshwa hit MBT umthamo noma aphule focus subpleural.

Uma pleurisy of omsakazo tuberculous, namanje ihlukaniswe izinhlobo eziningana:

• Ukutheleleka. Utfutfukisa ngemva kokuthintana staph, Pneumococcal, TB bacilli emaphashini.
• Noninfectious sofuba pleurisy eba ngokumelene ngemuva umdlavuza wamaphaphu, rheumatism nezinye pathologies.
• pleurisy Idiopathic eba ngezizathu akucacile.

Izifo singenzeka ehlukile, esinzima kangako emizini yabo angawodwa ifomu, subacute futhi ezingalapheki. Ngamunye inezimpawu lalo.

ukubonakaliswa isifo

Ukuze uhlobo pleurisy ngamunye libhekene izimpawu zaso. Dry tubercular izimpawu pleurisy zimi kanje:

• It kuzoba ukusabalala limfatogennoe ukutheleleka.
• Kukhona ubuhlungu esifubeni. Uma uhogela ke iyakhula futhi kungaba avuse sneezing, ukukhwehlela.
• Ukwandiswa nezinga lokushisa komzimba.
• Sekukonke kukhona ubuthaka inqubo yokuthuthukisa amakhono sifo.
• Ukudakwa kwenzeka.
• Kwehliswe iphango.
• isisindo encishisiwe.

Izimpawu zokuqala ungenzi kungenzeka ukuxilonga izifo ngesikhathi esisodwa, ngakho-ke ubuhlungu kuze i ukusazi ngokunembile isifo esikuphethe nzima. With ukuthuthukiswa sifo ubuhlungu buyaqina, zikhona izimo ngisho nokulahlekelwa ukwazi.

Symptomatology pleurisy owomile neuralgia ezithi azifane, ngakho-ke kubalulekile lokwenza ukuxilongwa umehluko ngesikhathi. Uma kukhona pleurisy ezomile, isiguli uzama amanga ngakolunye uhlangothi, kodwa ubuhlungu nakakhulu.

Uma udokotela nizongiphendula ukubukeka ubuhlungu ke uzwa lomsindo elivela ngomshikisho we pleura. Ukuxilonga lolu hlobo pleurisy ngokuvamile ukuhlolwa kwegazi ehluleka.

ifomu Exudative of zimpawu ezilandelayo:

• Ukuphelelwa ngumoya.
• Ubuthakathaka futhi umkhuhlane.
• Ukwandiswa lokushisa lomzimba kuya 38-39 degrees.
• Khwehlela.
• Ukoma emlonyeni.
• Chest ubuhlungu kusukela kwasendaweni lwegciwane.

Kaningi, effusion ezinjalo kuba Yiqiniso acute, kodwa zikhona izikhathi lapho izingane noma izingane sifo asymptomatic futhi itholwa kuphela emva luhlolo elingenhla ipheshana zokuphefumula.

Ngemva ekuqongeleleni uketshezi kule ingaphakathi pleural ka izimpawu zingancishiswa, ihlala yodwa eceleni yesisindo. Inani uketshezi ongafinyelela amalitha amabili. Kulokhu, ikhanda, isiyezi, ingane ingase ishintshe umbala kwesikhumba, ziba ucobekile, eliphaphathekile futhi ngokuvamile amanga ngakolunye uhlangothi.

Symptomatology ubovu pleurisy has inkulumo ezibuthakathaka nesineke ayikwazi ukushintshwa, kodwa kukhona ubuhlungu ohlangothini lwakhe, iphika, ubuthakathaka kanye imfiva. isimo ngokuvamile zaba zimbi kangangokuthi isiguli ngeke avuke embhedeni.

Izimpawu pleurisy zenyathi

Siye sathola ukuthi kukhona subtypes ka pleurisy, nakho azibonakali ngezindlela ezahlukene.

Perifocal inezimpawu sokubuza:

• ubuhlungu Ezintsha esifubeni.
• A ubuthakathaka encane.
• Nakuba ukulalela umsindo elincane esifubeni sakhe.

Lokhu zenyathi pleurisy kungapheli futhi uyahluleka uma elwa nokuphuza njalo, uma kukhona ukunqwabelana uketshezi, izimpawu kakade evelele:

• Ukwandiswa nezinga lokushisa komzimba.
• ukujuluka eqinile.
• Utfutfukisa tachycardia.

pleurisy Allergic livela ngale ndlela:

• Izinga lokushisa likhuphuka amadigri amathathu nesishiyagalolunye.
• Tachycardia.
• ekuqongeleleni Rapid uketshezi.
• Ukuphelelwa ngumoya.
• Kobukhulu ephefumula nobuhlungu ohlangothini lwakhe.

Lezi zimpawu zingase zithathe ngokushesha avele aphele kanye.

Uma athuthukile sofuba we pleura, isici kuye:

• Amazinga ongasukuma abe amadigri amane.
• ukujuluka ngokweqile.
• Ubuhlungu ohlangothini lwakhe.
• isifuba esomile.
• dyspnea Enhanced.

Uma kuwukuthi uhlobo ezingamahlalakhona, kuba ejwayelekile pleurisy tuberculous:

• Umuzwa yokuntuleka emoyeni.
• On entanyeni zingavuvukalanga emithanjeni, futhi zamanzi.
• Cyanosis sezindebe.

Lapho izimpawu isiguli kumele iphuthunyiswe esibhedlela. Kuyadingeka ukuqinisekisa ukuthi abantu lezi zimpawu akazange ahlale beshayela, kungcono ushayele "ambulensi" uma ungakwazi ulethe wena esibhedlela.

uphethwe

Uma kukhona tuberculous pleurisy uphethwe kunzima. Doctor lokwenza ukuxilongwa ayibalulekile nje ukwazi ukuthi lesi sifo ukuzibonakalisa ngeendlela ezihlukeneko, kodwa futhi ukuze baqhube izifundo ezihlukahlukene. Ngesisekelo yonke idatha kungaba ihlonzwe. Sifo kuhlanganisa:

1. inhlolovo isiguli ngendaba izikhalazo.
2. Iqoqa ulwazi mayelana Umdwebo kuwukubonakaliswa sifo.
3. Kuphethe ukuhlolwa tuberculin.
4. luhlolo Radiographic wembula izinguquko nezicubu wamaphaphu.
5. Ukuhlolwa kwegazi kwembula indlela yokwakheka leukocyte, ikakhulukazi izinguquko evelele egazini ngesimo ubovu pleuritis.
6. Urinalysis kuthola khona amaprotheni. Uma itholakale, uphethwe isobala.
7. Bronchoscopy kungathola sofuba nezibazi bronchial.
8. exudate uphenyo. Uma pleurisy tuberculous ke kukhona ingxenye amaprotheni, kanye glucose sinciphile.
9. Emazinga lasetulu titers omzimba e ukusabela IHA, IFA izobonisa khona sofuba ukutheleleka.
10. Ngokusebenzisa tomography kunqunywa omsakazo pleurisy.

Kwaze kwaba yilapho sebeshiye kuqinisekiswa ukuxilongwa "pleurisy tuberculous", ukwelashwa ebekwe udokotela.

Ukwelapha isifo

Ukuze ukubhekana nalesi sifo, sekuyisikhathi ezibalulekile sikubone futhi uqale ukwelashwa. Abaningi bayazibuza: pleurisy tuberculous esithathelwanayo noma cha?

Kuyinto isifo esithathelwanayo, futhi uma isikhwehlela iqukethe Amagciwane zokugula, isiguli enjalo uyingozi kwabanye. Ukwelashwa okufanele kwenziwe kuphela umtholampilo sofuba.

Ukwelashwa okufanele ngokuyinhloko ukukhuthaza ukumisa izicubu ekubhujisweni inqubo. Ukuze wenze lokhu, akhethe:

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

Isikhathi yokwelapha izidakamizwa izinyanga okungenani ayisishiyagalombili, uma futhi kwatholakala ukuthi nginesifo sofuba yamaphaphu, isikhathi singase siwathole isikhathi esingaba iminyaka emibili.

Ochwepheshe bakholelwa ukuthi kungase kuphumelele ekulweni nezifo kwamagciwane corticosteroids, njengokuthi "Prednisolone".

Ukuze kalula ukuthatha ezakheke evamile, kubalulekile ukuba afeze uzotshala uketshezi ukuvimbela ukwakheka izingqimba.

Ukwelashwa nokuvikelwa pleurisy tuberculous nayo eyenziwa nokusetshenziswa immunostimulants, izidakamizwa ezifana "Levamisole", "Taktivin".

Uma yokwelapha yezokwelapha eside akukuniki Imiphumela yayo, kubalulekile iphendukele ukuhlinzwa.

Phakathi ukwelashwa kufanele athobele embhedeni ukuphumula nokudla kufanele uhlaziywe. Ufuna ukhawule ukusetshenziswa sikasawoti kanye nokudla okunosawoti, aphuze kancane uketshezi, ukwandisa ukusetshenziswa kwemikhiqizo ne wokuqukethwe enkulu amaprotheni namavithamini.

ekuvimbeleni izifo

Ukuze uphinde ababuyelanga pleurisy tuberculous, impatho kungadingeki, kubalulekile ukuthobela izinyathelo. I-TB isifo nomphakathi ukuthi zihlobene ngokuqondile izinga lempilo yabo bonke abantu. enkingeni Epidemiological sofuba kubangelwa ukuwohloka izimo zenhlalo yomphakathi nezomnotho, ukwehla kwezinga lokuphila labantu, umsebenzi kwenye indawo kwe izinqubo.

Ukuze uvimbele kungenzeka ukuncoma iziqondiso ezilandelayo:

1. Ukwenza zokuvimbela futhi elwisana nesifo se njalo izinyathelo.
2. Ngokushesha ngangokunokwenzeka ukuxilonga izifo ezigulini futhi ukunikeza imithi yokwelapha.
3. Qiniseka ukuba afeze izivivinyo yezokwelapha umsebenzi ezindaweni ezingavamile okungekuhle izilwane sofuba.
4. Isimo kufanele ukwaba ahlukene ezindaweni ephilayo ophilayo, iziguli ezinemishini sofuba asebenzayo ikakhulukazi nangabe bahlala zokulala noma imikhaya emincane.
5. lokugoma okuyimpoqo kwezinsana.
6. Ayeba waminyaka yonke esifubeni X-ray kwamaphaphu.
7. Lapho kuvela izimpawu zokuqala zesifo liyadingeka ukuvakashela udokotela.

Ukuhambisana lezi zinyathelo ezilula zokuvimbela kuzonciphisa izinga lokuhlasela kwesifo lesi sifo futhi lisize ke ngendlela efanele usaqala yentuthuko, lapho kwelashwa kakhulu ngempumelelo.

Umuntu ngamunye yena ngokuyinhloko obangela impilo yabo. Akubalulekile lapho kuqubuka umkhuhlane kumina, ngaleyo ndlela sivumele-ejenti "isizinda kuleli amalungelo abo", futhi lesi sifo iqala ukuba bathuthuke. kudorhodere kuphela wenze ukusazi ngokunembile isifo esikuphethe futhi zibeka ukwelashwa okuphumelelayo.