Matenda Takayasu akuti: Zizindikiro ndi Chithandizo

M'zaka zaposachedwapa, anthu kwathunthu ndikusinthidwa mzimu wake kwa mitundu yosiyanasiyana ya matenda. Anthu ambiri masiku ano amakonda moyo wathanzi, yesani kudya bwino, kusunthira kutali zizoloŵezi zoipa. kukhwimitsa kutumikira monga kupewa matenda ambiri. Mwatsoka, ngakhale yolondola ya moyo si 100% chitsimikizo kuti munthu sichitipeza ndi ichi kapena matenda.

zambiri

matenda Takayasu a - ichi ndithu kutupa kwambiri zachilengedwe aakulu, zomwe chikondwerero ziwiya lalikulu magazi. ntchito yawo yaikulu ndi kusamutsa magazi kuchokera mumtima. Kumene, wonongeka thupi amakhudza thupi lonse. Apo ayi, matenda amenewa amatchedwa matenda pulseless, syndrome Takayasu kapena nonspecific aortoarteritis.

Ndi kupata kutupa kwa msempha ndi nthambi zake pang'onopang'ono kuonongeka mkati pamwamba pa zotengera okha. Motero, pali thickening a chipolopolo chapakati. Pali kukokoloka pakati yosalala wosanjikiza minofu. The lumen wa sequentially msempha kuoneka granuloma, wopangidwa makamaka maselo chiphona. Zonsezi zimachititsa chifukwa protrusion ndi kukula kwa magazi chotengera yokha, musayambe aneurysm. Mu nkhani ya kupitilira zina matendawa kufa otchedwa ulusi zotanuka. Chifukwa, pang'onopang'ono kusokonezedwa magazi zimenezi zingabweretse ischemia ziwalo ndipo zimakhala. Kenako pa makoma kuonongeka anapanga microthrombuses ndi mipukutuyi atherosclerotic.

matenda Takayasu a makamaka matenda atsikana ndi akazi a zaka kuyambira azaka 15 mpaka 25. Mu mankhwala, imatchedwanso nthawi ya matenda odwala wamwamuna.

Zizindikiro zoyambirira zimakhala zaka zapakati pa zaka 8-12. Nkofunika kukumbukira kuti matenda imafalira makamaka America South ndi kum'mwera chakum'mawa kwa Asia, koma milandu syndrome Takayasu masiku ano opezeka mu zigawo zambiri zakutali.

A mbiri pang'ono

Mu 1908, ndi maso pa Dziko la Kutuluka Sun M. Takayasu anafotokoza kusintha pathological mu diso wapezeka pa kuona yotsatira ya mtsikana. Mu chaka chomwecho, akatswiri ena ku Japan inati mapindikidwe ofanana wa fundus kwa odwala awo, kuti pamodzi ndi kusowa otchedwa pulsation a mtsempha wamagazi ndi zozungulira. N'zochititsa chidwi kuti mawu akuti "matenda Takayasu," iye anayamba kugwiritsidwa ntchito mwakhama mankhwala okha mu 1952.

The zifukwa

The etiologic wothandizila matendawa panopa osadziwika. Akatswiri amanena kuti matenda ndi onse matenda odziwika streptococcal, Chikukambidwa udindo wa mycobacterium TB.

Masiku ano, asayansi amakhulupirira kuti chofunika apamwamba mu mapangidwe matenda autoimmune ndi vutoli a chitetezo chokwanira otchedwa selo nkhoswe. N'zochititsa chidwi kuti mwazi wa odwala, kawirikawiri amalembedwa kuchuluka kwa CD4 + T-lymphocytes ndi kuchepetsa CD8 + T-lymphocytes. Komanso, akatswiri oterewa kukula kwa chiwerengero cha kufalitsidwa maofesi m'thupi, kuchuluka ntchito elastase ndi cathepsin G. wapadera

Monga wachinsinsi nonspecific aortoarteriit?

Takayasu matenda, zochokera thunthu la chotupa cha, salembedwa ogaŵikana mitundu yambiri.

1. Yoyamba. Itamva kung'ambika Chipilala ndi nthambi zonse anakafika ku izo.
2. Mtundu wachiwiri. Anakhudzidwa ndi msempha m'mimba ndi thoracic.
3. Mtundu wachitatu. Itamva kung'ambika Chipilala pamodzi thoracic ndi m'mimba.
4. Yachinayi. Matendawa ikukhudza mtsempha wamagazi m'mapapo mwanga.

zizindikiro

Choyamba, odwala kuyamba kudandaula maonekedwe a ululu manja, kufooka, kusapeza mu chifuwa ndi khosi. Motero, pali symptomatology khalidwe la matenda a ubongo. Mwachitsanzo, anabalalika tcheru, utachepa ntchito, mavuto kukumbukira.

Ngati matenda amagwirizana ndi mitsempha chamawonedwe, odwala aona kuchepa kwambiri masomphenya kapena khungu (zambiri diso okha imodzi).

Chifukwa kusintha pathological ziwiya khalidwe wolumikizira osauka otchedwa kung'ambika insufficiency. vuto umenewu umatipatsa infarction m'mnyewa wamtima ndi matenda mu makope inatsekeratu.

Ndi kusintha zazing'ono mwachindunji mu m'mimba otaya msempha magazi chatsitsa kwambiri mu miyendo poyenda, odwala kuona ululu komanso ululu.

Pamene aimpso mtsempha wamagazi zotupa mu mkodzo pa phunziro lotsatira anapeza erythrocytes. Mtsogolo, izo ndi mkulu Mwina kukhala thrombosis a mtsempha wamagazi ndi aimpso.

Pankhani ya okhudzidwa mu yotupa ndondomeko ya mtsempha wamagazi ndi m'mapapo mwanga, wodwalayo kufupika kwa mpweya, kupweteka pachifuwa.

Mankhwala lero ndi magawo awiri a matenda: pachimake ndi aakulu. Nkofunika kudziwa kuti yekha dokotala amatha molondola kudziwa Baibulo panopa matendawa. Zizindikiro matenda a mtundu pachimake kungakhale atypical, kotero mu matenda yake ndi lolondola kungakhale kovuta kwambiri. Chinthu ndi mawonetseredwe omwewo zitheka osati ndi matenda monga matenda Takayasu a.

Zizindikiro za nthawi pachimake:

• kuwonda;
• thukuta;
• pang'ono kuwonjezeka thupi kutentha;
• kutopa;
• zowawa enaake ophwanya mu malo.

Matenda gawo zambiri akufotokozera mwa zaka 6 kuchokera pa chiyambi cha matenda. Iwo amakhala ndi zizindikiro zosiyanasiyana matenda.

matenda Takayasu ndi kumaonekera mwa mawonekedwe a mutu pafupipafupi, kuyenda mkhutu, kusapeza m'kupita kwa mfundo yaikulu, aakulu minofu kufooka.

diagnostics

Tsimikizani pamaso pa matenda yekha woyenera ngati wodwalayo osachepera atatu zizindikiro zotsatirazi:

• mofulumira wa zimachitika mu dzanja;
• zaka zaka 40;
• pakati magazi pa chapamwamba miyendo kusiyana ndi osachepera 10 mm Hg. Article.
• phokoso mwa msempha;
• kulimbikira kuwonjezeka magazi;
• chosunga kuwonjezeka mu ESR.

Onse zizindikiro zakumwamba zambiri amasonyeza matenda Takayasu a. Zizindikiro akhoza mosiyana mosiyana pa nkhani iliyonse payekha.

Nkofunika kudziwa kuti dokotala ayenera adzaika zina mosamala thupi la wodwalayo. Amatanthauza ndi amuzolengedwa / ndondomeko ya malamulo, amene amalola kudziwa kupatuka pang'ono mwakale, ankaikira matenda. Ziyeneranso angiography ndi kusiyana jekeseni. Ichi ndi wapadera X-ray Kupenda ziwiya, ndi kulola kudziwa malo kuchepetsa wa mitsempha ya. Echocardiography amapereka mwayi kuti aone mtima ntchito. Ofunika ziwiya ultrasound. Kudzera ultrasound dokotala afika chithunzi thunzi chokwanira cha mkhalidwe wa ziwiya inatsekeratu ndi mathamangidwe magazi. Onse njira pamwamba matenda a kafukufuku kulola kuti atsimikizire kuli mavuto monga aortoarteriit Takayasu.

Kodi mankhwala ayenera?

Ngati ife kuganizira mfundo yakuti matenda m'kati makamaka pa unyamata, mankhwala kungakhale kovuta kwambiri. Ndithudi pamafunika woyenera kwathunthu njira ndi kutsatira malamulo a kupewa. Mu makamaka milandu yovuta kungafune mwamsanga alowererepo pa opaleshoni.

Takayasu chithandizo zikutanthauza ntchito ya medicaments. Pakuti olimba a wolumikizira kuthamanga, ambiri anawatumiza B-blockers ndi otchedwa blockers kashiamu njira. Kuthetseratu kuthekera kwa magazi kuundana odwala amalangiza kuti anticoagulants (kutanthauza "heparin" ndi ena). The mankhwala a matenda mulinso ntchito corticosteroids ndi mankhwala vasodilator (mankhwala "prednisolone" ndipo m. P.). Nkofunika kudziwa kuti lomaliza zayamba kuchepetsa ayankhe autoimmune ndi thupi.

Kodi mungachite kuthetsa matenda Takayasu chiyani? Kuchiza matenda ndi wotheka kudzera mwa otchedwa extracorporeal kudzudzulidwa magazi. Izi ndi njira zosavuta kwambiri. Amatanthauza kusankha wapadera zigawo zikuluzikulu pathological magazi mwachindunji ndi zoyambitsa matenda. Pokonza zinthu izi zichitika kunja kwa thupi la wodwalayo.

chithandizo opaleshoni

Malinga ndi akatswiri, mankhwala ndiwofatsa Sizotheka kugonjetsa arteritis Takayasu a. Zizindikiro amalowerera kusiya kwa kanthawi. Kumene, kukhwimitsa kosakwanira, posakhalitsa akhoza kubwera ndi kumwa. N'chifukwa chake nthawi zina, madokotala mwamphamvu amalangiza opaleshoni yomwe kwathunthu imatsitsimula patency bedi mtima.

The zikuonetsa chachikulu opaleshoni:

• oopsa pa maziko a syndrome renovascular;
• kutsekeka kwa msempha;
• chiopsezo ischemia mtima.

Ngati ife kulankhula za unapangitsa popanga munthu opaleshoni, iwo nthawi zambiri umaimiridwa ndi resection wa gawo pathological wa msempha, mtima kulambalala ndi endarterectomy. Pamene njira oyenerera, wodwalayo nthawi kuyiwala za chiyani arteritis Takayasu a.

kupewa

kudwala iliyonse, monga ife tikudziwira, angathe kupewedwa, ndipo matenda anali nazonso. zodzitetezera zikutanthauza ndi chithandizo mwamsanga matenda opatsirana ndi uthunthu tizilombo (pharyngitis, zilonda zapakhosi, pyelonephritis ndi T. D.). Malinga ndi akatswiri, matenda awa aakulu wayamba maziko nyengo chitukuko cha matenda Takayasu kotero odwala ali pa chiopsezo.

Nkofunikira kulimbikitsa chitetezo cha m'thupi mwa chaka. Chifukwa chaichi, akatswiri amalangiza kuti ndi maofesi multivitamin, kudya bwino, kuchita masewera olimbitsa thupi.

kaonedwe

Mokwanira yake chithandizo kwambiri amachepetsa chiopsezo cha imfa. Komanso, 90% odwala woyenera mankhwala prolongs moyo ndi pafupifupi 15 zaka.

Koma mavuto nthawi zambiri chifukwa chachikulu ndi imfa cerebrovascular ngozi (50%) ndi m'mnyewa wamtima infarction (25%).

Pomaliza

Odwala amene anapezeka ndi arteritis Takayasu a, ayenera kudziwa kuti vuto limeneli kumafuna nthawi yaitali mankhwala ndi mwambo okhwima onse malangizo dokotala. Apo ayi, angapo zosavuta matenda a mtima.

Pofuna kukhala mankhwala yabwino kwambiri, odwala onse popanda yekha, nthawi zonse tiyenera kukumana Kupenda mankhwala ndi kutenga nkhani zovuta.

Mwatsoka, kuchotsa matenda sizingatheke. Komabe, kugwiritsa ntchito mankhwala amalola kusamutsa matenda ku chikhululukiro, amene amalola odwala kukhala ndi moyo wabwinobwino, popanda akukumana ululu komanso kuganizira n'komwe za vuto monga matenda Takayasu a. Photo odwala bwino kutsimikizira mfundo imeneyi.

kwakukulukulu mankhwala bwino zimatengera ntchito za ndondomeko pathological ndi kukhalapo matendawo. Komanso, kale adzakhala molondola matenda, kuti madokotala ananena zawo ndi chidaliro. Ngati inu mukukhulupirira akatswiri, nkhondo yolimbana ndi matenda zimenezi ndi ndikofunikira.