Beck sarcoidosis: zizindikiro, kupewa, zimayambitsa ndi zizindikiro za chithandizo

Mndandanda wa matenda amene sangathe kachilombo anthu kapena nyama ndi zomwe pamabuka osati Mukalongosola mpaka mapeto a zifukwa mosalephera ndi matenda Beck. Sarcoidosis - Dzina lake panopa. Iwo amawapeza zambiri, palibe oposa 150 mwa 100 000 anthu, koma zimakhudza anthu pa paliponse, mogwirizana ndi chimene anatumizidwa malamulo lonse mu dongosolo la gulu la ICD-10. Izi ndi kuonetsetsa kuti madokotala m'dziko lililonse kosavuta kuyenda kwa tanthauzo la matenda sioneka, khama olowa kupeza mankhwala atsopano ndi kupeza mwachangu njira yoyenera, pamene wodwalayo akufunikira thandizo.

Sarcoidosis - ndi chiyani ichi?

Beck Sarcoidosis kumachitika pamene ziwalo zosiyanasiyana mwadzidzidzi anayamba kugawa ndi kusintha magulu maselo angathe phagocytosis. The tinatake tozungulira (granulomas) anapanga ndi ndondomeko imeneyi, yomwe mwina kuonekera mwa njira iliyonse kapena chifukwa kuwonongeka kwambiri udindo thanzi. Granulomas angayambe chiwalo chilichonse, kuphatikizapo mtima, maso, impso, chiwindi, koma nthawi zambiri isanafalikire mu mapapo. Kuphetsa ali osowa sarcoidosis ndipo analemba yekha mu odwala wofooka kwambiri ndi chitetezo chokwanira otsika, zimenezi sizinasinthe matendawa. Pafupifupi 10% odwala granulomas kutsimikiza paokha popanda mankhwala. Anthu ambiri akuvutika sarcoidosis zimafunika chithandizo yeniyeni ndi kukaonana ndi pulmonologist, cardiologist, maso, katswiriyu, dermatologist, rheumatologist.

History of anapeza

Sarcoidosis anafotokozedwa koyamba Beck (Böck), British dokotala, dermatologist J. Hutchinson. Mu 1877, iye anati odwala awiri: 53 wazaka mwamuna ndi mkazi 64 wazaka ndi khungu pa mapazi ndi manja anali wofiirira granulomas. Patatha zaka 12, French dokotala Besnier anafotokoza njira ya matenda a wodwalayo amene anali granuloma ofanana mphuno. Komanso wodwala uyu anali ndi grayish buluu kutupa kwa makutu ndi zala. Kaya Besnier, ndi Chinorowe dokotala Kaisara Böck anachita histological Kupenda ngati granulomas ndi adawapasa dzina la "chosaopsa khungu sarcoidosis." Anaonanso kuti tinatake tozungulira wofiirira akhoza kuoneka pa mucous mu mapapo, ndi Swedish dokotala Schaumann anayesa dongosolo deta pa mawonetseredwe osiyanasiyana sarcoidosis. Chifukwa cha matenda otchedwa "matenda Besnier a - Böck -. Schaumann" Mawu amenewa, ndipo tsopano mungapeze zikalata zachipatala.

gulu lonse

The ICD-10 dongosolo sarcoidosis Beck wachinsinsi monga matenda lachitatu kalasi. Izi zikutanthauza kuti mu etiology ake nawo chitetezo chokwanira mkhutu. Bungwe lina Catalog malamulo anatumizidwa ku matendawa D 86. Sarcoidosis granulomas yeniyeni matenda thupi la enumeration zotsatirazi:

• mu mapapo - D86.0;
• mu mwanabele - D86.1;
• onse m'mapapo ndi mwanabele - D86.2;
• khungu - D86.3;
• mosadziwika pathogenesis - D86.9.

Ngati sarcoidosis matenda matenda ena, izi manambala:

• limodzi ndi iridocyclitis kapena zapambuyo uveitis - D86.8 + H22.1 *;
• ziwalo za misempha cranial - D86.8 + G53.2 *;
• pamene arthropathy - D86.8 + M14,8 *;
• myocarditis - D86.8 + I41,8 *;
• mu myositis - D86.8 + M63.3 *.

Gulu la chikhalidwe cha otaya ndi

Sarcoidosis Boeck angayambe m'njira zitatu:

1. Matenda. Odwala wakhala kuwonongeka ambiri thanzi, wopanda nzeru kufooka, kusakhala ndi mumapezera mphamvu.

2. pachimake. fomu iyi amakhala ndi mwadzidzidzi kutentha kudumpha, anaonjezera lymph mfundo, kutupa m'malo olumikizirana mafupa nthambi.

3. Subacute. Pali thupi yoweyula ngati, ambiri mwapang'ono.

Kuonetsetsa komanso kupanga refractory (chithandizo sangakhale).

Gawo ndi kusalekerera

Anafotokoza nthendayo kusiyanitsidwa ndi madigiri atatu a mwamphamvu:

Choyamba. The odwala anawonjezera lymph mfundo chifuwa (bronchopulmonary, tracheobronchial, paratracheal, bifurcation).

Chachiwiri. Sarcoidosis Boeck digiri 2 yodziwika chakuti interstitial foci yotupa zimapezeka mu mapapo.

Chachitatu. Zikuoneka fibrosis (fibrosis) minofu m'mapapo, ndi mfundo intrathoracic si anawonjezera, koma kupangidwa ndiko kumayambitsa. Iwo, pamodzi ndi foci wa fibrosis kupanga conglomerates chachikulu kukhetsa. Odwala amadandaula kuwawa pachifuwa, kusafuna chakudya, kutopa kwambiri, kufooka, youma chifuwa, kufupika kwa mpweya, kupweteka malo.

Pali gulu, amene limatchula magawo asanu a sarcoidosis:

• Zero. Matendawa adayamba, koma chifuwa X-ray limasonyeza kanthu.
• Choyamba. Intrasternal lymph mfundo kuyamba kukula.
• Chachiwiri. Lymph mfundo ndi kukula, mu minofu m'mapapo kuonekere granulomas.
• Chachitatu. Mu m'mapapo kusintha minofu zimachitika.
• Chachinayi. M'mapapo mwanga fibrosis.

etiology

Sarcoidosis Beck ICD 10 younikanso amatanthauza matenda ena okhudzidwa ndi mkhutu chitetezo chokwanira chifukwa cha angapo zofufuza anawulula udindo wa HLA (anthu leukocyte antigens) mu maonekedwe a granulomas. Choncho, loci anapeza kuti adziteteze sarcoidosis kapena M'malo mwake, izo akapsa kuti chifukwa chiwonetsero cha kuwonongeka kwa ubongo, maso ndi ziwalo zina.

Bwino anakhazikitsa kuti sarcoidosis si opatsirana. chakuti matenda izi zimachitika pakati pa achibale, sakulamulira kunja kufala ake cholowa.

Mwina izi ndi zonse zimene ndi loona za etiology matendawa. Yankho okhazikika funso zokhudza chitukuko cha matenda, komabe. Asayansi amati mfundo zoopsa kungakhale:

• matenda kapena mafangasi matenda;
• mungu;
• zoipa mpweya mankhwala ndi nthuzi;
• zakudya m'thupi;
• zoipa zachilengedwe.

EPIDEMIOLOGY

Ngati asanalandire zimayambitsa ndendende okhazikika sarcoidosis Beck, ndi EPIDEMIOLOGY matendawa amadziwika bwino. Kotero, izo imatsimikizirika kuti matenda amakhudza anthu a mibadwo yonse, kuphatikizapo ana aang'ono, koma nthawi zambiri zimawonedwa odwala zaka 20-40, ndi akazi amene amakonda izo. Ndi mpikisano alinso kusiyana. Sarcoidosis anthu kawirikawiri odwala mu Middle East ndi Japan, ndi India ndi matenda mu 150 100 000. Mu kumpoto kwa Ulaya, anthu 40 amadwala 100 000 mu mbali ya kum'mwera ya kanjedza ndi pang'ono apamwamba. Mu Australia matenda Beck amawapeza mu 92 pa 100 000 mu United States pakati African America zili milandu 40-64, ndi anthu mzungu kudwala milandu 10-14 chabe pa 100 000 okhala.

Ndi zosadabwitsa kuti osuta amadwala sarcoidosis kamodzikamodzi kuposa amene alibe khalidwe.

symptomatology

Sarcoidosis mu magawo oyambirira nthawi zambiri alibe zizindikiro. Kawirikawiri anthu n'komwe kuti iwo ndi matenda. Izi bwino kwambiri zizindikiro za matenda omwe anati ngakhale pa madigiri 3, pamene apo pakubwera otchedwa m'mapapo ndi mawonekedwe mediastinal wa sarcoid Boeck a. Pankhaniyi, ambiri odwala zizindikiro pano:

• kusafuna kudya;
• mphwayi, ulesi;
• kutopa (chikondwerero kuchokera pamene kudzutsidwa);
• kutentha;
• ululu minofu;
• imfa ya thupi;
• chifuwa kuti si ankachitira ndi mankhwala antitussive.

madandaulo otere nthawi zambiri poyera matenda a "ozizira" kapena "ARI", koma kupitirira wa sarcoidosis amakhala yaitali motero chifuwa, hemoptysis limapezeka pa khungu kukhala zooneka granulomas. M'tsogolo, palibe mankhwala akhoza kukhala maso akhudzidwa, chiwindi, mtima ndi ziwalo zina. Symptomatology pa chilichonse mawonekedwe ndi zinthu khalidwe. Mwachitsanzo, lembani sarcoidosis D86.8 + H22.1 * masomphenya chatsitsa, zikope chofuna limapezeka maso madzi. Pamene inu kutayipa D86.8 + I41,8 * zizindikiro za matenda a mtima, kufupika kwa mpweya, arrhythmia. Pamene inu kutayipa D86.3 awonekere khungu erythema nodosum. Iwo amakhala ngati totupa. Anakhudzidwa nkhope, mkono wonse wakumanja, shins.

diagnostics

Sarcoidosis Beck ali ndi zizindikiro zofanana ndi zizindikiro za matenda ena. Kuti bwino kusiyanitsa izo, wodwalayo amafuna kuona ndi upo madokotala ambiri yopapatiza mbiri ndi chiwerengero cha mayesero kuti achotse:

• chifuwa chachikulu;
• berylliosis (limapezeka kukhudzana ndi beryllium);
• la misempha;
• lymphoma (zilonda neoplasm wa lymph mfundo);
• thupi lawo siligwirizana ndi chilichonse;
• mafangasi matenda.

Wodwala amachita kuwunika:

• magazi (ndi amuzolengedwa);
• mkodzo (okwana);
• ECG;
• bronchoscopy;
• kuphunzira bronchial kusamba madzi;
• TB chitsanzo;
• X-ray (n'zotheka molumikizana ndi CT jambulani ya kupuma dongosolo), makamaka zabwino zotsatira akamagwira multislice CT, ndi kudziwa granulomatous kusintha mtima mankhwala Kujambula;
• taroskopiya (ntchito Zikavuta).

US sarcoidosis Beck kuchita transesophageal kupereka zotsatira zabwino mosamala mfundo intrathoracic lymph. Pa nthawi yomweyo achite biopsy.

mtundu wina wa kafukufuku - chindodo ndi gallium. zitsulo Izi amakonda kudziunjikira mu malo kutupa. Patapita masiku 2 pambuyo makonzedwe mtsempha wa thunthu la wodwala scanned. The sangathe ndi gallium akhoza kudziunjikira mu foci aliyense yotupa, kaya chifukwa cha sarcoidosis kapena matenda ena.

Chithandizo cha sarcoidosis Beck

Cholinga cha mankhwala kwa matenda ichi ndi kusunga ntchito ziwalo bwanji. Ngati mapapo wodwalayo anali mabala, muchisiye iwo panonso.

Pamene chifukwa cha mayesero onse anatsimikizira matenda a "sarcoidosis", dokotala n'kukulemberani mankhwala. Waukulu mankhwala - "Prednisolone". The njira ya mankhwala yaitali, mpaka miyezi 8. Pankhaniyi, pangakhale mavuto:

• kutupa;
• kunenepa;
• mmimba kupweteka;
• mmene alili;
• oopsa;
• ziphuphu zakumaso.

Ngakhale kutenga mankhwala mwamsanga pali ubwino, koma pambuyo discontinuation zizindikiro za matenda abwerere.

Zovuta Kwalamulidwa "Pentoxifylline", "Methotrexate" "Chloroquine."

Popeza kuti granulomas akhoza kutha paokha, odwala amene ali sarcoidosis sayambitsa kusapeza kapena ululu, musati mankhwala mankhwala, koma ndi okhazikika polojekiti odetsedwa thanzi.

kaonedwe

Ngati matenda a "sarcoidosis Beck" ndi CT jambulani chifuwa X-ray, kusanthula biopsy Zolakwika sangakhale, koma simuyenera mtima. The matenda ndi ufulu chithandizo sizichepetsa muyezo wa chikhalidwe sikumangotikhudza luso ntchito, ndi akazi ndi matenda popanda mavuto kubereka wathanzi ana.

Zovuta uka yekha mu gawo la odwala amene anali ankachitira m'nthawi yake. Iwo akhoza kukhala:

• kupuma insufficiency;
• kwambiri masomphenya kuwonongeka, kuphatikizapo khungu;
• aggravation matenda mkati.

Kupewa sarcoidosis sichinayambe anayamba chifukwa kumachitika etiology ake. Madokotala amavomereza kokha ambiri:

• kusunga mode olondola a tsiku;
• zomveka kudya;
• Kodi moŵa;
• musayandikire mankhwala oopsa, makamaka kukhala osakhalitsa mkulu, komanso mpweya ndi fumbi.