Ua rau, tsos mob, kuaj mob thiab kho hemorrhagic vasculitis hauv menyuam yaus

2024 Tus sau: Priscilla Miln | [email protected]. Kawg hloov kho: 2024-02-18 01:45

Hemorrhagic vasculitis, lossis kab mob Henoch-Schonlein, cuam tshuam nrog kev puas tsuaj rau cov hlab ntsha me - cov hlab ntsha, venules, capillaries - uas nyob hauv daim tawv nqaij, plab hnyuv, pob qij txha, ob lub raum. Tus kab mob no cuam tshuam rau cov menyuam yaus txhua lub hnub nyoog, tab sis raws li kev txheeb cais, feem ntau nws muaj hnub nyoog 4 txog 12 xyoos. Tsis tas li ntawd, nws tau pom tias cov tub hluas yuav luag ob zaug yuav mob li cov ntxhais. Ntxiv rau hauv tsab xov xwm, peb yuav xav txog qhov ua rau nws tshwm sim, cov cim qhia thiab kev kho mob hemorrhagic vasculitis hauv menyuam yaus yog dab tsi.

Kev piav qhia tus kab mob

Y Nyob rau hauv hemorrhagic vasculitis, cov txheej txheem inflammatory ntawm microvessels thiab thrombus tsim tshwm sim nyob rau hauv lawv. Raws li qhov tshwm sim ntawm o ntawm phab ntsa ntawm cov hlab ntsha, lawv ua nkig. Feem ntau muaj kev puas tsuaj rau capillaries ntawm daim tawv nqaij, ob lub raum thiab digestive kabmob. Ntau cov ntshav txhaws tsim nyob rau hauv microvessels, cov ntshav ncig yog cuam tshuam thiab lub cev tsis kam tiv nrog nws cov dej num. Tseem ceeb vascular puas tsuajhemorrhagic syndrome, uas yog manifested los ntawm me me hemorrhages nyob rau hauv cov ntaub so ntswg. Edema thiab mucosal puas tshwm sim nyob rau hauv lub plab hnyuv ib ntsuj av, thiab vascular patency yog impaired nyob rau hauv lub raum. ICD-10 hemorrhagic vasculitis nyob rau hauv cov me nyuam yog code D69.0 thiab muaj cov tsos mob ntawm allergic purpura.

Kev faib tawm ntawm hemorrhagic vasculitis

Raws li chav kho mob, tus kab mob tau muab faib ua cov qib hauv qab no:

• Mild - tus neeg mob muaj qhov txaus siab: daim tawv nqaij ua pob me me thiab mob me me hauv pob qij txha.
• Nruab nrab - muaj pob liab liab nyob rau hauv lub cev, kev hnov mob hauv pob qij txha nce, tsis xis nyob hauv plab, muaj cov ntshav tawm hauv cov zis.
• Mob hnyav - ntau pob pob nrog thaj chaw necrotic ntawm daim tawv nqaij, Quincke's edema yog ua tau, cov protein-lipid metabolism cuam tshuam vim kev puas tsuaj rau lub raum, uas yuav tsis ua haujlwm, ntshav nyob hauv cov zis, los ntshav tau pom. hauv plab hnyuv.

Keeb kwm tus kab mob tshwm sim:

• mob - kav ntev txog ob lub hlis;
• protracted - txog rau lub hlis;
• Ntse-relapsing - kav rau xyoo.

Hemorrhagic vasculitis hauv cov menyuam yaus, cov ntaub ntawv kho mob uas nyob ntawm lub cev cuam tshuam, tuaj yeem yog hom hauv qab no:

• Dermal - tsuas yog daim tawv nqaij cuam tshuam. Tus kab mob no feem ntau tshwm sim. Cov pob khaus tshwm rau ntawm pob tw, plab thiab cov pob qij txha.
• Renal - tus yam ntxwv ntawm lub raum puas: tsis qab los noj mov, tsis muaj zog, xeev siab, muaj protein ntau thiab cov qe ntshav liab hauvtso zis tsom xam. Tsis muaj pob khaus.
• Dermo-articular - muaj o ntawm cov pob qij txha ntawm sab sauv thiab sab qis, ib pob liab tshwm rau ntawm daim tawv nqaij.
• Dermal-abdominal - muaj mob plab hauv plab thiab pob khaus ntawm daim tawv nqaij.

Ua rau kab mob

Qhov tseeb ua rau hemorrhagic vasculitis hauv cov menyuam yaus (cov duab ntawm qhov tshwm sim ntawm tus kab mob tuaj yeem pom ntawm cov chaw tshwj xeeb) tsis tau txheeb xyuas txog niaj hnub no. Nws ntseeg tau tias tus kab mob no tshwm sim los ntawm kev ua haujlwm tsis zoo ntawm lub cev tiv thaiv kab mob, thaum cov tshuaj tiv thaiv pib tsim tawm uas rhuav tshem cov phab ntsa ntawm cov hlab ntsha me. Yog li ntawd, lawv dhau los ua xoob, lawv cov permeability cuam tshuam thiab petechial hemorrhages tshwm. Cov laj thawj uas ua rau muaj qhov tshwm sim ntawm cov txheej txheem autoimmune feem ntau yog:

• kab mob kis yav dhau los;
• ua xua rau zaub mov lossis tshuaj;
• kab mob chronic;
• kev raug mob lossis kev phais;
• tshuaj tiv thaiv;
• kab mob kab mob;
• hypothermia.

Lub luag haujlwm tseem ceeb yog ua los ntawm kev hloov pauv.

Pathogenesis ntawm tus kab mob

Nyob rau hauv pathogenesis ntawm hemorrhagic vasculitis nyob rau hauv cov me nyuam, hyperproduction ntawm kev tiv thaiv complexes, uas ua rau kom cov permeability thiab kev puas tsuaj ntawm vascular endothelium, yog ib qho tseem ceeb tshwj xeeb. Yeej, cov hlab ntsha me tshaj plaws raug puas tsuaj, vim tias cov qauv ntawm cov ntaub so ntswg ntawm phab ntsa cuam tshuam thiab microthrombosis tshwm sim. Cov hlab ntsha ntawm lub dermis puas lawm, thiab hemorrhages ncav cuag lub epidermis. Nrog kev puas tsuaj rau lub plab zom mov, edema thiab submucosalhemorrhages, nrog rau erosions thiab mob ntawm lub mucous daim nyias nyias. Hauv ob lub raum, segmental tsis ua haujlwm ntawm glomeruli tshwm sim. Lub capillaries ua clogged nrog fibrinoid pawg. Yog li ntawd, o tshwm sim nyob rau hauv lub microvessels, cov phab ntsa raug puas, nyob rau hauv kev twb kev txuas nrog no, lawv permeability nce. Cov ntshav coagulation system yog overactive, muaj kev pheej hmoo ntawm cov ntshav txhaws, thiab qhov no yog ib tug txaus ntshai tshwm sim.

Cov tsos mob

Hemorrhagic vasculitis hauv cov menyuam yaus, qhov pib kho mob uas yog nrog los ntawm qhov kub thiab txias, feem ntau tshwm sim los ntawm ARVI. Tom qab ntawd, cov pob liab liab tshwm thiab lwm cov tsos mob tshwm sim, uas nyob ntawm daim ntawv ntawm tus kab mob. Lawv tuaj yeem yog:

• kev tsis txaus siab;
• xeev siab thiab ntuav;
• mob plab;
• pob qij txha;
• reddening ntawm daim tawv nqaij;
• tsis ua haujlwm hauv plab hnyuv - raws plab, tsis qab los;
• fever;
• ntshav tso zis los yog quav.

Nrog hemorrhagic vasculitis nyob rau hauv cov me nyuam, cov tsos mob nyob rau hauv daim ntawv ntawm ib tug yam ntxwv ua pob liab vog tsis tshwm nyob rau hauv tej hom ntawm tus kab mob, uas ua rau kev kuaj mob nyuaj heev. Nyob rau tib lub sijhawm, qee zaum tus kab mob tam sim ntawd ploj mus tom qab 2-3 lub lis piam, thiab tom qab ntawd rov tshwm sim tshiab.

Diagnosis

Txhawm rau kuaj mob, tus kws kho mob tuaj koom mloog cov lus tsis txaus siab, ua qhov kev kuaj pom, kawm txog tus neeg mob keeb kwm kho mob, thiab tom qab ntawd sau cov kev ntsuas hauv qab no:

• kuaj ntshav thiab zis;
• coprogramquav thiab worm qe test;
• ECG;
• Ultrasound ntawm lub raum thiab lub plab;
• radioography;
• ntsuas ntsuas ntsuas lub xeev kev tiv thaiv;
• pab biopsy.

Rau qhov kev kuaj mob ntawm hemorrhagic vasculitis hauv cov menyuam yaus, feem ntau yuav, kev sab laj ntawm cov kws kho mob nqaim thiab, tej zaum, yuav tsum tau kuaj thiab kuaj ntxiv. Tom qab kuaj tau qhov tseeb, tus kws kho mob tau sau cov kev kho mob uas tsim nyog.

Nyob rau me nyuam

Txhua tus menyuam uas muaj vasculitis tau pom zoo noj zaub mov tshwj xeeb, suav nrog 5-6 pluas noj ib hnub. Cov khoom noj uas muaj cov vitamins A, K, C, B xav tau, thiab kev noj ntsev yuav tsum txwv. Txhawm rau them nyiaj rau qhov tsis muaj calcium, nws raug nquahu kom siv cov khoom noj uas muaj roj tsawg. Nyob rau hauv lub raum daim ntawv ntawm tus kab mob, koj yuav tsis noj cov zaub mov uas muaj poov tshuaj. Cov zaub mov dav dav rau hemorrhagic vasculitis hauv cov menyuam yaus suav nrog cov khoom noj hauv qab no:

• Steamed, steamed, boiled or ci zaub thiab nqaij.
• Siv mis nyuj thiab pureed soups.
• Npua-boiled porridge.
• Sweet fruits.
• dej tshiab, rosehip decoctions, ntsuab tshuaj yej.

Tib lub sijhawm, cov khoom noj rog thiab ntsim tsis suav nrog hauv kev noj haus.

Deprecated:

• citrus;
• coffee;
• chocolate;
• cocoa;
• txiv hmab txiv ntoo, berries thiab zaub liab:
• qe qaib.

Tom qab qhov kawg ntawm kev kho mob hemorrhagic vasculitis hauv cov menyuam yaus, nws raug nquahu kom ua raws li cov tshuaj tiv thaiv tsis haum rau kaum ob lub hlis.kev noj zaub mov, maj mam suav nrog cov khoom noj uas txwv tsis pub noj. Thaum lub sijhawm tshem tawm, tus kws kho mob ib leeg rau txhua tus neeg mob xaiv cov khoom tsim nyog thiab kev noj haus, suav nrog cov yam ntxwv ntawm lub cev thiab daim ntawv ntawm tus kab mob.

Sick Mode

Ib tug me nyuam uas muaj hemorrhagic vasculitis yuav tsum tau muab tso rau hauv tsev kho mob, qhov chaw kho mob. Lub txaj so yog qhov yuav tsum tau ua ua ntej rau kev rov zoo. Tsis tas li ntawd, nws yuav tsum tau saib xyuas kom txog thaum daim tawv nqaij ua pob khaus ploj tag, vim tias txhua yam kev ua si lub cev ua rau muaj kev nce hauv purpura. Tsis tas li ntawd, thaum lub sijhawm kho nws yog ib qho tseem ceeb heev uas yuav tsum ua raws li kev noj zaub mov hypoallergenic, kom tsis txhob muaj kev sib cuag nrog cov tshuaj hauv tsev.

txoj kev kho

Lub hauv paus ntawm kev kho mob hemorrhagic vasculitis hauv cov menyuam yaus, raws li cov lus pom zoo hauv chaw kho mob, suav nrog cov haujlwm hauv qab no:

• Nyob so - rau lub sijhawm ntawm daim tawv nqaij ua pob khaus thiab ob lub lis piam tom qab pom cov papule kawg.
• Hypoallergenic noj - tsis suav tag nrho cov khoom noj uas tuaj yeem ua rau muaj kev fab tshuaj.
• Enterosorption - enterosorbents tau muab tshuaj rau ib lub lim tiam, cov tshuaj nquag uas tshem tawm cov metabolites thiab toxins los ntawm lub cev.
• Kev kho tshuaj - ua tiav hauv peb theem.

Cov kab mob zoo ib yam yog kho tau li ntawm ib hlis, thiab undulating, thaum kev tshem tawm raug hloov los ntawm exacerbation, mus txog peb.

YFirst stage drug therapy

Nyob rau hauv kev kho mob hemorrhagic vasculitis hauv cov menyuam yaus, lawv nrhiav kev tshem tawm cov teebmeem ntawm antigens, kub hloov thiab kev ntxhov siab ntawm ob txhais ceg. Rau Kev Kho MobCov tshuaj hauv qab no yog siv:

• Txhim kho cov ntshav microcirculation - pab txhawb kev nthuav dav ntawm cov hlab ntsha thiab ua kom cov ntshav txaus rau hauv nruab nrog cev thiab cov ntaub so ntswg: "Nicotinic acid", "Eufillin", "Dibazol"
• Anti-inflammatory non-steroids - txo qhov mob: Ibuprofen, Voltaren.
• Glucocorticoids - inhibit lub cev tsis muaj zog thiab muaj cov tshuaj tiv thaiv kab mob: "Prednisolone".

Nyob rau hauv rooj plaub ntawm contraindications rau cov tshuaj hormones, tshuaj tiv thaiv kab mob yog siv: Plaquenil, Ortofen.

• Vitamin A thiab E.
• tshuaj tiv thaiv kab mob.

theem ob ntawm kev kho cov menyuam yaus

Nyob rau hauv lub xub ntiag ntawm plab syndrome, cuam tshuam rau kev ua haujlwm ntawm lub raum thiab nquag rov ua dua ntawm daim tawv nqaij ua pob khaus rau kev kho mob hemorrhagic vasculitis hauv cov menyuam yaus, raws li cov lus pom zoo hauv kev kho mob, "Heparin" yog siv los ua kom cov ntshav coagulation. Ua ke nrog Heparin, cov tshuaj antiplatelet raug sau tseg uas tiv thaiv kev tsim cov ntshav txhaws thiab txhim kho nws cov khoom: Curantil, Trental, Ticlopidin.

Thaum mob, siv cov piam thaj-novocaine sib tov. Yog tias qhov kev kho mob tsis zoo, tus me nyuam raug plasmapheresis - ib txoj kev los ntxuav cov ntshav plasma los ntawm cov protein molecules uas muaj cov tshuaj lom.

Third stage of therapy

Thaum tsis muaj txiaj ntsig los ntawm kev kho yav dhau los tau ua nyob rau thawj ob theem ntawm kev kho mob, tus menyuam raug tshuaj cytostatics. Cov nocov tshuaj muaj txiaj ntsig zoo, tab sis muaj ntau yam kev phiv. Yog li ntawd, ua ntej sau ntawv, tus kws kho mob soj ntsuam cov txiaj ntsig thiab kev phom sij ntawm cov tshuaj hauv lub cev thiab tsuas yog tom qab ntawd ua kev kho mob nrog lawv lossis tsis kam. Rau kev kho mob hemorrhagic vasculitis hauv cov menyuam yaus, cytostatics yog siv: Cyclophosphamide thiab Azathioprine.

Cov tshuaj ntau tshaj yog siv txog li ob lub hlis, ces lawv hloov mus rau kev kho mob rau 30 hnub. Kev kho tus kab mob yog ua raws li kev saib xyuas nruj ntawm tus kws kho mob. Cov niam txiv yuav tsum tau saib xyuas kev ua raws li tus cwj pwm thiab kev noj haus ntawm tus menyuam. Feem ntau, qhov kev cia siab ntawm tus kab mob yog qhov zoo. Tom qab muaj mob, cov menyuam raug zam los ntawm kev mus kawm preschool thiab tsev kawm ntawv cov tsev kawm ntawv rau ib xyoos. Tau peb xyoos, lawv raug txiav tawm los ntawm kev txhaj tshuaj tiv thaiv thiab tsis pom zoo kho spa.

Hemorrhagic vasculitis hauv menyuam yaus: qhov tshwm sim thiab teeb meem

Nrog kev kho kom txaus thiab raws sijhawm, tus menyuam rov zoo tag nrho. Qee lub sij hawm rov ua kom rov zoo tuaj yeem ua tau 2-3 lub lis piam tom qab pib ntawm cov txheej txheem pathological. Thaum tsuas yog cov tawv nqaij raug cuam tshuam, tus kab mob kis mus rau hauv daim ntawv tsis mob hnyav thiab cov tshuaj sparing yog siv rau kev kho mob. Yog hais tias lub raum thiab lub plab zom mov raug cuam tshuam, tus neeg mob tus mob yuav hnyav heev: qhov kub thiab txias nce, qhov tsis muaj zog thiab qhov mob raug pom, lub hauv nruab nrab thiab cov kab mob peripheral cuam tshuam. Tab sis qhov txaus ntshai tshaj plaws yog txoj kev loj hlob sai (tshwj xeeb-ceev) ntawm tus kab mob hauv feem ntau ua rauua kom tuag taus. Tam sim no, cov txheej txheem ntawm nws txoj kev kho mob tau tsim, thiab lawv muab cov txiaj ntsig zoo, tab sis muaj teeb meem loj tshwm sim:

• Glomerulonephritis tom qab mob raum tsis ua haujlwm.
• Kev mob plab hnyuv, thaum ib feem ntawm txoj hnyuv nkag mus rau lub lumen ntawm lwm tus, ua rau muaj kev cuam tshuam.
• Kev raug mob rau phab ntsa plab hnyuv thiab nkag mus rau cov ntsiab lus hauv peritoneum.
• Kab ntshav hauv plab zom mov.
• Kev poob qis hauv hemoglobin vim poob ntshav loj.

Cov txiaj ntsig zoo li no kuj tshwm sim nrog tus kab mob ntev lossis ntev. Kev puas tsuaj rau lub raum yog qhov txaus ntshai tshwj xeeb, ua rau cov txheej txheem rov qab tsis tau, thaum lawv tsis kam ua haujlwm thiab qhov no, hemodialysis yog qhov tseem ceeb.

Hemorrhagic vasculitis hauv menyuam yaus: cov lus pom zoo

Tom qab tus me nyuam tawm hauv tsev kho mob, cov niam txiv yuav tsum ua tib zoo saib xyuas nws tus mob. Cov kws kho mob pom zoo:

• Kev soj ntsuam ntawm tus menyuam tsawg kawg tsib xyoos, vim tias lub raum tsis raug puas. Txwv tsis pub, kev tswj tseem nyob rau lub neej.
• Ob zaug ib xyoos mus ntsib kws kho mob, thaum tsis muaj exacerbations.
• Kev kuaj hniav los ntawm kws kho hniav thiab kws kho mob otolaryngologist peb zaug hauv ib xyoos.
• Kev zam ntawm kev kawm lub cev rau ib xyoos, tom qab ntawd hloov mus rau pab pawg npaj.
• Tshem tawm los ntawm kev txhaj tshuaj txhua hnub ob xyoos, tom qab ntawd nrog kev tso cai los ntawm tus kws kho mob uas tuaj koom nrog qhov yuav tsum tau noj tshuaj tiv thaiv kab mob.
• Kev soj ntsuam cov zis thiab cov quav tsis tu ncua.
• Kev ua raws li kev noj zaub mov tsis zoo.

Mus ntsib kws kho mob, cov niam txiv tau txais lus qhia txog kev kho cov kab mob tshwm sim, kev noj haus, kev coj tus menyuam hauv tsev thiab tom tsev kawm ntawv. Nrog nruj ua raws li tag nrho cov lus pom zoo, hemorrhagic vasculitis hauv cov menyuam yaus yeej tsis rov qab los.

Kev tshuaj xyuas txog hemorrhagic vasculitis

Ntau tus niam txiv uas muaj menyuam yaus uas muaj kab mob hemorrhagic vasculitis qhia lawv cov kev paub rau cov neeg tuaj tshiab. Nov yog ob peb yam:

• Cov niam txiv feem ntau xav txog kev noj zaub mov. Piv txwv li, thaum twg cov khoom qab zib yuav tsum tau muab tom qab muaj mob? Nws raug qhia kom ua qhov no maj mam, pib nrog cov khoom qab zib.
• Qee tus neeg txhawj xeeb heev tias tus kab mob rov qab los tas li, txawm tias kev noj zaub mov nruj thiab tsis muaj tshuaj tshiab. Tus kws kho mob yuav teb cov lus nug. Nws qhia kom tsis txhob nrhiav kev pab los ntawm cov neeg uas nws cov menyuam tau mob ib yam kab mob. Txhua tus neeg muaj lub cev sib txawv thiab lawv tus yam ntxwv. Nws tsuas yog tsim nyog los sab laj nrog tus kws kho mob uas kho cov kab mob vasculitis hauv cov menyuam yaus.
• Tshaj xyuas seb puas tuaj yeem xa tus menyuam mus kawm qib kindergarten tom qab muaj mob kuj txawv: qee tus niam txiv hais tias ua tau, tab sis tsuas yog tias nws tsis noj, lwm tus qhia kom tus menyuam nyob hauv tsev. ib xyoos thiab tsuas yog sim coj nws mus rau qib kindergarten. Zoo, lub tswv yim thib peb yog hloov tus menyuam mus kawm ntawv hauv tsev.
• Cov niam uas nws cov menyuam tau mob hemorrhagic vasculitis pom zoo kom tsis txhob poob siab, ua raws li txhua tus kws kho mob cov lus pom zoo: noj zaub mov,ceev faj txog kev noj tshuaj, tsis txhob hloov koj qhov chaw nyob mus tas li, ntxiv dag zog rau koj lub cev tiv thaiv kab mob thiab txhua yam yuav zoo dua nrog lub sijhawm.

Nyob zoo tom qab kev kho mob

Cov menyuam yaus uas muaj cov kab mob hemorrhagic vasculitis xav tau lub sijhawm rov zoo. Cov niam txiv ntawm cov me nyuam yuav tsum tau hloov tag nrho lawv txoj kev ua neej: kev ua txhua hnub, kev noj haus, kev coj cwj pwm thiab kev coj cwj pwm. Nws yog ib qho tseem ceeb heev kom muaj peev xwm tiv thaiv kev loj hlob ntawm cov kab mob sib kis. Thaum kho, tsis suav nrog kev siv tshuaj tua kab mob thiab lwm yam tshuaj uas tuaj yeem ua rau muaj kev fab tshuaj. Txhua hnub koj yuav tsum tau ua haujlwm ntxiv dag zog rau kev tiv thaiv. Txhawm rau ua qhov no, taug kev txhua hnub hauv huab cua ntshiab, noj cov vitamin complexes, siv cov khoom siv tshuaj tiv thaiv kab mob. Tus menyuam yuav tsum raug tiv thaiv los ntawm kev sib cuag nrog cov neeg muaj mob. Nyob rau hauv lub tsev apartment tas li ua ntub tu thiab systematic airing. Tus menyuam yuav tsum paub txog nws tus mob kom coj tus cwj pwm kom raug. Nws yog ib qho tseem ceeb heev kom nrhiav tau ib qho kev ua ub no uas tsim nyog rau nws, uas yuav txwv tsis pub ua haujlwm, tab sis tib lub sij hawm yuav zoo siab thiab nthuav.

Zoo kawg

Hauv kev kho tus kab mob Henoch-Schonlein hauv cov menyuam yaus, nws yog ib qho tseem ceeb heev uas cov niam txiv ua raws li kev noj zaub mov tsis haum thiab kev pw tsaug zog pom zoo los ntawm kws kho mob. Tsis tas li ntawd, koj tsis tuaj yeem siv ntau cov tshuaj uas tuaj yeem ua rau muaj kev tawm tsam tshiab ntawm tus kabmob. Daim ntawv mob me tshaj plaws yog cutaneous hemorrhagic vasculitis hauv cov menyuam yaus, thaum tsuas yog daim tawv nqaij cuam tshuam, thiab lub raum yog ib qho mob hnyav tshaj plaws.daim ntawv. Nrog rau kev kuaj mob raws sij hawm thiab kev kho mob raws sij hawm, kev soj ntsuam ntawm tus kab mob yog qhov zoo. Txawm li cas los xij, txawm tias tom qab kho tiav, nws raug nquahu kom lawv saib xyuas kev nyab xeeb rau lub neej.