Nyob hauv lub ntiaj teb niaj hnub no, muaj ntau tus kab mob ntawm ntau yam kabmob tau paub. Qhov muag tsis muaj qhov zam. Thaum thawj cov tsos mob tshwm sim, koj yuav tsum sab laj nrog kws kho mob. Chorioretinitis ntawm lub qhov muag yog ib qho txheej txheem inflammatory uas cuam tshuam rau cov ntu tom qab ntawm cov hlab ntsha ntawm lub qhov muag. Pathology tuaj yeem kis mus rau retina. Tus kab mob no zoo heev txo tus nqi ntawm cov ntshav ncig. Qhov tseeb no tau piav qhia yooj yim heev: cov neeg kis kab mob coob tshaj plaws nyob rau sab nraub qaum ntawm lub qhov muag. Hauv kev tshuaj xyuas no, peb yuav ua tib zoo saib seb chorioretinitis ntawm qhov muag yog dab tsi, yuav kho tus kab mob no li cas, nrog rau kev tiv thaiv.
Kev txhim kho kab mob
Yog li koj yuav tsum paub dab tsi txog qhov no? Lub chorioretinitis ntawm lub qhov muag kis maj mam. Thaum pib, tus kab mob cuam tshuam rau lub network ntawm capillaries uas muab cov ntshav mus rau retina. Tom qab ntawd, nws dhau mus rau lub network ntawm cov hlab ntsha loj. Kev mob tshwm sim tuaj yeem tshwm sim hauv ob qho tib si mob thiab mob ntev. Tus kab mob tuaj yeem raug cais raws li tus lej ntawm cov tsos mob. RauTxhua yam mob muaj nws tus yam ntxwv.
Chorioretinitis ntawm lub qhov muag tuaj yeem tshwm sim nws tus kheej txhua lub hnub nyoog. Hauv menyuam yaus, nws tuaj yeem ua rau muaj kev sib kis ntawm cov kab mob sib kis, thiab hauv cov neeg laus nws tuaj yeem tshwm sim los ntawm kev siv cov tshuaj kho qhov muag tsis raug lossis vim muaj kev sib cuag nrog cov tshuaj reagents.
Kev faib tawm
Cia peb saib kom ze rau qhov no. Lub choriorenitis ntawm lub qhov muag tuaj yeem raug cais nyob ntawm ntau cov cim qhia uas txiav txim siab txog daim ntawv thiab hom kev loj hlob ntawm tus kab mob. Cov no suav nrog:
- ntau tus kabmob kis;
- thaj chaw faib khoom;
- sijhawm tshwm sim.
Nyob ntawm thaj chaw faib khoom, lawv muab faib:
- Central serous chorioretinitis ntawm lub qhov muag (tso tawm hauv thaj chaw macular).
- Peripapillary (tso nyob ze ntawm qhov muag pom).
- Equatorial (mob ntawm choroid nyob ze ntawm qhov equatorial ntawm lub cev ntawm lub zeem muag).
- Peripheral chorioretinitis ntawm lub qhov muag (tso tawm ntawm ciam teb ntawm cov kab hniav).
Tus kab mob tuaj yeem tshwm sim hauv ib lossis ntau qhov chaw ntawm lub qhov muag. Raws li qhov no, tus kab mob tuaj yeem muab faib ua:
- focal chorioretinitis ntawm lub qhov muag: thaum qhov mob tshwm sim hauv ib cheeb tsam nkaus xwb;
- multifocal: cov txheej txheem inflammatory hauv cheeb tsam hauv ntau thaj chaw ib zaug;
- diffuse chorioretinitis: tus yam ntxwv los ntawm ntau qhov mob nrog ua tau fusion.
Pathology tuaj yeem ua tausib txawv ntawm lub sijhawm. Daim ntawv mob hnyav tau hais tias yog thaum tus kab mob tshwm sim nws tus kheej ua ntej peb lub hlis twg. Tus kab mob mob ntev yuav txhawj xeeb ntev, tsawg kawg peb lub hlis.
Chorioretinitis ntawm lub qhov muag kuj tuaj yeem raug cais nyob ntawm seb qhov twg tau dhau los ua tus neeg sawv cev ntawm pathology. Raws li qhov no, tus kab mob tau muab faib ua:
- kab mob chorioretinitis;
- post-traumatic;
- tsis- kis-xws li;
- kis mob-ua xua.
Feem ntau peb tham txog hom kab mob sib kis. Kuj tseem muaj cov kab mob congenital - toxoplasmic chorioretinitis. Hauv qhov no, kab mob tshwm sim hauv tsev menyuam nrog toxoplasmosis. Tsis tsuas yog lub qhov muag xwb, tab sis kuj muaj lwm yam kabmob. Lub foci ntawm tus kab mob yog sawv cev los ntawm pronounced contours nrog muaj zog pigmentation.
Los ntawm qhov tshwm sim, qhov mob hauv kev sib tham tau muab faib ua hom hauv qab no:
- Tuberculosis: kab mob thib ob uas tshwm sim thaum kis tus kab mob. Nws manifests nws tus kheej nyob rau hauv qhov tshwm sim ntawm disseminated tubercles. Tom qab kev kho mob, chorioretinal nti yuav nyob twj ywm.
- Syphilitic: tshwm nyob rau hauv lub fundus, yam ntxwv los ntawm alternating fibrous foci ntawm atrophy thiab pigmentation foci.
- Purulent: vim kev tiv thaiv kab mob. Qhov phom sij tseem ceeb ntawm daim ntawv no yog kev sib kis ntawm exudate mus rau lwm qhov ntawm lub qhov muag. Ib qho kev tiv thaiv kab mob ntau yam yog qhov txawv, uas yog tus cwj pwm los ntawm thaj chaw loj ntawm kev puas tsuaj, necrotic thiab hemorrhagic cim. Hla daim ntawv notus kab mob no hnyav txaus thiab tej zaum yuav xaus rau qhov muag tsis pom.
Lwm hom kab mob muaj qhov ua tau zoo tsis muaj qhov txawv txav. Myopic chorioretinitis tuaj yeem paub qhov txawv. Nws feem ntau tsim nyob rau hauv cheeb tsam ntawm qhov chaw daj nyob rau saum npoo ntawm retina. Qhov ua rau ntawm tus kab mob yog rov tshwm sim hemorrhages hauv retina.
Stages
chorioretinitis ntawm qhov muag pom tau li cas? Cov tsos mob nyob ntawm theem ntawm tus kab mob. Thawj theem yog tus cwj pwm los ntawm:
- pom cov kab mob greyish-daj nrog tsis muaj zog contours;
- tsim cov exudate raws lub network ntawm cov hlab ntsha;
- pom cov hemorrhages me.
Nyob rau theem zuj zus ntawm tus kab mob, cov kab mob nrog cov lus qhia, muaj zog pigmentation, thiab retinal atrophy tshwm.
Yog vim li cas
Cia peb saib lawv kom ntxaws ntxiv. Dab tsi ua rau chorioretinitis ntawm qhov muag? Feem ntau qhov no pathology yog qhov tshwm sim ntawm cov kab mob hauv qab no:
- kab mob autoimmune xws li mob caj dab thiab ntshav qab zib;
- kab mob sib kis: syphilis, toxoplasmosis, tus kab mob herpes;
- kab mob tiv thaiv kab mob;
- raug rau co toxins;
- kab mob kis;
- kev puas tsuaj thiab kev raug mob;
- kev tsis haum;
- ncua sij hawm raug hluav taws xob;
- kev txhim kho ntawm cov teeb meem.
Symptoms
Yog li, koj yuav tsum ua tib zoo saib ua ntej ntawm tag nrho? Raws li txoj cai, cov tsos mob ntawm tus kab mob no tau tshaj tawm nyob rau hauv qhov chawqhov chaw ntawm qhov tshwm sim. Koj tuaj yeem kuaj tus kab mob los ntawm cov cim hauv qab no:
- pos huab ntawm kev pom;
- kev puas tsuaj ntawm qhov muag pom kev;
- pom thaj chaw tsaus;
- kev tshwm sim;
- flickering sparks thaum saib xyuas;
- distortion ntawm cov qauv thiab qhov ntau thiab tsawg ntawm cov khoom hauv nqe lus nug;
- nyuaj taug kev hmo ntuj;
- retinal opacity;
- nce rhiab heev rau lub teeb ci ci;
- pom qhov mob hauv qhov muag;
- hloov xim kev nkag siab.
Cov cim qhia no qhia txog kev txhim kho ntawm qhov muag pathology, yog li ntawd, yog tias pom ib qho tshwm sim, nws yuav tsum tau nrhiav kev pab los ntawm tus kws kho mob uas tsim nyog thiab ua qhov kev kuaj mob. Nws tseem yuav tsum tau nco ntsoov tias qee hom kab mob yog asymptomatic. Cov no suav nrog ntau yam peripheral.
Diagnosis
Tus kab mob chorioretinitis qhov muag kuaj tau li cas? Dab tsi yog nws thiab dab tsi yog nws peculiarity? Txhawm rau kom paub meej qhov kev kuaj mob, tus neeg mob tau txais kev kuaj xyuas hauv qab no:
- kev kuaj pom kev pom: lub hauv paus chorioretinitis ntawm lub qhov muag yog tus yam ntxwv los ntawm kev tsis zoo ntawm kev pom, thaum nws yuav tsis tuaj yeem kho nws yav tom ntej;
- periometry;
- refractometry;
- biomicroscopy: qhov kev ntsuam xyuas no pab txhawm rau txheeb xyuas qhov muaj deformities ntawm lub cev vitreous;
- kev kuaj lub teeb: tuaj yeem pom qhov pom ntawm lub cev;
- Yophthalmoscopy:tso cai rau koj los txiav txim siab qhov kev loj hlob ntawm tus kab mob;
- fluorescein angiography: kuaj pom cov kev hloov pauv hauv cov hlab ntsha fundus (zoo li shunts thiab microaneurysms);
- electroradiography: tso cai rau koj los txiav txim siab txog qhov xwm txheej ntawm retina thiab txiav txim siab seb nws puas ua haujlwm;
- kho qhov muag coherence tomography: qhia pom muaj cov yam ntxwv morphological ntawm kev ua kom pom tseeb ntawm qhov mob;
- Ultrasound: kuaj pom lub xeev ntawm cov xov xwm kho qhov muag.
Specialists
Tus kws kho mob twg pab tshem tawm chorioretinitis ntawm qhov muag? Kev kho tus kab mob no yuav tsum muaj nyob rau hauv kev saib xyuas ntawm ntau tus kws kho mob tshwj xeeb hauv ib zaug. Yog tias tsim nyog, koj tuaj yeem nrhiav tswv yim los ntawm tus kws kho mob, tus kws kho mob tshwj xeeb, tus kws kho qhov muag, tus kws kho mob venereologist, tus kws kho mob, kws kho mob, kws kho mob ENT, kws kho hniav.
Yog tias pom pom chorioretinitis hauv nruab nrab ntawm lub qhov muag hauv tus menyuam, ces koj yuav tsum hu rau tus kws kho menyuam yaus.
Kev kho mob
Qhov no yuav tsum tau muab tshwj xeeb. Tus kab mob no kho tau li cas? Nws yuav tsum to taub tias kev kho mob rau chorioretinitis yog xaiv ib tus zuj zus. Kev kho mob hauv zos hauv qhov no tej zaum yuav tsis muaj txiaj ntsig zoo. Qhov tshwj xeeb yog txhaj tshuaj parabulbar thiab retinobulbar.
Kev kho tshuaj tiv thaiv feem ntau suav nrog ob pawg tshuaj:
- etiotropic: tshem tawm qhov ua rau muaj kev cuam tshuam;
- tshuaj tua kab mob: siv thaum tus kab mob ua rau muaj kab mob.
Yog qhov ua rau chorioretinitis ntawm qhov muag yogCov kab mob, interoferons, inducers ntawm interferonogenesis thiab tshuaj tua kab mob feem ntau yog muab rau kev kho mob.
Cov kab mob syphilitic ntau yam hauv kev sib tham yog kho nrog tshuaj tua kab mob ntawm pab pawg penicillin. Yog tias tus neeg mob intolerance rau hom tshuaj no, nws yuav raug muab tshuaj rau doxycycline, macrolides thiab cephalosporins. Tus kws kho mob uas tuaj koom yuav tsum tau txiav txim siab txog qhov ntau npaum li cas ntawm cov tshuaj no.
Hauv cov txheej txheem inflammatory, "Pyrimethamine", "Sulfalimezin" tuaj yeem raug tshuaj. Rau kev kho mob ntawm tuberculous chorioretinitis, kev pab los ntawm Phthisiatrician yuav tsum tau. Nyob rau hauv daim ntawv mob ntev ntawm tus kab mob, ib chav kawm ntawm Isoniazid, Streptomycin, Kanamycin, nrog rau kev kho tshuaj hormone tuaj yeem raug sau.
Ib qho yuav tsum tau ua ntawm kev kho mob yog kev kho tshuaj tiv thaiv. Nws tuaj yeem suav nrog kev noj tshuaj xws li Indomethacin, Hydrocotison, Diclofenac, Lexamethasone. Lawv feem ntau yog noj hauv qhov ncauj, vim tias lawv qhov kev ua haujlwm tau qhib rau hauv plab hnyuv. Rau kev txhaj tshuaj intramuscular thiab txhaj tshuaj, Didrospan kuj raug sau.
Kev tshem tawm cov txheej txheem ntawm kev kho mob suav nrog "Hemodez" thiab 5% kua qabzib. Cov tshuaj no tau muab tso rau hauv cov hlab ntsha.
Nyob ntawm qhov mob hnyav, cov tshuaj tiv thaiv kab mob kuj raug sau tseg. Piv txwv li, nrog rau daim ntawv nquag ntawm tus kab mob, siv cov tshuaj tiv thaiv kab mob xws li Fluorouracil thiab Merc altopurine, thiabkuj immunostimulants.
Kev kho mob hyposensitizing tuaj yeem ua tau thaum noj tshuaj tiv thaiv kab mob. Cov no suav nrog Erius, Suprastin thiab Claritin. Tsis tas li ntawd, txhawm rau txhim kho lub cev tiv thaiv kab mob, tus kws kho mob tuaj koom tuaj yeem sau tshuaj noj cov vitamins B, ascorbic acid thiab multivitamin complexes.
Yog tias cov kab mob tshwm sim nws tus kheej dhau sijhawm, ces cov txheej txheem ntxiv rau lub cev tuaj yeem siv los kho nws. Cov no suav nrog plasmapheresis thiab hemosorption. Physiotherapy kuj tseem tuaj yeem ua kom cov txheej txheem kho kom zoo. Ib qho txiaj ntsig zoo yog muab los ntawm electrophoresis nrog rau kev noj "Fibrinolysin" thiab "Lidase".
Yog tus kab mob tau ua rau muaj teeb meem loj, lossis cov txheej txheem inflammatory tau kis ntau dhau, yuav tsum tau phais. Txhawm rau ua kom cov txheej txheem no qeeb, laser coagulation ntawm retina tuaj yeem ua tau. Cov txheej txheem no yog ua los txwv cov kab mob chorioretinal los ntawm qhov chaw tsis muaj kev cuam tshuam. Yog hais tias lub chorioretinal membrane yog tsim los yog lub retina yog detached, vitrectomy yog tsim nyog.
Muaj Teeb Meem
nam no yuav tsum tau nyeem ua ntej. Tam sim no peb paub kwv yees li cas chorioretinitis ntawm lub qhov muag yog, yuav ua li cas kho tus kab mob no, peb yuav tsum txheeb xyuas cov teeb meem tshwm sim. Nrog kev kho tsis zoo lossis theem siab ntawm tus kab mob, chorioretinitis tuaj yeem ua rau muaj teeb meem loj. Cov no suav nrog:
- tsim ntawm neovascularmembrane;
- retinal detachment;
- tshwm sim ntawm cov hemorrhages retinal;
- Retinal venous thrombosis ua rau dig muag.
ntsuas kev tiv thaiv
Yog li koj yuav tsum paub dab tsi txog qhov no? Txhawm rau tiv thaiv kev loj hlob ntawm tus kab mob xws li chorioretinitis ntawm lub qhov muag hauv tus menyuam lossis cov neeg laus, nws txaus los ua raws li cov lus pom zoo hauv qab no:
- Hu rau tus kws kho mob tshwj xeeb ntawm thawj cov tsos mob ntawm txhua yam kab mob;
- mus ntsib kws kho qhov muag tsis tu ncua los kuaj xyuas qhov muag; mus ntsib kws kho mob sai li sai tau 3 lub hlis tom qab yug me nyuam;
- sim tsis txhob ua mob rau koj ob lub qhov muag;
- saib qhov muag huv si;
- sijhawm tu foci ntawm qhov mob hauv qhov ntswg thiab qhov ncauj.
Nws yuav tsum tau nco ntsoov tias nrog kev loj hlob ntawm tus kab mob thiab kev kho mob tsis tu ncua, kev pheej hmoo ntawm kev tsim muaj ntau yam teeb meem, mus txog qhov tsis taus tom ntej, yog siab heev.
Zoo kawg
Chorioretinitis yog ib yam kab mob uas nyuaj thiab cuam tshuam tsis tau. Lo lus no yog hais txog kev mob ntawm lub posterior retina thiab choroid. Cov tsos mob tseem ceeb ntawm tus kab mob yog cov tsos ntawm floaters thiab yoov nyob rau hauv lub qhov muag. Tej zaum kuj yuav muaj qhov txo qis hauv qhov pom kev pom thiab ua txhaum ntawm kev hloov kho qhov tsaus ntuj, lossis hu ua qhov muag tsis pom kev hmo ntuj. Muaj ntau ntau yam ntawm cov kab mob no: tuberculous, post-traumatic, kis kab mob, syphilitic, central chorioretinitis ntawm lub qhov muag sab xis. Tus kab mob no tuaj yeem tshwm sim thaum twg los tau. Nws yog tsim nyog sau cia tiasCov menyuam yaus muaj kev pheej hmoo, vim lawv tshwj xeeb yog kis kab mob thiab kis kab mob.
Kev kho tshuaj rau tus mob no feem ntau suav nrog tshuaj tua kab mob thiab tshuaj tiv thaiv kab mob. Tsis tas li, tus kws kho mob tuaj yeem sau tshuaj stimulants, reparants, mydriatics thiab glucocorticosteroids. Feem ntau, tus neeg mob tau qhia kom noj cov vitamin complexes rau kev ntxiv dag zog rau lub cev. Physiotherapeutic txoj kev kho mob kuj muab cov txiaj ntsig zoo. Cov mob hnyav yuav tsum tau phais.
