Has anyone around you ever had tuberculosis?
The first one is my classmate and colleague, majoring in respiratory medicine. I seldom saw him for a while, because I was busy myself, so I didn't pay attention. When I saw him again, he was weak and lost a lot of weight, just like a different person. I didn't know he had tuberculosis until I asked. He was unfortunately infected by a patient at work. He has been in treatment since he fell ill, and he didn't go to work, and he didn't tell anyone about it. After his accident, I also brought a mask for a while (but I didn't bring it after the accident, which is really big)
The other is my michel platini, who suddenly fell ill because of overwork. I went for a checkup and got tuberculous pleurisy. Although tuberculous pleurisy is not contagious, it needs treatment for half a year, so I took sick leave and rested at home for almost a year. People are thin, too In the past six months, he has rested at home every day, so he can't do heavy manual work. Others cook meals. Although tuberculous pleurisy is not contagious, he didn't tell anyone. After all, tuberculosis is terrible in our concept, so in order to avoid unnecessary panic and trouble, he didn't tell outsiders. Only a few relatives know, the unit also said that it was sick, and only a few direct leaders knew what the disease was.
In recent years, the incidence of tuberculosis has increased significantly. The news also reported several cases of tuberculosis spreading in schools, which should attract everyone's attention.
1. Try not to go to crowded and unventilated places. If you must go, try to put on a mask.
Don't spit everywhere, the main mode of transmission of tuberculosis is respiratory tract.
3. If you cough, have fever, hemoptysis or lose weight for a long time, you should go to the hospital in time.
As doctors, especially respiratory doctors, people get tuberculosis every day. You have to talk to them. Look at them. Listen to the sounds in their lungs. Listen to their tuberculosis. It is true that this disease is too tormenting. Although it can be cured, the course of treatment is extremely long, and there are four side effects when it is not used. The key is to endure this side effect for at least 6 to 9 months.
They cough, expectorate and even hemoptysis. They are afraid, they have a fever, and they are even getting thinner. No tuberculosis patient can smile through psychological consultation like a pneumonia patient. Even if it is cured, it will leave many sequelae at the meeting. This disease needs a lifelong struggle.
Caring for them a little more is something that everyone can do.
Tuberculosis was once considered as one of the main infectious diseases that seriously endangered human health, and it was also one of the infectious diseases under key control in China. The disease is not incurable, but it can be cured with active treatment. The standard of cure is that chest X-ray shows the formation of calcified lesions, and sputum examination shows mycobacterium tuberculosis (-).
The pathogens of tuberculosis are common in four categories, namely Mycobacterium tuberculosis, Mycobacterium bovis, Mycobacterium africanum and Mycobacterium MICROTUS. Among them, more than 90% of TB patients are Mycobacterium tuberculosis (acid-fast bacilli). Mycobacterium tuberculosis is very difficult. It can reproduce and multiply within 14~20 hours. It can survive for months or years in dry environment and months in dark and humid environment, but it can kill Mycobacterium tuberculosis within 7 hours in the sun, which means that the disease spreads in dark, humid or dry weather all the year round.
The route of transmission of tuberculosis is through respiratory tract, that is to say, when coughing, expectoration, laughing and talking loudly can discharge mycobacterium tuberculosis into the air, if someone happens to have poor physical resistance at this time, the prevalence rate will be high. Of course, there are other influencing factors, such as malnutrition, overcrowding and poverty, which will increase the infection rate.
When infected with tuberculosis, there will be symptoms of tuberculosis poisoning, such as low fever, night sweats, fatigue, burnout, poor appetite and weight loss in the afternoon, respiratory symptoms, such as cough, expectoration and blood in sputum. When complicated with bacterial infection, sputum may be purulent, about one third of patients have symptoms of hemoptysis, and a few patients have severe hemoptysis. The danger of massive hemoptysis lies in blocking the respiratory tract and suffocation.
The treatment was mainly combined drugs, such as isoniazid, rifampicin, pyrazinamide and ethambutol in intensive period for 2 months, and then isoniazid and rifampicin were taken for 4 months. This is the initial treatment of active pulmonary tuberculosis, with a short course of disease. Because anti-tuberculosis drugs have side effects, you should go to the hospital regularly for blood tests and liver function tests, and if necessary, you should go to the doctor to adjust the drugs.
I am a doctor in the Department of Critical Care Medicine, but half of the patients I usually contact are tuberculosis patients.
Are there many tuberculosis patients?
From 2065438 to April 2008, the National Health and Family Planning Commission announced that there were 100054 new cases of pulmonary tuberculosis and 152 deaths of pulmonary tuberculosis.
Within a month, 65,438+10,000 cases of pulmonary tuberculosis were newly discovered in China. Don't pretend we don't have tuberculosis around us!
The typical symptoms of tuberculosis are:
1, fever, body temperature will not be too high, 37-38, fever time is also regular, usually after noon, so there is a special word, low fever in the afternoon.
2, night sweats, regardless of spring, summer, autumn and winter, cold rain is warm, wake up after sleep, pillows and quilts are sweaty.
3, cough and expectoration, as a respiratory disease, this is the basic attribute, and sometimes there will be hemoptysis. Of course, there are also a few people who are atypical, just coughing occasionally and not much phlegm.
4, emaciation, most tuberculosis patients, the weight will not exceed the standard, eat nothing fat, and even have no weight loss plan, the weight can also drop rapidly! Should I be happy or sad?
5. Patients with pleurisy may have chest pain and chest tightness.
6. Patients with peritonitis may have abdominal pain.
7, meningitis patients, may slowly coma.
How to prevent tuberculosis?
Wash hands frequently, strengthen nutrition, exercise moderately, and open windows frequently for ventilation.
Remember to wear a mask when you enter the crowd.
Start from yourself, don't spit everywhere, and discourage people who spit everywhere.
Find or suspect tuberculosis, see a doctor in time, treat it early and benefit early! The damage of mycobacterium tuberculosis to lung tissue is often irreversible!
Tuberculosis can be prevented and cured, so don't worry, let alone feel embarrassed about it, because your tuberculosis was passed on to you by others!
As a radiologist, I meet tuberculosis patients every day.
Tuberculosis is a Class B infectious disease under the centralized management of the state. Before answering, tell a story about tuberculosis.
Xiaowen and his cousin Xiao Qiang are in the same school, in the same class and dormitory. A new teaching building is being built next to Xiaowen Brothers' dormitory, which is dusty, so the dormitory does not open windows and is not ventilated all day. In the last month, both Xiaowen brothers have developed symptoms such as cough, expectoration, low fever, night sweats and weight loss. Xiaowen also had symptoms of coughing up blood and phlegm half a month ago. A week ago, my unit happened to be engaged in tuberculosis publicity activities in this school. Brother Xiaowen saw the brochure of our unit and was afraid that his tuberculosis would affect his studies, so he consulted my colleagues. After understanding, my colleague took Xiaowen's brother back to the hospital for further examination. Our hospital gave Xiaowen brothers chest X-ray examination and sputum examination respectively. Unfortunately, both Xiaowen brothers suffer from tuberculosis.
(Xiaowen's chest X-ray)
(Xiao Qiang's chest X-ray)
What is tuberculosis? Tuberculosis is a chronic infectious disease caused by the invasion of mycobacterium tuberculosis, which can occur in any part of the human body, especially in the lungs.
What are the manifestations of tuberculosis?
Cough, expectoration for 2 weeks, hemoptysis or blood in sputum are the main symptoms of tuberculosis, and those with any of the above symptoms are suspected symptoms of tuberculosis. In addition, chest tightness, chest pain, low fever, night sweats, fatigue, loss of appetite and weight loss are other common symptoms of tuberculosis patients.
Who is prone to tuberculosis?
① People who have close contact with pulmonary tuberculosis patients who have not been found or thoroughly treated, such as family members (especially children) and medical staff. ② People who live and work collectively in a poorly ventilated environment. ③ People with weak collective resistance, such as children, the elderly, malnourished people, pneumoconiosis, diabetics, and people who use immunosuppressants for a long time after gastrectomy.
How to diagnose tuberculosis early?
For those with suspicious symptoms of pulmonary tuberculosis, chest X-ray examination is generally performed first, and sputum smear examination is performed for those with abnormal chest X-ray. Sputum smear examination is convenient and quick, and it is a reliable method to diagnose tuberculosis at present. Positive test results mean that tuberculosis is found in sputum and can be diagnosed as tuberculosis.
The most effective measure to control the spread of tuberculosis is to find patients as soon as possible and carry out active and effective treatment. Kill mycobacterium tuberculosis by drugs, reduce and eliminate infectivity. In addition, patients should not cough, sneeze or speak loudly in front of others. Cover your nose and mouth with a handkerchief when necessary, don't spit everywhere, and keep the doors and windows of the room open to keep the indoor ventilation and fresh air.
How to prevent tuberculosis?
Tuberculosis is mainly infected by inhaling droplets when patients with infectious tuberculosis cough, sneeze or speak loudly. An untreated infectious pulmonary tuberculosis patient can infect 10 15 healthy people a year. Therefore, the prevention of tuberculosis should pay attention to the following aspects:
1. Timely find tuberculosis patients and those with suspicious symptoms and treat them early; 2. The family members and close contacts of tuberculosis patients shall receive relevant examinations; 3. Pay attention to the ventilation and environmental sanitation of the living place; 4. Pay attention to nutrition and rest, and exercise properly; 5. Newborn babies are vaccinated with BCG.
The state provides free treatment for infectious tuberculosis patients, free examination for suspected tuberculosis patients who cough and expectorate for more than 2-3 weeks, and free anti-tuberculosis drugs for infectious tuberculosis patients required by the unified treatment plan formulated by the World Health Organization.
The treatment principle of pulmonary tuberculosis is: early, combined, moderate, regular and whole course. More than 95% of tuberculosis patients can be cured by regular treatment. After treatment, the infectivity can be basically eliminated after two weeks. If the treatment is stopped after the initial symptoms are improved, it is easy to relapse or develop drug resistance, resulting in retreatment or refractory pulmonary tuberculosis patients.
The incidence of tuberculosis is very high, but as we all know, tuberculosis is an infectious disease, so it is generally kept secret for fear of discrimination.
No one around me has tuberculosis, but I know tuberculosis patients very well because I have worked in tuberculosis department for more than ten years.
Anyone who is sick is not hiding anything. It is also an infectious disease and has a bad reputation. Ordinary people have little knowledge and know who is an infectious disease, so they will definitely stay away.
When I was in the tuberculosis department, occasionally people from my hometown and village came to see me, but I got tuberculosis, and of course I was cured later. Later, when I returned to the village, I saw them. They didn't show any enthusiasm as if nothing had happened. I also understand that they don't want to talk about their illness in front of villagers. In fact, they are afraid that others will find it untenable in the village.
Later, I chatted with my family, who said that they didn't know who had tuberculosis at all. -They're hiding deep. Doctors will tell pulmonary tuberculosis patients to pay attention to isolation before completing treatment, so as not to infect others, and then go to public places after the negative infection of sputum test disappears after treatment. In fact, it is very difficult for patients to do this.
Unless you are a relative, you won't know even if you have tuberculosis patients around you. As many as 550 million people in China are infected with tuberculosis. The prevalence rates of active tuberculosis and infectious tuberculosis in China are 367/65438+ 10,000 and 122/65438+ 10,000 respectively. There are more than 4.5 million active pulmonary tuberculosis patients, including about 1.5 million infectious pulmonary tuberculosis patients. There must be tuberculosis patients around you, but you just don't know it.
Tuberculosis patients who excrete bacteria are important sources of infection. When a patient speaks loudly, coughs or sneezes, sputum containing tubercle bacilli is sprayed into the air in the form of fog droplets, each fog droplet can contain 1- 10 tubercle bacilli, and the fog droplets containing bacteria are inhaled into the alveoli of healthy people through the respiratory tract to cause infection. Respiratory tract is an important route of infection.
Whether mycobacterium tuberculosis invades the human body depends on the pathogenicity of mycobacterium tuberculosis, the immune response of the body and the comparison between immune response and allergic response.
After being infected by Mycobacterium tuberculosis, the probability of getting tuberculosis for life is about 5- 10%. The factors that affect people's susceptibility to tuberculosis can be divided into two categories: natural resistance and acquired specific resistance. Besides genetic factors, social factors such as poverty, overcrowding and malnutrition also affect the body's natural resistance to tuberculosis. Infants' immune system is not perfect, and people with low immune function, such as the elderly, HIV-infected people, immunosuppressant users and patients with chronic diseases, are all susceptible to tuberculosis.
Pay attention to people's sports and learn more about tuberculosis prevention and treatment.
As a tuberculosis doctor, I need to contact with tuberculosis patients every day. Of course, people around you also have cases of tuberculosis. The causes of tuberculosis usually include the following:
3. Secondary: refers to the rekindling of the potential lesions left in the lungs during the primary infection or reinfection of Mycobacterium tuberculosis.
Although tuberculosis sounds terrible and everyone is talking about it, I don't know that tuberculosis patients who excrete bacteria are important sources of infection. When a patient speaks loudly, coughs or sneezes, sputum containing tubercle bacilli is sprayed into the air in the form of fog droplets, each fog droplet can contain 1- 10 tubercle bacilli, and the fog droplets containing bacteria are inhaled into the alveoli of healthy people through the respiratory tract to cause infection. Respiratory tract is an important route of infection. Although tuberculosis is terrible, it can be cured. Although it can be cured, the course of treatment is very long. Generally, four drugs are used in combination, and the side effects of the drugs are quite large, and the treatment time of tuberculosis is relatively long, at least 6 to 9 months.
When I was in the army, one of my officers got tuberculosis and started coughing, hemoptysis, chest pain and fever in the afternoon. Because I was always by his side, I was not afraid. A few years ago, he and I were still very healthy, and we often contacted each other.
20 17 10No. 17, diagnosed as pulmonary tuberculosis, male 19 years old.
Nothing, it's not a big problem. I just took the medicine for a year and a half, more than 300 a month. Because in other places, free medicine has to be collected at the local CDC. I was too troublesome to buy it at the hospital. The doctor asked to be hospitalized, so I didn't want to spend money, so I didn't stay. I heard that it was not serious, so I took the medicine and didn't need to be hospitalized.
Tuberculosis drugs 150 or so, liver protection drugs are better, water flies, 170 or so, plus monthly liver examination, the cost will not exceed 800.
After one year, the condition was stable, and the highest cost was 20 thousand. Severe hospitalization should be within two months and 10 thousand yuan, and then discharge is to take medicine for eight months, some for one year or even two years
First treatment, stable condition, hospitalization in February, taking medicine for one year, excluding food and clothing, the cost will not exceed 20 thousand.
Not being hospitalized, except for food, clothing, housing and transportation, will cost about 10 thousand a year.
The general family conditions can be seen.
Mainly afraid that taking tuberculosis drugs will damage the liver, because tuberculosis drugs are very toxic and the liver is detoxified, so the liver will bear great pressure. If the liver has been seriously damaged, you can't take anti-tuberculosis drugs, and you must restore your liver function. But in the meantime, if you take medicine again, you will develop drug resistance, kill tuberculosis bacteria, and then damage the liver, which is very troublesome. This is instability, and it will cost a lot of money.
It's the annual college entrance examination season. At this time of year, many senior three students will come to take the college entrance examination, and chest X-ray is a must. I am a radiologist, and I publish image reports. Tuberculosis is mainly diagnosed by chest X-ray or CT. Every year, several students in the college entrance examination find out tuberculosis because of chest X-rays. Unfortunately, once diagnosed as infiltrative tuberculosis, you need to take medicine for half a year before you can continue to go to school, and the college entrance examination can only be postponed. Tuberculosis is still very common at present.
Why is the management of tuberculosis so strict? Because it is contagious.
Because tuberculosis is an infectious disease, it is mainly transmitted through the respiratory tract. When a person with pulmonary tuberculosis coughs, pulmonary tuberculosis enters the air and is inhaled. If this person has strong resistance, it may not cause disease, but if it is a person with low resistance, infants, the elderly or diabetics are prone to infection. Word of mouth has serious consequences. Therefore, once infectious tuberculosis is found, it is necessary to treat it in isolation.
Tuberculosis can be cured.
Don't worry too much about tuberculosis. It can be cured after regular treatment, and the course of treatment is generally 6-9 months. Moreover, the state's treatment drugs for tuberculosis are free, but not all of them are free. Here, we must emphasize the regularity and sufficiency of the course of treatment, insist on taking medicine, and don't stop taking medicine after taking it for a while. Because this will lead to drug resistance of Mycobacterium tuberculosis, repeated withdrawal of drugs, and later use of these drugs will be ineffective, and it will be difficult to cure in the future.
When I was internship in respiratory department, a young soldier just got tuberculosis, but he thought he had good resistance. After taking the medicine, he stopped Later, he had repeated attacks and developed drug resistance. The usual medicine is useless to him. Once he was ready to leave the hospital, and he had a fever the day before. 23 years old, very painful.
Tuberculosis is still very common.
Although tuberculosis has decreased, as a radiologist, it is the first level to confirm suspected tuberculosis, and tuberculosis cases can be encountered every day. Generally, young people cough and expectoration for more than a month, but they have not improved. They think it's a common cold. The doctor will ask for a chest X-ray, and a typical chest X-ray can diagnose tuberculosis. So we radiologists can directly diagnose tuberculosis as soon as they see the typical chest film. Just said that our country has strict management of tuberculosis. As radiologists, once tuberculosis is diagnosed, we still have to report the patient's information, fill in the infectious disease card and urge the patient to go to the infectious disease hospital. If the superior comes to check and finds that we missed the report, we will be deducted.
Therefore, when doctors ask patients for detailed information, they hope to cooperate, which is also to urge patients to treat early, recover as soon as possible and reduce the spread of society.
What symptoms does tuberculosis have to be vigilant?
At work, many people think that they have a cold and cough, and it doesn't matter, but it turns out to be tuberculosis. So don't underestimate cough. Especially young people, people with low resistance, cough and expectoration for 2 weeks, low fever of 37-38 in the afternoon (that is, fever begins in the afternoon), night sweats, massive hemoptysis and hemoptysis, so it is necessary to take a chest X-ray to rule out tuberculosis and lung infection.