Thrombocytopenic purpura akuluakulu: matenda, zimayambitsa ndi mankhwala

Thrombocytopenic purpura akuluakulu - ndi matenda kungachititse kuti zikamera mofulumira mikwingwirima lalikulu ndi magazi. Monga ulamuliro, kutaya magazi chifukwa kugwa ulemu waukulu kupatsidwa zinthu za m'mwazi achiyesa - maselo zimene zimachititsa clotting ake.

Ena magwero a kudwala chimenechi chimatchedwanso thrombocytopenia m'thupi. Zingamvekere akulu ndi ana, koma odwala wamng'ono ngati chikhalidwe zambiri akufotokozera mu maziko a matenda enaake ndipo watsimikiza lokha popanda chithandizo chapadera. Akuluakulu, matenda ndi nthawi zambiri yaikulu.

Ngati mulibe zizindikiro za magazi ndi kupatsidwa zinthu za m'mwazi kuwerenga, ngakhale otsika, koma mfundo zogwira mtima, dokotala Mosakayikira sadzakhala mankhwala mankhwala. Nthawi zina Komabe, chiwerengero cha othandiza magazi kuundana ikagwa osachepera yovuta, kuchititsa moyo pachiswe magazi mkati. Zochizira matendawo izi zimafunikira yomweyo alowererepo zachipatala.

zizindikiro

Thrombocytopenic purpura akuluakulu (onani chithunzi pamwambapa) nthaŵi zonse ndi mawonetseredwe kunja matenda. Pankhani ya zizindikiro lililonse ndi zizindikiro zakutsatapo matenda:

• kwambiri mofulumira mapangidwe kufinya lalikulu (hematoma);
• zachiphamaso magazi pakhungu owoneka ngati totupa wa ting'onoting'ono, red-wofiirira mawanga (petechiae) ndi isanafalikire makamaka pa miyendo;
• magazi kuchokera m'kamwa kapena mphuno;
• kukhalapo kwa magazi mu mkodzo kapena chopondapo;
• modabwitsa katundu msambo magazi.

Pamene kuwona dotolo

purpura Thrombocytopenic akuluakulu akhoza kukhala zofunika kwambiri, ndipo mu nkhani iyi ndi bwino nthawi yokumana pasadakhale kuti katswiri wodziwa bwino.

Ngati inu anayamba kutuluka magazi, itanani "ambulansi." Chitsanzo cha magazi matenda sangathe ankalamulira kudzera ochiritsira ku zida kunyumba kapena njira ankaikira oyima magazi. Mwachitsanzo, sangathandize kuthamanga thupi pa malo yoyenera thupi. Akatswiri amalangiza kutembenukira kwa adokotala posachedwapa.

zifukwa

Idiopathic thrombocytopenic purpura akuluakulu zina akufotokozera chifukwa thupi chitetezo molakwika kuukira ndi kuwononga maselo othandiza magazi kuundana. Mawu akuti "idiopathic" amatanthauza "kusanduka kwa osadziwika chifukwa"; thrombocytopenia kotero zimaonetsa pa nthawi imene madokotala akulephera kudziwa zimene zinayambitsa kuchepa zimene chitetezo cha m'thupi.

Ana anaika maziko kudwala zambiri mosavuta, kuyambira matenda kukhala umangokhala matenda (mumps kapena chimfine). Amaganiza kuti matenda amasokoneza uziyenda yachibadwa ya chitetezo cha m'thupi.

Kuonjezera kupatsidwa zinthu za m'mwazi azingokhala

Ngati matenda koyamba amakhala purpura thrombocytopenic akuluakulu, chipatala (mawonetseredwe matenda) chikugwirizana, kawirikawiri ndi matenda ndi m'thupi. The chitetezo angagwirizanitse kwa maselo othandiza magazi kuundana, chosonyeza iwo monga maselo awonongedwe. Ndulu cholinga kuthana ndi matenda kunja, ndi oteteza amaona ndipo amachotsa maselo othandiza magazi kuundana m'thupi. Chifukwa cha malamulo olakwika mu magazi amazungulira laling'ono kwambiri chiwerengero cha othandiza magazi kuundana poyerekeza ndi mwakale.

Normal kupatsidwa zinthu za m'mwazi udindo osiyanasiyana monga maselo 150 450 zikwi pa microliter wa kufalitsidwa magazi. Anthu anapezeka ndi "thrombocytopenic purpura" (akulu) kusanthula limasonyeza maselo 20,000 okha chofunika. Popeza othandiza magazi kuundana kulimbikitsa magazi clotting, kuchepetsa chiwerengero chawo kumaonjezera ngozi ya magazi ndi magazi mkati. Mlingo wa 10 zikwi selo kupha. Woterowo kuchepa kwambiri chiwerengero cha othandiza magazi kuundana kukha magazi mkati angathe kuyamba ngakhale popanda kupwetekedwa iliyonse.

Zina mwa zifukwa

Thrombocytopenic purpura akuluakulu (Photo ntchito kumayambiriro kwa nkhani ino, zikusonyeza mawonetseredwe kunja matenda) likupezeka pa msinkhu wina uliwonse, asayansi apeza awiri mfundo zoopsa kuti walandira kukhala zizindikiro matenda. Ali:

• amadziwikira kugonana. Mu akazi, matenda amawapeza pa nthawi pafupifupi awiri kapena atatu zambiri kuposa abambo.
• Posachedwapa, tizilombo nthenda. Mumps, chikuku ndi matenda kupuma zingachititse kuti maonekedwe a zizindikiro khalidwe la thrombocytopenia, koma mgwirizano ndi mavairasi anapeza zambiri ana.

Tiyeneranso kupewa ngozi ya mavuto. The aakulu kwambiri a iwo - izi ndi a kukha mwazi muubongo amene akhoza chakupha.

pregnancy

Ngakhale thrombocytopenic purpura akuluakulu matenda ngakhale amayi apakati, udindo wa thanzi wakhanda ngati kudwala amayi nthawi zambiri si bwanji. Komabe, akatswiri Ndi bwino kufufuza mlingo wa maselo othandiza magazi kuundana ndi mwazi wa mwana yomweyo pambuyo pa kubadwa.

Ngati muli ndi pakati, koma zotsatira kusonyeza kuchepa achiyesa kupatsidwa zinthu za m'mwazi, muli pangozi Mwina ndi kutsegula amphamvu a postpartum kukha mwazi ndi mkulu. Zikatero, pali gynecologist kapena kuchipatala, madokotala ayenera kukambirana nanu za mankhwala alipo ali bwino ana.

diagnostics

dokotala anali wokhoza kuti apange matenda molondola "thrombocytopenic purpura" (akulu), matenda ayenera kuchitidwa pa masiyanidwe mfundo. Ziyenera kukhala pomwepo kulamulira mavuto ena zotheka magazi ndi kuchepetsa chiwerengero cha othandiza magazi kuundana - matenda mwachitsanzo, aakulu kapena mphamvu ya mankhwala anatengedwa ndi inu.

The katswiri ndikufunsani mafunso okhudza mbiri yanu ya zachipatala, udzabala zachipatala Kupenda koyamba ndipo adzakhala tisonyezeni chimodzi kapena zingapo muyezo mayesero matenda. Dama:

• Complete magazi. Kuchokera pa chitsanzo anatengedwa kuchokera m'magazi a wodwala anatsimikiza chiŵerengero chonse maselo a magazi, ndipo nambala inayake ya maselo othandiza magazi kuundana. Pamene thrombocytopenia otsiriza chizindikiro ndi abnormally otsika, ngakhale kuti kuchuluka kwa maselo oyera ndi ofiira adzakhalabe kuti pafupifupi.
• Chipatala kusanthula magazi. Phunziro lino Nthawi zambiri kuti atsimikizire mlingo wa maselo othandiza magazi kuundana akamagwira kusanthula okwana magazi. A chitsanzo mtima aikidwa pa wapadera galasi Wopanda ndi kufufuza simungathe kutiona.
• Analysis a mafupa. njira kufufuza bwino kokha odwala wamkulu ndi matenda wakale "thrombocytopenic purpura" (akulu poyankha chochitika yotere zambiri chokwanira, iwo savuta kulekerera ndondomeko).

Othandiza amatuluka mu m'mafupa - zofewa, chofewa ngati siponji minofu pakati pa mafupa lalikulu. Nthawi zina, adokotala akhoza kuchotsa nyemba fupa minofu ili mkati biopsy njira mafupa. Ena akatswiri amakonda kutenga zitsanzo kwa kusanthula ndi ndondomeko amatchedwa "kukhumba," ndiyeno amachotsedwa mafupa okha gawo la chigawo madzi. Nthawi zambiri, njira ziwiri zimagwiridwa imodzi ndi zimatchedwa amatchedwa "mafupa kusanthula."

Idiopathic thrombocytopenic purpura mafupa amasulidwa pathologies, monga kuchepetsa kupatsidwa zinthu za m'mwazi chizengerezo chifukwa cha kuwonongedwa kwa maselo a m'magazi ndi kukanika a ndulu ndipo palibe vuto ndi yopanga maselo othandiza magazi kuundana.

chithandizo

Easy thrombocytopenic purpura akuluakulu, zimayambitsa amene si molondola anakhazikitsa, kawirikawiri sikutanthauza mankhwala enieni - mokhazikika ndinawona dokotala, ndipo nthawi kuchepetsa mlingo wa maselo othandiza magazi kuundana. Ana pafupifupi konse amafuna chithandizo, ndi kukhumudwa akuthamanga yokha. Akuluakulu Komabe, amafuna mankhwala ngati mmene wakhala kwambiri kapena yaitali (aakulu) khalidwe.

Njira mankhwala zosiyana mosiyana ndi kukula mankhwala kulimbikitsa kupatsidwa zinthu za m'mwazi achiyesa isanafike opaleshoni kuti achotse ndulu (splenectomy). Iwo m'pofunika kukambirana ndi dokotala ku options pasadakhale chithandizo pamodzi ndi ubwino ndi kuipa kwa ntchito. Odwala ena amaona kuti mavuto kwa kumwa mankhwala kuwalanditsa anachitazi ndi kusapeza kuposa zotsatira zenizeni za matendawa.

mankhwala

adokotala kukambirana nanu mavuto ndi mlingo wa mankhwala ndi zowonjezera zakudya kuti mukutenga pa mphindi. Mwina ena a iwo amathandiza kuchepetsa kuchuluka kwa maselo othandiza magazi kuundana m'magazi kufalitsidwa. zotsatirapo zimenezi ndi aspirin "Ibuprofen", "Ginkgo biloba" ndi "Warfarin".

Mndandanda waukulu

Pamene matenda zikutsimikiziridwa ndi "thrombocytopenic purpura" akuluakulu, chithandizo chake chingakhale kutenga mankhwala zotsatirazi:

1. mankhwala kuti kubisa chitetezo cha m'thupi. odwala ambiri mu mankhwala oyambirira akatulutsidwa corticosteroids m'kamwa monga "Prednisone". Kuchepetsa chitetezo ntchito, mankhwala amalimbikitsa kupatsidwa zinthu za m'mwazi kuwerengedwa. Kamodzi mlingo chonse wafika msinkhu zolandirika, adzakhala kuyang'aniridwa ndi dokotala pang'onopang'ono kusiya kumwa mankhwala. The njira ya mankhwala adzachotsa kwa masabata awiri kapena isanu ndi umodzi.

Vuto n'lakuti thrombocytopenic purpura akuluakulu, zizindikiro amene anabwera osaonekanso atalandira "Prednisone" angabwerenso pa mapeto a mankhwala. Madokotala zambiri mankhwala njira yatsopano ya corticosteroids Komabe, mankhwala sangathe anapitiriza kalekale chifukwa cha zotsatira zina zoyipa za mtundu mankhwala. Ngati nkotheka ambiri osokoneza mathithi, kuchuluka shuga, kuchuluka chiopsezo cha matenda opatsirana ndi kufooka kwa mafupa (kufooka kwa mafupa).

2. jekeseni kuonjezera chiwerengero cha maselo magazi. Ngati corticosteroids sititenga, madokotala mankhwala jekeseni wa immune globulin. Izi mankhwala ntchito nthawi imene wodwala anaulula amataya magazi kuti amafuna yomweyo alowererepo pa opaleshoni. Zotsatira kumatenga masabata. Mwa zotsatira zotheka mbali - mutu, kusanza ndi kuthamanga otsika magazi.

3. formulations imathandizira kupanga kupatsidwa zinthu za m'mwazi. Mankhwala monga "Romiplostim" ndi "Eltrombopag" ( "PROMAKTIV"), kumathandiza mafupa kubala othandiza magazi kuundana kwambiri. Mu mawonekedwe mavuto akhale mutu, chizungulire, kunyansidwa ndi kusanza.

4. immunosuppressants Other. "Rituximab" ( "Rituxan ') amachepetsa mphamvu ya yankho nthenda ya chitetezo cha m'thupi zomwe zimachititsa othandiza magazi kuundana yachibadwa anawonongedwa. Zotsatira Angathe mbali monga zotupa pa khungu mochedwerako magazi, malungo, ndi zilonda zapakhosi.

Ngati mankhwala sangathandize

Ngati (ndi zina sititenga mu zakudya wamkulu monga mfundo za moyo wathanzi, kupewa kumwa mowa ndi kumwa mankhwala kuchotsa vuto) inu patsogolo thrombocytopenic purpura, dokotala angakulangizeni opaleshoni. Kuchotsa ndulu (splenectomy) mofulumira kumatha kudwala, monga dokotala amadula wowonongayo chachikulu cha othandiza magazi kuundana. Kumbukirani kuti inu mudzakhala pa chiopsezo mavuto postoperative. Komanso, anthu opanda ndulu zonse mu angathe kutenga matenda opatsirana kuchuluka.

njira zina

Ngati, thanzi kapena zifukwa zina, simungathe kugula opaleshoni, katswiri mwina mankhwala ndi kuvomera mankhwala atsopano - mwachitsanzo, "azathioprine" ( "Azathioprine", "Azasan"). Komabe mankhwala zambiri zimene kumafuna zotsatira kwambiri mbali. "Azathioprine", makamaka amachititsa kuwonjezeka thupi kutentha, mutu, nseru, kusanza ndi ululu minofu.

Ndi nkhanza aakulu

Inu amapezeka ndi "thrombocytopenic purpura"? Akuluakulu, pakutchulidwa za matenda amafuna kusintha moyo. Popeza matenda limodzi ndi chiopsezo cha magazi kuchuluka, kupewa kuchita ngozi kukhudzana masewera (nkhonya, masewera a karati, mpira) ndi momwe mukhoza kusamalira thupi yekha.