Bacillus tiibhii: vangani upenyu, sezvinotaurwa? Chii TB?

Tiibhii - chinhu chirwere achinyengera kuti chinobata kwete chete vakuru asiwo vana. To kunoguma chirwere basa mycobacteria (Koch kuti bacillus) ari mumuviri womunhu. In pakurapa pathologies vakashandisa multicomponent mishonga, izvo zvinogona kutora mwedzi mitanhatu kana kupfuura. Muna 50% nyaya, kushayikwa kurapwa, hosha kunoguma murufu. Chii tubercle bacillus pamusoro Koch, rikawira mugomba muviri womunhu uye sei kudzivirira kukura chirwere sei - mibvunzo iyi ichapindura munyaya ino.

Pfungwa mycobacteria

Tiibhii - ane zvirwere zvinokonzerwa mapoka Mycobacterium vari Mycobacterium tibhii (MBT). Izvi mhando mabhakitiriya unowanzonzi tubercle bacillus - nezita musayendisiti German Roberta Koha. Science unozviziva 74 mhando mycobacteria zvinowanikwa muvhu, mvura, mhuka uye vanhu. Ndinofanira kutaura kuti okuva tibhii kukonzerwa dzakasiyana siyana mycobacteria akasiyana mumwe.

Tubercle bacillus ane unodzivirira mumuhara, iyo inobatsira utachiona kurarama mu zvakatipoteredza. MTB ndiyo yakarurama kana zvishoma curved, mira, kana Kamudzira nezvimiro kwete spores, zvishoma nezvishoma propagates ane chepuraimari panoparadzana muzvitokisi maviri, weboka kunoita maawa 14-18. Kazhinji, kubereka rinowanikwa muna zviviri munzira - ne yotunga, asingasviki branching.

Mycobacterium kunyora nezvavo miganhu: dhayamita kunosiyana-siyana pakati 0.2-0.6 m, urefu - 1-10 microns. Tubercle bacillus ndohwaJehovha notumwe nokuti akafanana unoratidzwa chete okisijeni rinodyiwa. MTB nyuchi tananaira (mukati memazuva 34-55) kukura pamusoro hwakasimba unosvikirwa, vane dzemakwiringwindi pamusoro, zvakaneta pigmented - a blue-orenji kana samafuta.

Sechivako MTB masero

Masero Chirwere pakati tubercle bacillus ine zvinotevera zvinhu:

• Sero rusvingo - akaumbwa vanoverengeka akaturikidzana, Mycobacterium Kudzivirira zvemaziso uye nemakemikari kurwisa; Rinotibatsira dzose Ukuru chimiro pamakamuri (zviya, chikamu containment unotora munhu waxy, mafuta fuma);
• kwemabhakitiriya cytoplasm pamwe granular inclusions;
• cytoplasmic Kamudzira;
• renyukireya fuma, mukati umo tenderera DNA.

MBT riri kuramba kwazvo zvezvakatipoteredza zvinofurira uye refu anoramba chinhanho kwayo. upenyu vangani tubercle bacillus? Mycobacteria anogona kuvapo: kusvika makore 7 ari nyoro uye rima panzvimbo imwe tembiricha 23 ° C; kusvika mwedzi 12 ari murima uye yakaoma nzvimbo; kusvika 6 mwedzi muvhu; kune 5 months mumvura; kusvika 3 months mumabhuku; kusvika 2 months mumugwagwa muguruva; kusvika 2 weeks ari chizi mukaka; kusvikira pagore mafuta uye chizi. Mycobacterium tiibhii havana kutya pakati dzinotsanagura kuora uye mwedzi mishoma angawanika akavigwa pasi miviri. Zvisinei, mashoko zvakananga kupenya kwezuva kuparadza ILO uye maawa nehafu ultraviolet mwaranzi - mumaminitsi mashoma. Chlorinated disinfectors ukunde bacillus kwemaawa 5. Mycobacteria uyewo nehanya rehydrogen peroxide. Vakaurayiwa tubercle bacillus nokuda kudziyisa: kwemaminitsi 20 pa 60 ° C uye kwemaminitsi 5 - pa 70 ° C.

MBT zvingakonzera chirwere pashure maviri kana kuti matatu kuvapo uye asymptomatic nokuti muviri nguva refu kutanga Anti-TB kutapata.

Chii TB?

Sezvacherechedzwa kare, tiibhii - ane zvirwere kunokonzerwa Mycobacterium basa. Vazhinji chirwere rinopararira pedyo droplet noutachiona munhu ane HIV kuti utano kuonana (vangakosora, sneezing, kukurukurirana). Dzimwe utachiona zvinogona hunhu zvokudya (yakatsvuka mukaka).

Pangozi - vanhu vaigara munzvimbo ine kukodzera utsanana - majeri, misha misha. Izvi zvinosanganisira varwere simba zvirwere (HIV, kenza varwere). chirwere cheshuga; vacheche; vakwegura; nhengo dzemhuri nechirwere chorurindi; vanosvuta; Vanhu vane murombo muviri - Mapato aya vanhu vakawanda kazhinji kurwisa kunyange tubercle bacillus. simba nzira kunoda fanira yaunodya mavhitamini uye zvicherwa kubatsira nokudzosazve wakaderedzwa masoja basa.

Kuitika tibhii kunokonzerwa nomumwe zvechadenga nhengo uyewo chokuita mupfungwa mamiriro wacho sezvo zvakananga. Maererano zera kodzero iri hunodzorwa boka revanhu kwemakore 18-26 okuberekwa.

The peculiarity chirwere ichi ndechokuti TB bacillus yava vachiva nemishonga, saka kurapwa nzira kunosanganisira kushandisa zvinodhaka akawanda panguva imwe chete.

Maererano WHO nenhamba, inenge chetatu vepasi yasvibiswa tubercle bacillus, asi muviri wakasimba haibvumiri kuti Office kuwanda. The zvokurwara rikaitika muviri chete pasi akanaka ezvinhu ichi - akatura kutapata. Gore negore kubva matambudziko ose tibhii, inouraya vanhu vanenge mamiriyoni matatu munyika. World TB Day rakaitirwa musi 24 March.

TB kufamba nzira

Pane ina huru idzo tiibhii anoparadzira rutanda:

• kuenda neherikoputa kana mycobacteria kupinda mumhepo mumate apo vangakosora, sneezing kushivirira;
• alimentary - chirwere kunoitika kuburikidza nemudumbu;
• kuonana - chirwere kunoitika kuburikidza meso conjunctiva (utachiona ganda haiwanzowaniki kutanga);
• utero - utachiona hosha placenta panguva pakuzvarwa kubva amai mwana.

In hwakanaka muviri kufema gadziriro kunodzivirirwa pamusoro kupinda ose mycobacteria madzihwa, izvo anosunungurwa nemasero kushandiswa. Zvisinei, pamwe kuzvimba kufema ezvinhu, uyewo pasi pokudzora muchetura "dziviriro" haashandi. Mukana chirwere parutivi alimentary kunoenderana ezvinhu rusvingo intestinal, ayo Absorção de Água vanokwanisa.

Sezvo tubercle bacillus riri kunze muchitokisi uye anowedzera zvishoma nezvishoma zvinyama kwenguva yakati kuramba maumbirwo yavo utano, zvisinei, Mycobacterium imwe nguva kupinda aibuda node node nodes uye dzakapararira muviri. Chinonyanya akanakira mycobacteria miviri chete dzakabudirira microvasculature (zvemapapu, renal cortex, madhipatimendi fallopian sepombi). Pangosvika Office pinda masero mukati, vanotanga kukuvadza nechivako ayo uye kugoverana.

zvokurwara anatomi

In nhengo sei chirwere kunoitika, "inotonhora" kuzvimba inotungamira kuti paumbwe granulomas muzvizhinji - hillocks havatani kudzikisirana. Maitiro muviri anoratidzwa mune shomanana pashure chirwere. Cellular kutapata achiumbwa pashure pemwedzi miviri. Inotevera chokutambudzika kukura pathological muitiro kunoratidzwa kunonoka kukura Office, kuti anogumbura mhinduro akarasika, Zvisinei, causative mutumwa anogumbura pfungwa haisi chose chapedzwa.

Tubercle bacillus mumuviri inochengeterwa kwenguva refu, uye munhu anogona kuva mutakuri ILO upenyu. Tiine kwakaderera kutapata yasara Vagari Office huchatungamirira kugoverana, achiita zvishoma nezvishoma kukura tibhii. The pangozi yokuita nehosha yokutanga utachiona munhu 10% mumakore okutanga maviri apfuura mushure chirwere. Nokufamba kwenguva uchava kuderera mukana wokuti chirwere.

Apo simba kutapata pamusoro muviri hakusi kupikisa Mashoko utachiona masero kuti kunoitika exponentially. Nokuti upenyu akaumba MTB chaiwo zvakanaka ezvinhu umo yoga granulomas vari akabatanidzwa mune zvakafanana vhoriyamu, saka vanoti kuti chikuru chirwere unobuda kuti danho kunotoda kurapwa tibhii. Kuzvimba rinopararira mberi mhiri dzichipfekeka hurongwa.

Forms uye mhando chorurindi

Pashure chirwere zvokurwara anova Isimba rakadini rinogona kubudiswa chimiro, kureva. E. Kakawanda asymptomatic. chimwe chete kubva nyaya gumi, unopinda kushingaira kutotanga. Coli TB kunyanya kunokanganisa mumapapu asi anogona kukanganisa vamwe muviri enyika.

Kusiyanisa mhando mbiri TB:

• rakavhurika,
• up.

Kana kuvapo rakavhurika chimiro tubercle bacillus iri nyore kuona mu sputum kana mune mamwe murwere secretions (weti, mutsvina yadzo). Kutadza kutevedza Utsanana zvokungwarira chimiro ichi zvingaita kuti chirwere vamwe. In namahwindo chimiro mycobacteria haana kuona, uye varwere regai vangangokukuvadza vamwe.

Zvichienderana worudzii dzichipfekeka gadziriro iri pachena kuti tubercle bacillus, zvokurwara Classified sezvinotevera:

• pulmonary tibhii,
• extrapulmonary tibhii.

Zvichienderana kuti zvokurwara apararira mumuviri, Munokudzwa:

• Isimba rakadini rinogona kubudiswa tibhii,
• neakangwara tibhii,
• zvatichiri tibhii,
• caseous nemabayo,
• tubercles
• fibro-cavernous tibhii,
• cirrhotic tibhii,
• pleural tibhii, dokeriro kana trachea - kutanga zvisinganyanyi kuitika.

Extrapulmonary tiibhii kunokanganisa mumwe muviri, mauri zvokurwara iri Classified mu:

• TB CNS uye meninges - maperembudzi kunokanganisa musana uye pfungwa, nesimba deko;
• zvomudumbu ezvinhu, umo kazhinji inobata dzakaonda uye caecum;
• Tiibhii of urogenital bhora kunokanganisa itsvo, Urinary turakiti, nhengo dzokubereka nadzo;
• pfupa hurongwa;
• lupus;
• Tiibhii maziso.

The zvekuchipatara Kuratidza chirwere. tiibhii zvomusoro tsinga

Sezvandambotaura, nokuti kuti tubercle bacillus rinokamukana zvishoma nezvishoma, vanouwana Pandakangowana nguva zvinobvira. Naizvozvo zvokurwara anogona refu kuoneka uye gare gare akaziva netsaona munguva fluoroscopy kana tuberculin nemiedzo. Mukuwedzera, maduramazwi nezviratidzo chirwere Chokwadi, haako. Chokwadi kuti muviri kunoitika kudhaka, zvingaratidza pallor, chirwere kuneta, kana hope, kusakendenga, zvishomanana kuwedzera muviri tembiricha (anenge 37 ° C), wakawedzera vangadikitira, uremu, akawedzera node nodes.

Laboratory kuongorora ropa varwere tibhii anoona simbi kushaikwa, kuderera kwenhamba masero eropa machena. Gare gare, apo chirwere anopinda kupfuura kushingaira danho kuti vabatane apa zviratidzo tiri zviratidzo zvakajeka zvokurwara pakati njodzi nenyere.

Kana Mycobacterium inokanganisa musimboti tsinga, murwere wakacherechedza, kuwedzera refu tembiricha, imwe hope, hukasha, yakanyanya nomusoro, kurutsa. Pakupera kwevhiki yacho kutanga kwezviratidzo kuchinja yokutanga rechipiri kuitika muuropi Kamudzira zvivako, izvo kubudikidza kusungika kwemitsipa tsandanyama uye kutadza inozivikanwa kusamuendesa chirebvu wako muchipfuva chako, ruoko makumbo ako napo. The chirwere cheshuga pangozi mapazi, kana vatakuri immunodeficiency utachiwana. Hazvishamisi kuwanikwa muna pakanyorwa zvokurwara iyi chirwere chepfungwa uyewo havachanyatsogoni kuziva, nehanya, kwebasa eyeballs.

Kusiyana nehosha mune vakura kwevanhu tubercle bacillus muvana zvimwe kunokonzera chirwere zvikuru nokukurumidza uye kwazvo, dzimwe nguva zvichikonzera rufu. It dzinoruramiswa anonyanya underdeveloped mwana zvirwere. Kubatwa nezvirwere ichi kakawanda kupfuura vana vari ezvinhu varombo zvoutsanana, murombo muviri, nguva zvakapfuuridza. Tubercle bacillus muvana kunokonzera zvakananga zviratidzo muviri wacho, saka vabereki vanofanira anokwezvera kurutsa, kurukutika mwana, akaderedza kutarisirwa, kurasikirwa kudya, uremu, muviri.

Tiibhii zvimwe dzichipfekeka gadziriro

Kuwedzera zvemapapu masero uye nechepakati tsinga zvokurwara anorwisa dzimwe nhengo mumuviri womunhu, akadai kufema hurongwa. Saka, tuberculous pleurisy - kukundwa of pleura Kamudzira anofukidza mumapapu. zvokurwara Izvi zvinogona kuva yakazvimirira chirwere, kana kuitika somugumisiro yakaoma pulmonary tiibhii hurongwa. Chimwe kuomesa kwakaita pulmonary tiibhii kunogona tibhii yokumusoro kufema turakiti, apo mune kushoma kunobatanidza pharynx uye dokeriro. Zviratidzo chirwere chakadai kuwedzera chambotaurwa nezvacho muri hoarseness kana kuome kumedza.

The kukundwa of tubercle bacillus inonzi node raiva pedyo nebundu tiibhii lymphadenitis. Kazhinji pasi kurwisa supraclavicular kana remuromo node nodes kuti awanda asi nyarara.

MTB kunogonawo kukanganisa nhengo yacho urogenital hurongwa. Maperembudzi kunoratidzwa yakapinza kurwadziwa mukati muchiuno kana musana, refu muviri tembiricha. Kana weti zvinogoneka kusvibisa. The zvokurwara rinowanikwa zvienzane mari mu vose vakadzi nevarume.

Tiibhii repfupa rinenge inozivikanwa kakawanda mitswe, kurwadziwa Munzvimbo, nekusagona kutama zvakanaka. Kumhanya siyana zvokurwara kwakadaro kunotungamirira kurufu.

Kuongorora chirwere uye kurapwa

In nechirwere kuti basa tiibhii ndiyo inonyanya kufarirwa nzira sputum zodzera microscopy uye X-ray. Analysis zodzera Zvisinei, haagoni kunzi kushanda uye yakavimbika nzira, kubvira mangwanani nzendo chirwere, uyewo vanenge chirwere muvana kudzidza rinopa zvakaipa mugumisiro.

X-ray chirwere nzira dzinobudirira kunyanya yemhando chirwere. Kuwedzera chirwere nzira idzi anowanzoshandiswa tuberculin ganda bvunzo, panodamwa zvakafanana Mantoux kuita.

Chinangwa chikuru chemusha pakusarudza marapirwo murwere redunhu ndeyokudzidza kurapika, kureva. E. The nehanya kuti mycobacteria tsika rakura murabhoritari, kuti gadziriro medicamentous.

Nhasi, chikuru nzira Mabatirwo tibhii vachifarira pakurapa TB, ndiro multicomponent. Kusiyanisa ternary, quaternary uye quinary kurapwa zvaiitwa.

Ternary dhayagiramu anotora kushandiswa zvinodhaka zvitatu zvinokosha - "streptomycin yakawanikwa" "INH" uye a-aminosalicylic asidhi (pas.) zano uyu chaiwo, zvisinei, haawanzopiwi kushandiswa nhasi nokuda mukuru toxicity pas. The nzira inoshandiswa chetyrohkomponentnoy "Rifampicin" ( "Rifabutin") "INH" "Pyrazinamide" "Ethambutol". zvokurapa dzakawanda nzvimbo vanoshandisa zvinotova yepamusoro unyanzvi - shanu-zano kuti, kuwedzera kune apa zvinodhaka mana kuti vanoshandisa "Ciprofloxacin".

Ndinofanira kutaura kuti tiibhii - ane chirwere achinyengera, idzo kukura ndiko tubercle bacillus kunokonzera mumuviri womunhu. Treatment kunofanira nokukurumidza uye akarurama, nekuti pasina norufu yokurapa zvirwere apedza 50% nyaya. Zvinouraya Mugumisiro kunoitika mukati makore mashoma kubva pakutanga yezviri chokutambudzika chirwere. The yasara 50% nyaya kuguma chirwere chimiro chirwere. Uyezve, murwere, uyo akaratidza chirwere tiibhii ngozi vamwe, sezvo pfungwa huru mycobacteria mune zvakatipoteredza.

dziviriro

Matanho pamusoro tibhii nhasi anogona kunzi, zvimwe, BCG mushonga iro zvinobudirira kunodzivirira chimwe chezvinhu ngozi siyana tibhii - tuberculous yomumuzongoza. Maererano National majekiseni anodzivirira Purogiramu, majekiseni mwana achiri muchipatara mumazuva 3-7 oupenyu rokutanga. Uyezve, 7 uye 14, rinoitwa pasi mamiriro booster akaipa Mantoux maitiro uye kusavapo contraindications.

BCG (Bacillus Calmette-Zherena) chinoratidza rakaisvonaka mugumisiro asi fanira kubaya pamusoro tibhii hazvitombobvumidzwi zvose kunyika zvenyika, zvose zvinoenderana pachiyero TB mudunhu. Mwedzi mishomanana pashure kubaya panguva jekiseni nzvimbo ganda maitiro anooneka - chisimbiso chiduku.

Vaccinating mwana contraindicated anotevera nyaya:

• achangobva chirwere immunodeficiency, uyewo mhuri ine mwana chiso, vanotambura nezvirwere ichi;
• vane hama nehanzvadzi achangoberekwa yematambudziko achamuka shure yokudzivirira zvakadai;
• mwana, pane vakaremara ari nechepakati tsinga.

Vaccination anofanira ichinonoka kana:

• mwana haana donoshen,
• akawana ani zvirwere
• amai mwana yakasiyana kusapindirana kweropa chikonzero.

Zvakakosha kuyeuka kuti intractable chirwere kunokonzera tubercle bacillus. Achidya murwere kwevanhu mune mishonga anofanira kuva noutano uye zvakarurama. Tisanyanyozvidya kudyiwa mafuta zvokudya. The kuitwa zvokudya iri TB varwere chakaoma. Izvi nokuda anatomical maumbirwo MTB masero - goko rine zvakawanda mafuta. Munhu ane zvokurwara inoda zvokudya yakapfuma mapuroteni, makabhohaidhiretsi, mavhitaminzi uye microelements.

Kurerutsa mukana wokuti chikuru noutachiona mumba, zvinokosha kuti tirambe zvakanaka utsanana, kupedza nguva yakawanda panze, akusungirire amakwai uye zvigadzirwa donje muzuva.