Rhabdomyolysis: chii, hunokonzera, zviratidzo, pakurapa chirwere

Anoita pfungwa iri tsandanyama rinenge vari aizivikanwa vanhu vaiita mitambo ounyanzvi. Avo vanogamuchira kugara muviri uye mufananidzo zvinobatsira avo uye ngozi kuziva pfungwa "rhabdomyolysis". Zviratidzo chirwere ichi chakakomba zvikuru. Pasinei netyazholoe nokuti zvokurwara kungaita kuti migumisiro yakaipa kuti muviri. Rhabdomyolysis - chii? Kuti tipindure mubvunzo uyu murege chete vanachiremba, asi chero akakodzera anodzidzisa chimwe chete zvemitambo. The zvokurwara chinhu ngozi chaizvo uye kwazvo Danho kunogona kutungamirira kurufu. Zvisinei, kana kuri kuona nguva, zvichida mushonga wakakwana.

Chirwere rhabdomyolysis - chii?

zvokurwara iri kakawanda kuchengetwa tsandanyama kukuvara. Kunosanganisira kuparadzwa zvinyama uye kubva zvinokuvadza muropa. Saka unogona kutsanangura zvishoma musimboti wenyika chirwere rinonzi rhabdomyolysis. Chii, zvichava zvikuru pachena kana kudzidza kwauchaita okukura chirwere uye nemigumisiro yayo muviri. Yeuka kuti haana kukuvadzwa ose kana kurovedza muviri kunoita kuti chirwere. Rhabdomyolysis - mumwe chirwere umo kudzikisirana yacho tsandanyama tishu. Nekuti kuparadzwa skeletal tsandanyama muropa anopinda venhumbi anowanzoita havafaniri kuva imomo. Izvi - puroteni myoglobin. Iye kunokosha pakuderedza kuti tsandanyama. Chaiye itsvo iri inactivated uye asingauyi kukuvadza muviri. Asi tsandanyama kudzikisirana uye kuora uwandu muropa zvasvika refu pfungwa. Somugumisiro, myoglobin refu circulates kuburikidza nomuviri, kwokusunungura nephrotoxic vakasununguka radicals. Izvi zvinhu zviri chaizvo kukuvadza munyama ari renal tubules. On hwaro ichi, zvinokwanisika kupindura mubvunzo: "? Rhabdomyolysis - chii uye sei ngozi" Kuwedzera kuparadzwa tsandanyama, chirwere ichi chinogona kukonzera yakadaro chakakomba mamiriro sezvo chakasimba renal kukundikana. Kana rubatsiro kukurumidza akapa arrester anokwanisa kukonzera rufu.

Rhabdomyolysis: Zvinokonzera chirwere

Kune mapoka 2 zvinokonzera kuti kukonzera kukura rhabdomyolysis. Muchiitiko chokutanga - ndiwo zvinokuvadza pamusoro skeletal tsandanyama. Havazivi zvinosanganisira zviduku migumisiro pamusoro tsandanyama (mavanga). Pakati kukuvadza zvinhu dzoga:

1. Heavy mutsaona yomumugwagwa.
2. Large nzvimbo hudiki uye kudzika (kusvika tsandanyama rukoko).
3. Migumisiro Magetsi kumuviri.
4. mabasa chisimba kuti kukonzera tsandanyama kukuvara.
5. Toxicosis anokonzerwa zvinorwadza kuvhunduka.
6. Long-izwi zvomusejari kupindira.

Chimwe chinokonzera rhabdomyolysis vane simba marwadzo ose tsandanyama tishu. Izvi zvinogona kukonzera zvakakomba panyama mupfungwa (kujairika kuti muviri), nokugwinha.

Uyezve, pane zvimwe zvinhu zvinoita kuti rhabdomyolysis. Ndivo ishoma, asi achiri anogona kukura zvokurwara ichi. Izvi zvinosanganisira electrolyte kusaenzana, kwemabhakitiriya uye nemavhairasi zvirwere, uyewo zvinodhaka kudhaka. All izvi zvinoita pave nokushayiwa ATP. Zvinozivikanwa kuti kushayikwa fuma iyi zvarinoita kukura rhabdomyolysis. A shoma ATP rinoita vasanyanye chitunha electrolyte. Izvi zvinosanganisira zvinhu zvakadai calcium, phosphate uye potassium. Zvakaipira izvi zvinhu zviri kucherechedzwa muna chafariz uye sunstroke, hypothermia. Mune zvimwe zviitiko, kuparadzwa tsandanyama rinenge zvichizoita kwenguva refu kugara kwevanhu mune supine nzvimbo - immobilization.

The mashandiro pamusoro rhabdomyolysis

The pathogenesis pamusoro rhabdomyolysis apo kunobva chii chakaita mhaka kuparadzwa skeletal tsandanyama. Kana tsandanyama zvakaparadzwa nezviitiko Migumisiro kana metabolic zvinetso, ipapo ari kuzvimba masero. Izvi zvinoitika nokuda mvura ingress kubva nharaunda kupinda Kamudzira pamusoro myocytes. Nokuda kuti kutyora iyi masero kuzvimba uye kukura. Akachinjwa myocytes mberi yakapoteredza zvinyama uye tsinga fibers. Saka, ropa riyerere kune utano tsandanyama masero ari kwakakanganiswa, zvichitungamirira kuparadzwa kwavo. Nokuda kudzikisirana ose skeletal tsandanyama mapuroteni kusunungurwa kunoitika - myoglobin. Kazhinji, nefuma hakusi chepfu kuna muviri. Kunyange zvakadaro, puroteni anogona kukonzera renal basa. Izvi zvinoitika sezvinotevera: myoglobin anotsinga aine pfuma huripo munyika renal masero. remubatanidzwa Izvi zvinotungamirira inotungamirwa hwakasimba kuvhiringidza ropa riyerere. Uyezve, myoglobin ane nephrotoxic migumisiro.

Clinical zviratidzo chirwere

Govera inorema uye chiedza zviratidzo rhabdomyolysis. Muchiitiko chokutanga kuparadzwa tsandanyama chirwere pamwe renal insufficiency. Rabdomioz nyoro chenjera renal kukundikana haina kuremerwa. The zvekuchipatara Kuratidza chirwere dzinosanganisira:

1. Kupera simba.
2. Dark weti ruvara. chinhu ichi inoratidza itsvo basa iri yokuongororwa yokuona nayo rhabdomyolysis.
3. Kuzvimba nounyoro ari skeletal netsandanyama.

Pamusoro accession, renal kukundikana murwere ezvinhu kuipa. Zviratidzo chakasimba renal kukundikana dzinosanganisira:

1. richiripo edema.
2. Low weti goho, kusvikira ayo vasipo.
3. Kamuri syndrome. Zviri nokuda tsandanyama tishu kuzvimba. Kunogona kukonzera compression dzinokosha nhengo. Zviratidzo chirwere ichi vari: kupfupika mweya, kunoderedza BP, kuvhunduka.
4. Tachycardia, vakabva - thready kufamba kweropa.
5. Electrolyte kusaenzana.
6. Pakoma.

Chirwere dzekuziva nadzo rhabdomyolysis

Fungira chirwere chinogona inobva: dambudziko kutambudza tsandanyama rinenge tsandanyama soreness, uye kuzvimba, weti achiipa. Zviratidzo izvi wevanhurume rokutanga chirwere "rhabdomyolysis". The chirwere anogara pamwe nokuchinja muropa uye weti. The chirwere inoonekwa kana zvinotevera kutyorwa kuzivikanwa muna murabhoritari zvidzidzo:

1. Yakakwirira kwevari creatine kinase.
2. Pakuonekwa myoglobin muropa.
3. Inosimudzira phosphorus uye potassium yomuropa, akaderedza karusiyamu ions.
4. With kukura renal kukundikana - yakawanda creatinine uye urea.
5. Myoglobinuria (mapuroteni mu weti).

Uyezve, kuchinja zvinochengetwa pamusoro unonzi, electrocardiograph (kuwedzera ventricular zvivako, panowanikwa T-mafungu). In nemuumbi compression pamusoro chirwere chingava kukuvara nhengo dzomukati, mapfupa. Naizvozvo, nokuti chirwere kuti zvirwere zvakafanira kuti kuitisa X-ray.

Nzira kurapa rhabdomyolysis

Kubatsira murwere kutanga kupa pakarepo, achangogara akabatwa chirwere "rhabdomyolysis". kurapwa chirwere zvinofanira kuitwa muchipatara, sezvo muchipatara pakururamisa zvinokwanisika kuongorora ufanane electrolytes. Kuchenesa muviri akabata rehydration. Kana chakakomba rhabdomyolysis inodiwa Urume marapirwo pamwe sesaline. Uyewo chinokosha ndiko kurangwa mvura-munyu uye electrolyte muviri. diuretics "Furosemide" hunosumwa kuti normalization kuti diuresis kana "Mannitol". In zvikuru kwazvo nguva hemodialysis inoshandiswa. Kana tsandanyama nevezera rinosvika 30 mm. HG. . Art, Need kuvhiya excision kuti zvinyama - fasciotomy. The chete nzira chokugumisa kuti mberi compression mitumbi.

Possible yematambudziko zvirwere

Unofanira kuziva kuti nguva kubatsira chirwere nyoro achamira rhabdomyolysis. Photo varwere chirwere data, zvakawanda pamusoro mapeji kuMudzidzisi mashoko pfuma zvokurapa misoro. Kuti vazive kuti kutarira njodzi tsandanyama kuchikosha zvikuru vanhu vaiita rinorema remaoko. Kana vakafunga rhabdomyolysis zvakakodzera kuti tiite rabhoritari miedzo ropa uye weti. Kana chirwere kwakasimbiswa kusvika chakakomba dhigirii, zvine ngozi zvinotevera matambudziko:

1. Kukuvara mapazi uye munyama. It kunoitika nokuda mupanda syndrome.
2. Chenjera renal kukundikana.
3. DIC. It imhaka murombo kweropa. In Muzviitiko zvakaipisisa, inotungamirira kurufu.

For muupenyu rhabdomyolysis

The fungidziro kunobva mwero chirwere nekuomarara. Panguva kutanga pavaipfuura chirwere anopindura zvakanaka mishonga. Recurrences zvinochengetwa chete nyaya apiwa traumatization. Kana zvokurwara yasvika chakakomba dhigirii, asi fungidziro zvishoma zvakanaka. Kunyange zvakadaro, kupora zvinogoneka chete mubatanidzwa zvinodhaka mishonga uye kuvhiya kupindira. Kana chakasimba renal kukundikana mwero wokufa kwevanhu ndiko 20%.