MFUNDO syndrome (HELLP-syndrome) - vuto loopsa mu III trimester ya mimba: zimayambitsa, matenda, mankhwala

Pa moyo wa munthu aliyense zivute zitani akubwera mphindi amakakamiza kutembenukira kwa thandizo kunja. Nthawi zambiri othandizira mu zoterezi ndi azachipatala. Izi zimachitika pamene thupi la munthu litalanda matenda sioneka, ndiponso kupirira iwo sizingatheke. Aliyense akudziwa kuti wokondwa boma mimba - si matenda, koma kuti Moms m'tsogolo akufunika kwambiri thandizo kuchipatala ndi m'maganizo.

"Thandizeni!" Kapena dzina la matenda

Kupempha thandizo zinenero zosiyanasiyana kuwomba osiyana. Mwachitsanzo, mu English ndi wosachiritsika Russian, "Thandizo!" Kodi kutchulidwa ngati "MFUNDO". MFUNDO syndrome (HELLP) pafupifupi mwangozi mu nyimbo ndi pempho tsopano mayiko thandizo.

Zizindikiro ndi zotsatira za vuto ili pa mimba ngati kuti mwamsanga kupita kuchipatala n'kofunika. HELLP chidule kwa mitundu yosiyanasiyana ya matenda: mu chiwindi, ndi clotting magazi ndi chiopsezo cha magazi kuchuluka. Kuwonjezera pa pamwamba, HELLP-syndrome amachititsa wonongeka a impso ndi matenda a kuthamanga magazi, potero kwambiri kukulitsa njira ya mimba.

Chithunzi cha matenda ndi lolemera kwambiri moti pali kukana mfundo ya kubereka ana thupi, autoimmune kulephera amapezeka. Zimenezi zimachitika okwana zimamuchulukira wa thupi wamkazi pamene chitetezo safuna kugwira ntchito, kuchotsa ndi maganizo aakulu, anayamba kuchepa chifuniro chifukwa cha kuphunzira moyo ndi kupitiriza kulimbana. Magazi si aumirira, chilonda ankachiritsa, magazi sasiya, ndi chiwindi sangathe kugwira ntchito yake. Koma ndi mwakayakaya amenable malangizo kuchipatala.

mbiri zachipatala

syndrome MFUNDO limafotokonzera m'ma 19 mochedwa. Koma mu 1978 Gudlin anamanga kudwala autoimmune wa chisanadze eclampsia pa mimba. Ndipo mu 1985, chifukwa Weinstein, zizindikiro anthuwo anali ophatikizidwa pansi dzina lina: HELLP-syndrome. N'zochititsa chidwi kuti magwero zoweta zachipatala, ichi ndi vuto lalikulu pafupifupi limafotokoza. anesthetists ochepa Russian ndi odwala mwakayakaya akatswiri kupereka mwatsatanetsatane ankaiphwasula vuto ili lalikulu preeclampsia.

Nthawiyi, MFUNDO syndrome pa mimba mofulumira ikupita patsogolo nachotsa kwambiri ya moyo.

Ife kufotokoza iliyonse Vuto payokha.

hemolysis

MFUNDO matenda makamaka zikuphatikizapo intravascular hemolysis. Izi matenda oopsa yodziwika ndi chiwonongeko cha selo. Kuwonongedwa ndi ukalamba maselo a magazi amayambitsa kutentha thupi, matenda a chikasu ndiyo wa khungu, maonekedwe a magazi maphunziro mkodzo. Kwambiri moyo pachiswe zotsatira - chiopsezo magazi lolemera.

Kubereka thrombocytopenia

Mbali yotsatira ya achidule syndrome - thrombocytopenia. chikhalidwe ichi amakhala ndi kuchepa kupatsidwa zinthu za m'mwazi achiyesa mwa chilinganizo cha magazi, kenako kuchititsa magazi lachibadwa. Lekani ndondomeko izi zitha kukhala mu chipatala, ndi woyembekezera, chikhalidwe ichi makamaka oopsa. chifukwa akhoza kukhala amphamvu matenda m'thupi, zomwe zinachititsa kuti anomaly imene thupi amalimbana ndi lokha, kuononga thanzi maselo ofiira. Bwaloli kuopseza moyo unachokera pa maziko a kusintha kwa chiwerengero cha othandiza magazi kuundana clotting matenda.

Lowopsya nyengo yachisanu ikupita: kuwonjezeka michere chiwindi

The pathologies zovuta m'gulu la syndrome MFUNDO, korona ngati zosasangalatsa chizindikiro monga kuchuluka michere chiwindi. Kwa amayi oyembekezera omwe amatanthauza kuti chimodzi cha ziwalo zofunika kwambiri m'thupi la munthu pali mavuto awo akuluakulu. Ndipotu, chiwindi osati utisambitsa thupi la poizoni ndi kuthandiza kukhazikitsa ntchito za m'mimba, komanso zimakhudza psycho-maganizo dera. Nthawi zambiri ngati kusintha zoipa ndi wapezeka pa chizolowezi atayezetsa, amene chikuyendetsedwera kuti mkazi wapakati. Pamene preeclampsia kobvuta ndi matenda kanjedza MFUNDO kusiyana kwambiri mwakale, kuwulula chithunzi pachiswe. Choncho, mankhwala malangizo - ndondomeko woyamba, umene ndi kuvomerezedwa kuti aphedwe.

Makamaka trimester lachitatu

3 trimester mimba n'kofunika kwambiri tsogolo la gestation ndi yobereka. zosokonezeka pafupipafupi ndi edema, kutentha pa chifuwa ndi m'mimba kukanika.

Izi zimachitika chifukwa cha monyanyira mu impso ndi chiwindi. Chokulitsidwa chiberekero ali kuumiriza kuseka ziwalo m'mimba, amene chifukwa iwo ndi kuyamba kumasulira. Koma gestosis angakhalepo chikhalidwe wotchedwa chisanadze eclampsia ndi eclampsia, amene kukulitsa ululu mu epigastrium, imautsa maonekedwe a nseru, kusanza, edema, kuthamanga kwa magazi. Against maziko a mavuto ubongo angayambe khunyu. Zizindikiro zowopsa kuonjezera, nthawi zina pafupifupi ngati mphezi, kuchititsa mavuto aakulu kwa thupi, kusokoneza moyo wa mayi woyembekezera ndi mwana wosabadwayo. Chifukwa preeclampsia kwambiri, nthawi zambiri umabweretsanso 3 trimester mimba, pali zambiri syndrome ndi wokamba wotchedwa.

zizindikiro yowala

HELLP-syndrome: matenda chithunzi, matenda, obstetric machenjerero - mutu wa kukambirana lero. Choyamba, muyenera kuzindikira angapo zizindikiro pachimake kuti ayende Vuto oopsa.

1. Pa mbali ya chapakati mantha dongosolo. Mantha dongosolo kuyankha khunyu awa matenda, mutu kwambiri, zithunzi kuwonongeka.
2. Job mtima dongosolo anawawidwa chifukwa edema wa zimakhala ndi utachepa magazi.
3. njira kupuma nthaŵi zambiri sanaphwanye, koma edema m'mapapo mwanga angayambe wangobereka kumene.
4. Pa mbali ya hemostasis ndi thrombocytopenia anati kuphwanya kupatsidwa zinthu za m'mwazi zinchito zikuluzikulu za ntchito.
5. Yafupika chiwindi ntchito, nthawi zina imfa ya maselo ake. Kawirikawiri anati mowiriza kwa chiwindi chophukacho, imbaenda ku imfa.
6. Kuphwanya dongosolo genito-mkodzo: oliguria, aimpso kukanika.

MFUNDO matenda yodziwika ndi zizindikiro zosiyanasiyana:

• kusapeza mu chiwindi;
• kusanza;
• pachimake mutu;
• kukomoka;
• thupi chikhalidwe;
• chosokoneza cha chikumbumtima;
• mkodzo insufficiency;
• edematous minofu;
• osasamba kuthamanga;
• kukha magazi angapo m'malo mpheto;
• yellowness.

matenda Laboratory akuwonetseredwa ndi thrombocytopenia, hematuria, kudziwika mapuloteni mu mkodzo ndi magazi, otsika hemoglobin, kuchuluka kwa bilirubin mu magazi. Choncho, kunena momveka bwino matenda okhazikika dziko lonse mayesero ovuta zasayansi adzafuna.

Kodi kuzindikira mavuto a?

Pofuna yake kudziwa ndi kupewa mavuto aakulu, ndipo anagwira kuchipatala limene mums tsogolo akulangizidwa kufika nthawi zonse. katswiri pakati wavala umboni, ndiyeno kwambiri kuyan'ana kusintha m'thupi la mayi pa nthawi yonse. Choncho, gynecologist yake kukonza zolakwika osafunika ndi kanthu moyenerera.

Kuonetsera kusintha pathological ndi ntchito mayesero zasayansi. Mwachitsanzo, mkodzo mapuloteni chingatithandize kudziwa ngati pali wina. Kuwonjezeka zizindikiro mapuloteni ndi chiwerengero cha leukocytes zikusonyeza monyanyira kutchulidwa mu ntchito ya impso. Mwazina, pangakhale kuchepetsa lakuthwa kuchuluka kwa mkodzo, ndiponso kuchuluka kwambiri edema.

Mavuto chiwindi ndi kuwonetseredwa osati kumanja chapamwamba ululu nusu, kusanza, komanso kusintha magazi (kuchuluka tochepa michere chiwindi), ndi chiwindi kukulitsa pa palpation ali anamva bwino.

Thrombocytopenia amadziwikanso wapezeka ndi zasayansi likuyesetsa mwazi wa mkazi wapakati, umene weniweni kuopseza MFUNDO syndrome.

Ngati mukukayikira eclampsia ndi matenda MFUNDO kuvomerezedwa kulamulira magazi chifukwa cha kuphipha Mitsempha ndi magazi kuundana wa ntchito wake akhoza kwambiri kuonjezera.

matenda masiyanidwe

Yapamwamba masiku ano MALANGIZO syndrome matenda mu obstetrics chapeza kutchuka, kawirikawiri nachiyika molakwika. Nthawi zambiri kubisa kumbuyo izo ndi matenda chosiyana, osati zochepa yoopsa, koma zambiri wamba ndi wamba:

• gastritis;
• tizilombo matenda a chiwindi;
• zokhudza zonse lupus erythematosus;
• urolithiasis;
• obstetric sepsis;
• matenda a chiwindi (mafuta, matenda enaake);
• thrombocytopenic purpura wa etiology sakudziwika;
• impso kulephera.

Choncho masiyanidwe. Matendawa ayenera kuganizira zosiyanasiyana options. Motero, tanena wa ku - hyperenzymemia chiwindi, hemolysis ndi thrombocytopenia - osati nthawi zonse akusonyeza pamaso pa vuto ili.

Zimayambitsa MFUNDO-syndrome

Mwatsoka, mfundo zoopsa osati bwinobwino, koma pali maganizo kuti tifulumizane MFUNDO syndrome angakhale zifukwa zotsatirazi:

• matenda obwera chifukwa choganiza kwambiri;
• mankhwala anachititsa chiwindi;
• enzymatic kusintha kwa maselo a chiwindi;
• prolificacy.

Mu matenda ambiri oopsa kumachitika pamene osakwanira chidwi preeclampsia kobvuta Inde - eclampsia. Nkofunika kudziwa kuti matenda khalidwe sizimadziwika kwambiri: izo kusiyana pa liwiro mphezi, izo Mwamsanga lokha.

miyeso achire

Pamene mayesero onse ikuchitika ndi masiyanidwe. matenda, mukhoza kupanga mfundo zina. Pamene inu kwabasi matenda "MFUNDO syndrome" chithandizo umalimbana ofunika boma la mayi oyembekezerayo ndi mwana wosabadwayo, komanso yobereka mwamsanga palokha akuti. ntchito Medical akutsatiridwa ndi thandizo la azamba-gynecologist, gulu kuwatsitsimula, ndi dzanzi. Ngati ndi kotheka, kulumikiza akatswiri ena: a katswiriyu kapena maso. Makamaka inathetsedwa angapo kulephera limba, ndipo anapereka njira zodzitetezera kuti kupewa mavuto zotheka.

Mwa wamba complicating njira za phukusi la mankhwala, tingaone:

• placental detachment;
• kukha mwazi;
• ubongo edema;
• edema m'mapapo mwanga;
• pachimake aimpso kulephera;
• kusintha amapha chiwindi ndi lisaoneke;
• indomitable magazi.

Pamene matenda zolondola yake ankathandiza dokotala kuti ziyenda odwala amamuchititsa yochepa.

obstetric strategy

Machenjerero ankachita obstetrics poyerekezera ndi mitundu choopsa cha preeclampsia, ndi zovuta syndrome MFUNDO m'mbali: kugwiritsa ntchito gawo la Kaisara. Pamene okhwima chiberekero wokonzeka azikhala zachilengedwe, ntchito prostaglandins ndi kumanga epidural.

Zikavuta, gawo la Kaisara ntchito mankhwala ochititsa dzanzi yekha endotracheal.

Moyo akabereka

Akatswiri ananena kuti matenda kumachitika osati pa trimester wachitatu, komanso amatha kupita patsogolo mu masiku awiri pambuyo ndiyotani pakuchotsa katundu.

Choncho, THANDIZANI syndrome atabadwa - chodabwitsa ndi N'kutheka kuti amalankhula mu mtima wa polojekiti pafupi wa mayi ndi mwana mu nyengo ya postpartum. Makamaka izo nkhawa akazi kwambiri loyenda preeclampsia pa mimba.

Ndani ndi chochita?

MFUNDO matenda - ndi kusokonezeka kwa pafupifupi onse ziwalo ndi machitidwe a thupi wamkazi. Pa matenda pali outflow tima wa umoyo ndi Mwina mkulu wa imfa, ndipo intrauterine kuvutika yoopsa. Choncho, kuchokera 20 sabata TH wa mayi woyembekezera ndi zofunika kuchita kudziletsa kuyan'anila tsikulo, zomwe kusintha zonse zikuchitika mu thupi. chidwi ziperekedwe kwa mfundo zotsatirazi:

• magazi: izo kudumpha m'mwamba maulendo atatu ayenera kuchenjeza;
• kulemera metamorphosis: ngati anali kuwutsa zikuchepa, mwina, chifukwa kuti anali kutupa;
• yoopsa kayendedwe kwambiri kwambiri, kapena, Tikawonetsetsa stilled kayendedwe - bwino chifukwa chithandizo kwa dokotala;
• pamaso pa edema: chotupa chachikulu cha zimakhala zikusonyeza kukanika aimpso;
• zachilendo kupweteka kwa m'mimba: lapadera m'dera la chiwindi;
• pafunika kumasanthula zonse zakonzedwa, ziyenela kuchitidwa mu chikhulupiriro chabwino ndi nthawi, monga chiyenera kukhala chifukwa cha phindu la mayi kwambiri ndi mwana wosabadwa.

Zizindikiro zonse chenjezo ayenera yomweyo inati kwa dokotala wanu, gynecologist monga wokhoza mokwanira mmene zinthu zilili pamoyo ndi kutenga mwanzeru.