Edincin's edema ndi mkhalidwe wovuta kwambiri, umene uli ndi kutupa kwakukulu kwa zikopa za khungu ndi mafuta osokoneza thupi, nthawi zina zimakhudzana ndi momwe matendawa amachitira. Matendawa amatchulidwa ndi dokotala G. Quinke, yemwe adalongosola poyamba mu 1882. Dzina lachiwiri la matenda ndi angioedema.
Quincke's Edema - zomwe zimayambitsa
Mofanana ndi ming'oma, Quincke's edema imagwirizanitsidwa ndi vasodilation komanso kuwonjezereka kwa chivundikiro cha madzi osakaniza magazi, koma pakadali pano, kudzikuza sikuwonekera pokhapokha, koma mu zigawo zakuya za khungu, minofu ya mucous, mafuta osakaniza. Kusungunuka m'magulu a madzi amkati opatsirana kumatsimikizira kuti Edema. Kuwonjezeka kwa maselo ndi kuwonjezeka kwa kuperewera kwawo kumachitika chifukwa cha kumasulidwa kwa zinthu zamoyo (bradykinin, histamine, etc.), zomwe zimachitika chifukwa cha chitetezo cha mthupi pogwiritsa ntchito zifukwa zina.
Angioedema ikhoza kukhala yosiyana, ndipo nthawi zambiri imakwiyitsa ndi izi:
- chiwonongeko;
- matenda osokoneza ubongo;
- kusokonezeka kwa dongosolo la endocrine;
- kumwa mankhwala (mankhwala opatsirana pakamwa, analgesics, antibiotics, ACE inhibitors, katemera, serums);
- matenda otupa;
- matenda a magazi;
- mavairasi ndi parasitic zilonda za thupi;
- zovuta zowonongeka m'thupi;
- kusiyana pakati pa kuthamanga kwa mlengalenga, kutentha kwa mpweya, ndi zina zotero.
Edema wodalirika wa Quincke
Imodzi mwa mitundu yosawerengeka ya matenda omwe akugwiritsidwa ntchito ndi odwala angioedema, omwe akugwirizanitsidwa ndi matenda mu njira yothandizira yomwe imaperekedwa ndi cholowa. Njira yothandizira, yomwe imaphatikizapo kuphatikiza mapuloteni, ndi gawo lofunika kwambiri la chitetezo cha mthupi, chomwe chikuphatikizidwa mu zotupa ndi zomwe zimachitika. Ulamuliro wa dongosolo lino ndi chifukwa cha michere yambiri, pakati pawo - inhibitor C1. Pamene puloteniyi ilibe vuto, kusayendetsedwa kumaphatikizapo kutsegulira ndi kutulutsa zinthu zambiri zomwe zimayambitsa edema zimachitika.
Zizindikiro zoyambirira za Quinck's edematous edema zingawoneke ngakhale ali mwana, koma nthawi zambiri nthawi yoyamba msinkhu kapena zaka za pakati. Kukula kwa chiwembu nthawi zambiri kumachitika ndi chinthu chimodzi kapena china chochititsa chidwi:
- matenda;
- mphamvu;
- opaleshoni;
- kuvulala;
- kutenga mankhwala alionse.
Allergic Quincke's Edema
Matendawa ndi omwe amachititsa kuti angioedema ayambe. Kuonjezera apo, nthawi zambiri matendawa amaphatikizidwa ndi matenda ena omwe sagwirizana ndi matendawa, poizoni, kupwetekedwa kwa mphuno, urticaria, atopic dermatitis , etc. Ngati njira yowoneka ngati matenda ndizovuta, edema wa Quincke ndi mtundu wa mayankhidwe. Monga zinthu zokhumudwitsa zingakhale:
- Zakudya ndi zowonjezera kwa iwo (nsomba, zipatso za citrus, uchi, mtedza, chokoleti, zokometsera, zokongoletsa, zoteteza, etc.);
- mpweya ;
- nthenga ndi mbalame;
- tsitsi la nyama ;
- poizoni ndi misozi ya tizilombo;
- fumbi la chipinda;
- Njira zogwiritsira ntchito mankhwala;
- dzuwa;
- kutentha kapena kutentha;
- mankhwala, ndi zina zotero.
Idiopathic Quincke's Edema
Palinso angiedema ya idiopathic, yomwe siingathe kufotokozedwa. Pachifukwa ichi, kuyesedwa kwa kusagwirizana kwenikweni kwa zamoyo sikungathe kugwirizana ndi zina zomwe zisanachitike. Matendawa, akatswiri ambiri amanena kuti ndi owopsa kwambiri, chifukwa, posadziwa chomwe chimayambitsa kutupa, simungakhoze kulepheretsa maonekedwe ake ndi kuthetseratu chinthucho.
Quincke's Edema - zizindikiro
Zizindikiro za Angioedema zimatchulidwa, zomwe zimakhala zovuta kusamvetsera, kuphatikizapo chifukwa zimatha kuvulaza kwambiri komanso zimapangitsa kuti ziwalo zina za thupi zisagwire ntchito. Edema pa dera lakukhudzidwa ndiwoneka ndi maso, khungu (kapena mucous membrane) likuwoneka kutupa, pomwe silikusintha mtundu wake (patapita nthawi ikhoza kutembenuka moyera).
Madera omwe amapezeka kumidzi ndi awa:
- munthu;
- chingwe chamlomo;
- chiyankhulo;
- phula;
- tsatanetsatane;
- khosi;
- ziwalo zoberekera;
- miyendo yam'mwamba ndi ya m'munsi;
- ziwalo zamkati (m'mimba, matumbo, chikhodzodzo, meninges, etc.).
Kumalo okhudzidwa, odwala amakumana ndi vuto, kuthamanga, kupweteka pang'ono, kuwotcha, kumangirira, kawirikawiri - kuyabwa. Ziwalo zamkati zingakhudzidwe ngati kupweteka kwa m'mimba, kunyoza, kusanza, kutsekula m'mimba, mkodzo, kupweteka mutu, ndi zina zotero. Njira yopuma yopuma imakhudza maonekedwe a kupuma pang'ono, kutsokomola, kupuma kovuta, kungachititse kuti munthu asatope. Matenda a quemke omwe amachititsa kuti Quincke awonongeke nthawi zambiri amawoneka ndi maonekedwe ofiira ofiira. Kutsika kwa kudzikuza kungakhale kowotcha pang'ono ndi kuyabwa.
Kodi msangamsanga wa Quincke umafulumira bwanji?
Kawirikawiri, ngati mankhwalawa amatha kutenga mbali, chinyontho cha Quincke chikuwoneka mofulumira, ndikuyamba mwadzidzidzi. Zizindikiro zimakhala mkati mwa mphindi 5-30, ndipo chisankho chiyenera kuyembekezedwa pambuyo pa maola ambiri kapena masiku 2-3. Ndizimene zimakhala zosavomerezeka, kudzikuza kumawonekera mkati mwa maola 2-3 ndipo kumatha masiku 2-3.
Angioedema wa larynx
Angioedema ya mmero imakhala zoopsa kwambiri kwa thupi ndipo zingayambitse imfa mwadzidzidzi. Mphindi zochepa chabe, mpweyawu ukhoza kutsekedwa chifukwa cha ziphuphu zotupa. Zizindikiro zoopsa, zomwe ziyenera kukhala chifukwa chomveka choyimbira ambulansi, ndi izi:
- khungu la buluu la nkhope;
- kulimba kwamphamvu;
- dontho lakuthwa la kuthamanga kwa magazi;
- kupweteka.
Angioedema wa nkhope
Pamaso, edema wa Quincke, amene chithunzi chake chimasonyeza chizindikiro chodziwika bwino, kawirikawiri amapezeka m'maso, masaya, mphuno, milomo. Pa nthawi yomweyi, zisoti za diso zimakhala zochepa kwambiri, mapepala a nasolabial akhoza kusinthidwa, chimodzimodzi kapena milomo yonse iwiri ingakulire kukula. Edema ikhoza kusunthira kumalo a khosi, kukhudza maulendo a ndege ndi kutseka mpweya wabwino. Choncho, kutupa kwa Quincke pa nkhope kuyenera kuimitsidwa mwamsanga.
Angioedema wa mapeto
Zizindikiro za Quincke's edema, zomwe zimapezeka pamanja ndi m'mapazi, nthawi zambiri zimawonedwa kumbuyo kwa mapazi ndi mitengo ya kanjedza. Mtundu uwu umakhala wochepa kwambiri kuposa momwe tafotokozera pamwambapa ndipo sikuti umakhala woopsa kwambiri ku ntchito ya thupi, ngakhale kuti umayambitsa vuto lalikulu. Kuphatikiza pa maonekedwe ochepa a kumagwirizana kwa miyendo, khungu limatha kukhala ndi chigoba cha bluish.
Zomwe mungachite ndi kutupa kwa Quincke?
Odwala omwe ali ndi chidziwitso chodzidzimutsa cha thupi limodzi kapena mbali imodzi kamodzi m'moyo wawo ayenera kudziwa kuchotsa kutupa kwa Quincke, chifukwa matendawa akhoza kubweranso mwadzidzidzi. Choyamba, muyenera kuyitanitsa ambulansi, makamaka pamene pali kutupa pamsewu kapena pali kukayikira komwe kumapezeka ziwalo za mkati. Asanafike ogwira ntchito zaumoyo, chithandizo choyamba chiyenera kutengedwa.
Edema Quincke - Thandizo Loyamba
Kusamala koopsa kwa kutupa kwa Quinck, komwe kungaperekedwe kuti ambulansi isadzafike, ikuphatikizapo magawo otsatirawa:
- Kusungulumwa kwa wogwidwayo kuchokera kuchitidwe cha mphukira (ngati itayikidwa).
- Kupereka mwayi waufulu woyeretsa mpweya.
- Kutulutsidwa kwa wodwalayo kuchotsa zovala ndi zipangizo.
- Kukonzekera kwa wodwalayo mu gawo limodzi kapena kukhala pansi kuti athe kupuma.
- Kusunga malo ochepetsetsa, kuteteza mantha.
- Kuponyedwa kwa chimfine cha compress pa tsamba la lesion.
- Perekani mowa wambiri (makamaka mochere).
- Mankhwala: madontho a vasoconstrictive m'mphuno (Naphthyzin, Otryvin), antihistamines (Fenistil, Suprastin) ndi matsenga (Enterosgel, Atoxil) mkati.
Zomwe tatchula pamwambazi, zomwe zimathandiza ndi kutupa kwa Quincke, ndizofunika, poyamba, pamene zati:
- kupuma kwa mphuno;
- milomo yotupa;
- kutupa kwa mucosa wamlomo;
- kutupa kwa mmero, ndulu;
- kutupa kwa khosi;
- edema wa ziwalo zamkati.
Kodi chithandizo cha angioedema ndi chiyani?
Mankhwala amwadzidzidzi kuti athetse vuto la edema ndi kubwezeretsa ntchito zofunika zingakhale monga kugwiritsa ntchito mankhwala oterowo:
- Adrenaline - ndi kuchepa kwa kuthamanga kwa magazi;
- Prednisolone, Dexamethasone - pa nkhani ya Edema ya Quinck, mawonetseredwe aakulu achotsedwa;
- Glucose, Haemodez, Reopoliglyukin - kuthetsa mantha ndi kuchotsa poizoni;
- Dimedrol, Suprastin jekeseni - ali ndi vuto;
- Furosemide, Mannitol - pafupipafupi komanso kuthamanga kwambiri kuchotsa madzi ochulukirapo ndi zotsekula;
- Eufillin ndi Dexamethasone - pofuna kuchotseratu kuphulika kwapweteka, ndi zina zotero.
Mankhwala osagwirizana ndi edema Quincke ali osiyana, nthawi zina amapangidwa mwa kuikidwa magazi a m'magazi komanso kugwiritsa ntchito mankhwala oterowo:
- Z-aminocaproic acid;
- Counter.
Kuchokera pachimake, mankhwala angaphatikizepo:
- kusalidwa ndi zifukwa zomveka;
- Maphunziro afupipafupi a mankhwala otchedwa hormonal treatment (Prednisolone, Dexazone);
- kugwiritsa ntchito mankhwala pofuna kulimbitsa dongosolo la mitsempha ndi kuchepetsa kuperewera kwa m'mimba (Ascorutin, calcium, vitamini complexes);
- kutenga antihistamines (Loratadine, Suprastin, Cetirizine).
Quincke's Edema - zotsatira
Odwala amene amapezeka kuti ali ndi angioedema omwe amatha kukhala osapitirira nthawi zonse ayenera kukhala okonzeka kupeĊµa mavuto komanso kunyamula mankhwala oyenera kuti athetse chiwonongeko. Pamene pali zotupa za Quincke, zizindikiro ndi chithandizo chomwe sichidziwika kapena chithandizo chokwanira chikuchitika, izi zimawopsyeza thanzi ndi zotsatira zowopsya. Zina mwa izo:
- anaphylactic mantha;
- asphyxia;
- matenda a ubongo;
- chowopsa cystitis;
- matumbo a m'mimba;
- peritonitis.