Pulmonary tuberculosis

Pulmonary tuberculosis
Tuberculosis is commonly called as " Tuberculosis " ,It is the tubercle bacillus that invades the infection caused in the body, it is a kind of chronic and deferred infectious disease easy to happen of young people. All the year round can have illness coming on, 15 year old 35 -year-old teenagers tuberculosis high to take place peak age. 4- 8 weeks of incubation period. Among them 80% happen in lung, other positions (neck lymph, meninx, peritoneum, intestines, skin, skeleton) Can also then send and infect. Mainly transmit through respiratory tract, it is to contact the pulmonary tuberculosis patient who arranges the fungus to infect the source. Liberate the descendant's constant improvement of living standard, tuberculosis has already been basically controlled, but in recent years, with the spread of environmental pollution and AIDS, tuberculosis stages a comeback again.

Tuberculosis is a chronic infectious disease caused by branch bacillus of tuberculosis, can involve a plurality of organs of whole body, but the pulmonary tuberculosis is the most common. Can spread and hide for a long time to whole body, have illness coming on when organism resistance is reduced, the pathologic characteristic of this disease is tuberculosis and tubercle and cheese and a kind of necrosis, it is apt to form the cavity. Though nearly two has been over the past thirty years, the morbidity has obviously dropped, it is still one of the common chronic infectious diseases occuring frequently at present.


Define

It is the lung infective disease caused by tubercle bacillus. It is the main way that a disease is infected that the respiratory tract is transmitted between men. Its main clinical manifestation has exhausted, insomnia, night sweating, in the afternoon hectic, coughing, expectoration, spitting blood, chest to ache and have difficulty in breathing etc..

Disease this pathologic characteristic the intersection of tuberculosis and tubercle and be cool necrosis, it is apt to form the cavity. Presenting chronic course more on clinic, minority can be worried to get up to have illness coming on. Respiratory system such as whole body symptom of often having low-heat, weak etc. and coughing, spitting blood behave.


Cause of disease and pathogenesis:

First, tuberculosis fungus

It is the branched bacillus, the slide is dyed and resisted acidly, claim and resist and tingle the bacillus also. Foreign resistance strong, 5 have the above, tan by the sun down 2 hours in burning sun in can survive by dark and damp place, 5- 12% the intersection of lysol and water keep in touch 2- 12 hour, 70% alcohol keep in touch 2 minute, or one minute such as boiling, can be killed. And the simplest sterilization method is to spit the phlegm on the paper and burn directly.

Second, infect the route

The tuberculosis fungus mainly spreads through the respiratory tract. It is mainly the phlegm of the pulmonary tuberculosis patient who arranges the fungus to infect the source. The secondary route to infect is to enter body by the digestive tract.

Third, reactivity of human body

The immunity of tuberculosis is mainly cell immunity, display the enhancement which cause the quick and cell phagocytosis in lymphocytes. After invading the intersection of tuberculosis and fungus engulf, through punish, process, transmit the intersection of T and lymphocyte to antigenic information, make it cause quickly. When causing quick T lymphocytes to meet the tuberculosis fungus again, release a series of lymph. Factor make macrophage assemble around bacterium, engulf, kill bacterium, upper leather cell and the intersection of my darling and rare big and small afterbirth of turning into etc., form tuberculosis and tubercle finally.

Pathology: The tuberculosis fungus causes inflammation to react behind invading the human body, the trial of strength between bacterium and human resistance mutually has growth and decline, the course of pathological change is complicated, but its basic pathological change mainly has oozing out, hyperplasia, going bad.


Clinical manifestation:

Typical pulmonary tuberculosis get up disease to be slow gradually, it is longer for course of disease to undergo, there is low-heat, be weak, lose the appetite, cough and spit blood on a small quantity. But most patient diseases promise slightly, does not often have obvious symptom, are found by the health examination beginning of X-ray, some patients admit unexpected hemoptysis behave and discover, but can often trace back to slight toxic symptom in the course of disease.

First, whole body symptom:

The toxic symptom of whole body is shown as afternoon low-heat, weak, appetite fail, the weight is lightened, night sweated etc.. While promising rapid progress to sow at the lung disease scatteredly, there can be hyperpyrexia, women can have menoxenia or amenorrhea.

Second, respiratory system:

Generally have dry cough or have a small amount of mucus only. Accompany and continue the hair it when being infected with, the phlegm presents mucus or suppuration. About 1/ 3 of the patients have hemoptysis at various degrees. When involving one storey of pleuras of wall in inflammation, the corresponding wall of the chest has shouting pain, generally not violent, and cough and aggravate with breath. Chronic serious disease and pulmonary tuberculosis, the breathing function is slowed down, have difficulty in breathing.


Laboratory and other inspections:

First, tuberculosis fungus are checked

It is the main basis of making a definite diagnosis of pulmonary tuberculosis to find the tuberculosis fungus in the phlegm.

Second, X-ray examination

The X-ray examination of lung not only can find pulmonary tuberculosis in early days but also can make diagnosis to the position, range, property, development and result that the disease promise.

Third, tuberculin test

Positive: Show tuberculosis is infected, but might not be ill. Dilute degree and make covers to try presenting the positive ones, there are active tuberculosis cooking stoves to often brief on the body.

Negative: Do not have tuberculosis fungus to infect to brief on. But still should get rid of the following situations.

A, tuberculosis fungus need 4- 8 weeks after infecting the allergy can be fully set up; So in earlier stage such as allergy, form, test as negative usually.

Immune inhibitors person such as B, employing glucocorticoid,etc., malnutritive and measles, whooping cough patient, form and usually react and can disappear temporarily.

C, serious tuberculosis and various critical patients are right to form plainly and reactionlessly.

D, other such as the lymphocytic immune system defect ' Leukemia, tubercle) The knot of patient and the elderly usually reflects it is often negative.


Diagnose the main point

First, weak, the weight is lightened, generate heat, night sweat.

Second, expectoration, chest slice shows lung soaking change in the X-ray.

Third, tuberculin test masculine gender.

Fourth, phlegm liquid slide resist the acid and dye the masculine gender.

Fifth, phlegm train the tubercle bacillus to be positive.


Pulmonary tuberculosis type

First, primaryth lung tuberculosis type) : Infect the clinical symptom caused in order to send tuberculosis originally. Including sending scrofula in syndrome and chest originally. While erupting bronchus Lou of lymph node simultaneously, if the enlargement of lymph nodes is more prominent, there is only less one when sow scattered pathological change in two lungs, still originally type return.

Second, scattered lung tuberculosis type of walking and sowing of blood) : Including acute the blood walks and sows scattered pulmonary tuberculosis (one type tuberculosis of acute millet) And subnormal temperature, chronic blood competent to sow scattered pulmonary tuberculosis.

Third, soaking lung tuberculosis type) : Continue the main type of pulmonary tuberculosis of hairdo. The lung has one kind of pathological changes of oozing out, soaking and/or cheese at various degrees. It is obvious the cavity takes shape. Cheese pneumonia and tuberculosis ball belong to the one type.

Fourth, chronic fibrous cavity type lung tuberculosis type) : Continue the chronic type of pulmonary tuberculosis of hairdo. Often sow scattered pathological change and obvious pleura to increase with more extensive bronchus thick. The lung tissue destroys often more prominent, organize obvious hyperplasia with the fiber and cause lung tissue shrinking and mediastinal, pulling in the lung of affected part to shift, the neighbouring lung tissue often presents compensating pulmonary emphysema.

Fifth, tuberculosis pleurisy type) : Have already got rid of pleurisy that other reasons have caused on clinic.

Six: Propagate the route: The spread route of tuberculosis is respiratory tract, digestive tract, skin and uterus, but mainly pass the respiratory tract.

The digestive tract has bigger resistance on tuberculosis fungus, the tuberculosis fungus enters stomach, very easy to be killed by a large amount of gastric acid, unless has eaten a large number of tuberculosis funguses, otherwise difficult to be infected, but the respiratory tract is different, so long as 1~2 tuberculosis funguses suck persons to the alveolus, once organism resistance is low, can cause and have illness coming on. Because most of digestive tract tuberculosis are drunk and have not been caused by the milk of boiling. Pulmonary tuberculosis is spread and infected through the respiratory tract, the traditional view overweights the dust and carries disease germs to infect, call the dust aerosol of mushroom to infect now, namely point and arrange the fungus patient and spit everywhere because of pulmonary tuberculosis, the bacterium stirs up a cloud of dust at the same time after drying, breathed in people and caused the infection to have illness coming on by others. So in the tuberculosis prevention measure in the past, especially emphasized the disinfection of patient's phlegm of pulmonary tuberculosis, maintain the pulmonary tuberculosis patients' phlegm all demand to vomit and pour out after through boiling in a phlegm bottle no matter in the hospital or family, can bury etc. the phlegm in the countryside deeply, the extensive lasting ground launch propaganda in the masses, No Spitting. In addition emphasize patient want, isolate with healthy people, can divide to divide room into room, can't divide can divide bed or sleep separately too, notice the patient's tableware is sterilized, prevents the digestive tract from infecting. The above-mentioned the intersection of infection and way no doubt should notice, speak, cough, sneeze, discharge to drip nuclear infection a little, should cause the attention too air into arranging the intersection of fungus and patient.


Treat:

It is mainly chemical drug therapy, it is dark that the commonly used medicine has isonicotinyl hydrazine, rifampin, Streptomycin, pyrrole piperazine acyl, second amine cube alcohol and thiacetazone. Employ chemotherapy to follow 5 following principles: It is early. Once make a definite diagnosis of and use medicine immediately; Unite and use. Jointly employ 2 or more antituberculotic in order to guarantee curative effect and prevent producing and is able to bear nature, reduce the poisonous side effect; Right amount of. Law. Must guard against omitting and cutting off; Whole journey. Generally needing to take medicine can stop medicines until more than one year.

Resisting the chemical drug therapy of tuberculosis plays a decisive role to control of tuberculosis, rational chemotherapy can make the disease promise and all sterilize, fully recover. Traditional rest and nutrition play an auxiliary role.


Prevent general knowledge

After entering the 1990s, had already got pulmonary tuberculosis controlled, had presented the extensive fashion trend worldwide again. People have entered new period to the struggle of tuberculosis. Have certain tuberculosis fungus against nature, it is more difficult to treat, so the prevention to pulmonary tuberculosis is very important. As you have unidentified low fever of a reason, become thin, be weak, cough, night sweat, have not found the other causes of disease, should go to the hospital to check, make a definite diagnosis of rapidly. The law under the guidance of specialist, using medicine in the whole journey, the course of treatment can't be shorter than half a year, the patient should be patient enough. Have a rest, sufficient nutrition, appropriate outdoor sports, strengthening the resistance of whole body, it is still the important condition of overcoming disease. The patient should isolate appropriately during arranging the fungus, it is very important to protect kinsfolks and the collective crowd's health, especially protect children.

1,Children should inoculate Bacillus Calmette-Guerin on time. Can increase immune ability after inoculating, can prevent from and is infected by the tubercle bacillus but ill.

2,Mainly propagating the route and is infected by the droplets of pulmonary tuberculosis. It cough, sneeze, talk and laugh loudly when spray by dropletses with fungus and last peoples healthy. If the patient spits everywhere, the phlegm fungus is sown in the air by airplane and infected with the dust after treating the phlegm liquid dry. The patient finding the tubercle bacillus in the phlegm should wear the gauze mask to go out, don't facing toward the faces of others and speak, can't spit everywhere, should spit in the handkerchief or wasted paper, concentrate on sterilizing or burning and sterilizing with the fire. The phlegm liquid can be soaked for 2- 12 hours and sterilized with 5- 12% lysol solution. The patient should form and divide the food to make the habit, the food polluted by the tubercle bacillus in meal or ingestion can cause the infection of digestive tract altogether with the patient.

3,Positive patient should isolate the phlegm fungus. If the family isolates, the patient should live alone in the room, the diet, tableware, ware should be separated. Bed clothes, clothes,etc. can be tanned by the sun for 2 hours and sterilize under the sunshine, boiling such as the tableware can kill the tubercle bacillus in one minute.

The room should keep airiness, sunny, should open the doors and windows 3 times every day, 20- 30 minutes each time. Generally can cancel isolating when the phlegm fungus is negative.

4,There should be to pulmonary tuberculosis there is specific drug therapy in correct understanding, pulmonary tuberculosis at present, curative effect is very satisfied with. Pulmonary tuberculosis is no longer incurable disease. There should be optimistic spirit and positive attitude, make sure to insist that takes medicine according to quantity on time, finish the course of treatment that stipulates, otherwise apt to recur.

5,Can choose projects such as qigong, health care work, taijiquan,etc. to do exercises, can make the physiological function of the organism return to normal, get well gradually, strengthen the resistance against diseases. Notice the winter protection is cold-proof at ordinary times, control the sexual life.

6,The diet takes high protein, carbohydrate, vitamins as the core, should eat the fresh vegetables, fruit and beans. Should give up smoking and prohibit against alcoholic drinks.

It proves, smoking will make the blood density against consumptive disease medicine reduce to study in recent years, to treat unfavorable pulmonary tuberculosis, can increase the intersection of bronchus and the intersection of phlegm and secretion of liquid, make it aggravate not to cough, tuberculosis promises and spreads, symptom of aggravating hectically, spitting blood, night sweating etc.. Drinking can increase and resist the toxicity to the liver of consumptive disease medicine and is applied, cause medicine hepatitis, can make the organism blood vessel expand, symptom that prone to spitting blood.


Pulmonary tuberculosis
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