Health guide:
1. Children should be vaccinated with BCG on time. After inoculation, the immune ability can be improved and the disease caused by infection with mycobacterium tuberculosis can be avoided.
2. The main route of transmission of tuberculosis is droplet infection. When patients with open tuberculosis cough, sneeze and laugh loudly, they spray droplets with bacteria and infect healthy people. If the patient spits everywhere, the sputum bacteria will spread with the dust flying in the air after the sputum is dried. Patients with mycobacterium tuberculosis found in sputum should wear masks when going out, don't talk to other people's faces, don't spit everywhere, don't spit in handkerchiefs or waste paper, and focus on disinfection or burn with fire for sterilization. Sputum can be disinfected by soaking in 5 ~ 12% lysol solution for 2 ~ 12 hours. Patients should form the habit of eating separately. Eating with patients or food contaminated by mycobacterium tuberculosis can cause digestive tract infection.
3. Patients with positive sputum examination should be isolated. If the family is isolated, the patient's room should be separated, and the diet, utensils and utensils should be separated. Bedclothes, clothes, etc. Exposure to the sun for 2 hours can disinfect, and tableware boiling 1 minute can kill mycobacterium tuberculosis.
The living room should be well ventilated and sunny, and the doors and windows should be opened three times a day for 20 to 30 minutes each time. Generally, when sputum bacteria are negative, isolation can be cancelled.
We should have a correct understanding of tuberculosis. At present, there are specific drugs for tuberculosis, and the curative effect is very satisfactory. Tuberculosis is no longer an incurable disease Only with an optimistic spirit and a positive attitude can we insist on taking medicine on time and in quantity and complete the prescribed course of treatment, otherwise it is easy to relapse.
5. You can choose Qigong, health care, Tai Ji Chuan and other sports to exercise, which can make the physiological function of the body return to normal.
Gradually restore health and enhance disease resistance. Usually pay attention to cold and warmth, and control sexual intercourse.
6. The diet is mainly high in protein, sugar and vitamins, and you should eat more fresh vegetables, fruits and beans. Quit smoking and drinking.
Recent studies have proved that smoking can reduce the blood concentration of anti-tuberculosis drugs, which is not conducive to the treatment of tuberculosis. It can also increase the secretion of bronchial sputum, aggravate cough, spread tuberculosis lesions, and aggravate symptoms such as hot flashes, hemoptysis and night sweats. Drinking alcohol can increase the toxic effect of anti-tuberculosis drugs on the liver, lead to drug-induced hepatitis, dilate the blood vessels of the body, and easily produce hemoptysis symptoms.
tuberculosis
Concept:
Tuberculosis is a chronic infectious disease caused by Mycobacterium tuberculosis, which can involve many organs of the whole body, but tuberculosis is the most common.
The pathological features of this disease are tuberculosis nodules and necrosis of trunk, which is easy to form cavities. Clinically, it is mostly a chronic process, and a few of them can have an acute onset. There are often systemic symptoms such as low fever and fatigue, and respiratory manifestations such as cough and hemoptysis.
Etiology and pathogenesis:
I. Mycobacterium tuberculosis
It belongs to the genus Mycobacterium, and the smear is acid-resistant, also known as acid-fast bacilli. The external resistance is strong, and more than five people can survive in wet places, but exposure to the hot sun for 2 hours can kill them. 5- 12% contacts Lysol for 2- 12 hours, and 70% contacts alcohol for 2 minutes, or boils 1 minute. The simplest sterilization method is to spit on paper and burn it directly.
Second, the route of infection.
Tuberculosis is mainly transmitted through respiratory tract. The main source of infection is the sputum of tuberculosis patients who excrete bacteria. The second route of infection is through the digestive tract into the body.
Third, the human body's reaction ability.
The immunity of tuberculosis is mainly cellular immunity, which is manifested by the enhancement of lymphocyte sensitization and phagocytosis. After the invading mycobacterium tuberculosis is swallowed, it is treated to transmit antigen information to T lymphocytes to sensitize them. When sensitized T lymphocytes encounter mycobacterium tuberculosis again, they will release a series of lymphocytes. Factor makes macrophages gather around bacteria, devour and kill bacteria, then transform into epithelioid cells and Langerhans giant cells, and finally form tuberculosis nodules.
Pathology: Tuberculosis invades human body, causing inflammatory reaction. The contest between bacteria and human resistance is ups and downs, and the pathological process is complex, but its basic pathological changes mainly include exudation, proliferation and deterioration.
Clinical manifestations:
Typical pulmonary tuberculosis has a slow onset and a long course, with low fever, fatigue, loss of appetite, cough and a small amount of hemoptysis. However, most patients have mild lesions and often have no obvious symptoms, which can only be found through X-ray health examination. Some patients think that sudden hemoptysis is discovered by accident, but it can often be traced back to mild poisoning symptoms in the course of the disease.
First, systemic symptoms:
Symptoms of systemic poisoning include low-grade fever in the afternoon, fatigue, loss of appetite, weight loss, night sweats and so on. When lung lesions spread rapidly, high fever may occur, and women may have menstrual disorder or amenorrhea.
Second, the respiratory system:
There is usually a dry cough or only a small amount of mucus. When accompanied by secondary infection, phlegm is mucinous or purulent. About13 patients have different degrees of hemoptysis. When the inflammation spreads to parietal pleura, there is a tingling sensation in the corresponding chest wall, which is generally not serious, and it gets worse with breathing and coughing. Chronic severe pulmonary tuberculosis, slow respiratory function, dyspnea.
Laboratory and other inspections:
First, tuberculosis examination
Finding tuberculosis in sputum is the main basis for diagnosing tuberculosis.
Second, X-ray examination.
Lung X-ray examination can not only find tuberculosis early, but also diagnose the location, scope, nature, development and effect of the lesion.
Third, tuberculin test.
Positive: indicates tuberculosis infection, but not necessarily a disease. If the skin test dilution is positive, it often suggests that there are active tuberculosis lesions in the body.
Negative: indicates that there is no tuberculosis infection. However, the following situations should be ruled out.
A, it takes 4-8 weeks for allergic reaction to be completely established after tuberculosis infection; Therefore, in the early stage of allergic reaction, nodulin test can be negative.
B, the application of glucocorticoid and other immunosuppressants, malnutrition and measles, whooping cough patients, the tuberculin reaction can temporarily disappear.
C, severe pulmonary tuberculosis and various critically ill patients have no response to tuberculin.
D, others such as patients with lymphoimmune system deficiency (leukemia, sarcoidosis) and the elderly often have negative tuberculin reaction.
Diagnosis:
1, sputum tuberculosis examination
2.x-ray health examination
3. Clinical symptoms
Treatment:
Anti-tuberculosis chemotherapy plays a decisive role in the control of tuberculosis, and reasonable chemotherapy can sterilize and heal all the lesions. Traditional rest and nutrition play an auxiliary role.
(Criteria for disease diagnosis, classification and staging)
Tuberculosis is a chronic infectious disease caused by Mycobacterium tuberculosis, which can involve many organs in the whole body. But tuberculosis is the most common. Sterilized patients are the source of social infection. People infected with tuberculosis may not get sick, but only when their resistance is low. The pathological features of this disease are tuberculous nodules and caseous necrosis, which are easy to form cavities. Except for a few cases that may be acute, the clinical process is mostly chronic. There are often systemic symptoms such as low fever and fatigue, and respiratory manifestations such as cough and hemoptysis. Since the 1950s, although the epidemic situation of tuberculosis in China has generally shown a downward trend, due to the large population and unbalanced epidemic control in various regions, tuberculosis is still an important public health problem and one of the top ten causes of death in China, which should arouse our serious concern.
Diagnostic points
First, fatigue, weight loss, fever, night sweats.
The second is expectoration, and X-ray chest film shows pulmonary infiltrative changes.
Third, the tuberculin test is positive.
Fourth, sputum smear is positive for acid-fast staining.
Five, sputum culture is positive for Mycobacterium tuberculosis.
Diagnostic criteria (formulated by the National Conference on Tuberculosis Prevention and Control, Liuzhou, June 1978)
Types of tuberculosis
Primary pulmonary tuberculosis (type I): Clinical symptoms caused by primary tuberculosis infection. Including primary syndrome and intrathoracic lymph node tuberculosis. When combined with lymphadenobronchial fistula, it still belongs to this type if the lymphadenopathy is obvious and there are only a few disseminated lesions in both lungs.
2. Hematogenous disseminated tuberculosis (type II): including acute hematogenous disseminated tuberculosis (acute miliary tuberculosis) and subacute and chronic hematogenous disseminated tuberculosis.
Infiltrating pulmonary tuberculosis (type Ⅲ): It is the main type of secondary pulmonary tuberculosis. There are exudation, infiltration and/or caseous lesions in the lungs. It can be seen that a cavity is formed. Caseous pneumonia and tuberculoma also belong to this type.
4. Chronic fibrocavitary pulmonary tuberculosis (type IV): It is a chronic type of secondary pulmonary tuberculosis. It is often accompanied by widespread bronchopathy and obvious pleural thickening. The destruction of lung tissue is often obvious, accompanied by obvious fibrous tissue hyperplasia, which causes the contraction of lung tissue in the affected area and the displacement of mediastinum and lung, and the adjacent lung tissue often presents compensatory emphysema.
Five, tuberculous pleurisy (ⅴ type): Clinically, pleurisy caused by other reasons has been ruled out.