Tuberculosis Genitourinary: iimpawu, uxilongo, iindlela zosulelo

Izifo kwenkqubo wokuchama ngendlela eqhelekileyo. Ezichaphazela nezintso, womchamo, isinye. Kuzo zonke ezi zifo kukubonelela kwaye cinga isifo sephepha genitourinary. Malunga esi sifo, kufuneka wazi wonke umntu, ngenxa yokugula akukho mntu omzimba.

Funda ngaphezulu malunga nesifo sephepha, kananjalo belubhukuqa inkqubo womchamo

Ayisiyiyo umntu onjalo, ongayiyekelelanga weva isifo sephepha. Sisifo eqhelekileyo apho ibhaktiriya ekuthiwa inegciwane, kuchaphazela emiphungeni. Noko ke, hayi kuphela kwezi amalungu baphile okuthiwa. Abo ngolwazi iintlobo extrapulmonary ezaziwayo esi sifo. Okokuqala phakathi kwezi ke tuberculosis genitourinary.

Njani na kwesi sifo ndinaso? Womchamo Inkqubo Goch eletha kuwa indlela hematogenous. Ngenxa yesi sizathu, sinokugqiba ukuba umntu wokuqala abanentsholongwane tuberculosis evela isigulane njengesiqhelo, ukhupha kokusingqongileyo kwamagciwane. Kamva Goch eletha angangena inkqubo wokuchama ukuya egazini. Ngoko ke, le ndlela losulelo - okokuqala emoyeni uze hematogenous.

Isifo sephepha kwenkqubo enzala kwi amadoda nabafazi iqala nomonakalo wezintso. Kwezi, inkqubo ezosulelayo isasazwa yi tubules kwezintso, imithambo yegazi isinqe sezintso. Emva koko luchaphazela ureters, isinye womchamo. Nakujoliso olutsha sephepha kwenzeka izintso zombini, kodwa, xa kusenziwa, luqhubela phambili inkqubo zophendlo lwezifo kwelinye kuphela kwisibini izitho zangaphakathi.

Njengoko esi sifo okhula? eletha Goch xa udubuleke izintso ezichaphazela uthinte kunye Medulla. Xa umzimba kukho amaqhuma. Kancane ulcerate, apho ukubola obufana. Ngenxa yoko, angabi nemingxuma kwakheka. Around kubo nokuphuhlisa iinkqubo ukudumba, kukho amaqhuma. Konke oku kunokukhokelela ukutshatyalaliswa ngokupheleleyo izintso ukwakha pyonephrosis.

Kuphuhliso olungaphezulu sephepha genitourinary phakathi kwabafazi namadoda ichaphazela fibrotic kunye adipose philisi ilungu lwangaphakathi. La maqhuqhuva kunye nezilonda kuvela isinqe kwezintso, ureter. Wall ngenxa kuyo izokhula, Babe ngokunyebelezela, edematous. Yezilonda zarubtsovyvayutsya koko kwakhiwa isakhiwo ukunqanda ukuphuma umchamo.

Xa engekho unyango efanelekileyo usulelo edlula izintso ukuya lwesinye. Inkqubo yezifo iqala kuqala kummandla apho ureters achithwe. Xa isifo omzimba lwangaphakathi kwenzeka tubercles. Bona phantsi ekungafuneki ngakumbi. Endaweni yabo akhiwa izilonda, amanxeba. Kamva esinyini uba ukushwabana ngenxa yokuba eludongeni lwangaphakathi organ ochaphazelekayo indawo inyama sclerotic.

Isifo sephepha kwenkqubo genitourinary: kucalulo emfutshane izifo

Abaziingcali practice isicelo kucalulo eyahlula kumabakala ezininzi sifo:

• Kuba kwinqanaba lokuqala sifo luphawulwa sephepha infiltrative kidney, t. E. Non-yingozi.
• In inyathelo lesibini ukuthotywa lokuqala emsebenzini, okt. E. kwisisu omnye abonakale ezincinane. Ububanzi, zibe ngaphantsi kwe-1 sentimitha.
• Kwinqanaba wesithathu kukho yintshabalalo elilinganiselweyo. Ngo omnye iinxalenye izintso kuvela incipha enkulu okanye sisifo sephepha polikavernozny.
• Kuba Isigaba sesine lubonakala ngokuba intshabalalo iyonke okanye losuku.

Lo mfanekiso kwezonyango sifo

tuberculosis Genitourinary nga ha kombisa ngokwalo ngeendlela ezahlukeneyo. Yiloo nto le ngokugula iincwadi zonyango njengomnye "mystifies" zixhaphakileyo phakathi izifo esinyini, sezintso womchamo. Phezu zokubonisa nesifo ngokufuthi iingxaki ezichaphazela wajoyina. Oku kunokuba pyelonephritis, ukusilela ezinganyangekiyo kwezintso.

Iimpawu nesifo sezintso bohlulwa babe ngamaqela 2:

• iimpawu ezifanayo zenzeka xa utshintsha imeko jikelele umntu ogulayo;
• Iimpawu zendawo, yahlulwa leyo kwi luluvo (abo zizizwe) kunye nenjongo (ukubonwa ziingcali kwisaveyi).

Iimpawu Common sephepha kwenkqubo womchamo

Xa esi sifo 20-30% yabantu iqondo lobushushu emzimbeni banda. Ngokubanzi ke luqala ekubeni degrees 37-38. Kwezinye izigulane izifo ezongezelelweyo, iingxaki wabona lobushushu ngokulinganayo degrees 38-39, kuthibaza liyavela.

Malunga wabona lwegazi (uxinzelelo lwegazi oluphezulu) ngo-5-18% abantu abagulayo. Ngaphambili, iingcali babekholelwa ukuba le uphawu yi ngenxa acceding pyelonephritis. Ngoku kuvunyiwe ukuba lwegazi - luphawu lokuba asenokubonisa kidney isifo sephepha. Kufuneka kuqatshelwe ukuba isehlo le uphawu kuxhomekeke kuhlobo sifo. Umzekelo:

• tuberculosis parenchymal sezintso lwegazi luchaphazela malunga 1.1% abantu abagulayo;
• tuberculosis papilla sezintso - 3.2%;
• polikavernoznom tuberculous pyonephrosis kunye nesifo sephepha - 18.3%.

Iimpawu ezikhathazayo Local

Ngokuqhelekileyo abantu bebuza, "iimpawu, ukuba kukho isifo sephepha genitourinary, yintoni?" Ukuziva ezinokwenzeka - oko ukuchama kabuhlungu kunye rhoqo. Iingcali kwi-imi- 50-60 kwinkulungwane yokugqibela ukutyhilelwe usikhokele bantu bonke. Waza waqala umkhuba yokuncipha kwenani nezihlandlo iimpawu. In imi--60-70, 48 kuphela% yabantu bakhalaza malunga nokuhluthwa ukuchama kwaye kwiminyaka 80 -% kuphela 43 ezigulane. Kwiminyaka yakutshanje, uphawu yiyona iqhelekileyo. ukuncipha olunjalo luchazwa nezihlandlo izitshanguba le inwebu kwiinwebu lwesinye.

Lidla kukho iimpawu - buhlungu kwingingqi empontshwa evela xa liqala ukuphuhlisa isifo sephepha genitourinary. Ezi mpawu bathi xa malunga nesiqingatha abantu abagulayo. Ezi namahlaba ngokuqhelekileyo elinye macala. Malunga mizwa ekhathazayo localized macala omabini, ndivakalisa% 15-20 kuphela abantu abagulayo.

Ngobume bayo, iintlungu sibi, ezifana yokulunywa kwezintso. Oku kuvela ngenxa yaphula umsebenzi excretory ngenxa ukuvaleka egazi igazi ureter, ubovu isivalo, udumba inwebu yangaphakathi. yokulunywa sezintso - luphawu leyo waphawula nje kuphela tuberculosis kwenkqubo womchamo. Yena iyinqaba, kunye nezinye izifo. Omnye wabo - urolithiasis. Ukuxilongwa luyenziwa zoviwo yomchamo.

ubungqina Injongo Local

Ezona mpawu-ikhankanywe apha ngasentla, leyo tuberculosis yenkqubo genitourinary - iimpawu ezikhathazayo. Izalathi njongo ziquka pyuria. Eli gama libhekisela inani okwandisiweyo leukocytes Umchamo. Leucocyturia - umqondiso yokuqala sifo. Kulo mzekelo, oko ayisosinyanzelo. Ukuba kule khosi zohlalutyo umchamo iiseli ezimhlophe zegazi azizaliswanga elibhaqiweyo, oko akujongwa njengobungqina yokunqongophala sifo.

Iimpawu ze-TB ziquka inkqubo eritrotsiturii enzala. Xa amayeza, eli gama libhekisela inqanaba ephakamileyo iiseli ezibomvu zegazi yokuchama. Kwiminyaka yakutshanje, lo mlinganiswa ngoyena kutyhilwa kaninzi - malunga nama-70-75% abantu abagulayo. Iziganeko elibomvu enxulumene nophuhliso inkqubo etshabalalisayo kwi kwizintso.

uphawu Early njongo sephepha - proteinuria (protein ubhaqo kucazululo umchamo). Oku sifo e 85-95% abantu abagulayo. Kwisehlo proteinuria abe izimvo ezimbalwa:

1. Ezinye iingcali zikholelwa ukuba akukho inxulunyaniswa tuberculosis inkqubo womchamo. umthombo protein, ngenxa yabo, iiseli ezibomvu.
2. Abanye abaphandi bathi ukuba protoinuriya ebangelwe lutshintsho sisiba mandundu kwi tubules kunye glomeruli ezintso.

ngonyaka ngamnye, amagqirha ngakumbi nangakumbi ufumane omnye umqondiso lwesifo sephepha. Oku kumalunga bacteriuria nonspecific. Usuleleko bungabonakala kuzo zonke izigaba sifo. Ngokufuthi oko ukukhombisa iifom cavernous. Amagciwane usuleleko nonspecific wokuchama zahlukile. Kuchongwe ne-Escherichia coli, kunye Staphylococcus, kunye iStreptococcus, neentonga ubomvu blue-eluhlaza. Ingaqhelekanga i izihluma exutyiweyo.

Uphawu inokuthenjwa esi sifo - ukukhangelwa Goch pali yokuchama. Noko ke, iingcali azisoloko ukuphatha ukufumana-arhente causative iphambili sifo. Nkqu mihla iindlela zovavanyo bacteriological musa ukunceda. Isibakala sokuba abanye abantu bathathe antibiotics emiselwe ngugqirha evela izifo ezikhoyo okanye usele la machiza, ukuzibandakanya self-medicate. Ngenxa yoko, Mycobacterium tuberculosis banokulahlekelwa kukuba nako kwabo ukuzala nokukhula. Emva kokutyala, bona, Kakade ke, ngenxa yesi sizathu ayikwazi ukuba andibhaqwa. Kunzima ukuchonga pathogen kwi umzimba umntu ogulayo.

Ingakumbi tuberculosis kwenkqubo wokuchama abantwana abadala

Esi sifo sichaphazela abadala kakhulu. Xa abantwana, singasathethi olufunyanwa tuberculosis genitourinary. uphawu rhoqo nasekuqaleni avela kubo - oku polyuria, okt ukwanda umthamo umchamo ... Kukho ezinye iimpawu, kodwa bahambisana kunye nezinye izifo. Enye inkalo ebalulekileyo ye-TB ebantwaneni kukuba amantombazana uhlobo oluxhaphakileyo ngakumbi esi sifo ayikho entshabalalo, kunye namakhwenkwe - yingozi.

Isifo sephepha kwenkqubo wokuchama ichaphazela abantu abaninzi abadala. Oku kungenxa yokuncipha xa kuthethwa omzimba, ukuvela izifo ezahlukahlukeneyo. On iimpawu ze-TB echaphazela axhasayo kunye nezifo yomchamo. Ezi ziquka: .. lwegazi, izifo iphecana zesisu, isifo amatye zezintso, pyelonephritis nonspecific, njl Ngenxa yoku, isifo sephepha kwale nkqubo wokuchama akusoloko andibhaqwa. iimpawu zayo ezigqunyiweyo ziimpawu sezifo ngasentla.

Iimpawu langoku isifo amadoda nabafazi

Ukususela emgangathweni kuxhomekeke sephepha ngayo kubonakale genitourinary. Kwabasetyhini, iimpawu ziquka intlungu ngaphantsi kakhulu. Xa abantu, bomelele. Kwakhona kungenzeka kakhulu ukuphuhlisa isifo sephepha, kumalungu obuni. Amanani abonisa ukuba le inkqubela kwabasetyhini kwenzeka kuphela-7% amatyala, ngelixa amadoda - 31%.

Xa ucinga isifo sephepha genitourinary emadodeni, iimpawu zesi sifo, kubalulekile ukukhumbula ukuba wokuqala Goch eletha wabetha endlaleni (yesinye). Kwinkqubo zophendlo lwezifo ezibandakanyekayo kunye nezinye iinxalenye isakhiwo uhlelo zokuzala: vesicle amadlozi, iba lityhalarha, epididymis. Kwiimeko ezinqabe kakhulu, lobudoda abachaphazelekayo. Kubonakala isifo isilonda kuchaphazela iindawo nkovu peripheral. Ezo mpawu kwenziwa lobudoda, ifuna uxilongo mahluko ngumhlaza.

tuberculosis Genitourinary: isifo

Xa lokufunyaniswa iindlela zonyango zisetyenziswa kuqala. Abayi musa ukuvumela ukuba ethembekileyo umntu isifo sephepha okanye hayi. Noko ke, iingcali ukubona iimpawu bandikrokrele umbulelo kubo. yenze uphando lwezonyango ziquka uphando umntu ogulayo, ekuqhubeni uhlolo, Ngokucofa iindawo ezibuhlungu.

Indima ebalulekileyo lokufunyaniswa iindlela laboratory play:

1. Izigulane Kwathi uvavanyo lwegazi. Akazange phendla naziphi na iimpawu ezithile ezendeleyo tuberculosis kwenkqubo wokuchama, kodwa unako ukubonisa leukocytosis kanye nokunyuswa kwezinga neentlenge erythrocyte. Oku kuya kubonisa ubukho ukudumba emzimbeni.
2. Oqeshwe yi umchamo. Le yeyona ndlela iphambili loxilongo yelebhu isifo sephepha. Xa umchamo izifo wafumana Goch inegciwane, nezinye izifo (ukuba zikhona, okanye uphuhliso yeengxaki). ZePCR ukuze ubonise proteinuria, pyuria, eritrotsiturii.

Iingcali mbonise ukubaluleka kokusebenzisa zonke iindlela kunokwenzeka uphando, ukudityaniswa zabo kunye nokusetyenziswa ezininzi.

Uluhlu ubuchule diagnostic kuquka tuberculin. kubume bayo ilele kulawulo ongama le eqinileyo medium ekhethekileyo. Libizwa ngokuba tuberculin. Tuberculin Thina ezibonisa kunye Izimo. Ngu ezibonisa ziquka: a urhano lwesifo sephepha kwenkqubo genitourinary, uvavanyo lwefuthe wenziwe unyango oluthile, umsebenzi wolawulo nkqubo. Izimo enza isici.

Xa isifo sephepha unokusebenzisa iindlela endoscopic zophando:

1. One of them - cystoscopy. Kule ndlela, i mbhobho, nto leyo catheter kunye yokungenisa ukukhanya kunye neenkqubo enombala, lifakwa ngalo urethra kungena lwesinye. Iimpawu Nonspecific sephepha kuphuma hyperemia ehlasela okanye focal ingqalelo ilungu isifo lwangaphakathi. Iimpawu ezithile cystoscopy kunikwa - tubercles, amanxeba, izilonda kwakheka kwi ndawo.
2. Kwezinye iimeko, xa kunzima ukwenza ukuxilongwa kwaye kukho amathandabuzo, ebibanjwe endovezikalnaya biopsy. Xa babesenza izinto ucingo uphando. Isiphumo nga ukuqinisekisa ubukho lwesifo sephepha kunye lwesinye nomhlaza. Ngenxa yoko elibi akukhethi isifo sephepha.

Njengoko iindlela zophando oluncediswayo kusetyenziswa ray plain kunye Itomography. Ngezi ndlela yeengcali yophando iya kufunda parameters zezintso, nenqatha perinephric karhulumente, atyhila calcifications kunye namaziko kwamathambo amalungu inkqubo wokuchama, iindawo nkovu, indawo retroperitoneal. Ngelo a isifo angiography kwezintso. Kunye wamlenya utshintsho entshabalalo kwi izintso, sezintso izakhiwo semithambo ndifunda, emisela ukukwazi ukwenza ekulondolozeni utyando kunye kidney inyama volume ukuba resected.

Maxa wambi uphathiswe scan ultrasound. Le ndlela non-invasive test ye yophando. Ultrasound ukuhlola inkqubo pyelocaliceal, ozibonayo amatye kwizintso, utshintsho sclerotic, calcifications nepokotho, angabi nemingxuma, cysts bokuqala. Ngelo xesha Ehostruktura izilonda akunakwenzeka ukuba ukuxilongwa. Ukuhlola iziphumo ultrasound nga zibonisa kuphela kukho isifo sephepha.

Treatment iirejimeni izifo

Unyango lwesifo sephepha kwenkqubo genitourinary yabelwa kuxhomekeke eqongeni:

• Kumanqanaba okuqala amayeza awasebenzisayo. Izigulane babelwa iziyobisi tuberculostatic xa zidityaniswe kunye macrolides kunye fluoroquinolones, immunomodulators, enzyme proteolytic. Ukhetho lwamachiza ngoogqirha, kuthathelwa ingqalelo ethe-ekufumanekeni M. isifo sephepha kunye nefuthe nothomalaliso isicelo.
• Ngelo xesha unyango ngamachiza isifo III zidibene ndiconga uqhaqho. Le nephrectomy kavernotomiya nomonde okanye inxenye linokukwenziwa (yokuvulwa ibinomthwebeba).
• Kwinqanaba lokugqibela sifo amayeza ithwalwa kwaye nephrectomy (ukususwa sezintso ochaphazelekayo).

Nephrectomy phakathi TB inkqubo wokuchama kahle rhoqo. Oku kungenxa kokudluliselwa kade unyango abanezakhono umgangatho unyango olungalawulwayo. Emva nephrectomy, izigulo postoperative zinokwenzeka, kodwa kunqabile kakhulu. Ezi ziquka hematoma, nenqatha ithumba ongama, ubomvu, kwaye ixesha elide ephilisa fistulas, hernias.

Isifo sephepha kwenkqubo enzala ngabantu, ezizezi zangasese, nzima ukunyanga. Nguye kubi efanele kuthomalaliso endala. Kuba unyango bamiselwe yi ezithile amachiza alwa i-TB kwi idosi enye njengoko nesifo sephepha le nkqubo womchamo. Ukongeza, xa sifo kuboniswa immobilization nge scrotal esinzulu omelene ebanjwe ekuvaleni isicelo novocaine intambo spermatic (ngokusebenzisana streptomycin). Isifo sephepha kwenkqubo oyindoda enzala ithathwa iinyanga-2 okanye ezi-3. Ukuba iziphumo azikho ngokwanelisayo, ngoko kuliwa resection le epididymis okanye epididymectomy. Xa nya wetyhalarha zazide umsebenzi lowo ukuba asikhulule. Ukuba TB kuchaphazela esinobubovu wesinye vesicles amadlozi, ngoko ukumisela unyango endala.

Xa ndiqukumbela, kubalulekile ukuphawula ukuba isifo sephepha genitourinary ikhula kwiminyaka emalunga 10-15 emva ukuqala pulmonary okanye osteoarticular isifo sephepha. Xa iimpawu Kucetyiswa ukuba bafune uncedo kwi ngobugcisa ukuba sakubambezela utyelelo, ngokuba ngenxa ukuqhubela phambili kwesifo kwixesha elizayo ingafuna ukususwa nezintso. Kumanqanaba okuqala ze unciphise zinokuthintelwa.