1.什麼是結核病?
結核病是由於感染結核菌所引起的一種傳染病,結核菌侵入人體後,可以在任何器官引起病變,如肺、腦膜、淋巴腺、骨骼、腸、泌尿及生殖器官等。因結核菌(嗜氧)的繁殖需要氧氣,因此90%會發生在肺葉的上半部,即為肺結核(俗稱肺癆)。
2.哪些人是肺結核的高危險群?
受到結核菌感染後並不是每一個人都會發病,在身體抵抗力較差的時候,就比較容易發病。因此開放性肺結核病人的家屬、年紀大的人、患有糖尿病或塵肺病的人、長期服用類固醇藥物的人、酗酒的人、以及免疫機能不全的人都是比較可能得到肺結核病。建議這些人每年定期做胸部X光檢查,期能早日發現,早日治療。
3.肺結核的病因與傳染途徑?
肺結核的病原體是結核菌,主要經由飛沫來傳染。當開放性肺結核病人咳嗽或打噴嚏時,會排出含有結核菌的細小飛沫到空氣中,別人吸入含菌的飛沫後,細菌便在肺的深部繁殖,使肺部受到結核感染。因此常和開放性肺結核病人密切地接觸的人,最容易受到感染。
4.肺結核的症狀及檢查
早期肺結核的病人可能不會有什麼不舒服的症狀出現,所以很容易忽略而延誤病情。到了後期可能會有食慾不振、體重減輕、夜間盜汗、咳血等反應。故定期的檢查非常重要,可以在沒有症狀之前早期發現早期治療。肺結核檢查主要有三種:
◆胸部X光檢查(成人應該每年至少做一次胸部X光檢查)
X光為最直接且快速協助醫師診斷是否疑似肺結核的方法。故開放性肺結核病患的同住一起的親友,建議於病患發現疾病後至門診定期追蹤X光有無變化。
◆驗痰分為三種檢驗方式:
◆TB-PCR(聚合脢鍊反應):可檢驗痰液中是否帶有結核分枝桿菌的基因,但是結果無法直接判定是否具有傳染性。
◆TB/AFB(分枝桿菌耐酸性染色檢驗):如呈陽性,而又由TB-PCR確定為結核分枝桿菌,表示是具有傳染性的開放性肺結核。
◆TB culture(結核菌培養):是確定肺結核以及是否有抗藥性結核菌的方法,但耗日費時需要6-8週。
5.肺結核的治療
目前肺結核治療主要是以結核藥物來治療,治療期間至少需要六個月。只要診斷正確,在治療中與醫護人員合作,按照規定服藥,定期複查,肺結核是可以完全治癒的。初期具有開放性時,醫師會建議在負壓環境裡隔離,確定沒有傳染性之後就可以回家,只要按規定服藥,均衡飲食,不過度勞累使身體抵抗力降低就可以了。
健康小叮嚀:
住院隔離期間,醫師會依病情每週或每二週做一次痰液檢驗,若已為非開放性肺結核,即可出院回家休養,或是轉至一般病房繼續治療。住院期間因與外界隔離,極需要家人親友的支持與鼓勵,可以多利用電話及會客時間探視機會聯繫感情,降低因入住負壓病房所產生的隔離壓力。how to cheat
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