Upangiri Wathunthu pa Zomwe Zimayambitsa Chifuwa, Zizindikiro & Chithandizo

Chidule cha TB

TB kapena TB ndi matenda opatsirana omwe amayamba chifukwa cha bakiteriya, Mycobacterium tuberculosis. Malinga ndi lipoti lapadziko lonse la TB loperekedwa ndi World Health Organization kapena WHO, TB ndi imene imachititsa anthu kufa kwambiri padziko lonse chifukwa cha matenda opatsirana. Ndilo nambala yachisanu ndi chinayi yomwe imayambitsa imfa padziko lonse lapansi. Mu 2016, panali anthu pafupifupi 1.3 miliyoni omwe anamwalira ndi TB pakati pawo HIV- anthu opanda pake (kutsika kuchokera pa 1.7 miliyoni mu 2000). Mu 2016 mwa anthu onse omwe adadwala TB pafupifupi 90% anali akuluakulu. 56% ya anthu akukhala m'mayiko asanu (India, Indonesia, China, Philippines, ndi Pakistan). Pafupifupi anthu 10.4 miliyoni adadwala TB mu 2016.

Bakiteriya wa TB nthawi zambiri amafalikira kuchokera kwa munthu kupita kwa wina kudzera mu timadontho ting'onoting'ono timene timatulutsira mumpweya pamene mukutsokomola komanso mukuyetsemula. Mabakiteriyawa nthawi zambiri amalowa m'mapapo, koma amathanso kukhudza ziwalo zina za thupi, monga ubongo, impso kapena msana. Gwero la TB mwa anthu omwe ali ndi matenda a m'mapapo. Munthu amene ali ndi matenda a chifuwa chachikulu cha m’mapapo akakhosomola, kulankhula, kuyetsemula, kuimba kapena kuseka, amafalitsa TB. Ndi matenda oopsa omwe amatha kuchiritsidwa ndi maantibayotiki oyenera.

Mungafunike kukaonana ndi dokotala ngati mukuwonda mosadziwika bwino, chifuwa chosalekeza, kutuluka thukuta usiku komanso mosadziwika bwino. malungo. Dokotala angatsimikizire ngati muli ndi TB kapena ayi mwa kukuyezerani mwatsatanetsatane. Zizindikiro zimatha kusiyana pakati pa munthu ndi munthu ndipo zimagawidwa kukhala TB yobisika komanso yogwira kutengera ndi zizindikiro zomwe zimawonetsedwa mwa anthu.

Matenda a TB obisika

• Mwa anthu ena, akalowa m’thupi, mabakiteriya a TB amakhala opanda mphamvu, ndipo wodwalayo sakhala ndi zizindikiro zilizonse. Komabe, ngati chitetezo chawo cha mthupi chifooka pakapita nthawi, ndiye kuti akhoza kudwala matenda.

TB yogwira

• Itha kuchitika mkati mwa milungu ingapo yoyambirira kapena ingatenge zaka zambiri mabakiteriya a TB atalowa m’thupi. Matendawa amatha kufalikira kuchokera kwa munthu kupita kwa wina.
• Anthu omwe ali ndi kachilombo ka HIV kapena AIDS komanso anthu omwe amamwa mowa ndi mankhwala osokoneza bongo a IV ali pachiwopsezo chachikulu chotenga matenda a TB. Zowopsa zina ndi matenda a impso omaliza, shuga, kuperewera kwa zakudya m’thupi ndi khansa zina. Chiwopsezo cha TB chimakhala chokwera mukapita kumadera (mayiko ngati Africa ya kum'mwera kwa Sahara, India, ndi Mexico) komwe chiwopsezo cha TB ndi chokwera.
• M’zaka zaposachedwapa, mitundu yambiri ya TB yosamva mankhwala yabuka. Zimachitika pamene mankhwala opha mabakiteriya akulephera kupha mabakiteriya onse ndipo mabakiteriya omwe atsala amakhala osamva mankhwalawo. Mabakiteriya ena a TB ayamba kusamva isoniazid ndi rifampin (mankhwala omwe amagwiritsidwa ntchito kwambiri pochiza chifuwa chachikulu).

Zomwe Zimayambitsa TB (TB)

Chifuwa chachikulu ndi matenda opatsirana omwe amayamba chifukwa cha bakiteriya, Mycobacterium tuberculosis amatchedwanso tubercle bacilli. Itha kufalikira kuchokera kwa munthu kupita kwa wina kudzera mu madontho aang'ono omwe amatuluka mumlengalenga kuchokera kwa munthu yemwe ali ndi kachilombo (TB yogwira). Mabakiteriyawa ndi aerobic, omwe amakula pang'onopang'ono. Amakhala ndi khoma lapadera lomwe limateteza thupi ku njira zodzitetezera.

Tizilombo toyambitsa matenda timayambitsa mapapu, koma amatha kufalikira kudzera m'magazi kapena ma lymphatic kupita ku ziwalo zambiri monga impso ndi mafupa (makamaka ziwalo zomwe zimakhala ndi mpweya wochuluka). Amatha kusunga utoto wina ngati fuchsin, utoto wofiyira ngakhale mutatsuka ndi asidi. Mabakiteriya amawononga minofu ndikuyambitsa necrosis. Maderawa ali ndi mawonekedwe owuma, ofewa komanso obiriwira.

Odwala omwe ali ndi kachilombo ka HIV, chitetezo cha mthupi chimakhala chofooka, motero zimakhala zovuta kuti thupi lithe kulimbana ndi tizilombo ta tubercle. Pali mwayi waukulu woti matendawa apitirire mpaka kufika ku matenda omwe akugwira ntchito mwa anthuwa.

TB yosamva mankhwala

Odwala ochepa samva mankhwala a TB awiri amphamvu kwambiri (isoniazid ndi rifampin) ndipo amadziwika kuti ali ndi TB yosamva mankhwala ambiri. Kukana kumeneku kwa mycobacteria kumachitika pamene wodwalayo satenga chithandizo choyenera kapena kulephera kwa chithandizo kumawoneka.

Nthawi zina, ndi odwala owerengeka omwe samva mankhwala a rifampin ndi isoniazid, kuphatikiza fluoroquinolone iliyonse pamodzi ndi mankhwala amodzi mwamtundu wachiwiri monga kanamycin, amikacin, kapena capreomycin. Odwalawa amadziwika kuti ali ndi chifuwa chachikulu cha XDR (chosamva mankhwala osokoneza bongo)

Zizindikiro Ndi Zizindikiro wa TB

Chifuwa cha m'mapapo

Ndiwo omwe amachititsa 85% ya matenda a TB. Zizindikiro zakale zachipatala ndi zizindikiro za TB ya m'mapapo zingaphatikizepo izi

• Kutuluka Kwausiku
• Kutentha kosadziwika bwino, chifuwa chachikulu
• Kuchepa kapena kusowa chilakolako cha kudya, kutaya thupi mosadziwika bwino
• hemoptysis (kutsokomola sputum wamagazi), kupuma movutikira
• Kupweteka pachifuwa
• Kutupa kwa m'mimba ndi kutopa
• Mwa odwala okalamba, chibayo (matenda omwe amawotcha matumba a mpweya m'mapapo) amatha kuwoneka

Zowonjezera Pulmonary Tuberculosis

Zizindikiro zowonjezera za chifuwa chachikulu cha chifuwa chachikulu cha m'mapapo zimachitika pamene chifuwa chachikulu cha TB chimakhudza madera ena osati mapapu (malo omwe sianthu enieni).

• Pleural effusions (madzi m'mapapo) ndi empyema (kusonkhanitsa mafinya m'mapapo) amawonedwa mu pleural TB,
• Kupweteka kwa msana, kuuma kwa msana ndi Kufa ziwalo ndizotheka mu TB (yomwe imatchedwanso matenda a Pott).
• Kupweteka kwamutu kosalekeza, kusintha kwa malingaliro, ndi chikomokere zimawonekera mu TB meningitis.
• TB nyamakazi: Zomwe zimakhudzidwa kwambiri ndi chiuno ndi mawondo ndipo nthawi zambiri zimakhala zowawa pamgwirizano umodzi.
• Kupweteka kwa m'mphepete, dysuria (kupweteka pamene mukukodza), kuwonjezeka kwafupipafupi kukodza, unyinji kapena zotupa (granulomas) mu impso zimawonedwa mu genitourinary TB.
• Tizilombo tating'ono ting'onoting'ono tambirimbiri tafalikira mu ziwalo zomwe zimafanana ndi mbewu za mapira mu chifuwa chachikulu cha miliary.
• Kuvuta kumeza, kupweteka m'mimba, malabsorption, zilonda zosachiritsa, kutsekula (angakhale kapena alibe magazi) amawonekera m'mimba ya TB.
• Kaŵirikaŵiri TB imatha kupatsira madera ozungulira mtima wanu. Zingayambitse kudzikundikira madzimadzi kuzungulira mtima ndi kutupa. Mkhalidwe umenewu ukhoza kupha ndipo ukhoza kufa. Imadziwika kuti tamponade yamtima.

Zowopsa TB (TB)

Chiwopsezo cha TB chimawonjezeka ngati wodwala ali ndi mphamvu yofooka ya chitetezo cha mthupi. Zowopsa zambiri zimagwirizanitsidwa ndi TB monga

• Ana ndi okalamba omwe ali ndi mphamvu zowononga chitetezo cha mthupi (makamaka omwe ali ndi kachilombo ka TB)
• Odwala omwe ali ndi kachilombo ka HIV komanso matenda a shuga
• Ogwiritsa ntchito mankhwala osokoneza bongo (makamaka kugwiritsa ntchito mankhwala osokoneza bongo a IV omwe chitetezo chawo cha mthupi chili chofooka amakhala ndi chiopsezo chachikulu akakumana ndi mabakiteriya a TB)
• Alendo ndi alendo ochokera kumadera omwe amadziwika kuti ali ndi matenda a TB (Africa, Russia, Eastern Europe, Asia, Latin America ndi Caribbean Islands)
• Odwala omuika
• Odwala matenda a impso
• Anthu omwe amalandira chithandizo cha immunosuppressive monga CHEMOTHERAPY
• Kuperewera kwa zakudya m'thupi ndi siliconosis
• Kugwiritsa ntchito fodya
• Mankhwala ena omwe amagwiritsidwa ntchito pochiza nyamakazi ya nyamakazi, psoriasis ndi matenda a Crohn.
• M’mayiko amene umphaŵi ndi kuchulukirachulukira kwachuluka

Matendawa wa TB

Matenda a TB amatha kupezeka mwa kuyeza zotsatirazi

Kuyesa Khungu

Kuyezetsa khungu kumadziwika kuti Mantoux tuberculin skin test (kapena) tuberculin skin test (kapena) TST. Kuyezetsa khungu kumeneku kungathe kuchitidwa kuti mudziwe ngati mukunyamula mabakiteriya a tubercle. Pakuyesa uku, 0.1 mL ya PPD (yopangidwa ndi puloteni yoyeretsedwa kapena tuberculin - yopangidwa kuchokera ku mycobacteria yaphedwa) imabayidwa pansi pakhungu lanu. Ngati pali welt kapena induration pambuyo masiku 2-3 pakhungu, mukhoza kukhala positive. Kuyezetsa kumeneku sikumatsimikizira ngati muli ndi matenda oyambitsa matenda koma kumadziwa ngati munadwalapo TB m'mbuyomu kapena ayi.

Komabe, mayesowo si olondola nthawi zonse. Anthu omwe alandira katemera wa BCG posachedwa atha kukhala ndi kachilomboka. Odwala ena amayankha kuyezetsa ngakhale alibe TB ndipo ena samayankha ngakhale ali ndi TB.

X-ray pachifuwa: Ngati dokotala wanu apeza kuti mayeso anu a PPD ali abwino, ndiye kuti angakulimbikitseni kuti mukhale ndi chifuwa cha x-ray. Ngati mawanga ang'onoang'ono awonedwa m'mapapo anu mu x-ray pachifuwa, ndiye kuti zitha kuwonetsa matenda a TB. Thupi lanu likayesa kupatula mabakiteriya a tubercle, mawangawa m'mapapo amatha kuwonekera pa x-ray.

Kuyeza sputum

Makodzo amachotsedwa mkati mwa mapapu anu kuti aone ngati ali ndi kachilombo ka TB. Ngati sputum atayezetsa ali ndi HIV, ndiye kuti muli ndi matenda a TB ndipo mankhwala ayenera kuyambika nthawi yomweyo. Njira zodzitchinjiriza monga kuvala chigoba chapadera, kupewa malo opezeka anthu ambiri kuyenera kutengedwa kuti tipewe kufalikira kwa mabakiteriya a TB kwa ena.

Zikhalidwe

Kukula kwa mycobacteria kuchokera ku chikhalidwe cha sputum kapena minofu biopsy Culture ndi yotsimikizika matenda a TB yogwira. Ma mycobacteria ndi mabakiteriya omwe amakula pang'onopang'ono, chifukwa chake zingatenge masabata kuti akule pazama media apadera.

Mayesero Ena

IGRA (interferon-kuyesa kutulutsa kwa gamma): Mayesowa amatha kuyeza momwe chitetezo cha mthupi chimathandizira ku Mycobacterium tuberculosis.

Anthu omwe ali ndi zizindikiro zabwino, sputum smear, kapena zikhalidwe zabwino amatengedwa kuti ali ndi TB komanso kupatsirana (chifuwa chachikulu).

chithandizo wa TB

Ngati mwapezeka ndi TB muyenera kumwa mankhwala amodzi kapena angapo kwa miyezi isanu ndi umodzi kapena isanu ndi inayi kutengera mtundu wa matenda. Chithandizo cha TB chimadalira,

• Mtundu wa matenda a TB ndi
• Kutengeka kwa mankhwala a mycobacteria

Mankhwala oyamba omwe amagwiritsidwa ntchito ndi isoniazid (INH), rifampin (RIF), ethambutol (EMB), ndi pyrazinamide. Mumapatsirana kwa milungu iwiri kapena itatu mukamalandira chithandizo ngati mutapezeka ndi TB ya m'mapapo. CDC imapereka chiwongolero chamankhwala oyambira a TB (matenda a TB omwe ali ndi mankhwala) motere:

a) Mu Gawo Loyamba

Dongosolo lomwe mukufuna tsiku lililonse ndi isoniazid, rifampin, pyrazinamide ndi ethambutol kwa Mlingo 56 (masabata asanu ndi atatu).

Njira zina za tsiku ndi tsiku ndi isoniazid, rifampin, pyrazinamide ndi ethambutol kwa Mlingo 14 (masabata awiri), kenako kawiri pa sabata kwa Mlingo 2 (masabata 12).

b) Mu gawo lopitiliza

Chifuba cha TB chosamva mankhwala komanso mankhwala ambiri

Kuchiza osamva mankhwala ndi MDR TB kungakhale kovuta. Njira zingapo zimalangizidwa ndi CDC kwa odwala MDR ndi XDR TB omwe amaphatikizapo ndondomeko ya chithandizo chamankhwala ndi mankhwala ena oletsa TB. Chithandizo chamankhwala sikisi kapena kuposerapo chingafunike, ngati muli ndi kachilombo ka TB kosamva mankhwala.

Mankhwala atsopano & ndandanda yamankhwala omwe amavomerezedwa ndi FDA ndi

• Bedaquiline (Sirturo) wavomerezedwa kuti azichiza MDR TB, ndi
• Kafukufuku pa moyankwo (yokhala ndi mankhwala oletsa tizilombo toyambitsa matenda), ikusonyeza kuti ikhoza kuthandizira pazamankhwala.

Chithandizo cha Opaleshoni

Opaleshoni resection wa matenda m`mapapo minofu ikuchitika odwala ena pamene m`mapapo chiwonongeko kungakhale kwambiri.

Zotsatira Zotsatira

Kutaya njala, jaundice, nseru kapena kusanza, kupanga mabala (kutuluka magazi) ndi kusintha kwa masomphenya ndi zotsatira zochepa chabe za chithandizo cha TB.

Anthu amene amamwa mankhwala a TB ayenera kupewa mlingo waukulu wa mankhwala opha maantibayotiki omwe angawononge chiwindi ndipo ayenera kudziwa zizindikiro monga mkodzo wakuda, kusowa chilakolako cha chakudya, zosadziwika bwino. nseru kapena kusanza, jaundice, chikasu pakhungu kapena ngati kutentha thupi kumatenga masiku atatu.

Prevention wa TB

1) Njira yonse yamankhwala: Odwala omwe ali ndi TB yogwira ntchito, chofunikira kwambiri ndikumaliza mankhwala onse. Bakiteriya wa TB akhoza kuyamba kusamva mankhwala amphamvu kwambiri (Ex: rifampin ndi isoniazid) ngati mwasiya mankhwala msanga kapena kulumpha kumwa. Mitundu yosamva mankhwala imakhala yovuta kwambiri kuchiza ndipo imatha kupha wodwalayo.

2) Mayeso a TB: Ngati mukukhala m’madera amene anthu ambiri akudwala TB kapena ngati mukukayikira kuti mungadwale ndi mabakiteriya a TB, muyenera kuyezetsa TB. Ngati mutapezeka kuti muli ndi HIV, mukhoza kulangizidwa ndi dokotala wanu kuti mumwe mankhwala.

3) Dzitetezeni nokha ndi banja lanu: Ndi TB yokhayo yomwe imapatsirana kwambiri. Ngati muli ndi matenda a chifuwa chachikulu cha TB, mutha kuchitapo kanthu kuti mupewe kufalikira kwa TB kwa achibale anu ndi anzanu.

• Tsekani pakamwa panu ndi minofu kapena chopukutira pamene mukutsokomola kapena kulankhula ndi anthu ena (kuteteza kufalikira kwa mabakiteriya mumlengalenga),
• Mutha kuvala chigoba kuti muchepetse chiopsezo chotenga kachilomboka m'masabata atatu oyamba a chithandizo.
• Mpweya wabwino wa zipinda ndizofunikira. Mabakiteriya a TB amatha kufalikira mosavuta m'zipinda zotsekedwa ndi malo ang'onoang'ono.
• M'milungu ingapo yoyambirira ya matenda a chifuwa chachikulu, pewani kukhala kapena kugona m'chipinda chimodzi ndi anthu ena. Pewani kupita kumalo opezeka anthu ambiri monga kuntchito, kusukulu, kumapaki ndi zina.
• TB yosamva mankhwala ambiri komanso TB yosamva mankhwala ingapewedwe pofufuza msanga anthu amene akuganiziridwa kuti ali m’madera amene TB yafala. Kuwunika mwachangu kwa odwala, kutsatira malangizo ovomerezeka a chithandizo, kuyang'anira momwe odwala akuyankhira chithandizo ndi kuonetsetsa kuti chithandizo chatha kungathenso kuteteza MDR ndi XDR TB.
• Oyang'anira matenda ndi akatswiri a zaumoyo akuyenera kufunsidwa kuti achitepo kanthu kuti apewe kufalikira kwa TB (makamaka m'malo odzaza anthu monga ndende, nyumba zosungirako okalamba, malo ogona anthu opanda pokhala).
• Njira zoyenera zoyendetsera chilengedwe ndi kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe kabwino kabwino kabwinobwinobwinobwinokeke. Chiwopsezo chotenga TB chimachepa ngati njira zodzitetezera kapena njirazo zitsatiridwa. Njira zinanso zaumwini zitha kuchitidwa monga kugwiritsa ntchito zida zodzitetezera pakupuma.
• Katemera wa Bacillus Calmette-Guerin (BCG) amaperekedwa kwa makanda kuti apewe mitundu yoopsa ya chifuwa chachikulu cha TB m'madera omwe kufala kwa TB kuli kwakukulu.

FAQ's wa TB

1) Kodi ndingadziteteze bwanji kuti ndisatenge chifuwa chachikulu cha TB?

Pewani kukhudzana kwambiri ndi odwala TB odziwika omwe ali m'malo odzaza anthu komanso otsekedwa monga zipatala, zipatala, ndende, kapena malo ogona.

2) Nditani ngati ndikuganiza kuti ndakumana ndi munthu yemwe ali ndi matenda a TB?

Ngati mukuganiza kuti mwakumana ndi munthu yemwe ali ndi matenda a TB, muyenera kuonana ndi dokotala ndikudziwitsani za kuwonekera kwanu ndikuyezetsa khungu la TB kapena kuyezetsa magazi a TB.

3) Kodi katemera wa TB (BCG) angathandize kupewa XDR TB?

Katemera wa TB amatchedwa Bacille Calmette-Guérin (BCG), ndipo amagwiritsidwa ntchito m’maiko ambiri pofuna kupewa mitundu yoopsa ya TB mwa ana. Komabe, sikunatsimikizidwe kuti kumateteza TB kwathunthu mwa munthu amene wamwa katemera wa BCG.

Apollo Hospitals ali ndi madotolo abwino kwambiri a chifuwa chachikulu ku India. Kuti mupeze madotolo abwino kwambiri a chifuwa chachikulu mumzinda wapafupi nanu, pitani maulalo omwe ali pansipa:
https://www.askapollo.com/book-health-check