Txhua hom kab mob ntshav (hemorrhagic) yog ib qho kev tshwm sim hauv kev kho mob niaj hnub no. Kwv yees li ntawm 50% ntawm tus neeg mob yog thrombocytopenic purpura, qhov ua rau ntau heev thiab tsis sib txawv. Tus kab mob no cuam tshuam rau lub cev thaum muaj hnub nyoog.
Thrombocytopenic purpura - ua rau
Verlhof tus kab mob los yog tus kab mob trombocytopenic purpura, uas ua rau tsis paub tseeb txog tam sim no - tshwm sim los ntawm ib tug kws tshawb fawb German rov qab thaum 1735. Nyob rau hauv cov neeg nws yog hu ua "kab ntsig ciaj" vim hais tias nyob rau hauv xws li cov neeg mob nyob rau saum npoo ntawm lub cev ntawm no thiab muaj tshwm ntawm hemorrhages ntawm ntau ntau thiab tsawg.
Kab mob, feem ntau ntawm cov mob, tshwm sim rau cov me nyuam txij thaum yug mus rau thaum tiav hluas, thiab tom qab ntawd ces yuav ploj mus tas li txawm tias tsis muaj kev ntsuas tshuaj. Hauv cov menyuam tsis tau muaj hnub nyoog ob xyoos, cov neeg mob purpura raug kaw ntau hauv cov tub. Hauv cov neeg laus, qhov kev kuaj no yog ua rau 1-13 tus neeg mob ntawm 100,000 tus neeg, feem ntau ntawm cov neeg mob yog poj niam.
Cov ntaub ntawv ntawm cov kab mob trombocytopenic purpura
Tus kab mob ntshav zoo li thrombocytopenic purpura (Verlhof's disease) tshwm sim thaum cov qe ntshav - platelets, suppressed los ntawm lawv tus kheej lub cev tsis muaj zog thiab tuag prematurely. Lub sijhawm ntawm lawv lub neej tsis yog 7-10 hnub, yog ob peb teev. Rau qhov zwm ntawm cov tshuaj tua kab mob autoimmune, tus po yog lub luag haujlwm. Tus kab mob no muaj ntau hom uas nyob ntawm qhov ua rau muaj kev mob nkeeg, tab sis kuj txawv me ntsis hauv tus yeeb yam:
- autoimmune los yog idiopathic;
- heteroimmune;
- transimmune.
Cov ntaub ntawv ntawm cov kab mob hauv lub plhaw (idiopathic) purpura, tsis hais txog qhov ua rau, raug faib rau:
- ntse;
- Mob ntev (nrog nquag, tsis tshua los sis pheej rov huam mob dua).
Autimmune thrombocytopenic purpura
Qee zaum, lub cev pib ua haujlwm rau nws tus kheej. Qhov no yog ntau yam kab mob autoimmune. Platelets raug puas lawm los ntawm lub cev tsis muaj zog, uas ua rau lawv lub hlwb txawv teb chaws. Hom kab mob no tej zaum kuj tshwm sim tawm tsam tom qab ntawm lwm qhov kev kho mob hauv lub cev. Idiopathic thrombocytopenic purpura yog yam ntxwv ntawm qhov kev rhuav tshem ntawm nws cov pa platelets hauv qaug tshuaj ntau yam. Qee zaum qhov no yog kev kis kab mob raws keeb kwm raug, tab sis feem ntau qhov ua rau tus kab mob tshwm sim muaj xws li hauv qab no:
- kev mob lupus erythematosus ;
- autoimmune hemolytic anemia ;
- allergic vasculitis ;
- kab mob qog ntshav siab (lymphocytic leukemia);
- txhoj puab heev;
- glomerulonephritis .
Heteroimmune thrombocytopenic purpura
Hauv thaum yau, tus kab mob heteroimmune (tsis yog lub cev) ntawm tus kab mob no yog thrombotic thrombocytopenic purpura, tshwm sim ntau dua li cov laus. Qhov xwm zoo yog qhov uas cov me nyuam qhov kev mob rov qab tau yog zoo. Ua rau tus kab mob no yog:
- noj tshuaj (paracetamol, furosemide, quinine, ampicillin, cephalosporins, betta-blockers, thiab lwm yam);
- kev txhaj tshuaj tiv thaiv (txhaj tshuaj tiv thaiv nrog BCG, kabmob hnoos hawb pob, qhwv ntsuab, mob khaub thuas, mob hnyuv laus);
- kis kab mob.
Thrombocytopenic purpura - cov tsos mob
Tus kab mob ntawm Verlhof, cov tsos mob ntawm cov uas yog heev eloquent, txawv los ntawm lub sij hawm ntawm cov tsos ntawm hemorrhages. Uas yog, nyob rau hauv thaum pib, bruises los yog, raws li lawv yog hu ua los ntawm cov kws kho mob - petechiae, yog qhia heev qaim, maj txo qhov siv ntawm cov xim thiab tig mus rau hauv ib lub cyanotic, ntsuab hue, maj hloov daj. Nyob rau ntawm ib lub sij hawm, txhua hom bruises yuav ua rau lub cev, uas yog ib daim duab txaus, tab sis lawv tsis mob heev, tsis zoo li qhov raug mob ntawm cov neeg muaj kev noj qab nyob zoo.
Hlub no nyob rau ntawm qhov nquag, tsawg dua ntawm lub cev, thiab tsis tshua muaj lub ntsej muag, tab sis mucous yog kev zam. Thrombocytopenic purpura muaj cov tsos mob zoo li cov neeg sib txawv. Lawv tuaj yeem tshwm sim los ntawm microtrauma, thiab tsis muaj ib qho ua rau. Yeej, qhov hemorrhage tshwm sim thaum tsaus ntuj. Hauv qhov no, tus neeg mob tsis hnov mob, tsuas yog rau cov mob hemorrhage, thaum tus neeg mob xav tau kev khomob sai. Qhia qhov txawv:
- los ntshav (ntawm lub qhov ntswg, cov pos hniav, lub tsev menyuam);
- sab hauv lub cev (plab hnyuv, lub plab, mob ntsws, mob paj hlwb).
Kev kuaj mob ntawm cov kab mob trombocytopenic purpura
Verlhof tus kab mob, qhov kev kuaj mob uas tsis xaus nrog kev kuaj xyuas cov tsos mob, raws li cov ntsiab lus ntawm kev ntsuam xyuas ntawm cov neeg mob thiab kev kuaj mob. Cov kws kho mob ua ib qho anamnesis thaum tus kab mob trombocytopenic purpura nws tus kheej rau thawj zaug. Tom qab cov kab mob sib kis tau tus mob thiab kuaj pom ntau yam kev tshawb nrhiav los ntawm kev siv ntshav rau kev ntsuam xyuas, ua ntej ua tiav cov kev kuaj ntshav. Cov no suav nrog:
- Cuff test , thaum lub ris tes taw rau kev ntsuas siab muab tso rau ntawm 10 feeb. Yog hais tias thaum xaus ntawm lub sij hawm no bloody dots tsim nyob rau hauv lub cuff, qhov kev xeem yog qhov zoo. Nws yog nqa tawm ntawm cov me nyuam los ntawm peb xyoos.
- Qhov kev kuaj no yog siv tawm thaum muaj kev mob nkeeg siv rau sab caj npab, uas tom qab ib lub sijhawm ua rau nqaij tawv - qhov no yog tsim rau cov neeg laus laus.
Thrombocytopenic purpura, yuav tsum muaj cov kev kuaj mob uas yuav ua kom pom tseeb ntawm tus neeg mob cov ntshav. Cov no suav cov kev ntsuas ntshav rau:
- hemoglobin;
- ntshav khawm ceev;
- cov platelets theem;
- tsis tuaj yeem los yog muaj qhov retraction ntawm cov ntshav khov;
- muaj cov tshuaj antiplatelets hauv cov ntshav.
Tsis tas li ntawd, hauv cov mob hnyav lossis muaj kev tsis sib haum xeeb ntawm lwm hom mob trombocytopenic purpura, pob txha hlwb pob txha ua tiav - tus kws kho neeg mob. Nrog kev pab ntawm lub cuab tam tshwj xeeb trepan, ib qho me me ntawm tus txha nqaj qaum yog ua nyob rau thaj chaw hauv cheeb tsam lumbar coj me me ntawm cov khoom siv pob txha, periosteum thiab cerebrospinal kua rau kev ntsuam xyuas.
Thrombocytopenic purpura - kev kho mob
Cov kab mob ntshav yuav tsum hnyav tus cwj pwm, vim hais tias kev noj qab haus huv ntawm tus neeg mob ntawm txhua lub hnub nyoog yog nyob ntawm seb qhov no zoo npaum li cas. Kev kho mob ntawm cov roj ntsha muaj tus kab mob hauv lub tsev kho mob (thaum lub sij hawm muaj kev ua kom zoo dua) thiab nyob hauv tsev. Nws yog ib qho tseem ceeb kom muab tus neeg mob nrog ntau tshaj so thiab txaj so kom txo tau tsawg lub sij hawm muaj kev puas ntsoog. Tiv thaiv no tom qab, cov kev siv tshuaj kho mob yog siv nrog cov tshuaj pej xeem. Nws yog ib qho tseem ceeb heev uas ua raws li kev noj haus.
Yuav kho li cas yog Verlhof tus kab mob?
Nyob ntawm seb thaum twg muaj hnub nyoog li cas thiab nyob rau qhov twg ntawm tus kab mob Verlhof tau kuaj pom, yuav muaj lus nug txog nws txoj kev ua kom zoo. Hauv thaum yau, kev kuaj pom yog qhov zoo, yog tias tus me nyuam tau kuaj pom ntxov thiab tswj tau kom nyob rau hauv rau lub hli. Tom qab lub sijhawm no, qhov kev kuaj mob ua rau mob ntev, thiab nws ua suab nrov zoo li mob hemorrhagic thrombocytopenia.
Cov laus tuaj yeem tsis muaj hmoo - tus mob no tuaj yeem ua ke nrog lawv tas lawv lub neej nrog kev sib tov thiab kev ntxiv dag zog. Muaj qee zaum, cov neeg mob thrombocytopenic purpura yuav kho tau thaum tus neeg raug tshem tawm, tab sis qhov no tsis tau lees tias 100%. Qhov no hloov txav platelets thiab nws yog tus yeeb ncuab ntawm lub cev. Qhov kev siv no yog siv qhov kev sib cav dhau los, thaum lwm hom kev kho mob tsis zoo. Ua haujlwm raws li txoj kev siv kabmob, thiab nrog kev pabcuam ntawm laparoscopy.
Thrombocytopenic purpura - tshuaj
Lub hom phiaj ntawm cov kev kho mob ntawm Verlhof tus kab mob yog kom muaj theem ntawm cov ntshav hauv cov ntshav ntawm qhov yuav tsum tau txhaj. Idiopathic thrombocytopenic purpura yog kho, feem ntau ntse, uas tso cai rau ua kom tau ib txoj haujlwm zoo rau ntau xyoo. Yog hais tias tsis muaj kev kho mob los yog kev khiav hauj lwm tau pab, lub tswv yim rau kev noj tshuaj yog hloov mus rau ib qho tshiab. Ua li no, siv:
- Prednisolone (Methylprednisolone) yog lub tshuaj steroid-muaj tshuaj, kom txo tau cov kev ua ntawm kev tiv thaiv. Nws yog siv nyob rau hauv thawj theem ntawm kev kho mob, ua ntej tshem tawm ntawm tus po.
- Interferon a2 yog siv los ua kom nws lub cev tiv thaiv kab mob, thaum tshuaj steroid tsis muaj zog.
- Immunoglobulin G yog siv ua ntej kev phais kom mob platelets.
- Immunosuppressants (Cyclophosphamide, Vincristine thiab Azathioprine) yog siv thaum tus neeg mob tsis pom lwm txoj kev kho mob. Muaj ib qho kev tiv thaiv ntawm cov tshuaj tiv thaiv kab mob hauv cov ntshav, ua rau muaj kev nce hauv platelets.
- Cov tshuaj Danazol, ua rau lub caj pas pituitary nrog txoj kev txais tos ntev yuav cuam tshuam cov duab ntawm cov ntshav.
Thrombocytopenic purpura - kev kho mob nrog tshuaj tua neeg
Acute thrombocytopenic purpura yog ib yam kab mob ntshav, thiab yog li ntawd tshuaj ntsuab preparations (decoctions) nrog hemostatic cov cuab yeej yog ntse siv rau nws txoj kev kho:
- dioecious nettle;
- ntshav-caj pas;
- coral bark;
- chokeberry;
- ib tug tswv yug yaj lub hnab;
- chamomile;
- yarrow.
Noj cov zaub mov muaj roj ntsha nrog
Tsis muaj cov khoom noj tshwj xeeb rau Verlhof tus mob. Nws yog ib qho tseem ceeb tias cov tais diav uas siv rau hauv daim ntawv me me los sis txias txias. Cov zaub ntsuab nrog cov kab mob sib kis kab mob sib tov, xws li cov txiv hmab txiv ntoo yog cov tseem ceeb, tiam sis lawv yuav tsum tsis txhob ua xua. Cov npe ntawm cov khoom uas tau pom zoo muaj xws li:
- porridge - buckwheat, pob kws, oatmeal;
- txiv hmab txiv ntoo thiab zaub nyob rau hauv daim ntawv ntawm juices - carrot, kua, beet, pomegranate, lws suav;
- berries - currants, blackberries, raspberries;
- nqaij nruab deg;
- nqaij - nqaij nyug.
Nws yog tsim nyog los tshem tawm ntawm kev noj haus:
- salted cov khoom;
- cov khoom haus luam yeeb;
- seasonings thiab spices;
- qaub zaub;
- cov khoom noj ceev;
- carbonated dej;
- kas fes;
- cawv.
Thrombocytopenic purpura - teeb meem
Tus kab mob ntawm Verlhof, nws cov teeb meem yog heev txaus ntshai, tas yuav tsum tau nruj mob kev saib xyuas. Cov teeb meem muaj xws li:
- cerebral hemorrhage;
- gastric thiab lub raum los ntshav;
- mob hnyav heev hauv cov hluas.
Thrombocytopenic purpura - kev tiv thaiv
Thaum tus neeg mob paub tias "thrombocytopenic purpura," qhov no txhais tau hais tias yog ib tus kheej muaj kev noj qab haus huv muaj kev tso cai ntau yam, qhov teeb meem thiab qhov qub, hloov txoj kev ua neej. Cov kev tiv thaiv kev tiv thaiv yog tswj kev tswj cov qib ntshav thiab hemoglobin vim muaj kev noj haus nplua nuj, zoo li cov cais tawm xws li kev puas hlwb:
- da dej;
- nquag ua si;
- tawv noj haus kom yuag poob;
- teeb meem ntxhov siab.