Vasculitis wa mwana: hemorrhagic, matupi awo sagwirizana. Zoyambitsa, zizindikiro, zithunzi, chithandizo, madokotala ananena zawo

Vasculitis wotchedwa gulu lonse la zinthu pathological. Ogwirizana ndi mbali chimodzi - kutupa mu Mitsempha, zikubweretsa kuwonongeka awo ndi chiwonongeko pang'onopang'ono. Zikhoza kuwonongeka monga mitsempha lalikulu mitsempha ndi capillaries yaing'ono. Kukula matenda zokhudza minofu ozungulira ndi ziwalo, amene amasokoneza kugwira ntchito zawo ndipo amadzetsa thupi lonse.

Kudwala amakhudza amuna ndi akazi a misinkhu yonse. Oopsa kwambiri, makamaka milandu kumene vasculitis mwanayo. Young mwana thupi sangathe kulimbana ndi matenda. Panthawi yake chithandizo kuchipatala kupewa mavuto.

mitundu ya vasculitis

Vasculitis amagawidwa angapo a muyezo: mtundu ndi digiri ya kuwonongeka kwa mitsempha ya magazi (mitsempha, mitsempha, capillaries), cholinga malo, kukula kwake, etc. Izi zimapangitsa kuti m'malo ovuta m'kagulu, kuwonjezera, nthawi zambiri ndikusinthidwa .. Komabe, tiyenera kusiyanitsa pakati pa magulu awiri a vasculitis:

• dongosolo - umawononga kuti zimakhala ndi ziwalo, chifukwa kuyan'anila za kotunga magazi awo;
• khungu - anawonetseredwa mu mawonekedwe a khungu yeniyeni totupa, kawirikawiri kuyambitsa mavuto.

Komanso pa chinthu chachikulu chomwe pakutchulidwa wa vasculitis anawagawa m'magulu awa:

• chachikulu - anatuluka monga matenda osiyana chifukwa kulephera kwa zimagwirira m'thupi;
• sekondale - chikanachitika ndi matenda ena (matenda, tizirombo, parasitic, etc.).

Vasculitis wa mwana ndi wamkulu poyera kuti gulu limodzi.

oopsa bwanji vasculitis ana?

Ngati vasculitis akufotokozera mwana, izo kumaonjezera ngozi ya matenda otaya zowombetsa mkota, T. E. Kufalitsa thupi lonse. Unformed thupi la mwana sangathe palokha kulimbana ndi ndondomeko matenda, ndi matenda amakula mwamsanga. Choncho, isanayambike kumachitika mu mawonekedwe pachimake. Ndipo pambuyo kuchira N'kutheka kuti ayambiranso.

Malungo, ambiri kuwonongeka, kusowa chilakolako cha khalidwe totupa kuchititsa ululu komanso kuyabwa - zizindikiro ndi amene angathe kuzindikira vasculitis ana (predsavleno chithunzi m'munsimu). Zinthu zovuta chifukwa chakuti mwanayo amayamba chipeso mawanga vuto kuposa traumatize khungu, kumapangitsa mapangidwe minofu yovulazidwa. Kudzera pachilondapo likulowerera matenda magazi, izi worsens zina chikhalidwe ndi kubweza lipole.

Ngati pali mavuto alionse a vasculitis akhoza kuyenda mu njira zina kwambiri. Kenako anadabwa simuli zotengera yekha wa khungu, komanso yaikuluikulu mitsempha, mitsempha ndi zina thupi ndi ziwalo. Minofu ndi mafupa simukhala zakudya zokwanira ndi kupereka magazi, pang'onopang'ono manja ndi kutaya kuyenda. vuto kumatanthauza vasculitis ana. Kuchiza ndi thandizo amayenera kukhala yake.

Hemorrhagic vasculitis ana

Hemorrhagic vasculitis imatchedwanso matenda Henoch purpura. Zokwanira wamba matenda ana kwa zaka 4 mpaka 7, koma kumachitika mu makanda. Zimayambitsa - kulanda matenda opatsirana (tizilombo toyambitsa), infestations parasitic, vaccinations angapo, chifuwa chakudya.

Umboni woyamba wa zizindikiro za matenda - hemorrhagic totupa wa amawasonyeza mosiyanasiyana mwamphamvu. Nthawi zambiri izo isanafalikire pa malekezero m'munsi, pafupi mafupa, anaŵerama. kawirikawiri, totupa kuonekera pa ziwalo zina za thupi - manja, mapazi, khosi, nkhope. Apa ndi chotupa kufalikira mu zotengera wamng'ono wa khungu. Ichi ndi chizindikiro chachikulu chimene anatsimikiza ndi hemorrhagic vasculitis ana.

Zizindikiro khalidwe la matenda, angayambe limodzi ndi totupa pakhungu kapena mtsogolo mwa mawu ake. kugonjetsedwa Izi zimfundo ndi, chidawoneka ululu, kutupa, edema. N'zotheka okhudzidwa mu ndondomeko pathological a dongosolo m'mimba, amene anatsagana ndi kulemera pamimba, colic, nseru, kusanza.

Pa 1 kapena 2 na- chaka cha moyo akhoza kukhala ndi mphezi mawonekedwe, amene kwambiri complicates ndi hemorrhagic vasculitis ana. Zimayambitsa - kulanda matenda otchedwa ana -. Chofiira malungo, nthomba, chikuku, etc. The njira ya matenda ndi nthawi pachimake, yodziwika ndi mawonetseredwe kwambiri zizindikiro, ndipo kungakhale koopsa kwa ana unformed thupi.

njira yachipatala

Pakuti mayiko, kuchita matenda, ndi hemorrhagic vasculitis akhoza lophatikizana ndi ubwamunalo linagawanika mu mawonekedwe zotsatirazi:

• A mtundu wophweka. Chikudziwika ngati purpura cutaneous. Anawonetseredwa mu mawonekedwe a totupa utoto - ichi ndi chachikulu matenda chizindikiro ndi chisonyezo. Ambiri amakhudza miyendo m'munsi, kawirikawiri limatuluka pamwamba.
• Khungu articular purpura. mawonetseredwe More choopsa cha matenda. Kuwonjezera totupa pakhungu, kuwonongeka olowa amapezeka. Iwo limodzi ndi ululu ndi kutupa. Makamaka anakhudzidwa mfundo bondo, osachepera - chigongono ndi dzanja.
• M'mimba purpura (matenda). Limodzi ndi ululu ndipo ululu lakuthwa m'mimba, kusanza. Ngati muli ndi chizindikiro ichi ndi zovuta oterewa ndi hemorrhagic vasculitis ana. Zimayambitsa matenda - kugonjetsedwa kwa ziwalo m'mimba, ndicho thirakiti m'mimba.
• Nephritic syndrome. Nthawi zambiri akufotokozera pa maziko a zizindikiro zina za matendawa.
• Obwerawa mawonekedwe. Iwo akhoza kuphatikiza onse kapena onse 3 zizindikiro.
• Kawirikawiri mitundu. Kulankhula matenda a m'mapapo, mantha dongosolo ndi Ziwalo zoberekera. Padzakhala nthawi zina.

zimayambitsa

Hemorrhagic vasculitis a matenda m'thupi zovuta. M'kuwonekera kwake ndi Kukula kwa maofesi m'thupi nawo - mu magazi kufalitsidwa Antigen-oteteza pawiri (AH - AT). maonekedwe awo amaona kuti zimachitika kuti malowedwe mu thupi la zinyalala kapena tizilombo wothandizila - selo zinyalala, poizoni, mabakiteriya tosaoneka bowa, mavairasi, mogwirizana (majeremusi). N'chifukwa chake hemorrhagic vasculitis zambiri akufotokozera patapita masabata angapo pambuyo akudwala matenda opatsirana kapena katemera.

Kawirikawiri maofesi AT - AG anawononga maselo magazi wapadera - phagocytes. Koma nthawi zina akhoza kudziunjikira mu m'magazi, "kukhazikika" mu pafupi, chifukwa kutupa kwa zimakhala ndi ziwalo. Kuwonjezera yatsoka AG - AT maofesi kumawonjezera permeability makoma chotengera, kutsegula kwa dongosolo womuyenerera - mapuloteni nawo yankho m'thupi. Malinga ndi magawo awa, matenda zasayansi imachitika.

matenda a matenda

Vasculitis wa mwana akapezeka ndi mbali zotsatirazi:

1. Pamaso pa khungu totupa wofiirira, wofiira mitundu. The mawanga a awiri ang'onoang'ono, otukukira kunja mawonekedwe. Angayambe pa mbali iliyonse ya thupi, koma nthawi zambiri - mu malekezero m'munsi.
2. M'mimba (ku Latin pamimba -. The m'mimba) ululu. Pangakhale likukulira, zakulitsa iliyonse chakudya.
3. Biopsy (kafukufuku mpukutu minofu) makoma a venules kapena arterioles Zosonyeza kuwonjezera chiwerengero cha granulocytes.

deta Laboratory si diagnostically kwambiri pa nkhaniyi. Komabe, kulabadira kuwonjezera chiwerengero cha mtundu A immunoglobulins mu seramu magazi. Komanso zizindikiro chofunika kwambiri kukhala mkulu titer antistreptolisin-O (chinenero chamanja-O) ndi erythrocyte mlingo sedimentation (ESR), amene anapezeka vasculitis ana.

Zoneneratu akhoza wotchulidwa yabwino. Nthawi zina, zizindikiro zikawoneka pambuyo pa 30 Patapita masiku mawonetseredwe pachimake cha matenda. Komabe, pali chiopsezo kulephera aimpso, zosokonezeka wa kapepalako m'mimba kapena dongosolo chapakati mantha.

Hemorrhagic vasculitis ana: chithandizo

Chithandizo cha hemorrhagic vasculitis anayamba pokhapokha chomaliza unsembe katswiri matenda ndi zimayambitsa matenda. Chithandizo kudzadalira gawo la matenda ndi digiri ya chitukuko.

Mulimonsemo kuchepetsa locomotor ntchito. Zimenezi n'zofunika kwambiri makamaka m'kati mwa matenda pachimake. Bedi zina kutumikiridwa mpaka mofulumira khola la ziwengo. anakhala pafupifupi za 3-4 masabata. Kulakwila chikhalidwe ichi zingachititse kobwereza hemorrhagic totupa. Mu chochitika cha matenda oyamba pachimake ndi zochita za matenda bedi zina kutalikitsa.

Onetsetsani kuti asankhe zakudya ndi likuyesetsa okhwima kwa zakudya allergenic ndipo zingakhale zakudya allergenic. Ngati matenda ndi mu mawonekedwe a matenda m'mimba, zotchulidwa zakudya №1. Vuto vuto aakulu nephritis - zakudya №7 (kukusalani mchere, nyama, tchizi). Chotero chakudya kuchepetsa zizindikiro zosasangalatsa zomwe zimabweretsa hemorrhagic vasculitis ana.

Chithandizo, kaya matenda, limapangidwa kulandira mankhwala antiplatelet - mankhwala kuchepetsa thrombosis ndi fibrinolysis activators - zinthu nawo "Kutha" magazi kuundana. Kapangidwe ndi kuchuluka kwa mankhwala, mlingo wawo ndi nthawi ya phwando amadzinenera dokotala.

Popeza pakutchulidwa matenda kugwirizana ndi kukhazikitsidwa kwa asilikali m'thupi, mankhwala tichipeza mu akuchotsa thupi maofesi AG - AT. Pa matenda ndipo palibe contraindications kuchititsa mawotchi kuyeretsa magazi - plasmapheresis. Izi ndondomeko adzachotsa magazi osati maofesi m'thupi, komanso tizilombo toyambitsa matenda, tosaoneka bowa, poizoni.

Matupi awo sagwirizana vasculitis ana

Chifukwa matenda - matupi awo sagwirizana anachita. Childs, izi akuchitanji m'thupi ndi mankhwala, chakudya, kapena matenda m'thupi. Izi zimachititsa kutupa ndi kuwonongeka kwa mitsempha, makamaka khungu. Nthawi zambiri kumachitika ana kwa zaka 15 pambuyo akudwala matenda opatsirana kapena njira ya mankhwala. Nthawi zina chifukwa chakuti pali hypersensitivity vasculitis ana, sizingakhale bwino. Ndiye muyenera mbiri mokwanira mankhwala.

The chizindikiro chachikulu ndi zidzolo yaikulu, kuyabwa. Iwo ali kuoneka mawanga ndi / kapena timabamputimabampu otukukira kunja wofiirira kapena ofiirira mtundu pa malo akulu a pakhungu. Iwo makamaka awonekere miyendo, ntchafu, matako. Mwina matuza ndi ulceration, amamuyambitsa timabala ziwiya kuonongeka. Matupi awo sagwirizana vasculitis zambiri watsimikiza lokha mwa masabata ochepa. Komabe, mavuto zotheka monga kuwonongeka kwa ziwalo chifukwa kuphwanya kotunga magazi awo.

Mitundu ndi mitundu

Malinga ndi awiri a chotengeracho akulimbana, wolemekezeka:

• pamwamba (dermal) matupi awo sagwirizana vasculitis - amakhudza capillaries, arterioles ndi venules pakhungu zakuya;
• kwambiri kapena dermo-hypodermal - kumachitika pamene ndondomeko pathological nawo mitsempha ndi mitsempha ya kukula sing'anga.

Malinga siteji ya chitukuko cha ziwengo, pali njira zingapo za matenda:

• papular - totupa oumbidwa, palpable, inki;
• vezikuleznaya - anapanga thovu (vesicles) ndi nkhani madzi;
• pustulnaya - kuoneka cavities wodzazidwa ndi mafinya;
• chilonda - pamalo pustules kuoneka zilonda necrotic;
• chilonda - limodzi ndi amamuyambitsa timabala wa khungu kuonongeka.

Chithandizo cha matupi awo sagwirizana vasculitis

Izo umalimbana kuchepetsa kutupa chifukwa mankhwala. Ophatikizana mankhwala mulinso phwando Kumatanthauza kuchepetsa clotting (mankhwala antiplatelet), kuonjezera mtima kamvekedwe, ndi mankhwala kuchepetsa thupi lawo siligwirizana. Ngati nthendayo kobwereza mu chikhalidwe, inu simungakhoze kutenga mankhwala ntchito oyambirira, n'zotheka kuti thupi kuyamba kukana kwa iwo.

Kuthetseratu chikoka chakudya wothandizila matupi awo sagwirizana amapatsidwa kulandira enterosorbents. Mankhwalawa kumumanga ndi kuchotsa poizoni matumbo, kuteteza iwo kulowa m'magazi. Komanso zakudya okhwima kupatulapo mankhwala chakudya kuti angathe kukumverani munthu amene m'thupi. Zimenezi kumanga pamene anapezeka ndi vasculitis ana.

Zimayambitsa matenda akhoza zosiyanasiyana. Nthawi zina, ngati akufunika kutero, ulamuliro wa mankhwala zomwe zingachititse sayanjana. Kutalika kwa mankhwala zimadalira chikhalidwe cha matenda (wavy kapena kobwereza).

Chofunika kudziwa makolo?

Makolo ayenera kusamala kwambiri totupa aliyense pa khungu la mwanayo. Ngakhale anthu kuti ngati zosapindulitsa koyamba. Makolo Ndizofunikanso kudziwa kuti vasculitis mwana kumachitika mu mafunde nthawi chikhululukiro m'malo musabise. Komanso, zizindikiro kachiwiri akutulukira matenda osiyanasiyana kuchokera kwa amene kale. Panthawi yake chithandizo kuchipatala kupewa zotsatira zoipa.

Sikuti kuti mwanayo kuchitiridwa paokha ngati anali amaganiziridwa vasculitis. Ana, matendawo angakhale osokoneza. Matendawa ndi chithandizo ayenera chinkhoswe mu katswiri wodziwa bwino. Makamaka satchula ufulu kusankha immunostimulatory ndi mankhwala immunomodulatory. Ndipotu, cholinga chachikulu maonekedwe a mtundu uliwonse wa vasculitis - kuphwanya ntchito poteteza zimagwirira thupi.

Popewa kachiwiri zikamera wa matenda mwana amathandiza kusunga miyezo ya chidule:

• Kuchepetsa chiwerengero cha zinthu nkhawa;
• kuonetsetsa kuti azidya chakudya, moyo yogwira;
• kukhalapo kwa kuwala zofuna kukhetsa thukuta;
• kulimbikitsa chitetezo cha m'thupi.

Nkofunika kudziwa kuti matenda zonyamula patsogolo mwana ali wamng'ono angakhale chimawononga kukula thupi ndi m'maganizo.