Necrolysis epidermal toxic: zviratidzo, zvinokonzera, mifananidzo

Zvirwere zvakaoma zvehutachiona, izvo zvinogona kutyisidzira upenyu, hazvisi zvakajairika. Zvisinei, ivo. Imwe yeiyi necrolysis epidermal toxic. Ichi chirwere chisingawanzo chirwere cheganda chinogona kutungamirira kurufu.

Chii chinorwara?

Necrolysis epidermal toxic chirwere chakakomba chinokonzerwa nehutachiona, chigumisiro chekudhonza kwechikamu chepamusoro peganda. Anobva afa, uye muviri unenge wava kudhakwa. Pasina kukodzera kurapwa, munhu angawana chirwere uye kufa.

Kuchinja kusina kufadza uye rufu hazvirevi chete ganda, asiwo mucous membrane. Chirwere ichi chinonyanyisa. Ichokwadi ndechokuti kunyange mukati memukati mutsvuku inogona kuchinjwa , iyo inowanzoita kuti kuve nekubuda ropa, kusagadzikana kwemabasa ekufema uye mamwe matambudziko emuviri.

Kazhinji inowedzera necrolysis epidermal inotyisa mushure mekushandiswa kwemimwe mishonga. Zvisinei, pangave nezvimwe zvikonzero. Kuonekwa uye chikwata chechirwere chacho hazvikwanisi kufanotaura.

Zvinokonzera kukura

Chikonzero chinonyanya kukosha chekugadzirwa kwehutano ndiko kudya kwemarudzi mamwe emishonga:

• Sulfonamides.
• Macrolides: "Erythromycin."
• Penicillin preparations.
• Anticonvulsant: "Lamotrigine", "Carbamazepine", "Phenobarbital."
• Quinolones: "Trovafloxacin."
• Anti-inflammatory nonsteroid drugs: Indomethacin, Ibuprofen, Piroxicam.

Nhamba yezvikwata ichiderera zvikuru uye inowanzova 1 kero pa1 000 000 vanhu pagore. Vakadzi vanowanzotambura. Zera rinotarisirwawo, sezvo maitiro akawanda ekubudirira kwezvirwere anoonekwa pashure pemakore 55.

Mukuwedzera pakutora mishonga, chinokonzera necrolysis chinogona kuva nehutachiwana nehutachiona hwetachipenlococcal.

Zviratidzo zvechirwere

Necrolysis ye epidermal toxic inokura zvakakurumidza. Kana pane chirwere, muviri wechirwere chekuzvidzivirira haugoni kuziva nekuregeredza chinhu chinotyisa, kwatiri, chirwere. Izvo zvinokonzera kugadzirisa zvinosimba zvakanyanya.

Panguva imwecheteyo, hutachiona hunoparadza ganda, nokuti rinovaona sechiri kunze kwemuviri. Panguva imwecheteyo, mutemo wekuparadzana kweprotheni yezvinhu inopwanyika. Mukati peganda rinotanga kuunganidza hupfu, izvo zvinotungamirira kudhakwa kwemuviri. Kana iwe usingatangi chirwere panguva, munhu wacho achafa.

Mhando uye nzvimbo

Dhiyabhorosi epidermal necrolysis (zviratidzo zvehutano zvatatofunga nezvazvo) zvinogona kuiswa sezvizvi:

1. Idiopathic. Izvo zvinoitika payo, uye chikonzero chayo chisingasimbiswi.
2. Inokonzerwa nekukanganisa kwemimwe mishonga.
3. Yakasununguka pasi pesimba re staphylococcal. Urwu hutano hwehutano hunoonekwa hukuru kune vana. Panguva imwecheteyo, kukanganisa kwehupenyu hunouraya hakubvumi.
4. Yakabatanidzwa nedzimwe zvirwere.

Zvipembenene zvinogona kuwanikwa munzvimbo dzakadaro: matope, mapepa, chifuva, mimba uye kumashure, mucous membrane yemuromo.

Symptomatology yechirwere

Dambudziko repidermal necrolysis (Lyell's syndrome) rinowanzozivikanwa nezviratidzo zvakadaro:

• Kukanganisa kwakawanda kwemuviri, kunozviratidza mukurasikirwa kwechido, misoro yepamusoro, kuwedzera kwekushisa kwepasi. Chiratidzo chinowanzoitika chechirwere chinowedzera nyota.
• Marwadzo uye kusagadzikana mukati memakumbo. Panguva imwecheteyo, kunzwa kwavo kunowedzera. Somuenzaniso, kana uchidya uchimedza, murwere anonzwa kurwadziwa.
• Kuonekwa kwemavara matsvuku, mashes uye mablisters paganda uye mucous membrane. Muzviitiko zvakawanda, anenge 30% yemuviri inotambudzwa, kunyange zvazvo chiyero ichi chinogona kunge chakakura zvikuru.
• Kutarisa kwepidermis. Muchiitiko ichi, ganda rinotanga kukanganiswa kunyange nekunzwa kusina simba. Kana nzvimbo yakakanganiswa yeganda ichibviswa, ronda ropa rinooneka pasi payo.
• Renal insufficiency.
• Zvirwere zvinotapukira. Ichokwadi kuti ganda harigoni kushanda zvakanaka uye rinodzivirira munhu kubva pamigumisiro yezvipembenene zvepathogenic. Mamiriro ezvinhu angaguma nekuita sepsis.
• Muchikamu chekupedzisira kwehutachiona, kupera mvura, tachycardia, uyewo hypotension inogona kuonekwa.
• Pain mumisungo.
• Fever uye chifukidziro.
• Anorexia.
• Nausea uye kurutsa.

Izvo zvinofanira kuonekwa kuti zvipembenene zvemukati mutsara zvinoratidzika pachavo nekukurumidza kudarika zvinetso zveganda. Kana pazvikamu zvekutanga zvehutachiona epidermal necrolysis, uyo mufananidzo wacho hausi wekushaya simba kwemoyo, hauna kuoneka pachena, zvino inogona kuonekwa zvakanaka kwazvo mushure mekunge.

Zviratidzo Zvokuona

Kana iwe unokonzera chepidermal necrolysis, ipapo unoda kuona chiremba pakarepo. Anofanirwa kutungamirira kusiyanisa uye kunyatsoongorora, izvo zvinosanganisira:

1. Kugadziriswa kwekunyunyuta kwemunhu akabatwa. Kucherechedza kunokweverwa kumakumbo ose, kurwadziwa.
2. Kuunganidza anamnesis omurwere. Icho chikonzero, chiremba anofanira kuziva kana ane chirwere chipi nechipi chakakonzera kukura kwekusangana kwakanyanya kwakadaro. Izvo zvinodikanwa kuziva kana kune matambudziko akafanana mumhuri dzomurwere.
3. Kuongorora kunze kwemu murwere. Muchiitiko ichi, dermatologist inotarisa kumumvuri weganda, kuvapo kweharura uye blisters pane mucous membrane. Murwere anogona kuita maererano neicho chakakomberedzwa kwete chakanaka.
4. Kuongorora kweropa rose. Ichapa mukana wekutarisisa kana uwandu hweeukocytes huwedzerwa, kana kune masero asina ropa, kusimba kwe erythrocyte sedimentation. Kana izvi zviyero zvinopfuura kudarika, saka mamiriro acho ezvinhu anoratidza kuvapo kwekuvhiringidza.
5. Kuongorora ropa kunonzi biochemical. Kana chigumisiro chiri chikwata chakawedzera chebilirubin kana kuti puroteni shoma shoma, murwere angave ane zvinetso nemishonga inoshanda.
6. Kuongororwa kwemuti kune huwandu. Ichi chidzidzo chinodikanwawo kuti chione kushanda kwetsvo. Kana pane ropa mumuguta, zvino dambudziko nderokuwanda kwenyika yose.
7. Chiyero chemuitiro wemwoyo, ropa rekuisa zviratidzo.

Kuongororwa kunobatanidzwawo kuitira kusiyanisa chepidermal necrolysis kubva kune dzimwe zvirwere: pemphigus, scarlet fever, erythema, bullous impetigo, red flat lichen.

Zvikamu zvekurapa

Chirwere chinoratidzwa chinofanira kunge chichifanira kubatwa. Kana zvisina kudaro, murwere anokwanisa kumirira sepsis uye rufu. Kana murwere aine zviratidzo zvinoratidzwa pamusoro apa, zvino zvinofanira kukurumidza kuendeswa kuchipatara. Kana chirwere chechirwere ichi chakakomba, uyo anenge atambudzwa akaiswa muimba huru yekuchengetedza, uko vanamukoti vanogona kumubatsira.

Iwadi iyo iyo murwere anowira ichava yakaora, iyo inenge isingabatanidzi mukana wokubatana nedzimwe zvirwere. Kurapwa kwehutano kunosanganisira kubviswa kwechikonzero chakakonzera chirwere chacho.

Nezvokurapa zvinodhaka, corticosteroids uye antihistamine zvichauya pakununura. Mukuwedzera, kupirisa kwekodzero kunofanira kurongeka . Antibiotics inogona kushandiswa chete kana murwere ane utachiona hwechipiri.

Dambudziko repidermal necrolysis (zvinodaro, iwe unenge uchiziva) rinofanirawo kurapwa nemishonga yemunharaunda iyo inobatsira kudzorerazve kugadzirwa patsva kweganda: anesthetics (anesthetics), marashi, antiseptics.

Mukuwedzera, iwe unofanirwa kuomerera kune yakadaro mitemo yerapiyo:

1. Inofanira kunge yakakurumidza sezvinobvira kushambidza muviri wezvinodhaka zvinotorwa. Nokuda kweizvi, inemas inoshandiswa.
2. Izvo zvinodikanwa kutora zvinodhaka zvinobatsira kudzorera zvakakwana mvura-munyu unyanzvi, semuenzaniso, "Regidron."
3. Chiremba achapa mishonga yekudzivirira chiropa, kunyanya "Gepabene".
4. Kunyanya kwezvinhu zvinoderedza huwandu hwekuvhara ropa.

Ndezvipi zvinetso zvinogona kuonekwa?

Kana wakawana chirwere chepidermal necrolysis, zvinetso zvinogona kuva:

• Kukura kwehutachiona hunokonzera bhakitiriya.
• Kusuruvara kwemhepo kwakanyanya, izvo zvinogona kukonzera kufa kwemurwere.
• Kurasikirwa kwehuwandu hweganda. Kana munhu achirasika zvinopfuura hafu ye epidermis, zvirokwazvo ndiye kufa.
• Kuchema kweganda, kuonekwa kwezviyo pairi, kuchinja kwemavara.
• Kudengenyeka kwekusingaperi kwemukasi membrane.

Forecast

Kana kurapwa kwehutachiona kusati kwatangwa panguva, ipapo kufa kwehutano kunogona kusvika 70%. Kurasikirwa kwechikamu chikuru cheganda kuchaita kuti murwere anzwewo zvirwere zvakasiyana-siyana.

Kutanga kwenguva yakareba kurapwa hakubatsiri chete kubvisa chirwere chacho, asiwo kudzivisa zvinetso zvakashata zvakadai sekubuda ropa mukati, kukanganisa kwerudzi rwemagetsi, kusakwanisa kuona chikafu, hosha uye chiropa kusakundikana.

Zvinofanira kuonekwa kuti vana vanorwara nechirwere ichi zvishoma kudarika vanhu vakuru. Kana murwere akayambuka muganhu wemakore makumi matanhatu, ipapo kufungidzira kwake kunogumbura. Zvisinei, kurapa kwakakodzera kunogona kuvandudza mamiriro ake.

Kudzivirira kwehutano

Rimwe zita rehutachiona huno, sehutachiona epidermal necrolysis, ndiRyell's syndrome. Mufananidzo wechirwere ichi zviri nani kuti usatarise vanhu vanoyeka. Ichi chirwere chakaoma chinogona kudziviswa kana iwe ukatevera matanho ekudzivirira:

• Mishonga inofanirwa kutorwa chete kana inorayirwa nachiremba.
• Nyanzvi inofanirwa kuziva kana iwe unenge uine matanho evanhu.
• Chero chero hutachiona hwaunacho, usatora mishonga inopfuura 7 panguva imwe.
• Usazviti-mishonga staphylococcal uye inopisa zvirwere zveganda.
• Dzivisa kushamwaridzana nechinhu chipi nechipi chinogumbura chinogona kukonzera kurwara.

Nezvekurapa, zvinhu zvose zvinoenderana nemamiriro ehupenyu uye murwere ane chido chekurwisa kupesana. Iva noutano!