Fibro-cavernous ụkwara nta: mgbaàmà na ọgwụgwọ. Prevention na Atụmatụ

Fibrocavernous akpa ume ụkwara nta - a-ebibi ọrịa, ihe e ji mara nke na ọ bụ ọnụnọ ke dịpụrụ adịpụ akpa ume oghere. Na nkà mmụta ọgwụ, ọ na-akpọ "oghere". Nsogbu bụ nzọụkwụ dị progression nke akpa ume ụkwara nta. Ọtụtụ mgbe, ndị dị otú ahụ a daa ọrịa ọgwụ na-ehichapu agwa.

Atụmatụ nke ọrịa

A, fibrous-cavernous ụkwara nta hụrụ okenye ọrịa. Na na nwata, bụ isi TB mgbaàmà ndị nnọọ obere.

Cavernous daa ọrịa eme dị ka ihe ga-esi nke infiltrative ụkwara nta, ma ọ na-eme na-amalite akwadebe ma ọ bụ patchy, ụdị daa ọrịa.

Fibrocavernous ụdị ojoo 5% nke ikpe nke ụkwara nta.

Cavernous ụkwara nta ka a n'itinyekwu nkume mmepe nke fibro-cavernous daa ọrịa

A mara mma nke pathomorphological cavernous ụkwara nta bụ ọnụnọ nke a otu uji eze, ọ dịghị mbufụt na fibrotic mgbanwe bronchi, Lymph arịa na gburugburu anụ ahụ. The ọrịa abụghị ihe karịrị 2 afọ.

caverns-agwọ ọrịa emee na guzobere:

• rumen;
• tuberculoma;
• otu na-elekwasị anya nke ụkwara nta;
• sanitized oghere.

Na enweghị kwesịrị ekwesị ọgwụ cavernous ụdị nwere ike ịga na fibrocavernous ụkwara nta, fibrosis nke bụ pụta ụwa mgbidi uji eze na gburugburu akpa ume parenchyma. Ọzọkwa hụrụ multiple foci nke ofufe.

symptomatology nke ọrịa

A, fibrous-cavernous ụkwara nta na-metụtara nanị akụkụ ụfọdụ na otu akpa ume. Mmepe nke ọrịa na-adị na 3-4 ọnwa nke adighi ike ọgwụ nke ọzọ ụdị ụkwara nta. Ngosipụta nke ọrịa na-karịsịa na-egbuke egbuke na ire ere na-adọ.

Isi mgbaàmà nke ọrịa nwere ike-atụle:

• asthenia;
• ọnwụ nke agụụ;
• na-adịghị ike ụkwara;
• coughing elu ọbara;
• agba ọbara;
• crackles na ida nke uji eze.

Mgbe e guzobere uji eze mgbaàmà ibu ụkọ, Dị nnọọ kwesiri ngosi na nonspecific. Onye ọrịa pụrụ ime mkpesa nke n'ozuzu adịghị ike, mgbe nile ike ọgwụgwụ, na arọ ọnwụ, na ọnụnọ nke ala ọkwa okpomọkụ.

Na mmepe nke latent TB nwere ike na-egosi na-agba ọbara na akpa ume na-amalite n'ihi na ọ dịghị ihe mere.

Anamnesis nke ọrịa n'ahụhụ na fibro-cavernous ụkwara nta na-egosi afụ N'ezie. Etiti oge n'etiti nnukwu na ngbaghara oge nwere ike ịbụ ogologo oge ma ọ bụ, ọzọ, nnukwu na-adọ nwere ike na-egosi ezi mgbe.

Fibro-cavitary ụkwara nta nwere dị iche iche na-adakarị mgbaàmà. Ọ e mere site a-enweghị nchịkwa na usoro, nakwa dị ka onye na-ejere nsogbu.

E nwere ihe abụọ iche nke ọrịa: a mmachi ma ọ bụ dịtụ mụ, ebe n'okpuru nduzi nke na-anara ọgwụ stabilization emee na ọrịa bụ na ngbaghara, na-aga n'ihu ruo ọtụtụ afọ.

Na nnukwu oge okpomọkụ ịrị elu na mmepe nke mbufụt gburugburu uji eze. Okpomọkụ nwere ike iru elu-etoju, ma ọ bụrụ na a isi ọrịa metụtara ọrịa nke abụọ agwa.

Imeri bronchi so site na-egbu mgbu ụkwara keolu mgbaka, nke sputum, imi na abu nwere iche na ihe isi ike.

A ndidi ata ahụhụ site fibro-cavernous ụkwara nta, n'ụzọ dị ịrịba ama ida ibu ibu. Ọ na-ekwu akọrọ akpụkpọ, nke mfe wrinkles. The uru nke onye ọrịa na-gụrụ atrophy. The lekwasịrị nke enweghị nchịkwa usoro-aghọ ubu belt, azụ na mpaghara n'etiti ọgịrịga.

Ọrịa na-ewekarị Ugboro igbu egbu. Na exacerbations nke akụkụ okuku ume na ọrịa na-amalite insufficiency 1 na 2 degrees. Ekemende nwere ike akara na-abawanye na imeju olu. Nwere ike ịpụta aza.

Na progression nke ọrịa akara mmeri nke ogwooro na eriri afọ, nke na-eduga a-agwụ ike nke dịghịzi usoro. Mgbe kahesii, amyloid nephrosis na congestive obi ọdịda, ọrịa akpa ume prognosis ọjọọ.

Na-akpata ọrịa

Mbibi nwere ike triggered mgbe ọ bụla na-adakarị n'ụdị ụkwara nta. Provocateur development nwere ike eme ihe dị ka superinfection. Site pathogens kwesịrị ịgụnye mycobacteria. Kpam kpam na e nwere 74 aha. Ha bụ ndị nke genus Mycobacterium. Otú ọ dị, ụkwara nta na ụmụ mmadụ triggered dabere họrọ ụdị, dubbed Mycobacterium ụkwara nta.

Predisposing ihe n'ihi na mmepe nke ọrịa na-:

• azụ larịị nke uche;
• ịgbanwe na reactivity;
• ọrịa nke esịtidem akụkụ;
• àgwà ọjọọ.

Isi na-adọ nke ọrịa

Ọ kpebiri igbunye ọzọ na-adọ nke fibrous-cavernous ụkwara nta:

• Infiltration. Ọ presupposes ịdị adị nke ihe mbufụt-elekwasị anya.
• Ire ere. The mbufụt n'ekwú a kpụrụ a oghere nke jupụtara na a pụrụ iche necrotic anụ - caseous uka. Akọrọ ọdịnaya na-aghọ mmiri mmiri, na-eji nwayọọ nwayọọ na-ada apụ mgbe agwụ bronchus. Na ya ebe-anọgide oghere. Mgbe nke ahụ gasịrị, ọ na-amalite jupụta na ikuku, na na mebiri nke drainage na bronchi - mmiri mmiri.
• The guzobere cavities. Education a kpụrụ na resorption nke perifocal mbufụt na fibrosis. Mgbidi nke anomaly nwere atọ n'ígwé. The n'ime oyi akwa dere caseous uka (polygenic oyi akwa). Emi odude ke n'etiti granulation shei, lined na nnukwu epithelial mkpụrụ ndụ. Ebe ọ bụ na ná mpụta oghere òkè kpuchiri a Capsule nke connective anụ ahụ.
• Seeding. Na usoro a, uji eze size na-abawanye, na gburugburu perifocal infiltration emee ma ọ bụ seeding. The usoro na-agụnye mmepe nke ọhụrụ mkpali ọnya na cavernous ụkwara nta. N'ihi ya amalite fibrocavernous ụdị ọrịa ahụ.

Ugboro nsogbu

E nwere ndị na-esonụ nsogbu nke fibro-cavernous ụkwara nta:

• Hemoptysis.
• Agba ọbara na akpa ume.
• Ọnụnọ nke percussion. Ọ na-kwupụtara a shortening nke ụda na ebe nke pleural ndim na fibrosis.
• Na-ege ntị na-adịghị ike respiration na ebe nke ndim nke pleura. Ọzọkwa hụrụ crackles na bronchial iku ume. Dị otú ahụ wheezing kpughere ọnụnọ nke nnukwu-sized cavities. N'ime obere formations na dị iche iche N'ikwu banyere ndabere ụda.

ụzọ nke nchoputa

Olee otú chọpụtara fibro-cavernous ụkwara nta? The akụkọ ihe mere eme nke ọrịa na oge nke nchoputa, dị ka a na-achị, na-ama nwere ihe ọmụma banyere gara aga myocardial ụkwara nta na ọrịa.

Ọ ga-kwuru na auscultatory ịrịba ama ndị nta ọmụma. Inyochakwu iji X-ray ekpughe ọnụnọ nke na-ekoghị onyinyo na elu ebe n'ụdị ihe oval ma ọ bụ gburugburu. Mgbe data nwetara site X-ray diffraction achọ esi nchoputa na ndị dị otú ahụ daa ọrịa dị ka akpa ume etuto, elu cancer, bullous emphysema, pneumothorax, echinococcosis ma ọ bụ encysted pleurisy.

Kwado Diagnostic na laabu ụzọ ndị endoscopic usoro.

Sputum analysis na-ekpughe a elu larịị nke MTB. Laboratory ule kpughere a elu larịị nke iche bacilli. Mgbe ụfọdụ, na usoro na-aghọ ufiop. Ọzọkwa staghorn mata agbanwe emep uta eri.

Na enweghị sputum gosiri ejide bronchoscopy. Ọ na-ekwe gị aka ịmata foci nke mbufụt ke akpa ume na bronchial akpa, nke gbochie mmechi nke uji eze.

Blood ule. Ọrịa na ọnụnọ fibrocavernous ụkwara nta akara lymphopenia na accelerated ESR oke ka 30-40 mm / h.

Mgbe e nwere onye na-abawanye nke abụọ oria nke leukocytes ka larịị egosi 19 000-20 000, nakwa dị ka na-amụba na ọkwa nke neutrophils.

E elu ọdịnaya nke protein na mmamịrị.

ọgwụ ụkpụrụ

Ọ eliminates fibro-cavernous ụkwara nta? Ọgwụgwọ a rụrụ na a ụlọ ọgwụ dị na TB dispensaries.

ọgwụ atụmatụ dabeere na imekotaotuugbo ojiji nke atọ ma ọ bụ anọ ọgwụ ọjọọ eduzi megide mmepe nke daa ọrịa. Dị ka a na-achị, na-eji "Inh", "ethambutol", "Rifampicin" na "streptomycin". Drugs nwere ike ndinọ intravenously ma ọ bụ kpọmkwem n'ime onu oghere.

Na-eji tuberkulinoterapiya, na-eku ume omume, ọgwụgwọ anụ ahụ, laser ọgwụ, ultrasound na inductothermy.

ebu ọgwụ

Olee ihe ọzọ na-tutu amama fibro-cavernous akpa ume ụkwara nta? Ọgwụgwọ-agụnye mmejuputa na-anara ọgwụ. Usoro na-kenyere n'otu n'otu na dị na-egosi nke uche na ọgwụ ọjọọ.

N'ozuzu, ma ọ bụrụ na iguzogide isi ọgwụ megide ụkwara nta a rụrụ dị na a anọ na-anara ọgwụ ọchịchị. The ọgwụgwọ na-agụnye jikọtara iji ọgwụ ndị dị otú ahụ dị ka "kanamycin", "Prothionamide", "Cycloserine", "Pas" na "fluoroquinolones". Na oge nke na-anara ọgwụ bụ ihe na-erughị 15-18 ọnwa.

Ọrịa na ọnụnọ fibrocavernous TB gosiri ejide pathogenetic ọgwụ nke na-iji na-agbazi mkpọchị ọrụ dị iche iche organism. N'ịgbari gị n'ụlọnga na-eji, nakwa dị ka preparations maka mweghachi nke dịghịzi usoro, na mmiri ọgwụ mmadụ.

Na a mma ọgwụgwọ mgbe ọnwa isii mma Ọnọdụ. Ọ kara akara Mbelata ke oke nke bacilli, nakwa dị ka ọnụ na uji eze mmechi.

ịkpa aka

Agwọ fibrotic cavities na-mgbe na-rụrụ nnọọ nwayọọ nwayọọ. Ọ bụrụ na n'oge n'elu oge bụ ekwe omume iji nweta ezi ihe, ndị fibro-cavernous akpa ume ụkwara nta a na-ewepụ site n'ịwa ahụ. Na nke a na-egosi na unilateral akpa ume resection. Emejuputa atumatu duplex ọrụ na usoro. Ọ na-nwere a elu ogo arụmọrụ na-enye gị ohere iji zọpụta onye ọrịa nwere na-arụ ọrụ. The afọ ndụ nke a na-arịa ọrịa onye ukwuu lengthened. Mwepu nke mycobacteria akwụsị.

Ọzọ ụdị ịwa ahụ bụ nke ogwugwo ida ọrịa, na-ekwu na imposition nke wuru pneumothorax.

Mgbe ọgwụgwọ n'ụlọ ọgwụ na ọnụnọ a chọrọ amanyere bụ iwu sanatoriums, outpatient ọgwụgwọ , sochiri chọpụtara na ọgwụ.

prognosis

Ihe ka nnọọ ọtụtụ nke fibro-cavernous ụkwara nta amenable ka ọgwụ. Oghere nke obere akụkụ na-emechi na n'ichihịa. Education na ọnụnọ nke isiike mgbidi karịrị oge refilled na caseous ọdịnaya na-akpalite psevdotuberkulemy.

Ìgwè abu, ọnụnọ nke aspergillosis, ọganihu nke ụkwara nta na-obere.

mgbochi

Fibrocavernous ụkwara nta bụ nke na udi nke ọrịa ndị oghom na-elekọta mmadụ ihe. Ọtụtụ mgbe, ndị na-akpata nke arịa ọrịa nke ibi ndụ na ihu ọma nke ndị bi na.

Dị ka ọnụ ọgụgụ, ndị ikom na-arịa ọrịa 3 ugboro karịa ndị inyom. Ihe bụ isi daa ọrịa bụ ofu na afọ 20 na 39 afọ.

Iji gbochie dụrụ na-edebe ụkpụrụ ndị a:

• eduzi kwesịrị ekwesị mgbochi;
• n'oge njirimara nke ndị mmadụ na-emetụta ọrịa;
• nhọrọ steeti ego maka ọgwụ ọjọọ;
• mmejuputa iwu-nke mbido ọgwụ nnyocha mgbe na-achọ ọrụ na anụ ụlọ oru;
• ntọt ke ebe maka ulo nke ọrịa ndị na-chọpụtara na-arịa ụkwara nta;
• adọ mmejuputa iwu nke ịgba ọgwụ mgbochi ọrịa na ụmụ ọhụrụ n'ọnwa mbụ mgbe amuchara nwa.

ọgwụgwụ

Fibro-cavernous akpa ume ụkwara nta (nsogbu-eyi egwu na steeti ahụ ike) bụ a-adịghị ala ala ọrịa. Dị ka a na-achị, ọ na-kpasue cavernous ụkwara nta. The ọrịa nwere ike ji dị ka a unilateral ma ọ bụ bilateral ọnya.

Na mbụ daa ọrịa siri ike na-emeso, ọ bụ ugbu a na nkà mmụta ọgwụ nwere a dịgasị iche iche nke dị iche iche ọgwụgwọ ụgbọelu na ga-hụ anụ kwụsịtụkwara ọtụtụ afọ. Bịara n'Ezi Oge ọgwụgwọ nwere ike ịzọpụta onye ọrịa nwere na-arụ ọrụ.