Osler nodes - chii ichi? VaBennett pathogenesis, kurapwa

Endocarditis - ane kuzvimba endocardium, yomukati lining mwoyo. Kunogona kukonzera zvirwere zvakawanda nhengo uye mugadziriro womunhu Kukuvara muviri, hypercoagulable uye vamwe vasiri rwarisa zvinokonzera. Naizvozvo pacharo endocarditis inongova zviratidzo zvavo, kuvapo iyo Roth makwapa, Osler nodes uye zvimwe unhu mapundu pamusoro muviri hariwaniki. Varwere angasanzwa kusanzwa, uye kashoma kunyunyutira mwoyo vakan'un'una, fivhiri. Uye chete kana endocardial kuzvimba kwakakonzera parasitic Micro-zvinenge muropa, inova yoga chirwere inonzi rwarisa, bacteriological kana kwemabhakitiriya endocarditis. Osler nodes - mumwe yacho kwokunze zviratidzo. Paakatsanangura navo 1885, inoshamisa wokuCanada chiremba William Osler. Infective endocarditis - chirwere ngozi chaizvo unotungamirira kusingarapiki deformation mwoyo, saka zvinokosha kuziva chii uye sei chinoratidza pacharo.

Zvinoumba infective endocarditis

chirwere ichi kunokonzerwa zvinenge zvose pathogenic utachiona uye hunokuvadza, uye dzimwe nguva kunyange nemavhairasi uye majemusi zviri muropa romunhu. Zvinopfuura endocardium angabvuma mu yezvirwere zvirwere zvokufema, rheumatism, periodontitis, tonsillitis, tibhii, urethral catheterization, zino kubviswa nezvimwe manipulations. Osler nodes openya Mureza kuti akapa zvinokonzera chirwere kuomesa - infective endocarditis. Kazhinji, nokuti Pachatanga parasitic basa zvigare mumwoyo anofanira wakaremara chero nzira:

- venous catheters;

- pacemakers;

- vascular prostheses kana mwoyo mavharuvhu;

- moyo siyana kuremara;

- microtrauma;

- kuvhiyiwa.

Dzimwe kwemabhakitiriya zvinopfuura endocardium uye pasina risati kukuvara tishu. Zvadaro kuumbwa abscesses, fistulas nezvimwe kuremara.

zviratidzo

Infective endocarditis anogona kutaura pachavo zvakajeka uye zvakajeka, uye anogona kukanganisa chete kuneta, pakutanga mwoyo ino- tsutsumwa, vakawanda simba, uye inozezesa zviratidzo kuwedzera zvishoma nezvishoma. Idzi dzinosanganisira:

- fivhiri;

- chills;

- kunonyengedza ziya;

- inorwadza tsandanyama uye mapfundo;

- uremu;

- kuchinja ruvara rweganda (anova grayish, zvishoma yellowish);

- mumwe mapundu pamusoro mucous membranes.

Osler nodes kuoneka pashure pamusoro zviratidzo. Dzimwe nyanzvi ndevokungoita navo kwakasiyana uye kuvapo kuchiitwa infective endocarditis, nepo vamwe vari kuratidzwa dererei pairi, umo hosha iri subacute fomu.

Osler nodes, pathogenesis

zvivako izvi aonekwa maoko, nyore, tsoka nokuda kuzvimba kunokonzerwa chirwere navaduku tsinga uye inomiririra nda. Histological kudzidza nokusunungura mapfundo mavari kuratidza kunowedzerwa venules uye arterioles. Vari dzimwe nguva kuvhiringidzwa ane sema mapundu kana septic purpura. Sei nodules Osler, Photo rinonyatsoratidza zvikuru. Hazvina convex, chakakura pizi kana zvishoma Mobile inotungamirwa tsvuku kana shava Hue, dzimwe nguva kurwadza, dzimwe nguva haana. Vanokurukura kukurumidza kutsakatika voga, havasi ari oga chirwere, saka kurapwa mapiritsi kana nezvizoro haadi. Asi kana munhu akaona dzimwe nokusunungura mapfundo dzakadaro, anofanira pakarepo kunobvunza chiremba wako okuwedzera rabhoritari uye zvekuchipatara zvidzidzo.

Roth kuti mavara

Kuwedzera nodules Osler, mune infective endocarditis zvingaitika okuvhurumuka Hemorrhagic hunhu kumativi namakumbo, ropa pasi mbambo ndiro, mavara Zhaneve yomuka uyewo Osler nodes, pamusoro yemichindwe uye inotsika. Asi, mukusiyana kune nodules, mavara aya zvachose nyarara, haruzvitsvakiri somunhu pizi uye dzinokonzerwa nhokwe ropa kusvikira capillaries.

In infective endocarditis, mukuwedzera ganda, maziso uye zvingakanganiswa. Chimwe chezvinhu zvakafanana zviratidzo maitiro kuti kuzvimba mavara Roth. Akarondedzera chiremba wavo Swiss Roth. Roth mavara zvinomiririra microbleeds ari the retina. In chimiro vari denderedzwa kana kumativi ane chena dot pakati. In varwere, idzodzo izvi angaita ungaderedza chiratidzo, izvo, pashure pakurapa runotikurudzira chirwere anomutswa.

Roth mavara ndivo chiratidzo kwete infective endocarditis, asiwo kupererwa neropa, connective tishu chirwere. Naizvozvo, kuti chirwere zvinokosha kuitisa zvimwe zvidzidzo.

Other zviratidzo infective endocarditis

Pane vanenge gumi nevaviri zviratidzo anoratidza kuzvimba endocardium nokuda pakatanga chirwere.

Osler nodes, Lukin mavara (kana kurudyi-chiratidzo Lukin Liebman), zviratidzo Rock, Dmitrienko, Janeway nemamwe rubatsiro vanachiremba rokuongorora, kunyanya mune zviitiko apo zvimwe zvakafanana zviratidzo chirwere vari Blurred kana vasipo.

Chiratidzo Lukin-Liebmann ndiye nechitarisiko petechiae pfungwa ine whitish dzikafunga mipendero namafungiro uye conjunctiva.

Rock chiratidzo kunooneka pacharo mukuwedzera mboni yeziso kuruboshwe.

Chiratidzo Janeway - nayo erythematous dzidzo, uyewo ikaona Roth, kuita pamusoro emichindwe uye inotsikwa netsoka, asi muchiitiko chino vari mupfupi.

Chiratidzo Dmitrienko kunoratidzwa kunyoroveswa pakati matauriro namo I, izvo Ndokusaka Anonziwo "vherevheti inzwi." Taiona ichi chikamu mune kare nzendo chirwere.

mabatiro

Kuti asimbise mhosva Kunyanya chiratidzo kungava chiremba. Kazhinji, izvi zvinoda rabhoritari nemiedzo ropa, ECG, echocardiography. Zviri fanira kuita bakposev ropa kuziva rwarisa mumiririri. Kana miedzo zvakaratidza kuvapo infective endocarditis mune murwere, mushonga unorwisa iri ushandiswe yakakodzera boka. In Muzviitiko zvakaipisisa, kuvhiya rinoitwa (mapurasitiki, prosthetic mwoyo vharafu).

With nenguva chirwere akarurama uye nenguva atanga kurapwa 50-90% wevarwere kurarama anopfuura 5 years. Kuitira kudzivirira panowanikwa infective endocarditis yakatanga rinokosha Nzira vanhu pangozi. Rine modes wandei muzvidzivirire, kwakavakirwa negashiro nemishonga akasarudzwa ezvinhu unyanzvi.