Cov kab mob ntawm daim tawv nqaij, mucous daim nyias nyias ntawm tib neeg yog tshwm sim ntawm erythema multiforme exudative. Cov kab mob hnyav no, uas tshwm sim los ntawm qhov tshwm sim ntawm cov pob liab liab, muaj qhov rov ua dua tshiab. Feem ntau tus kab mob no cuam tshuam rau cov neeg hluas thiab cov hnub nyoog nruab nrab, tsawg dua kuaj pom hauv cov menyuam yaus. Cov kab mob zoo li no yog ib yam kab mob uas feem ntau tshwm sim thaum lub caij so.
Cov ntsiab lus no yog siv los ntawm cov kws tshaj lij txhawm rau txheeb xyuas cov pob khaus zoo sib xws uas zoo li nce zuj zus los ntawm qee cov kab mob uas muaj kab mob sib kis lossis ua xua. Hauv qhov no, ob hom kab mob tau txiav txim siab:
- tshuaj lom-ua xua exudative erythema;
- kis mob-ua xua.
Yog li, dab tsi yog vim li cas rau erythema multiforme exudative (ICD-10 code L51)? Wb sib paub ua ke.
Yog vim li cas
Tam sim no, cov kws tshaj lij tseem tsis tau txheeb xyuas qhov tseeb ntawm cov laj thawj uas ua rau muaj kev loj hlob ntawm tus kab mob sib kis. Tab sis feem ntau sib cav hais tias qhov ua rau ntawm kev loj hlob ntawm tus kab mob yog ib tug kab mob focal uas twb muaj nyob rau hauv tib neeg lub cev. Ib qho zoo sib xws tau pom hauv kwv yees li 70% ntawm cov neeg mob uas tau kuaj pom tus kab mob no. Cov neeg zoo li no pom muaj kev nkag siab zoo rau cov kab mob pathogenic microorganisms. Thaum lub sij hawm tsim ntawm ib tug relapse ntawm tus kab mob, cov kev tiv thaiv ntawm lub cev tsis muaj zog poob ho.
Dab tsi yog qhov tshwm sim ntawm tus kab mob erythema multiforme?
Cov kws kho mob tshwj xeeb ntseeg tias qhov laj thawj tseem ceeb ntawm kev txhim kho cov kab mob sib kis-ua xua yog ib qho kev tiv thaiv kab mob uas tshwm sim vim:
- kab mob kis kab mob;
- heliomagnetic cuam tshuam;
- kab mob chronic;
- hypothermia.
Ib qho ua rau muaj tshuaj lom-ua xua ntawm tus kab mob yog kev noj tshuaj los ntawm ntau pawg. Feem ntau, lub cev reacts nyob rau hauv txoj kev no rau cov tshuaj los ntawm tetracycline series, barbiturates.
Toxic-allergic form
Cov tshuaj lom-ua xua ntawm exudative erythema multiforme. Hauv cov xwm txheej no, muaj qhov pom tseeb hyperemia ntawm foci. Lawv kuj muaj peev xwm ua ke. Mucous daim nyias nyias feem ntau raug (qhov chaw mos mucosa, kab noj hniavmloog, thiab lwm yam). Cov hlwv yog cov tshuaj tiv thaiv epidermolytic.
daim ntawv kab mob-xws li
Hauv qhov no, muaj cov kab mob me me ntawm daim tawv nqaij, uas feem ntau tsis sib koom ua ke. Feem ntau, lawv nyob rau hauv qis extremities. Tsis tshua muaj tshwm sim ntawm cov mucous daim nyias nyias ntawm lub qhov ncauj thiab qhov chaw mos. Daim ntawv no ntawm pathology yog pom feem ntau, nws tsis yooj yim rau kev kuaj mob. Cov kws tshaj lij kuj tau txheeb xyuas cov kab mob loj heev uas ua rau muaj kev loj hlob ntawm tus kab mob. Yeej, cov no yog cov kab mob uas tsim cov kab mob foci ntawm cov kab mob ntev hauv tib neeg lub cev, uas dhau los ua ntu zus.
Thiab qhov mob hnyav thiab hnyav tshaj plaws ntawm tus kab mob no yog Stevens-Johnson syndrome. Nrog rau qhov mob ntawm daim tawv nqaij thiab daim tawv nqaij, qhov muag, qhov ntswg thiab qhov chaw mos kuj raug cuam tshuam. Yog tias tsis tau pib kho kom haum raws sijhawm, ces qhov tshwm sim ua rau tuag taus.
Symptomatics
Cov tsos mob raug txiav txim siab nyob ntawm tus kab mob uas tus neeg muaj. Cov cim qhia ntawm qhov tshwm sim yog tib yam hauv cov menyuam yaus thiab cov neeg laus. Nws yuav tsum raug sau tseg tias hauv cov menyuam yaus, erythema multiforme exudative yog qhov nyuaj tshwj xeeb. Cov tsos mob zoo ib yam ntawm cov neeg laus thiab menyuam yaus. Yog li ntawd, nws yog ib qho tseem ceeb heev uas yuav tsum tau coj tus menyuam mus rau lub tsev kho mob tam sim ntawd rau kev teem caij nrog tus kws kho mob tshwj xeeb thaum txheeb xyuas thawj cov cim qhia ntawm kev loj hlob ntawm tus kab mob. Cov tsos mob ntawm pathology ntawm tus kab mob-kev tsis haum:
- malaise;
- mob taub hau;
- mob caj pas thiab pob qij txha.
Qhov tshwm sim ntawm pob khaus
Raws tawm ntawm daim tawv nqaij. Lawv raug pom nyob rau hauv cov mucous daim nyias nyias ntawm lub qhov ncauj, ntawm daim di ncauj, ntawm qhov chaw mos. Nws yog ib qho tseem ceeb uas yuav tau xav txog tias cov pob khaus no tuaj yeem nyob hauv ib qho chaw tshwj xeeb, piv txwv li, tsuas yog ntawm daim di ncauj lossis tsuas yog ntawm qhov chaw mos. Intoxication cov tsos mob ntawm erythema multiforme txo qis tom qab 3-5 hnub tom qab qhov pib ntawm cov pob liab liab, thiab qhov kub thiab txias tuaj yeem kav ntev txog peb lub lis piam.
Txwv edematous me ntsis los yog papules tshwm rau ntawm qhov ncauj mucosa thiab ntawm daim tawv nqaij. Lawv feem ntau yog xim liab-liab hauv cov xim. Xws li formations sai nce loj. Qhov siab tshaj plaws yog 3 cm. Cov pob khaus hauv nruab nrab muaj cov xim xiav thiab dab dej me ntsis. Nyob rau hauv qhov chaw, tus yam ntxwv vesicles kuj tsim, uas muaj exudate nyob rau hauv. Cov neeg mob feem ntau yws yws ntawm khaus, feem ntau lawv pom qhov kub hnyiab.
Multiform exudative erythema hauv qhov ncauj kab noj hniav
Daim duab kho mob ntawm hom exudative erythema no feem ntau yog monotonous. Tab sis daim ntawv no ntawm tus kab mob no hnyav heev, vim hais tias cov tsos mob yog heev pronounced. Qhov feem ntau "nyiam" localizations ntawm pob khaus yog lub puab tsaig, daim di ncauj, palate, vestibule ntawm lub qhov ncauj. Tag nrho cov no yog qhov tsis kaj siab heev thiab txo qis lub neej zoo mus rau qhov loj.
Nws yuav tsum tau muab sau tseg ntawm no tias tus kab mob no pib sai sai thiab mob. Nyob rau hauv thawj theem ntawm kev loj hlob, ib tug diffuse thiab edematouserythema, uas nws thiaj li hloov mus rau hauv vesicles tom qab ob peb hnub. Ob peb hnub tom qab, cov npuas no qhib thiab cov chaw erosive tshwm. Lawv tuaj yeem loj heev thiab npog tag nrho qhov ncauj mucosa, cuam tshuam rau daim di ncauj. Xws li cov cheeb tsam cuam tshuam feem ntau yog them nrog cov txheej greyish-daj. Nws yooj yim cais, tab sis tom qab tshem tawm, parenchymal los ntshav tshwm sim.
Ntau zaus, nrog erythema multiforme, ntshav tuab ua rau ntawm daim di ncauj, uas tsis tso cai rau lub qhov ncauj qhib tag nrho. Nws yuav tsum raug sau tseg tias hauv qee tus neeg mob, kev yaig tuaj yeem kis mus rau tag nrho lub qhov ncauj mucosa, thaum lwm tus tsuas yog ib qho pob liab liab tshwm.
Qhia txog kev puas tsuaj loj ntawm mucosal
Nrog kev puas tsuaj rau qhov ncauj mucosa, cov tsos mob hauv qab no tau pom:
- tsis tau qhib qhov ncauj;
- ntse mob;
- tsis muaj peev xwm noj txawm tias ua kua;
- nyuaj tham;
- exudate tau tso tawm los ntawm qhov chaw yaig ntau ntau;
- drooling nce.
Cia peb xav txog daim ntawv thib ob ntawm erythema multiforme.
Txoj kev ua xua ntawm tus kab mob
daim ntawv no yog tus yam ntxwv ntawm cov pob liab liab, uas tuaj yeem pom qhov muag piv nrog cov pob liab liab ntawm daim ntawv kis kab mob. Foci tuaj yeem nthuav dav lossis ruaj khov. Yog tias qhov pob khaus loj tuaj, qhov ncauj qhov ncauj feem ntau cuam tshuam.
Rashes tsautau tsim nyob rau hauv cov chaw uas lawv tau tsim ua ntej, tab sis qhov no tsis tau txhais hais tias lawv tsis tuaj yeem tshwm sim hauv lwm qhov chaw. Feem ntau, formations tshwm sim nyob rau hauv lub qhov ncauj kab noj hniav, vim hais tias nws yog nyob rau hauv cov cheeb tsam no uas lub siab rhiab heev rau cov tshuaj yog txaus siab. Nws yuav tsum raug sau tseg tias hlwv tuaj yeem tshwm sim ntawm thaj chaw ntawm daim tawv nqaij tsis hloov lossis mucosa.
Daim ntawv no ntawm pathology tshwm sim tsis hais lub caij twg. Thiab nws tsis yog ua ntej los ntawm cov tsos mob. Muaj tsawg zaus, qhov kub yuav nce me ntsis.
Cov lus qhia kho mob rau erythema multiforme exudative yuav tsum ua raws li nruj me ntsis. Peb yuav teev lawv hauv qab no.
Kev kuaj mob ntawm no pathology
Daim duab kho mob ntawm erythema yog qhov tseeb thiab zoo heev uas tsis tas yuav siv lwm txoj hauv kev ntxiv hauv txoj kev tshawb no. Qee lub sij hawm cov kws kho mob tuaj yeem mus rau kev kuaj ntshav ntawm cov pob liab liab los yog smear-prints. Qhov no yuav muab lub sijhawm los refute lwm yam pathologies.
Kev kuaj mob sib txawv ntawm erythema multiforme exudative yog ua nrog cov kab mob no:
- Duhring's disease.
- Secondary syphilis.
- Lichen planus.
- Pemphigoid.
- Pemphigus.
Kev kho mob rau erythema multiforme exudative yog dab tsi?
Kev kho mob ntawm exudative erythema
Pathology hauv cov neeg laus thiab menyuam yaus raug kho yuav luag raws li tib lub tswv yim:
- yog tias pom muaj kev fab tshuaj rau cov zaub mov, nws raug qhia kom noj enterosorbents;
- xav tau kiag lizam kom tsis txhob raug cov zaub mov ua xua thiab tshuaj noj;
- yog tias pom cov pob khaus tawv nqaij, siv cov tshuaj aniline;
- yog tus kab mob hnyav, ces chav kho mob ntxiv nrog kev txhaj tshuaj thiab tshuaj pleev corticosteroid;
- yog tias muaj kab mob tshwm sim nrog erythema, ces cov tshuaj tua kab mob dav dav raug pom zoo rau kev kho mob;
- siv cov tshuaj pleev thiab aerosols nrog cov nyhuv analgesic rau kev kho mob hauv zos;
- Yvitamin therapy.
Yuav kom tshem tawm cov pob khaus hauv qhov ncauj sai sai, koj yuav tsum tau siv cov tshuaj Rotokan tsis tu ncua rau kev yaug. Kev daws ntawm poov tshuaj permanganate thiab boric acid kuj tsim nyog. Txoj kev kho no zoo heev, tab sis koj yuav tsum tau ua kom zoo.
Kev kho tus kab mob no tau ua nyob rau hauv tsev kho mob thiab ua raws li cov kws kho mob saib xyuas tas li.
Qee zaum cov tshuaj kho pej xeem tuaj yeem raug sau ua ib txoj hauv kev kho mob ntxiv. Tab sis koj tsis tuaj yeem siv lawv ntawm koj tus kheej, vim qhov no tsuas yog ua rau qhov xwm txheej tsis zoo. Kev kho mob nrog pej xeem tshuaj tsuas yog muab los ntawm tus kws kho mob.
Kev noj haus rau qhov pathology
Rau txhua hom kab mob, kev noj zaub mov kuj raug sau tseg, uas yuav tsum tsis suav nrog cov khoom no los ntawm kev noj haus:
- txiv ntseej;
- txiv hmab txiv ntoo, tshwj xeeb tshaj yog txiv kab ntxwv, zaub liab thiab txiv kab ntxwv, suav nrog txiv lws suav;
- ntses, tshwj xeeb tshaj yog liab thiab nqaij nruab deg;
- nqaij qaib thiab cov khoom ua los ntawm nws;
- chocolate, zib ntab, nplua nuj hmoovkhoom;
- cov khoom haus luam yeeb, ntsim thiab cov khoom siv tawm, horseradish, radish, marinades, spices, pickles, mustard;
- kas fes thiab dej cawv.
Cov khoom noj hauv qab no tuaj yeem noj:
- cereal thiab zaub soups, cereals nrog butter thiab zaub roj;
- tshiab dib, dill, parsley, ci txiv apples thiab watermelon;
- nqaij lean;
- comotes los ntawm cov txiv apples tshiab, cherries, txiv hmab txiv ntoo qhuav thiab plums;
- poorly brewed teas;
- khoom noj txhua hnub.
Yog hais tias qhov ncauj kab noj hniav raug cuam tshuam los ntawm cov kab mob no, ces cov tais diav huv thiab kua tau noj. Tsis tas li ntawd, kev haus dej ntau yog qhia. Yog tias nqos tsis tau, kev noj zaub mov ntawm niam txiv yog nqa tawm.
Kev kho mob nrog pej xeem cov kev kho mob suav nrog kev siv:
- chamomile tshuaj yej;
- decoction ntawm arnica (yaj);
- arnica tshuaj pleev.
Tsuas yog siv txoj kev kho nyuaj, yuav tau txais txiaj ntsig.
