Fibro-cavernous lefuba: matšoao a le kalafo. Thibelo le ditomotsebe

Fibrocavernous methapo lefuba - lefu le senyang, pontšo ea eo e ba teng ka thōko ea matšoafo cavity. Ka moriana, o bitsoa "cavity". Mahloreho ke mohato ka letotong la lefuba methapo. Hangata, jwalo Tleliniki bolwetse e hlakoloa botho ba hae.

Features ya lefu lena

Ka tloaelo ho, fibrous-cavernous lefuba hlokomela bakuli ba baholo. Bongoaneng, matšoao TB mathomo ke ka seoelo haholo.

Cavernous bolwetse sebetsang sebakeng sa hae e le phello ea infiltrative lefuba, empa e se etsahala hore develops disseminated kapa patchy, mofuta oa bolwetse.

foromo Fibrocavernous lemoha ka 5% ea maemo a ho lefuba.

Cavernous lefuba ka lejoe hata ho ntshetsopele ya fibro-cavernous bolwetse

A tsobotsi bath ya pathomorphological cavernous lefuba ke boteng ba cavity le 'ngoe, ha ho na ho ruruha le liphetoho fibrotic ka bronchi e, likepe lisele tsa mmele le dinama tse nyenyane tse e potolohileng. Lefu lena le ke ke ua e fetang lilemo tse 2.

caverns ke pholiso le hlaha le sebopeho sa:

• koko;
• tuberculoma;
• a tsitsinkela le 'ngoe ea lefuba;
• sanitized cavity.

Ho ba sieo ha phekolo e nepahetseng foromo cavernous ka tsamaea ka fibrocavernous lefuba, fibrosis eo ke ntho ea tlhaho ho marako a cavity le pota-potileng ea matšoafo parenchyma. Hape o ile a re foci multiple a tšoaetso.

symptomatology lefu lena

Ka tloaelo ho, fibrous-cavernous lefuba e localized ka matšoafo ngoe. Ntshetsopeleng ya lefu lena le hlaha ka likhoeli tse 3-4 tsa phekolo thuso ea mefuta e 'ngoe ea lefuba. Liponahatso tsa lefu lena le ke haholo-holo e khanyang ka mohato ho bola.

Matšoao se ka sehloohong sa lefu lena ka nkoa:

• asthenia;
• tahlehelo ea takatso ea lijo;
• fokolang khohlela;
• khohlela mali;
• tsoa mali;
• crackles ka ho putlama ha cavity ena.

Ka mor'a hore sebopeho sa matšoao a cavity ba haella, bonahaleng feela le nonspecific. Mokuli a ka tletleba la bofokoli kakaretso, mokhathala sa khaotseng, ho lahleheloa ke boima ba 'mele,' me ho ba teng ha mocheso tlaase sehlopheng.

Ka ntshetsopele ya TB latent 'na a bontša ho tsoa mali ka matšoafong hore develops ntle ho lebaka.

Anamnesis bakuli hlorileng le fibro-cavernous lefuba bolela feto-fetoha 'nete hore. Tšoaneng pakeng tsa nako a hlobaetsang le bolelang ho leballa motho a ka ba le nako e lekaneng kapa, lehlakoreng le leng, mohato hlobaetsang ka hlaha hangata.

Fibro-cavitary lefuba na le matšoao a sa tšoaneng tsa tleleniki. E bakoang ke tshebetso pathological, hammoho le mathata mohlanka.

Ho na le mefuta e sa tsoaneng tse peli tsa lefu lena: e fokolang kapa e batlang e tsitsitse, moo le tlas'a tšusumetso ea phekolo ea lik'hemik'hale tsitsisoa le hlaha le mamello e kokobetse, tsoelang pele ka lilemo tse 'maloa.

Ka a hlobaetsang le nako ho hlaha mocheso le ntshetsopele ya ho ruruha ho pota cavity ena. Thempereichara e ka fihla phahameng, haeba lefu le ka sehloohong tse amanang le tšoaetso ea botho ba mahareng.

Hlōloa bronchi tsamaea le bohloko khohlela omeletse, moo sekhohlela, mucus le boladu nang arohane ka thata.

A le mamello a utloa bohloko ho tswa ho fibro-cavernous lefuba, ka tsela e hlollang lahleheloa ke boima ba 'mele. O re: letlalo omileng, eo habonolo wrinkles. Mesifa ea mamello ba pepesehetse felloa ke matla. Tsa hlaseloa tshebetso pathological fetoha lebanta ka mahetla, ka morao le sebaka se pakeng tsa likhopo.

Bakuli ba nang le tšekamelo ea ho botahoa khafetsa. Ka exacerbations tsa lefu matšoafo develops insufficiency 1 le likhato 2. Ka mor'a moo a ka a tla tšoauoa keketseho ea bophahamo ba modumo sebete. A ka hlaha a ruruha.

Le letotong la lefu lena le sa tšoaea ho hlōloa ha ba larynx le intestine, e isang fokolisa ya boitshireletso ba mmele. Ha kahesii, amyloid nephrosis le congestive ha pelo, methapo lefu itse'ng sa thabiseng.

Lisosa tsa lefu lena

Felisoeng ha di ka baka ho mofuta ofe kapa ofe ea tleleniki ea lefuba. ntshetsopeleng Provocateur ka sebetsa jwalo ka superinfection. Ke likokoana-hloko lokela ho kenyeletsa mycobacteria. Ka kakaretso ho na le 74 mabitso. Ba ho matleng a genus Mycobacterium. Leha ho le joalo, lefuba ho batho tsosa tlas'a maemo kgethile mofuta, bitsoa Mycobacterium lefuba.

Predisposing lintlha bakeng sa ntshetsopele ya lefu lena le ke tsena:

• ho tsosa boemo ba sensitization;
• fetola ka reactivity;
• mafu a litho tse ka hare;
• mekhoa e mebe.

Mohato o ka sehloohong oa lefu lena

Ho etsa qeto ea ho abelwang karolo ya mohato e latelang ea fibrous-cavernous lefuba:

• Khukhuneloa. Ho presupposes boteng ba e ruruha tsepame.
• Ho bola. The ho ruruha leifo Ho thehoa ka cavity eo e tletse foromo e khethehileng ea necrotic dinama tse nyenyane tse - caseous boima. dikahare Dry fetoha mokelikeli, 'me butle-butle a oa theoha ka mor'a draining bronchus. Sebakeng sa eona o hlola ka sekoti. Ka mor'a moo, ho qala ho tlatsa ka moea, 'me ha tlōlo ea drainage ka bronchi e - mokelikeli.
• Sebopeho sa cavities. Thuto Ho thehoa le resorption la ho ruruha perifocal le fibrosis. Lerako la anomaly ho na le le dikarolo tse tharo. Lera le ka hare e na le boima caseous (polygenic lera). Located bohareng ba granulation khetla, lined ka lisele tse kgolo epithelial. Ho tloha ka ntle cavity karolo e koahetsoe ke komiki ea dinama tse nyenyane tse connective.
• Seeding. Ka mokhoa ona, ho cavity boholo eketseha, 'me ho pota khukhuneloa perifocal le hlaha kapa seeding. tshebetso akarelletsa ntshetsopele ya diso foreshe a hlabang ho cavernous lefuba. Ka tsela eo develops foromo fibrocavernous lefu lena.

mathata khafetsa

Ho na le mathata a latelang a fibro-cavernous lefuba:

• Hemoptysis.
• Tsoa mali ka matšoafo ka.
• Ho ba teng ha percussion. E bontšoa ka ho khutsufatsa la molumo libakeng la thickening mesothelioma le fibrosis.
• Mamela fokolang respiration libakeng tsa thickening ya pleura ena. A boela a fumana crackles le bronchial hema. wheezing joalo o ile a senola ho ba teng ha cavities kgolo-boholo bo lekaneng. Holim'a lihlopha tse nyenyane ka melumo e fapaneng voicing.

mekhoa ea phumano

Kamoo e fumanoa fibro-cavernous lefuba? Histori ea lefu lena le ka nako ya tepelletse maikutlong, e le busa, a se a ntse e na le tlhahisoleseding e mabapi le tšoaetso ea pejana myocardial lefuba.

Re lokela ho hlokomela hore matšoao auscultatory ke lesedi hanyane. ho hlahloba sebelisa X-ray e senola ho ba teng ha moriti lesoba hare le sebaka pheriferale ka mokgwa wa e oval kapa selika-likoe. Ka mor'a hore ya data fumanoa ka X-ray diffraction hloka differential tepelletse maikutlong le bolwetse tse kang abscess matšoafo, bakeng sa kankere pheriferale, bullous emphysema, pneumothorax, echinococcosis kapa encysted pleurisy.

Tshehetso Diagnostic le laboratori ea mekhoa ke endoscopic botegeniki jono.

and analysis sekhohlela e senola boemo bo phahameng ba MTB. liteko laboratori ea senola boemo bo phahameng ba ho itšehla thajana bacilli. Ka linako tse ling ho etsa joalo e ba e matla. Hape staghorn tsejoa likhoele rekere.

Ho ba sieo ha sekhohlela bontša tšoere bronchoscopy. E lumella u ho khetholla foci ea ho ruruha ka matšoafong le bronchial methapo, e leng ho thibela ho koalo ea cavity ena.

teko ea mali. Bakuli le ho ba teng ha fibrocavernous lefuba tšoauoa lymphopenia le potlakisa ESR paramethara ho 30-40 limilimithara / H.

Ha ho na le e leng keketseho ea tšoaetso ea bobeli ea leukocytes boemong pontshi 19 000-20 000, hammoho le eketsa boemo ba neutrophils.

Ho na le e phahameng le dikahare tsa protheine ka moroto wa.

melao-motheo ea phekolo

Ho felisa ho fibro-cavernous lefuba? Kalafo o etsoang tsoa ka sepetlele ka dispensaries TB.

phekolo sekemeng e thehiloe tabeng ea ho sebelisa tsoa hong ea lithethefatsi tse tharo kapa tse 'nè o ile a laela khahlanong le ntshetsopele ya malwetse. E le busa, ba sebelise "Inh", "ethambutol", "Rifampicin" le "streptomycin". Lithethefatsi ka laolwa entoe kapa ka kotloloho ka cavity molomo.

Hape sebediswa tuberkulinoterapiya, ho hema tsa boitlhakiso, phekolo 'meleng, phekolo tham mong bang laser, oa ultrasound le inductothermy.

jereng ka chemotherapy

Kamoo e mong e felisoa fibro-cavernous methapo lefuba? Phekolo e kenyeletsa ho sebediswa ha chemotherapy. Mekgwatshebetso ya ho tse laetsoeng ka motheo oa motho ho latela litsupa ba nahanela ho lithethefatsi.

Ka tloaelo, ha ho hanyetsa phekolo mantlha khahlanong le lefuba e etsoa ho latela ka karolo ea bone, chemotherapy puso. The kalafo e akarelletsa ho sebelisoa a ikopantseng a lithethefatsi tse kang "kanamycin", "Prothionamide", "Cycloserine", "Lebakeng" le "fluoroquinolones". Ka nako ea phekolo ea lik'hemik'hale e seng ka tlase ho likhoeli tse 15-18.

Bakuli le ho ba teng ha fibrocavernous TB bontša tšoere phekolo pathogenetic eo o ikemiseditse ho e lokisa ha mesebetsi phytoteratology fapaneng phelang. Metabolizing moemeli sebelisoa, hammoho le litokisetso tsa ho tsosolosoa ha boitshireletso ba mmele, le mahlahana hormonal.

Ka tsela e tšoanelang ea kalafo ka mor'a ka bang likhoeli tse tšeletseng ka dipharologanyo khothatsang. Ho tšoauoa ho fokotseha ha kabo ya bacilli, hammoho le fokotseha le cavity koalo.

tshebedisano kenella

Healing cavities fibrotic kamehla atlehe butle haholo. Haeba nakong ea holimo ha ho khonehe ho fihlela liphello tse ntle, ho fibro-cavernous methapo lefuba e tlosoa ka ho buuoa. Tabeng ena e bontša unilateral matšoafo resection. Sebediswa ho duplex tshebetsong le tshebetso. E boetse e na ka tsela e itseng e phahameng ea bokgoni le lumella u ho pholosa le matla a le mamello ea ho sebetsa. The phela le motho ea kulang lengthened haholo. Ho itšehla thajana ea mycobacteria khaotsa.

mofuta o mong oa ho buoa ke buoa putlama phekolo, fana ka maikutlo a ho kenngwa ha pneumothorax maiketsetso.

Mora kalafo ka sepetlele lula hlokahala sanatoriums tlamang, outpatient kalafo , lateloa ke shebisisa ka tleliniking.

itse'ng

Boholo ba batho ba fibro-cavernous lefuba amenable ho phekolo. Cavity ea litekanyo tse nyenyane li koaloa le scarring. Thuto le ho ba teng ha mabota thata ka nako e telele la tseloa ka le dikahare caseous hore qholotsa psevdotuberkulemy.

Bokella boladu, boteng ba aspergillosis, tsoelo-pele ea lefuba ke ka seoelo.

mehato e thibelang

Fibrocavernous lefuba ke ea dihlopha tsa mafu a bakoang ke mabaka a mabe ea sechaba. Atisa ho ba sesosa sa ho senyeha melao e phelang e emelang palo ea baahi ba.

Ho ea ka lipalo-palo, banna ba kulang makhetlo a 3 hangata ho feta basali. The bolwetse mantlha e tsitsitseng ka ka ba lilemo li 20 ho ea ho 39.

E le hore ho thibela ho a eletsa ho boloka melao e latelang:

• tsamaisa mehato loketseng ho tse e thibelang e ka;
• boitsebiso ba pele ba batho ba anngoeng ke ho kula;
• khetha puso chelete bakeng sa lithethefatsi;
• tshebediso ya ho hlahloba ka selelekela tsa bongaka ha o etsa kopo ya mosebetsi ho ya mokga wa liphoofolo tse ruiloeng;
• eketseha ka sebaka bakeng sa tsa bodulo tsa bakuli ba ba ne ba na le boloetse ba lefuba;
• ho kenya tshebetsong ka nako e loketseng ea ente e ho masea a ka khoeli ea pele ka mor'a tsoalo.

bofello

Fibro-cavernous methapo lefuba (mathata a sokela ho boemo ba bophelo) ke lefu le sa foleng. E le busa, e halefile cavernous lefuba. Lefu lena le ka tšoauoa ka diso le unilateral kapa omimvo.

Pele bolwetse thata ho tšoara, ho ke hona joale moriana o na le lintho tse ngata bokgoning fapaneng oa phekolo o tla netefatsa kokobetse tsitsitseng ka lilemo tse ngata. kalafo ka nako e loketseng ka boloka matla a le mamello ea ho sebetsa.