Extrapulmonary tiibhii: Zvinokonzera, Zviratidzo neMarapirwo

Extrapulmonary tiibhii - izwi iri rose boka kwezvirwere zvabatanidzwa kukanganisa siyana nenhengo dzawo kubva ganda uye mapfupa uye kuzviuraya tsinga uye node nodes. Zvirwere izvi kune ngozi kunyanya nokuti chirwere yapera, kare panguva padariro pakukura yematambudziko.

Chokwadika, vanhu vakawanda vanofarira ruzivo pamusoro zvirwere izvi. Ita extrapulmonary tiibhii kunoitawo kuti vamwe vashingaire? Chero Nhengo hurongwa kunogona kukanganisa utachiona? Ndezvipi zviratidzo zviri pamwe zvakawanda zvive? Mhinduro dzemibvunzo iyi ichava kubatsira vaverengi vazhinji.

Extrapulmonary tiibhii maronda avo zvinokonzera

Extrapulmonary tiibhii - ane zvirwere chokuita kupinda muviri womunhu mycobacteria. Vanogona sei zvakasiyana nenhengo dzawo, kusanganisira marangwanda, ura, dumbu, ganda, maziso, itsvo uye zvichingodaro. D. Maererano Statistical zveBhaibheri, extrapulmonary siyana, somunhu mutemo, muri chesekondari zvirwere uye kukudziridza pamusoro pakanyorwa vachishingaira inoyerera pulmonary tibhii. Zvisinei, nguva nenguva varwere akaonekwa chete extrapulmonary maronda.

Kana isu kutaura pamusoro chirwere womunhu muviri, zviri pamusoro 90% sezvo causative mumiririri anoita Mycobacterium tibhii (tubercle bacillus). Zvikuru kashoma kutanga TB necheseri nhanganyaya rinoita kubereka Mycobacterium bovis - Utachiona, nenzira, kunogonawo kukanganisa vamiririri mombe. Munyika dzinopisa, mumwe nevakawanda tisawirirane pakati nayo utachiona - M.africanum.

Zvinonzi zviri zvikuru nemishonga tusingaoneki. In mvura, vanokwanisa kuramba kukwanisa kugona kurarama mwedzi mishanu. In kufashaira mvura mycobacteria vapone maminitsi 5-45. Ukuwo, kuti TB utachiona vari nehanya chaizvo ultraviolet nemwaranzi.

Unogona kuwana extrapulmonary tiibhii?

Chokwadi, extrapulmonary tibhii, uyewo pulmonary chimiro maperembudzi chinopfuudzwa kubva munhu anorwara kuti utano. The causative mumiririri ukasunungurwa kupinda kwezvakatipoteredza pamwe madzihwa panguva vangakosora, sneezing, uye zvichingodaro. D. Saka, muna boka ane ngozi ndivo vanhu vanogara uye dyidzana pamwe TB nevarwere.

Asi zvinhu hazvisi nyore. vanhu vazhinji, kunyange pashure anopfuura rimwe gumi wokurarama pasi chete pedenga sezvo murwere haisi kutapukirwa. Uyezve, utachiona hazvirevi chirwere. Zvinofungidzirwa kuti vanenge chetatu vepasi - vatakuri Koch bacillus. Zvisinei, havasi vose vari chaizvoizvo kutambura tibhii.

chirwere vatakuri havasi chinotapukira uye anogona kurarama pasina kuziva pamberi chirwere. Kunyange zvakadaro, pane mukana kuva chirwere. Activation kuti mycobacteria kunoitika tikafunga yakasimba kuderera kutapata, saka, zvinhu pangozi zvinosanganisira mazhinji chirwere, chisingaperi anogumbura zvirwere kuti kungoita deplete muviri, uyewo kazhinji mupfungwa, mumuviri kushushikana, hormone zvirwere, kushaya zvokudya zvinovaka muviri, muchidimbu, zvose zvinogona kukanganisa kushanda masoja maitiro.

Kupatsanura uye chimiro chirwere

Kune akawanda kupatsanura enyika kuti pathologies izvi. Somuenzaniso, mashoko Zvinonyanyozivikanwa zvinotevera siyana extrapulmonary tiibhii:

• dzomunharaunda - imwe nzvimbo yaiva imwe njodzi nhengo (kana chidimbu kana toreva Somuenzaniso, kuti muzongoza);
• Zvakajairika - mune mumwe chete nhengo dziri foci akawanda;
• akawanda maronda - kutaura nezvake ari chiitiko kuti tibhii kunokanganisa wandei nhengo imwe chete ino;
• chirwere "sochetannyj tiibhii" anoiswa panyaya, kana pane kurasikirwa miviri anoverengeka dzakasiyana hurongwa (saka, wemishonga "pulmonary / extrapulmonary tiibhii" Zvinogoneka).

Panguva nechirwere, uye teererai dhigirii basa chirwere:

• kushingaira chimiro chirwere (mberi, relapsing, kure zvakare);
• vakaneta extrapulmonary tibhii (murefu kuchinja dzakananga nhengo akachengetedzwa maitiro tibhii, kuvapo foci duku abscesses kana scarring, asi rabhoritari nemiedzo inoratidza haana kuchinja).

Nokuti nechirwere acho inokosha uye kuvapo yematambudziko. Vanogona kugoveranwa (semuenzaniso, immunodeficiency chesekondari, chepfu uye sema nehosha zvomukati, amyloidosis, systemic pathologies tsika) uye nemakanzuru (nechokuita zvakananga njodzi nhengo kana maitiro).

Tiibhii mapfupa uye mapfundo

Extrapulmonary tiibhii mapfupa uye mapfundo - a hwakanyatsorwisa zvakajairika chirwere kuti pamwe maronda dzakasiyana-siyana zvetsandanyama nemapfupa hurongwa. Tikafunga nezvebasa pathogenic tupukanana tusingaoneki, paumbwe zvakananga granulomas, uyewo mberi kuparadzwa pfupa rinenge izvo anongonzwa rinobatanidza kwete dzichipfekeka kuchinja chete anatomical asiwo marangwanda.

Maererano nenhamba, ruzhinji varwere nechirwere ichi - vakwegura. Inenge 60% nyaya hosha rinokanganisa nomuzongoza, zvichitungamirira kuremara. Zvifambiso, spondylitis uye coxitis - ichi ndicho kutyorwa, icho pamwe extrapulmonary tibhii. Zviratidzo zvakaoma kuitika mukutanga nzendo chirwere.

Dzimwe nguva, varwere yakashuma kurwadziwa njodzi chikamu zvetsandanyama nemapfupa hurongwa. Kana chirwere hwapedyo yemajoini mhando, zvinogona kucherechedzwa kusanzwa, kuzvimba mu majoini duku, dzisina kufamba. Kana totaura musana lesion, kuwedzera granuloma kazhinji anorumanya etsinga midzi, iyo pamwe dzakasiyana-siyana chetsinga zvirwere.

Zviratidzo zvingasanganisira zvishoma nezvishoma kuchinja mamiriro. Tsandanyama vanotanga kurasikirwa matauriro avo, nokuti munhu akaoma kutama.

Zvinosuruvarisa vanhu kuenda chiremba akazotevera matanho, kana zviri vatovapo yematambudziko extrapulmonary tiibhii zvakadai, sezvo abscesses, nemishonga skeletal deformities, fistulas. Chirwere chirwere chinogona chokuita nevamwe dambudziko, nokuti chiremba mufananidzo uri Blurred chaizvo. Kazhinji, kunyange pashure zvakarurama aipedza kurapwa mapfupa deformities zviripo.

Kukuvara tsinga

Extrapulmonary tiibhii of meninges anonzi wakakura zvikuru chimiro chirwere. Kurwara hwapedyo nokukurumidza uye pasina kurapwa kunotungamirira kusingarapiki kwazvinoita tsinga, uye pano neapo rufu. Zvisinei, kuti zuva, nyaya yacho chirwere zvinonyorwa Kazhinji.

Panguva iyoyo, anowanzodanwa chirwere chakafanana extrapulmonary tiibhii vana. Zvinoderedza chirwere chokuita muhombe kuwanda akatakura BCG kubaya mu vacheche. Dzidziso aya anotsigirwa chokwadi kuti zuva, tuberculous yomumuzongoza kuitika pakati pavana pasina kubaya.

Short-rokuti nomusoro, zvishoma nefivha, simba uye zvakawanda zvive - saka extrapulmonary tiibhii kunotanga. Zviratidzo kuonekwa sezvo kukura yomumuzongoza. Headache rinowanika kakawanda uye huchawedzera zvikuru. tembiricha muviri achisimuka 39-40 inegumi. Inosimudzira excitability, anovandudza aikanganiswa nechiedza. A maitiro chinhu ndiko kwaita neanorexia uye nokukurumidza uremu. Kana untreated, rufu murwere anouya 3-5 vhiki, iyo chokuita kuoma kufema kana vasomotor centre wouropi.

abdominal tiibhii

Zvinokosha kucherechedza kuti abdominal maronda hadziwanzowaniki uye pamusana 2-3 chete% vose nyaya extrapulmonary tibhii. Kazhinji, wokutanga pathological muitiro kunobatanidza node nodes uye mesenteric zabryushinnoogo nzvimbo uye chete ipapo tubercular maronda kungapfuurira kune abdominal zvomukati.

Zvinonzi dzimwe nguva chirwere anogona mberi yegurokuro. Muzviitiko zvakadaro pane zvishoma nezvishoma esophageal ulceration madziro chubhu, iyo taper kusvikira zvizere stenosis. About mumuitiro iri kuchengetwa maronda mudumbu - iri pyloric nharaunda uye mukuru curvature yokuumba diki, asi vakawanda unpainful maronda.

intestinal kukuvara kunogona zvakaitika chinokosha zvikuru okuwedzera. Dzimwe nguva tiibhii kunokwanisa kuonekwa, uye duku ura pavarwere. Zvinosuruvarisa kuti kuziva extrapulmonary tiibhii muchiitiko ichi chinhu chakaoma muitiro. Zviratidzo zviri chirwere vari kunyanya kutaurwa, uye kurapwa mufananidzo kazhinji afanane chisingaperi enteritis, appendicitis nezvimwe zvirwere zvomudumbu hurongwa.

Ngozi siyana tibhii rinoreva mesadenitis. Ane chirwere akadaro kunokukanganisa ari nhengo dzinobudisa midziyo yose peritoneum, asi muitiro mberi zvishoma dumbu uye ovaries. Fibrosing kuzvimba dzokubereka nadzo inova chinokonzera kushaya mbereko vakadzi.

TB ganda maronda

Koch kwakaita bacillus rinowanzoshandiswa vemunyika kuti ganda uye subcutaneous munyama, zvichikonzera siyana zvirwere.

• Tuberculous chancre - iri nekuumbanidzwa inotungamirwa mukati iyo kuitika purulent pezvakaitwa. Kazhinji, zvivako akadaro yakaumbwa muna node raiva pedyo nebundu. Maronda kazhinji azaruka, achikusiyirai fistula.
• Lupus - chirwere kunoratidzwa chitarisiko chaiyo mapundu pamusoro ganda. Kwemakomo vari gobvu nokusunungura mapfundo, izvo zvishoma nezvishoma Kubatanidza pamwechete kuumba gobvu, flat nda. goko Its rinowanzoshandiswa yakafukidzwa nemaronda kana fistulas.
• Kollikvativny lupus - chirwere, iyo inozivikanwa nokuva paumbwe duku gobvu ganda raiva pedyo nebundu diameters ose 1-3 masendimita iyi nyarara kuzvimba, yakaratidza akawanda fistulas ..
• Warty chimiro tibhii ganda pamwe chitarisiko ganda zvisimbiso, iro yakaita papilloma. Kunyange zvakadaro, pane misiyano. Kunyanya, paumbwe kumativi nomukombero pane anogumbura uye ganda munzvimbo iyi kunova cyanotic Hue. Izvi anowanzodanwa chirwere chimiro chirwere pavarwere pamwe yakazaruka chimiro pulmonary tibhii, nokuti ganda panguva vangakosora nguva dzose anowana phlegm. Boka pangozi zvinosanganisira vanachiremba uchishanda TB nevarwere, uyewo Veterinarians.
• Miliary tiibhii achabatsirwa chitarisiko duku papular mapundu vaaleanpunainen. Kazhinji vari vemunyika akapoteredza orifices, kunyange zvazvo zvichiita vakaparadzira kune dzimwe ganda nzvimbo. Sezvo chirwere mberi akaumba papules urikanwi duku pakati, iyo zvino yakafukidzwa goko. Untreated ulcerations zvikamu kuva foci ose necrosis.

Zvisinei wechinhu cutaneous tiibhii inozivikanwa usimbe pamusoro pasina chinokosha kuzvimba kana soreness. Nguva ruregerero yakatsiva exacerbations, izvo kazhinji unowira pamusoro chitubu uye kwematsutso.

urogenital tiibhii

Kana totaura chirwere ichi sezvo extrapulmonary tibhii, anenge 37% nyaya utachiona kunokanganisa nhengo yacho excretory hurongwa. Maererano nenhamba, varume, uye utachiona anopararira kusvika dzokubereka nadzo, apo pakati vakadzi nyaya dzakadaro vashoma zvikuru.

Most vanowanzotambura kubva cheitsvo. The kunotoda ronozwi damerau chaizvo. Zviratidzo zvokutanga uye haana kuonekwa. With kukura chirwere kuonekwe zvishoma, vachirwadziwa kurwadziwa rezasi musana. Kakawanda ini rokuongorora renal tiibhii tsaona, panguva zvakakwana weti bvunzo, Detective mycoplasma mu ivhu.

Kana murwere asina zvakafanira kurapwa, pane mukana fibrosis uye hydronephrosis.

Muzviitiko apo utachiona anopararira kusvika nhengo dzokubereka nadzo nevanhu kunonyanya kunokanganisa kweprostate gland. Uyezve kuva nemamwe matambudziko akadai chirwere ari manhu, asi vas deferens uye spermatic tambo.

Tiibhii kuti node nodes

The inonyanya chimiro ndicho extracellular tibhii, izvo kunokanganisa peripheral node nodes. Maererano nenhamba, nezvokuvandudzika zvinokuhwandira akapoteredza 50% kwose chirwere extracellular kwemarudzi. Uyezve, sezvo mutemo kuti unobatanidzwa kuchikuvadza mapapu nedzimwe nhengo pechipfuva.

In mushonga ano, zviitiko vomunharaunda tuberculous lymphadenitis chakanyorwa kakawanda. Chirwere chinobata mumwe chete boka node nodes, uye kazhinji kutambura remuromo uye submandibular. Zvishoma kacho, utachiona kupinda munharaunda yacho inguinal uye axillary node nodes. Uyezve, zvinoita generalized chimiro chirwere umo sei mapoka mamwe matatu node nodes panguva imwe chete.

Zviratidzo extrapulmonary tiibhii munyika iyi haisi zvakare haana. In kwokutanga nzendo nokuwedzera node nodes. Vane kwakavharwa nenyama, manyoro ari kubata, kuchinja uye pakutanga nyarara. Change saizi wavo ane chokuita chikosoro kana zvirwere repamusoro kufema turakiti.

A maitiro chinhu chiri tuberculous lymphadenitis fomu iri kubatanidzwa mune chirwere kwacho yakapoteredza zvinyoronyoro munyama, uyewo chirwere - uye dzakapoteredza node nodes. Saka vakaumba kumbonyanya guru kuzvimba. Mune ramangwana, pakati bundu rinowanika kunyoroveswa nzvimbo. Panguva iyi pamusoro sei ganda riri wakawondereiko kudai mazuva ose pamakona, dzimwe nguva yava tsvuku kana rinokwanisa kucheneruka tint.

Kana untreated, pane atsamwira kuti munyama, zvichiguma fistula kuburikidza iyo zvinobuda zviri cheesy kusachinja-chinja. Jira azere namaronda, ropa zvinobvira. The fistula anogona coalesce, uye pamusoro wayo pechiso mafungu mavanga aumba. Zvinosuruvarisa zvinyama kuporesa hahugari refu - a dzokororo, umo fistula kuzarurwa zvakare.

Mune zvimwe zviitiko, rimwe zvavo pamusoro pathological muitiro kunokanganisa mamwe mapoka node nodes. Izvi zvinokonzerwa ngozi kunokonzerwa extrapulmonary tibhii. Chirwere iri kuitwa iyi nokuda biopsy pamwe unozotevera rabhoritari bvunzo ivhu yapihwa.

How rokuongorora extrapulmonary tiibhii?

Sezvaunogona kuona, pane zviratidzo zvizhinji uye matambudziko, izvo zvinoita kuti pave extrapulmonary tibhii. Chirwere zvirwere izvi zvinosuwisa, pasi zvimwe zvinetso, sezvo kuona chiremba mufananidzo uri kure mune chimwe nechimwe. Uyezve, vakawanda varwere vari panoonekwa atova yepamusoro zvokukura tibhii.

Sezvingatarisirwa, nokuti vasabatwa chirwere zvakafanira kuitisa tsvakurudzo. Izvi anonyanya Mantoux bvunzo pamwe zvakasiyana mishonga kuti tuberculin. bvunzo Izvi zvinobatsira kuziva kana murwere ndorwevaya boka panjodzi. Uyezve, danho rinokosha chirwere ndiye radiography uye fluoroscopy sezvo extrapulmonary chirwere kazhinji kuva pamusoro pulmonary tibhii. Kunyange duku, residual pulmonary lesion anogona kusimbisa kuvapo chirwere ari murwere avo kana dzimwe nhengo.

Mune ramangwana, mamwe zveBhaibheri zvinoitiswa uye, zvikurukuru, Ultrasound, rinobva resonance uye kombiyuta tomography, biopsy uye rabhoritari pakuongorora nzvimbo dzomuviri kuvapo Mycobacterium tibhii.

Mabatirwo extrapulmonary tiibhii yayo peculiarities

Chokwadi, ichi ndicho chirwere ngozi, asi nekuda pakutanga zvido varwere nokuvapo inobudirira kuchirapa dzokuvhiya. Mabatirwo extrapulmonary tiibhii - refu uye kunzwisisa, uye chikuru ayo nzendo uwirirane zano yokurapa nokuda pulmonary siyana chirwere.

Zvinosuruvarisa inorwisa mabhakitiriya kurapa kazhinji anoshanda. Chokwadi chokuti mycobacteria nokukurumidza kusaurayiwa zvinenge nemarudzi ose inorwisa mabhakitiriya, saka zvinodhaka izvi zvinowanzoratidzwa kushandiswa upiyona hwebetsero.

Zvinonzi kuonekwa inonyatsobudirira mishonga. Nhasi, kune zvirongwa kurapwa kwakadaro anoverengeka. Kakawanda izvozvo ichiitwa Yaunoti quadruple kurapa zvinosanganisira kushandiswa rifampicin, streptomycin, isoniazid uye pyrazinamide. Vamwe private makiriniki vari kushandisa yakawanda mberi pyatikomponentuyu zano, achiwedzera kuti ndandanda zvinodhaka, zvimwe zvinodhaka zviri chizvarwa chitsva. Zvakanaka akasarudzwa mubatanidzwa kunobatsira kuparadza utachiona kubva tibhii, asi zvinosuwisa, mishonga hazvirevi kuguma ikoko.

Nekuti mishonga tibhii kwakakanganisa kunokanganisa muviri, pane hepatoprotectors siyana, uyewo zvinodhaka, kuwedzera muitiro dzichibvisa tsvina kubva muviri (zvinoreva dzine acetylcysteine, reosorbilakt). Uyezve, chikamu chinokosha yokurapa ndiyo yaitonga immunostimulants, kusanganisira glutoksim, xymedon, galavit.

Dzimwe nguva, marapirwo zvaiitwa zvinosanganisira mavhitaminzi kuti boka A kuitira kudzivirira kukura peripheral neuropathies. Mune zvimwe zviitiko, kuvhiya kunokosha. Kunyanya, kuvhiyiwa iri nezvaro kana granuloma inotungamirwa ari nomuzongoza, sezvo iyi ndiyo chete nzira kudzivisa zvakakomba kuvadza etsinga nemidzi uye musana.

Kunyange pashure vose mishonga matanho mitemo inofanira kutungamirira murwere. An chinokosha pavaipfuura kuzoita muviri ndiwo mararamiro utano uye kudya kwakakodzera. Zvokudya zvinofanira kusanganisira zvokudya, uyewo yose zvakaoma mavhitamini uye zvicherwa. Zvakakosha kudzorera chakaipa muviri uremu. Uye TB (pulmonary uye extrapulmonary) tichisunga nguva dzose pachipatara pacho kurapwa.