Inegciwane isifo sephepha: zingaphi ubomi, njengoko ingxelo? Yintoni i-TB?

Isifo sephepha - an sifo singanyangekiyo echaphazela abantu abadala kuphela, kodwa abantwana. Ukuba kubangela umsebenzi isifo mycobacteria (eletha Goch kaThixo) emzimbeni womntu. Xa unyango ezimbi izicelo chemotherapy multicomponent, elinokuthatha ukuya kwiinyanga ezintandathu okanye ngaphezulu. Ngowe-50% amatyala, yokunqongophala konyango, esi sifo kuphelela ekufeni. Yintoni inegciwane tubercle ka Goch, kuba njani na umzimba womntu nendlela ukuthintela ukunwenwa kwesifo - le mibuzo iza kwenza kweli nqaku.

Ingcamango mycobacteria

Isifo sephepha - sisifo esosulelayo esibangelwa ngamaqela Mycobacterium zezi tuberculosis Mycobacterium (MBT). Olu hlobo iintsholongwane idla ngokuba inegciwane tubercle - ngalo igama sisazinzulu waseJamani Roberta Koha. Science uyazazi 74 entlobo mycobacteria ezifumaneka lomhlaba, amanzi, izilwanyana kunye nabantu. Ndimele nditsho ukuthi iintlobo sephepha okubangelwa iintlobo ezahlukeneyo mycobacteria kwahluka enye kwenye.

Tubercle eletha has esingxotyeni salo ekhethekileyo yokhuselo, nto leyo inceda ntsholongwane ukuba baphile kokusingqongileyo. MTB yi ngqo okanye imilo ukugoba kancinane, esisigxina, yenza akukho imbewu okanye njengezingxobo, ngokucotha kakhulu Ukhuthaza i lahlule iyevakala kwizisele ezimbini, umjikelo ukwahlulwa iiyure 14-18. Njengomgaqo, ukuvelisa kwenzeka ngeendlela ezimbini - ngokuthi amagqabi, ngaphantsi eyayizalwa.

Mycobacterium zobukhulu kudume: ubukhulu uyahluka 0.2-0.6 m, ubude - 1-10 microns. Tubercle eletha fanele ukuba fungi ngenxa yokufana kwawo kuboniswe kule mpilo efanayo. MTB koloni kancinci (kwiintsuku 34-55) akhule phezu medium, kuba nodonga rough, wavuma ulwehlo - pink-orenji okanye iMilky.

Ubume weeseli MTB

iiseli esihlobene tubercle eletha kuba nezi zinto zilandelayo:

• iseli eludongeni - benziwa ngeengcamba eziliqela, Mycobacterium ngokukhuselwa ekuhlaselweni ngoomatshini kunye kwemichiza; Inika ubungakanani rhoqo kunye nohlobo lwe iiseli (ngasendleleni, kukho inxalenye ukuqulatha iqulathe angwevu, anencindi, okunamafutha iziyobisi);
• kukho icytoplasm iintsholongwane kunye inclusions granular;
• ndizayo cytoplasmic;
• into enyukliya, ngaphakathi apho DNA setyhula.

MBT ayinyangeki kakhulu kwiimpembelelo zokusingqongileyo kwaye igcina elide nokubanakho. Zingaphi ubomi tubercle eletha? Mycobacteria zinakho ukuba khona: ukuya kutsho kwiminyaka 7 kwindawo emanzi kunye mnyama obushushu-23 ° C; ukuya kutsho kwiinyanga ezili-12 kwindawo emnyama owomileyo; ukuya kutsho kwiinyanga ezi-6 emhlabeni; ukuya kwiinyanga ezi-5 emanzini; ukuya kwiinyanga ezi-3 kwiincwadi; ukuya kwiinyanga ezi-2 eluthulini esitalatweni; ukuya kwiiveki 2 ubisi samasi; ukuya kunyaka-oyile kunye netshizi. are Mycobacterium tuberculosis Musani ukuboyika iinkqubo yokubola kwiinyanga ezimbalwa sinokubakho wangcwatyelwa kumaqumrhu emhlabeni. Noko ke, imitha yelanga atshabalalise ILO kunye iiyure enesiqingatha, lo yelanga eyingozi - kwimizuzu embalwa. disinfectors ikhlorini ukumelana eletha iiyure ezi-5. Mycobacteria kwakhona iso hydrogen peroxide. Abafa tubercle eletha ngokutshisa: imizuzu engama-20 kwi-60 ° C ne imizuzu emi-5 - 70 ° C.

MBT kunokubangela izifo emva kweminyaka emibini ukuya kwemithathu ubukho kunye nazimpawu ixesha elide emzimbeni ukuqalisa umzimba anti-TB.

Yintoni i-TB?

Njengoko sibonile ngaphambili, isifo sephepha - sisifo esosulelayo esibangelwa umsebenzi Mycobacterium. Uninzi sifo ngamathana kumntu onesifo kumfowunelwa esempilweni (ukukhohlela, uthimla, ingxoxo). Ngamanye amaxesha usulelo kunokuba uhlobo ukutya (milk ekrwada).

Emngciphekweni - abantu abahlala kwiindawo neemeko zococeko ezingafanelekanga - ezintolongweni, amakhaya abantu abangenamakhaya. Oku kuquka izigulane kunye neenkqubo buthathaka omzimba (abantu abane-HIV, izigulane ezinomhlaza). seswekile; iintsana; abantu abadala; amalungu entsapho abaphethwe tuberculosis; oqalayo; Abantu abadli - ezi ndidi zabantu abaninzi badla ehlasela inegciwane tubercle. indlela amandla ifuna inani olusisinyanzelo iivithamini kunye neeminerali ukunceda ukubuyisela umsebenzi wokugonyeka lifinyele.

Iziganeko sephepha sibangelwa ngeempawu ngamanye ephilayo, ngokunjalo ezinxulumene ne ngqo nezengqondo yomntu. Ngokutsho isiqinisekiso yobudala ilawulwa liqela labantu abaneminyaka 18-26 ubudala.

Le peculiarity kwesi sifo kukuba inegciwane TB kuya ngokukhawuleza emithini, ngoko indlela unyango lubandakanya ukusetyenziswa kweziyobisi ezininzi ngexesha elinye.

Ngokutsho manani WHO, isinye kwisithathu sabemi behlabathi abanentsholongwane inegciwane tubercle, kodwa umzimba usempilweni akuthethi ukuba i-Ofisi ukuba phinda. Le ngezifo kwenzeka emzimbeni womntu kuphela phantsi kweemeko ezifanelekileyo kule - kwehlisa nezifo. ngonyaka ngamnye ukususela iingxaki sephepha, ubulala malunga nezigidi ezithathu abantu ehlabathini. World Day TB ibanjwa Matshi 24.

transmission TB indlela

Kukho iindlela ezine eziphambili isifo sephepha esi sinwenwa intonga:

• emoyeni xa mycobacteria ufake umoya kunye amachaphaza xa ukhohlela, uthimla nomonde;
• alimentary - HIV kwenzeka xa iphecana zesisu;
• contact - HIV kwenzeka ngokusebenzisa amehlo conjunctiva (usulelo lwe isikhumba a amila);
• Esibelekweni - abosulelwe yi beendawo enesifo ngethuba lokubeleka ukusuka kumama ukuya emntwaneni.

Xa inkqubo yokuphefumla umzimba usempilweni ikhuselwe nxamnye kwii-mycobacteria yencindi, nto leyo ekhutshwa iiseli ezikhethekileyo. Nangona kunjalo, kunye ukudumba isixokelelwano sokuphefumla, ngokunjalo phantsi kweempembelelo ityhefu "yokhuseleko 'ayisebenzi. Amathuba osulelo yi-alimentary ixhomekeke nemeko eludongeni isisu, umthamo wayo ukufunxeka.

Ekubeni tubercle eletha ibekwe ngaphandle iseli Awandise kancinane zomzimba ixesha elithile kugcina ubume okunempilo, Noko ke, Mycobacterium ixesha bangene ukuhamba nkovu ezalathelwe nkovu kunye wonke umzimba. Eyona ezithandwa kakhulu mycobacteria imizimba kunye microvasculature eziphuhlileyo (umphunga, neuron sezintso, amasebe tubes). Kamsinya nje Ofisi ukungena iiseli ngaphakathi, baqalise ukonakalisa ubume bawo kwaye wabelane.

zokugula nokwakheka

Xa amalungu usulelo abachaphazelekayo kwenzeka ukudumba "iqhosha lokulayita" nto leyo ekhokelela kuseko granulomas Ukuba kwisininzi - hillocks ezizisulu ngokuhla ngokomgangatho. Indlela umzimba siboniswa kwiiveki ezimbalwa emva kokosuleleka. okukwazi yeselula ukhandwa emva kweenyanga ezimbini. Isigaba esilandelayo yophuhliso inkqubo zophendlo lwezifo luphawulwa Ofisi ukukhula kade, impendulo yokukrala ilahlekile, nangona kunjalo, i-arhente causative ukujoliswa yokukrala akukho lupheliswe ngokupheleleyo.

Tubercle eletha emzimbeni zigcinwe ixesha elide, kwaye umntu abe yenethiwekhi ubomi ILO. Ngenxa buthathaka umzimba eseleyo kwabemi Ofisi iza ngenkuthalo, ebangela kancane sephepha. Umngcipheko wokuhlaselwa sisifo ngumntu wokuqala osulelekileyo yi-10% kule minyaka yokuqala emibini emva kokosuleleka. Ngokuhamba kwexesha ziya ukunciphisa amathuba okuba sifo.

Xa okukwazi elibuthathaka ngayo ephilayo akanako ukumelana nokuba andise iintsholongwane iiseli eyenzeka ngokucacileyo. Ngokuba ukuphila kwakheka MTB indawo ekhethekileyo kakuhle apho granulomas ekwanti ziyadityaniswa zibe ngumqulu eqhelekileyo, oko bathi usuleleko lokuqala ingeniso kwisigaba lwesifo sephepha onyango. Ukudumba ingahlakazeki ngakumbi kuyo yonke inkqubo esebenza.

Forms kunye neentlobo nesifo

Emva nezifo ngezifo uba ifomu afihlakeleyo, okt. E. abaninzi badla nazimpawu. Kuphela mnye amatyala ezilishumi, ingena lusanda esebenzayo. Coli TB ikakhulu kuchaphazela emiphungeni kodwa zingachaphazela ezinye iinkqubo zomzimba.

Ukwahlula iintlobo ezimbini TB:

• evulekileyo,
• ivaliwe.

Xa ubukho uhlobo evulekileyo inegciwane tubercle lulula labonwa isikhohlela okanye kwezinye netuwa nomonde (umchamo, endleni). Ukungaphumeleli ukuba bagcine amanyathelo ucoceko kule fomu kungakhokelela kusuleleko abanye. Xa uhlobo okuvala mycobacteria hayi elibhaqiweyo, kwaye izigulane musa isongela kwabanye.

Kuxhomekeka kuhlobo inkqubo esebenza ubethwa inegciwane tubercle, ngonobangela wokufa zahlulwa ngolu hlobo lulandelayo:

• tuberculosis pulmonary,
• tuberculosis extrapulmonary.

Kuxhomekeka kwindlela leengxaki isasazeke emzimbeni, ahluka:

• tuberculosis ebhekiswe,
• tuberculosis nezisasaziweyo,
• tuberculosis focal,
• inyumoniya caseous,
• tubercles
• fibro-cavernous isifo sephepha,
• tuberculosis cirrhotic,
• pleural isifo sephepha, kwingqula okanye noqhoqhoqho - isenzeko kakhulu ezinqabileyo.

tuberculosis Extrapulmonary kuchaphazela naliphi na iqumrhu, apho ngezifo ihlelwa:

• nesifo sephepha CNS kunye meninges - esi sifo sichaphazela umnqonqo nobuchopho, iqokobhe nzima;
• inkqubo yokucola ukutya, apho ngokuqhelekileyo echaphazela ezingcakacileyo kunye caecum;
• Isifo sephepha kwisigaba enzala luchaphazela izintso, womchamo, amalungu okuzala;
• izakhiwo bone;
• lupus;
• emehlweni Tuberculosis.

Wabonakala kwezonyango sifo. tuberculosis yenkqubo luvo

Njengokuba nditshilo ngaphambili, ngenxa yokuba inegciwane tubercle iyahlula ngokucothayo kakhulu, abayifumanayo kwi ixesha kangangoko kunokwenzeka. Ngoko ngezifo nga elide ukuzibonakalisa, yaye kamva yafunyanwa ngama ezengozi ngexesha iimvavanyo fluoroscopy okanye tuberculin. Ukongeza, iimpawu ezithile zesi sifo, enyanisweni, ayikho. Into yokuba umzimba ukunxila, ukuze abonise pallor, ukudinwa esinganyangekiyo, okanye ukozela, ukungakhathali, ukunyuka kancinane lobushushu emzimbeni (malunga 37 ° C), ukubila ukwanda, ukwehla kobunzima, wawandisa ezalathelwe nkovu.

Uhlalutyo Laboratory legazi kwezigulane sephepha ibhaqa imibala intsimbi, ukuncitshiswa kwenani iiseli ezimhlophe zegazi. Kamva, xa esi sifo singena kwisigaba esebenzayo ngakumbi, ukuba ujoyine mpawu zingasentla iimpawu ecacileyo ngezifo welungu achaphazelekayo.

Ukuba Mycobacterium kuchaphazela inkqubo luvo, isigulana emsebenzini, ukongeza lobushushu eliphezulu, indawo yokulala, ndlongo, iintloko ezibuhlungu kakhulu, ukugabha. Ekupheleni kweveki yesibini ekuqaleni Iimpawu zokuqala utshintsho kwenzeka ebuchotsheni nezakhiwo inwebu, obubonakala ngokuba yincwadi evuliweyo ukuqina izihlunu entanyeni kunye nokungakwazi cinezela isilevu yakho esifubeni sakho, Yolule imilenze yakho kangangoko kunokwenzeka. Le seswekile zone umngcipheko okanye abathwali immunodeficiency virus. Kuyinto ukwenzeka akuqhelekanga ngasemva kule ngezifo ukuphazamiseka kwengqondo kwakunye ezingqondweni kakuhle, novakalelo, nentshukumo amehlo.

Ngokungafaniyo izifo umntu omdala yabantu tubercle eletha ebantwaneni ebangela kungenjalo isifo okukhawulezayo kwaye kakhulu ngakumbi, maxa wambi leyo ekufeni. Oku bugwetyelwe inkqubo yomntwana ikakhulu ngokwaneleyo yokuzikhusela. Baboniswa kule isifo ngaphezu abantwana neemeko indle, ukungondleki kakuhle, rhoqo eyayisebenza. Tubercle eletha kubantwana ebangela iimpawu ezithile umzimba wakhe, ngoko abazali kufuneka ukuba bafunxe ingqalelo ukugabha, ukudinwa umntwana, kwanciphisa ingqalelo, ukungabi namdla, ukwehla kobunzima, nomkhuhlane.

Isifo sephepha ezinye iinkqubo ezisebenzayo

Ukongeza iiseli wemiphunga central system ngezifo luvo ihlasela ezinye ngokwamalungu omzimba womntu, ezifana isixokelelwano sokuphefumla. Ngoko ke, unepleurisy tuberculous - ekubulaleni inwebu pleura esogqume emiphungeni. Le ngezifo isenokuba isifo ezimeleyo, okanye zenzeka ngenxa yokuba inkqubo sisifo sephepha ezintsonkothileyo miphungeni. Enye ingxaki lwesifo sephepha yemiphunga kunokuba isifo iphecana eliphezulu zemiphunga, apho kwinkqubo yokukrala ibandakanya pharynx kunye kwingqula. Iimpawu isifo esinjalo ukongeza ngentla zezi hoarseness okanye ubunzima ligwinya.

Ekubulaleni inegciwane tubercle kuthiwa nkovu node tuberculosis lymphadenitis. Amaninzi phantsi ukuhlasela iindawo nkovu supraclavicular okanye wesibeleko ukuba ziphangalalisiwe kodwa elula.

MTB nayo kuchaphazela amalungu kwinkqubo enzala. Isifo kuboniswa iintlungu elibukhali kwi esinqeni okanye umva, lobushushu emzimbeni eliphezulu. Xa echama na amabala okunokwenzeka. Le leengxaki kwenzeka ngezixa obulinganayo kuzo zombini abasetyhini kunye namadoda.

Isifo sephepha kwethambo inyama lalidume kwizaphuko rhoqo, iintlungu eziqatha kummandla ochaphazelekayo, ukungakwazi ukuhamba ngokuqhelekileyo. Iifomu Running loo ngezifo rhoqo kukhokelela ekufeni.

Isifo kwaye afumane unyango

Xa isifo sephepha esebenzayo zezona ndlela uthandwayo isikhohlela smear microscopy kunye X-ray. Uhlahlelo smear, Noko ke, aziyi kuqwalaselwa indlela ziyasebenza kwaye zithembekile, ukususela nisaqala sifo, kwakunye kwiimeko yokugula kubantwana isifundo unika isiphumo esibi.

X-reyi iindlela zokuxilonga zisebenza ikakhulu izifo phambili. Ukongeza kwezi iindlela zokuxilonga adla ngokusetyenziswa isikhumba uvavanyo tuberculin, ekuthiwa ukubizwa awasabela Mantoux eqhelekileyo.

Eyona njongo iphambili ekukhetheni unyango yaloo mmandla isigulana ukufunda bangancedwa ngamachiza, okt. E. Uvakalelo inkcubeko mycobacteria likhule elebhu, ukuba amalungiselelo medicamentous.

Namhlanje, indlela engundoqo unyango lwesifo sephepha obuxhasa unyango lwe-TB, nto leyo a multicomponent. Ukwahlula izithathu, koqeqesho irejimeni yonyango quinary.

Umzobo izithathu ithatha ukusetyenziswa kweziyobisi ezisisiseko abathathu - "streptomycin" "INH" kunye para-aminosalicylic acid (PAS). Esi sikimu classic, Noko ke, kunqabile kusetyenziswa namhlanje ngenxa ubuthi ophezulu PAS. Inkqubo esetyenzisiweyo chetyrohkomponentnoy "rifampicin" ( "Rifabutin") "INH" "Pyrazinamide" "Ethambutol". Amaziko zonyango abaninzi basebenzisa ubuchule nakakhulu - ezintlanu-yesikimu, ukongeza kungentla amachiza amane ezisebenzisa "ciprofloxacin".

Ndimele ndithi ukuba isifo sephepha - an sifo singanyangekiyo, apho uphuhliso inegciwane tubercle ibangela emzimbeni womntu. Unyango kufuneka ngoko nangoko kwaye zichanekile, ngokuba kungekho ekufeni unyango lwezifo akugqiba-50% amatyala. isiphumo esibi lwenzeka emva kwiminyaka embalwa ukususela ekuqaleni kwesigaba esebenzayo zesi sifo. I-50% eseleyo yamatyala kungabangela uhlobo ezingapheliyo kwesi sifo. Ngaphezu koko, umguli, othe wavakalisa isifo esinganyangekiyo kuyingozi kwabanye, njengokuba iimbalasane mycobacteria kokusingqongileyo.

ukuvimbela

amanyathelo othintelo nxamnye sephepha namhlanje ekunokuthiwa, mhlawumbi, lugonyo lwe-BCG elikhusela ngempumelelo omnye yeentlobo ingozi sephepha - tuberculous meningitis. Ngokutsho kwe National Ugonyo kwiShedyuli, zagonyelwa umntwana ngxi esibhedlele ngethuba lekota yokuqala iintsuku 3-7 yobomi. Okulandelayo, ngo-7 no-14, lwenziwa phantsi imeko lokomeleza ezimbi Mantoux awasabela kunye nokungabikho Izimo.

BCG (eletha Calmette-Zherena) ibonisa iziphumo ezigqwesileyo, kodwa ugonyo mandatory nxamnye sephepha ayamkelwa kuwo onke amazwe ehlabathini, konke oko kuxhomekeke kwinqanaba TB kule ngingqi. Kwiinyanga ezimbalwa emva kogonyo kuyo inaliti ulusu reaction livela - uphawu encinane.

Ukugonya umntwana contraindicated kwezi meko zilandelayo:

• olusanda kuzalwa immunodeficiency bene, kwakunye entsatsheni sinobuso nomntwana, nokubandezeleka kulo sifo;
• kuba abazalwana noodade iingxaki usana kuvela emva zokugonya ezinjalo;
• umntwana, kukho bekhubazekile kwinkqubo luvo.

Ugonyo kufuneka senziwa ukuba:

• umntwana ukuba donoshen,
• wafumana nasiphi na isifo esosulelayo,
• umama nomntwana yahlukile RH into.

Kubalulekile ukukhumbula ukuba isifo amalahle ebangela inegciwane tubercle. Dining nomonde yabantu nothomalaliso kufuneka abe sempilweni entle kwaye zichanekile. Kuphephe kukutya kakhulu ukutya okunamafutha. Le nokwenziwa kwe ukutya izigulane TB kunzima. Oku kungenxa isakhiwo yokwakheka weeseli MTB - Shell iqulathe eninzi ngamanqatha. Umntu ngezifo ufuna esisityebi ukutya iiprothini, isitatshi, iivithamini kunye Micro elements.

Ukunciphisa amathuba osulelo zaseprayimari ekhaya, kuyimfuneko ukuba uzigcine ucocekile buqu, ukuchitha phandle ixesha elingakumbi, bambelela noboya nomqhaphu iimveliso elangeni.