Tuberculosis _ general knowledge of peritonitis

Tuberculosis _ general knowledge of peritonitis
Tuberculosis peritonitis is that the filling the air peritoneum caused by tubercle bacillus and all over the place is infected, a lot of patients continue tuberculosis in organism other positions of the hair. Age any can have illness coming on, but with between twenty and fifty to meet woman slightly exceed men more.

1,Cause of disease

When organism resistance is reduced, invade tubercle bacillus of peritoneum, can breed, cause a disease through various route.

( 1) Spread directly: The infection route of main this disease is that the focal directness of tuberculosis spreads in an abdominal cavity. Such as tuberculosis of intestine, mesenterium lymphocytic tuberculosis and pelvis tuberculosis,etc..

( 2) Competent to sow scattered blood: The organism is often tuberculosis focus with other positions. Such as pulmonary tuberculosis of a sex of millet, tuberculosis meningitis, tuberculosis pleurisy,etc., can walk and sow scatteredly and infect to the peritoneum through the blood.

Dissect specially according to the pathology of this disease, can be divided into adhesion type, ascites type and done cool types.

2,Clinical manifestation

The majority arises it is attacked that the disease is latent, at the beginning symptom is relatively light, cause the patient not to often even seek medical advice and make a diagnosis and give treatment until several months for several weeks after having illness coming on, the disease is worried and sudden that a few patients get up, with acute abdominal pain and the hyperpyrexia, in order to mainly behave.

( 1) Whole body symptom: Generate heat, be weak, night sweat as main clinical manifestation. Generally generate heat for being intermediate, about body temperature at 38 . The ascites type, with having remittent fever to do coolly type, the body temperature can reach 40 . Such symptoms as most patients have losing the appetite, weak, weight that drop. Abdominal distension, suffer from diarrhoea relatively common, rare and soft having mucus excrement and urine of suffering from diarrhoea etc., suffer from diarrhoea with constipation replacing, appearing sometimes. In addition, having umbilicus week, upper abdomen or the whole uncomfortable or dull pain belly, minority have sharp pain.

( 2) The physical sign of belly: About half the a patient has typical belly walls " The flexible sense " Physical sign, the intersection of weight and the intersection of belly and tenderness and small quantity to ascites to hit quantity, adhesion type be cool patient belly can touch, come in different sizes and edge neat

3,Diagnosis

( 1) Yes let's generate heat, it night sweat, abdominal distension, belly tenderness and " The flexible sense " Wait for symptom and physical sign.

( 2) Laboratory check, have anaemia, erythrocyte sedimentation rate accelerate, can have old tuberculin test ' 1: 10,000) Positive, it is often exudative that the ascites is checked.
( 3) Some can have medical history of tuberculosis, such as fetching and examining and doing pathology and is checked and can be made a definite diagnosis of alive through the peritoneoscope or operation.

( 4) Effective after resisting the tuberculosis treatment regularly.

5,Treat and attend to

( 1) Generally attend to:

Have a rest. Want, stay in bed generate heat, ascites desirable half lie in the location a long time.

Diet. Give high heat, high protein, high vitamin, apt to digest, are imbued with the nutritive food.

Strengthen the condition to observe. Besides poisonous blood disease of whole body, should consider whether there are complications such as intestinal perforation, intestinal obstruction,etc.. As to the hyperpyrexia patient, pay attention to the heat observing type, do a good job of the nursing of the hyperpyrexia patient.

( 2) It is early, unite, resist the tuberculosis treatment in the whole journey: Generally select Streptomycin, isonicotinyl hydrazine, rifampin and second amine cube alcohol,etc. for use and unite chemotherapy, reflect the side effect about antituberculotic in time. Check hearing, eyesight, liver regularly renal function, blood alike, etc.

( 3) Use the adrenocortical hormone on the foundation against tuberculosis treatment: To there is blood that walks and sows the scattered or serious poisonous blood disease personning, can add and use the adrenocortical hormone at the same time, in order to lighten symptom, reduce intestinal adhesion, intestinal obstruction. Pay attention to observing patient's blood pressure, the situations of blood glucose and excrement and urine. Because organism resistance drops, should prevent from infecting.

( 4) A large amount of ascites person, can carry on the abdominal cavity and puncture and put the ascites appropriately, it can be to note medicine in the abdominal cavity to check the belly swimming skill quality in time. In order to accelerate the ascites to disappear, lighten the peritoneum adhesion. The nurse should assist the doctor to make the abdominal cavity and puncture and put the liquid treatment. Wear to the patient with more number of times the belly, should do a good job of the belly skin care.

( 5) Surgery treatment: Work as, appear intestinal perforation, intestinal obstruction,etc. at the acute abdomen, should report to a doctor in time, consider the surgery treatment if necessary.
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