Daim ntawv teev cov kab mob uas sim tawm tsam kev noj qab haus huv ntawm cov neeg nyob niaj hnub no yog qhov dav heev. Ib qho ntawm qhov txaus ntshai tshaj plaws ntawm kev kuaj pom thawj zaug yog edematous syndrome, qhov ua rau tuaj yeem sib txawv kiag li. Tab sis yog tias koj delve rau hauv qhov teeb meem, nws hloov tawm tias cov kua dej ntau hauv lub cev feem ntau tshwm sim tawm tsam keeb kwm ntawm cov teeb meem kev noj qab haus huv loj uas xav tau kev cuam tshuam los ntawm cov kws kho mob tsim nyog.
Dab tsi yog edematous syndrome?
Tus kab mob no yuav tsum nkag siab tias yog cov kua dej uas muaj protein ntau hauv cov alveolar ducts, alveoli, interstitial (connective) cov ntaub so ntswg thiab hauv bronchi. Qhov ua rau edema yog suav tias yog nce vascular permeability. Raws li qhov tshwm sim ntawm qhov tshwm sim ntawm cov khoom sib txuam, qhov txo qis hauv lub peev xwm ntawm cov kab noj hniav serous lossis nce hauv cov ntaub so ntswg tuaj yeem tshwm sim.
Edematous syndrome kuj tuaj yeem ua rau muaj kev hloov pauv hauv lub cev ntawm lub cev thiab cov ntaub so ntswg, nrog rau kev ua txhaum ntawm lawv txoj haujlwm.
Hauv kev kho mob, muaj ob hom edema:
- Nyob zoo. Qhov no yog ib qho kev tshwm sim dav dav ntawm cov dej zoo sib npaug hauv lub cev.
- Local, uas yog cov kua dej ntau ntxiv hauv thaj chaw tshwj xeeb ntawm lub cev lossis cov ntaub so ntswg.
BNyob rau hauv tus txheej txheem ntawm kev kuaj mob edematous syndrome, kws kho mob ua ntej ntawm tag nrho cov tsis suav nrog o (yog tias koj nias ntawm daim tawv nqaij nrog koj tus ntiv tes, ces tsis muaj fossa). Feem ntau, cov txiaj ntsig ntawm kev ntsuam xyuas cov thyroid ua haujlwm thiab tus nqi ntawm kev tsim edema yog siv los txiav txim siab tus neeg mob qhov mob.
Tus mob no tshwm sim li cas hauv cov menyuam yaus?
Hmoov tsis zoo, qee zaum cov niam txiv yuav tsum tau ua rau qhov tsis txaus siab qhov tseeb xws li cov kua dej ntau hauv cov ntaub so ntswg lossis cov kabmob ntawm lawv cov menyuam mos. Qhov tshwm sim feem ntau ntawm qhov kev kuaj mob no yog ntau yam kab mob raum.
Edematous syndrome hauv cov menyuam yaus feem ntau tshwm sim los ntawm qhov nce hauv qhov edema nws tus kheej mus rau qhov nruj ntawm cov ntaub so ntswg thiab txawm tias qee qhov chaw hollow xws li pleura, scrotum thiab peritoneum. Qhov tseeb tias cov kua ascitic ntau ntau tau sau rau hauv cov chaw tshwj xeeb qee zaum ua rau cov txheej txheem ntawm cov ntshav tawm ntawm cov ntshav venous, vim tias tus neeg mob ua rau lub plawv tsis ua haujlwm.
Edema hauv cov menyuam yaus kuj tuaj yeem tshwm sim vim kev puas tsuaj rau cov hlab ntsha, uas feem ntau tshwm sim los ntawm nephritis. Nyob rau hauv cov ntaub ntawv no, tus me nyuam tsim o nyob rau hauv daim tawv muag, thiab ces nyob rau ntawm pob taws thiab pem hauv ntej nto ntawm lub hauv caug. Cov tsos mob ntawm tus mob no yog cov zis thiab ntshav siab kiag li.
Raws li cov menyuam yug tshiab, lawv cov mob edematous tuaj yeem tshwm sim nyob rau hnub 3-4. Raws li txoj cai, nyob rau hauv cov xwm txheej zoo li no, ib tus tuaj yeem soj ntsuam kev txhim kho ntawm qhov teeb meem no tsis pub dhau ob peb hnub, tom qab ntawddamping tshwm sim. Raws li txoj cai, nyob rau hauv qhov chaw uas muaj qhov o, muaj qhov txawv txav ntawm qhov tshwj xeeb ntawm lub cev, hyperemia, pallor lossis cyanosis ntawm daim tawv nqaij. Txhua tus kws paub txog neonatologist, hauv kev txheeb xyuas cov cim zoo li no, yuav muaj peev xwm txiav txim siab tus mob edematous hauv cov menyuam mos. Feem ntau, peb tuaj yeem hais tias tus kab mob no tuaj yeem ua rau muaj teeb meem loj. Vim li no, nws yog ib qho tseem ceeb uas thawj ob peb hnub tom qab yug me nyuam, tus me nyuam nyob rau hauv kev saib xyuas tas li.
Causes of edematous syndrome
Edema tuaj yeem tsim tawm tsam keeb kwm yav dhau los ntawm cov kab mob hauv qis qis, lub txaj vascular, tshwm sim ntawm qee yam teeb meem sab hauv lossis ntau yam pathologies.
- Ntau venous pressure. Ntawm no, lub luag haujlwm tseem ceeb hauv kev tsim cov edema yog ua si los ntawm qhov tsis txaus ntawm cov hlab ntsha, qhov tshwm sim ntawm kev mob venous thrombosis, varicose veins thiab compression ntawm cov leeg sab nraud vim cov qog loj hlob.
- mob plawv tsis ua hauj lwm.
- Kev ua txhaum ntawm lymphatic outflow. Hauv qhov no, cov tsos mob xws li kev cuam tshuam ntawm cov kab mob lymphatic los ntawm filariae, ntxhw mob nrog rov tshwm sim erysipelas, tom qab raug mob lymphedema, uas venous thiab lymphatic obstruction tau ua ke, nrog rau kev mob lymphostasis, tshwm sim.
- Pathology ntawm lub raum, nrog rau mob nephritic thiab nephrotic syndrome. Peb tab tom tham txog cov kab mob xws li kab mob lupus erythematosus, mob ntshav qab zib glomerulosclerosis, amyloidosis ntawm lub raum, lymphogranulomatosis, rheumatoid mob caj dab,lymphocytic leukemia, nephropathy ntawm cov poj niam cev xeeb tub.
- Hypoproteinemia, uas tsim los rau cov laj thawj hauv qab no:
- albumin synthesis disorders;
- protein poob;
- ua txhaum ntawm cov txheej txheem digestive (exocrine pancreatic insufficiency);
- nephrotic syndrome;
- noj cov protein tsis txaus (kev noj zaub mov tsis txaus lossis kev tshaib plab);
- Kev zom tsis tiav ntawm cov protein (resection thiab puas rau phab ntsa ntawm cov hnyuv, kab mob celiac).
6. Mixed edema.
Ntseeg ntawm ascitic syndrome
hom edema no, qhov tseeb, ib qho kev sib txuam ntawm cov kua hauv lub plab kab noj hniav. Lo lus ascites nws tus kheej txhais tau tias "lub hnab, hnab". Edema-ascitic syndrome feem ntau tshwm sim hauv cov neeg uas muaj cirrhosis ntawm daim siab. Tus kab mob no tshwm sim, raws li txoj cai, sai, tab sis cov txheej txheem ntawm nws txoj kev loj hlob ntxiv tuaj yeem ncav cuag li ob lub lis piam mus rau ob peb lub hlis. Yog vim li cas rau qhov kev npaj txhij txog ntawm edema tuaj yeem yog cov kab mob xws li qaug cawv, qhov tshwm sim ntawm hepatocellular insufficiency tiv thaiv keeb kwm ntawm kev poob siab thiab hemorrhagic syndrome.
Edematous-ascitic syndrome tuaj yeem txheeb xyuas los ntawm cov yam ntxwv hauv qab no:
- ua tsis taus pa;
- plab o;
- zoo li flatulence.
Yog tias cov kua dej ascitic ntau dua 20 litres, ces lwm cov tsos mob yuav tshwm sim:
- herniated hemorrhoidal veins;
- puab tsaig hernias;
- Ygastroesophageal reflux;
- swelling ntawm jugular leeg;
- umbilical hernia;
- nce siab hauv cov leeg jugular;
- iris shift.
Kev kuaj mob tau zoo
Ib qho ntawm cov kev ntseeg siab tshaj plaws los ntawm kev kuaj pom tus mob edematous yog kev kuaj mob sib txawv. Nws cov ntsiab lus kub dhau los txiav txim siab cov hauv qab no:
- muaj cov hlwb atypical (hauv ib nrab ntawm cov xwm txheej lawv tuaj yeem tshwm sim hauv HCC thiab hauv 22% tawm tsam keeb kwm ntawm kab mob siab metastatic);
- triglycerides (rau kev raug mob lymphatic flow);
- amylase (pab txuas ascites rau portal hypertension);
- glucose (txiav txim siab edematous syndrome, kev kuaj mob sib txawv hauv qhov no ua haujlwm nrog oncopathology thiab perforation ntawm lub cev hollow);
- bilirubin (perforation ntawm biliary ib ntsuj av);
- xim ntawm ascitic kua (mis nyuj, daj, tsaus xim av, liab), thiab lwm yam.
Tau qhov tseeb tias qhov ua rau ntawm kev loj hlob ntawm cov kab mob edematous tuaj yeem sib txawv kiag li, nws yog ib qho tseem ceeb heev uas yuav tsum tau ua qhov kev kuaj mob sib txawv.
Edema tshwm sim los ntawm kab mob raum
Ib qho tshwj xeeb ntawm hom kab mob edematous no yog nws qhov tsos thiab kev loj hlob sai. Yog hais tias tus neeg mob feem ntau nyob rau hauv ib tug upright txoj hauj lwm, ces ob txhais ceg yuav luag ib txwm o. Hauv qhov no, pallor ntawm daim tawv nqaij, nrog rau qhov o ntawm tes thiab lub ntsej muag yog qhov kev zam.
Muaj ntau ntau yam kab mob raum uas tuaj yeem ua rau cov kua dej ntau dhau mus rau hauv cov ntaub so ntswg hauv lub cev:
- jade;
- qog nqaij hlav hauv lub raum;
- vasculitis;
- nephrosis;
- amyloidosis;
- Yglomerulonephritis;
- raum tsis ua haujlwm.
Edematous syndrome nyob rau hauv cov kab mob hauv lub raum feem ntau tshwm sim yog tias muaj kab mob, kev ua xua, kev tsis haum xeeb hauv cov qauv ntawm lub cev, thiab qaug cawv hauv lub cev. Raws li txoj cai, nyob rau hauv lub xub ntiag ntawm cov yam tseem ceeb, cov protein muaj pes tsawg leeg ntawm cov ntshav yog cuam tshuam thiab ions accumulates. Raws li kev cuam tshuam ntawm cov kab mob no, edema tshwm sim thaum sawv ntxov.
Tsis tas li, cov neeg uas tau raug mob raum qee zaum ua rau mob nephrotic syndrome, uas thaum txhua tus tso zis muaj li 60 grams ntawm cov protein.
Txoj kev txhim kho zoo li cas?
Ua ntej edematous lub raum syndrome ua rau nws tus kheej hnov, qee qhov kev hloov pauv tshwm sim hauv tib neeg lub cev ua rau muaj kab mob zoo sib xws:
- Ua ntej ntawm tag nrho, qhov no yog qhov nce siab hauv intracapillary. Hauv qhov xwm txheej no, cov ntaub so ntswg ua kom pom cov kua dej, thiab nws cov reabsorption txo qis.
- Lub raum excretory cuam tshuam.
- txo qis hauv plasma proteins. Qhov tshwm sim ntawm lawv qhov tsis muaj yog ua txhaum ntawm kev tshem tawm cov dej los ntawm qhov chaw intercellular.
- nce capillary permeability. Ib qho xwm txheej zoo sib xws yog qhov zoo rau cov neeg mob uas tau kuaj pom tias muaj kab mob pathological lossis glomerulonephritis.
- Kev ua txhaum cai ntawm cov dej- ntsev metabolism. Nyob rau hauv cov ntaub ntawv no, nce secretion ntawm cov tshuaj hormones ua rau khaws cia ntawm sodium thiab dej ions.aldosterone.
Nws tsim nyog sau cia qhov tseeb tias edema tshwm sim los ntawm kab mob raum yog tus cwj pwm los ntawm kev faib tawm ntawm cov kua dej sib sau thoob plaws tag nrho cov ntaub so ntswg subcutaneous.
Immune-inflammatory disease as the edema
Ntau zaus, edematous syndrome yog tshwm sim los ntawm ib qho teeb meem xws li glomerulonephritis. Lub sij hawm no yuav tsum tau to taub raws li ib tug kab mob immunoinflammatory, thaum lub sij hawm uas lub interstitial ntaub so ntswg, tubules thiab glomerular apparatus puas. Kev loj hlob ntawm theem mob hnyav ntawm tus kab mob no feem ntau yog rau cov menyuam yaus hnub nyoog qis dua 2 xyoos.
Edematous syndrome hauv glomerulonephritis feem ntau tshwm sim hauv lub ntsej muag. Yog tias cov kab mob loj zuj zus tuaj, ces ascites, hydrothoracas thiab anasarca tuaj yeem tshwm sim. Qhov laj thawj tseem ceeb rau kev loj hlob ntawm glomerulonephritis yog cov kab mob sib kis (adenoviruses, kab mob siab B, 12 hom kab mob A beta-hemolytic streptococcus, thiab lwm yam).
Kev txhim kho ntawm tus mob hauv lub plawv tsis ua haujlwm
Qee zaum, edema tuaj yeem tshwm sim los ntawm kev ua haujlwm qeeb hauv cov ntshav hauv cov kabmob thiab cov ntaub so ntswg. Cov mob no yog ua txhaum ntawm lub plawv. Yog li ntawd, cov kua dej accumulates hauv cov ntaub so ntswg, ua rau tus neeg mob hnyav. Tom qab ntawd, edema tshwm nyob rau hauv lub cev thiab qis extremities.
Koj tuaj yeem pom cov kev hloov pauv no yooj yim. Tsis tas li ntawd, edematous syndrome nyob rau hauv lub plawv tsis ua hauj lwm ua rau ib tug txo nyob rau hauv daim tawv nqaij elasticity. Yog hais tias tus kab mob no qhiaci, tawg tuaj yeem tshwm rau ntawm daim tawv nqaij los ntawm cov kua oozes.
Nyob rau hauv lub plawv tsis ua hauj lwm, ua ntej edema tshwm sim, tus neeg mob ua pa tsis txaus. Raws li rau tsub zuj zuj ntawm cov kua, cov txheej txheem no pib los ntawm hauv qab no thiab maj mam nce lub cev. Nyob rau tib lub sijhawm, edema nws tus kheej yog symmetrical thiab hloov me ntsis. Yog hais tias tus neeg mob feem ntau dag, ces daim tawv nqaij edematous yuav pom nyob rau hauv lub lumbar cheeb tsam. Rau cov neeg uas coj txoj kev ua neej nquag - ntawm lawv ko taw.
Edematous syndrome nyob rau hauv daim siab mob
Yog tias peb tham txog kab mob siab edema, nws tsim nyog sau cia tias nws nyob hauv lub plab. Nyob rau hauv tas li ntawd, lub tsub zuj zuj ntawm cov kua tej zaum yuav nrog cov tsos ntawm cov hlab ntsha uas cuam tshuam los ntawm varicose veins. Cov ceg, tig mus, ua thinner, thiab lub cev yuav siv sij hawm ib tug unnatural tsos. Hnyav, kua dej puv plab sways thaum tsiv. Nws yog ib qho tseem ceeb uas yuav tsum nco ntsoov tias qee zaum cov kua dej hauv qab ntawm daim tawv nqaij tuaj yeem ncav cuag 25 litres. Lub xeev ntawm edematous syndrome no txhais tau tias yog ascites. Tau kawg, edema ntawm qib no tsis tuaj yeem tsis quav ntsej, thiab thawj cov tsos mob nws tsim nyog hu rau tus kws kho mob gastroenterologist, uas yuav tsum tau sau ntawv kho mob hnyav.
Kev kho mob Edematous syndrome
Thawj qhov koj yuav tsum tau ua tib zoo saib xyuas yog tias muaj teeb meem xws li edema yog kev ua raws li kev kho mob tsis txaus ntseeg, uas tus kws kho mob tsim nyog yuav pab tsim. Yog li ntawd, kev kuaj mob ntawm tus mob edematous tsis yog ib yam uas yuav tsum tsis saib xyuas. Yog tias cov kua dej sib sau ua ke hauv cov ntaub so ntswg tuaj yeem ua rau pom qhov kajhnyav heev, koj yuav tsum tau txais kev xa mus rau kev kho mob hauv tsev kho mob.
Nyob hauv ib puag ncig hauv tsev kho mob, cov kws kho mob yuav tuaj yeem txiav txim siab txog cov kab mob tshwj xeeb uas ua rau mob edematous. Lawv kuj tseem tuaj yeem tsim kho algorithm. Nws yuav tsis tuaj yeem txiav txim siab seb qhov pathogenesis ntawm tus mob edematous muaj li cas, thiab yog tias tsis txheeb xyuas cov kab mob tseem ceeb tiv thaiv qhov edema tau tsim, nws tsis tuaj yeem cuam tshuam qhov teeb meem zoo. Piv txwv li, nyob rau hauv cov neeg txom nyem los ntawm daim siab kab mob, pathogenesis ntawm ascites hides lub cawv ntawm ntau yam. Txhawm rau txheeb xyuas lawv, kev koom tes ntawm tus kws tshaj lij yog qhov tsim nyog.
Lub hauv paus ntsiab lus no tseem cuam tshuam rau kev kuaj mob xws li edematous scrotum syndrome. Hauv qhov no, tus mob yog qhov tshwm sim ntawm ntau yam kab mob pathological. Cov kab mob hauv qab no poob rau hauv cov ntsiab lus no: hydatid torsion thiab hydrocele, nrog rau cov txheej txheem inflammatory.
Pom tseeb, nws yuav nyuaj heev los ua kom tsis muaj teeb meem xws li edematous scrotum syndrome yam tsis muaj kev pab los ntawm kws kho mob tsim nyog. Yog li ntawd, nws yog ib qho tsim nyog yuav tsum tau them sai sai rau qhov tseeb tias kev kho mob yuav ua tau zoo tsuas yog nrog kev koom tes ntawm tus kws kho mob tshwj xeeb.
Txhawm rau ua tiav qhov xav tau, koj yuav tsum tau saib xyuas cov khoom noj kom raug. Nws yog ib qho tseem ceeb kom haus ib co dej (txog li 1.12 litres ib hnub twg) thiab txo qhov kev noj qab haus huv ntawm lub rooj ntsev (tsis ntau tshaj 2 grams). Raws li txoj cai, rau cov neeg mob feem ntau, txo cov tshuaj ntsev txhua hnub tsis yog ib txoj haujlwm yooj yim. Nyob rau hauv thiaj li rau lub sij hawm ntawm tau txais ib tug tshiab sajcov zaub mov dhau yooj yim tshaj plaws, nws yog ib qho tsim nyog yuav tau ntxiv cov txuj lom thiab tshuaj ntsuab rau cov tais diav. Txog li 6 pluas noj ib hnub tau tso cai, tab sis tsuas yog tias nws muaj calorie tsawg thiab zom tau yooj yim.
Tom qab kawm txog tus neeg mob tshwj xeeb, tus kws kho mob tuaj yeem tsim qee yam kev txwv ntawm kev noj cov rog, proteins thiab carbohydrates. Ntxiv nrog rau kev noj zaub mov raws li kev kho mob, thaum muaj teeb meem xws li edematous syndrome, kev kho mob yuav suav nrog kev siv cov tshuaj uas muaj cov nyhuv diuretic. Nyob rau tib lub sijhawm, nws yog ib qho tseem ceeb uas tus kws kho mob coj mus rau hauv tus account tag nrho cov contraindications thiab cuam tshuam rau lub cev ntawm ib tug ua ke ntawm cov tshuaj, nrog rau lwm yam tshuaj.
Nws yog ib qho yooj yim los txiav txim siab tias edema yog ib qho teeb meem loj heev, uas feem ntau yog tshwm sim los ntawm kev ua txhaum loj ntawm kev ua haujlwm ntawm lub cev. Yog li ntawd, thaum thawj cov tsos mob ntawm edematous syndrome tshwm sim, nws tsim nyog npaj mus ntsib kws kho mob. Qhov no yuav pab kom sai thiab muaj qhov tshwm sim tsawg kawg uas cuam tshuam qhov teeb meem.
