Pulmonary tuberculosis
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Pulmonary tuberculosis (TB) he maʻi lele ia mai nā mea hoʻomaʻi e pili ana i nā akemāmā. Pālahalaha paha ia i nā meaola ʻē aʻe.
Hoʻokumu ʻia ka pulmonary TB e ka maʻi bacteria Mycobacterium tuberculosis (M tuberculosis). He maʻi lele ko TB. Hoʻomaopopo maʻalahi ʻia kēia bacteria mai kahi mea maʻi i kekahi mea ʻē aʻe. Hiki iā ʻoe ke loaʻa ka TB ma ka hanu ʻana i nā kulu lewa mai kahi ʻeha a sneeze paha o kahi mea maʻi. ʻO ka hopena o ka maʻi hānai ua kapa ʻia ʻo TB mua.
Ola ka hapa nui o ka poʻe mai ka maʻi TB mua me ka ʻole o ka hōʻike hou o ka maʻi. Noho palaka ka maʻi (dormant) no nā makahiki. I kekahi poʻe, lilo i mea hana hou (reactivates).
ʻO ka hapa nui o ka poʻe i hoʻomohala i nā ʻōuli o ka maʻi TB i hele a maʻi i ka wā i hala. I kekahi mau hihia, lilo ka maʻi i loko o mau pule ma hope o ka maʻi maʻi mua.
ʻOi aku ka makaʻu o ka poʻe aʻe i ka TB hana a i ʻole ka hoʻoulu hou ʻana i ka TB.
- Nā mākua makua
- Nā pēpē
- ʻO ka poʻe me nā ʻōnaehana pale nawaliwali, no ka laʻana ma muli o ka maʻi HIV / AIDS, chemotherapy, diabetes, a i ʻole nā lāʻau e hoʻonāwaliwali i ka ʻōnaehana pale.
E piʻi aʻe kou makaʻu no ka hopu ʻana i ka TB inā ʻoe:
- Aia a puni ka poʻe i loaʻa i ka TB
- Noho i ka nohona lehulehu a haumia ʻole paha
- Loaʻa kaʻai maikaʻi ʻole
Hiki i nā mea aʻe ke hoʻonui i ka helu o ka maʻi TB i ka heluna kanaka.
- Hoʻonui i nā maʻi HIV
- Hoʻonui i ka helu o ka poʻe home ʻole (kahi nohona maikaʻi ʻole a me nā meaʻai)
- Ke kū nei o nā ʻano kūpaʻa lāʻau kūpaʻa o TB
ʻAʻole hoʻokumu ka pae mua o ka TB i nā ʻōuli. Ke hiki mai nā ʻōuli o ka pulmonary TB, hiki iā lākou ke hoʻopili:
- Pilikia hanu
- ʻEha ʻeha
- Cough (maʻamau me ka huaʻai)
- ʻApu ʻana i ke koko
- ʻO ka sweating nui loa, keu hoʻi i ka pō
- Ka luhi
- Fiva
- Kaumaha emi
- ʻUhihi
E hana ka mea mālama ola i kahi hoʻokolohua kino. Hōʻike paha kēia:
- ʻO ka clubbing o nā manamana lima a me nā manamana wāwae (i ka poʻe me ka maʻi kiʻekiʻe)
- Pehu a palupalu paha nā lymph node i ka ʻāʻī a i ʻole nā wahi ʻē aʻe
- Fluid a puni kahi māmā (pleural effusion)
- Kani ka hanu maʻamau (crackles)
ʻO nā hoʻokolohua i kauoha ʻia e komo pū:
- ʻO Bronchoscopy (hōʻike e hoʻohana i kahi pae e ʻike i nā alaloa)
- Scanner CT pahu
- Pākuʻi x-ray
- Hoʻokuʻu ʻo Interferon-gamma i ka hoʻāʻo koko, e like me ka hōʻike QFT-Gold e hoʻāʻo no ka maʻi TB (ʻeleu a maʻi paha i ka wā i hala)
- Ninaninau Sputum a me nā moʻomeheu
- Thoracentesis (ke kaʻina hana e lawe i ka wai mai ka lewa ma waena o ka uhi o ka waho o nā akemāmā a me ka paia o ka umauma)
- Hōʻike ʻili Tuberculin (i kapa ʻia he hōʻike PPD)
- ʻO Biopsy o nā mea i hoʻopili ʻia (hana iki ʻia)
ʻO ka pahuhopu o ka mālama ʻana e hoʻōla i ka maʻi me nā lāʻau e hakakā i ka bacteria TB. Mālama ʻia ʻo TB pulmonary active me ka hui pū ʻana o nā lāʻau he nui (maʻa mau he 4 mau lāʻau). Lawe ke kanaka i nā lāʻau a hōʻike i nā hoʻokolohua lab e hōʻike i nā lāʻau e ʻoi aku ka maikaʻi.
Pono paha ʻoe e inu i nā pila like ʻole i nā manawa like ʻole o ka lā no 6 mau mahina a ʻoi paha. He mea nui e lawe i nā pila i ke ala a kāu mea lawelawe i kauoha ai.
Ke lawe ʻole ka poʻe i kā lākou lāʻau TB e like me ka mea i manaʻo ʻia, hiki i ka maʻi ke lilo i mea paʻakikī e mālama. Hiki i ke koʻohune TB ke kūpaʻa i ka lapaʻau. ʻO kēia ka hana ʻole o nā lāʻau.
Inā ʻaʻole lawe kekahi i nā lāʻau āpau e like me ke kuhikuhi, pono paha kahi mea hāʻawi e kiaʻi i ke kanaka e lawe i nā lāʻau i kuhikuhi ʻia. Kapa ʻia kēia ala i mālama pono ʻia i ka lāʻau. I kēia hihia, hāʻawi ʻia nā lāʻau i 2 a i ʻole 3 manawa i ka pule.
Pono ʻoe e noho ma ka home a i ʻole e hoʻokomo ʻia i ka haukapila no 2 a 4 mau pule e pale ai i ka hoʻolaha ʻana i ka maʻi i nā poʻe ʻē aʻe a hiki i kou wā maʻi hou ʻole.
Koi ʻia kāu mea hoʻolako e ke kānāwai e hōʻike i kāu maʻi TB i ka keʻena olakino kūloko. E hōʻoia kāu hui mālama ola i loaʻa iā ʻoe ka mālama maikaʻi loa.
Hiki iā ʻoe ke hoʻomāmā i ke koʻikoʻi o ka maʻi ma ke komo ʻana i kahi hui kākoʻo. ʻO ke kaʻana ʻana me nā poʻe ʻē aʻe i loaʻa nā ʻike maʻamau a me nā pilikia hiki ke kōkua iā ʻoe e noʻonoʻo i ka kaohi.
Hoʻonui pinepine nā ʻōuli ma 2 a 3 mau pule ma hope o ka hoʻomaka ʻana o ka mālama ʻana. ʻAʻole hōʻike kahi x-ray umauma i kēia hoʻomaikaʻi a hiki i nā pule a i ʻole mau mahina ma hope. Maikaʻi loa ʻo Outlook inā ʻike mua ʻia ka pulmonary TB a hoʻomaka wikiwiki ʻia ka mālama ʻana.
Hiki i ka pulmonary TB ke hana i nā pohō paʻa mau inā ʻaʻole e mālama mua ʻia. Hiki iā ia ke pāhola i nā ʻāpana ʻē aʻe o ke kino.
Hoʻohana ʻia nā lāʻau e mālama ai i ka TB i nā hopena ʻaoʻao, e like me:
- Nā hoʻololi i ka hihiʻo
- ʻO nā waimaka ʻalani a ʻeleʻele paha a me ka mimi
- Rash
- Hū ke ake
E hana ʻia paha kahi hōʻike hihiʻo ma mua o ka hoʻomaka ʻana o ka lāʻau i hiki i kāu mea hāʻawi ke nānā i nā loli i ke olakino o kou mau maka.
Kāhea i kāu mea hāʻawi inā:
- Manaʻo ʻoe a ʻike paha ua hōʻike ʻia ʻoe i ka TB
- Hoʻolālā ʻoe i nā ʻōuli o ka TB
- Hoʻomau kāu mau ʻōuli ma muli o ka mālama ʻana
- Hoʻolālā nā ʻōuli hou
Hiki ke pale ʻia ka TB, ʻoiai i ka poʻe i hōʻike ʻia i kahi kanaka maʻi. Hoʻohana ʻia ka hoʻāʻo ʻili no ka TB i nā heluna makaʻu nui a i ʻole i ka poʻe i ʻike ʻia i ka TB, e like me nā limahana mālama ola.
Pono ka poʻe i hōʻike ʻia i ka TB e hōʻoia i ka ʻili i ka hikiwawe loa a loaʻa kahi hōʻike ukali ma kahi lā ma hope, inā maikaʻi ʻole ka hōʻike mua.
ʻO kahi hōʻoia ʻili maikaʻi i hui pū ʻia me ka bacteria TB. ʻAʻole ia he manaʻo he maʻi TB kou a he maʻi lele paha. E kamaʻilio i kāu mea hoʻolako e pili ana pehea e pale ai i ka loaʻa ʻana o ka TB.
He mea nui ka lapaʻau wikiwiki i ka pale ʻana i ka laha ʻana o ka TB mai ka poʻe i loaʻa ka maʻi TB i ka poʻe i loaʻa ʻole i ka maʻi TB.
Hāʻawi kekahi mau ʻāina me ka nui o ka maʻi TB i ka poʻe i ka lāʻau lapaʻau i kapa ʻia ʻo BCG e pale aku ai i ka TB. Akā, kaupalena ʻia ka maikaʻi o kēia lāʻau āpau a hoʻohana ʻole ʻia ia ma ʻAmelika Hui Pū ʻIa no ka pale ʻana i ka TB.
ʻO ka poʻe i loaʻa iā BCG e hoʻāʻo paha i ka ʻili no ka TB. Kūkākūkā i nā hopena hōʻike (inā maikaʻi) me kāu mea hāʻawi.
TB; Tuberculosis - pulmonary; Mycobacterium - pulmonary
Tuberculosis i ka puʻupaʻa
Tuberculosis i ka akemāmā
Tuberculosis, holomua - umauma x-kukuna
Pulmonary nodule - nānā mua umauma x-ray
Pulmonary nodule, mehameha - CT scan
Puʻu Miliary
Puʻukū o nā māmā
Pili ʻia ʻo Erythema nodosum me sarcoidosis
ʻŌnaehana hanu
Hōʻike ʻili tuberculin
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Hauk L. Tuberculosis: nā kulekele no ka hōʻailona mai ATS, IDSA, a me CDC. He Kauka Lapaʻau. 2018; 97 (1): 56-58. PMID: 29365230 pubmed.ncbi.nlm.nih.gov/29365230.
Wallace WAH. ʻAha hanu. I: Cross SS, ed. Underwood's Pathology. ʻEpekema 7 Piladelapia, PA: Elsevier; 2019: chap 14.