Caseous nemabayo: Zviratidzo, kurapwa, nhoroondo zvokurapa, chiremba Chokwadi, photo, differential kuongorora chirwere

Panguva iyoyo, nzanga ano iri kutyisidzira matenda akawanda kuti zvingakanganisa kuenda dambudziko. It zvirwere zvakadai HIV, hepatitis B neC uye chokwadi tiibhii. A mukuru chikamu kufa uye waipedza nemigumisiro regai kusiya munhu mumwe mukana kundorwa chirwere, uye kana tikafunga kuti nechirwere inoenderana varwere pachavo, chivimbo chavo muna chiremba uye anoda kubatwa, tinofanira kuchitarira kuti uzviise zvinyoronyoro, risingafadzi mufananidzo.

tsananguro

Caseous nemabayo inzira zvemapapu tibhii. It kunoitika zvakawanda nyanyisa pane dzose nemabayo zvakakonzera coccal kasvisto. Uye dzinoratidzwa predominance pamusoro necrotic pezvakaitwa ari zvemapapu kuti aumbe Curd panzvimbo hwandaiva zvemapapu parenchyma. Nokufamba kwenguva, vanenge pasi lysis, uye panzvimbo yavo vari in guru. Zvadaro, dzingava kana vanga, kuderedza nenyama yose mapapu uye, naizvozvovo, okisijeni nokukura uye kuwedzerwa, kungoita arikunze nhego parenchyma. Izvi anewo inokanganisa gasi Exchange uye inotungamirira kuchiita exogenous hypoxia.

kupatsanura

Zvichienderana nzvimbo hunenge rinenge caseous mabayo rakakamurwa subtypes zvitatu:

1. Lobar. Independent chimiro, rinoburitsa mugove zvose zvizere. Sezvo bhuku tagovera zvinyama necrosis, uye zvaiswa pasi huru, varwere rikunde rinorema kudhaka chiratidzo. Somugumisiro, chiedza yanyungudika uye kuumbwa nemakomba.
2. Lobular chimiro, kana lobulit. kuomesa uyu kumbova tibhii. Kusiyana yapfuura mumwe, kunosanganisira lobes akawanda, zvichiita zvikuru poizeni tishu kuora.
3. Acinar. It kunoonekwa kuomesa kwakaita miliary (anongoremberera) tibhii. Pasinei nokuti acinus - ndiwo zviduku mugove zvemapapu, maperembudzi Kutamiswa zvakaoma, sezvo nzvimbo sei kazhinji kungogara, asi chose mutumbi parenchyma.

epidemiology

Sezvaratidzwa pamusoro apa, TB rakaoma nemutsa chirwere sezvo caseous mabayo kwakadaro. Nhoroondo chirwere akanga vanopfuura zana nemakore, uye panguva iyoyo vanhu usingagoni kukwira aine mushonga. Mishonga kuti vari varwere vava hachibatsiri pashure pemakore gumi kana makumi maviri, nekuti nayo utachiona vachava nenguva kusaurayiwa ichi nemakemikari chokupfeka.

The chirwere hwapedyo nokukurumidza, zviratidzo zvokutanga kuoneka zvakanaka nokukurumidza pashure chirwere. Zvinokachidza neve utachiona kuti kukanganisa dziviriro yezvirwere mumuviri zvoderedza nayo. Huru contingent, pasi caseous nemabayo vanotambudzika mumagariro vanhu. Uye kwete chete nokuda kushaya zvinokosha utsanana, murombo muviri uye magariro, asiwo nokuda kukundikana pakurapa runotikurudzira zvokurwara.

Kukura chirwere

Nokuda nokukurumidza weboka uye kukura kwakaita M. tiibhii mumapapu hwakaipa vakawanda uye nemakanzuru kutapata. The tusingaoneki berekai makemikari kuti muchetura kuti cellular zvirwere, triggering apoptosis (nemasero anotsiva anenge afa). Saka, pashure kuunganidza yakaoma guru mabhakitiriya anotanga atadze kushanda zvakanaka kudzivirira zvigadziriswe dzemuviri. A chinokosha kuitika mutumwa ari zvomukati uye zvinodhaka toxicity kutungamirira kuti kuderedzwa chiropa basa, adrenal shwanu, degeneration pamusoro cardiac tsandanyama uye tsinga lesion.

Munharaunda, pamusoro pakanyorwa yakaderera kutapata, akacherechedza necrotic pezvakaitwa ari zvemapapu parenchyma, vakawanda foci kuti kuzvimba pamwe Curd mukati. Zvishoma nezvishoma, ivo kuiparadza makemikari muviri yavo, uye panzvimbo yavo akaonekwa ari mhango (in).

zviratidzo

The kunotoda nzira caseous nemabayo kunogona pezviitiko shoma:

1. Utachiona hwedenda, kuti rakafanana chaiwo nemabayo - .. High tembiricha (kusvika mana madhigirii), chills, chikosoro, muchipfuva marwadzo, dyspnea.
2. Flu - catarrhal mananara (runny mhino, maziso mvura, dokeriro edema) vakawanda pamusoro kudhaka. Pane zvishoma nefivha, kungava chikosoro.
3. Sepsis - refu kwazvo tembiricha (makumi kusvika mana nerimwe dhigirii), kudhaka, migraine, chikosoro offline.

Pakutanga, hapana kufunganya zviratidzo vasiri kuchengetwa. Easy wakaoma chikosoro, simuka mu tembiricha usiku, kurasikirwa kudya. Vanogona kwaaisvika zvakakwana kusvikira yakaoma chikosoro handingakwiri pakati nyoro, uye pachava viscous greenish sputum. Panguva iyi, tembiricha anodonhedza kare, uye kufema kukundikana, nekusiyana, riri kukura. Chiremba anogona vanofungidzira kuti murwere caseous nemabayo. Zviratidzo zviri non-zvakananga, asi vari pamwe chete Kuongororwa uye nhoroondo upenyu nechirwere inojeka.

Diagnostics

Kuwedzera nekunhonga vezvokurapa nhoroondo uye nhoroondo zvokurapa, chiremba anofanira ukanyatsoongorora munhu kuti zvibvire kuti palpate ari node nodes, teerera mweya wako. Asi kuti zvakarurama nechokwadi chokuti zvekungofungira ake zvakarurama, chiremba murwere Craps pamusoro yezvirwere miedzo:

1. Maekisirei pechipfuva. Phthisiologists akawana mamirire zvinhu zviri kuri mumashoko zvirwere zvakadai nemabayo caseous. Photo chiedza mufananidzo inopiwa pamusoro zvinoita here kuona vakawanda foci utsotso muviri tishu.
2. Mantoux kana Diaskintest. Simple uye vashoma anokurumidza nzira kuziva kuvapo Anti-TB kutapata. Asi haana kupa zana muzana kuvimbisa chirwere, uye kunogona akanaka uye venhema venhema kunaka.
3. Sputum microscopy. Murwere akakumbirwa kuunganidza sputum kwemazuva matatu ari muchirongo chena. Zvadaro rinoreva murabhoritari apo akaiswa rinokosha svikiro Lowenstein-Jensen kuitika munhu muzvizhinji muviri vanoenderana kwemabhakitiriya kukura. Uye vhiki bedzi gare gare achazivikanwa, chinosiyanisa murume tubercle bacillus kana kwete.
4. Iva nechokwadi kuti dzibate mitemo kurapwa chirwere miedzo: zvakakwana ropa count, urinalysis, ropa nemakemikari omuviri, ropa shuga, macalorie muzana yaytseglist.

differential kuongorora chirwere

chiremba wokutanga kuva nechokwadi chokuti murwere here cheesy nemabayo. Differential chirwere ichi nyaya kunobatsira kudzivirira zvirwere zviri akaora zvikuru zvakafanana avo vaiona nesu zvokurwara. Uye mutsara wokutanga anova kuipa lobar kana pleuropneumonia. Musiyano chete pakati pavo achava hunhu necrotic zvavo uye vari exciter. Vamwe parameters kuungana.

Nokufungidzira yechipiri inogona kuva pulmonary infarction. Asi zviri zvakakwana kuita chinhu angiogram ushe kubva Muchiitiko chakadaro. Mukuwedzera, murwere anofanira kupa nhoroondo kana kukuvara, kana atherosclerosis, kana pakatanga mhepo kupinda muropa uye / kana jikichira mhinduro.

The chirwere wechitatu, izvo zvinofanira kuenzaniswa ndiyo neronda rinonyenga. Kukura zvokurwara ichi vane fivha, zvikuru kudhaka, asi pachange chikosoro uye phlegm.

mabatiro

Kamwe chirwere "caseous nemabayo", kurapwa ndiye anosarudza pakarepo. Munhu hwakatamisirwa chaihwo TB muchipatara, apo pane mukana kutevedza yakakodzera mubhedha zororo uye kudya.

Chokutanga, chiremba munyaya zvakazorodza rikwanise ezvinhu, ingava hunokachidza kuvhunduka kana kufema kukundikana. Nokuti murwere uyu kuita aizomupa sorbents uye diuretics, kuitisa plasmapheresis. Kwozouya kwezana vanoshingaira kurapwa kana kuuya chiito nemishonga antihypoxants, anticoagulants, mahormone, interferon. Chaizvo kurapa ndiko kushandiswa namano antibacterial mishonga akagadzirirwa zvakananga Mycobacterium tibhii.

mataridzikiro

Caseous nemabayo zvakaoma kurapa, saka, nokuti upenyu uye utano Marwadzo kunge kusingarapiki. Zvichida kunyange kuparadzwa zvachose pakati zvemapapu, izvo vanotozvikuvadza kunounza kufema kukundikana.

Zano rakapiwa vanhu vane TB navanachiremba chirwere Koch seinä vari kuderedzwa kuti chokwadi kuti haufaniri kumhanya chirwere. Zvakakodzera kutanga kurapwa nenguva uye vafambe nayo zvachose, asi nokuda murombo socialization wevarwere, uyewo avo magariro, caseous mabayo chinhu kakawanda kuomesa kwakaita tibhii. denda iri, iro vanachiremba asiri kurarama nhasi.