Ko te pathogenesis o te mate kohi. Ko te etiology o te mate kohi. Tohu me nga tohu o te mate kohi

Mō mate kohi i rongo i tokomaha, engari ite torutoru iwi te ati tūturu o tenei mate e wehingia ana. No te tau maha, kua ako tākuta huri noa te ao i nga take whai wāhi ki te whanaketanga o te mate, nga tohu matua me tohu. I roto i tenei wa, i kitea ai e taea te wā wawe o kohi o nga pūkahukahu, me te tahi atu whēkau tupu i roto i te puka asymptomatic, me te kore o te maimoatanga arata'i ki pōauautanga nui.

mōhiohio Poto e pā ana ki te mate

Ki te rā, te pathogenesis o mate kohi ako i roto i te ki tonu i. Ko te mate kino, me te tino ma'i meinga e āpiha hopuhopu i te puninga Mycobacterium tenei.

He maha ngā momo o microorganisms e whakapataritari mate i roto i te tangata. Ko ētahi o ēnei:

• tangata, puta tino maha, whakaaro, mo te 92% o te wā korerotia katoa;
• Bovine, hua i roto i tino iti mate, mamae ratou i pā ana ki 5%;
• takawaenga, te nuinga tohaina i roto i Āwherika ki te Tonga, i roto i Russia te mate kitea i roto i te 3% o tūroro;
• kiore me manu, kitea te anake i roto i takitahi ki āhua ārai i roto i te aamu.

e mohio ana torutoru iwi e kore te te tinana o te pūnaha romahā iti ki te mate kohi. Kei te patu ano hoki te Bacillus:

• wheua;
• wahi gastrointestinal;
• pūnaha genitourinary;
• roro.

Ahakoa o wāhi, ko tino mōrearea te mate, a ka heipü arahi ki te mate, ki te kāore.

Ko te mate he wā heki roa. kia puta te tohu tuatahi i muri i te 3 marama - 1 tau i muri i te kupu whakataki o te kaihoko hopuhopu.

tatauranga

He tino āwangawanga e pā ana ki te horapa tere o te mate ngaio hauora huri noa i te ao. Russia i te rārangi o whenua e wahi 22th.

I mua, ko te nuinga o nga tangata huaketo te tavini i ngā rerenga kōrero i roto i te whare herehere. Otiia mai tīmata te wawe 90-doma te pakarutanga, me te Bacillus ki te horapa nui.

Daily pāngia take hou o te mate kohi i roto i te mau utuafare taonga, ko te nuinga o nga tamariki i te tūroro.

I roto i te whakahaere tiaki hauora, e hāngai ana tenei meka i ki te hekenga i roto i te paerewa o te ora o tangata, e i noa kite i te wa, ka i meinga e te hanganga tōrangapū o te whenua.

No te tau maha kua whakatinanahia tenei tohunga urutā te huinga o āraihia e tukua iti ki te ū te āhuatanga, ki te whakaiti i atu tahumaero me te tahuti nei. Ko ētahi o ēnei:

• Vaccination o hou i roto i te fare ma'i;
• aroturuki take hou mā te whakamahi i te whakamātautau Mantoux (mō ngā tamariki), me x-hihi (i roto i ngā pakeke).

Ko te tino ātete ki huringa taiao kohi Bacillus, na tonu te wa roa i roto i te āhua ka taea i roto i te wai, te whenua, me te pera i runga i. N. hoki hanganga ture-kore ki te ture taketake o te mōrea akuaku whaiaro o te whiwhi rawa tiketike.

tohu āhuatanga

Ko te pūtake tuatahi o pathogenesis ko te kătahi o rakau pathogenic ki te tinana. e kore e taua iwi hinga tonu kino, i runga i, i reira he kahore amuamu.

Ki te vaivai o kia ara ake i te wātea i te mate:

• he hua iti i roto i te pāmahana te tinana;
• auau ngakau nui haere;
• sweating nui i te po;
• numinumi ngā ki ataahua kiri te ngau ke;
• ngoikore, whanoke;
• mare;
• sputum i konatunatua ki te toto.

Ino o te huru whānui whakatika hoki o nga iroriki tāoke paihana. Ko te atu te tokomaha nga tohu atu te korerotia atu.

pea te tohu tuatahi o te mate kohi i roto i te tūroro ki te pūnaha ārai mate kaha iti ngaro ranei i toe.

kitea te akoranga, me te tere haereraa i tino kino i roto i nga tangata ki te raruraru hauora.

Ki te patua te te moroiti:

• Bone - i reira ko te mamae kaha i roto i hononga, me te pakeke katoa.
• Brain - i reira he whakapairuaki, ruaki, ānini nui, me te mamae uaua.
• pūnaha mimi - te manawanui mana'o tonu waipuke tōngāmimi. Ko te atamira matatau o te ahua o te toto i roto i te mimi.
• wahi gastrointestinal (Git) - i reira ko te tamau hūhi puku, whakapairuaki, whai koputaputa he whero i roto i te kumete.
• Kiri - i runga i tona mata i hanga nodules ki tonu i te pirau, e kua whakakitea i roto i te akoranga e tika ana.

reira he he momo granulomatous inflammatory o te tukanga e taea te kitea i roto i tetahi okana pāngia ki te puipuitua o te akoranga roa o te mate kohi. Ki te tāutu i tona whakamahi tikanga hou o te tātaritanga.

rōpū mōrearea

Kua whakaaturia roa Medicine e te pathogenesis o kohi tei runga i te āhua o te pūnaha ārai o te tinana.

Mai i te whakaparu i kahore tetahi he ārai, engari i roto i te rōpū mōrea teitei ngā tangata:

• HIV me AIDS;
• herehere;
• mate ana i te tini o nga mate ma'i (tuwhenua o te pūnaha kūnatu, mate huka, aha ...);
• whai peu kino;
• muri;
• tau'a ore o ture akuaku whaiaro;
• whakapā auau ki te tangata i pangia,;
• i roto i te hapū;
• ite te ahotea auau;
• e kore e riro i te huaora e tika ana, me ngā kohuke;
• noho i roto i ngā wāhi taiao rawakore;
• i te mau utuafare iti-moni;
• kore whakaritea wahi o te noho.

A, no te whakahohe, te tukanga pathological, āhuatanga te pathogenesis o mate kohi e nui haere hopuhopu.

āhua

Ko te momo o te mate tei runga i te roanga o te maimoatanga, te tūponotanga matapae o te whakaparu i te tahi atu mau taata. Tohatoha i te wāhanga e whai ake nei o te mate kohi:

1. Open. Kitea i roto i pāpaka o te pūkahukahu. Ki te mea kua whakapumautia kawea i roto i te tātari sputum te aroaro o tukumate i reira, he pipihi te tangata.
2. Katia. Ki te hua kino, e kore te mea te manawanui he kaikawe o te mate.

Ki te tuatahi ka te rakau ki te tinana whakaaro puka tuatahi, i roto i te take te ritenga atu o te tuarua.

I tua atu, ka taea e te mate rerekē i roto i te whakangaromanga āhua:

• miliary;
• tohatohaina;
• infiltrative;
• iti;
• cheesy;
• fibrocavernous;
• tuberkulemny;
• cavernous;
• cirrhotic;
• kiripūkahu tuberculous.

Course o te mate i roto i te kōhungahunga me te wā hapūtanga

Ko te etiology o te mate kohi kōrero e te pea te nuinga ki te kia te huaketo iwi ki ngoikore ngā pūnaha ārai mate. kia congenital he ofatiraa taua, engari te nuinga o maha puta i roto i te tukanga o te ora, i raro i te mana o ngā āhuatanga.

I roto i te tamarikitanga kore e hanga e tino pūnaha tiaki, na nui haere te mōrea o te mate i roto i te rahi kōaro ki te tau o te tamaiti. E. i ko i raro ia, te rakau kino atu pea.

I muri i mate, puta te mate i roto i te ara ano e rite ana i roto i ngā pakeke, engari i roto i te puka atu kino. e kore e rerekētanga motuhake faufaa.

e kore te mea he take mo tona whakamutunga TB i roto i te hapūtanga.

Ka taea te kite i te whakawhitinga ki te wāhanga kaha i roto i te huatū tuatahi i muri i te tuku ranei. I te tahi atu mau taime e ono. Ko e tika ana ki te mahi o te pūnaha ārai mate, me ngā rerekētanga hormonal i roto i te tinana tenei.

e kore e kitea tonu mate o te kukune. Fele he reira angamaheni mo nga puka e whai ake nei:

• fibrocavernous;
• nui haamou;
• tohatohaina.

Taua tukumate ngāwari whiti te arai placental, meinga raruraru nui i roto i te kukune.

Kia te tātaritanga tika ko te manawanui i raro i te mana o te rata mātai me kohi.

tīmata Treatment tonu, me ngā hua tīpakohia e whai i te pānga tōraro iti rawa i runga i te tamaiti e parauhia te.

Ki te kitea te mate i roto i te wa, i te waitohunga mo te wahine me te koati-hoa, engari i reira he okotahi. I te tahi taime e tūtohu tonu materoto.

rangahau

I muri i te ahua o nga tohu tuatahi o te tūroro hihira uaua tirotiro i te tākuta, engari i roto i te noa. Muri te kanohi kia huna rohirohi kinokore kohi kore anake, engari ano hoki i ētahi atu mate nanakia.

kia waiho Ahakoa he ino iti o te hauora ki kahore he tohu o mate romahā whakapeka, engari ki te kirika, he take ki te haere ki te tākuta.

Ka kaiwhakatika tirohanga tuatahi e whakarongo ki amuamu katoa, ka tango ki pūkete te etiology o mate kohi, me te hoatu aronga ki te whakamātautau noa (toto me te mimi), me ētahi atu akoranga e tika ana, e taea e te reira:

• Fluorography. 1 tū ia tau mai i te tau o te 15. āhei te reira ki a koe te tautuhi i kohi pūkahukahu, me te tahi atu mate romahā. Kei roto i te rārangi o ngā rangahau whakahauanga mō te mahi, i mua i te haere ki te ope, a na i runga i. N. Ki te he taupatupatu te hua o te x-hihi, mahi te atu X-hihi.
• whakamātautau Mantoux. hape whakapoauau tokomaha te iwi reira ki te uhi. Ko te ahua motuhake o te tātaritanga o te mate kohi tenei. Kei te kawea te reira i roto i ki te tamariki katoa i roto i te tau i te 1 tau ki 14 - 15 tau, i ētahi wā ki runga ki te 17. whakaurua te ngira iti te i raro i te kiri o te taonga - tuberculin. I roto i tona hanganga kei te hua kua ururuatia o rakau pathogenic. ki "He pātene" puta i muri i taua whakapā. Hoki te hua aro mātai whanganga tona diameter.
• anga matou hono immunosorbent (Elisa). āhei te reira ki a koe te whakatau i te aroaro o microorganisms i roto i te toto i te wa o te ako.
• tātari sputum Ziehl-Neelsen. Kawea atu i roto i te tūroro katoa ki te mare auroa. poke sputum te ki te otinga motuhake, e taea ana ki te whakatau i te aroaro o te bacilli pathogenic.
• sowings Bacteriological. taea te reira matau koutou he aha te ahua o te rakau i whakapataritari te mate. tupulaki ruinga e pā ana ki 1-2 marama, engari homai reira hua tika rawa, e āhei ki a koe te whiriwhiri i te therapy whai hua.

Hoki kohi whakapae o te tahi atu whēkau i roto i te tua kawea i roto i:

• X-hihi;
• MRI ranei CT scan o te rohe pānga;
• encephalogram me m. p.

Ko te pathogenesis o mate kohi he tino rite ngā āhuatanga ki maha atu mate, pērā i te mate pukupuku, na e kore e tonu taea ki te whakapae ia tonu.

maimoatanga

Tīpakonga o therapy te nuinga tei runga i te pathogenesis me TB haumanu. Kei te whakamana te reira i raro i te mana o ngā tohunga TB me e he wa roa. I roto i te nuinga o te wā, he reira 2 tau, he iti iti 3-4.

Ko te kōwhiringa o te kaupapa tarukino tei runga i ngā āhuatanga maha. Ko te tikanga, e te tākuta he whakatau taua i runga i te pūtake o:

• huru o te manawanui;
• tau, me te ira tangata;
• hua whakamātautau, me pera i runga i. n.

Ko te whāinga matua o te maimoatanga:

• hanga i te manawanui kore-ma'i pee;
• whakaongaonga i te whakaora o te kopa pakaru;
• whakahokia hauora.

Ka taea te tutuki hua pai ki te awhina o nga raau taero e whai ake nei:

• Para-aminosalicylic waikawa.
• "Streptomycin".
• "Kanamycin".
• "Rifampicin".
• "Ftivazid".
• "Pyrazinamide".
• "Ethionamide".

whakamahia Te nuinga 3, 4, ranei 5 wāhanga wā kotahi.

Kia tino ki te whakamahi i takoto hahau, roanga, me te inenga te takitahi.

I muri tono kaitaua rongoā tukanga kikokiko houtanga he puhoi a kore rawa i rite tika ana, reira, mo te tukanga hanga kiko māori phthisiatricians maha whakaritea maimoatanga pathogenetic. Kei roto i tēnei te whānuitanga katoa o ngā mahi ki te whakatutuki i ngā hua pai. Ko ētahi o ēnei te fariiraa:

• āpiha anti-inflammatory;
• immunomodulators;
• whākōkī;
• huaora B;
• sorbents;
• taero hoki te tiaki me te faaho'iraa mai o te ate (ate);
• waikawa glutamic;
• anticoagulants;
• antikininov;
• steroids anabolic;
• āpiha antiallergic me ētahi atu.

mahi

Nuinga o ngā wā, i te ahua tuatahi o te mate e kore e rapua e maimoatanga hāparapara. I roto i te wā matatau, kahore e kore e taea te mahi i taua tikanga. Ki te pānga ki te pūkahukahu kawea i roto i te:

• Lobectomy.
• Resection.
• Bilobektomiyu.
• Pneumonectomy.
• Kavernoektomiyu.
• Pneumothorax.

Whakaaro i te pathogenesis o te mate kohi extrapulmonary taua hoki e taea te tono pokanga.

A, no te ki te pōauautanga i te wahi gastrointestinal o te mahi ohorere ranei pokanga whakaritea huaketo tango i te mau hopearaa.

Mate kohi CNS tukinotia tikanga te nuinga momo. Ki te kore ratou e te āwhina, puta ki te tango o pāpaka. Ko te tukanga rawa matatini, e taea arahi ki hopearaa tina heke tenei.

taea hoki te whakahaeretia granulomas kiri purulent.

Ko te whakaaro matua o taua mahi - ki te whakakore i te mau hopearaa o te mate, me te whakahoki pea te pūnaha pāngia.

Aha ki te mahi ki te kore e whiwhi

Ahakoa o te pakanga pau ki kohi hauora, he tino noa i roto i te taupori tonu māuiuitanga, kia ka mohio kahore he kino e founga ki te tiaki ia koe me tō whānau:

• Vaccination. Hanga tenei werohanga i ratou matua, engari e kore e whakarerea reira. āhei te reira ki a koutou te whakawhanake i wātea i te mate kaha te tamaiti ki te mate, e riro te kaha tino i muri i te taenga 1 tau. Ka rite ki te hua, e kore ko te tamaiti mate ki te mate kohi, te kawe i te reira i roto i te tikanga ngāwari ranei.
• tirohanga i ia te wā. āhei te reira ki a koe te tautuhi i te mate i roto i ona tīmatanga, ka kawe i te maimoatanga whai hua ki te ārai i te mate o te tokomaha nui o tangata. Kei roto i tēnei te Mantoux whakamātau me te pouaka X-ray.

E whakaaturia ētahi rōpū o tūroro hahau ārai, anga reira:

• He he pūnaha ārai ngoikore mate pūkahukahu ma'i, wahi gastrointestinal, pūnaha io pokapū ranei.
• Noho i roto i te ruma kotahi ki te tangata i pangia,.
• He he huringa i roto i te wahi romahā ki te papamuri o te mamae mate kohi.
• Childhood ki hua rawakore Mantoux whakamātautau.

I tua atu ki wawaotanga hauora, i reira e he maha o ngā tūtohutanga e taea te whakaiti i te mōrea o te whakawhanake i te mate. Ki te mahi i tenei:

• faaohipa wā;
• kai he kai hauora;
• uaua ki te faatītīraa;
• horoi ringa tino i mua i te kai, me te i muri i te haere ki nga wahi tūmatanui;
• whakawhāiti whakapā ki te tangata mate;
• pai wharahanga ruma ma te wahi huaketo te;
• tango wā huaora me taka kei roto fatty hamanga waikawa omega-3.

tohunga-TB katoa, e mohio ana tākuta he ngaro iti i runga i te āhua o ki te whakaiti i te tūpono o te kirimana kohi. Ki te mahi i tenei, me whai koe i parakuihi i te ata, me te karo i te wā roa o te te kai i roto i te ra (tautautefito ki he taimi te hiahia ki te whakamahi i ngā waka tūmatanui). Kei te whakapono te reira e mai te Bacillus kua tata kore whai wāhi ki te tomo i te tinana.

pōauautanga

tohua te pānga kino o te mate kohi i runga i o ratou kanohi, kia whakaroa te haerenga ki te tākuta me te ore tātaritanga. Rere puka taea whakawehi ki te tangata:

• cardiac me kore romahā;
• toto i te whekau pāngia;
• ulceration, fistula;
• waimaero mahi tākihi me te ate;
• whanaketanga o granulomas puta noa i te tinana;
• amyloidosis;
• pneumothorax;
• ino o te nekeneke mahi;
• pāpāngia;
• sepsis;
• kikohangatia;
• necrosis;
• coma;
• mate.

A, no te nga fifi o te waitohunga mate ko tino rawakore.

Mai i te runga ake e taea te faaoti i te reira e whakaoho te mate he momo o tohumate. kia faaite mai te tohu tuatahi o te mate kohi pūkahukahu mare roa, e kore e faaore i te raau taero mucolytic. kia mōhio tenei te manawanui me te whiwhi ki a ia te kite i te tākuta. Ko te utu ki te mahara e whakautu pai te mate ki te maimoatanga me te maimoatanga wā reira, a i roto i te take o te whakawhiti ki te puka matatau o te tūpono tiketike o te whakawhanake pōauautanga, te taniwha ārahi ki te mate fakamamahi.