Rheumatism umntwana: izimpawu, ukwelashwa, zokuvimbela

Kulesi sihloko sizoxoxa ngokuningiliziwe indlela ingane wabonakaliswa rheumatism. Izimpawu zilwane, ikakhulukazi ekwelapheni, ukuxilongwa kanye nokuvimbela - omagazini main okuzoxoxwa.

Ngokushesha iphawule yakho yokuthi rheumatism ingaqala ngasiphi yobudala ngokuphelele. Lesi sifo imvelo ezithathelwanayo kanye nomzimba. A ezihlukahlukene ukubonakaliswa emitholampilo ngenxa yokuthi ukuthi rheumatism kuthinta hhayi umzimba ethile, kanye ezicutshini ukuthi kuyisici esihlupha bonke imizimba yabantu. Cabanga izimpawu fever rheumatism ezinganeni.

Kuyini lokhu?

Siqala indaba yethu kanye umqondo welithi "rheumatism". Kuyini lokhu sifo? Ngakho ngokuthi isifo ukuvuvukala oluthinta wonke umzimba ngesikhathi esifanayo (isb, kuyinto uhlelo). Umsuka imfiva rheumatism - i ezithathelwanayo-nomzimba. Anakho elinye igama: Sokolowski izifo Buyo.

It libhekene izilonda zezinzwa izicubu isifo. Ikakhulu abathintekayo izicubu zezinzwa we senhliziyo isimiso sezinzwa esiyinhloko. Kukhona imininingwane yezibalo, okukhombisa ukuthi abesifazane avame yilesi sifo - ngokuphindwe kathathu ngaphezu amadoda. Nokho, lo mehluko ubalekela lapho usukhulile.

Yiziphi izici imfiva rheumatism ezinganeni? Izimpawu nasekwelashweni kwezifo kungakephuzi ebuntwaneni kancane ezahlukene. Lokhu kungenxa yokuthi izingane rheumatism has ezinye izici, njenge:

• kobukhulu evelele kohlelo zenhliziyo;
• izinguquko kwamanye amasistimu izitho;
• kungenzeka shintsho ifomu njalo lesi sifo (amaphesenti Amathuba ebuntwaneni kakhulu);
• okuvela ngangibuye ngihluleke.

Ifomu ezingamahlalakhona kuboniswa kanje: emva kokwelashwa kunenkathi ithule, kodwa ngemva kwesikhashana inkinga ibuyisela. Kuyaphawuleka ukuthi ukuphinda imfiva rheumatism kuyagcinwa ezinganeni kuvamile.

Izimpawu umkhuhlane rheumatism ezinganeni ezineminyaka engu-2 noma ezingu-10 musa ihluke nomunye. Sicela uqaphele ukuthi izingane ikakhulukazi ukungenwa yizifo kusukela kwabaneminyaka engamashumi ayisikhombisa nanhlanu. Izingane rheumatism ubhekene eziningi izinkinga ngemva kokuhlinzwa, kuhlanganise senhliziyo futhi. Rheumatism ngokuvamile uqala ukuthuthukisa emva kokutheleleka. Lezi zihlanganisa imfiva ebomvu, umphimbo obuhlungu nokunye.

Isikhathi esining impela Focus zitholiwe esimiso senhliziyo nemithambo yegazi. imfiva Rheumatic kuvamile emhlabeni wonke, ikakhulukazi emazweni ampofu, lapho amazinga lesi sifo ziphezulu kakhulu.

Sithatha sihlolisise ngezimpawu sitholakele isifo ebuntwaneni kuqhubeke, kodwa manje ngifuna ukuziqhakambisa nenqubo Jones. Kubalulekile wazi ukuthi uhlukanisa phakathi nenqubo ezinkulu nezincane. Uma kukhona okungenani esisodwa isici esigabeni sokuqala, kwanele ukuxilonga izifo.

zindlela angeziwe	zindlela ezincane
Carditis (ebonwe 70% amacala), polyarthritis (75%), i-erythema (10%), chorea (10%), kumiswa Izigaxana ongama (20%).	Fever, arthralgia, rheumatism anemneze, ESR anda noma CRP.

izimpawu

Manje cabanga ngokuningiliziwe izimpawu fever rheumatism ezinganeni. Njengoba kushiwo ngaphambili, rheumatism ongabhubhisa ezicutshini kwezitho zomzimba eziningi. Lokhu kungaba ukuchaza inombolo enkulu ukubonakaliswa ezahlukene zesifo. Konke kuncike ifomu nobukhali inqubo.

Lwegciwane rheumatism ezizokhuthaza ukukhiqizwa kwamangqamuzana into okuthiwa amaprotheni C-esisheshayo. Kuyinto lowo okubangela ukuvuvukala kubhujiswa lesi ezicutshini. Nalapha futhi, sicela uqaphele ukuthi imfiva rheumatism ayibonakali angaqondi ukuthi kungani. Inqubo ukuthuthukiswa iqala emva kokutheleleka. labelwe Ubude amafomu ezintathu zesifo, sizoxoxa ngazo kamuva. Isici esiyinhloko imfiva rheumatism - i ukuqala oyingozi. Izinkomba ilezi:

• waba ukwanda okukhulu kwezincwadi lokushisa komzimba;
• ubuthakathaka ezinzima;
• Ukuwohloka impilo.

Manje izimpawu ezivamile kokuqala yabalwa. Ezinganeni (iminyaka engu-2) izimpawu fever rheumatism kungaba:

• ukucasuka;
• tearfulness;
• ukulala neziyaluyalu, nokunye.

Eceleni kwabo izobe kancane kancane belekelelwa izimpawu agcwele ifomu rheumatism. imfiva Rheumatic ezinganeni, izimpawu kanye nokwelashwa esiphila ngayo esihlokweni, ungakwazi ukuzibonakalisa ngezindlela ezahlukene, kodwa cishe 85% izimo, isifo okusongelayo nezinkinga inhliziyo.

ngezigaba

Sekukonke kunezinhlobo ezintathu zesifo:

• articular;
• inhliziyo;
• sezinzwa.

Thina ukuyichaza ngokuningiliziwe ngazo ngokuhamba kwesikhathi.

Kuyaphawuleka ukuthi izimpawu streptococcal imfiva rheumatism ezinganeni kuyaqapheleka. Lesi sifo njalo kunemiphumela ngesimo yezinkinga noma rheumatism kuba amahlala khona.

Izimpawu umkhuhlane rheumatism ezinganeni iminyaka engu-10 futhi abasebancane izakhamuzi zaseBosnia zifana ngokuphelele. Kuvele professional abanolwazi kalula ukuxilonga izifo kunoma yisiphi isigaba.

imfiva Rheumatic has izigaba ezimbili:

• asebenzayo;
• ngasebenzi.

Yiziphi nenqubo womsebenzi isifo? Lezi zihlanganisa:

• kobukhulu ukubonakaliswa;
• izinguquko nakomaka laboratory.

Ngokusekelwe lokhu, zikhona degrees ezintathu rheumatism. Tiniketwe eSitatimendeni ethebuleni elingezansi.

idigri yokuqala	Umsebenzi ubuncane	Kulesi sigaba, emnene emitholampilo laboratory izimpawu.
besigaba sesibili	umsebenzi ngokulinganisela	degree Okwesibili streptococcal imfiva rheumatism ezinganeni, izimpawu zazo kakade eshiwo ngokucacile, ke sitholakale kalula. Lokhu kungenxa yokuthi izimpawu zokwelapha, umonakalo omkhulu obangelwa imisebe nezinye kakade ebonakalayo.
degree wesithathu	umsebenzi Ubuningi	izici Isici yilezi: imfiva, rheumatism inhliziyo izimpawu isifo, articular syndrome, ngokuphazima kweso lapho imingcele laboratory kanye nokunye.

ifomu articular

Manje ubheke izimpawu rheumatism ngesimo ingane ngokuhlanganyela. Asiqale elekhanda esincane imininingwane yezibalo. Izinsana akuvamile awela kulesi sigaba. Cishe u-20% i-rheumatoid arthritis livela abaneminyaka ephakathi kwengu-eyodwa iminyaka emihlanu; futhi cishe 80% - kusukela eminyakeni eyishumi nanhlanu.

Izimpawu amalunga rheumatism ezinganeni kungenzeka ukuzibonakalisa kanje:

• umkhuhlane;
• ngenxa yobuthakathaka;
• ukuphathwa ikhanda;
• ubuhlungu bamalunga;
• ububomvu kanye ukuvuvukala emalungeni nokunye.

Naphezu kweqiniso lokuthi amacala ziziningi, pathogen namanje akunqunywa. Ngokungangabazeki, rheumatism iyathelelwana ngokwemvelo. Lokhu ukutheleleka kuthinta kakhulu-lymph ise nasopharynx. Izifo ezihambisana umlando ezidlule angina, abole amazinyo, ukuvuvukala.

Kuyaphawuleka ukuthi kunezinkolelo-mbono eziningi zalesi sifo. rheumatism Articular ezinganeni, izimpawu kanye nokwelashwa okuyinto esizoyicabangela kulesi sihloko umbono weningi, kuyinto uhlamvu ezithathelwanayo-nomzimba. Lena imfundiso yokuziphendukela ezivamile. Uma banamathele kule umbono, the rheumatism - ngemiphumela ziyabagulisa abantu. Ngenxa ukungena imikhiqizo cell umzimba amagciwane esikhathini bayashintshana ekufukameleni kwenzeka olubekhona umzimba. Streptococci kulokhu angabangela izimpawu ngenhla rheumatism.

Sishilo kakade ukuthi imbangela rheumatism ngokuvamile idluliselwa phambi yisiphi isifo esithathelwanayo (ezifana scarlet fever). Nokho, ezinye izibonelo inganikelwa:

• hypothermia;
• ukuzikhandla ngokweqile.

Abaningi izimpawu zibonisa ukuthi ingxenye CNS (isimiso sezinzwa) enqubeni. Lezi zimpawu zihlanganisa:

• chorea;
• motor thuthuva;
• ukugula ngengqondo;
• izifo kwenzwa nokunye.

Kubalulekile ukwazi ukuthi zonke lezi izifo ngokuvamile ahambisana rheumatism. Ucwaningo lubonisa ukuthi reactivity we- cortex cerebral is kakhulu ziyancipha. Kungaba ukuhlonza ingcweti onekhono ngaphandle nobunzima. Kungani lokhu kwakwenzeka? Ivame kuhlotshaniswa excitability anda izikhungo subcortical, esithinta umzimba wonke.

inhliziyo ukuma

Manje sinikeza okuthé xaxa ukuze ukhulume ifomu inhliziyo rheumatism e ingane, izimpawu zesifo. Ngokushesha iphawule yakho yokuthi izinkinga inhliziyo usungaqala kanyekanye nefomu articular rheumatism, kanye ukuvela kancane kancane. ifomu Sinzima rheumatism libhekene yokuthi iziyaluyalu zenhliziyo izimpawu uyephuza kakhulu, okungukuthi, lesi sifo eba engabonwa.

Ngasekuqaleni sishilo ukuthi isici esasenza rheumatism - ukuhlaselwa okuzumayo nokunobudlova. Kukhona indawo ngeminjunju abukhali, nokunye. Nokho, ezinye izingane zingase esekhala ubuhlungu kancane emalungeni, ukukhathala. Ngisho kuleli cala, kungenzeka ukuthuthukisa iziyaluyalu zenhliziyo. Ukuze ugweme nemiphumela engathi sína futhi ngokushesha baqala ukwelashwa, ukuya ngokuxhumana onguchwepheshe, ngisho ngaleso sikhalazo.

Rheumatic isifo senhliziyo ezinganeni, izimpawu kanye nokwelashwa okuyinto sicabanga njengamanje, ngokuthi rheumatism isifo senhliziyo. Esigabeni sokuqala cishe akusho ukuzibonakalisa. Izimpawu zingase zihlanganise:

• ukukhathala;
• ukwenqaba imidlalo;
• ukwenqena ukusebenzisa;
• iphika;
• palpitations inhliziyo;
• isikhumba okhanyayo.

ifomu Sinzima ephelezelwa lokushisa ephakeme, ngokuvamile akukho degrees ezingaphezu kuka amathathu nesishiyagalombili. I isimo jikelele ingane ngesikhathi esifanayo siya siba sibi nsuku zonke.

Inhliziyo ukuma rheumatism kungaholela abanye ukuphazamiseka inhliziyo, okwethulwa ethebuleni elingezansi.

endocarditis	kokunikezwa kwe-ulwelwesi yenhliziyo
myocarditis	yesibili
pericarditis	yangaphandle
endopericarditis	zonke ezintathu

Konke lokhu kuholela ukuthuthukiswa yokuba nesifo senhliziyo, okungukuthi, ukuvuvukala luthuthukisa kuya valve. Kubalulekile ukwazi ukuthi ukwelashwa kusenesikhathi nokulandela eziyalezweni ebekiwe - kuyisihluthulelo nekusasa elijabulisayo. Izingane eziningi abaphethwe ukukhubazeka inhliziyo, uphile impilo ejwayelekile (esikoleni, ukuzihlalela nabangane, ngokuvakashela amakilabhu, nokunye). Uma kunjalo yethulwa, lesi sifo kuthatha ifomu ezinzima, esithinta inhlalakahle kanje:

• khona iziyaluyalu kwegazi;
• ilungu ukuvuvukala;
• kufushane okunzima umoya;
• isibindi ukukhulisa.

Esinye isici esasenza ifomu ezinzima zesifo - ukuqubuka okwesongo esikhumbeni. Lapho izimpawu zokuqala zokwelashwa esiphuthumayo! Ukuqalwa Esifike Ngesikhathi sokwelashwa - ithuba ukuphila okuvamile wengane, okuyinto akufanele ezingabanjwanga.

ifomu sezinzwa

Kulesi sigaba isihloko sizobe banake ifomu sezinzwa rheumatism ezinganeni. Izimpawu nasekwelashweni kwezifo kungakephuzi - lawa nezindaba main ukuthi sizobe ukumboza kulesi sihloko.

Isici esiphawulekayo ifomu sezinzwa fever rheumatism ezinganeni - chorea, ukulahlekelwa ezindaweni ezithile ingqondo. Chorea eba kancane kancane, izimpawu zingase zihlanganise:

• imizwa yethu ishintshashintsha;
• ukucasuka;
• tearfulness;
• ukudikiza imisipha (yazi ukuthi lokhu uphawu uyakwazi ukuba bathuthuke, futhi abanye abazali bacabanga ukuthi ingane yenza ubuso Naughty, ngisho ngaphandle kokwazi isimo kweqiniso wezasekhaya);
• yokuntuleka isiyalo;
• ukunganaki;
• ushintsho wesandla;
• ukubukeka egwinya inkulumo;
• Gait flail.

Ngokuqondene kwesiyalo futhi ukunganaki, futhi kufanele wenze ezinye kucaciswa. Empeleni, ingane Akunakusolwa. It ngempela ayikwazi ngokunembile intambo phezulu emabhuzwini abo, ngokuvamile sehla izimfoloko, nezinkezo, amapeni nezinye izinto. Nakani lezi zimpawu. Abaningi ukudida ngayo ukukhathala noma ngobudedengu. Empeleni, ingane idinga usizo lwakho. Lezi zimpawu izovela naye kungathi izinyanga ezintathu. Ngonanzelelo ukuziphatha kanye nesimo ingane, ngakho miss isikhathi esifanele futhi ukuze uqale ukwelashwa ngesikhathi.

Izindaba ezinhle kule isifo: senhliziyo nge rheumatism ifomu sezinzwa kukalutshwana kakhulu. Uma sinikwa isifo noma izinkinga zokwenza uhlelo senhliziyo nemithambo yegazi, isifo kungenzeka kalula. Uma uqaphela izinguquko ukuziphatha ingane okungenani - xhumana nodokotela wakho.

Manje ake ukukhokha ezinye hyperkinesia ukunakwa. Kuyinto isimo efika ukuphakama isifo. Phakathi nale nkathi, umuntu uhlale in motion (akakwazi ahlale, ame noma ulale). Kukhona okungalindelekile imisipha Kufinyeta ukuthi ingase iphazamise nengane ukusetshenziswa ukudla (ukunciphisa nemisipha yolimi, izindebe nokunye). Baphindze basebentise kwamanye amaqembu kwemisipha, lezi zimpawu ezilandelayo kungenzeka:

• Siyafulesha unomphela;
• ulimi ophumile;
• obuhlinayo.

Sicela uqaphele ukuthi ngesikhathi sokulala zonke izimpawu hyperkinetic zinyamalale. Ngaphandle nazo zonke izimpawu ngenhla ingatholakala inhlolovo kwehle imisipha ithoni. Ayikho Luhlolo ekhethekile kuyadingeka amafomu ezinzima, njengoba kungabonwa ngeso lenyama. Ingane elinefomu ezinzima zalesi sifo bengingayikuphakamisa ikhanda lakhe noma ahlale. Ngokuvamile, izimpawu usuku amasonto amathathu kuya ezinyangeni ezintathu. Khona-ke kancane kancane abohle. Qiniseka khumbula ukuthi uyahluleka uma elwa nokuphuza kukhona lalivamile (ukuthuthukiswa isikhathi - cishe ngemva konyaka kunjalo leliphelile, ngalesinye sikhatsi ngaphambili kakhulu).

Chorea ingahluka kancane ukwandisa izinga lokushisa komzimba (37.5 degrees). Kwangathi avele ukuvuvukala futhi ubuhlungu emalungeni.

izizathu

Kulesi sigaba isihloko sizozama ukuhlaziya ngokuningiliziwe umbuzo izimbangela imfiva rheumatism ezinganeni. Njengoba kushiwo ngaphambili, ngisho kwezokwelapha zanamuhla abakwazi ukunikeza impendulo ngqo kulo mbuzo. Kunemibono eminingana, futhi wakhela phezu kwabo, singaphetha ngokuthi izimbangela kungaba izinto eziningi.

isici	ukucaciseleka
Muva nje, izifo ezithathelwanayo	Lezi zihlanganisa izifo sibi zokuphefumula, namathansela, scarlet fever, namathansela nokunye. Kubalulekile wazi ukuthi zibangelwa streptococcus iqembu A. Kuyadingeka ukucacisa ukuthi akukho ukusilaphazeka ukutheleleka isimo main sokuthuthukiswa imfiva rheumatism. Lokhu kudinga ukungasebenzi kungenza isimiso somzimba sokuzivikela. Kuphela kulesi simo-ke iqala ukuhlasela amaseli enempilo. Lokhu kubonakala ezimweni lapho ukwelashwa oqale (sekwephuzile) noma banephutha qha.
Isici sesibili - the lezinceku	Inani yezifundo kanye survey, kwatholakala ukuthi isici lezinceku nakho kufeza indima ekuthuthukiseni fever rheumatism. Kwaphawulwa ukuthi lesi sifo ngokuvamile kwenzeka emikhayeni.
Yesikhathi eside abathwali ukutheleleka streptococcal	Ngokuvamile, streptococcus eside kungaba ehlala nasopharynx, lapho amasosha omzimba glitches. Umphumela - ukuthuthukiswa imfiva rheumatism.
isici yesibili	Isimanga ukuthi uzwakale, kodwa kunezinye (zesibili) izici ezingase zibangele ukuthuthukiswa imfiva rheumatism ebuntwaneni. Lezi zihlanganisa: hypothermia, ukukhathala, ukungondleki kahle. Kukuthinta kanjani ukuthuthukiswa zesifo? Impela wamane, lezi zici babe nomthelela omubi omzimba ingane. Ngenxa yalokho, izikhathi eziningana kwandisa amathuba wokuthuthukisa rheumatism.

ukuhlola

Kuyini imfiva rheumatism ezinganeni (izimpawu, isithombe, izizathu enikezwa esihlokweni), futhi manje, sithemba, yebo. Siphendukela sitholakele lesi sifo. Okokuqala kumelwe kuthiwe khona esolwa ukugula kwengane can ngokuphelele ubani, eziqala abazali nothisha, ziphethe wezingane noma wamathambo.

Umtholampilo rheumatism ezinganeni (izimpawu zokwelashwa) nhlobonhlobo. Kubalulekile ukwazi nenqubo eziyisisekelo:

• carditis (noma iyiphi ifomu yayo);
• chorea (sifo, thina ikhokhwe a lot of ukunakwa ngaphambili);
• khona ngamaqhubu ngaphansi kwesikhumba wengane;
• erythema;
• polyarthritis;
• ukutheleleka streptococcal zamuva;
• Isici sitholwa njengefa.

Uma ingane yakho ine okungenani eyodwa yalezi zimpawu, kufanele uxhumane nodokotela wakho ngokushesha. Ngaphezu nalezi zindlela, kukhona abanye:

• arthralgia;
• umkhuhlane;
• okushintshiwe igazi nemingcele.

Ukuze sitholakele ukuhlolwa amancane inhlolovo isiguli. Ukuze ukusazi ngokunembile isifo esikuphethe kuyadingeka ukuze afeze eziningi zocwaningo, okuhlanganisa esifubeni X-ray, ECG, echocardiography.

X-ray usizo ukunquma ukucushwa kwe inhliziyo, ECG sizobonisa ukuphazamiseka inhliziyo (uma ikhona), echocardiography kuthola khona isifo senhliziyo.

ukwelashwa

Sibukeze uphethwe futhi izimpawu fever rheumatism ezinganeni. Ukwelashwa zesifo - nanku umbuzo olandelayo. Esimeni samanje kudinga indlela eqotho. ukwelashwa rheumatism kuhloswe:

• Isithombe esiqoshiwe izimpawu;
• ukusebenza kwi flora streptococcal.

imfiva Rheumatic ezinganeni (izimpawu, ukwelashwa, nezithombe sicabanga) iphathwa esibhedlela. Sicela uqaphele ukuthi imishanguzo Kwenziwa ngisho nalapho lesi sifo okusolwayo.

Ingane idinga:

• embhedeni ukuphumula , kanye ukwenyuka kancane umsebenzi asebenzayo;
• umsoco ofanele, ekudleni iqukethe esiningi potassium;
• inhlangano efanele imisebenzi yokuzilibazisa ngezinga elingakanani.

ukwelashwa kusekelwe:

• amalungiselelo elwa namagciwane;
• hormone;
• anti-inflammatory;
• Vitamin izakhiwo;
• amalungiselelo potassium;
• immunostimulant.

Konke lokhu izidakamizwa ukusiza ukulwa microflora pathogenic. Ngenxa yalokho, lokhu kuwukhulula ukuvuvukala njalo iyehlisa izimpawu zesifo. Kubalulekile ukuqaphela ukuthi imithi babelemisebenzi eminye imiphumela emibi:

• ukuthuthukiswa izilonda;
• ukopha kakhulu esiswini;
• ukuphazamiseka nezindlala endocrine.

zokuvimbela

Lesi sigaba lunikezelwe nokuvimbela imfiva rheumatism ezinganeni. eyinhloko Behlukene kanye nokuvinjelwa yesibili. Esimweni sokuqala, ukunakwa ikhokhelwa ekuthuthukiseni kahle ingane:

• ukuqina;
• umsoco ofanele;
• ezemidlalo;
• alwe yizifo ngokucindezela streptococcus iqembu A.

Izinhloso Secondary ukukhandela lokubuya kwesifo:

• "Bitsilin 5" - amayunithi 1.5 million njalo emavikini amane zesikole;
• "Bitsilin 5" Isikali amayunithi kwezigidi ezingu 0.75 njalo emavikini esikoleni ezimbili.

Sicela uqaphele ukuthi kunconywa ukuba afeze yesondlo zokuvimbela exacerbations unyaka wonke, njalo ngenyanga. ubude Kunconywe - iminyaka emihlanu.

ukuba nombono ongafani ngeke

Omama abaningi bakwazi ukubhekana nalesi sifo, isikhathi ukuya esibhedlela ukuze uthole usizo lwezokwelapha. Uma nikwenza umkhuba ukufeza nokuvinjelwa imfiva rheumatism ke umuntu abuyele kulo mkhuba. ngeke okuyisimo esisongela ukuphila. Thina ezinemininingwane umbuzo rheumatism ezinganeni, izimpawu izibuyekezo. Yiziphi izibikezelo?

Qaphela ukuthi rheumatism isifo senhliziyo imayelana 25 amaphesenti isikhathi ephelezelwa inqubo yentuthuko yesifo senhliziyo. Phinda Inkulumo engashiyi ithuba ugweme kokunikezwa kwe-valve. Ngenxa yalokho, udinga ukuhlinzwa inhliziyo. Ukufa kusuka senhliziyo cishe 0.4%. Kufanele kuqashelwe ukuthi umphumela isifo kuncike ukunemba kanye Ukwenza ukwelashwa.