Kufalitsa chifuwa chachikulu

Kufalikira kwa chifuwa chachikulu ndi matenda a mycobacterial momwe mycobacteria imafalikira kuchokera m'mapapu kupita mbali zina za thupi kudzera m'magazi kapena ma lymph system.

Matenda a chifuwa chachikulu (TB) amatha kuyamba atapuma m'madontho opopera m'mwamba kuchokera pachifuwa kapena kuyetsemula ndi munthu amene ali ndi khansa Mycobacterium chifuwa chachikulu bakiteriya. Matendawa am'mapapo amatchedwa TB yoyamba.

Malo omwe amapezeka TB ndimapapu (TB yam'mapapo), koma ziwalo zina zimatha kutenga nawo mbali. Ku United States, anthu ambiri omwe ali ndi chifuwa chachikulu cha TB amachira ndipo alibe umboni wina wamatenda. Kufala kwa TB kumayamba mwa anthu ochepa omwe matendawa amateteza matendawa.

Matenda omwe amafalitsidwa amatha kuchitika patangotha ​​milungu ingapo kuchokera matenda oyamba. Nthawi zina, zimachitika mpaka zaka mutadwala. Mutha kutenga TB yamtunduwu ngati muli ndi chitetezo chamthupi chofooka chifukwa cha matenda (monga Edzi) kapena mankhwala ena. Makanda ndi achikulire nawonso ali pachiwopsezo chachikulu.

Chiwopsezo chanu chotenga TB chikuwonjezeka ngati:

• Ali pafupi ndi anthu omwe ali ndi matendawa (monga paulendo wakunja)
• Khalani m'malo odzaza kapena odetsedwa
• Musakhale ndi zakudya zopatsa thanzi

Zinthu zotsatirazi zitha kukulitsa kuchuluka kwa matenda a TB mwa anthu:

• Kuchuluka kwa matenda opatsirana pogonana
• Kuchulukitsa kwa anthu osowa pokhala okhala ndi nyumba zosakhazikika (malo opanda thanzi ndi chakudya)
• Maonekedwe a mitundu yolimbana ndi mankhwala a TB

TB yofalitsidwa imatha kukhudza madera osiyanasiyana mthupi. Zizindikiro zimadalira mbali zomwe zakhudzidwa ndi thupi ndipo zimatha kuphatikiza:

• Kupweteka m'mimba kapena kutupa
• Kuzizira
• Chifuwa ndi mpweya wochepa
• Kutopa
• Malungo
• Kusapeza bwino, kusakhazikika, kapena kudwala (malaise)
• Ululu wophatikizana
• Khungu loyera chifukwa cha kuchepa kwa magazi m'thupi (pallor)
• Kutuluka thukuta
• Zotupa zotupa
• Kuchepetsa thupi

Wothandizira zaumoyo adzayesa. Izi zitha kuwonetsa:

• Kutupa chiwindi
• Kutupa ma lymph node
• Kutupa nthenda

Mayeso omwe atha kulamulidwa ndi awa:

• Biopsies ndi zikhalidwe za ziwalo kapena ziwalo zomwe zakhudzidwa
• Bronchoscopy ya biopsy kapena chikhalidwe
• X-ray pachifuwa
• Kujambula kwa CT komwe kwakhudzidwa
• Fundoscopy imatha kuwulula zotupa m'maso
• Interferon-gamma amatulutsa mayeso amwazi, monga mayeso a QFT-Gold kuti ayesere ngati ali ndi TB
• Chifuwa chamapapo
• Chikhalidwe cha mycobacterial of marora kapena magazi
• Zosangalatsa kwambiri
• Kuyesa kwa khungu la Tuberculin (mayeso a PPD)
• Kufufuza kwa sputum ndi zikhalidwe
• Thoracentesis

Cholinga cha mankhwalawa ndikuchiza matendawa ndi mankhwala omwe amalimbana ndi mabakiteriya a TB. Chithandizo cha TB yofalitsidwa chimaphatikizapo kuphatikiza mankhwala angapo (nthawi zambiri amakhala 4). Mankhwala onse amapitilizidwa mpaka kuyezetsa labu ikuwonetsa yomwe ikugwira ntchito bwino kwambiri.

Mungafunike kumwa mapiritsi osiyanasiyana kwa miyezi 6 kapena kupitilira apo. Ndikofunikira kwambiri kuti mumwe mapiritsi momwe woperekayo walangizira.

Anthu akamamwa mankhwala awo a chifuwachi monga momwe alangizira, matendawa amakhala ovuta kwambiri kuwachiza. Mabakiteriya a TB amatha kulimbana ndi mankhwala. Izi zikutanthauza kuti mankhwala sakugwiranso ntchito.

Pomwe pali nkhawa kuti mwina munthu sangamwe mankhwala onse monga adanenera, wopezera ndalama angafunike kuti amuyang'ane munthuyo akumwa mankhwala. Njirayi imatchedwa chithandizo chodziwika bwino. Poterepa, mankhwala amatha kuperekedwa kawiri kapena katatu pamlungu, malinga ndi zomwe woperekayo wanena.

Mungafunike kukhala kunyumba kapena kulandilidwa kuchipatala milungu iwiri kapena iwiri kuti mupewe kufalitsa matendawa kwa ena mpaka mutapatsirana.

Woperekayo angafunike mwalamulo kuti anene matenda anu a TB ku dipatimenti yazaumoyo yakomweko. Gulu lanu lazachipatala lidzaonetsetsa kuti mulandila chisamaliro chabwino koposa.

Mitundu yambiri ya TB yofalitsidwa imayankha bwino kuchipatala. Minofu yomwe imakhudzidwa, monga mafupa kapena mafupa, imatha kuwonongeka kwamuyaya chifukwa cha matendawa.

Zovuta za kufalitsa TB zitha kukhala:

• Matenda akuluakulu opuma (ARDS)
• Kutupa chiwindi
• Kulephera kwa mapapo
• Kubwerera kwa matenda

Mankhwala omwe amachiza TB amatha kuyambitsa mavuto ena, kuphatikiza:

• Zosintha m'masomphenya
• Misozi yofiirira- kapena bulauni ndi mkodzo
• Kutupa
• Kutupa chiwindi

Kuyesedwa kwamasomphenya kumatha kuchitidwa musanalandire chithandizo kuti dokotala wanu athe kuwunika kusintha kulikonse kwamaso anu.

Itanani omwe akukuthandizani ngati mukudziwa kapena mukukayikira kuti mwapezeka ndi TB. Mitundu yonse ya TB komanso kuwonekera kumafunikira kuwunika mwachangu ndi chithandizo.

TB ndi matenda otetezedwa, ngakhale kwa iwo omwe adakumana ndi munthu yemwe ali ndi kachilomboka. Kuyezetsa khungu pakhungu la TB kumagwiritsidwa ntchito mwa anthu omwe ali pachiwopsezo chachikulu kapena mwa anthu omwe atha kukhala kuti ali ndi TB, monga othandizira azaumoyo.

Anthu omwe adakumanapo ndi chifuwa chachikulu cha TB ayenera kuyezetsa khungu nthawi yomweyo ndikuyesanso kumapeto kwake, ngati kuyezetsa koyambirira kulibe.

Kuyezetsa khungu kumatanthauza kuti mwakumana ndi mabakiteriya a TB. Sizitanthauza kuti muli ndi matenda opatsirana kapena opatsirana. Lankhulani ndi dokotala wanu za momwe mungapewere kutenga chifuwa chachikulu.

Chithandizo chofulumira chimafunikira kwambiri pakuletsa kufalikira kwa TB kuchokera kwa omwe ali ndi matenda a TB opita kwa omwe sanatengepo ndi TB.

Mayiko ena omwe ali ndi chifuwa chachikulu cha TB amapatsa anthu katemera (wotchedwa BCG) wopewa TB. Mphamvu ya katemerayu ndiyochepa ndipo siyimagwiritsidwa ntchito ku United States.

Anthu omwe adakhalapo ndi BCG atha kuyesabe khungu la TB. Kambiranani zotsatira za mayeso (ngati zili zabwino) ndi omwe amakupatsani.

TB ya Miliary; Chifuwa chachikulu - kufalikira; Chifuwa chowonjezera cha TB

• TB mu impso
• Chifuwa cham'mapapo
• Mapapu ogwira ntchito yamakala - chifuwa x-ray
• TB, patsogolo - chifuwa x-ray
• Matenda a TB
• Erythema multiforme, zotupa zozungulira - manja
• Erythema nodosum yokhudzana ndi sarcoidosis
• Njira yoyendera

Ellner JJ, Jacobson KR. Matenda a chifuwa chachikulu. Mu: Goldman L, Schafer AI, olemba. Mankhwala a Goldman-Cecil. 26 wa. Philadelphia, PA: Elsevier; 2020: chap 308.

Fitzgerald DW, Sterling TR, Haas DW. Mycobacterium chifuwa chachikulu. Mu: Bennett JE, Dolin R, Blaser MJ, olemba., Eds. Mandell, Douglas, ndi Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020: chap 249.