RUBATSIRO syndrome (HELLP-chirwere) - nengozi kuomesa iri III trimester akazvitakura: zvinokonzera, nechirwere, kurapwa

Muupenyu ose munhu vanotozvikuvadza auya kwekanguva kuti Hunoita kuti kuenda kunze rubatsiro. Kazhinji vabatsiri mumamiriro ezvinhu akadaro ndivo vakashinga. Izvi zvinoitika kana muviri womunhu nechisimba achinyengera chirwere, uye kurarama navo hazvibviri. Munhu wose anoziva kuti kufara ezvinhu pamuviri - hachisi chirwere, asi kuti ramangwana moms zvikurukuru vanofanira yekurapa uye mupfungwa rubatsiro.

"Batsirai!", Kana apo zita chirwere

Kudaidza rubatsiro mumitauro kuridza yakasiyana. Somuenzaniso, muna Chirungu nezano Russian, "Rubatsiro!" Ko iziviswe se "RUBATSIRO". RUBATSIRO syndrome (HELLP) anenge netsaona nomuimbirwo pamwe ikozvino dzakawanda chikumbiro rubatsiro.

Zviratidzo uye migumisiro kuomesa ichi panguva pamuviri zvokuti nokukurumidza kurapwa kunokosha. HELLP chidimbu rose zvakawanda zvoutano: iri chiropa, neropa pakugwamba uye mikana yakawanda ropa. Kunze apa, HELLP-chirwere hunokonzera atadze kushanda zvakanaka itsvo uye BP zvinetso, nokudaro kuwedzera zvikuru nzira pamuviri.

Picture of chirwere zvakadaro rinorema kuti pane nokumunyima nezvokuti dzizoberekana muviri, autoimmune kukundikana kunoitika. Izvi inomuka apo zvachose zadzisa munhukadzi muviri kana kuzvidzivirira kuramba kushanda, yobvisa wakakura zvikuru mwoyo, rinooma kuda upenyu kuita uye mberi hondo. Ropa haasi clot, vanga haana kuporesa, ropa haagumiri, uye chiropa haasi kukwanisa kuita mabasa ayo. Asi zviri yakaoma ezvinhu amenable kune zvokurapa kururamiswa.

nhoroondo zvokurapa

RUBATSIRO chirwere paakarondedzerwa mukupera kwezana remakore rechi19. Asi chete muna 1978 Gudlin tambo autoimmune zvokurwara kuti pre-eclampsia panguva yepamuviri. Uye muna 1985, akavonga Weinstein, asi zvakasiyana zviratidzo vakanga akabatanidza pasi rimwe zita: HELLP-syndrome. Zvinokosha kuona kuti mune zvipfuwo zvokurapa zvinyorwa, ichi ndicho chinetso chakakomba kushanda kwete kurondedzerwa. Chete vashoma anesthetists Russian uye yevanorwara zvikuru nyanzvi dzinopa zvakadzama namambo mumwe chete dzakaparara ichi kuomesa ve- preeclampsia.

Zvichakadai, RUBATSIRO chirwere panguva pamuviri yava kuwedzera uye anobvisa yakawanda upenyu.

We tsanangura mumwe kuomesa yoga.

hemolysis

RUBATSIRO chirwere kunonyanya zvinosanganisira intravascular hemolysis. Ichi chirwere chakaipisisa kunoratidzwa kuparadzwa zvachose muchitokisi. Kuparadzwa uye kukwegura masero matsvuku eropa chinokonzera fivha, jaundice ganda, pakuonekwa ropa iri weti zvidzidzo. Chinonyanya zvinouraya nemigumisiro - mukana rinorema kubuda ropa.

Mukana thrombocytopenia

Inotevera chezvinonhuwira kuti chirwere abbreviations - thrombocytopenia. Ichi chirwere kunoratidzwa vasanyanye platelet count iri nzira ropa, pakupedzisira vachikonzera vaingoerekana kubuda ropa. Rega ichi muitiro unogona chete kuva muchipatara, uye panguva pamuviri, ichi ndicho zvikuru ngozi. Chikonzero kunogona kuva yakaoma masoja zvinetso, izvo zvakazoita kuti anomaly umo muviri anokurwirai pachawo, achiparadza utano masero matsvuku eropa. Rinomiririra upenyu akasimuka pamusoro pakanyorwa nokuchinja nhamba maplatelet pakugwamba zvirwere.

Vanotyisa harbinger: nokuwedzera chiropa makemikari

The akaoma pathologies dziri RUBATSIRO chirwere, korona chiratidzo zvakadai kusingafadzi sezvo kwakawedzera chiropa makemikari. Vanaamai pamuviri izvo zvinoreva kuti mune chimwe chezvinhu zvinokosha zvomukati womunhu muviri pane zvikanganiso zvakakura. Pashure pezvose, chiropa kwete chete rabvisa muviri muchetura uye anobatsira Implementation ari zvomudumbu basa, asiwo kunokanganisa psycho-mupfungwa bhora. Kazhinji kuchinja undesired hwakadaro dzakaonekwa munguva yokungoitawo bvunzo ropa, iro chinotarisirwa mukadzi pamuviri. Kana preeclampsia kuoma ne chirwere BATSIRA Nhamba akasiyana yekudyidzana kubva ndozvakajairwa, kudura unotyisa mufananidzo. Saka, zano zvokurapa - wokutanga muitiro, riri madikanwa kuti aurayiwe.

Kunyanya trimester wechitatu

3 trimester pamuviri inokosha kwazvo yemberi gestation uye pakusununguka. Kakawanda matambudziko vari edema, chirungurira uye zvomudumbu dysfunction.

Izvi zvinoitika nokuti hadzina kufambiswa zvakanaka zviri itsvo uye chiropa. Yakakura dumbu ane hadzisekesi vomanikidza zvomudumbu zvomukati, riri sei vari kutanga kukanganisika. Asi gestosis angamuka ezvinhu inonzi pre-eclampsia uye eclampsia, izvo sembura kurwadza vari epigastrium, kutsamwisa nechitarisiko kuda kurutsa, kurutsa, edema, cheBP. Tikafunga chetsinga yematambudziko zvinogona kuitika pfari. Ngozi zviratidzo kuwedzera, dzimwe nguva vanenge semheni, zvichiita kukuvadza zvikuru muviri, kutyisidzira upenyu amai vanepamuviri uye azvarwa. Nokuda zvakakomba preeclampsia, izvo kazhinji anotakura nayo ine 3 trimester pamuviri, pane kazhinji chirwere pamwe nomukurukuri inonzi RUBATSIRO.

inopenya zviratidzo

HELLP-chirwere: kunotoda mufananidzo, chirwere, obstetric nzira - nomusoro kukurukurwa ano. Chokutanga, unofanira kuziva nhamba dzaKora zviratidzo pematanho ichi kuomesa inotyisa.

1. On chikamu epfungwa. Tsinga anopindura izvi pfari zvinetso, zvikuru nomusoro, kutadza kuona zvakanaka.
2. Job kumwoyo akashatirwa nokuda edema kuti munyama uye ungaderedza kweropa.
3. Respiratoria pezvakaitwa kazhinji havasi akambokanganiswa, asi pulmonary edema anogona kuitika mushure yokusununguka.
4. On chikamu hemostasis uye thrombocytopenia vakachengeta kutyorwa platelet dzichipfekeka chezvinonhuwira basa.
5. Akaderedza chiropa basa, dzimwe nguva rufu masero ayo. Kashoma kuchengetwa kwatangwa hepatic atsamwira, iyo inotungamirira kurufu.
6. Kutyora genito-Urinary hurongwa: oliguria, renal dysfunction.

RUBATSIRO chirwere dzinoratidzwa siyana zviratidzo:

• kusagadzikana mune chiropa;
• kurutsa;
• chenjera nomusoro;
• pfari;
• kwokupisa ezvinhu;
• kuvhiringidza pfungwa;
• Urinary insufficiency;
• edematous tishu;
• mugari kumanikidzwa;
• akawanda hemorrhages munzvimbo evanhu;
• yellowness.

Laboratory chirwere kunoratidzwa thrombocytopenia, hematuria, kuti vasabatwa mapuroteni mu weti uye ropa, pasi Chizenga, kuwedzera bilirubin pabvunzo ropa. Naizvozvo, kujekesa zvachose zvokuongorora yose kunzwisisa rabhoritari miedzo zvinoda.

Sei kuziva kuti matambudziko?

Kuti nenguva zvikavengwa kudzivirira kwazvo matambudziko, uye akaita zano nokurapwa izvo ramangwana mums vari zano kusvika nguva dzose. pamuviri nyanzvi akapfeka rekodhi, uye ipapo kunyatsotevera kuongorora kuchinja muviri mukadzi panguva yose iyoyo. Saka, mumwe chiremba rinowirirana kugadzira zvarakasiya vasingafarirwi uye chiito chakakodzera.

Kuzivisa Kumwe kuchinja kunotanga nokushandisa rabhoritari nemiedzo. Somuenzaniso, weti mapuroteni chichabatsira wanikidza kana pane mumwe. The kuwedzera mapuroteni zviratidzo uye uwandu leukocytes inoratidza raidudzwa hadzina kufambiswa zvakanaka mubasa neitsvo. Pakati pezvimwe zvinhu, pangava rakapinza zvinoderedza uwandu weti, uye kuwedzera edema.

Zvinetso chiropa zvinozarurwa kwete chete zvakarurama yokumusoro quadrant marwadzo, kurutsa, asiwo kuchinja muropa (vakawedzera uwandu chiropa makemikari), uye chiropa akawedzera pamusoro palpation Runonzwika zvakajeka.

Thrombocytopenia zvakare dzakaonekwa nokuda Murabhoritari anoedza ropa mukadzi pamuviri, iro zvechokwadi kutyisidzira RUBATSIRO syndrome.

Kana uchifungidzira eclampsia uye RUBATSIRO chirwere fanira kudzora BP somugumisiro spasm midziyo ropa uye clots vake waivako anogona zvakakomba kuwedzera ropa.

differential kuongorora chirwere

Fashionable mazuva ano KUBATSIRA chirwere chirwere muna Obstetrics awana mukurumbira, saka kakawanda akariisa zvisizvo. Kazhinji kuvanda seri kwayo akasiyana zvachose zvirwere, kwete zvishoma ngozi, asi zvikuru zvisingakoshi uye tose:

• gastritis;
• nemavhairasi chiropa;
• chinonzi systemic lupus erythematosus;
• urolithiasis;
• obstetric sepsis;
• zvirwere chiropa (mafuta, cirrhosis);
• thrombocytopenic purpura kuti asingazivikanwi etiology;
• itsvo kukundikana.

Naizvozvo differential. Chirwere anofanira kufunga zvakasiyana-siyana zvipi. Nokudaro, akaratidza pamusoro vanamwari vatatu vatatu - hyperenzymemia chiropa, hemolysis uye thrombocytopenia - kwete nguva dzose zvinoratidza kuvapo kuomesa ichi.

VaBennett RUBATSIRO-urwere

Zvinosuruvarisa, zvinokonzera njodzi zvakanaka kunzwisiswa, asi pane mazano vanotsamwisa RUBATSIRO chirwere chingava kwezvikonzero zvinotevera:

• psychosomatic zvirwere;
• zvinodhaka Kutemeswa chiropa;
• enzymatic nemagene kuchinja chiropa;
• prolificacy.

Vakawanda chirwere ngozi kunoitika apo kukwana pfungwa preeclampsia kuoma kosi - eclampsia. Zvakakosha kuziva kuti hosha haazvibati nezvimwewo chaizvo: riri kukura pa semheni, izvozvo haazombotaurwi pamusoro wayo.

kuchirapa matanho

Kana zvose miedzo kunze uye differential. chirwere, unogona kuita zvimwe mhedziso. Kana iwe kuisa chirwere "RUBATSIRO chirwere" kurapwa zvainanga pakudzikamisa mamiriro mukadzi pamuviri mwana mudumbu, uyewo nokukurumidza kukurukura yakazvimirira rokuti. Medical mabasa vakatakudzwa kubva tichibatsirwa ane obstetrician-gayinakorojisiti, nokumutswa chikwata, ari anesthesiologist. Kana zvakakodzera, batanidza vamwe vanachiremba: chiremba wetsinga kana ophthalmologist. Zvikurukuru zvachose vakawanda nhengo kukundikana, uye akatipa matanho kuti tidzivise matambudziko.

Pakati zvavo complicating nzira dzokurapa kupindira, vangazivikanwa:

• placental yokuzviparadzanisa;
• ropa;
• pfungwa edema;
• pulmonary edema;
• chenjera renal kukundikana;
• zvinouraya chiropa kuchinja uye pakakoromoka;
• indomitable kubuda ropa.

Kana zvakarurama zvokuongorora uye nenguva akapa rubatsiro rwenyanzvi mukana wokuti hwevanhu vanorwara ruchigona kushoma.

obstetric nzira

Nzira vaiita Obstetrics toreva kwazvo marudzi preeclampsia, zvikuru yakaoma chirwere RUBATSIRO, zviri pachena: kushandisa caesarean chikamu. Kana vakura dumbu vakagadzirira dzinongoitika mwana, vachishandisa prostaglandins uye anosunga nhengo dzomuviri.

In Muzviitiko zvakaipisisa, caesarean chikamu rinoshandiswa chete endotracheal yokutindivadza.

Upenyu pashure kusununguka

Vanachiremba vakaona kuti hosha kunoitika kwete chete panguva yechitatu trimester, asiwo kuita kuti kufambira mberi mumazuva maviri pashure ndichipfeka kubvisa mutoro.

Naizvozvo, KUBATSIRA chirwere pashure pokuberekwa - the Chiitiko ingangodaro anotaura nyasha pedyo richiona amai mwana ari postpartum nguva. Kunyanya nezvezvitadzo vakadzi doro inoyerera preeclampsia panguva yepamuviri.

Ndianiko mhosva uye zvokuita?

RUBATSIRO chirwere - a nokuvhiringidzirwa zvinenge zvose nhengo uye hurongwa munhukadzi muviri. Panguva chirwere pane ndichibvunza water drainage kuti simba uye yakakwirira mukana rufu, uye intrauterine fetus abnormalities. Saka, kubva 20 fung vhiki amai vanepamuviri zvinokosha kuita kuzvipira vachiongorora dhayari, izvo kuuya kuchinja zvose kuitika mumuviri. Cherechedzai inofanira kubhadharwa kuti pfungwa dzinotevera:

• BP: nayo akasvetuka kumusoro kupfuura katatu vanofanira kuona;
• uremu metamorphosis: kana akanga kumuka hasha, zvichida, chikonzero chaiva bundu;
• fetus kufamba zvakare zvikuru, kana, Ukuwo, vakanyaradza kufamba - pachena chikonzero kurapwa nachiremba;
• kuvapo edema: hombe mumatenhere munyama inoratidza renal dysfunction;
• chechienzi dumbu marwadzo: kunyanya kukosha munzvimbo chiropa;
• Kugara Kuongororwa zvose anogadzwa, anofanira kuitwa mukutenda akanaka uye nokufamba kwenguva, sezvo kuva kubatsira amai kwazvo uye mwana asati aberekwa.

zviratidzo yambiro All anofanira pakarepo vakaudza chiremba wako, gayinakorojisiti sezvo unogona chete zvakakwana kuongorora mamiriro ezvinhu uye tora chisarudzo chakarurama.