La misempha mwana: zizindikiro, chithandizo, kupewa

M'nkhani ino tikambirana mwatsatanetsatane mmene mwanayo akuwonetseredwa la misempha. Zizindikiro mitundu, makamaka mankhwala, matenda ndi kapewedwe - ndi mfundo zikuluzikulu zimene tidzakambirane.

Pomwepo kuweruza chakuti la misempha angathe pa m'badwo uliwonse kwathunthu. Matendawa ndi matenda ndi matupi awo sagwirizana chikhalidwe. A zosiyanasiyana mawonetseredwe matenda chifukwa chakuti la misempha zimakhudza thupi iliyonse, ndi minofu connective kuti alipo mu matupi onse. Taganizirani zizindikiro za matenda enaake ophwanya m'thupi ana.

Ndi chiyani icho?

Timayamba nkhani yathu ndi maganizo "la misempha". Kodi matenda? Chotero anaitana yotupa matenda amene amakhudza thupi lonse pa nthawi imodzi yomweyo (i.e., ndi dongosolo). Chiyambi cha matenda enaake ophwanya m'thupi - ndi matenda-matupi awo sagwirizana. Iye ali dzina lina: Sokolowski matenda Buyo.

Iwo amakhala ndi zotupa za matenda connective minofu. Makamaka bwanji zimakhala connective a dongosolo mtima ndi chapakati mantha. Pali zambiri zowerengera, zimene zikusonyeza kuti nthawi zambiri akazi ambiri amadwala matenda - katatu kuposa amuna. Komabe, kusiyana kumeneku Mwamsanga mu mukadzakula.

ndi mbali ya matenda enaake ophwanya m'thupi ana chiyani? Zizindikiro ndi mankhwala a matenda ana osiyana pang'ono. Ichi ndi chifukwa chakuti ana la misempha ali peculiarities, monga:

• kukuonekera kwambiri kukula kwa dongosolo mtima;
• kusintha machitidwe ena ndi ziwalo;
• n'zotheka kusintha mu mawonekedwe aakulu a matenda (kuchuluka Mwina ubwana ndi mkulu);
• pakutchulidwa wa musabise.

Mawonekedwe aakulu akuonetsedwa ngati motere: mankhwala alipo nthawi matalala, koma patapita kanthawi vuto akubwereranso. N'zochititsa chidwi kuti zisadzachitikenso malungo enaake ophwanya ali anaona ana sizachilendo.

Zizindikiro za matenda enaake ophwanya m'thupi mwa ana a zaka 2 kapena 10 musati amasiyana Chrixitu. Chonde dziwani kuti ana makamaka atengeke matenda kwa zaka zisanu ndi ziwiri kwa khumi. Ana la misempha loyang'anizana angapo mavuto, kuphatikizapo matenda a mtima ndi. La misempha amakonda kuyamba kukhala pambuyo matenda. Zikuphatikizapo fever, zilonda zapakhosi ndi zina zotero.

Nthawi zambiri kuganizira wapezeka mu dongosolo mtima. enaake ophwanya m'thupi ndi wamba lonse, makamaka m'mayiko osauka, kumene mitengo ya matenda ali kwambiri.

Timatenga tione zizindikiro ndi matenda a matenda a mwana, koma tsopano ine ndikufuna kuti Atchule akugwirizana ndi Jones. Nkofunika kudziwa kuti akusiyanitsa i yaikuluikulu. Ngati pali mbali imodzi ya gulu loyamba, ndi okwanira matenda a.

i More	i zazing'ono
Carditis (anamuona pa 70% milandu), polyarthritis (75%), erythema (10%), chorea (10%), mapangidwe tinatake tozungulira subcutaneous (20%).	Malungo, arthralgia, la misempha anemneze, kuchuluka ESR kapena CRP.

zizindikiro

Tikambirana mwatsatanetsatane zizindikiro za matenda enaake ophwanya m'thupi ana. Monga tanena kale, vuto la misempha zingawononge connective minofu ziwalo angapo. Izi akhoza kufotokoza zambiri za mawonekedwe osiyana a matenda. Izi zidalira pa mawonekedwe ndi kukula kwa ndondomekoyi.

Tizilomboto la misempha kumapangitsa kupanga mankhwala otchedwa C-zotakasika mapuloteni. Ndi iye amene amachititsa kutupa ndi kuwonongedwa kwa minofu connective. Kachiwiri, chonde onani kuti matenda enaake ophwanya m'thupi sizimawoneka balamanthu. Njira ya chitukuko akuyamba pambuyo matenda. Total allocated mitundu itatu ya matenda, tikambirana ina. Mbali yaikulu ya malungo enaake ophwanya - ndi pachimake isanayambike. Zizindikiro monga:

• kuwonjezereka lakuthwa kutentha thupi;
• aakulu kufooka;
• kuwonongeka wa thanzi.

Tsopano zizindikiro zosonyeza koyamba anazilemba. Ana (zaka 2) zizindikiro za matenda enaake ophwanya m'thupi akhoza kukhala:

• irritability;
• tearfulness;
• kugona matenda, ndi zina zotero.

Kenako adzakhala pang'onopang'ono limodzi ndi zizindikiro zina zomwe mawonekedwe la misempha. Enaake ophwanya malungo ana, zizindikiro ndi chithandizo chimene ife m'nkhani, angasonyeze m'njira zosiyanasiyana, koma pafupifupi 85% ya milandu, matenda agonjetsa mavuto mtima.

Gawo

Okwana pali mitundu itatu ya matenda:

• articular;
• mtima;
• mantha.

Ife kufotokoza mwatsatanetsatane za iwo mtsogolo pang'ono.

Dziwani kuti zizindikiro za malungo streptococcal enaake ophwanya ana amaona. Matendawa nthawi zonse zotsatira mu mawonekedwe a mavuto kapena la misempha amakhala aakulu.

Zizindikiro za matenda enaake ophwanya m'thupi ana zaka 10 ndipo wamng'ono ali osiyana kotheratu. An akatswiri odziwa mosavuta matenda pa siteji iliyonse.

enaake ophwanya m'thupi ali magawo awiri:

• yogwira;
• anafooka.

ndi muyezo wa ntchito matenda chiyani? Njirazi ndi monga:

• popereka mawonetseredwe;
• kusintha mu zolembera zasayansi.

Kuchokera pa ichi, pali kusiyana atatu la misempha. Iwo anapereka tebulo pansipa.

digiri yoyamba	Ntchito osachepera	Pa nthawi imeneyi, ofatsa matenda ndi zasayansi zizindikiro.
digiri yachiwiri	zinthu zolimbitsa	digiri yachiwiri streptococcal enaake ophwanya malungo ana, zizindikiro za amene kale bwino umaonetseredwa, kuti mosavuta matenda. Ichi ndi chifukwa chakuti matenda, radiological ndi zina zizindikiro ndi kale kuonekera.
digiri lachitatu	Zolemba ntchito	mbali khalidwe ndi: malungo, enaake ophwanya zizindikiro matenda a mtima, matenda articular, kusintha mwadzidzidzi magawo zasayansi ndi zina zotero.

mawonekedwe articular

Tsopano yang'anani zizindikiro za la misempha mu mwana mawonekedwe olowa. Tiyeni tiyambe ndi mutu wa pang'ono zambiri zowerengera. Ana kawirikawiri mumaganiza izi. Pafupifupi 20% a nyamakazi limapezeka zaka zapakati pa wina kwa zaka zisanu; ndipo pafupifupi 80% - kuchokera zaka khumi ndi khumi ndi asanu.

Zizindikiro zimfundo enaake ophwanya ana kungaonekere motere:

• malungo;
• kufooka;
• mutu;
• olowa ululu;
• redness ndi kutupa kwa mfundo ndi zina zotero.

Ngakhale kuti milandu achuluka, tizilomboto akadali sanalemberetu. Mosakayikira, la misempha ndi matenda m'chilengedwe. matenda amakhudza kwambiri mfundo za lymph ili mu nasopharynx lapansi. Matenda kugwirizana ndi mbiri yakale angina, mano, kutupa.

Dziwani kuti pali maganizo ambiri a matenda. Articular la misempha ana, zizindikiro ndi chithandizo chimene ife m'nkhani ino ndi maganizo a anthu ambiri, ndi matenda-matupi awo sagwirizana khalidwe. Ichi ndi chiphunzitso ambiri. Ngati inu kutsatira maganizo, ndi la misempha - zotsatira za thupi lawo siligwirizana anthu. Chifukwa kulowa malonda selo kagayidwe kachakudya mabakiteriya mu nthawi makulitsidwe amapezeka reconfiguration chamoyo. Streptococci Pankhaniyi angachititse tangotchulawo zizindikiro za la misempha.

Tanena kale kuti chifukwa cha vuto la misempha kawirikawiri anasamutsa pamaso matenda alionse opatsirana (monga fever). Komabe, zitsanzo zina angaperekedwe:

• hypothermia;
• mopambanitsa.

Ambiri mwa zizindikiro amasonyeza kuti mbali ya CNS (chapakati mantha dongosolo) mu ndondomeko. Zizindikiro zimenezi zikuphatikiza:

• chorea;
• msokonezo galimoto;
• matenda a misala;
• matenda mitsempha, ndi zina zotero.

Nkofunika kudziwa kuti onse a matenda amenewa nthawi zambiri limodzi ndi vuto la misempha. Kafukufuku akusonyeza kuti reactivity wa kotekisi oziziritsa ali kwambiri yafupika. Iwo akhoza kudziwa mmisiri waluso mosavuta. Zachitikiranji zimenezi? Nthawi zambiri kugwirizana ndi excitability kuchuluka kwa malo subcortical, kumene kumakhudza thupi lonse.

mawonekedwe mtima

Tsopano timapereka kwambiri pang'ono kulankhula za mtundu mtima la misempha mwana, zizindikiro za matenda. Pomwepo kuweruza chakuti mavuto mtima angayambe imodzi ndi articular mawonekedwe misempha, komanso kuonekera pang'onopang'ono. mawonekedwe choopsa cha vuto la misempha amakhala ndi chakuti matenda mtima zizindikiro ndi wochedwa, ndiko kuti, matenda akufotokozera padera.

Poyamba paja ananena kuti chizindikiro cha vuto la misempha - mwadzidzidzi komanso wachiwawa kuukira. Pali ululu kwambiri, ndi zina zotero. Komabe, ana ena angadandaule ululu pang'ono zimfundo, kutopa. Ngakhale mu nkhani iyi, angathe matenda mtima. Kupewa mavuto aakulu mwamsanga anayamba mankhwala, kupita upo ndi katswiri, ngakhale madandaulo amenewa.

Enaake ophwanya matenda a mtima ana, zizindikiro ndi mankhwala omwe tikambirana pompano, wotchedwa enaake ophwanya matenda a mtima. Siteji koyamba pafupifupi alibe kuonekera. Zizindikiro ingakhale monga iyi:

• kutopa;
• kukana masewera;
• kusafuna kuthamanga;
• kufupika kwa mpweya;
• palpitations mtima;
• wotumbululuka khungu.

mawonekedwe aakulu limodzi ndi kutentha okwera, zambiri palibe madigiri zoposa makumi asanu ndi atatu. The chikhalidwe wamkulu wa mwana pa nthawi yomweyo worsens tsiku.

Mtima mawonekedwe la misempha kungachititse kuti ena kusokoneza mtima, naperekanso tebulo pansipa.

endocarditis	kuphwanya akalowa mkati mwa mtima
myocarditis	yachiwiri
pericarditis	lakunja
endopericarditis	onse atatu

Zonsezi kumabweretsa chitukuko cha matenda a mtima, ndiye ndondomeko yotupa mapanganowo kuti kuli nthambi ya. Nkofunika kudziwa kuti kulandira chithandizo mwamsanga ndi kugwilizana ndi chakudya zotchulidwa - ndicho chinsinsi ndi tsogolo labwino. ana ambiri amene amadwala zopindika mtima, munthu wabwinobwino (kusukulu, chongocheza ndi anzake, kuyendera ndodo, ndi zina zotero). Ngati choncho ndi anapezerapo, matenda zimatengera mtundu waukulu, ndipo izi zimakhudza umoyo motere:

• pamaso pa matenda magazi;
• Ziwalo kutupa;
• aakulu kupuma movutikira;
• chiwindi kukulitsa.

Chinthu china chapadera ndi mawonekedwe choopsa cha matenda - wozungulira woboola pakati totupa pakhungu. Pamene zizindikiro woyamba chidwi mwamsanga kuchipatala! Panthawi yake mwambo wa mankhwala - mwayi kwa munthu wabwinobwino mwana, omwe sayenera anaphonya.

mawonekedwe mantha

M'chigawo chino wa nkhani ife adzamvetsera mawonekedwe mantha ya la misempha ana. Zizindikiro ndi mankhwala a matenda - izi ndi mfundo zikuluzikulu kuti ife kuphimba m'nkhani ino.

Chinthu chapadera cha mawonekedwe mantha malungo enaake ophwanya ana - chorea, imfa ya m'madera ena ubongo. Chorea akufotokozera pang'onopang'ono, zizindikiro ingakhale monga iyi:

• kusintha maganizo;
• irritability;
• tearfulness;
• kukokana kwa minofu (onani kuti chizindikiro ichi amatha patsogolo ndi makolo ena amaganiza kuti mwana akupanga nkhope ndi wosamvera, ngakhale popanda kudziwa zililidi);
• kupanda khalidwe;
• chosasamala;
• kusintha cholembedwa;
• maonekedwe slurred kulankhula;
• flail gait.

Koma kupanda khalidwe ndipo chosasamala, muyenera kuyesetsa ena zofotokoza. Ndipotu mwana si mlandu. Kwenikweni sangakhoze molondola zingwe mmwamba nsapato nthawi zambiri akutsikira mafoloko, spoons, zolembera ndi zinthu zina. Samalani zizindikiro zimenezi. Ambiri amasokoneza ndi kutopa kapena kusasamala. Ndipotu, mwanayo amafunikira thandizo lanu. Zizindikiro zimenezi adzaoneka miyezi itatu. Samalani kwambiri kuti khalidwe ndi chikhalidwe cha mwana, kotero kuti muphonye nthawi yoyenera ndi kuyamba chithandizo nthawi.

Uthenga wabwino matenda: kulephera mtima ndi vuto la misempha mawonekedwe mantha ali osowa kwambiri. Ngati tapatsidwa matenda kapena vuto la kachitidwe mtima, matenda kumachitika mosavuta. Ngati inu munazindikira osachepera kusintha khalidwe la mwanayo - kudziwitsa dokotala anu.

Tsopano tiyeni kulipira ena hyperkinesia tcheru. Ndi chikhalidwe chimene chimabwera kutalika kwa matendawa. Nthawi imeneyi, munthu nthawi zonse zoyenda (sakhoza kukhala, kuima kapena pogona). Pali musanaganizire minofu contractions kuti Vuto ndi mwanayo kugwiritsa ntchito chakudya (kuchepetsa minofu ya lilime, milomo ndi zina zotero). Akugwiranso ntchito kwa magulu ena a minofu, zizindikiro izi zingachitike:

• okhazikika kung'anima;
• lilime yotundumukira kunja kwa mpanda;
• grimacing.

Chonde dziwani kuti akagona zizindikiro zonse hyperkinetic kutha. Koposa zonse zizindikiro pamwamba angapezeke mu kafukufukuyu utachepa minofu kamvekedwe. No mayeso wapadera zifunika m'njira kwambiri, monga Tingaone ndi apoyera. Mwana ndi mawonekedwe choopsa cha matenda sichingakhoze kugwira mutu wake kapena kukhala. Kawirikawiri, zizindikiro otsiriza milungu itatu mpaka miyezi itatu. Kenako pang'onopang'ono kuchepa. Onetsetsani kukumbukira kuti musabise ndi zofala (chitukuko nthawi - pafupifupi chaka nkhani latha, nthawi zina kale kwambiri).

Chorea mwina pang'ono kuonjezera thupi kutentha (37.5 madigiri). Zingaoneke kutupa ndi ululu malo.

zifukwa

M'chigawo chino wa nkhani tidzayesetsa yosanthula mwatsatanetsatane funso zimayambitsa matenda enaake ophwanya m'thupi ana. Monga tanena kale, ngakhale mankhwala amakono sangathe kupereka yankho lenileni la funso limeneli. Pali maganizo ambiri, ndi kumanga iwo, tinganene kuti chikuchititsa akhoza kukhala zifukwa zambiri.

chinthu	powunikira
Posachedwapa, matenda opatsirana	Zikuphatikizapo matenda pachimake kupuma, zilonda zapakhosi, fever, zilonda zapakhosi ndi zina zotero. Nkofunika kuzindikira kuti iwo amayamba ndi streptococcus gulu A. M'pofunika kufotokozera kuti palibe kuipitsidwa matenda ndi chikhalidwe chachikulu chitukuko cha matenda enaake ophwanya m'thupi. Izi zimafunika wonongeka kwa chitetezo cha m'thupi. Only mu nkhani iyi iwo amayamba kuukira maselo wathanzi. Izi zimaonekera pa nthawi imene chithandizo anayamba mochedwa (mochedwa) kapena ndi chabe zolakwika.
Chinthu chachiwiri - ndi cholowa	chiwerengero cha maphunziro ndi kafukufuku, chinapezeka kuti chinthu cholowa nalonso ntchito pa chitukuko cha matenda enaake ophwanya m'thupi. Inafotokoza kuti matenda nthawi zambiri amapezeka mu mabanja.
onyamula yaitali matenda streptococcal	Childs, nthawi streptococcus angakhale mu nasopharynx ndi, umene ndi chitetezo cha m'thupi glitches. Zotsatira - chitukuko cha matenda enaake ophwanya m'thupi.
chinthu yachiwiri	Zachilendo mmene zingamvekere, koma pali ena (sekondale) Zinthu zimene zingachititse chitukuko cha matenda enaake ophwanya m'thupi mwa mwana. Zikuphatikizapo: hypothermia, kutopa, zakudya m'thupi. Kodi zimenezi zimakhudza bwanji chitukuko cha matenda? Ndithu chabe, mfundozi zimakhudzanso likuwonongekera chitetezo cha m'thupi la mwana. Chifukwa, kangapo kumachititsa kukhala ndi vuto la misempha.

diagnostics

Kodi enaake ophwanya malungo ana (zizindikiro chithunzi, zifukwa anapatsidwa m'nkhani), ndipo tsopano, ife tikuyembekeza, kumene. Ife titembenukira kwa matenda a matenda. Choyamba ayenera kuti anaganiza pamaso pa matenda mwana mungathe mwamtheradi aliyense, kuyambira makolo ndi aphunzitsi, kutsiriza ndi dokotala kapena rheumatologist.

Clinic ya la misempha ana (matenda zizindikiro) zosiyanasiyana. Nkofunika kudziwa mfundo zikuluzikulu:

• carditis (aliyense wa mawonekedwe ake);
• chorea (matenda, ife analipira kwambiri chidwi kale);
• pamaso pa tinatake tozungulira pansi pa khungu la mwanayo;
• erythema;
• polyarthritis;
• posachedwapa streptococcal matenda;
• cholowa china.

Ngati mwana wanu ali mmodzi wa zizindikiro zimenezi, muyenera kufunsa dokotala nthawi yomweyo. Kuwonjezera akwaniritsa zimenezi, pali ena:

• arthralgia;
• malungo;
• adasandulika magawo magazi.

Kwa matenda a anayendera ang'ono ndi kafukufuku wa wodwalayo. Pakuti matenda molondola n'kofunika kuchita angapo mayesero choyezera, monga chifuwa X-ray, ECG, echocardiography.

X-ray thandizo kudziwa kasinthidwe wa mtima, ECG adzakusonyezani kusokonezeka kwa mtima (ngati), echocardiography detects kukhalapo kwa matenda a mtima.

chithandizo

Takambirana matenda ndi zizindikiro za matenda enaake ophwanya m'thupi ana. Chithandizo cha matenda - ili ndi funso lotsatira. Pankhani pano amafuna munthu njira Integrated. la misempha chithandizo umalimbana:

• mpumulo zizindikiro;
• mphamvu pa zomera streptococcal.

enaake ophwanya m'thupi mwa ana (zizindikiro, chithandizo, ndi zithunzi kuti tione) mankhwala kuchipatala. Chonde dziwani kuti chithandizocho ikuchitika ngakhale pamene matenda ndi achifwamba.

Mwana amafunikira:

• bedi zina , ndi kuwonjezeka pang'onopang'ono ntchito yogwira;
• kudya zakudya zopatsa nthanzi, zakudya lili yambiri potaziyamu;
• bungwe moyenera zosangalatsa.

mankhwala zachokera:

• Kukonzekera antibacterial;
• m'thupi;
• odana ndi yotupa;
• vitamini maofesi;
• Kukonzekera potaziyamu;
• immunostimulant.

Zonse mankhwala kuthandiza kumenya microflora tizilombo. Chifukwa, izo relieves kutupa ndipo kwambiri kumachepetsa zizindikiro za matendawo. Nkofunika kukumbukira kuti mankhwala zingakhudze mmene ena mbali:

• chitukuko cha zilonda;
• muzituluka magazi;
• disruptions kuti zopangitsa za endocrine.

kupewa

gawo ili laperekedwa kwa kupewa matenda enaake ophwanya m'thupi ana. Kutalikirana pulayimale ndi sekondale kupewa. Mbali yoyamba, chidwi linaperekedwa kwa popanga wa mwana:

• oipa;
• kudya zakudya zopatsa nthanzi;
• masewera;
• amenyane matenda ndi streptococcus gulu A.

zolinga Secondary kupewa muyambirenso:

• "Bitsilin 5" - oposa 1.5 miliyoni mayunitsi pa masabata anayi asukulu;
• "Bitsilin 5" mlingo miliyoni 0,75 mayunitsi iwiri iliyonse sanayambebe kupita kusukulu.

Chonde dziwani kuti tikulimbikitsidwa kuchita kukonza njira ya exacerbations chaka chonse, mwezi uliwonse. nthawi tikulimbikitsidwa - zaka zisanu.

kaonedwe

Amayi ambiri anali wokhoza kuthana ndi matenda, nthawi kupita kuchipatala thandizo kuchipatala. Ngati inu mukutsatira kupewa matenda enaake ophwanya m'thupi, ndiye kusuta sadzakhala moyo pachiswe. Ife zofunikila funso la misempha ana, zizindikiro za ndemanga. ndi odziŵa za chiyani?

Onani kuti matenda enaake ophwanya mtima ndi pafupifupi 25 peresenti ya nthawi limodzi ndi njira ya chitukuko cha matenda a mtima. Re-akuti masamba zosatheka kupewa kuphwanya kuli nthambi ya. Chifukwa, muyenera opaleshoni ya mtima. Imfa ndi matenda a mtima ndi pafupifupi 0.4%. Tikumbukenso kuti zotsatira za matenda zimadalira molondola ndi Timeliness mankhwala.