Rheumatism ari mwana: zviratidzo, kurapwa, dziviriro

Munyaya ino tichakurukura muudzame sei mwana akaratidza rheumatism. Zviratidzo marudzi, kunyanya mishonga, chirwere uye kudzivirira - ndivo vanonyanya nyaya dzichakurukurwa.

Pakarepo vaswedere kwako pfungwa yokuti rheumatism anogona kuva chero zera zvachose. The chirwere rwarisa uye sema hunhu. A-siyana kunotoda kurapwa kuratidzwa nokuti chokuti rheumatism inobata munhu chaiyo muviri, uye connective zvinyama kuti aripo mumiviri yevanhu. Funga zviratidzo rheumatic nefivhiri muvana.

Chii?

Tinotanga nyaya yedu pfungwa "rheumatism". Chii chinonzi chirwere ichi? Saka akadana anogumbura chirwere kunokanganisa muviri wose panguva iyoyo (i.e., ndiwo maitiro). Mabviro rheumatic fivha - ane chirwere-sema. Ane rimwe zita: Sokolowski chirwere-Buyo.

It kunoratidzwa maronda ose connective tishu chirwere. Ainyanya zvakakanganisa connective nyama pamusoro zvemwoyo uye nechepakati tsinga. Kune Statistical mashoko, izvo zvinoratidza kuti vakadzi vakawanda kazhinji vanotambura nechirwere ichi - katatu kupfuura varume. Zvisinei, kusiyana uku haazombotaurwi vakura.

Ndezvipi zvinhu rheumatic nefivhiri muvana? Zviratidzo uye kurapwa zvirwere pauduku duku yakasiyana. Izvi imhaka yokuti vana rheumatism ane zvimwe peculiarities, yakadai se:

• zvikuru raidudzwa kwokuomerwa kumwoyo;
• kuchinja dzimwe gadziriro uye nhengo;
• tinogona kuchinja mune chirwere chimiro chirwere (chikamu ndingangokuvara pauduku chaizvo);
• panowanikwa zvazvo.

The chirwere chimiro anoratidzwa sezvinotevera: pashure kurapa pane wakaderera nguva, asi pashure penguva yakati dambudziko anodzoka. Zvinokosha kucherechedza kuti dzokororo ine rheumatic nefivhiri vari kuchengetwa vana kwakajairika chaizvo.

Zviratidzo rheumatic nefivhiri muvana 2 years kana 10 regai kwakasiyana nepedyo. Tapota cherechedza kuti vana vari kubatwa nezvirwere kubva manomwe nemashanu. Vana rheumatism inotarisana nhamba yematambudziko, kusanganisira mwoyo nokukundikana uye. Rheumatism kazhinji anotanga kuva pashure chirwere. Izvi zvinosanganisira rutsvuku fivha, kwazvo huro uye zvichingodaro.

Kakawanda pfungwa dzakaonekwa mu kumwoyo. Rheumatic fivha kwakajairika pose, kunyanya munyika murombo, apo dziine chirwere yakakwirira kwazvo.

Tinotora tikanyatsoongorora zviratidzo uye zvokuongorora chirwere ari muduku, asi ikozvino ndinoda nezvesimba Jones zvinodiwa. Zvakakosha kuziva kuti iye kusiyanisa zvikuru nezviduku zvinodiwa. Kana paine chinenge chiri muchikwata yokutanga, zviri zvakakwana rokuongorora chirwere.

More zvinodiwa	kuduku zvinodiwa
Carditis (kuchengetwa 70% nyaya), polyarthritis (75%), erythema (10%), chorea (10%), paumbwe subcutaneous nodules (20%).	Nefivha, arthralgia, rheumatism anemneze, vakawedzera ESR kana CRP.

zviratidzo

We funga zvino zvakadzama zviratidzo rheumatic nefivhiri muvana. Sezvambotaurwa, rheumatism anogona kuparadza connective zvinyama mune vakawanda nhengo. Izvi zvinogona kutsanangura vakawanda kuratidzwa siyana pamusoro chirwere. Zvose zvinoenderana muchimiro nekuomarara kwacho.

Utachiona hwakakura rheumatism kunomutsa kugadzirwa imwe pfuma inonzi C-reactive mapuroteni. Ndiye anoita kuzvimba uye kuparadzwa connective tishu. Zvakare, tapota cherechedza kuti rheumatic fivha asimo pasina. Muitiro okukura rinotanga pashure chirwere. Total dzinounzwa mhando nhatu chirwere, tichataura pamusoro pavo papera. The chikuru chinoratidza rheumatic fivha - kusachengeteka kukuru Pazvinotanga. Zviratidzo zvinosanganisira:

• rakapinza kuwedzera tembiricha muviri;
• zvakakomba simba;
• Kuipa utano.

Zvino zvakafanana kutanga zviratidzo vakaverengwa. In vana vaduku (2 years) zviratidzo rheumatic fivha inogona kuva:

• kugumbuka;
• tearfulness;
• Matambudziko Okurara, uye zvichingodaro.

Next kwavari achava zvishoma nezvishoma tuhova zviratidzo izvo zvaizobatsira rudzi rheumatism. Rheumatic fivha muvana, zviratidzo uye kurapwa yatiri funga munyaya, kungazviratidza nenzira dzakasiyana, asi vanenge 85% nyaya, hosha vanotyisidzira mwoyo matambudziko.

kupatsanura

In zvachose pane vatatu siyana chirwere:

• articular;
• mwoyo;
• huta.

We hunonyatsodonongodza pamusoro pavo papera chinguva.

Zvinokosha kucherechedza kuti zviratidzo streptococcal rheumatic nefivhiri muvana kwaunoita. The chirwere nguva dzose ane migumisiro muchimiro yematambudziko kana rheumatism anova chisingaperi.

Zviratidzo rheumatic nefivhiri muvana makore 10 uye muduku vari zvachose indistinguishable. An ruzivo nyanzvi inogona kuziva chirwere chero rwakazara nyore.

Rheumatic fivha ane maitikiro maviri:

• vanoshingaira;
• vakaneta.

Ndezvipi zvinodiwa kuti basa chirwere? Idzi dzinosanganisira:

• kwokuomerwa ari kuratidzwa;
• kuchinja murabhoritari zvezvinangwa.

Kubva musi uyu, pane madhigirii matatu rheumatism. Ivo dzaitaurwa tafura pazasi.

chokutanga dhigirii	pasipasi Activity	Panguva iyi, munyoro kwazvo kurapwa uye mumarabhoritari zviratidzo.
rechipiri dhigirii	mwero basa	Second dhigirii streptococcal rheumatic fivha nevana, zviratidzo izvo kare akaratidza zvakajeka, zviri nyore chirwere. Izvi imhaka yokuti kurapwa, radiological uye zvimwe zviratidzo zviri kare kuoneka.
dhigirii rechitatu	Maximum basa	Mamirire zvinhu vari: fivha, rheumatic mwoyo chirwere zviratidzo, articular urwere, pakarepo kuchinja murabhoritari parameters uye zvichingodaro.

articular chimiro

Chitarisa zviratidzo rheumatism ari mwana pamwe chimiro. Ngatitange nemusoro shoma Statistical mashoko. Vacheche kashoma kuwira muchikwata ichi. Vanenge 20% dzinonzi rheumatoid arthritis rinowanika pakati pemakore mumwe namakore mashanu; uye vanenge 80% - kubva gumi kusvika gumi apfuura.

Zviratidzo rheumatic majoini vana vanogona unooneka sezvinotevera:

• fivhiri;
• simba;
• nomusoro;
• kurwadza kwemajoini;
• akatsvuka uye mumatenhere mapfundo zvichingodaro.

Pasinei chokwadi kuti nyaya izhinji, nayo utachiona richiri haana kutsunga. Pasina mubvunzo, rheumatism iri chirwere zvakasikwa. chirwere ichi chinobata yakawanda node nodes riri nasopharynx. Zvirwere chokuita kare munhoroondo angina, mazino, kuzvimba.

Zvinokosha kucherechedza kuti pane zvakawanda dzidziso chirwere. Articular rheumatism muvana, zviratidzo uye kurapwa yatiri munyaya ino ndiyo mafungiro evoruzhinji, chinhu rwarisa-sema hunhu. Ichi ndicho dzidziso. Kana ukaramba pfungwa iyi rheumatism - migumisiro neutachiona muvanhu. Nokuda kupinda sero metabolic zvibereko utachiona vari incubation nguva kunoitika reconfiguration muviri. Streptococci mune iyi inogona kukonzera yekunwa zviratidzo rheumatism.

Takatodzidza kutaurwa kuti mhaka rheumatism rinowanzoshandiswa Kutamiswa pamberi chero zvirwere (akadai tsvuku fivhiri). Zvisinei, dzimwe mienzaniso anogona kupiwa:

• hypothermia;
• overexertion.

Vakawanda zviratidzo anoratidza kuti chikamu CNS (nechepakati tsinga) kwacho. Zviratidzo izvi zvinosanganisira:

• chorea;
• motokari mabongozozo;
• mupfungwa kurwara;
• zvirwere tsinga, uye zvichingodaro.

Zvakakosha kuziva kuti vose zvirwere izvi kazhinji achiperekedzwa rheumatism. Ongororo dzinoratidza kuti reactivity pakati cerebral cortex iri yekudyidzana ipfupi. Inogona kuziva unyanzvi Artisan pasina dambudziko. Nei izvi zvichiitika? Zvinonzi Kazhinji chokuita yakawedzerwa excitability pamusoro subcortical nzvimbo, iyo kunokanganisa muviri wose.

mwoyo chimiro

Zvino isu zvishoma kupa kutaura nezvemwoyo muchimiro rheumatism ari mwana, zviratidzo chirwere. Pakarepo vaswedere kwako pfungwa yokuti matambudziko mwoyo unogona kutanga panguva imwe chete chete articular chimiro rheumatism, uyewo kuonekwa zvishoma nezvishoma. Zvakakomba chimiro rheumatism kunoratidzwa ndechokuti cardiac nepfungwa zviratidzo anononoka chaizvo, kureva, chirwere hwapedyo kuzviona.

Pakuvamba takati kuti nevamwe chinhu rheumatism - pakarepo uye chisimba kurwisa. Kune unopinza nemarwadzo, uye zvichingodaro. Zvisinei, vamwe vana anganyunyuta nezvenyaya marwadzo majoini, kurukutika. Kunyange iyi, anogona kuva cardiac zvirwere. Kudzivisa migumisiro uye nokukurumidza kutanga kurapwa, enda zano nyanzvi, kunyange zvichemo zvakadaro.

Rheumatic mwoyo chirwere kuvana, zviratidzo uye kurapwa yatiri funga zvakanaka zvino, kunzi rheumatic mwoyo chirwere. The kwokutanga Danho iri rinenge haadi unooneka. Zviratidzo zvacho zvingasanganisira:

• nekuneta;
• kurambwa mitambo;
• kusada kumhanya;
• kupfupika mweya;
• mwoyo palpitations;
• ganda akacheneruka.

Zvakakomba chimiro achiperekedzwa tembiricha yakakwirira, kazhinji hapana madhigirii kupfuura makumi matatu namasere. The vakawanda nezvevakafa mwana panguva iyoyowo Zvinoipisisa daily.

Heart chimiro rheumatism kungaita kuti zvimwe nokuvhiringidzirwa mwoyo, dzaitaurwa tafura pazasi.

endocarditis	kutyora yomukati lining mwoyo
myocarditis	yechipiri
pericarditis	kunze
endopericarditis	zvose zvitatu

izvi zvose zvinotungamirira kukura chemwoyo, kureva, kushoma kufambira mberi kuti mavharuvhu. Zvakakosha kuziva kuti mangwanani kurapwa uye zvaidiwa ushandiswe zvaiitwa - ndiyo kiyi neramangwana rinofadza. Vana vakawanda vanotambura mwoyo kuremara, kurarama sezvinongoita (kuchikoro, akarembera neshamwari, kushanyira netsvimbo, uye zvichingodaro). Kana nyaya iri raparurwa, hosha anotora kwazvo chimiro, izvo kunokanganisa zvakanaka sezvinotevera:

• kuvapo kweropa zvirwere;
• nhengo bundu;
• zvakakomba kupfupika mweya;
• chiropa nedumbu.

Chimwe pachena chepfungwa chakakomba chimiro chirwere - serin'i mapundu pamusoro ganda. Kana zviratidzo kukurumidza kurapwa rokutanga! Panguva Chaiyo mharuro treatment - mukana dzose upenyu mwana, izvo hazvifaniri uchashayikwa.

huta chimiro

Muchikamu chino nyaya ticharamba kuteerera huta chimiro rheumatism muvana. Zviratidzo uye kurapwa zvirwere - Ndivo chikuru nyaya tichava kufukidza munyaya ino.

A pachena chepfungwa huta chimiro rheumatic nefivhiri muvana - chorea, kurasikirwa nedzimwe pfungwa kumatunhu. Chorea hwapedyo zvishoma nezvishoma, Zviratidzo zvingasanganisira:

• chinja manzwiro;
• kugumbuka;
• tearfulness;
• twitching kuti tsandanyama (ona kuti chiratidzo ichi anokwanisa mberi, uye vamwe vabereki vanofunga kuti mwana anoita chiso uye misikanzwa, kunyange tisingazivi mamiriro wechokwadi ezvinhu);
• kushaya chirango;
• kuregeredza;
• kuchinja manyorero;
• pakuonekwa kunokanganisika kutaura;
• flail gait.

Kana kushaya chirango uye kuregeredza, unofanira kugadzirawo zvimwe zvijeke. Kutaura zvazviri, mwana haisi mhosva. Here hazvigoni zvakarurama resi kumusoro majombo avo, kazhinji anosiya zvenyama, nezvirongo, matanga nezvimwe zvinhu. Nyatsoteerera nezviratidzo izvi. Vakawanda tinovhiringidza pamwe kuneta kana hanya. Kutaura zvazviri, mwana anoda rubatsiro wenyu. Zviratidzo izvi achaonekwa inenge mitatu. Kunyatsoteerera kuti maitiro uye mamiriro ezvinhu mwana, kuti arege kurasikirwa yakakodzera uye kutanga kurapwa nenguva.

Akanaka chirwere ichi: mwoyo kukundikana pamwe rheumatism huta fomu iri apo neapo. Kana tiri kupiwa chirwere kana kuomesa kwakaita kumwoyo, chirwere kunoitika nyore nyore. Kana ukaona vamwe kuchinja unhu mwana - kubata chiremba wako.

Zvino ngatitarise kubhadhara zvimwe nzeve hyperkinesia. Zviri chirwere kuti unouya pakakwirira chirwere. Munguva iyi, mumwe munhu nguva dzose inofamba (haangagoni kugara, mira kana pasi). Pane involuntary tsandanyama sunga kuti kuvhiringidza mwana ari kushandisa zvokudya (kuderedza tsandanyama rurimi, miromo, uye zvichingodaro). Ivo anoshandawo kune mamwe mapoka tsandanyama, zvinotevera zvingaratidza kuitika:

• zvachose kwepfumo;
• rurimi yakabudikira;
• grimacing.

Tapota cherechedza kuti pakurara zvose hyperkinetic zviratidzo apere. Kunze vose pamusoro zviratidzo angawanikwa ari kuongorora kunoderedza tsandanyama matauriro. No anokosha bvunzo zvinodiwa kwazvo siyana, sezvo inogona kuonekwa chinoabatsira. A mwana ane kwazvo chimiro chirwere haune musoro wake kana kugara. Kazhinji, zviratidzo yakareba kubva mavhiki matatu mwedzi mitatu. Zvadaro zvishoma nezvishoma kuserera. Iva nechokwadi kuyeuka kuti zvazvo vari zvakajairika (kukura nguva - rinenge gore pashure rokupedzisira nyaya, dzimwe nguva zvakawanda nezvake).

Chorea kungawedzera zvishoma muviri tembiricha (37.5 madhigirii). Kuonekwe kuzvimba uye marwadzo majoini.

zvikonzero

Muchikamu chino nyaya tichaedza kuongorora zvakadzama mubvunzo zvezvinokonzera rheumatic nefivhiri muvana. Sezvambotaurwa, kunyange mushonga ano haagoni kupa mhinduro chaiyo pamubvunzo uyu. Pane maonero akawanda, uye kuvaka pamusoro pavo, tinogona kugumisa kuti zvinokonzera anogona kuva zvinhu zvakawanda.

chinhu	kunyatsotsanangura
Munguva ichangopfuura, zvirwere	Izvi zvinosanganisira chenjera zvirwere kufema, tonsillitis, nezvitsvuku nefivha, tonsillitis uye zvichingodaro. Zvakakosha kuziva kuti vari anokonzerwa streptococcus boka A. Zvakakodzera kujekesa kuti hapana kusvibiswa chirwere Nde ezvinhu kuti kukura rheumatic nefivhiri. Izvi zvinoda atadze kushanda zvakanaka kwesimba romuviri rinodzivirira zvirwere. Chete muchiitiko ichi rwunotanga kurwisa masero utano. Izvi zvinooneka pane zviitiko apo kurapwa akatanga kunonoka (kunonoka) kana ndechokungoti chakaipa.
Chechipiri chakaita - nhaka	A nhamba yezvidzidzo uye kuongorora, kwakaonekwa kuti nhaka chinhu unoitawo basa kukura rheumatic nefivhiri. Yakati hosha rinowanzoberekera mumhuri.
Long-rokuti vatakuri streptococcal chirwere	Kazhinji, refu streptococcus anogona kugara nasopharynx, mauri zvirwere glitches. The mugumisiro - kukura rheumatic nefivhiri.
yechipiri chinhu	Strange sezvo zvinganzwika, asi pane dzimwe (yechipiri) zvinoita kuti zvingaita kuti kukura rheumatic nefivhiri muuduku. Idzi dzinosanganisira: hypothermia, kuneta, murombo muviri. Sei izvi zvinoita kukura chirwere? Quite nyore, izvi zvinoita vane rwakashata zvainoita rokuzvidzivirira mwana. Somugumisiro, kanoverengeka kunowedzera mukana wokuti dzichiri rheumatism.

Diagnostics

Chii rheumatic nefivhiri nevana (zviratidzo, photo, zvikonzero dzakapiwa munyaya), uye ikozvino, tinotarisira Ichokwadi. Tava kutendeukira kune nechirwere chirwere. Nokuti kutanga zvinofanira kutaurwa kuti vanofungidzirwa kuvapo chirwere mwana unogona zvachose munhu, kutangira vabereki nevadzidzisi, uye akaguma pamwe chiremba kana rheumatologist.

Clinic kuti rheumatism muvana (zvekuchipatara zviratidzo) zvakasiyana. Zvinokosha kuziva zvinokosha zvinodiwa:

• carditis (chero wawo);
• chorea (chirwere, tikavakudza yakawanda nzeve yapfuura);
• Kuvapo nodules pasi paganda mwana;
• erythema;
• polyarthritis;
• achangopfuura streptococcal chirwere;
• enhaka chikonzero.

Kana mwana wako aine mumwechete zvezviratidzo izvi, unofanira kubvunza chiremba wako pakarepo. Kuwedzera kune izvi zvinodiwa, pane vamwe:

• arthralgia;
• fivhiri;
• akachinjwa parameters ropa.

Nokuti nechirwere rokuongororwa duku uye kuongorora murwere. Nokuti yakarurama chirwere zvinokosha kuti tiite dzakawanda Murabhoritari nemiedzo, izvo zvinosanganisira chipfuva X-ray, ECG, echocardiography.

Maekisirei rubatsiro yokuziva configuration mwoyo, kuti ECG icharatidza nokuvhiringidzirwa mwoyo (kana), echocardiography anoona kuvapo mwoyo chirwere.

mabatiro

Taiongorora chirwere uye zviratidzo rheumatic nefivhiri muvana. Pakurapa chirwere - ndiwo mubvunzo unotevera. In aripo nyaya kunoda Integrated kusvika. rheumatism kurapwa nechinangwa:

• rusununguko zviratidzo;
• Mugumisiro streptococcal kasvisto.

Rheumatic nefivhiri nevana (zviratidzo, kurapwa, uye mifananidzo kuti isu funga) ari kurapwa muchipatara. Tapota ona kuti mishonga iri rinoitwa kunyange kana maperembudzi vanofungidzirwa.

Child anoda:

• mubhedha zororo , ane zvishoma nezvishoma kuwedzera kushingaira pabasa;
• kudya zvinovaka muviri, zvokudya rine yakawanda potassium;
• zvakakodzera sangano zvinokuvaraidza.

Drug kurapa hunovakirwa:

• antibacterial gadziriro;
• hormone;
• Anti-anogumbura;
• vhitamini zvivako;
• gadziriro potassium;
• immunostimulant.

All zvinodhaka izvi kubatsira kurwisa pathogenic microflora. Somugumisiro, izvozvo Unotsigira kuzvimba uye yekudyidzana kunoderedza zviratidzo zvechirwere chirwere. Zvakakosha kuziva kuti mishonga angava vamwe nemishonga:

• Kugadzirwa nemaronda;
• gastric ropa;
• disruptions kuti kwemakemikari anobudiswa mumasero.

dziviriro

Chikamu ichi kuna kudzivirira rheumatic nefivhiri muvana. Isolated nesekondari ekudzivirira. Muchiitiko chokutanga, pfungwa rwakabhadharwa kuna kunyatsogadzikana mwana:

• nokuomesa;
• kudya zvinovaka muviri;
• mutambo;
• kurwisa utachiona streptococcus boka A.

Secondary zvinangwa vasvutazve kudzivirira:

• "Bitsilin 5" - mamiriyoni 1,5 inokwana zviyero ose kwemavhiki mana vechikoro;
• "Bitsilin 5" chipimo chemushonga mamiriyoni 0.75 inokwana zviyero zviviri ose vhiki vanoenda kukireshi.

Tapota cherechedza kuti Zvinokurudzirwa kuti tiite chokudzivirira kwerunyararo exacerbations yegore, ose mwedzi. Varumbidzwa Duration - makore mashanu.

mataridzikiro

Vanaamai vakawanda vakakwanisa kutsungirira chirwere, nguva kuenda kuchipatara rubatsiro pakurapwa. Kana muchichengeta kudzivirira rheumatic nefivhiri, ipapo kuitazve haangazorori upenyu pangozi. We detailed mubvunzo rheumatism muvana, zviratidzo wongororo. Ndezvipi Zvaifungidzirwa?

Cherechedza kuti mwoyo chirwere rheumatic anenge 25 muzana nguva pamwe inofanira kukura mwoyo chirwere. Re-mashoko hakuuyisi mukana kudzivisa kutyora mavharuvhu. Somugumisiro, unofanira cardiac kuvhiyiwa. Rufu kubvira mwoyo kukundikana anenge 0,4%. Zvinofanira kucherechedzwa kuti mugumisiro chirwere anoenderana kururama uye timeliness kurapwa.