Waterhouse syndrome - Friderichsen: Pathogenesis, unonophelo olungxamisekileyo, unyango

Le adrenal emzimbeni yeyona ezidalwe ilungu ebalulekileyo. Hormone eziveliswa ngabo kuchaphazela parameters kuxinzelelo kunye isixa kulwelo elijikeleza, umgangatho neetyuwa izimbiwa kunye Micro ngamnye kwiqondo metabolic, nokuba ingqondo yebhinqa. Yaye kwiimeko apho umsebenzi ezi ingaba ezincinane kodwa ezibalulekileyo kakhulu ohluphekayo, ukuphuhlisa urhulumente, ukusongela ubomi kunye nempilo.

Inkcazo kunye nomsebenzi wembali

Waterhouse syndrome - Friderichsen - an insufficiency etsolo adrenal, olwenzeka emva okuthuthuzela umzimba ukopha kwi parenchyma yayo. Oku kwenza i okunzima kakhulu okusingqongileyo lwangaphakathi umzimba kwaye kunokukhokelela ekufeni.

Inkcazelo imeko yokuqala ukuvela ngo-1894, kodwa ibingonelanga, yaye ngowe-1911, Waterhouse ichonga iimeko ezilishumi elinantlanu, nto leyo yanceda ukuba baqokelele zonke iinyama kunye. Uhambisana naye, iminyaka esixhenxe kamva, ngowe-1918, Frederiksen nayo ipapasha isincoko malunga nale nkqubo yezifo.

izizathu

Izazinzulu ziyavuma ukuba syndrome Waterhouse - Friderichsen wabangela legazi omkhulu ngexesha elifanayo zombini adrenal. anokuvela ezinokuba yingozi - usana, iimveku, abantwana kunye nabantu abatsha. Umgangatho kule meko semxholweni. Le umbuso kuxhokonxwa unikezelo elide, foetal oxygen yindlala okanye phambili zayo emjelweni ukuzalwa usebenzisa forceps okanye cleaner zokukhupha. Ukongeza, kukho indima ebalulekileyo yesifo kakhulu awazalwa enaso, kunye nokukhulelwa ingxaki of gestosis emva kwexesha.

Waterhouse syndrome - Friderichsen abadala amaninzi kubonwa kwingxaki ye sisifo esosulelayo. Ngokuqhelekileyo, i-arhente i meningococcus, iStreptococcus okanye staphylococcus. Kodwa ke ngaphandle koku, oonobangela legazi kunokuba nosologies ezifana nemasisi, ifiva nebomvu, yicesina, isifo somqala omhlophe, yaye neoplasms yingozi, nangezilonda, peritonitis DIC kunye thrombosis ngemithambo adrenal.

Uphuhliso sifo

Ababhali abaninzi baye bakwazi esi sifo njengenxalenye indlela olulungisiweyo ukusilela kuphuhliso nokudumba ahlekise. Kodwa kusenokwenzeka ukuba abantwana abaselula kunye nabasetyhini abakhulelweyo indlela eyahlukileyo ngokupheleleyo ngazo iphuhlise Waterhouse syndrome - Friderichsen. Pathogenesis ukuthi kuziveza ngazo ukopha necrosis le uthinte adrenal. Baba baninzi ukuze umzimba uphela nkxu egazini, kukho hyperextension le philisi, yaye komsipha yayo.

Njengoko kuba Pathogenesis jikelele, athe wabonakala ngohlobo nokudumba:

- emithanjeni inimba kunye arterioles;
- zicaca ukunxila syndrome;
- ubukho meningitis ezihamba okanye meningoencephalitis;
- ukwanda kwiindawo nkovu zengingqi kunye thymus.

symptomatology

Waterhouse syndrome - Friderichsen kunye nesifo meningococcal basenokuba ngephanyazo imvelaphi intlalo-ntle. Yena inkqubela ngokukhawuleza kangangokuba umntu uyafa kwiintsuku.

Yonke lento iqala ngo excitability ngokugqithiseleyo, ukuba nochuku kunye yintloko. Uze uve iintlungu esiswini, isicaphucaphu, ukugabha kunye norhudo. Ukuba iintlungu kakhulu kakhulu, ugqirha kufuneka kurhanelwa kwizigulane kunye ngezifo oyingozi yotyando. Ekuqaleni, libya-grade fever, kodwa nje iiyure ezimbalwa abaqala oko degrees 39-40. Ngenxa ukuhlanza norhudo ukusuka umzimba abashiya ngamanzi kunye neetyuwa, nto leyo ekhokelela ukuphazamiseka intliziyo, ingqondo kunye namanye amalungu abalulekileyo. Ekugqibeleni, lo mntu ulahlekelwa sezingqondweni kwaye yeyela isiqaqa.

Kukho olunye uhlobo lwe esi sifo, esizibonakalisa kwiimeko ukuwa okukhulu uxinzelelo lwegazi okanye ziwe. Ezinye iimpawu mazingabi konke konke. Umntu kuqala ngalala, kodwa hypoxia sanda ngokukhawuleza iza ngalala okanye ukuba khokhoma. Ufa ngaphandle kokubuyela ezingqondweni.

Waterhouse syndrome - abantwana Friderichsen ukuqulunqa ngokukhawuleza kubantu abadala, kungakhathaliseki ukuba unobangela. Ngenxa kubuchule babo zembuyekezo kumzimba kuphele ngokukhawuleza, kunye neenkqubo ezininzi amalungu nangoku kwinkqubo lokuqulunqa nokuphuhlisa, isiphumo iza kwiintsuku zokuqala ekuqaleni kwesi sifo.

ekuxilongweni

Waterhouse syndrome - Friderichsen asakhasayo ukuze ngokukhawuleza ukuba oogqirha abanalo ixesha kuqhuba uviwo olupheleleyo ulawulo kwaye bona okwenzekayo ukuba nendoda. Ukuba kwigumbi labagula ugqirha umsebenzi ukrokrela le ngezifo, unyango iqala ngoko nangoko, kwaye isifo uzibandakanya kule nkqubo, kuba ngxelo kule wotshi.

Laboratory ukuqinisekisa uxilongo kuyimfuneko ukufumana kuhlalutyo jikelele igazi:

- leukocytosis kunye shift leftward zefomula;
- ukuncipha glucose igazi;
- thrombocytopenia kunye ekunqandeni eliphantsi;
- Ukwehla electrolytes;
- ukwanda urea igazi nitrogen.

Nangona kunjalo, ezi mpawu akukho ezithile kwaye inokuba kubonisa loluhlu olubanzi zoqhaqho kunye nezifo zenkqubo yezemfundo. Ukuze uqiniseke, kufuneka uqokelele ngenyameko imbali yezonyango, a endla ntirho empontshwa kwaye ukuba bachaze ubume neurologic. Kodwa konke oku kwenziwa emva kokuba nokuzinziswa imeko yoluntu.

diagnosis umehluko

Waterhouse syndrome - Friderichsen zingahlukaniswa iimeko esiswini ngotyando ezifana appendicitis etsolo, pancreatitis etsolo, isilonda perforation esiswini okanye duodenum. Qiniseka ukuba ugqirha kufuneka ukukhangela iimpawu meningeal, ukunqanda ukopha ebuchotsheni, cavernous sinus thrombosis. Xa ifomu ECG kwentliziyo kuya kukunceda uqonde ukuba umntu wahlaselwa yintliziyo okanye hayi.

unyango

Kwindawo yokuqala emva kokuba uxilongo "syndrome Waterhouse - Friderichsen" kufuneka ukubuyekeza isigulane sweated electrolytes ulwelo kunye nokungabikho iihomoni adrenal. Ukuze oku kuqaliswa ngokusetyenziswa ukufikelela lwemithambo ukuze kwesiqingatha selitha "hydrocortisone" okanye 120 milligrams "prednisolone" kunye iigram ezintathu glucose iipesenti ezintlanu kunye ngeemililitha ezilishumi iipesenti ezintlanu nesisombululo ascorbic acid. Ngoko ke senza Pathogenesis basic, ebangela Waterhouse syndrome - Friderichsen. Emergency Care ngexesha elifanayo kuphucula rheology igazi, dilutes oko konyusa ixabiso kolwelo nkqubo kwaye kwandisa uxinzelelo. A hormone steroid inceda ukugcina uxinzelelo kwinqanaba elifanelekileyo.

Emva Ukuzinziswa hormone kuqhubeka ukuba iphathwe intramuscularly, "Hydrocortisone" ka 50-75 mg zonke iiyure ezintandathu, kunye deoxycorticosterone acetate kwi ngeemililitha ezilishumi kathathu ngemini. Qiniseka ukuba ukulandela izalathisi kuxinzelelo kunye, xa kukho imfuneko, ukuba phina "Epinephrine," "Mezaton" glycosides inhliziyo.

Ukuba unobangela sifo kuba usuleleko, ezifana meningococcal, ukongeza kuthomalaliso ephambili, isigulana unikwa antibiotics. Xa imbuyekezo nomonde esiqhelweni, iihomoni baqale ngokuthe ukunciphisa idosi. Kubalulekile ukulungiselela ngokufanelekileyo umzimba kuba oko ngokuzimeleyo kufuneka aveze glucocorticoids. Musa zenyuka ukucima iziyobisi, oko kubangele enengxaki yesibini.

Kubalulekile ukuqinisekisa ukuba isigulana nje Waterhouse syndrome - Friderichsen. Yonyango ngokwalo kunokuba yingozi ezinjengezikhukhula ngokugqithiseleyo umzimba ubangela nokudumba systemic, kuquka nokudumba ebuchotsheni, kwaye ngokwemithamo enkulu zamadlala angadala ukuphazamiseka kwengqondo. Ngoko ke, imeko yomguli ibaluleke kakhulu rhoqo esweni kwaye ulungise ukuqeshwa ngokweemfuno zakhe.

Outlook

Waterhouse syndrome - Friderichsen - ngezifo ezinzima kakhulu, ibonisa ukuba akusoloko ngexesha ngenxa ezahlukeneyo iimpawu non-ngqo. Kuya kuxhomekeka kungekuphela izakuziphatha njani kakuhle ugqirha kwimeko yongxamiseko, kodwa phezu iqondo ngokutshatyalaliswa adrenal kunye namandla zembuyekezo yento ephilayo. Ezivame lesi sifo lelibulalayo.

ukuvimbela

Oku ikakhulu amanyathelo anti-Ubhubhane eziko yosulelo apho isigulane banesifo kunye nesifo meningococcal. Ugqirha uye wazityhila isigulana eso linyanzelekile ukuba lazise nokuhlola Sanitary ayivalele isigulane. Kwiintsuku ezintathu emva koko, itsheki labantu zoqhagamshelwano ubukho kwezifo kunye yedwa ekuhlaleni emsebenzini okanye iziko lemfundo isithuba seentsuku ezilishumi. Ukuze siphephe, abantu ukunxibelelana isigulane, amisele ikhosi emfutshane antibiotics.

lwezifo

Waterhouse syndrome - Friderichsen, ngelishwa, ngezifo kakhulu eqhelekileyo. Kumazwe aphuhlileyo, izehlo kwezifo meningococcal yi amatyala 1-3 100 000. Kwaye ngaphezu kwesiqingatha amatyala - abantwana abakwiminyaka zabasakhasayo. Ukongeza, amashumi ngalinye kubekho ukunyuka kwesifo. Oku kubangelwa kuguquka yabantu pathogen kunye nezifo nokwehla.

Ezi nkcukacha-manani kakhulu ukuba asiyonyani, njengoko kwiimeko ezininzi yiya akubonakali kuba iimpawu lomnqamlezo. Waterhouse syndrome - Friderichsen asakhasayo ukuze ngokukhawuleza ukuba oogqirha abanalo ixesha lokwenza inani elaneleyo uvavanyo.