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肺結核(TB)衛教資料

發佈日期:2000-01-01
發佈單位:怡和醫院
最新更新日期:2012-04-18
一、什麼是”肺結核”?
  結核病是結核菌所引起的一種慢性傳染病,其侵犯的部位在肺臟,故稱為”肺結核”及俗稱”肺癆”。
二、肺結核的傳染途徑:
  1.直接接觸傳染:
   如果直接吸入活動性結核病人由呼吸道排出的飛沫(如咳嗽、吐痰、打噴嚏)共用食用器具,親吻等。
  2.間接空氣傳染:
   及間接吸入附有結核菌的塵埃及空氣中有漂浮的結核菌。
三、常見症狀:
  1.全身性:
  (1).發燒:最常見,大多在38℃左右,很少超過40℃,而且多發生於午後。
 (2).體重減輕,食慾不好,比以前更容易疲倦。
  2.肺部症狀:
 (1).咳嗽:以吐黃色痰為主。
 (2).咳血或有血絲的痰:在結核病中常有的。
 (3).胸痛。
 (4).呼吸困難:受結核菌嚴重破壞時會出現此症狀。
四、診斷方法:
  1.X-光:診斷是否有肺結核及是否有擴散。
  2.結核菌素測驗:瞭解人體是否被結核菌侵犯。
  3.痰液檢查:抹片或培養可瞭解是否為陽性反應或瞭解治療後個案是否由陽性轉為陰性。
五、肺結核衛教:
  1.營養:
   肺結核病人可能因疾病及藥物之反應常感食慾不振,因此宜少量多餐及高熱量,加強菜色以提高食慾。
  2.活動:
   盡量減少到公共場所,必要時戴口罩,以免上呼吸道感染。
  3.藥物:
  (1).不可中斷服藥:
   若自行服藥,可能造成以下危險:
   a..抗藥性產生
   b..疾病復發。
   c..增加藥量。
   d..傳染他人。
  (2).依個人病況決定服藥時間6個月~1年。
  (3).服藥後若發現視力改變、聽力受損,請馬上就醫。
  (4).服藥2~4週後即不具傳染。
  4.可能的症狀及併發症:
   午後發燒、咳嗽、咳血、厭食、體重減輕、虛弱、噁心、嘔吐、頭痛、呼吸困難、胸痛、腹痛(較少見),若有大量咳血、呼吸急促、發燒、胸痛立即就醫。
  5. 保護自己及他人:
結核菌是由飛沫傳染,所以會由咳嗽、打噴嚏傳染他人,病人於打噴嚏、咳嗽時,需要掩住口鼻或戴口罩以避免傳染給健康者。
  6. 分泌物處理:
咳嗽時以衛生紙掩住口鼻,丟棄於有蓋垃圾桶(勿囤積太多)後焚燒或立刻丟入抽水馬桶沖水,並立刻洗手。
  7. 教導家屬若有抵抗力較低者、糖尿病患者、幼兒物照顧患者,照顧者若與病人接觸超過三個月者需要到防癆中心追蹤檢查。
  8. 患者之被蓋、床單需每星期於陽光下曬一天。
  9. 居家環境應保持空氣之流通。
  10. 菸酒不宜,以免刺激氣管引發咳嗽。

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