Tiibhii pakati intrathoracic node nodes, Diagnostics, marudzi chirwere

Tiibhii pakati intrathoracic node nodes - mufananidzo chirwere, iyo ichiri kwete zvakazara Classified. Vamwe vanodavira kuti chinogona raireva yakazvimirira chirwere, vamwe vanodavira kuti kunofanira kusiyiwa chikuru tiibhii yakaoma. chirwere ichi ichakurukurwa munyaya. We funga muudzame zvinokonzera chirwere, ayo siyana, nzira nechirwere uye kurapwa nzira, uyewo zvichibvira yematambudziko uye matanho.

Chii?

Tiibhii pamusoro intrathoracic node nodes (VGLU) - chirwere dzinoratidzwa anogumbura pezvakaitwa kutanga nodes riri zvemapapu midzi. Huchaita zvokurwara Mycobacterium tibhii. The causative mumiririri inogona pachishandiswa nemhuka utachiona.

VGLU Tibhii kazhinji inokanganisa vana, vayaruki uye vechiduku kusvikira makore 25. Nemhaka vakawanda kubaya dambudziko zvokuti hapana nyaya chirwere hadziwanzowaniki uye anowanikwa chete panguva yakaderera kutapata. zvokurwara Izvi dzinoratidzwa chirwere kosi ine ya zviito chinopedza muitiro. 70% of yematambudziko chirwere kuitika vana pasi makore matatu.

chirwere nzira

All marudzi tibhii ose intrathoracic node nodes muvanhu anokonzerwa utachiona Mycobacterium tibhii.

Chirwere kunoitika nenzira dzinotevera:

• Nokuda kushandisa zvekudya zvinobva murwere mhuka (semuenzaniso, mukaka).
• By mumate kubva utachiona munhu kana mhuka.
• Kuburikidza zvinhu zvezuva nezuva uye zvokudya kwakasvibiswa utachiona.
• Kuburikidza mavanga paganda.
• It hunogona kutapukira kubva amai mwana panguva pamuviri (kuburikidza placenta) uye lactation (mukaka).

Zvinonzi zvikuru zvichida kutapukirwa kuburikidza kufema turakiti. Munhu ane TB, nguva dzose vangakosora uye kutaura exhales mumhepo phlegm kuti rine tusingaoneki utsinye. Vanokwanisa kuwedzera kune chinhambwe mamita maviri uye kuramba mumhepo kweinopfuura awa. Vakazoudza uchagara pasi uye yakavhenganiswa guruva, uye chinhanho avo vakaramba kusvikira mwedzi mitanhatu.

Ndezvipi anowedzera mukana chirwere?

Miviri utano kufema evanhu anodzivirirwa TB utachiona, asi kusvuta uye bronchopulmonary zvirwere zvinogona kuderedza kutapata. Muna 95% nyaya panguva kuonana nevanhu tiibhii utachiona utachiona kunoitika.

Zvinhu zvinowedzera mukana chirwere:

• Kukwana uye kudzikama kudya kunovaka.
• Kwenguva refu nevanhu utachiona tibhii.
• Murombo dzimba ezvinhu.
• Kuvapo chisingaperi zvirwere.
• Great kwomuviri nepfungwa mupfungwa.

Kazhinji utachiona mumwe zvinhu izvi, uye kunyange vashoma kunosanganisira nhoroondo zvokurapa. saka tiibhii pamusoro intrathoracic node nodes inobata vanhu vane tsika dzakaipa vanotambura nekuora kuneta, uyewo vana kubva zvadzinoshayiwa. Chirwere zvisingaiti kuchengeta, kuti muviri chete utano pakarepo anotanga kuumbika dzinongoitika kutapata. Apo ndaiva murwere anogona rimwe zuva kutora vanhu vashoma, asi kubata mumwe chete muviri chisingafaniri takagadzirira kuzvidzivirira. Pangozi vana uye vakuru kuti vasina nhomba, uyewo varwere HIV uye vanhu vane simba zvirwere.

marudzi chirwere

Pane zvinotevera siyana tibhii ose intrathoracic node nodes:

• Bundu.
• Infiltrative.
• Small.

Bundu mufananidzo rinorema bronhoadenita. It rinowanzoberekera muvana vaduku vane simba yakawedzera node nodes (dhayamita yavo inogona kusvika kusvika 5 cm) uye hombe tubinfitsirovanii. Kazhinji njodzi zvinoriumba vari welded kuumba chete conglomerate.

Infiltrative chimiro kunokonzera zvishomanana yakawedzera node nodes, saka perinodulyarnoe kuzvimba chinokurira.

Short chimiro

Small chimiro tibhii ose intrathoracic node nodes zvakaoma kuona, uye kunokanganisa kunyanya vana. Late chirwere kana vasamuziva zvinoisa scarring pamusoro mediastinum, iyo kunokanganisa dzose kushanda rirambe richibvira ropa riyerere pulmonary. Uyewo zvokurwara kungaita kuti chidzoke zvikuru chakakomba uye ngozi muchimiro tibhii.

Kuti aite kwechokwadi chirwere uye kuziva zvirwere, zvinokosha kufunga rose rakaoma pakati radiological uye endoscopic data, unofanira kupedza tomography pamusoro mediastinum.

rokuongorora matambudziko diki chimiro

Kunyange basa chokutambudzika tibhii duku intrathoracic node nodes 1-2 kunoratidzwa maronda ari node nodes ane diki nokuwedzera (1.5 cm). Zviratidzo izvi chinogona kuoneka X-ray.

Clinical zviratidzo simba chaizvo. Nechipiriso hunongotaura nefivha yakaderera wegiredhi uye kudhaka syndrome. In kuyaruka, chikuru chokunyunyuta dystonia. Naizvozvo, varwere vari aiwanzotuma kuti ndiongororwe vanachiremba nevamwe profiles. In ichi chimiro duku tibhii ndiyo ngozi nokuti chirwere chinogona kukonzera dzimwe nhengo dzomukati.

zviratidzo

Tiibhii pamusoro intrathoracic node nodes ane zvinotevera zviratidzo:

• tembiricha muviri achisimuka madhigirii 39.
• Usiku, hakuna kujeka vangadikitira, kuti hazvikonzerwi nokupisa.
• Ungaderedza kudya.
• Chikosoro kunotanga seiya rinowanika whooping chikosoro.
• Chakakomba pallor ganda kuti munhu rinokwanisa kucheneruka Hue.

Zvisinei, zviitiko izvi zvinogona kurwara-kunotsanangurwa, ipapo kuongororwa zvakarurama pamusoro pavo achava zvakaoma. Asi zvimwe zvinhu zvinogona kuzivikanwa muna Kuedzwa kunoenderera:

• Kutarisana. Peripheral venous rezvebonde anowedzera zvinooneka munyika rokutanga uye rechipiri intercostal nzvimbo. Between Vanes midziyo zviduku anomunzwira muimba migove.
• Palpation. The panowanikwa marwadzo ari kumanikidza spinous dzinotsanagura ari thoracal vertebrae (kubva 3rd kuti 7th).

Zvinokosha nechirwere nokuda tibhii ari X-ray kuzviongorora. Voitakura kunze saizvozvo lateral uye Antero-posterior maberere, t. K. A mumvuri node nodes zvinogona kuvanzwa mediastinal nhengo uye cardiac tsandanyama. Zvinokoshawo kuti kuitisa Scans yacho tracheobronchial muti. Asi zvakawanda pamusoro hurukuro inotevera.

Diagnostics

Zvakaoma chaizvo kusiyanisa nedzimwe pathologies tiibhii yakafana intrathoracic node nodes. Differential chirwere chinodiwa sezvo pasi mumwe nomumwe chirwere.

Saka, sei kutanga kuongorora chirwere?

Danho rokutanga kuziva pamberi Mycobacterium tiibhii pamuviri. TB utachiona vanogona nyore kuwanikwa mukubviswa mvura mudumbu. Kakawanda vari inowanikwa kugeza mvura principales, sputum.

Next kumusoro ndiye fanira radiological kuzviongorora. Rinogona kushandiswa kwete chete kuti aone kana munhu noutachiona, asiwo kunzwisisa sei refu iye vatapukirwa. Uyewo zvakanaka kuri unyanzvi kuti tikwanise kuongorora nemamiriro node nodes kuti zviite vanachiremba zvakakomba dambudziko iri kuongorora chirwere.

An chirwere nzira inokosha ndiye Mantoux bvunzo. With yakanaka mugumisiro, zviri kunzi "chijana." Panyaya iyi, zvakaitwa utachiona kuita jekiseni ndiyo zvinotevera - the jekiseni nzvimbo kwakawedzera neinopfuura 5 mm. "Virage" kunokwanisa kuonekwa mune zvinotevera nyaya:

• Papule (rakavhara nzvimbo) anova mukuru 0.5 cm.
• It anova zvikuru zvichienzaniswa yapfuura zvabuda.
• Akapfuudza wokuyera 17 mm pasina kukamurwa yapfuura kubaya.
• Pashure 3 makore ayo saizi mukuru 12 mm.

Zvisinei, kwete nguva dzose zvakanaka Mantoux anotaura pamusoro chirwere. Pane mukana kuti chikonzero chakadaro maitiro kungava sema kana kare Kutamiswa zvirwere. Uyewo havasi akaipa bvunzo inoratidza kusavapo chirwere. Zvenhema nemigumisiro kunaka zvinogona kukonzerwa immunodeficiency kana chokuti kubvira nguva chirwere haisati akapfuura mavhiki 10.

Zvisinei, "vanobwembura" chikonzero yakakwana kuramba zvimwe yokuedzwa.

Uyewo, vanoita bvunzo ropa sechikamu chirwere dzokuvhiya. Kana uwandu MTB hweHIV leukocytes, lymphocytes, neutrophils, eosinophils achawedzerwa zvishoma.

Differential chirwere kuti tibhii ose intrathoracic node nodes

Apo chirwere kuti tibhii VGLU kazhinji kuti kusiyaniswa nevamwe pathologies tibhii. Kuti aite izvi, nokungwarira chiremba anofanira kuongorora nhoroondo, kuziva mukana wokuti kuonana varwere bacillary, kuongorora tuberculin bvunzo, dzokorora zvose kare Kutamiswa zvirwere inogona kufanana chirwere.

Kunze kukwanisa kuvhiringidzwa nomumwe VGLU tiibhii Tibhii maonero, hapana kazhinji kusiyanisa kubva nezvirwere intrathoracic node nodes.

Zvinogonekawo kuti kuvhiringidza zvokurwara pamwe metastasis kunobva kukundwa kenza yemapapu uye lymphosarcoma. Zvisinei, kwakadaro mukana anongowanika varwere vakwegura.

kurapwa

Tiibhii pamusoro intrathoracic node nodes muvana uye vakuru kunotora nzvimbo dzinenge zvakafanana, saka kurapa ushandiswe shoma kusiyana.

Kurapa kwaiita tibhii refu zvakakwana. Paavhareji, kunokwanisa kutora pose kubva 10 mwedzi kuti gore nehafu. Panyaya iyi, iyo 2-3 mwedzi wokutanga, murwere inofanira kuva chinhu tiibhii muchipatara. Chekutanga, kuti varege kukanganisa vamwe. Chechipiri, nokuti zvimwe anobudirira kurapwa.

nguva yose iyi yakaoma kurapa, izvo zvinosanganisira mishonga pamusoro tibhii, gepatoprotektory, mavhitaminzi, uye immunomodulators.

Uyewo ari wokutanga shoma vhiki iri yemhando nzendo chirwere chinogona kuitwa mishonga. Zvisinei, kakawanda basa akasiyana ezvinhu depuration. Somuenzaniso, intravenous Laser irradiation kana plasmapheresis ropa.

VGLU TB kurapwa rakakamurwa muzvikamu zviviri. Panguva ndichibvunza kurapwa rinoitwa tanga, nechinangwa rinoparadza Office, kuzoita wakakanganiswa zvemapapu rinenge pamusoro nguva uye kudzivirira zvirwere yematambudziko. Zvipatara pamusoro TB rinosanganisira mubatanidzwa zvinodhaka zvakawanda kuti anogona kuparadza marudzi ose MBT. Danho rechipiri hakusi kwazvo. Pano chikuru chinhu - kudzivirira apiwa kukura zvokurwara, kukurudzira zvinyama zvokuporesa, kuuraya chero mycobacteria dzasara inokuvadza uye kusimbisa zvirwere.

Panguva yose kurapwa inokurudzirwa kutevera chaiyo kudya, izvo zvichakubatsira kuti kuderedza toxicity muviri uye kuwedzera kuramba chirwere. Zvokudya nguva dzose zvinosanganisira zvokudya dzakakwirira mapuroteni chiratidzo (mazai, nyama, nomukaka zvigadzirwa), ruomba namafuta, nouchi, bota, michero nemiriwo yakawanda vhitamini C.

kuvhiya kupindira

Tiibhii pamusoro intrathoracic node nodes kazhinji kunotungamirira kune kudikanwa kuvhiyiwa, sezvo chirwere anomhanya zvikuru chinyararire, anenge asymptomatic.

In zvachose pane zvikonzero zviviri kuvhiyiwa:

• Tanga kuvaka tuberculoma node nodes.
• Kushaya chero yakanaka migumisiro kurapwa, iyo kwakatangwa mwedzi anopfuura matanhatu apfuura.

zvinogoneka yematambudziko

We nyora zvingangoitika matambudziko anoitika tibhii ose intrathoracic node nodes:

• Nezvekugadzirwa simbi-Árbol fistulas nokuda rinorema kukundwa yacho principales.
• Nokuda kutyorwa Árbol mhingaidzo, kunoitika apo Árbol sepombi kusvinwa ne muhombe node nodes kana blockage dzavo cheesy vakawanda kwakakwana, kazhinji pokuwa mugove, atelectasis ari zvemapapu rakamiswa pamusoro pekamuri kumanikidzwa kana blockage.
• Total kana zvatichiri atelectasis (spadenie chikamu kana akafukidza zvemapapu).

matanho

Tiibhii pamusoro intrathoracic node nodes, nechirwere icho MuNharireyomurindi zvakadzama nesu pamusoro zvinoshanda, uyewo zvose kumwe tibhii, kuti "munzanga chirwere." Kureva, ayo chitarisiko zvinoenderana nderemagariro uye padanho kubudirira. MuRussia, zvinokonzera denda vachirwara chirwere ichi chinonzi kuva unopinza kudzikira mune mitemo mupenyu, kuderedza kunaka ezvinhu socio-ezvoupfumi, Kuwedzera kwenhamba yevanhu pekugara, uyewo resumption kuti basa vaitamira pezvakaitwa.