Epidermal necrolysis anobuthi: izimpawu, izimbangela, isithombe

izifo eyindida dermatological ukuthi kungaba kuphila kwetfu engotini, akwenzeki njalo. Nokho, ziyisici. Enye yalezi ubhekwa anobuthi epidermal necrolysis. Lokhu zokugula iyisifo ezingavamile kwesikhumba engaholela ekufeni.

Kuyini zokugula?

Toxic epidermal necrolysis - a zokugula iguliswa ezinzima, olungaholela lamabutho ungqimba engenhla isikhumba. Wabe efa umzimba echayeke ukudakwa eqinile. Ngaphandle kokwelashwa abaqeqeshiwe abantu kungenzeka sepsis nokufa.

ukufa Bullous ezinguquko kanye okufanele abekeke hhayi kuphela isikhumba, kodwa futhi nolwelwesi lwamafinyila. Lesi sifo omshoshaphansi kakhulu. Iqiniso lokuthi iziteleka bangaze yangaphakathi nolwelwesi lwamafinyila, okuvame ukuholela ukopha kakhulu esiswini, nokuvaleka kwemigudu yokuphefumula, umsebenzi kanye nokunye ukwephulwa umzimba.

Ngokuvamile eba anobuthi epidermal necrolysis emva ukusetshenziswa kwezidakamizwa ezithile. Nokho, izizathu kungenzeka abanye. Ukuvela futhi Yiqiniso lesi sifo cishe akunakwenzeka ukubikezela.

izimbangela

Imbangela ezivame kakhulu izifo ukusetshenziswa kohlobo oluthile izidakamizwa:

• Sulfonamides.
• Erythromycin Macrolides '. "
• Penicillin izidakamizwa.
• Anticonvulsant: "lamotrigine", "carbamazepine", "Phenobarbital".
• Quinolones "Trovafloxacin".
• Protivovspalitelnye izidakamizwa nonsteroidal: "Indomethacin" "ibuprofen," "piroxicam".

Kuvamisile liphansi kakhulu futhi 1 kuphela icala ngalinye 1 isigidi sabantu ngonyaka. Ngokuvamile kuthinta abesifazane. Ubudala nakho kubalulekile, njengoba iningi amacala zokugula siyenzeka emva kweminyaka 55.

Ngaphezu imithi kubangele necrolysis ukuvela kungaba batheleleke nge staph ukutheleleka.

Izici ukuthuthukisa lesi sifo

Epidermal necrolysis anobuthi ivela ngokushesha ngokwanele. Uma kwenzeka lokugula izivikeli mzimba awukwazi ukubona kahle futhi iwukudambisa into enobuthi, kulesi simo umuthi wezokwelapha. Ukusabela iguliswa unamandla kakhulu.

Kulokhu, izivikeli mzimba sihlasela isikhumba, ngoba ubabheka nomzimba angaphandle. Ngakho isiqondiso zokuwohloka amaprotheni iphazamisekile. Isikhumba iqala buthelela ubuthi eziholela ukudakwa Imininingwane. Uma isikhathi kungaqali ukwelashwa, umuntu uzofa.

Lesitshalo futhi kwasendaweni

Toxic epidermal necrolysis (ngezimpawu zesifo, sixoxisane kakade) kungenziwa labizwa ngokuthi elandelayo:

1. Idiopathic. Kwenzeka ngokuzimela, futhi imbangela yayo akukwazi ukusungulwa.
2. Ibangelwa izidakamizwa ezithile.
3. Ezivukayo ngaphansi kwethonya igciwane staph. Lolu hlobo lwe-pathology sitholakale ikakhulukazi ezinganeni. Kulokhu, ngethuba lokufa ayifakiwe.
4. Kuhlangene nezinye izifo.

I izilonda kungatholakala ezindaweni ezifana: ezinqeni, emahlombe, esifubeni, emzimbeni emuva, mucosa ngomlomo.

symptomatology lesi sifo

epidermal Toxic necrolysis (Lyell Syndrome) ngokuvamile libhekene zimpawu ezilandelayo:

• Ubude isimo umzimba ukwephulwa esizibonakalisa a ukungakuthandi ukudla, ikhanda elibuhlungu, okwandisa izinga lokushisa basal. Ngokuvamile uphawu zokugula luyanda ukoma.
• Izinhlungu nokuphatheka kabi e nolwelwesi lwamafinyila. Nokho, uzwela yabo kakhulu anda. Ngokwesibonelo, ngenkathi bedla isiguli uyazwelana nathi ebuhlungwini lapho uvuleka.
• Okuvela kuyo izindawo abomvu, ukuqubuka shashaza esikhumbeni futhi nolwelwesi lwamafinyila. Ezimweni eziningi ithinta-30% emzimbeni, nakuba lokhu kungase kube olukhudlwana.
• Eliphathisa we epidermis. Kulokhu, isikhumba iqala ekuhlehleni ngisho ngaphansi touch ababuthakathaka. Uma Endaweni ethintekile isikhumba ukususa isilonda ukopha lizovela ngaphansi.
• esingamahlalakhona kwezinso.
• inqubo ezithathelwanayo. Iqiniso ukuthi isikhumba ayikwazi ukusebenza kahle kanye nokuvikela abantu nokusondelana namagciwane. Isimo kungaholela sepsis.
• Ezigabeni kamuva lesi sifo ungabukela amanzi emzimbeni, tachycardia futhi hypotension.
• Ubuhlungu bemisipha.
• Fever nokukhwehlela.
• I-anorexia.
• Ukucanuzela kwenhliziyo nokuhlanza.

Cabangela ukuthi izilonda mucosal zenzeka ngokushesha kunabazali sifo isikhumba. Khona-ke kamuva ngimbone kahle uma izigaba sokuqala anobuthi epidermal necrolysis, isithombe okuyinto akukhona eyethile ezithandayo, kancane obonakalayo.

ukuhlola Izici

Uma une izinsolo anobuthi epidermal necrolysis, kufanele uxhumane nodokotela wakho ngokushesha. Kumelwe lokwenza ukuxilongwa umehluko kanye olunzulu kakhulu, okubandakanya:

1. Nenkanuko edlulele isisulu izikhalazo. Okumele kuqashelwe zonke amawala, ubuhlungu emizweni.
2. Ukuqoqa umlando nesineke. Lokho, udokotela kufanele sithole ukuthi ayenakho umzimba wakho uxabana ne anomthelela ekuthuthukiseni yokusabela eziyinkimbinkimbi enjalo. Kungcono ukuthola ukuthi izinkinga ezifanayo izihlobo lesiguli.
3. luhlolo sangaphandle isiguli. Kulokhu, udokotela kuqhakambisa umbala kwesikhumba, khona izilonda futhi anamabhamuza ulwelwesi lwamafinyila. Isiguli bangase basabele letitfolakala endzaweni yabo akuyona ngempela eyanele.
4. Ukuhlaziya igazi Imininingwane. Uzobanikeza ithuba ukucacisa amazinga ukuthi aphakeme amangqamuzana amhlophe egazi, kukhona egazi angavuthiwe, ukusheshisa erythrocyte sedimentation. Uma lezi nemingcele uhambe ngalé kwemingcele evamile, isimo kubonisa khona ukuvuvukala.
5. ukuhlaziywa kwamakhemikhali kwegazi. Uma ngenxa yalokho kukhona ezingeni bilirubin isigqugquzeli sincane kakhulu noma inani amaprotheni, isiguli kungenzeka izinkinga nge nokusebenza kwezinso.
6. Urinalysis. Lolu cwaningo futhi ukuze kutholakale nokusebenza kwezinso. Uma kukhona igazi-ke, it is a ukukhathazeka kwembulunga umchamo.
7. Ukulinganisa umsebenzi inhliziyo, umfutho wegazi imingcele.

Sifo Kuyadingeka ukuhlukanisa phakathi epidermal necrolysis anobuthi neminye izifo: pemphigus, scarlet fever, i-erythema, impetigo bullous, ulele planus.

Izici yokwelashwa

Emelelwa sifo kufanele ngaso sonke isikhathi ziphathwe. Kungenjalo, isiguli singase ulinde sepsis nokufa. Uma isiguli samanje izimpawu ngenhla, khona-ke kumelwe inikelwe ngokushesha ezimweni esibhedlela. Uma lesi sifo kunzima, isisulu yafakwa egunjini labagula kakhulu, lapho abasebenzi bezokwelapha kumnika ngokunakekela okwanele.

Chamber, okuyinto singenwa ukugula, kufanele kube oyinyumba, okuyinto Uyoqeda kungenzeka ukujoyina ezinye izifo. Pathology Ukwelashwa kuhilela ukususwa zezici kwabangela isifo.

Njengoba for yokwelapha izidakamizwa, ngaleso sikhathi kuyoba basisize ka corticosteroids futhi antihistamine. Ngaphezu kwalokho, kufanele ihlelwe yokwelapha ukumnika. Imithi elwa namagciwane ingasetshenziswa kuphela uma kwenzeka ukuthi isiguli ukubusa ukutheleleka yesibili.

Toxic epidermal necrolysis (kuyini, usuwazi) kumele aphathwe ngosizo imithombo yendawo ukusiza ekuvuseleleni izindawo evamile isikhumba ukuvuselelwa: imithi yokubulala izinzwa (amaphilisi ezinhlungu) yokugcoba, antiseptics.

Ngaphezu kwalokho, kuyodingeka banamathele ezimisweni yokwelapha:

1. Kufanele kube yinto engenzeka ukuthi ngokushesha ecacile evela endikimbeni izidakamizwa esithathwayo ngaphambili. Isebenzisa enemas.
2. Kuyinto efiselekayo ukuba adle izidakamizwa, iqhaza ekubuyiselweni evamile amanzi-usawoti umzimba, njengokuthi "Regidron".
3. Doctor imithi imithi sokuvikelwa isibindi, ikakhulukazi "Gepabene".
4. Ukuthola ama-ejenti ukuthi ukunciphisa igazi ekunqandeni.

Yini yezinkinga singenzeka?

Uma uxilongwe anobuthi epidermal necrolysis, ukuxakeka kungabandakanya:

• Ukuthuthukiswa igciwane sina virus.
• amanzi emzimbeni Sinzima, okungase kubangele ukufa lesiguli.
• Ukulahlekelwa imali enkulu isikhumba. Uma Umuntu ulahlekelwa ngaphezulu kwengxenye epidermis, it mela lokufa.
• Omiswe kwesikhumba, ukubukeka izibazi kuye, bashintsha lesikhumba.
• ukuguguleka Okungalapheki ka nolwelwesi lwamafinyila.

ukuba nombono ongafani ngeke

Uma impatho zokugula ayiqalwanga ngesikhathi, izinga lokufa ongafinyelela 70%. Ukulahlekelwa ingxenye enkulu isikhumba uzokwenza isiguli singangena kakhulu izifo.

Sifike ngesikhathi yokwelapha okuqalwe kuyokusiza balahle lesi sifo, kodwa uzophinde unikeze ithuba ligweme izinkinga ezingase zivele okubuhlungu kangaka ezifana ukopha zangaphakathi, umonakalo ohlelweni genitourinary, ukungakwazi ukuba badle, ukungasebenzi kwezinso nesibindi.

Kufanele kuqashelwe ukuthi izingane ababulawa yilesi sifo incane kakhulu kunabantu abadala. Uma isiguli uye wangenela engu-60 mlando, ke kulindeleke esidumazayo. Nokho, ukuphatha kahle angathuthukisa isimo sakhe.

zokugula Prevention

Enye igama laleli zokugula njengoba anobuthi epidermal necrolysis - Lyell Syndrome. Izithombe lesi sifo kungcono hhayi ukubheka abantu izwele. Lena zokugula eziyinkimbinkimbi, okuyinto kungagwenywa uma ulandela izinyathelo:

• Imithi kufanele athathwe kuphela uma udokotela.
• Lo chwepheshe kumele bazi uma ubhekana nanoma yiziphi komzimba.
• Kungakhathaliseki ukuthi ayehlala ezindlini zokugula ungase, akufanele kuthathe ngaphezu 7 izidakamizwa kanyekanye.
• Ingabe akazibekanga staphylococcal kanye nezifo zesikhumba ukuvuvukala.
• Gwema ukuthintana nanoma imuphi ecasulayo ukuthi kungabangela komzimba.

Njengoba for ukwelashwa, khona-ke wonkhe umuntfu kweyeme etinyatselweni izici umzimba isifiso lesiguli ukubhekana ukuhlukumeza. Hlala uphilile!