Check and diagnose _'s symptom in the laboratory of tubercle

Check and diagnose _'s symptom in the laboratory of tubercle
90% of the patient's chests of of tubercle are unusual in X-ray examination. Regular chest X-ray examination can often find that there are mediastinal lymph node pathological changes. It is in fact general for X-ray examination to find ' 90% of the patients) There is lymph node pathological change by door and the right side bronchus of one pair of sides lung, though can be seen single side pathological change once in a while. The lung soaks and presents tiny rubing the hyaline change of sand of disperse on the X-ray stretch, but it appears with lymph node pathological change at the same time or thereafter; Or there is not lymph node pathological change that can be seen; Or is shown as the netted or granulous pathological change of millet; Or take the form of and merge form or big tubercle, is similar to shifting the focus. Cough and it has difficulty in breathing to be may be very much slight and No. The result is a lung fiber in later period of going on disease, the bag turns into and lung source heart disease.
Often there are leucocytes that are reduced. The serum uric acid is often raised, but there is little gout. The result that the liver is given much trouble makes serum alkaline phosphatase and - valley ammonia acyl transfer to peptide enzyme and rise. The inhibition of late hairdo hypersensitivity is the characteristic, but negative second intensity tuberculin reaction must exclude from erupting pulmonary tuberculosis simultaneously. Black philtrum often has high gamma globulin blood disease.
The lung function is checked and shown and breathed limitedly, the complying with is reduced, disperse ability is weakened. CO2 retention is uncommon, though with often having a angry way to block in the lung fiber or great patient that chases with the disease or later period in the bronchus. It is important to act as the lung function and check for estimating the progress of course of disease and guiding treating regularly.
The patient without symptom if has typical chest X-ray slice to behave, can diagnose as tubercle; If chest slice is normal, but above-mentioned symptom and physical sign must consider tubercle. Because differential diagnosis including lymphoma and fungal infection (for example organize the thick liquid fungus disease of afterbirth, sporular fungus disease of ball) ,It is essential to organize examining checking with microbiological histology alive, if there is symptom and have therapeutic indication of steroids of cortex. If there is simple pathological change that may be touched of tables (such as in the cover inside, lymph node or conjunctiva) ,Sample that examined alive, positive rate of tubercle> is 85%.
When the peripheral position can't do alive and examine, it is to offer the first best step of histologic evidence of of tubercle to sample alive and examine through the fibrous bronchus mirror. Can see the granulation in 50%~80% of the patients swollenly, no matter chest X-ray block reveals whether the lung is soaked or there is lung door lymph node pathological change only. Can also adopt the lung to organize the sample through the thorax mirror.
Can make alive position that examine, include the intersection of appearance and normal conjunctiva or mediastinal while being other, the latter can be sampled by the mediastinal incision or mediastinal mirror. Liver live 70% case it is obvious granulation to be swollen examine. Must get rid of the single organ ' Such as liver) Some tubercle of China reacts, the granulation of lung is swollen that infect, hypersensitivity and foreign matter react. When there is doubt, should examine alive in several places, look for infecting or foreign matter to react carefully.
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