Extrapulmonary sofuba: Izimbangela, Izimpawu kanye Ukwelashwa

sofuba Extrapulmonary - igama elithi ngawo wonke leqembu lezifo kuhlanganiswe ezithinta isitho izinhlelo ezihlukahlukene kusukela isikhumba namathambo nesiphetho kwemizwa uhlelo kanye zamanzi. Lezi zifo ayingozi ngokuyinhloko ngoba ukuxilongwa sekwephuzile, kakade ngesikhathi komqondo nezinga lokukhula kwengane yezinkinga.

Yiqiniso, abantu abaningi banesithakazelo ukwaziswa okwengeziwe mayelana nalezi zifo. Ingabe sofuba extrapulmonary iyathelelwana? Noma yiluphi uhlelo isitho kungathinta ukutheleleka? Yiziphi izimpawu ahambisana umkhuhlane? Izimpendulo zale mibuzo kuyoba usizo abafundi abaningi.

Extrapulmonary sofuba izilonda nezimbangela zabo

sofuba Extrapulmonary - isifo esithathelanayo elihlobene ne-Ukungena umzimba womuntu mycobacteria. Abakwazi kuthinte isitho izinhlelo ezahlukahlukene, kufaka phakathi i-skeleton, amathumbu, isisu, isikhumba, amehlo, izinso nokunye. D. Ngokocwaningo olwenziwa kwezibalo, amafomu extrapulmonary, njengoba umthetho, kukhona izifo yesibili nokuthuthukisa ku isizinda ngenkuthalo egeleza isifo sofuba yamaphaphu. Nokho, ngezinye izikhathi iziguli kutholakala ukuthi uphethwe yini izilonda kuphela extrapulmonary.

Uma sikhuluma ukutheleleka zomzimba womuntu, kumayelana 90% njengoba ejenti causative izenzo Mycobacterium sofuba (tubercle imbewu eletha). Okuningi mancane amathuba ukuthuthukisa TB esethulweni isizinda nokukhiqizwa asebenzayo Mycobacterium bovis - igciwane, ngasendleleni, kungathikameza abameleli wezinkomo. Emazweni ashisayo, uhlobo ezivamile pathogen - M.africanum.

Kuthiwa ukuthi nezilwanyana ezincane nzima kakhulu. Ngo amanzi, bayakwazi ukugcina ikhono ikhono siphile izinyanga ezinhlanu. Ngo amanzi abilayo mycobacteria ukusinda imizuzu 5-45. Ngakolunye uhlangothi, amagciwane e-TB optic nozwelo emisebeni ultraviolet.

Ungakwazi yini ukuthola sofuba extrapulmonary?

Yiqiniso, isifo sofuba extrapulmonary, kanye ifomu yamaphaphu lesi sifo sisuka umuntu ogulayo endaweni enempilo. I-ejenti causative ikhishwe ku imvelo kanye isikhwehlela phakathi ukukhwehlela, sneezing, nokunye. D. Ngakho-ke, iqembu ephezulu abantu abahlala futhi uxhumana eduze iziguli ezinalesi sifo.

Kodwa izinto azinjalo elula. Abantu abaningi, ngisho nangemva ezingaphezu kweyodwa eyishumi ka eziphilayo ngaphansi kophahla efanayo isiguli awuthelelekile. Ngaphezu kwalokho, lesi sifo akusho isifo. Kukholakala ukuthi cishe ingxenye eyodwa kwezintathu yabantu abasemhlabeni wonke - abathwali Koch imbewu eletha. Nokho, akuwona wonke abahlushwa ngempela esifweni sofuba.

ukutheleleka abathwali akuzona esithathelwanayo futhi bangaphila ngaphandle kokunaka khona ukutheleleka. Noma kunjalo, kukhona ingozi yokuba lesi sifo. Ukwenza kusebenze mycobacteria kwenzeka ngokumelene isizinda ukwehla oqinile amasosha omzimba, ukugula ngakho-ke, engcupheni zibandakanya zeluliwe, ezingelapheki izifo ukuvuvukala ukuthi umane deplete umzimba, kanye ukucindezeleka njalo, ukucindezeleka ngokomzimba, iziyaluyalu hormone, ukungondleki, ngamafuphi, konke kungathinta ukusebenza mzimba uhlelo.

Ukwahlukanisa futhi uhlobo lesi sifo

Kunezinhlobo eziningana izinhlelo ngezigaba lezi pathologies. Ngokwesibonelo, ezivamile amafomu alandelayo sofuba extrapulmonary:

• lendawo - omunye isikhungo elise eyodwa isitho ethintekile (noma ingxenye uma kuziwa, isibonelo, umgogodla);
• ezivamile - kwelinye futhi isitho efanayo foci eziningana;
• izilonda amaningi - ekhuluma ngaye uma kwenzeka ukuthi isifo sofuba kuthinta izitho eziningana ohlelweni olufanayo;
• ukuxilongwa "sochetannyj sofuba" ibekwa icala, uma kukhona ukulahleka emizimbeni eziningana izinhlelo ezahlukene (ngaleyo ndlela, inhlanganisela "yamaphaphu / sofuba extrapulmonary" kungenzeka).

Ngesikhathi uphethwe futhi banake degree womsebenzi isifo:

• ifomu asebenzayo lesi sifo (lesichubekako, relapsing, off futhi);
• ngasebenzi sofuba extrapulmonary (izinguquko nesineke ethize kwezitho zomzimba walondoloza isici sofuba, khona foci elincane abscesses noma nezibazi, kodwa ukuhlolwa laboratory khombisa ukungaqapheli kunoshintsho).

Ukuze sitholakele inqubo kubalulekile futhi khona izinkinga. Benza zinganikezwa (isib immunodeficiency yesibili, izitho esinobuthi iguliswa onesifo, amyloidosis, pathologies letindzala amagugu) kanye zendawo (ezihlobene ngokuqondile isitho ethintekile noma uhlelo).

Isifo sofuba of amathambo namalunga

sofuba Extrapulmonary of amathambo namalunga - isifo ezijwayelekile esingelapheki kuhambisana izilonda ezingxenyeni ezahlukene uhlelo zemisipha. Against isizinda umsebenzi nezilwanyana ezincane pathogenic, ukwakheka granulomas ethize, kanye ukubhujiswa okuqhubekayo ithambo izicubu, ngokwemvelo akuhileli nje kuphela izinguquko yokwakheka kodwa futhi ukusebenza lwamathambo.

Ngokwezibalo, iningi leziguli nale Ihlahlubo - asebekhulile. Cishe u-60% amacala lesi sifo sihlasela emgogodleni, okuholela ekukhubazekeni. Oshayelayo, spondylitis futhi coxitis - lena ukwephula ezivamile, okuyinto kuhambisana sofuba extrapulmonary. Izimpawu neze zenzeka kusaqalwa lesi sifo.

Ngezinye izikhathi, iziguli kubika ubuhlungu engxenyeni abathintekayo of the system zemisipha. Uma lesi sifo eba sokuqaqamba kwamalunga uhlobo, kungaba ukungakhululeki kuqashelwe, nokuvuvuka amalunga omzimba amancane, ukunyakaza elinganiselwe. Uma kuziwa lesion umgogodla, le granuloma ezikhulayo ngokuvamile licindezele izimpande kwenzwa okuyinto kuhambisana ezihlukahlukene iziyaluyalu zezinzwa.

Izibonakaliso ingafaka ushintsho kancane kancane indlela omi ngayo. Imisipha uqale ziphelelwe yisimo sazo, ngenxa yalokho indoda kunzima ukuhambisa.

Ngeshwa, abantu ukuya kudokotela e ezigabeni kamuva, uma kakade yezinkinga samanje ezifana nesifo sofuba extrapulmonary, njengoba abscesses, nemithi sengozini lwamathambo, fistulas. Sitholakele isifo zingahlanganiswa ebunzimeni obuthile, ngoba isithombe sokucindezeleka esilufifi kakhulu. Ezimweni eziningi, ngisho nangemva kahle wachitha ukwelashwa ithambo sengozini ahlale.

Ukulimala isimiso sezinzwa

sofuba Extrapulmonary we meninges kubhekwa ifomu olunzima lesi sifo. Ukugula eba ngokushesha futhi ukungabi khona ukwelashwa kuholela kokulimala isimiso sezinzwa, futhi ngezinye izikhathi nokufa. Nokho, kuze kube manje, amacala lesi sifo elotshiwe kanini.

Ngaleso sikhathi, ngokuvamile kutholakala ukuthi uphethwe yini efanayo extrapulmonary sofuba ezinganeni. Ukuncishiswa isifo elihlobene ne ekwandeni okukhulu ethwele BCG lokugoma in izinsana. Lo mbono usekelwa yokuthi kuze kube manje, tuberculous meningitis ezenzeka phakathi izingane ngaphandle ngokugoma.

Esifushane ikhanda, imfiva okuncane, ubuthakathaka kanye umkhuhlane - ngakho sofuba extrapulmonary iqala. Izimpawu zivela njengoba ukuthuthukiswa meningitis. Ikhanda elibuhlungu livela kaningi futhi babe babubukhulu ngokwengeziwe. lokushisa umzimba antante 39-40 degrees. excitability yanda, eba nokuzwela ekukhanyeni. Sici sici ukuvela sokuzincisha kanye okusheshayo kwesisindo. Uma ungatholi ukwelashwa, ukufa kwengane ngesifo kuziwa ngesonto 3-5, okuyinto lihlotshaniswa ukukhubazeka kwemigudu yokuphefumula noma isikhungo vasomotor zobuchopho.

sofuba besisu

Kuyaphawuleka ukuthi izilonda besisu awatholatholakali futhi akhawunti% 2-3 kuphela wonke amacala sofuba extrapulmonary. Ngokuvamile, le nqubo kuqala sokugembula kuhilela-lymph kanye mesenteric zabryushinnoogo isikhala bese kuphela izilonda tubercular ukunweba ezithweni besisu.

Kuthiwa ngezinye izikhathi lesi sifo kungase ithuthuka emphinjeni. Ezimweni ezinjalo kukhona kancane kancane ngomphimbo ulceration izindonga tube, le taper kuze stenosis egcwele. Mayelana isibonelo esifanayo ebonwe izilonda esiswini - esifundeni pyloric futhi ugobile enkulu ukwakha ezincane, kodwa amaningi izilonda unpainful.

umonakalo emathunjini Ungadlulisela kudala isithasiselo saleli Bhayibheli. Ngezinye izikhathi isifo sofuba sitholakale futhi emathunjini amancane ezigulini. Ngeshwa, ukuhlonza isifo sofuba extrapulmonary kulokhu nenqubo enzima. Izimpawu zesifo kungukuthi kakhulu sho futhi isithombe emtholampilo ngokuvamile sifana enteritis ezingamahlalakhona, appendicitis nezinye izifo wokugaya ukudla.

amafomu Kuyingozi sofuba libhekisela mesadenitis. Nge leso sifo sithinta le lymph we peritoneum, kodwa inqubo wabe kancane kancane kwesibeletho futhi ezikhiqiza amaqanda. Fibrosing ukuvuvukala uhlelo zokuzala iba imbangela ukungabi nenzalo kwabesifazane.

Izilonda TB

imbewu eletha Koch sika ngokuvamile yenziwe yaba yasendaweni kuya isikhumba nezicubu ongama, okubangela ezihlukahlukene nezifo.

• chancre Tuberculous - kuyinto ukwakheka ohlangene ngaphakathi okuyinto zenzeka ubovu izinqubo. Ngokuvamile, izakhiwo ezifana akhiwa engeyokuqala lymph. Izilonda ngokuvamile zivulwa, kusale fistula.
• Lupus - isifo libhekene ukubukeka ukuqubuka ethize esikhumbeni. Izintaba-mlilo ziqhume kukhona ifindo obukhulu, okuyinto kancane kancane uhlangane ndawonye ukuze zakhe ubuzalwane obukhulu, INGENA ISINYENYELA flat. Igobolondo layo ngokuvamile embozwe izilonda noma fistulas.
• Kollikvativny lupus - ukucinana, esibonakala by kumiswa encane obukhulu isikhumba node diameters ka 1-3 cm Lokhu ukuvuvukala kobuhlungu, okuyinto phendla fistulas amaningi ..
• ifomu Warty sofuba kwesikhumba ephelezelwa ukubukeka kwesikhumba kunezimvu zamanzi, okuyinto lesi sijame njengebhoksi papilloma. Noma kunjalo, kukhona umehluko. Ikakhulukazi, kumiswa emhlabeni usebe kukhona ukuvuvukala futhi isikhumba kule ndawo liba luhlaza cyanotic. Ngokuvamile lokhu kutholakala ukuthi uphethwe yini uhlobo lesi sifo in iziguli ifomu evulekile isifo sofuba yamaphaphu, ngoba isikhumba ngesikhathi ukhwehlela njalo uthola phlegm. Iqembu ingozi kuhlanganisa odokotela abasebenza nge TB, kanye bezilwane.
• sofuba Miliary kuhambisana ukubonakala encane papular ukuqubuka pink. Ngokuvamile basuke yenziwe yaba yasendaweni emhlabeni orifices, nakuba kungenzeka basakazekela kwezinye izindawo isikhumba. Njengoba isifo siqhubeka papules kwakhiwa isilonda encane phakathi nendawo, okuyinto ke embozwe uqweqwe. ezibangelwa ukungaphenduki embhedeni kungelashwa esishintshashintshayo babe foci of necrosis.

Kungakhathaliseki indlela sofuba cutaneous libhekene evilaphayo ngaphandle ukuvuvukala abalulekile noma soreness. Izinkathi ukuthethelelwa indawo exacerbations, ngokuvamile uwela phezu entwasahlobo and ekwindla.

sofuba urogenital

Uma kuziwa lesi sifo njengesifo sofuba extrapulmonary, cishe 37% of amacala ukutheleleka kuthinta izitho kohlelo excretory. Ngokwezibalo, amadoda, futhi ukutheleleka isakazekela uhlelo zokuzala, kanti phakathi kwabesifazane Ezimweni ezinjalo kukhona lingandile kangako.

Ngokuvamile uhlushwa isifo sezinso. Isithombe sokucindezeleka usongene kakhulu. izimpawu Okokuqala futhi akazange abonakale. With ukuthuthukiswa sifo angase avele kancane, ezidabukile ubuhlungu emuva aphansi. Ngokuvamile mina ukuxilonga kwezinso sofuba ingozi, phakathi nokuvivinywa umchamo ephelele, uzingela mycoplasma e amasampula.

Uma isiguli akanayo ukwelashwa ezidingekayo, kukhona ingozi cystic futhi hydronephrosis.

Ezimweni lapho ukutheleleka okudlulela ezithweni kohlelo nekutala amadoda ngokuyinhloko kuthinta endlaleni engasesinyeni. Athuthukise yezinkinga ezifana isifo amasende, le deferens vas nentambo spermatic.

Isifo sofuba we lymph node

Uhlobo oluvame kakhulu i-sofuba extracellular, esithinta neuropathy zamanzi. Ngokwezibalo, okubangela crouches azungeze 50% azo zonke izinhlobo isifo kwezinhlobo extracellular. Ngaphezu kwalokho, njengoba umthetho, it is kuhlangene ukulimala amaphaphu nezinye izitho kwesifuba.

Ngo inqubo yokwelapha yesimanje, amacala lymphadenitis tuberculous wendawo eqoshiwe kaningi. Ukutheleleka sithinta umuntu oyedwa kuphela iqembu lymph node, kanye okungenzeka kakhulu ukuba ahlupheke wesibeletho submandibular. Ngaphansi ngokuvamile, ukutheleleka lingena inguinal futhi axillary zamanzi. Ngaphezu kwalokho, kungenzeka ifomu generalized lesi sifo lapho abathintekayo namaqembu amathathu ngaphezulu lymph node kanyekanye.

Izimpawu sofuba extrapulmonary kuleli cala hhayi kakhulu libizwa. Ezigabeni zokuqala yokwanda e-lymph. Ziyakwazi nokunwebeka, buthambile, zivumelanise nezimo futhi ube ekuqaleni kobuhlungu. Shintsha usayizi yabo akuhlangene ne imikhuhlane noma izifo engenhla ipheshana zokuphefumula.

Sici sici tuberculous lymphadenitis fomu ukuhileleka inqubo isifo ezungezile kwezicubu ezithambile, kanye lesi sifo - nendawo ezungezile zamanzi. kwakhiwa Ngakho ukuvuvukala kahle esikhulu. Esikhathini esizayo, maphakathi isimila livela ukuthambisa indawo. Kulesi sigaba phezu kwesikhumba abathintekayo kuyinto engeli izacile, ngezinye izikhathi iba tint obomvu noma bluish.

Uma ungatholi ukwelashwa, kukhona uqhekeko kwezicubu, kuphumele fistula lapho okuphuma okuqukethwe ukungaguquguquki nokunjengoshizi. Indwangu embozwe izilonda, ukopha zingenzeka. I fistula kungase coalesce, futhi ubuso bayo akhiwa izibazi anolaka. Ngeshwa, izicubu ukuphulukiswa Asihlali isikhathi eside - ekuphindekeni, lapho fistula ivulekile futhi.

Kwezinye izimo, isiphetho yenqubo sokugembula kuthinta nabanye zamanzi. Lezi imiphumela eyingozi izimbangela sofuba extrapulmonary. Sifo Kwenziwa kulokhu biopsy namasampula ukuhlolwa laboratory okwalandela etholwe.

Indlela ukuxilonga sofuba extrapulmonary?

Njengoba ubona, kukhona izimpawu eziningi kanye nezinkinga, okuyinto kungaholela ekwakhiweni sofuba extrapulmonary. Ukuxilongwa kahle lezi zifo, ngeshwa, kuncike nobunzima obuthile, kusukela ukuqaphela isithombe sokucindezeleka kude esimweni ngasinye. Ngaphezu kwalokho, iningi leziguli uxilongwe kakade ngezigaba eziphambili isifo sofuba.

Ngokwemvelo, ngenxa ukuthola lesi sifo kubalulekile ukuqhuba ucwaningo. Lokhu ngokuyinhloko test Mantoux nge amazinga okukhishwa ezahlukene tuberculin. Lokhu kuhlola kusiza ukunquma uma isiguli uyilungu leqembu ingozi. Ngaphezu kwalokho, yisinyathelo esibalulekile ekufezeni uphethwe esimweni futhi fluoroscopy njengoba isifo extrapulmonary ngokuvamile ukuthuthukisa ngokumelene isifo sofuba yamaphaphu. Ngisho nabancane, asalile lesion yamaphaphu ziqinisekisa khona ukuthelelana isiguli kulezo, noma ezinye izitho.

Esikhathini esizayo, izifundo ezengeziwe kuyenziwa, ngokukhethekile, imisindo ephansi, resonance kazibuthe nekhompyutha tomography, biopsy futhi laboratory luhlolo kwezicubu ngokuba khona sofuba Mycobacterium.

Ukwelashwa nokuvikelwa sofuba extrapulmonary kanye izici zayo

Yiqiniso, lena uphethwe yingozi, kodwa ngoba kwasekuqaleni izithakazelo iziguli khona i izinqubo eziphumelelayo zokwelapha. Ukwelashwa nokuvikelwa sofuba extrapulmonary - a eside futhi eziyinkimbinkimbi, futhi izigaba zalo eziyinhloko uqondane icebo sokuvivinya amafomu yamaphaphu lesi sifo.

Ngeshwa, indlela yokwelapha ngemithi elwa namagciwane akuvamile isebenza. Iqiniso lokuthi mycobacteria ziba namandla okumelana cishe zonke izinhlobo kwamaphilisi ngokushesha, ngakho le mithi ngokuvamile asetshenziselwa nalabasitako.

It ubhekwa ngekhemikhali ephumelela kunazo. Namuhla, kunamabandla izikimu eziningana zale ndlela yokwelapha. Ngokuvamile-ke kwenziwa okuthiwa yokwelapha quadruple okubandakanya ukusetshenziswa rifampicin, i-streptomycin, i-isoniazid ne-pyrazinamide. Ezinye emitholampilo yangasese usebenzisa ezithuthukayo ezingaphezu pyatikomponentuyu scheme, unezela ohlwini izidakamizwa, ezinye izidakamizwa isizukulwane esisha. Kahle inhlanganisela abakhethiwe kusiza ukubhubhisa Amagciwane isifo sofuba, kodwa, ngeshwa, ukuphathwa akugcini lapho.

Ngenxa ngamakhemikhali sofuba kubathinta kabi umzimba, kukhona hepatoprotectors ezihlukahlukene, kanye nezidakamizwa, kuyashesha inqubo ekususeni ubuthi emzimbeni (izindlela ehlanganisa acetylcysteine, reosorbilakt). Ngaphezu kwalokho, kuyingxenye ebalulekile indlela yokuyelapha nokuphathwa immunostimulants, kuhlanganise glutoksim, xymedon, galavit.

Ngezinye izikhathi, le mishanguzo ukwelashwa kuhlanganisa amavithamini Iqembu ukuze kuvinjelwe ukuthuthukiswa neuropathies neuropathy. Kwezinye izimo, ukuhlinzwa kuyadingeka. Ikakhulu, i-operation ezinqunyiwe uma granuloma kwetinhlavu yomgogodla, njengoba lena kuyindlela kuphela ukuvimbela umonakalo omkhulu izimpande emsipheni nomgogodla.

Ngisho nangemva kokuba zonke izinyathelo zokwelapha imithetho okufanele ziqondise isiguli. Kuvele esiteji ebalulekile ekululameni somzimba ngendlela enempilo nokudla ukudla okunomsoco. Ukudla kufanele kufake izakhi, kanye wonke eziyinkimbinkimbi amavithamini namaminerali. Kubalulekile ukubuyisela esisindo evamile. Futhi sofuba (yamaphaphu futhi extrapulmonary) iyawabopha impatho esibhedlela njalo.