Fibro-cavernous tiibhii: Zviratidzo uye kurapwa. Madzivirirwe Mazano

Fibrocavernous pulmonary tiibhii - nechirwere dzinoparadza, kuti pakuva chinova pamberi iri yoga zvemapapu mhango. In mushonga, rinonzi "mhango". Kutambudzika idanho ari kufambira mberi pulmonary tibhii. Kazhinji, kwakadaro zvokurwara kiriniki zvinodzimwa hunhu.

Zvakakurukurwa chirwere

Kazhinji, fibrous-cavernous tiibhii kuchengetwa varwere akura. In pauduku, chikuru TB zviratidzo hadziwanzowaniki chaizvo.

Cavernous zvokurwara anoita sezvo magumisiro pamusoro infiltrative tibhii, asi zvinoitika kuti anovandudza neakangwara kana patchy, mhando zvokurwara.

Fibrocavernous chimiro dzakaonekwa muna 5% kuti zviitiko tibhii.

Cavernous tiibhii somunhu achipindira dombo kukura fibro-cavernous zvokurwara

A maitiro kuchiitwa pathomorphological cavernous tiibhii ndiyo kuvapo imwe mhango, hapana kuzvimba uye fibrotic zvachinja principales, node midziyo uye rwakapoteredza tishu. The chirwere haisi anopfuura 2 years.

nemakomba kuporesa kunoitika nokuumbwa:

• rumen;
• tuberculoma;
• kuroora muupenyu tibhii;
• sanitized mhango.

Pasina kurapwa kwakakodzera cavernous chimiro anogona kupinda fibrocavernous tibhii, fibrosis iyo tinoberekwa masvingo mhango uye yakapoteredza zvemapapu parenchyma. Vakacherechedzawo vakawanda foci zvokutapukirwa.

symptomatology chirwere

Kazhinji, fibrous-cavernous tiibhii iri vemunyika imwe zvemapapu. Kukura chirwere ndepana 3-4 mwedzi sashanda kurapa imwe mhando tibhii. Zvinoratidza chirwere nonyanya chinopenya kuora chokutambudzika.

The chikuru Zviratidzo chirwere chinogona kunzi:

• asthenia;
• kurasikirwa havi;
• simba chikosoro;
• vangakosora ropa;
• ropa;
• crackles iri kuparara mhango.

Pashure paumbwe mhango zviratidzo kuva mashoma, Just kuoneka uye nonspecific. Murwere anganyunyuta kuti vakawanda simba, kugara kuneta, uremu, uye kuvapo kupisa mugiredhi pasi.

Pamusoro pokumuka Isimba rakadini rinogona kubudiswa TB zvingaratidza ropa mumapapu kuti anova pasina chikonzero.

Anamnesis wevarwere vaitambudzwa fibro-cavernous tiibhii zvinoreva kwazvo muchikwidza nokuderedza inzwi kosi. Zvikamu pakati chenjera uye nokuregererwa nguva zvingava refu zvakakwana kana, Ukuwo, kuti rikwanise danho anogona kuonekwa kazhinji.

Fibro-cavitary tiibhii ane siyana zvekuchipatara zviratidzo. It kunokonzerwa nokuziva pathological muitiro, uyewo mubatsiri matambudziko.

Pane akasiyana mbiri chirwere: shoma kana hwakanyatsorwisa kugadzikana, apo achifuridzirwa mishonga Kudzikamiswa kunoitika uye murwere ari ruregerero, risati raguma kwemakore akawanda.

Munguva chenjera nguva tembiricha kumuka kukura kuzvimba akapoteredza mhango. Tembiricha inogona kusvika kumusoro zvese, kana chirwere chikuru akabatanidza chirwere hunhu yechipiri.

Kukundwa principales achiperekedzwa kunorwadza chikosoro shoshoma, sezvamakaropafadzwa sputum, madzihwa uye pus rine kuparadzaniswa nokutamburira.

A murwere chirwere fibro-cavernous tibhii, zvinoshamisa uremu. Anoti ganda rakaoma, izvo nyore wrinkles. Tsandanyama murwere kupesvedzera atrophy. Kunangwa pathological muitiro anova fudzi bhandi, kumashure uye nedunhu pakati mbabvu.

Varwere havatani kakawanda kudhaka. In exacerbations kuti kufema chirwere hwapedyo insufficiency 1 uye 2 madhigirii. Naizvozvo anogona akacherekedza kuwedzera chiropa vhoriyamu. Kuonekwe zvimba.

With kuchiita hosha kwakaratidza kukundwa pamusoro dokeriro uye ura, iyo inosvitsa kwakaderera dziviriro yezvirwere mumuviri. Kana kahesii, amyloid nephrosis uye congestive mwoyo nokukundikana, pulmonary chirwere fungidziro zvisingafadzi..

Zvinokonzera chirwere

Kuparadzwa anogona kukonzerwa chero kunotoda muchimiro tibhii. Provocateur budiriro inogona kuita superinfection. By utachiona zvinofanira kusanganisira mycobacteria. Pamwe pane 74 mazita. Vanopinda genus Mycobacterium. Zvisinei, tiibhii muvanhu akaparirwa conditionally vakasarudzwa mhando, vaimudana Mycobacterium tibhii.

Predisposing zvikonzero kuti kukura chirwere vari:

• kukwidza padanho sensitization;
• changed mu reactivity;
• zvirwere zvomukati;
• tsika dzakaipa.

The chikuru chokutambudzika chirwere

It vakasarudza govera inotevera chokutambudzika fibrous-cavernous tiibhii:

• Infiltration. It presupposes kuvapo imwe chokutsva kukoshesa.
• Kuora. The kuzvimba pachoto aumbwa ari mhango iyo rizere rinokosha necrotic zvinyama - caseous guru. Dry kugutsikana anova emura, uye zvishoma nezvishoma idonhe pashure zvikasabudiswa bronchus. Panzvimbo yacho inoramba mhango. Zvadaro, anotanga kuzadza pamwe mhepo, uye panguva kutyora abudise ari principales - mvura.
• Paumbwe in. Education achiumbwa pamwe resorption pamusoro perifocal kuzvimba uye fibrosis. Rusvingo anomaly rine zvitatu akaturikidzana. Yomukati rukoko rine caseous guru (polygenic rukoko). Zvinowanikwa pakati granulation goko, mudungwe pamwe epithelial masero makuru. ari Sezvo rokunze mhango mugove yakafukidzwa neboka Kamudzira pamusoro connective tishu.
• Seeding. In iyi, iyo mhango kukura kunowedzera, uye kumativi perifocal infiltration kunoitika kana seeding. Kwacho kunosanganisira kukura yakachena anogumbura maronda panguva cavernous tibhii. Saka anovandudza fibrocavernous chimiro chirwere.

kakawanda matambudziko

Pane zvinotevera matambudziko anoitika fibro-cavernous tiibhii:

• Hemoptysis.
• Ropa ari zvemapapu.
• Kuvapo percussion. It inotaurwa kupfupikisa inzwi iri nzvimbo pleural thickening uye fibrosis.
• Kuterera simba afemeruke munzvimbo thickening of pleura. Uyewo akawana crackles uye Árbol kufema. wheezing kwakadaro kunoratidzwa kuvapo guru kadikidiki in. Over idzodzo duku panguva dzakasiyana kutaura kurira.

nzira nechirwere

Sei chirwere fibro-cavernous tiibhii? Nhoroondo chirwere panguva nechirwere, sezvinoita mutemo, nechekare rine ruzivo pamusoro yapfuura myocardial tiibhii hweHIV.

Zvinofanira kucherechedzwa kuti auscultatory zviratidzo mashoko shoma. Kuongorora vachishandisa X-ray kunoratidza kuvapo nomumvuri serin'i pamwe peripheral nzvimbo muchimiro ane denderedzwa kana denderedzwa. Mushure Data yaunganidzwa X-ray diffraction kunoda differential chirwere pamwe zvokurwara akadai zvemapapu pute, peripheral kenza, bullous emphysema, pneumothorax, echinococcosis kana encysted pleurisy.

Kutsigira chirwere uye rabhoritari dzinoshandiswa endoscopic nzira.

Sputum kuongorora kunoratidza refu azvipire MTB. Laboratory nemiedzo kwakaratidza yakakwirira pamwero woga bacilli. Dzimwe muitiro anova chaizvo. Also staghorn vanozivikanwa kwakavharwa nenyama fibers.

Pasina sputum dzakaratidza vakabata bronchoscopy. Kunoitawo kuti kuziva foci pakati kuzvimba mumapapu uye Árbol sepombi, izvo kutadzisa kuvhara zviri mhango.

Blood bvunzo. Varwere kuvapo fibrocavernous tiibhii akacherekedza lymphopenia uye nokukurumidza ESR parameter kusvika 30-40 mm / h.

Kana pane kuwedzera yechipiri hweHIV leukocytes kusvika padanho chinoratidza 19 000-20 000, uyewo kuwedzera huwandu neutrophils.

Pane matunhu kugutsikana mapuroteni iri weti.

kurapa misimboti

It hakubvisi fibro-cavernous tiibhii? Treatment rinoitwa muchipatara munyika TB dispensaries.

kurapa zano anobva mawa kushandisa zvitatu kana zvina zvinodhaka kunangana kukura zvokurwara. Kazhinji, kushandisa "INH", "ethambutol", "Rifampicin" uye "streptomycin yakawanikwa". Zvinodhaka anogona kupiwa nomutsinga kana zvakananga kupinda nomumukanwa mhango.

Also kushandiswa tuberkulinoterapiya, kufema zviitwa, panyama kurapa, Laser kurapa, Ultrasound uye inductothermy.

akatakura mishonga

Sei zvimwe panobviswa fibro-cavernous pulmonary tiibhii? Treatment kunosanganisira Implementation kuti mishonga. Miitiro ushandiswe nomunhu maererano zviratidzo zviri aikanganiswa zvinodhaka.

Kazhinji, kana kuramba dzinokosha kurapa pamusoro tibhii rinoitwa maererano ine mishonga chechina hwechiKomonisiti. Marapirwo kunosanganisira kushandiswa akabatana zvinodhaka akadai "kanamycin", "Prothionamide", "Cycloserine", "Pas" uye "fluoroquinolones". Ya mishonga haisi asingasviki 15-18 pemwedzi.

Varwere kuvapo fibrocavernous TB vakaratidza dzakabata pathogenetic kurapa nechinangwa anoruramisa havachanyatsogoni mabasa akasiyana muviri. Metabolizing mumiriri kushandiswa, uyewo achigadzirira kudzorerwa zvirwere, uye hormone nevamiririri.

With yakanaka yawapiwa pashure inenge mwedzi mitanhatu zvakanaka simba. Ndechokupemberera zvinoderedza hurumende ichiisa bacilli, uyewo kuderera uye mhango kuvhara.

kushanda kupindira

Kurapa fibrotic in nguva dzose kuitwa zvishoma nezvishoma. Kana munguva apa nguva hazvibviri kubudirira migumisiro yakanaka, iyo fibro-cavernous pulmonary tiibhii yabviswa ne kuvhiyiwa. Panyaya iyi inoratidza yaitsigira divi zvemapapu resection. Rakatangwa muna duplex kushanda uye muitiro. Rinewo refu mwero kunyatsoshanda uye anobvumira kuti aponese murwere anogona kushanda. The rakapedza munhu anorwara upenyu miforo zvikuru. Voga kuti mycobacteria rinomira.

Rumwe rudzi Kuvhiya chinhu kuvhiya kuparara kurapa, zvichireva kuti nokuiswa chakagadzirwa pneumothorax.

Pashure kurapwa muchipatara mutsigiri runodiwa fanira nekwevanorwa pfungwa, outpatient kurapwa , zvichiteverwa pakuongorora pakiriniki.

fungidziro

Ruzhinji fibro-cavernous tiibhii amenable mushonga. Mhango pakati miganhu diki akavanzwa uye scarring. Education pamwe kuvapo vanachandagwinyira masvingo pamusoro nguva refilled pamwe caseous kugutsikana kuti chinokurwadzai psevdotuberkulemy.

Kuunganidza pus, kuvapo aspergillosis, kufambira mberi tibhii hadziwanzowaniki.

matanho

Fibrocavernous tiibhii ndohwaJehovha muchikwata kwezvirwere zvinokonzerwa kwakaomarara pasocial zvinhu. Kazhinji honzeri kuderera zvinodiwa mhenyu nyasha vemo.

Maererano nenhamba, varume vanorwara ka3 kakawanda kupfuura vakadzi. The chikuru zvokurwara ndee nemakore 20 kusvika 39 makore.

Kuitira kudzivirira zano kuchengeta mitemo zvinotevera:

• zvidzidzo zvakakodzera matanho;
• mangwanani kuziva vanhu nechirwere;
• kusarudzwa wehurumende mari zvinodhaka;
• Implementation of rokutanga vanachiremba kuongororwa kana uchitsvaka basa zvipfuwo zvekutepfenyura;
• kuwedzera munzvimbo kuti pekugara dzevarwere vakanga chirwere tibhii;
• rakakodzera Implementation of kubaya kuti vacheche mumwedzi wokutanga aberekwa.

mhedziso

Fibro-cavernous pulmonary tibhii (yematambudziko vangangokukuvadza mamiriro utano) ndiro chirwere. Kazhinji, zvinonzi atsamwiswa cavernous tibhii. The chirwere chinogona kuzivikanwa somunhu yaitsigira divi kana bilateral maronda.

Yakapfuura zvokurwara zvakaoma kurapa, ratova mushonga une zvakawanda zvakasiyana kuchirapa modalities kuti kuchaita kugadzikana kuregererwa kwemakore akawanda. Panguva Chaiyo kunokwanisa kuponesa murwere anogona kushanda.