Eritrea ndi chiyani? Miyeso ya erythremia

Erythremia ndi imodzi mwa mitundu ya matenda a magazi omwe amadziwika ndi kuchuluka kwa ma erythrocyte komanso kuwonjezeka kwa chiwerengero cha maselo ena (leukocyte, platelets). Ndizomwe zimakhala zosavuta, matenda omwe sali okwanira. Komabe, n'zotheka kuti matenda a khansa ya m'magazi ndi oopsa kwambiri. Erytremia ndi matenda omwe amakhudza anthu 4 pachaka kuchokera kwa anthu 100 miliyoni pachaka. Izo sizidalira pa chiwerewere, koma kawirikawiri zimapezeka mwa anthu achikulire ndi achikulire. Ngakhale kuti matendawa amalembedwa ndipo ali aang'ono, nthawi zambiri amayi.

Erythremia (ndondomeko ICD-10 - C94.1) imakhala yosalekeza.

Maselo a magazi ndi magetsi

Mchitidwe wa erythremia ukuyamba motere.

Erythrocytes ndi maselo ofiira ofiira, ntchito yaikulu yomwe ndikutumizira mpweya kwa maselo onse a thupi lathu. Zimapangidwa m'kamwa, fupa ndi chiwindi. Mafupa a mafupa amapezeka m'matumbo a mitsempha, mafupa, nthiti, mafupa a mapiko ndi sternum. Pa 96%, maselo ofiira ofiira amadzazidwa ndi hemoglobini, yomwe imachita kupuma. Mtundu wofiira wapatsidwa kwa iwo ndi chitsulo. Erythrocyte amapangidwa ndi tsinde la tsinde. Mphamvu zawo zosiyana ndizo mphamvu yogawana (kuonjezera), kusandulika mu selo lina liri lonse.

M'mapfupa, palinso fupa lakasu, lomwe limaimiridwa ndi minofu ya adipose. Amayamba kupanga zinthu zamagazi pokhapokha panthawi yovuta kwambiri, pamene magwero otsala a hematopoies sagwira ntchito zawo.

Erythremia (ICD-10 ndi matenda amitundu yapadziko lonse omwe matendawa amapatsidwa code C 94.1) ndi matenda omwe pathogenesis sinaphunzirepo. Pazifukwa zomwe madokotala sakudziwa bwino, thupi limayamba kuwonjezera maselo ofiira a magazi, omwe amalephera kulumikizana m'magazi, kutuluka kwa magazi kumakhala kosavuta, ndipo zitseko zimayamba kupanga. Pakapita nthawi, kumawonjezeka mu hypoxia (mpweya wa njala). Maselo samalandira zakudya zoyenera, pali kulephera mu dongosolo lonse la thupi.

Zina zosangalatsa za erythremia

1. Erytremia ndi matenda oopsa kwambiri a leukemias onse. Izi zikutanthauza kuti kwa nthawi yaitali zimakhala zosavuta komanso zimayambitsa mavuto m'malo mochedwa.
2. Zingakhale zozizwitsa ndipo musadzitchule nokha kwa zaka zambiri.
3. Ngakhale kuti pali mapaleletti owonjezeka, odwala amayamba kutuluka magazi ambiri.
4. Erytremy ali ndi chiwerengero cha banja, kotero ngati pali wodwala m'banja, chiopsezo chowonekera mwa mmodzi wa achibale chikuwonjezeka.

Zifukwa za Erythema

Mofanana ndi mitundu ina ya khansa ya m'magazi, erythremia sinaphunzire bwino, ndipo zomwe zimayambitsa maonekedwe sizidziwike. Komabe, zifukwa zomwe zilipo zimatchulidwa:

1. Zosintha zamoyo.
2. Zinthu zoopsa m'thupi.
3. Kutulutsa mazira.

Zosintha zamoyo

Pakalipano, sichidziwika kuti zimasintha za jini zimayambitsa maonekedwe a erythremia, koma zakhazikika kuti m'banja mwathu matendawa amabwerezedwa mobwerezabwereza m'mibadwo yotsatira. Kukhoza kwa matendawa kumawonjezeka nthawi zambiri, ngati munthu akuvutika:

• Matenda a pansi (kuphwanya mawonekedwe a nkhope ndi khosi, kukumba chitukuko);
• Matenda a Klinefelter (chithunzi chosayerekezereka komanso chotheka chitukuko);
• Bloom's syndrome (kukula kochepa, kuyimba kwa mtundu wa nkhope ndi kukula kwake kosayerekezereka, kuwonetsera kwa matenda opatsirana);
• Matenda a Marfan (kusokonezeka kwa chitukuko cha minofu yogwirizana).

Maonekedwe a erythremia ndi chifukwa chakuti zipangizo zamakono (kuphatikizapo zipangizo zamagazi) zimakhala zosasunthika, motero munthu amakhala ndi zotsatira zovulaza kunja - poizoni, poizoni.

Mafunde

Ngakhale ma X-rays ndi mazira a gamma amachotsedwa pang'ono ndi thupi, zomwe zimakhudza ma maselo. Iwo akhoza kufa kapena kusintha.

Komabe, ma radiation amphamvu kwambiri amalandiridwa ndi anthu omwe amachititsa khansa ndi mankhwala a chemotherapy, komanso omwe anali pamphepete mwa mabomba a mphamvu kapena mabomba a atomiki.

Zinthu zoopsa

Mukamwa, amatha kusintha kusintha kwa maselo amtundu. Zinthu zimenezi zimatchedwa chemical mutagens. Pambuyo pa kafukufuku wochuluka, asayansi anapeza kuti odwala okhala ndi erythremia anali okhudzana ndi zinthu izi chisanachitike. Zinthu izi zikuphatikizapo:

• Benzene (yomwe imapezeka mu mafuta ndi ambiri mankhwala solvents);
• Mankhwala oletsa antibacterial (makamaka, "Levomycetin");
• Mankhwala osokoneza bongo (mankhwala osokoneza bongo).

Miyeso ya erythremia ndi zizindikiro zawo

Gawo la Erythremia liri ndi zotsatirazi: zoyamba, zofutukuka ndi zotsirizira. Mmodzi wa iwo ali ndi zizindikiro zake. Gawo loyamba likhoza kukhala kwa zaka makumi ambiri popanda kusonyeza zizindikiro zoopsa. Zizindikiro zazing'ono zimakhala ndi matenda ena, ochepa kwambiri. Pambuyo pake, ngakhale madokotala nthaŵi zambiri samalipira chifukwa choyenera kusanthula magazi.

Ngati pali erythremia yoyamba, kuyezetsa magazi kuli ndi zocheperapo zosiyana ndi zomwe zimachitika.

Gawo loyambalo likudziwikanso ndi kutopa mofulumira, chizungulire, phokoso m'makutu. Wodwala samagona bwino, amamva ozizira m'maganizo, pali kutupa kwa manja ndi mapazi. Pali kuchepa kwa machitidwe a maganizo. Palibe mawonetseredwe akunja a matenda panobe. Mutu sungaganize kuti ndi chizindikiro chenicheni cha matendawa, koma chimachitika pachigawo choyambirira chifukwa cha kusokonezeka kwa magazi mu ubongo. Pa chifukwa chomwecho, masomphenya, chidwi ndi luntha zasachepera. Pamene matenda a "erythremia" a matendawa ali pachigawo chachiwiri ali ndi zizindikiro zawo - kutaya magazi, zimbudzi zochepa zimaonekera. Pamunsi mwa mwendo mukhoza kuwonekera mdima (zizindikiro za thrombosis) komanso ngakhale zilonda za trophic. Ziwalo zomwe erythrocyte zimapangidwira zimakula, - nthenda ndi chiwindi. Chifukwa cha chitukuko cha matendawa, maselo am'mimba amayamba.

Gawo lachiwiri la erythremia lingathe zaka 10. Kulemera kwake kumachepetsedwa. Khungu limatulutsa liwiro la chitumbuwa (nthawi zambiri manja ndi miyendo), palati yofewa imasintha mtundu, nthenda yolimba imasunga mthunzi wake wakale. Wodwala amasautsidwa ndi kuyabwa khungu, komwe kumawonjezeka atatha kusamba madzi otentha kapena otentha. Pa thupi, kutupa kwa mitsempha kumawoneka kuchokera ku magazi owonjezera, makamaka m'khosi. Maso ngati magazi, chifukwa cha erythremia, zomwe zizindikiro zake zimapezeka mokwanira m'gawo lachiwiri, zimapangitsa kuti magazi aziyenda m'mitsuko ya maso.

Chifukwa cha kusayenda bwino kwa capillaries, kupweteka ndi kutentha kwala zala ndi zala zakutsogolo kumawonetseredwa. M'zinthu zosanyalanyazidwa, mawanga a cyanotic pa iwo amadziwika.

Mafupa a mafupa ndi epigastric amapezeka. Kupweteka kwa nyamakazi kumagwirizanitsa ndi oric acid owonjezera. Kawirikawiri, ntchito ya impso imasokonezeka, pyelonephritis nthawi zambiri imatengedwa ndi kukopa miyala mu impso.

Tsitsi la mitsempha limavutika. Wodwala ali ndi mantha, maganizo ake ndi osasunthika, amasiyanitsa misozi ndipo nthawi zambiri amasintha.

Mawonekedwe otsekemera a magazi amanyamuka, omwe amachititsa kuoneka kwa thrombi mu malo osiyanasiyana. Palibenso chiopsezo chokhala ndi mitsempha yamatenda.

Chenjerani! Odwala angathenso kudwala matenda oopsa kwambiri komanso kutulukira zilonda zam'mimba mu duodenum. Izi zimakhala chifukwa cha kuchepa kwa thupi komanso kuwonjezeka kwa chiwerengero cha Helicobacter pylori - ndi bacterium yomwe imayambitsa chilonda.

Gawo lachitatu la erythremia limadziwika ndi kutalika kwa khungu, kufooka nthawi zambiri, kufooka komanso kufooka. Pali magazi ochulukitsa nthawi yaitali panthawi yovulala kwambiri, kupuma kwa magazi m'thupi chifukwa cha kuchepa kwa hemoglobin m'magazi.

Gawo lachitatu la erythremia: zizindikiro ndi mavuto

Erythremia ndi matenda a magazi omwe amakwiya pa siteji yachitatu. Pa nthawiyi, maselo a mafupa amatha kugwidwa ndi fibrosis. Iye sangathenso kutulutsa maselo ofiira ofiira, kotero miyambo ya maselo a magazi imatuluka, nthawizina kumakhala ovuta. Mu ubongo, kutentha kwa thupi kumawoneka, chiwindi chimayamba. Mu gallbladder ndi nkhungu, mazira a viscous ndi miyala yofiira. Chotsatira cha izi ndi chiwindikiro cha chiwindi ndi kutsekera kwa mitsempha ya mitsempha.

Poyambirira, anali kuwonjezeka kwaprombus komwe kunayambitsa imfa ya odwala erythremia. Makoma a ziwiya amatha kusintha, pali mitsempha ya mitsempha mumitsuko ya ubongo, mphala, mtima ndi miyendo. Pali matenda otsekula m'mimba - kutayika kwa ziwiya za miyendo ndi chiopsezo chawo chokwanira.

Impso zimakhudzidwa. Chifukwa cha kukula kwa uric acid, odwala amamva ululu wa nyamakazi wa khalidwe labwino.

Chenjerani! Ndi erythremia, miyendo ndi manja nthawi zambiri amasintha mthunzi wawo. Wodwala ali ndi vuto la bronchitis ndi chimfine.

Chifukwa cha matendawa

Erytremia ndi matenda ochedwa. Matendawa amadza mwaokha pang'onopang'ono, kuyambira kwake kumapitabe patsogolo komanso kumakhala kosaoneka. Odwala nthawi zina amakhala zaka zambiri, osamvetsera zizindikiro zochepa. Komabe, mu milandu yowopsa kwambiri, chifukwa cha thrombi, imfa ikhoza kuchitika mkati mwa zaka 4-5.

Pamodzi ndi erythremia, nthonje imakula. Sulani mawonekedwe ndi chiwindi cha chiwindi ndikugonjetsa ubongo wapakati. Pa nthawi ya matendawa, vuto lopweteka komanso lopatsirana limatha kugwira ntchito, nthawi zina odwala salola kulemba magulu ena a mankhwala osokoneza bongo, akudwala ming'oma komanso matenda ena a khungu. Maphunziro a matendawa ndi ovuta kwambiri chifukwa cha matendawa, chifukwa matendawa amakhala opangidwa kwa okalamba.

Myelofibrosis ya post-arrhythm ndi kuwonongeka kwa matenda kuchokera ku njira yowonongeka mpaka yoipa. Chikhalidwe ndichibadwa kwa odwala amene anapulumuka mpaka pano. Pachifukwa ichi, madokotala amavomereza kuti erythremia yapeza chikhalidwe chochepa.

Ndikofunikira kwambiri kupeza bwinobwino erythremia ndikupereka chithandizo choyenera. Kusanthula kumaphatikizapo maphunziro angapo.

Mayeso a magazi a erythremia

Ndili ndi matenda a "erythremia", kuyezetsa magazi, zizindikiro zomwe ziri zofunika kwambiri kuti azindikire, zayamba. Choyamba, izi ndizoyezetsa magazi ambiri. Ndizosiyana ndi zomwe zimachitika mwa iye amene amakhala mzere woyamba wa alamu. Kuchulukitsa chiwerengero cha maselo ofiira ofiira. Poyambirira, sizingatheke, koma ndi chitukuko cha matendawa chimakula mochulukirapo, ndipo pamapeto pake imagwa. Kawirikawiri, mlingo wa erythrocytes m'magazi a amayi ndiwo pakati pa 3.5 ndi 4.7, ndipo amuna - kuyambira 4 mpaka 5.

Ngati erythremia ikupezeka, kuyezetsa magazi, komwe kumasonyeza kuwonjezeka kwa erythrocytes, kumasonyezanso kuwonjezeka kofanana kwa hemoglobin. Hematocrit, posonyeza kuti mphamvu ya magazi ikanyamula mpweya, inakula kufika 60-80%. Chizindikiro cha mtundu sichinasinthidwe, koma mu gawo lachitatu likhoza kukhala liri lonse - labwino, lokwezeka kapena lochepa. Thrombocytes ndi leukocytes akuwonjezeka. Leukocyte imakula kangapo, ndipo nthawi zina kwambiri. Kupangidwa kwa eosinophils (nthawizina pamodzi ndi basophils) kumakula. Mapaleti okwera kwambiri. Mlingo wamakono wa erythrocyte si oposa 2 mm / ora.

Tsoka, kuwerengera kwa magazi, ngakhale kuli kofunikira pa matenda oyamba, sikungophunzitse, ndipo chifukwa chaichi ndizomwe matendawa sanagwiritsidwe.

Maphunziro ena ndi erythremia

• Kusanthula zamagetsi za magazi. Cholinga chake chachikulu - kudziwa kuchuluka kwa chitsulo m'magazi ndi kuchuluka kwa mayeso a chiwindi - AST ndi ALT. Amamasulidwa ku chiwindi pamene maselo akuwonongedwa. Kutsimikiza kwa kuchuluka kwa bilirubin kumasonyeza kuopsa kwa chiwonongeko cha erythrocyte.
• Kuthamanga kwa mafupa. Kusanthulako kumatengedwa ndi singano, yomwe imayikidwa mu khungu, kulowa mu periosteum. Njirayi ikuwonetsa maonekedwe a maselo a hematopoietic mu fupa. Phunziroli likuwonetsa chiwerengero cha maselo mumphongo, kukhalapo kwa maselo a kansa ndi fibrosis (kuchulukitsa kwa minofu yogwirizana).
• Ndili ndi matenda a "erythremia" omwe amapanganso ma laboratory ndi ultrasound ya m'mimba. Ultrasound ikhoza kuzindikira kuti ziwalo zowonjezera magazi, kukulitsa chiwindi ndi nthata, komanso foci ya fibrosis.
• Dopplerography imasonyeza kuuluka kwa magazi ndikuthandizira kuzindikira kutuluka kwa magazi.

Kuchiza kwa erythremia

Tiyenera kukumbukira kuti erythremia nthawi zambiri imayenda pang'onopang'ono ndipo imakhala yopanda ulemu. Poyamba, madokotala amalangiza kusintha njira ya moyo - kukhala kunja, kuyenda, kulandira malingaliro abwino (endorphinrapy nthawi zina zimapangitsa zotsatira zodabwitsa). Mitengo yomwe ili ndi kuchuluka kwa chitsulo ndi vitamini C iyenera kusatulutsidwa.

Pa gawo loyambirira la matendawa, cholinga chachikulu cha matenda a "erythremia" ndiko kuchepetsedwa kwa magazi m'magazi: hemoglobin 150-160, ndi hematocrit 45-46. Ndikofunika kuthetsa mavuto omwe amabwera chifukwa cha matendawa - matenda ozungulira, kupweteka ndi zala, ndi zina zotero.

Sakanizani hematocrit ndi hemoglobini kumathandiza magazi, omwe agwiritsidwa ntchito mpaka lero. Komabe, ndondomekoyi imachitika ngati gawo la chisamaliro chadzidzidzi, chifukwa chimayambitsa mafupa ndi ntchito ya thrombopoiesis. Palinso ndondomeko yotchedwa erythrocytapresis, yomwe imaphatikizapo kuyeretsa magazi ku maselo ofiira a magazi. Panopa, magazi a m'magazi amakhalabe.

Mankhwala

Cytostatics ndizokonzekera zachilengedwe, zomwe zimagwiritsidwa ntchito pa zovuta za erythremia - zilonda, thrombosis, matenda ozungulira ubongo omwe amapezeka pachigawo chachiwiri cha matendawa. "Myelosan", "Busulfan", hydroxyurea, "Imifos", phosphorous radioactive. Zomalizazi zimatengedwa kuti ndizothandiza chifukwa chakuti zimaphatikizapo mafupa ndipo zimapweteka ntchito ya ubongo.

Glucocorticosteroids amalembedwa kuti magazi azikhala ndi magazi m'thupi. Makamaka otchuka ndi Prednisolone. Ngati mankhwalawa sapereka zotsatira zoyenera, opaleshoni ikulimbikitsidwa kuchotsa mphala.

Pofuna kupewa kutayika kwa chitsulo, kukonzekera zitsulo - "Hemofer", "Totema", "Sorbifer" ingalembedwe.

Komanso, ngati n'koyenera, magulu awa a mankhwalawa amalembedwa:

1. Antihistamines.
2. Kuchepetsa kuthamanga kwa magazi.
3. Anticoagulants (magazi ochepa).
4. Hepatoprotectors.

Erythema, omwe amachiritsidwa kuchipatala, ndi matenda aakulu omwe amachititsa mavuto ambiri. Ndikofunika kuzindikira kuti mwamsanga ndikuyamba mankhwala.