Zochita Anaphylactoid: zizindikiro, matenda ndi gulu

Nthawi ya matupi awo sagwirizana (anaphylactic) zochita chifukwa cha wothandizila exogenous, ndi nthenda yotaya khalidwe yake yomweyo mtundu hypersensitivity. Monga ulamuliro, yodziwika ndi mmene thupi akhoza kukhala moyo pachiswe mankhwala chikhalidwe cha khungu, kupuma ndi ntchito cardio-mtima. Pambuyo yoyamba ndi Antigen ndi akuyamba m'badwo IgE chitetezo enieni cholinga chake. Iwo kuphatikiza ndi maselo udindo njira chitetezo chokwanira, ndipo pali zina kuti Antigen lapansi.

Kodi sayanjana?

kugunda wina amalimbikitsa kutulutsidwa kwa allergen udindo maselo mthupi mphamvu ya zinthu bioactive, makamaka histamine. Pa nthawi ya kusintha kwa mankhwala zako kuti pathological Maphunziro Akakhalidwe Kazolengedwa kusintha zobwera zikugwirizananso makamaka ziwiya magazi, lymph mfundo, bronchial yosalala minofu kuti kumathandiza kuti chitukuko ndi kuyamba kuonekera kwa syndromes awa:

• kuchepetsa kamvekedwe mtima;
• mwadzidzidzi chidule minofu yosalala minofu za m'mimba, bronchi, chiberekero;
• kuyan'anila krovosvortyvaemosti;
• kutupa ndi kutupa kwa mitsempha.

Mosiyana ndi matupi awo sagwirizana, anaphylactoid anachita, zomwe mChipangano zoyerekeza mankhwala, palibe IgE-mkhalapakati oteteza ndi basophils. Ngakhale kufanana zizindikiro ayankhe ndondomeko, onse ali kuwonekera kwa zowombetsa mkota hypersensitivity zimene lake.

ziwengo mankhwala kuchititsa zochita anaphylactoid

zochita Anaphylactoid - kumakhalanso amasulidwe histamine, kawirikawiri kale pa yoyamba ndi irritant ndi. Pseudoallergic panopa kuimira osiyanasiyana mwachilungamo lonse. Zodabwitsa, izi zimene thupi kaŵirikaŵiri zinkachitika pa nthawi ya kumwa mankhwala, relieves chifuwa.

Anaphylactic ndi anaphylactoid zosiyanasiyana mtundu yomweyo zimachitika nthawi zambiri pambuyo kumayambiriro relaxants minofu, mankhwala mankhwala ochititsa mankhwala, opioids, m'dera dzanzi mankhwala, katemera mankhwala timadzi, atropine ndi mavitamini B kuti allergens mulinso seramu, antigens ntchito mankhwala zolinga ndi matenda kudziwa khungu, matenda venereal. Milandu ya ziwengo kuti Zodzitetezela mankhwala. A chodabwitsa wamba amaona anaphylactoid anachita lidocaine wa ngati m'dera mankhwala mankhwala ochititsa ntchito kawirikawiri, koma zovuta mankhwala ake zikuchokera angathe kuyambitsa zotsatira zoyipa ngakhale chamoyo wathanzi, amene ziwengo kuti zigawo mankhwala si lililonse.

Nemedikametoznye zikuchitika

Ngati tikulingalira milandu mayankho a thupi zikuchitika zachilengedwe sanali pharmacological, pali makamaka "vuto" kungakhale chakudya:

• strawberries;
• nkhono;
• uchi;
• mtedza;
• bowa;
• Ena mitundu ya nsomba;
• mazira;
• zipatso.

zochita Anaphylactoid kumachitika pamene tizilombo kuluma kapena chakupha nyama zonse zopanda mafupa zomera. Odwala zonse akukumana thupi lawo siligwirizana chikhalidwe si mankhwala, ndi ngozi yaikulu anaphylaxis pa nkhani ya opaleshoni pogonekedwa ndi mankhwala ambiri.

gulu la anaphylaxis

Motero zimachitika ndi gulu la thupi lawo siligwirizana. Unit woyamba zikuphatikizapo zinthu zosiyanasiyana anaphylactic amene anawagawa katundu nkhoswe IgE, IgG nkhoswe ndi IgE-mkhalapakati ndi thupi. Pseudoallergy zochita anaphylactoid nkhoswe ndi losavuta amasulidwe owayimira, kenako kuitana amayamba ndi zochita za mankhwala, kukhudzana ndi chakudya ndi zinthu zakuthupi. A gulu osiyana protrude zochita anaphylactoid ndi mastocytosis; nkhoswe maofesi m'thupi, immunoglobulin aggregates pamene kutumikiridwa antisera ndi oteteza nkhoswe cytotoxic, radiopaque zinthu.

Kodi anaphylaxis?

Morphine ndi barbiturates ambiri, relaxants minofu, pethidine zingakhudze maselo mafuta, kuchititsa amasulidwe histamine. Pa cithunzithunzi ici matenda zimadalira mlingo ndi mlingo inflow mu thupi la yogwira zosakaniza. Khalani limasonyeza kuti anachita chikuchitika ambiri mtima wabwino okha kusonyezedwa yekha pa khungu.

zochita Anaphylactoid (ICD-10 amaitcha syndrome izi pathological) wofanana ndi unpredictability chitukuko mtsogolo komanso mwina ngakhale pang'ono zokhudza ayankhe yapita matupi awo sagwirizana ndi antigens. Popeza zotsatira za anaphylaxis Kireni oopsa thanzi ndi moyo, nkofunika kwa kuzindikira mwamsanga mavuto ndi kanthu moyenerera. Kaya limagwirira kapena anaphylactic zizindikiro pseudoallergic nzothandiza siyana kwambiri. Kuvala chikhalidwe mwangwiro payekha, mawonetseredwe lingayambire pakukhala kudumpha pang'ono magazi ndi zotupa pa khungu ndi bronchospasm kwambiri ndi kugwa kugwira ntchito dongosolo mtima.

Pa nthawi imeneyi, n'zosavuta kuona wina kusiyana psevdoallergenov kanthu pa thupi. Nthawiyi, zochita anaphylactoid, zizindikiro zimene angathe kuonedwa payekha kapena zinthu zosiyanasiyana osakaniza, ndi chimodzimodzi oopsa.

Symptomatology anaphylactoid anachita

Zizindikiro za matupi awo sagwirizana angachitire wodwala m'nkhani boma m'maŵa:

• chizungulire;
• okwana thupi kufooka;
• matenda mtima mungoli (tachycardia, fibrillation);
• kutsitsa magazi;
• kufupika kwa mpweya, kuukira mphumu, ndi broncho-laryngospasm, edema m'mapapo mwanga ndi pakhosi;
• khungu moto, kuyabwa zidzolo, ming'oma, redness integuments, angioedema ;
• matumbo omangana, nseru, m'mimba, kusanza;
• pakalibe zimachitika munthu;
• mtima kugwa;
• deceleration ndi polekezera za mtima.

zosokonezeka Nkosatheka pambuyo zochita anaphylactoid

The vuto lalikulu palokha chimaika mantha, pamodzi bronchospasm. Patapita nthawi zina za nthawi (kwa masekondi 30 mpaka ora, nthawizina 2-3 maola) Antigen analowa thupi amalimbikitsa matupi awo sagwirizana njira pathological mu thupi. Makamaka chifukwa zimene zimadalira mawonekedwe a nzothandiza malowedwe (kuwauza kapena parenterally). chitukuko mofulumira zambiri chifukwa cha imfa, kuchititsa mwadzidzidzi pachimake kupuma insufficiency, wosuliza perfusion kuthamanga dontho, kumene kumachitika chifukwa kulephera mwadzidzidzi magazi oziziritsa kukha magazi kapena edema, mkhutu ntchito ya tsinde, thrombosis wolumikizira.

Pa tsiku lachiwiri kuchokera akuvutika kuopseza mantha moyo ndi pochira concomitant matenda kupitilira anachititsa ndi matupi awo sagwirizana anachita ndi maziko. Ngakhale patapita masabata, ngozi za mavuto adakali mkulu. Kawirikawiri, pambuyo anaphylaxis , madokotala oterewa matenda ndi kukanika:

• chibayo;
• vasculitis;
• aimpso ndi kwa chiwindi kulephera, matenda a chiwindi, glomerulonephritis;
• epidermal necrolysis;
• myocarditis;
• nyamakazi.

amagawanika ungathe kusokoneza onse anaphylactic ndi zochita anaphylactoid. Mosiyana ndi mantha anaphylactic pathologies izi ndi kuti yotsirizira amafuna zina isanafike ndipo sangathe kukhala mu msonkhano woyamba ndi mankhwala allergen.

anaphylaxis chithandizo

Ufulu chithandizo mwadzidzidzi kamwedwe monga matenda adzatero mbiri chabe, kotero ndikofunika chisiyeni. Ziwengo symptomatology, mwachitsanzo. E. The chithunzi matenda, nalonso yofunika kwambiri kupanga chisankho othamanga. Komabe, yodalirika ndiponso wathunthu yankho la funso za matenda akhoza analandira pambuyo kafukufuku ziwengo ndi immunology zasayansi. Pa nthawi yomweyo, pa maziko a boma ovuta wodwalayo, makamaka thandizo lake mankhwala mwamsanga ayenera kupatsidwa, monga pa nkhani ya kumangidwa mtima kapena kupuma kumangidwa - amapangitsira kanthu.

Pa siteji ya kuzindikira chimayambitsa Poyankha siligwirizana, ntchito thupi ndi kuti agwire m'ziwawa zachipatala masiyanidwe matenda. mtundu wa kafukufuku cholinga kuti achotse chikoka zotheka zinthu sichingabweretse histamine kumasulidwa.

Zimenezi zingachitike wa chamoyo zifukwa zina sanali matupi awo sagwirizana

Nthawi zambiri, anaphylactic ndi anaphylactoid zochita (icho chiri ndi matenda oopsa kwambiri, ndi kofunika kudziwa anthu amene sachedwa ngakhale palibe vuto lililonse kwambiri koyamba, thupi lawo siligwirizana mu mawonekedwe a rhinitis) ndi kufanana ndi zinthu zina, zingakhale amatha kuyambitsa bronchospasm, hypotension:

• ambiri osokoneza wa dzanzi;
• thrombosis chifukwa cha mpweya entrapment kapena atherosclerosis;
• lolemera chiyembekezo cha nkhani chapamimba matenda;
• m'mnyewa wamtima infarction, pericardial tamponade;
• septic mantha;
• edema m'mapapo mwanga ndi zizindikiro zina kumphatikiza ndi chifuwa.

chisamaliro Emergency pamene mofulumira akutukuka monga anaphylactic kapena anaphylactoid anachita pafupifupi sasiyana ku zovuta za zochita umalimbana Kupha ndi chithandizo cha mantha anaphylactic.

Ndondomeko kanthu mwamsanga

Ndi kupitirira a chifuwa Choyenereza madokotala ndi kupereka chisamaliro m'tsogolo kwambiri ndi chinsinsi chithandizo bwino. Mfundo mpumulo anaphylaxis a mtundu mwamsanga ndi kuvomerezedwa Ndime ya magawo angapo:

1. Chiyambi zosatsimikiza koma zikanavulaza Antigen ayenera anasiya.
2. Anaphylactic kapena anaphylactoid zochita (chithunzi m'nkhani kuonetsa zizindikiro ambiri ndi zizindikiro za matenda), amene akufotokozera pa ochititsa dzanzi kapena pa ntchito, amafuna kuyimitsidwa yomweyo. Ziyenera kukhala cheke khalidwe pa mfundo cha kubwera kwa allergens. Ndi kulumpha lakuthwa magazi pansi pakamwa mwa kundipatsako kwa mankhwala ochititsa. Mu nkhani ya bronchospasm ntchito kuvomerezedwa dzanzi Mpweya.
3. Mpweya wabwino ndi airway ayenera anaonetsetsa ngakhale pa siteji kuti, pamene wodwala si kwambiri sakuyenda. The intubation mapapo muyenera nthawi zonse, mpaka ndiye, mpaka zikuonekeratu kwathunthu kuti airway operekedwa ndi thupi lenilenilo.
4. zochita Anaphylactoid, amene mankhwala amafuna makonzedwe mtsempha wa zikuwonjezereka masiku ano, chimaika pangozi kuti wodwala, ngakhale maola angapo pambuyo kuchotsa bronchospasm. Mlingo pa makonzedwe mobwerezabwereza Epinephrine akhoza ziwonjezeke chifukwa thunthu kuli ndi ubwino pa olimba maselo Posakhalitsa, kuchepa mtima permeability wa endothelium, amene n'kofunika mankhwalawa anaphylaxis.
5. Mu kufunika pachimake kwa kuwatsitsimula ndi zofunika kuonjezera buku la madzimadzi kufalitsidwa mu thupi. Chifukwa chaichi, madokotala kuika lalikulu awiri catheter m'nsinga (Vienna ntchito kuti nthawi ndi malo - nthawi ya kufufuza yake kusewera ndi alili) ndi kutsanulira mu malita angapo a crystalloid.
6. Pamene n'zosatheka kudziwa allergens kumene kunachitika chifukwa cha anachita anaphylactoid, ayenera kulabadira ntchito pa zinthu mtima kukhudzana lalabala. Opaleshoni magolovesi, mankhwala, alemba ntchito kupyolera Mbale lalabala chipewa, catheters mkodzo - zonsezi zingakubweretsereni anaphylaxis.

Pambuyo mankhwala mwadzidzidzi mosiyanasiyana anaphylactoid (komanso anaphylactic) zimafunika Inde yaitali mankhwala pofuna kupewa zisadzachitikenso matenda. The kunyalanyaza malangizo a madotolo kumaonjezera ngozi ya kuwonjezera osiyanasiyana allergens angathe.

Yotsatira chithandizo

Mwa mankhwala pulogalamu bronchospasm yofunika wa mankhwala "Salbutomol" kuwapatsa, "aminophylline". Ngati zingatheke, achisangalalo zina inhalation ntchito isoproterenol kapena ortsiprenalina. Popeza zochita anaphylactoid - kumasonyeza matenda a zokhudza zonse, zimene zizindikiro angakhale ovuta, m'pofunika ntchito glucocorticoids (mwachitsanzo, "Dexamethasone" "hydrocortisone") constraining ndondomeko mtima kugwa.

Childs cupping anaphylactic mantha limodzi ndi wotsatira madokotala mosalekeza tcheru. chakuti chitukuko cha kukanika mochedwa nthawi zonse ndi malo, ndi digiri aliyense wa kuopsa kwa hospitalization mtima ndi njira bwino. Kuvomerezedwa ndi madokotala ndikukhulupirira kubwera kwa kafukufuku khungu pa kudziwika chitetezo yeniyeni.

Prophylaxis wa anaphylactic ndi anaphylactoid anachita

zachipatala mbiri Mokwanira - yabwino muyeso wa kupewa ndi kuteteza kukonzanso anaphylaxis. Atasonkhanitsa zonse zofunika za njira ya matenda, tingaone odwala pangozi ndi kudziwa zimene ankayembekezera kukumana zochita kukonzanso anaphylactoid. Kodi zikutanthauza chiyani?

Popeza kuukira wotsatira zichitike odwala kwambiri ankawonjezereka amafuna mosamala kusankha mankhwala ndi mankhwala, ndiponso pa odwala mwakayakaya. Pamaso magazi kuti anthu sachedwa anaphylaxis, achite mayeso Kupenda chifukwa ngakhale ndi mankhwala ena magazi.

Ziwengo mankhwala lalabala predetermines tsogolo khalidwe mwai zosiyanasiyana popanda kugwiritsa ntchito ndalama zimenezi.