The first one is a classmate and colleague of mine, 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 that he had tuberculosis until I asked. He was unfortunately infected by a patient at work. He has been treated since he got sick, and he didn't go to work and didn't tell anyone about it. After his accident, I still wore a mask for a while (but I didn't bring it after the trouble, it was really a big heart)
The other is my michel platini, who suddenly fell ill because of overwork. I went to check up and had 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 been resting at home every day, unable to do hard physical work, and meals are cooked by others. Although tuberculous pleurisy is not contagious, he didn't tell others. 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, and the unit also said to take sick leave, and only a few direct leaders know what the disease is.
In recent years, the incidence of tuberculosis has obviously increased. The news also reported several cases of tuberculosis spread in schools, which should attract everyone's attention.
1. Try not to go to crowded and unventilated places. If you must go, try to wear a mask.
Don't spit everywhere, the main mode of transmission of tuberculosis is respiratory tract.
3. If you have a long-term cough, fever, hemoptysis or emaciation, go to the hospital in time.
As a doctor, especially a respiratory doctor, people get tuberculosis every day around. You have to talk to them. Check them out. Listen to the sound of their lungs. Listen to their suffering from 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 kinds of side effects when drugs are not used. The key is to endure this side effect for at least 6 to 9 months.
They cough, they expectorate, and they even hemoptysis. They are afraid, they are feverish, and they have even been wasting away. No tuberculosis patient can smile like a pneumonia patient through psychological counseling. Even after the cure, there will be many sequelae left on the meeting. This disease needs to be fought for life.
A little more care for them, which everyone can do.
Tuberculosis used to be 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. This disease is not incurable, but can be cured after active treatment. The cure standard is that chest radiograph indicates the formation of calcified foci, 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 people infected with tuberculosis are Mycobacterium tuberculosis (acid-fast bacilli), which is difficult. It can reproduce and multiply within 14~20 hours, survive for months or years in a dry environment, and survive for months in a dark and humid environment, but it can kill Mycobacterium tuberculosis within 7 hours in the sun exposure, which means that this disease is dark, wet or dry 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, then 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 in the afternoon, night sweats, fatigue, burnout, poor appetite and weight loss, respiratory symptoms, such as cough, expectoration, blood in the sputum, and 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 severe hemoptysis lies in blocking the respiratory tract and suffocation.
The treatment is mainly combined with drugs, such as isoniazid, rifampicin, pyrazinamide and ethambutol in the intensive period, for 2 months, and then taking isoniazid and rifampicin for 4 months. This is a plan for the initial treatment of active pulmonary tuberculosis, and the course of disease is short. Because anti-tuberculosis drugs have side effects, it is necessary to go to the hospital regularly for blood tests and liver function tests, and if necessary, to go to a doctor to adjust drugs.
I am a doctor in intensive care medicine, but half of the patients I usually contact are tuberculosis patients.
Are there many tuberculosis patients?
According to the National Health Planning Commission, there were 20 100054 new cases of tuberculosis in China in April/August, and 52 cases died of tuberculosis.
In a month, there are100000 tuberculosis cases newly discovered in China. Don't pretend that there is no 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, generally 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 and warmth, sleep and wake up, pillows and quilts are all sweaty.
3, cough and expectoration, as a respiratory disease, this is the basic attribute, and sometimes there is hemoptysis. Of course, a small number of people are not typical, only occasionally cough, 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, patients with meningitis, may slowly coma.
How to prevent tuberculosis?
Wash your hands frequently, strengthen nutrition, exercise moderately, and open the window frequently for ventilation.
Remember to wear a mask when you go into a 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 about it, let alone be embarrassed about it, because your tuberculosis was passed on to you by others!
As a radiologist, I actually meet patients with tuberculosis every day.
Tuberculosis is a Class B infectious disease under the centralized management of the state. Before you answer, tell a story about tuberculosis.
Xiaowen and his cousin Xiaoqiang are in the same school and are in the same class and dormitory. A new teaching building is being built next to the 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 symptoms such as cough, expectoration, low fever, night sweats, weight loss, etc. 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 propaganda activities in this school. The Xiaowen brothers saw the brochure of our unit and were afraid that their tuberculosis would affect their studies, so they consulted my colleagues. After understanding, my colleagues took Xiaowen brothers back to the hospital for further examination. Our hospital gave Xiaowen brothers chest X-ray examination and sputum examination respectively. Unfortunately, both Xiaowen brothers suffered from tuberculosis.
(Xiaowen's chest X-ray)
(Xiaoqiang's chest X-ray)
What is tuberculosis? Tuberculosis is a chronic infectious disease caused by the invasion of tuberculosis into human body, which can occur in any part of human body, especially in the lungs.
What are the manifestations of tuberculosis?
Cough, expectoration for 2 weeks, hemoptysis or bloody 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 susceptible to tuberculosis?
① People who have close contact with tuberculosis patients who have not been found or are not 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 young children, the elderly, malnourished people, pneumoconiosis, diabetic patients, people who use immunosuppressants for a long time after gastrectomy, etc.
How to diagnose tuberculosis early?
For those with suspicious symptoms of tuberculosis, chest X-ray examination is generally carried out first, and then sputum smear examination is carried out for those with abnormal chest radiographs. The sputum smear examination is convenient and quick, and it is a reliable method for diagnosing tuberculosis at present. A positive examination result means that tuberculosis is found in sputum, which 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 talk loudly in front of others. If necessary, cover their nose and mouth with handkerchiefs, do not spit everywhere, and keep the doors and windows of the room open, so as to keep indoor ventilation and fresh air.
How to prevent tuberculosis?
Tuberculosis is mainly infected by inhaling droplets from patients with infectious tuberculosis when coughing, sneezing or talking loudly. An untreated infectious tuberculosis patient can infect 10 15 healthy people in one year. Therefore, the prevention of tuberculosis should pay attention to the following aspects:
1. Find tuberculosis patients and those with suspicious symptoms in time and treat them as soon as possible; 2. The family members and close contacts of tuberculosis patients should accept 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 have coughed and expectorated 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 through regular treatment. After treatment, the infectivity can be basically eliminated after two weeks. If the treatment stops after the symptoms improve at the initial stage of taking the medicine, it is easy to relapse or develop drug resistance, forming a retreatment or refractory pulmonary tuberculosis patient.
The incidence of tuberculosis is very high, but everyone knows that tuberculosis is an infectious disease, so it is generally not made public 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, and it is also an infectious disease with a bad reputation. Ordinary people have little knowledge, and if they know who is an infectious disease, they will definitely stay away from it.
When I was in the tuberculosis department, people from my hometown and village occasionally came to see me, but they got tuberculosis, and of course they were all cured later. Later, when I went back 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 the villagers. In fact, they are afraid that they will be untenable in the village after others know.
Later, I chatted with my family, who said that they didn't know who had tuberculosis at all. -they are hidden deep. Doctors will tell pulmonary tuberculosis patients to pay attention to isolation before completing treatment, so as to avoid infecting 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 so.
Unless you are a relative, you won't know even if there are tuberculosis patients around you. As many as 550 million people in China have been infected with tuberculosis. The prevalence rates of active tuberculosis and infectious tuberculosis in China are 367/100000 and122/100000, respectively. There are more than 4.5 million active tuberculosis patients, including about1500000. You must have tuberculosis patients around you, but you just don't know it.
Pulmonary tuberculosis patients who excrete bacteria are important sources of infection. When the patient speaks loudly, coughs and sneezes, the sputum containing tuberculosis bacteria is sprayed into the air in the form of droplets, each droplet can contain 1- 10 tuberculosis bacteria, and the 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 TB invades the human body or not depends on the pathogenicity of TB, the immune response of the body, and the contrast between immune response and allergic reaction.
The chance of tuberculosis in one's life after being infected by mycobacterium tuberculosis 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. In addition to genetic factors, the factors that affect the body's natural resistance to Mycobacterium tuberculosis also include social factors such as poverty, crowded living and malnutrition. Infants' immune system is not perfect, and the elderly, HIV-infected people, immunosuppressant users, patients with chronic diseases and other immunocompromised people 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 be in contact with tuberculosis patients every day. Of course, people around you also have examples of tuberculosis infection. The causes of tuberculosis generally include the following:
3. Secondary type: refers to the re-ignition of potential lesions left in the lung during the primary infection or re-infection of mycobacterium tuberculosis.
Although tuberculosis sounds terrible, everyone talks about tuberculosis, but I don't know that tuberculosis patients who excrete bacteria are important sources of infection. When the patient speaks loudly, coughs and sneezes, the sputum containing tuberculosis bacteria is sprayed into the air in the form of droplets, each droplet can contain 1- 10 tuberculosis bacteria, and the 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 combined, and the side effects of 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 began to cough, hemoptysis, chest pain and fever in the afternoon. Because I was always around him, I didn't feel scared. I was still healthy with him a few years ago, and we often contacted him.
No.20 17 10/7, pulmonary tuberculosis was diagnosed, male 19 years old.
It's okay, it's not a big problem. It's just taking medicine for a year and a half, and it costs more than 300 yuan a month. Because in other places, free medicine has to be collected at the local CDC. I was too troublesome, so I bought it at the hospital. The doctor asked to be hospitalized, but I didn't want to spend money, so I didn't stay. I heard from others that it was not serious, so I just took medicine and didn't need to be hospitalized.
Tuberculosis drugs 150 or so, liver protection drugs are better, water flies, 170 or so, and the cost will not exceed 800 per month.
After one year, the condition is stable, and the maximum cost is 20,000 yuan. The intensive hospitalization period should be within 10,000 yuan in two months, and then the discharge is to take medicine for eight months, some for one year or even two years.
First treatment, stable condition, staying in the hospital in February, taking medicine for one year, except eating, drinking and wearing, the cost will not exceed 20 thousand.
Not being hospitalized, except food, clothing and clothing, costs about 10 thousand a year.
General family conditions can be seen.
I am 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 be under great pressure. If the liver has been seriously damaged, you can't take tuberculosis drugs, and you must recover your liver function. However, during this period, if you take medicine again, you will be resistant, and it will be very troublesome to kill tuberculosis bacteria and then damage the liver. This is instability, and it will cost a lot of money.
It is coming to the annual college entrance examination season. At this time of the year, many senior three students will come to do the college entrance examination, and chest X-rays must be done. I am a radiologist, and I issue image reports. Tuberculosis is largely diagnosed by chest X-ray or CT. Every year, several students in the college entrance examination have found tuberculosis because of chest X-rays. Unfortunately, once diagnosed with infiltrative tuberculosis, you need to drop out of school and take medicine for half a year before you can continue to go to school, and the college entrance examination can only be postponed. At present, tuberculosis is still very common.
Why is the management of tuberculosis so strict? Because it's contagious
Because tuberculosis is an infectious disease, it is mainly transmitted through respiratory tract. When a person with tuberculosis in his lungs coughs, the tuberculosis enters the air and is sucked in. 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, it is easy to get infected. The consequences of spreading the word from mouth to mouth are very serious. Therefore, once infectious tuberculosis is found, it should be treated in isolation.
Tuberculosis can be cured.
Don't worry too much if you get tuberculosis. You can be cured after formal treatment, and the course of treatment is generally 6-9 months. And the state's treatment drugs for tuberculosis are free, but not all of them are free. Here, we must emphasize the regular and adequate course of treatment, and we must insist on taking medicine, and don't stop after taking it for a while. Because this will lead to drug resistance of mycobacterium tuberculosis, drug withdrawal will be repeated, and it will be ineffective to use these drugs in the future, and it will be difficult to cure them later.
When I was an intern 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 became resistant. The usual medicine was of no use to him. Once he was ready to leave the hospital, he had a fever the day before. 23-year-old, very painful.
Tuberculosis is still very common.
Although tuberculosis has decreased compared with before, as a radiologist, it is the first level to diagnose suspected tuberculosis, and tuberculosis cases can be encountered every day. Generally, young people cough and expectoration for more than a month, but they don't get better. They think it's a common cold. The doctor will ask for a chest X-ray, and a typical chest X-ray of tuberculosis can confirm the diagnosis. Therefore, as soon as we radiologists see the typical chest film, we can directly diagnose tuberculosis. Just said that our country has strict management on tuberculosis. As a radiologist, once diagnosed with tuberculosis, we still need 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 get early treatment, recover as soon as possible and reduce the spread of society.
What symptoms should we be alert to tuberculosis?
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, severe hemoptysis, coughing up blood, so it is necessary to take a chest X-ray to rule out tuberculosis and lung infection.