Isifo sofuba ka intrathoracic lymph node, ukuhlola, amafomu lesi sifo

Isifo sofuba ka intrathoracic lymph node - uhlobo lesi sifo, okuyinto akukakabi oluthathwa ngokugcwele. Abanye bakholelwa ukuthi bangabizwa ngokuthi isifo ezimele, abanye bakholelwa ukuthi kufanele ukushiywa eyinhloko sofuba eziyinkimbinkimbi. Lokhu ukugula kuzoxoxwa ngakho esihlokweni. Sibheka ngokuningiliziwe izimbangela zesifo, izinhlobo, izindlela ukuxilongwa kanye nokwelashwa izindlela, kanye yezinkinga kungenzeka nezindlela zokuzivikela.

Kuyini lokhu?

Isifo sofuba ka intrathoracic zamanzi (VGLU) - isifo libhekene izinqubo ukuvuvukala ekuqaleni ISIZINDA ise izimpande wamaphaphu. Imbangela zokugula Mycobacterium sofuba. I-ejenti causative angadluliselwa by kwezilwane ezinegciwane.

VGLU sofuba ngokuvamile esizithinta ngayo izingane, intsha nabantu asebengena ebudaleni kuze kube iminyaka engu-25. Ngenxa mass lokugoma ubhubhane cishe akukho amacala lengculaza ezingavamile futhi zenzeka kuphela amasosha omzimba aphansi. Lokhu zokugula elinesimo Yiqiniso ezingamahlalakhona ubude besikhathi isinyathelo yenqubo esiwohlozayo. 70% ngenxa yezinkinga sifo zenzeka ezingaphansi kweminyaka emithathu.

ukutheleleka indlela

Zonke izinhlobo sofuba ka intrathoracic izindlala zamanzi abantu okubangelwa isifo sofuba igciwane Mycobacterium.

Ukutheleleka kwenzeka ngezindlela ezilandelayo:

• Ngenxa ukusetshenziswa ukudla ethathwe nesineke isilwane (isib ubisi cow sika).
• Ngu amaconsi esivela kumuntu onegciwane noma isilwane.
• Ngokusebenzisa tintfo letisetjentiswa malanga onkhe kanye ukudla igcwele amagciwane.
• Ngokusebenzisa amanxeba esikhumbeni.
• It angadluliselwa kusuka kumama kuya enganeni ngesikhathi sokukhulelwa (ngokusebenzisa placenta) kanye lactation (ubisi).

It is kakhulu kungenzeka itheleleke nge ipheshana zokuphefumula. Umuntu onesifo sofuba, ukukhwehlela njalo nokukhuluma exhales phakathi phlegm emoyeni equkethe nezilwanyana ezincane nobutha. Bayakwazi ukunweba ibanga ngamamitha amabili futhi bahlale emoyeni isikhathi esingaphezu kwehora. Babe axazulule phansi futhi ixubene uthuli, kanye nokusebenza sabo inakekelwa kuze kufinyelele ezinyangeni eziyisithupha.

Yikuphi kukhulisa ematfuba ukutheleleka?

Ngemizimba ukuphefumula yomuntu ephile bavikelekile igciwane le-TB, kodwa ukubhema futhi bronchopulmonary izifo kunganciphisa amasosha omzimba. Ngo-95% amacala ngesikhathi contact lokuqala ne igciwane sofuba ukutheleleka kwenzeka.

Izici ezandisa amathuba okutheleleka:

• umsoco Imphumelelo futhi ongenakulinganisela.
• contact isikhathi eside ne sofuba elinegciwane.
• izimo engcono.
• Ukuba khona izifo.
• ukucindezeleka Omkhulu ngokomzimba nangokwengqondo.

Ngokuvamile itheleleke eyodwa yalezi zinto, futhi yebo, lapho naniyingcosana kuhlanganisa nemlandvo wetekwelashwa kwakhe. Ngakho-ke isifo sofuba ka intrathoracic lymph node kuthinta abantu emikhubeni emibi abaphethwe ukukhathala okungamahlalakhona, kanye nezingane livela emindenini ehlwempu. Ukutheleleka kuyinto cishe engenakwenzeka ukuba agcine, ukuze umzimba ofanayo enempilo ngokushesha uqala ukwakha ukungatheleleki zemvelo. Lapho ngineminyaka engu-isiguli ongase akubonge ngelinye ilanga ukuthatha abantu abambalwa, kodwa ukubamba umzimba owodwa kuphela okuyinto ngeke lilungele ukuze bazivikele. Engozini izingane kanye nabantu abadala ezingakenziwa kusukela zigonywe, kanye iziguli ezine-HIV kanye nabantu izinhlelo ababuthakathaka mzimba.

izinhlobo isifo

Kukhona amafomu alandelayo sofuba ka intrathoracic lymph node:

• Isimila.
• Infiltrative.
• Small.

Isimila uhlobo bronhoadenita esindayo. Ngokuvamile kwenzeka ezinganeni ezincane nge ukwanda oluqinile e-lymph (ubukhulu babo ongafinyelela kuze 5 cm) kanye tubinfitsirovanii okukhulu. Ngokuvamile yezingxenye ethintekile basuke eziphothene ukwakha nhlanganisela olulodwa.

ifomu Infiltrative kubangela ukukhuphuka kancane e-lymph, ngaleyo ndlela perinodulyarnoe ukuvuvukala evelele.

ifomu iDemo

Ukubhala ngezinhlamvu ezincane ezihlukanisiwe sofuba ka intrathoracic lymph node kunzima ukuthola, futhi ithinta ikakhulukazi izingane. ukuxilongwa sekwephuzile noma imikhondo angaziwa ukuba nezibazi we mediastinum, othinta ukusebenza evamile capillary yamaphaphu ukugeleza kwegazi. Futhi zokugula kungaholela ukuvela ifomu sina yingozi isifo sofuba.

Ukuze afeze ithole ukuxilongwa okufanele kanye ukuhlonza isifo, kubalulekile ukuba acabangele lonke eziyinkimbinkimbi idatha radiology futhi endoscopic, futhi udinga ukuchitha tomography we mediastinum.

ukuxilonga izinkinga ifomu encane

Ngisho esigabeni asebenzayo isifo sofuba elincane intrathoracic lymph node 1-2 libhekene izilonda-lymph nokwanda kwentshiseko elincane (1.5 cm). Lezizibonakaliso kungabonwa x-ray.

izimpawu zokwelashwa ebuthaka kakhulu. Kwethulwa ngokuvamile kuphela ongaphakeme-ebangeni imfiva kanye ukudakwa syndrome. Entsheni, isikhalazo main kuyinto dystonia. Ngakho-ke, iziguli bavame ukuthunyelwa ezikhungweni ukuhlolwa odokotela nezinye amaphrofayli. Kuleli fomu elincane sofuba kuyingozi ngoba isifo kungabangela ezinye izitho zangaphakathi.

izimpawu

Isifo sofuba ka intrathoracic lymph node has zimpawu ezilandelayo:

• lokushisa umzimba antante degrees 39.
• Ebusuku, akukho ukujuluka ecacile, esingavunyelwe okubangelwa ukushisa.
• Kwehliswe iphango.
• Khwehlela iqala efana naleyo livela ukukhwehlela whooping.
• pallor Sinzima kwesikhumba kuze luhlaza bluish.

Nokho, lezi zimpawu zingase kabi kuchazwe ke i ukusazi ngokunembile isifo esikuphethe ngako kuyoba nzima kakhulu. Kodwa nezinye izici bungabonakala enqubeni wokuhlola:

• Visual. Neuropathy inethiwekhi emithambo yegazi yandisa kakhulu esikhaleni intercostal lokuqala nelesibili. Phakathi vanes emiphongolweni emincane ebasiza nasesikhathini izingxenye engenhla.
• Palpation. Okuvela ubuhlungu ngesikhathi ingcindezi izinqubo spinous ka amathambo thoracic (kusukela 3rd 7th).

Kubalulekile sitholakele isifo sofuba kokuxilongwa-X-ray. It is saqhutshwa ezenziwa ezilingene Antero-posterior, t. K. A shadow kusukela lymph node kungenziwa izitho mediastinal futhi imisipha inhliziyo kufihlwe. Kubalulekile futhi ukuba ukuqhuba okuskeniwe kwesihlahla tracheobronchial. Kodwa sizokhuluma ngalokho Inkulumo elandelayo.

ukuhlola

Kunzima kakhulu ukuhlukanisa kusuka naleti pathologies sofuba ka intrathoracic zamanzi. Imiphumela yaloku kuhlola okungenhla Ukwahlukaniswa kuyadingeka njengoba ngaphansi omunye komunye isifo.

Ngakho, indlela aqala ukuxilongwa?

Isinyathelo sokuqala ukuthola khona sofuba Mycobacterium emzimbeni. amagciwane e-TB kalula itholakala emanzini ngesigezo esiswini. Ngokuvamile ziseZwini amanzi okugeza kuwo ze- bronchi, isikhwehlela.

Okulandelayo Kuphoqelekile luhlolo radiology. Ingasetshenziselwa hhayi kuphela ukunquma ukuthi umuntu uthelelekile, kodwa futhi siqonde uye watheleleka esingakanani. Futhi imaging ezinhle ithekhniki le kuvumela ukuthi ukuba sihlaziye isakhiwo-lymph ukuthi lula odokotela sina inselele e uphethwe.

Indlela ebaluleke Kuhlolisisa isivivinyo Mantoux. Nge yalokho omuhle, ubizwa nangokuthi "ithuba." Kulokhu, ukusabela elinegciwane ukwenza lomjovo okulandelayo - isayithi umjovo landa ngamaphesenti angaphezu kuka-5 mm. "Virage" sitholakale kulezi zimo ezilandelayo:

• Papule (uphawu isikhala) siba sikhulu kunesijeziso 0.5 cm.
• Kuba kakhulu ngokuqhathaniswa Imiphumela odlule.
• Kudlulwe kuyinsakavukela ngo-17 mm ngaphandle komkhawulo we yokugoma odlule.
• Ngemva kweminyaka engu-3 yobukhulu bayo mkhulu kunezinhliziyo 12 mm.

Nokho, ngaso sonke isikhathi Mantoux omuhle ukhuluma mayelana ukutheleleka. Kukhona kungenzeka ukuthi isizathu ukusabela ngaleyo ndlela kungase kube izifo iguliswa noma ngaphambili adlulisiwe. Libuye ngaso sonke isikhathi ukuhlolwa negative kubonisa ukungabi ukutheleleka. imiphumela engemihle Amanga kungadalwa immunodeficiency noma ngenxa yokuthi esikhathini ukutheleleka ongakabi Kwadlula amasonto 10.

Nokho, "goba" isizathu esanele ukuze uqhubeke ukuhlolwa okwengeziwe.

Futhi, yenza ukuhlolwa igazi njengengxenye izindlela zokuxilonga. Lapho inani MTB isifo leukocyte, ama-lymphocyte, ama-neutrophil eosinophils uzobe kancane anda.

Imiphumela yaloku kuhlola okungenhla Ukwahlukaniswa sofuba ka intrathoracic lymph node

Lapho sitholakele isifo sofuba VGLU ngokuvamile kufanele ehlukaniswe kusuka kwamanye pathologies sofuba. Ukuze wenze lokhu, udokotela kufanele bahlolisise umlando, ukukhomba amathuba ukuxhumana iziguli bacillary, sihlaziye test tuberculin, ihlole zonke izifo ngaphambilini sidluliselwe ukuthi zingahlanganiswa ukutheleleka.

Ngaphandle ukukwazi kudidaniswe omunye VGLU sofuba sofuba buka, akukho Cishe ukuze lihlukaniswe izifo intrathoracic zamanzi.

Kungenzeka futhi ukudida zokugula nge Ukudlulela ezivela kokunqotshwa umdlavuza wamaphaphu lymphosarcoma. Nokho, kungenzeka ezifana livela kuphela iziguli esezikhulile.

zokwelapha

Isifo sofuba ka intrathoracic izindlala zamanzi izingane kanye nabantu abadala senzeka cishe ngokulinganayo, ngakho yokwelapha is ezinqunyiwe umehluko ongatheni.

Ukwelashwa nokuvikelwa lolu hlobo sofuba isikhathi eside ngokwanele. Ngokwesilinganiso, impatho kungathatha kuphi kusukela 10 izinyanga unyaka nesigamu. Kulokhu, ezinyangeni zokuqala 2-3, isiguli kufanele ibe esibhedlela isifo sofuba. Okokuqala, ukuze ukuthelela abanye. Okwesibili, i-ukwelashwa ngendlela ephumelela kakhudlwana.

Sonke lesi sikhathi imishanguzo eziyinkimbinkimbi, okuhlanganisa nezidakamizwa ngokumelene sofuba, gepatoprotektory, amavithamini, futhi immunomodulators.

Futhi emavikini ambalwa wokuqala ngezigaba eziphambili lesi sifo kungaba kwenziwe ngamakhemikhali. Nokho, it is ngokuvamile zinikezwa izinqubo ezahlukene depuration. Ngokwesibonelo, emthanjeni laser ngemisebe noma plasmapheresis igazi.

ukwelashwa VGLU TB ihlukaniswe izigaba ezimbili. Phakathi ukwelashwa olunzulu Kwenziwa lokuqala, okuhloswe ngalo kokubhubhisa Office, nokuvulwa ezilimele wamaphaphu izicubu ngokuhamba kwesikhathi kanye nokuvinjelwa izinkinga isifo. Ukwelashwa TB kuhlanganisa inhlanganisela yemithi eziningana ukuthi okudiliza zonke izinhlobo MBT. Isigaba sesibili akuyona okukhulu. Lapha into esemqoka - ukuvimbela kabusha nentuthuko zokugula, ukukhuthaza izicubu sokuphulukiswa, ukubulala nanoma iyiphi esele mycobacteria eziyingozi kanye ukuqinisa amasosha omzimba.

Phakathi nayo yonke ukwelapha Kunconywa ukulandela ukudla ekhethekile, ezosiza ukunciphisa ubuthi emzimbeni futhi ukwandisa ukumelana ukutheleleka. Ukudla kuhlanganisa ukudla amaprotheni eliphezulu inkomba (amaqanda, inyama, imikhiqizo yobisi), ibhotela olive oil, uju, okusanhlamvu, izithelo nemifino kunothile vitamin C odingekayo ngosuku njalo

kokungenela kuhlinzwa

Isifo sofuba ka intrathoracic lymph node akuvamile kuholela isidingo ukuhlinzwa, njengoba isifo siphela kakhulu buthule, cishe asymptomatic.

Sekukonke kunezizathu ezimbili eziyinhloko ukuhlinzwa:

• Qala ukwakha tuberculoma ISIZINDA lymph.
• Ukuswelakala kokusebenza ngokuhlanganyela neminye imiphumela emihle yokuphathwa, okuyinto wethulwa izinyanga ezingaphezu kweziyisithupha edlule.

yezinkinga kungenzeka

Sibala yezinkinga kungenzeka isifo sofuba ka intrathoracic lymph node:

• Kumiswa fistulas yensimbi-bronchial ngenxa ukunqotshwa esindayo ze- bronchi.
• Ngenxa yokuhlukumeza ephelele isimiso bronchial, okwenzeka ngesikhathi amashubhu bronchial isibambo nge okukhulu zamanzi noma ukuvaleka uquqaba lwabo nokunjengoshizi, ngokuvamile leso kusuke Ngokuwa yabelana, atelectasis yamaphaphu elitholakala ngenhla ingcindezi ekamelweni noma ukuvaleka.
• Ubude noma ebalulekile atelectasis (spadenie ingxenye noma Lobe ephashini).

izinyathelo

Isifo sofuba ka intrathoracic lymph node, kuxoxwa sitholakele okwakubekelwa ngokuningiliziwe yithi ngenhla osebenza, kanye nazo zonke ezinye izinhlobo sofuba, kuya "isifo yezenhlalakahle." Okungukuthi, ukubukeka kwayo kuncike izimo zokuphila futhi ezingeni lokuchuma. ERussia, izimbangela ubhubhane iyagula yalesi sifo ubhekwa ziwohloke abukhali usa emazinga ekuphila, ukunciphisa izinga izimo zenhlalo yomphakathi nezomnotho, ukukhula ngokushesha kwesibalo abantu abangenamakhaya, kanye resumption of asebenzayo kufuduka izinqubo.