Bacillus kohi: pehea maha ora, rite korerotia? He aha te mea TB?

Kohi - he mate haavare e pā kore anake ngā pakeke, engari ano hoki tamariki. Ki te hua mycobacteria mahi mate (Bacillus o Koch) i roto i te tinana tangata. I roto i te maimoatanga o pathologies tono hahau multicomponent, e taea muri ake ki te ono marama, neke atu rānei. I roto i te 50% o te wā, te kore o te maimoatanga, mutu te mate i roto i te mate. He aha te mea te Bacillus tubercle o Koch, pehea riro te reira ki te tinana tangata, me te pehea, ki te ārai i te whanaketanga o te mate - ka mahi enei pātai i roto i tēnei tuhinga.

Ko te ariā o te mycobacteria

Kohi - he mate hopuhopu meinga e ngā rōpū Mycobacterium he kohi Mycobacterium (MBT). Kei te maha i huaina tenei momo o huakita te Bacillus tubercle - i te ingoa o te pūtaiao Tiamana Roberta Koha. Pūtaiao mohio e pā ana ki 74 ngā momo o mycobacteria kitea i roto i te oneone, te wai, te kararehe me te iwi. Me mea e ahau e rerekē taumahatanga o te mate kohi meinga e rerekē momo o mycobacteria i ia atu.

Tubercle Bacillus he takotoranga tiaki motuhake, e tauturu te huakita ki ora i roto i te taiao. He tika tonu hanga paku kōpiko ranei MTB, whakaritea, hanga kahore pua capsules ranei, rawa āta whakanoho he wehewehe māmā ki rua ngā pūtau, te huringa wehenga o 14-18 haora. Ka rite ki te tikanga, puta uri i roto i rua ara - na roto i te hua, iti iho te pekapeka.

Mycobacterium āhuatanga hokiate: diameter rerekē i waenganui i 0.2-0.6 m, roa - 1-10 microns. no tubercle Bacillus ki te harore no o ratou faitatau whakaaturia te i roto i te kohi hāora kotahi. MTB koroni āta (i roto i 34-55 ra) tupu i runga i te reo totoka, i te mata taratara, ngonge pigmented - he māwhero-karaka Academy ranei.

Ko te hanganga o ngā pūtau MTB

pūtau kitakita o te tubercle Bacillus ngā o te huānga e whai ake nei:

• taiepa pūtau - i hanga ki te maha ngā paparanga, Mycobacterium tiaki ki te whawhai mīhini me te matū; E whakarato ana i te rahi tamau me te ahua o nga pūtau (i te ara, he wahi o te raunga Kei roto he parikoriko, fatty taonga);
• cytoplasm kitakita ki inclusions potakataka;
• membrane cytoplasmic;
• taonga karihi, i roto i nei he DNA porohita.

Ko te tino ātete ki awe taiao MBT me roa te mau tonu tana noho tuwhera tonu. Kia pehea te maha oraraa tubercle Bacillus? Ka taea e Mycobacteria te tīariari: ki runga ki te 7 tau i roto i te wahi maku, me te pouri i te pāmahana o te 23 ° C; ki runga ki te 12 marama i roto i te wahi pouri, me te maroke; ki runga ki te 6 marama i roto i te oneone; ki te 5 marama i roto i te wai; ki runga ki te 3 marama i roto i te pukapuka; ki runga ki te 2 marama i roto i te puehu ara; ki runga ki te 2 wiki i roto i te waiu tīhi; ki runga ki te tau i roto i te hinu, me te tiihi. e kore e wehi o nga tukanga o te pirau Mycobacterium kohi, me te kia i te marama torutoru wa tanumia i roto i te tinana whenua. Heoi, nga hihi tika o te ra whakangaro te ILO me haora he hawhe, nga hihi katinga - i roto i te meneti torutoru. disinfectors Chlorinated akakoromaki i Bacillus mō te 5 haora. Mycobacteria tairongo hoki ki te hauwai. Patua tubercle Bacillus i whakawera: hoki 20 meneti i 60 ° C, me mo te 5 meneti - i 70 ° C.

kia MBT meinga mate i muri i rua ki te toru tau o te oraraa, me asymptomatic mo te wa roa i roto i te tinana ki te kōkiri i anti-TB wātea i te mate.

He aha te mea TB?

Ka rite ki tuhia i mua, kohi - he mate hopuhopu meinga e te mahi Mycobacterium. Te nuinga o te mate horahia e mate droplet i te tangata i pangia, ki te whakapā hauora (maremare, te tihe, whakahaere). I te tahi taime e taea te mate hei te āhua o te kai (waiu raw).

I mōrea - iwi e noho ana i roto i ngā wāhi ki ngā āhuatanga kāore parukore - whare herehere, kāinga mo te manene. Kei roto i tēnei tūroro ki ngoikore ngā pūnaha ārai mate (iwi ki HIV, tūroro mate pukupuku). wharewhare; kohungahunga; te kaumātua; melo o te utuafare e mate ana i te mate kohi; kaipaipa; Iwi ki te kai tōtika rawakore - tino maha enei kāwai o te iwi patu te Bacillus tubercle. titau tikanga mana horomanga whakahauanga o huaora me ngā ōpapa ki te āwhina whakahoki te mahi iti ārai.

meinga te pā o te mate kohi ko e āhuatanga takitahi o te rauropi, me te tika e pā ana ki te āhua hinengaro o te tangata. E ai ki te tohu tau nuinga e te rōpū o te iwi 18-26 tau.

Ko te taa o tenei mate ko e te tere hoko ātete ki raau taero te Bacillus TB, na tā tikanga maimoatanga te whakamahi o te maha taero i te wa ano.

E ai ki ngā tatauranga WHO, e pā ana ki te toru o te taupori o te ao huaketo ki te Bacillus tubercle, engari e kore e he tinana hauora tukua te Tari ki te tini. Puta ana te māuiuitanga i roto i te tinana tangata anake i raro i ngā āhuatanga pai mō tenei - tuku iho te mate. Ia tau i fifi o te mate kohi, whakamate e pā ana ki toru miriona iwi i roto i te ao. puritia Day TB World te Maehe 24.

Ara TB tuku

E wha huarahi matua i roto i nei kohi horahia rakau:

• mahino ka tomo nga mycobacteria te rangi ki rūrūtia ka maremare, te tihe manawanui;
• puta mate i roto i te wahi gastrointestinal - alimentary;
• puta mate i roto i nga kanohi o te kirikamo (mate o te kiri ko te āhuatanga onge) - whakapā;
• utero - huaketo e ewe mate i roto i whanau i te whaea ki te tamaiti.

I roto i te pūnaha manawa tinana hauora tiakina te ki te kătahi o mycobacteria hūpē, tukua nei e pūtau motuhake. Heoi, ki te mumura o te pūnaha romahā, me te i raro i te mana o tāoke "tiaki" e kore e mahi. Ko te tūponotanga o te mate i te alimentary tei runga i te huru o te taiepa intestinal, tona kaha absorption.

Mai Kei tubercle Bacillus te waho te pūtau, me te āta e whakamahatia kiko mo etahi wa pupuri ratou hanganga hauora, Heoi, Mycobacterium etahi wa ki te tiki ki te rere o taikiri waitinana, ka horahia puta noa i te tinana. Ko te tino pai mō te mycobacteria he tinana ki te microvasculature whakawhanakehia (pukapuka, uho tākihi, tari korere kākano). Ka rite ki te Tari tomo pūtau roto, timata ratou ki te tūkino tona hanganga, me te faaite.

anatomy māuiuitanga

I roto i te whēkau puta mate pāngia "makariri" mumura i arata'i ki te hanganga o te granulomas plurality - he e pängia ana ki te kinonga hillocks. whakaaturia te tauhohenga o te tinana i roto i te wiki torutoru i muri i te mate. i hanga wātea i te mate Cellular te i muri i te rua marama. āhuatanga te wāhanga i muri o te whanaketanga o te tukanga pathological e Office tupu puhoi, kua ngaro, Heoi, e kore e tino whakakorea te whakautu inflammatory te kaihoko fakatupu o te arotahi inflammatory.

Tubercle Bacillus i roto i te tinana kei te rongoa mo te wa roa, a ka taea e te tangata e he kaikawe o te ora ILO. Ki te vaivai o te wātea i te mate e toe taupori o te Tari e kaha faaite, meinga te whanaketanga āta o te mate kohi. Ko te mōrea o te whakawhanake i mate i roto i te tangata i pangia tuatahi ko 10% i roto i te rua nga tau tuatahi i muri i te mate. Ki te wahi o te wa, ka whakaiti i te tūponotanga ka o mate.

A, no te kore e taea ki te te tu atu te whakatö o huakita pūtau e puta ē te wātea i te mate whakawarea o te rauropi. Hoki i hanga te ora taiao pai motuhake MTB i nei e hanumi te granulomas taratahi i roto i te rōrahi noa, ko te kupu te mea e puta mate tuatahi ki te wā o te mate kohi haumanu. horahia atu mumura puta noa te pūnaha mahi.

Puka me ngā momo o te mate kohi

I muri i mate māuiuitanga riro puka moe, ie. E. nuinga maha asymptomatic. Anake tetahi i roto i o take tekau, haere ki te wāhanga hohe. Coli TB te nuinga pā te pūkahukahu, engari ka taea e pā ki ētahi atu pūnaha tinana.

Wehewehe rua ngā o TB:

• tuwhera,
• kati.

A, no te te ngāwari kitea te aroaro o te ahua tuwhera o te Bacillus tubercle i roto i sputum ranei i roto i te tahi atu secretions manawanui (mimi, feces). Te oreraa e haapa'oi matakite mā i roto i tenei puka kia arahi ki te mate o ētahi atu. I roto i te puka kati o mycobacteria kore kitea, a kahore e tūroro tū te riri ki ētahi atu.

Tei runga i te ahua o te pūnaha mahi e whai wāhi ki te Bacillus tubercle, māuiuitanga whakarōpūtia e whai ake:

• kohi pūkahukahu,
• kohi extrapulmonary.

Runga anō i te āhua o kua horapa māuiuitanga i te tinana, he nunui:

• kohi moe,
• kohi tohaina,
• kohi ngahunga,
• kakā caseous,
• tubercles
• kohi fibro-cavernous,
• kohi cirrhotic,
• pleural kohi, paeoro ranei pukorokoro - he āhuatanga tino onge.

kohi Extrapulmonary pā tetahi atu tinana, ai te whakarōpūtia te māuiuitanga ki:

• mate kohi CNS me meninges - te mate pānga te ua, me te roro, anga pakeke;
• pūnaha kūnatu, i roto i nei te tikanga pānga kikokore, me te caecum;
• Kohi o te ao urogenital pā te whatukuhu, mimi, whekau whakaputa uri;
• hanganga wheua;
• lupus;
• kanohi kohi.

Ko te mau faaiteraa haumanu o mate. kohi o te pūnaha io pokapū

Ka rite ki ahau whakahuatia mua, e tika ana ki te meka e tuwhaina e te Bacillus tubercle rawa āta, i kitea i te reira i te tuatahi taea wā. Na reira māuiuitanga e taea roa ki te whakaatu ano, a muri mai kitea i te aituā i roto i whakamātautau fluoroscopy tuberculin ranei. I tua atu, i te tohu motuhake o te mate, i roto i te meka, e kore e tīari. Ko te take i te tinana, ko te haurangi, kia tohu ataahua, te rohirohi ma'i, ranei te momoe, tau'a, he hua iti o te pāmahana tinana (e pā ana ki 37 ° C), nui haere sweating, mate taimaha, whakarahi o taikiri.

tātari Laboratory o toto o te tūroro ki te kohi kitea hē rino, whakaiti i roto i te maha o ngā pūtau ma toto. I muri mai, ka tomo te mate he wā kaha ake, kia uru atu nga tohu i runga ake e mārama tohu o māuiuitanga o te okana pāngia.

Ki te pānga Mycobacterium te pūnaha io pokapū, kua kitea te manawanui, i roto i te tua ki te pāmahana nui, he mate moe, fakaaoao, pāhoahoa kino, ruaki. I te mutunga o te wiki tuarua o te tīmatanga o te tohu tuatahi o ngā rerekētanga puta i roto i te hanganga membrane roro, e kua āhuatanga e mānukanuka o te uaua kaki, me te ngoikore ki te pēhi i tō kauwae ki tou uma, totoro koutou waewae rite nui rite taea. Ko te wharewhare rohe mōrea kawe ranei huaketo ārai. Ehara i te mea tupu nohinohi i roto i te papamuri o tenei māuiuitanga o disorders hinengaro me te mahara waimaero, tūtohutanga, nekehanga o te nenewha.

Haunga te mate i roto i te pakeke Bacillus tubercle tangata i roto i ngā tamariki te kore ai he atu tere, me te nui o nga mate, i ētahi wā hua i roto i te mate. Kei te tika ai te reira i te pūnaha ārai mate o te tamaiti matua underdeveloped. Kitea ki tenei mate atu pinepine atu i te tamariki te hunga e i roto i ngā āhuatanga o te rerenga parukore rawakore, rawakore kai tōtika, tonu Lena. Tubercle Bacillus i roto i ngā tamariki ai tohu motuhake o te tinana, kia hiahia ngā mātua ki te utu whakarongo ki ruaki, rohirohi te tamaiti, whakarongo iti, mate o hiahia, mate taimaha, kirika.

Kohi o te tahi atu pūnaha mahi

I tua atu ki ngā pūtau pūkahukahu, me te pokapū māuiuitanga pūnaha io taea patu i te tahi atu whēkau i roto i te tinana tangata, pērā i te pūnaha romahā. Na, kiripūkahu tuberculous - te hinga o te membrane kiripūkahu e hipokina te pūkahukahu. Ka taea e tēnei māuiuitanga e he mate motuhake, puta rite ki te hua o uaua pūnaha mate kohi pūkahukahu ranei. Ko tētahi atu pōauautanga o te mate kohi pūkahukahu taea e kohi wahi romahā runga, te wahi i roto i te tukanga inflammatory tā te pharynx me paeoro. Ko te tohu o te mate taua i roto i te tua ki te faahitihia e whango fifi ranei i horomia.

huaina te hinganga o te Bacillus tubercle te waitinana kōpuku kohi lymphadenitis. Nuinga o ngā wā i raro ki te patu i taikiri supraclavicular waha ranei e te hunga rahi engari ongonoa.

Ka taea hoki e MTB pā whekau o te pūnaha urogenital. whakakitea te mate e koi mamae i roto i te hope te hoki, he pāmahana tinana tiketike ranei. A, no te urination he taea spotting. Puta ana te māuiuitanga i roto i rite moni i roto i rua wahine me te tangata.

Kohi o wheua kikokiko āhuatanga e piere auau, te mamae nui i roto i te wāhi kua pā, ki te ngoikore neke noa. puka rere taua māuiuitanga maha arahi ki te mate.

Tātaritanga me te maimoatanga

I roto i te tātaritanga o te mate kohi kaha ko nga tikanga tino rongonui o te sputum pani Microscopy me X-ray. Analysis pani, Heoi, e taea e kore te whakaaro tikanga tika, me te pono, mai te tīmatanga o te mate, me te i roto i te wā o te mate i roto i te ako tamariki homai he hua kino.

He whai hua te nuinga i roto i te mate matatau X-ray tikanga tātaritanga. I tua atu ki enei tikanga tātaritanga maha e whakamahia whakamātautau kiri tuberculin, e kiia nei ko i noa te tauhohenga Mantoux.

Ko te whāinga matua i roto i te kōwhiri i te maimoatanga o te ara iahiko manawanui ko te ki te ako resistance tarukino, ie. E. te tūtohutanga o te ahurea mycobacteria tupu i roto i te taiwhanga, ki taka medicamentous.

I teie mahana, te tikanga matua o te maimoatanga o te mate kohi i roto i te manakohia o te maimoatanga mo TB, i te mea he multicomponent. Te wehe ternary, quaternary me te talena maimoatanga Pī.

riro hoahoa Ternary te whakamahi o toru drugs taketake - "streptomycin" "Inh" me te waikawa para-aminosalicylic (pa). Tenei kaupapa ko te aronui, Heoi, kei te uaua whakamahia tenei ra no te mea o te tāoke tiketike o pas. Ko te tukanga e whakamahia ana chetyrohkomponentnoy "Rifampicin" ( "Rifabutin") "Inh" "Pyrazinamide" "Ethambutol". whakamahi maha pokapū hauora technique noa atu matatau - rima-he kaupapa e, i roto i te tua ki te raau taero i runga wha e whakamahi "Ciprofloxacin".

Me mea e ahau e kohi - he mate haavare e, hoki i te whanaketanga ko te Bacillus tubercle ai i roto i te tinana tangata. kia tonu, me te tika Treatment, no te mea i roto i te ngaro o te mate i te mate therapy oti 50% o te wā. puta putanga whakamate i roto i te tau torutoru i te tīmatanga o te wāhanga kaha o te mate. Ko te toe 50% o te wā hua i roto i te puka ma'i o te mate. Ano, te manawanui, e kua whakahuatia i te mate kohi ma'i he mōrearea ki ētahi atu, kia rite ki nga ngā o mycobacteria i te taiao.

ārai

āraihia atu ki mate kohi e taea te pēnei i tenei ra, pea, te kano ārai mate BCG i tōtika tiaki ki tetahi o nga momo tino kino o te mate kohi - kiriuhi tuberculous. E ai ki te National Rārangi Ārai Mate, werohia tamaiti tonu i roto i te fare ma'i i roto i te ra tuatahi 3-7 o te ora. Next, i 7 me 14, kua kawea atu i raro i te huru booster tōraro tauhohe Mantoux me te ngaro o contraindications.

BCG (Bacillus Calmette-Zherena) E whakaatu ana hua pai, engari e kore e te te werohanga whakahauanga ki kohi manakohia i roto i nga whenua katoa o te ao, i te reira katoa tei runga i te taumata o TB i roto i te rohe. He marama torutoru i muri i te werohanga i te tauhohenga kiri wāhi i werohia puta - he hiri iti.

Vaccinating contraindicated he tamaiti i roto i te wā e whai ake nei:

• tamarii fanau ārai pāngia, me rite i roto i te utuafare e te mata pēpi, e mate ana i tenei mate;
• i whakatika teina, me tuahine o nga pōauautanga hou i muri i taua kano;
• te tamaiti, i reira he hē congenital o te pūnaha io pokapū.

kia Vaccination e kumea kia roa ki te:

• e kore te te tamaiti donoshen,
• kitea e ia tetahi mate hopuhopu,
• He rerekē take rH te whaea me te tamaiti.

He mea nui ki te mahara e te mate a tātau ai te Bacillus tubercle. Me te kainga manawanui tangata i roto i te therapy ki kia hauora, me te tika. A ape i te kohi nui o ngā kai fatty. He uaua te whakawhenumi o te kai i roto i te tūroro TB. Ko e tika ana ki te hanganga kikokiko o pūtau MTB tenei - anga kei reira he rota o te ngako. He tangata ki te māuiuitanga hiahia kai taonga i roto i te pūmua, te warowaihā, huaora me microelements.

Hei whakaiti i te tūponotanga o te mate tuatahi i roto i te whare, he mea e tika ana ki te mau tonu akuaku whaiaro pai, ki te noho wa ake waho, whakairi hua huruhuru me te miro i roto i te ra.