Leffler's syndrome: zviratidzo uye kurapa

Sei zvakakosha kuisa fluorography gore rega roga uye nguva nenguva kutora ropa? Izvi zvidzidzo zvinobvumira kusangana kwechimwe chezvirwere zvepemmonari, nokuti vazhinji vavo havana kumira. Izvi zvinosanganisira Leffler syndrome. Zviratidzo uye kurapwa kwehutano hwehutachiona, pamwe chete nezvinokonzera zviya zvichakurukurwa munyaya yanhasi.

Tsanangudzo yechirwere

Pasi peLeffler's syndrome, vanachiremba vanoona mapurmonary allergies. Apo kugadzirisa kune chimwe chinhu chinokonzera kunoitika munhengo dzomuviri wekupemha, zviratidzo zvinoumbwa-zvinopinda. Ivo vakazadzwa nerudzi rwakasiyana rwemasero eropa, ayo ariwo maruva eukocyte uye anonzi "eosinophils."

Izvo zvakakosha zvezvinhu izvi muuropi yeropa zvinowanzoratidza zvirwere zvehutachiona / hwehutachiona mumuviri, utachiona nemaronda kana tumarara. Kupindira kunoratidzwa nekwanisi yekuenda kune nhengo yakakanganiswa. Vanogona kupera pachavo pachavo uye havazosiyi kunyange kuchinja kwechikoro.

Kwenguva yokutanga, chironda chesosinophilic chemapurmonary system chakatsanangurwa pakutanga kwezana remakore rechi20. Kubvira ipapo, masayendisiti haana kukwanisa kuziva Leffler syndrome mune imwe nzira yekurapa. Kunyangwe zvidzidzo zvakawanda zvakakundikana kupa mhinduro pamusoro pezvinokonzera zvikonzero uye zvaidiwa kuti zviitike. Ichi ndicho chakavanzika chechiremba chaiyo. Hapana humwe ruzivo rwakananga pamusoro pezera uye hukama hwevanhu. Mune zvimwe zvidzidzo, zvinonzi kuti chirwere chinokanganisa vana chete, uye boka rekukuvadza rinosanganisira vagari vemunyika dzine kutonhora kwemamiriro okunze. Zvisinei, hutano hunobudirira hunoenda pasi pose. Pakati pevarwere kune vakomana vaduku nevamiriri vekukwegura.

Zvinokonzera kutapukirwa

Pasinei nematambudziko ekutsanangurira maitiro ehutano, vanachiremba vakakwanisa kuzivisa boka rezvinhu zvinokuvadza. Zvinoshamisa kuti zviratidzo zvinoratidzira Leffler syndrome zvinogona kubuda mushure mekusangana nemhuka uye kunyange panguva yekurapwa kweimwe zvirwere.

Pakati pezvinhu zvikuru zvinotapurirwa navanachiremba vakanyora kuti:

1. Air allergens. Kubudirira kwechirwere kunowanzoonekwa semhinduro yezvisikwa kumapureni emichero kana furu yefungi. Makemikari reagents ane ngozi zvikuru.
2. Mishonga. Kushandiswa kwemamwe mapoka ezvinodhaka ndezvisingambofungidziki asi chikonzero chinogamuchirika cheplmonary eosinophilia. Maererano neongororo dzakadzidziswa, izvo zvinowirirana zvinogona kuonekwa pamishonga inorwisa mabhakitiriya, izvo zvinoshanda zvinonzi penicillin uye nitrofuran.
3. Mabhakiteriya (mamwe marudzi e staphylococci, streptococci uye brucella). Pathogenic flora inoparadzirwa kubva kune munhu anorwara kusvika kune munhu ane hutano kuburikidza nekubatana kwemaoko, zvinhu zvehutsanana uye zvokudya. Pashure pacho, inopinda mumuviri kuburikidza nemaronda akazaruka. Usaisa mukana wenzira yekutenderera mabhakitiriya.
4. Worms. Zvirwere zvinopinda mumapfupa ekufema 2-3 mavhiki mushure moutachiona. Izvi zvinogona kuva secarcarid, matumbo emukati, toxocares, trichinella kana hookworms. Vagari vanoitika zvose kubva kuvanhu vanorwara, uye mushure mekusangana nemhuka.

Leffler syndrome ICD-10 (International Classification of Diseases) inotsanangura pasi pemutemo J82.

Bhuku rakanyanya ngozi

Nhamba dzezvokurapa dzoropa dzinoita kuti zvikwanise kuzivisa boka rezvikonzero zvinokonzera munhu kuti awane ngozi kune chirwere. Icho pamusoro pemitemo chaiyo uye hutano hwakakwana.

Ndiani ari munzvimbo yakanyanya ngozi?

1. Vanoda fodya. Vanosvuta vacheche ndevowo veboka iri. Iyo mishonga inoderedza simba rekuchengetedza kwemapapu.
2. Asthmatics. Inenge 50% yevarwere vane confirm confirmed pulmonary eosinophilia vane nhoroondo yebhondi inonzi asthma.
3. Vachirwere neHIV. Chikonzero chikuru chekusimudzirwa kwehutachiona hunoita kuti simba risati rasvika.
4. Varwere vane zvirwere zvehutachiona.
5. Vafambi. Kazhinji izvi zvinoshanda kuvashanyi vanoongorora nyika dzeAsia neAfrica.

Kushamwaridzana kune imwe kana zvikamu zvakasiyana kubva pane zvakarongwa pamusoro apa kunowedzera mikana yepermonary eosinophilia.

Clinical picture

Ndezvipi zviratidzo zveLeffler's syndrome? Pakati pekuratidzwa kukuru kwehutachiona, vanachiremba vanosiyanisa: fever, general malaise uye kushaya simba. Vamwe varwere vanotambura nekukanganiswa kusina simba uye kubviswa kwechitubu chinonzi sputum, chinotsanangurwa nekuvapo kwevakafa eosinophils.

Mumufananidzo mushure mekuongorora kwe-X-ray, imwechete kana kuti yakawanda futi yekupinda inogona kufungwa. Panguva imwe chete, hukuru hwavo uye nzvimbo yakasiyana inosiyana. Kana uyo ane utachiwana ane simba rekudzivirira zvirwere zvemuviri, anopindira kazhinji kuzvisarudzira mukati memavhiki maviri.

Munguva yepasusiti inorwara, imwe chiratidzo zvakare inogona kuonekwa - yakaoma rales. Sezvo mutemo, iwo anowanikwa munzvimbo dzepamusoro dzemapapu. Biochemical blood test inoratidza kuvepo kweukoukocytosis pakatarisana nenhamba yeiosinophils (60-80%).

Nzira yehutano hwehutano

Ichi chirwere chinogona kuitika mune imwe yemhando mitatu. Ngationgororei imwe neimwe yezvisarudzo zvakanyatsotsanangurwa.

1. Nyore nyore. Inozivikanwa nekliniki yekliniki yemifananidzo. Munguva yekukanganiswa, sputum yakanyanyisa nekusvibiswa kweropa, uye kusagadzikana kunowanikwa munharaunda ye trachea. Kana utachiona hunokonzerwa nekupinda kwe helminths mumuviri, uye mazai avo ari muGI system, pancreatitis inowedzera.
2. The form acute. Leffler syndrome inotanga nekukwira kamwe kamwe kwekushisa uye inoratidzika nenzira yakaoma. Murwere ane zviratidzo zvekudhakwa. Munguva pfupi pfupi, nguva yekufema kunoputika. Mishonga inogara ichiitwa muchipatara.
3. Chronic form. Kazhinji kazhinji inowanika kuvakadzi vanotambura nechirwere chinonzi bronchial asthma. Pakati pezviratidzo zvikuru zvechiremba ndesimba rakakura, kuora kurasika uye kupera kwekufema.

Kusarudza maitiro ehutachiona hunobatsira kusarudza chirongwa chakakodzera.

Nzira dzekuongorora

Chirwere chemakliniki chinorondedzerwa pamusoro apa hachisi uchapupu hwakakwana hwokutsigira Leffler syndrome. Zviratidzo zvevana zvehutano huno uye kuvanhu vakuru hazvisi zvakasiyana, naizvozvo mapoka ose evarwere anopiwa sarudzo yakawanda yekuongorora. Inosanganisira mabasa anotevera:

1. Radiograph. Mumufananidzo ne pulmonary eosinophilia, nzvimbo dzemawere dzinogona kuonekwa zvakajeka. Uku ndiko kupindira.
2. Kuongorora ropa. Kazhinji, muropa romunhu ane utano, nhamba ye eosinophils haifaniri kudarika 5-10%. Kuwedzerwa kwechiratidzo ichi kusvika 20-80% kunobvumira mumwe kunyunyuta Leffler syndrome. Nhamba ye eosinophils muvana vari mumuviri wakagadzikana haisi yakasiyana neyiyi parameter muvanhu vakuru.
3. Sputum analysis. Iyo chakavanzika inotarirwa kuvepo kwemaitiro e-crystalline kubva kuma enzymes eosinophils.
4. Stool analysis. Inoitwa kuti ione zvirwere mumutumbi.
5. Allergological test.

Chimwe chinhu chinonyanya kukosha chekuongororwa ndechekudzidza kwemurwere aneinnesis. Ichi chikamu chinokosha chekugadzirisa zvikonzero uye mamiriro ehutachiona. Pasina zvikamu izvi hazvibviri kuisa kurapa kwakakodzera.

Kurudziro inorayirwa

Inowanzoitika kuti Leffler's syndrome haifaniri kutarisirwa. Zviratidzo muvanhu vakuru nevana munguva pfupi pfupi pasina kupfuudza uye kusamboonekwa zvakare. Tsanangudzo yezvesayenzi chete yeiyi ndechokusavapo kwekubatana ne-allergen.

Mune zvimwe zviitiko, kurapwa kwakaderedzwa kusvika pakuregererwa kwezvinhu zvinokonzera kukura kwayo. Somuenzaniso, zvipembenene zvinokonzera muviri ne helminths. Kana chikonzero ichi chiri mumishonga inotorwa, zvinoreva anogue zvinosarudzwa.

Dzimwe nguva Leffler's syndrome haigone kukundwa kunyange pashure pokurapa kwakasimba. Muchiitiko ichi, iwe unogona kudikanwa kuti ubatanidze ventilator uye zvinodhaka zvinodhaka. Pakati pemishonga inorayirwa muhondo yekurwisana ne-pulmonary eosinophilia, tinokwanisa kusiyanisa:

1. Steroid hormones. Inonyanya kukosha ndeye "Prednisolone". Kushandiswa kwenguva refu kweiyo kunokurudzira kukurumidza "resorption" yepiltrates. Kana maitiro akasimba asingaonekwi, zvinokurudzirwa kutungamirira kudzokorora. Zvingangodaro, murwere ane kuvhiringidza kwemarudzi akasiyana.
2. Anti-asthmatic agents ("Aminophylline").
3. Expectorant mapiritsi. Kuti kuvandudzire kushandiswa kwekutsvaira, varwere vanorayirwa mucolytics (Lazolvan, Ambroxol). Kana pane zvinetso nehutachiona hwepamuviri, mishonga inorongwa inofanira kuendeswa nenzira yekudzivirira.

Kurapa zvinodhaka kunongorongedzerwa nachiremba. Kuzvipa mishonga hakukurudzirwe, sezvo zvakaoma kumunhu akawandisa kuverenga kuyerwa kwemishonga uye nguva yehutungamiri hwavo. Kana zvisina kudaro, hazvisi nyore kuti urege kunetseka.

Antiparasitic course of treatment

Leffler syndrome ne ascariasis inowanzoitika. Nokudaro, zvinonzwisisika kuongorora zvakasiyana nemishonga inoshandiswa kurwisa dambudziko iri. Kana iwe uchitenda vanachiremba, zvakaratidza kuti:

1. "Pirantel". Kurwisana nematodes, kubudirira neuromuscular blockade muhutachiona husinganzwisisiki. Somugumisiro, vanobviswa zvakabudirira kubva pamakumbo ekudya.
2. "Karbendatsim." Izvo zvinoshandiswa zvinhu zvinopinda nepakati pe helminth shell, ichichikuvadza. Somugumisiro, zvipembenene zvinorasikirwa nekwanisi yekuzvigadzirisa pacheche mumatumbo emukati.
3. "Mebendazole." Iyi mishonga inoshanda kubudikidza nehonye dzakawanda dzinozivikanwa nemishonga.

Nechiremera chakaoma cheHelminthic kupinda, apo mishonga yakanyorwa yakasangana nemabasa avo ekutanga, murwere ari muchipatara. Kana zvisina kudaro, kupera kwemvura kunogona kuitika.

Migumisiro mumuviri

Leffler's syndrome inoporesa. Kubvira pakucherechedza hazvifaniri kukodzera kunyange mukati memwedzi mushure mekunyangarika kwezviratidzo. Kana zvisina kudaro chirwere chokuputika chicharamba chichifambira mberi, uye zvinokonzera kukanganisa zvinokonzera pulmonary edema. Uyewo usaisa mukana we fibrosis - ichi ndicho chimwe chinetso chechirwere. Icho chinoperekedzwa nehutu husina kuwanikwa hwemapapu emapapu. Chirwere ichi chinogona kukanganisa basa remwoyo, zviratidzo zvekudya. Kurwisana nekunze kwekushayikwa kwekushaya oxygen hakubvumi kutyorwa kwemabasa europi.

Mikana yekudzoka zvakare

Kusiyanisa zvakakosha kutaura pamusoro pematambudziko ekudzokazve. Kazhinji kacho, vanofanira kutarisana nekuda kwekusakanganisika kana kusingatarisirwi kuongororwa, kusarapwa. Mushure mokurapa kwechirwere, murwere angangotarisa aine utano hwakanaka. Kunyange zvakadaro, kushungurudzika kwakanyanya kana kugara nguva dzose kusangana ne-allergen kunokonzera imwezve kudzoka.

Nzira dzekudzivirira

Ko Leffler inogona kudzivirirwa kurwara here? Kuti iyi ichokwadi chirwere chinotyisa, ikozvino hapana mubvunzo. Saka, vanhu vazhinji vari pangozi vanofarira kudzivirira.

Icho chikuru chekudzivirira chiyero ndechokushanyira nguva dzose kuhofisi yeergenerist. Kana hutachiona hwakasiyana nedzidziso iyi, zvakakosha kunyatsoteerera mazano eumwe nyanzvi uye kutora mishonga inorayirwa. Iwe unoda kutengesa mararamiro akaenzana emishonga nenzira iyo iwe unogona kumira kurwisa kunotevera kwekutengesa.