Waterhouse ciwo - Friderichsen: pathogenesis, gaggawa kula, magani

A adrenal gland a cikin jiki ne mai muhimmanci endocrine sashin jiki. Hormones samar da su shafi sigogi na matsa lamba da kuma adadin da ake zagawa da ruwa, da matakin na ma'adinai salts da mutum microelements a rayuwa kudi, ko da a kan pituitary gland shine yake. Kuma a cikin yanayi inda da aiki na wadannan kananan amma sosai muhimmanci gland shine yake yana shan wahala, ci gaba da bayyana, barazana da rayuka da lafiya.

Definition da kuma tarihin

Waterhouse ciwo - Friderichsen - wani m adrenal insufficiency, wanda ya auku bayan rauni ga jikin wani hemorrhage a parenchyma. Wannan sa mai tsanani take hakki na ciki yanayi na jiki da kuma na iya kai ga mutuwa.

Description of yanayin na farko ya bayyana a cikin 1894, amma shi ya kasa, da kuma a 1911, Waterhouse gano goma sha biyar lokuta, wanda ya taimake shi ya tattara dukan guda tare. Tsayawa up tare da shi, shekara bakwai daga baya, a shekarar 1918, Frederiksen ma wallafa wata muqala game da wannan pathological tsari.

dalilai

Masana kimiyya sun yarda da cewa ciwo Waterhouse - Friderichsen sa m hemorrhage a lokaci guda a cikin biyu adrenal gland. Wuraren da akwai hatsari contingent - wani jariri, da jarirai, da yara da kuma matasa. A bene a cikin wannan hali m. Wannan jiha za a iya jawo da shafe tsawon delivery, fetal oxygen yunwa ko ta ci gaba ta hanyar da haihuwa canal amfani forceps ko injin extractor. Bugu da kari, muhimmiyar rawa ga mai tsanani nakasar cuta, da kuma ciki wahala Marigayi gestosis.

Waterhouse ciwo - Friderichsen a manya ne mafi sau da yawa gani a matsayin mai wahala na wani cutar. Yawanci, da wakili ne a meningococcus, streptococcus ko staphylococcus. Amma kuma wadannan, da Sanadin hemorrhage iya zama nosologies kamar kyanda, da mulufi zazzabi, typhoid zazzabi, diphtheria, kuma m neoplasms, marurai, peritonitis DIC da thrombosis adrenal jijiyoyinmu.

A ci gaba da cuta

Mawallafa, da dama sun ware wannan ciwo a matsayin wani ɓangare na Na'urar inji na gazawar a cikin ci gaban da m sepsis. Amma yana yiwuwa cewa yara da mata masu ciki mabanbanta inji ta wadda tasowa Waterhouse ciwo - Friderichsen. Pathogenesis shi bayyana kanta a yawa hemorrhagic necrosis na adrenal bawo. Sun kasance haka da yawa da cewa dukan jiki tsomasu a tsanake cikin jini, akwai hyperextension na kwantena, kuma ko da ta katsewa.

Amma ga general pathogenesis, shi aka bayyana a cikin nau'i na sepsis:

- dilated capillaries da kuma arterioles.
- pronounced maye ciwo.
- gaban concomitant meningitis ko meningoencephalitis.
- wani karuwa a yankin Lymph nodes kuma thymus.

symptomatology

Waterhouse ciwo - Friderichsen da meningococcal cuta na iya ci gaba ba zato ba tsammani a bango na alheri. Ya aka ci gaba da sauri sosai cewa mutum zai iya mutuwa a cikin kwanaki.

Yana duk farawa da matsanancin excitability, irritability da ciwon kai. Sa'an nan shiga ciki zafi, tashin zuciya da amai da gudawa. Idan zafi ne ma m, likita iya zargin a marasa lafiya tare da m m Pathology. Da farko, low-sa zazzabi, amma kawai 'yan sa'o'i na farko shi ne 39-40 digiri. Saboda amai da zawo daga jiki barin ruwa da kuma ma'adanai, wadda take kaiwa zuwa rushewa daga cikin zuciya, kwakwalwa da kuma sauran muhimmanci gabobin. A karshen, mutumin da ya rasa sani da dama a cikin wani coma.

Akwai wani nau'i na cutar, wanda bayyana kanta a kaifi fall a jini ko auka. Sauran cututtuka na iya ba ya zama a duk. Man shi ne na farko a cikin mãyen, amma kamar yadda hypoxia progresses sauri zo mãyen da coma. Mutu ba tare da ya farka,.

Waterhouse ciwo - Friderichsen yara ci gaba da sauri fiye da a manya, ko da a cikin hanyar. Ba su compensatory ikon da kwayoyin hanzari tsautsayi, da kuma da yawa da kuma tsarin gabobin ne har yanzu a kan aiwatar da samuwar kuma ci gaba, sakamakon zo na farko kwanaki na farko da cutar.

bincikowa da

Waterhouse ciwo - Friderichsen tasowa haka hanzari da cewa likitoci sau da yawa ba su da lokacin da za su gudanar da cikakken binciken da kuma ganin abin da ya faru ga wani mutum. Idan gaggawa dakin wajibi likita zargin wannan Pathology, magani fara nan da nan, da kuma ganewar asali shiga a cikin tsari, saboda lissafi ne a kan kowane lokaci.

Laboratory for tabbatar da ganewar asali ne dole a samu a cikin general bincike na jini:

- leukocytosis da leftward motsi na da dabara.
- karu a jini glucose.
- thrombocytopenia da low clotting.
- rage Wutan.
- karuwa a jini urea nitrogen.

Duk da haka, wadannan Manuniya ba musamman da kuma na iya zama nuni da fadi da kewayon m da kuma tsari cututtuka. Don tabbatar da haka, kana bukatar ka a hankali tattara likita tarihi, da kuma gudanar da wani lumbar huda kuma ya bayyana neurologic matsayi. Amma duk da wannan ne yake aikata bayan da karfafawa daga cikin mutum yanayin.

bambanci ganewar asali

Waterhouse ciwo - Friderichsen a iya bambanta daga m ciki yanayi kamar m appendicitis, m pancreatitis, miki perforation na ciki ko duodenum. Tabbata likita ya kamata a duba don meningeal bayyanar cututtuka, su hana zub da jini a cikin kwakwalwa, cavernous sinus thrombosis. Lokacin da cardiac ECG form zai taimake ka ka fahimci ko da mutum yana da wani ciwon zuciya ko ba.

magani

A farko wuri bayan da ganewar asali "ciwo Waterhouse - Friderichsen" ya kamata rama da haƙuri sweated ruwa Wutan da rashin adrenal ji ba gani. Don wannan yana gabatar ta hanyar da venous damar zuwa rabin lita "hydrocortisone" ko 120 milligrams "prednisolone" da kuma uku grams na glucose biyar bisa dari da goma milliliters na biyar bisa dari bayani daga ascorbic acid. Saboda haka muka yi aiki a kan asali pathogenesis, haddasa Waterhouse ciwo - Friderichsen. Gaggawa kula a lokaci guda inganta jini rheology, dilutes shi qara adadin tsarin m kuma qara matsa lamba. A steroid hormone maye taimaka wajen kula da matsa lamba a dama matakin.

Bayan karfafawa daga cikin hormones ci gaba da za a gudanar intramuscularly, "hydrocortisone" na 50-75 MG kowane awa shida, da kuma deoxycorticosterone acetate a kan goma milliliters sau uku a rana. Tabbata a bi Manuniya na matsa lamba da kuma, idan ya cancanta, to nashi up "Epinephrine," "Mezaton" cardiac glycosides.

Idan cikin hanyar cutar ya zama wani kamuwa da cuta, kamar meningococcal, ban da primary far, da haƙuri da aka ba maganin rigakafi. Da zarar haƙuri dawo al'ada, hormones fara rage da kashi. Yana da muhimmanci a yadda ya kamata a shirya jiki ga abin da ya dole ne da kansa nuna glucocorticoids. Kada abruptly soke kwayoyi, shi zai iya fararwa da wani biyu rikicin.

Yana da muhimmanci a tabbatar da cewa haƙuri ne kawai Waterhouse ciwo - Friderichsen. A lura da kanta zai iya zama haɗari kamar yadda jiki ta wuce kima ambaliya sa tsari edema, ciki har da cerebral edema, da kuma manyan allurai hormones iya fararwa shafi tunanin mutum da cuta. Saboda haka, yanayin haƙuri da matukar muhimmanci a kullum saka idanu da kuma daidaita da alƙawura bisa ga bukatun.

Outlook

Waterhouse ciwo - Friderichsen - musamman mai tsanani Pathology, ta nuna cewa ba ko da yaushe a kan lokaci saboda iri-iri na ba-takamaiman bayyanar cututtuka. Sakamakon dogara ba ne kawai kan yadda da kyau zai nuna hali likita a gaggawa halin da ake ciki, amma kuma a kan mataki na halakar da adrenal gland da compensatory iya aiki da kwayoyin. M kawo karshen wannan cuta ne m.

rigakafin

Wannan shi ne yafi anti-annoba, a cikin matakan da hearth kamuwa da cuta a cikin abin da haƙuri da aka kamu da meningococcal cuta. A likita wanda ya saukar da irin wannan haƙuri zamar masa dole ya sanar da Sanitary dubawa da kuma ware da haƙuri. A na gaba kwanaki uku, wani rajistan shiga na lamba mutane ga gaban cutar da kuma rigakafi a aikin al'umma ko ilimi ma'aikata na tsawon kwanaki goma. A matsayin shirinku, mutane a kusa lamba tare da haƙuri, rubũta a takaice hanya na maganin rigakafi.

epidemiology

Waterhouse ciwo - Friderichsen, da rashin alheri, quite na kowa Pathology. A raya ƙasashe, da abin da ya faru na meningococcal cuta ne 1-3 lokuta da 100 000 yawan jama'a. Kuma fiye da rabin mutanen da suka kamu - yara na makarantan nasare shekaru. Bugu da kari, kowane shekaru goma ya gani a Yunƙurin a cikin abin da ya faru. Wannan shi ne saboda maye gurbi na pathogen yawan jama'a da kuma ragewa rigakafi.

Wadannan lissafi ne mafi kusantar ba gaskiya ba ne, kamar yadda mutane da yawa lokuta tafi undiagnosed saboda bayyanar cututtuka na gicciye. Waterhouse ciwo - Friderichsen tasowa haka hanzari da cewa likitoci ba su da lokacin da za a gudanar da wani isasshen yawan gwaje-gwaje.