Felty a Syndrome: Zizindikiro, Matendawa

Pansi syndrome Felty amanena kuti vuto la nyamakazi, lomwe limapezeka mu% 1 kokha odwala onse ndi matenda. Malungo, minofu ya manja, mtundu ndi chiwopsezo kwa matenda opatsirana chikhalidwe - zonsezi zambiri ayende syndrome Felty a. Kudwala Matendawa zachokera mbiri ya nyamakazi, lofunika kwambiri limabweretsa magawo zasayansi. Chithandizo kumafuna madyedwe a corticosteroids, splenectomy. Kwa nthawi yaitali kudwala yodziwika ndi chikhalidwe chosadziwika ndi chithunzi matenda. Mu 1929, AP Felty anafotokoza lapansi. Kuyambira matenda anali kusiyanitsidwa monga nosology palokha.

Felty syndrome: ndichiyani?

Matendawa ndi chimafotokozera pamaso pa pathologies atatu munthawi yomweyo: ndi nyamakazi, anaonjezera ndulu ndi leucopenia (otsika maselo oyera). syndrome Izi zambiri anapezeka ku anthu achikulire kuposa zaka 40, nthawi zambiri mu kugonana chilungamo.

Akatswiri amanena kuti chifukwa cha matenda ndi ndondomeko autoimmune. Iwo atuluka ndi nkhani mwachindunji zimakhala lymphoid ndi mapangidwe wotsatira wa maofesi m'thupi komanso chitetezo yeniyeni. Kudwala chidawoneka neutropenia ndi kuchepetsa kuvomerezedwa mu kukana kuti matenda ambiri, ndipo akapezeka - kuti kwambiri. Natenepa lero ndi splenectomy (kuchotsa ndulu ya) anazindikira yodalirika njira mankhwala.

syndrome Felty a amakhala ndi kuchuluka kwambiri, kawirikawiri atypical. Matenda mwina patsogolo zaka zingapo (5 mpaka 10) matenda otchedwa rheumatoid polyarthritis ndi okhudzidwa munthawi yomweyo mu pathological mfundo ndondomeko interphalangeal, ndi osiyana a mwamphamvu.

Komano, ambiri odwala matenda lino limadalira mawonetseredwe mmene minofu connective. Izi zikhoza kukhala malungo, mapangidwe tinatake tozungulira subcutaneous, myocarditis, imfa ya thupi, poliserozita.

The zifukwa

The etiology matenda ndi losadziwika. Si odwala onse ndi matenda a "nyamakazi" kusiyana kudwala izi. Mu mafupa a munthu wathanzi ndi mosalekeza imatulutsidwa ndi maselo oyera a m'magazi. Odwala matenda, ngakhale makope wotsika, leukocytes amagwiritsidwa anapanga. Iwo akhoza kudziunjikira mu yambiri mu ndulu ya.

Kodi zizindikiro limodzi syndrome Felty ndi akuluakulu?

• Articular syndrome (nyamakazi zimfundo zing'onozing'ono).
• Kukula kukula kwa chiwindi.
• Zowombetsa mkota lymphadenopathy (matenda 50% milandu).
• Kuwonjezeka mwapang'onopang'ono kukula ndulu (monga anatsimikiza mtima palpation).
• Polyneuropathy.
• Mtundu pakhungu, zilonda shins lapansi.
• Akakufunsani fibrosis m'mapapo mwanga.
• Rheumatoid tinatake tozungulira.

mbali zonse pamwamba n'zotheka kuti matenda syndrome Felty a. Zizindikiro za odwala onse amaoneka mosiyana. Mwachitsanzo, nthawi zina kukulitsa a ndulu ali kokha mu magawo kenako chitukuko matenda.

matenda

Maziko chitsimikiziro chomaliza cha matenda matenda a mitundu munthawi yomweyo splenomegaly ndi nyamakazi. kuyezetsa magazi amakhala ndi magazi m'thupi, leukopenia, neutropenia. The immunoassay ambiri detects RF titers kwambiri, CEC, pamaso pa chitetezo antinuclear. Malinga ndi zotsatira myelogram myeloid mafuta hyperplasia akapezeka ndi olakwika kwa zinthu mwana ma. njira malangizo a kufufuza (Kujambula, CT, ultrasound zimfundo ndi) amapezeka imfomeshoni pang'ono. syndrome Felty n'kofunika kwambiri kusiyanitsa ndi matenda enaake ndi sarcoidosis.

zoyamba za chithandizo

Therapy, mu nkhani iyi ikukhudza njira mabuku. Nyamakazi amaliona monga muyezo. Therapy mobwerezabwereza matenda, ndi nyamakazi kuphatikizapo mankhwala kuthandiza la misempha ( "Azathioprine", "MTX").

Odwala matenda aakulu Ndi bwino kuti jakisoni mlungu ndi mlungu za chinthu, amene kumapangitsa granulocyte njuchi. Izo kumawonjezera chiwerengero cha maselo oyera.

mankhwala Basic akhoza kuchepetsa symptomatology amene ayende nyamakazi, Felty syndrome mwachindunji. monga Zikuphatikizapo: "Methotrexate", "Penicillamine".

Glucocorticoids ogwira okha Mlingo mkulu. Apo ayi, zikuchulukirachulukira mosavuta kumwa. Komano, ntchito yaitali glucocorticoids kungachititse kuti chitukuko cha matenda intercurrent.

I kwa mphamvu ya mankhwala:

• Kuwonjezera chiwerengero cha granulocytes kuti 2000 / mm.
• Kuchepetsa kufala matendawo opatsirana a chilengedwe.
• Kuchepetsa kuukira malungo.
• Kuchepetsa zilonda pa mawonetseredwe khungu.

Pamene opaleshoni bwino?

Kodi mungachite kuthetsa matenda Felty chiyani? Chithandizo ndi opaleshoni bwino ngati mankhwala anali osamveka kapena chifukwa cha zifukwa zina, iwo contraindicated. Pankhaniyi, ndi zambiri funso splenectomy. Nkofunika kukumbukira kuti 25% ya milandu neutropenia recurs pambuyo njirayi.

Pansi splenectomy zikutanthauza opaleshoni, imene adokotala kwathunthu kapena pang'ono amachotsa ndulu. Masiku ano, pali zinthu ziwiri wochita yoteroyo: laparoscopic poyera splenectomy.

Laparoscopy imagwiridwa ntchito mankhwala ochititsa dzanzi ambiri. Pankhaniyi, opaleshoni kumafuna kugwiritsa ntchito chida woonda ndi kamera pa mapeto, wotchedwa ndi laparoscope. Dokotalayo zimapangitsa amacheka angapo ang'onoang'ono pamimba kudzera amene anayambitsanso zida mwai wotsatira. Nthawi kuchira, monga ulamuliro, sikutanthauza nthawi zambiri.

Open splenectomy kumaphatikizapo ang'ambe thupilo lalikulu m'munsimu nthiti, imene dokotala amachotsa ndulu. Pambuyo kuchotsa thupi kuti thupi zosefera kunja mabakiteriya ndi tizilombo tina magazi ndi ndinasintha yafupika.

zosokonezeka zotheka

Zovuta ndi matenda osowa kwambiri ndi kungaonekere mu mawonekedwe a munthu ndulu utaphulika, chitukuko otchedwa oopsa zipata, m'mimba magazi kwambiri zikuchitika matenda sekondale.

Pomaliza

Felty ndi matenda - matenda n'chosoŵa, koma vuto la gulu lonse la pathologies lomwe masiku ano amapezeka kawirikawiri. Izi sizikutanthauza kuti ife kunyalanyaza mankhwala ake ndipo osati kufuna thandizo oyenerera kwa dokotala yoyenera. Zizindikiro chachikulu ayenera kuchenjeza aliyense ndi kukhala chifukwa akufunafuna uphungu kwa katswiri. Apo ayi, zikuchulukirachulukira mosavuta kuwonongeka kwa boma ambiri ndi chitukuko cha mokwanira woopsawo mavuto thanzi, monga chotupa cha ndulu yokha. Yodalirika mankhwala njira tsopano chimatengedwa ngati splenectomy a.

Tikukhulupirira kuti onse mudziwe anapereka m'nkhaniyi pa nkhaniyi adzakhala zothandiza kwenikweni kwa inu. Khalani wathanzi!