Cov kab mob dermatological nyuaj uas yuav ua rau muaj kev phom sij rau lub neej tsis muaj ntau. Txawm li cas los xij, lawv yog. Ib qho ntawm cov no yog epidermal lom necrolysis. Cov kab mob no yog kab mob ntawm daim tawv nqaij tsawg uas tuaj yeem ua rau tuag taus.
YPathology yog dab tsi?
Toxic epidermal necrolysis yog ib qho kev tsis haum tshuaj loj heev, qhov tshwm sim ntawm uas yog exfoliation ntawm txheej sab sauv ntawm daim tawv nqaij. Tom qab ntawd nws tuag, thiab lub cev yog raug rau intoxication muaj zog. Yog tsis muaj kev kho mob uas tsim nyog, ib tug neeg yuav muaj sepsis thiab tuag.
Bullous transformation and death can be exposed to the skin, but also to the mucous membranes. Tus kab mob yog insidious heev. Qhov tseeb yog tias txawm tias cov mucous membranes tuaj yeem raug cuam tshuam, uas feem ntau ua rau mob plab, ua pa tsis ua haujlwm thiab lwm yam kab mob ntawm lub cev.
feem ntau txhim khoepidermal toxic necrolysis tom qab siv qee yam tshuaj. Txawm li cas los xij, tej zaum yuav muaj lwm yam laj thawj. Cov tsos mob thiab kab mob yuav luag tsis tuaj yeem kwv yees.
Vim txoj kev loj hlob
Qhov feem ntau ua rau kev txhim kho pathology yog kev siv qee yam tshuaj:
- YSulfanilamides.
- Macrolides: "Erythromycin".
- Penicillins.
- Anticonvulsants: Lamotrigine, Carbamazepine, Phenobarbital.
- Quinolones: "Trovafloxacin"
- Cov tshuaj tiv thaiv kab mob tsis zoo: Indomethacin, Ibuprofen, Piroxicam.
Qhov tshwm sim tsawg kawg nkaus tsuas yog 1 kis ntawm 1,000,000 tus neeg hauv ib xyoos. Cov poj niam feem ntau cuam tshuam. Hnub nyoog kuj tseem ceeb, txij li feem ntau ntawm kev txhim kho pathology tau sau tseg tom qab 55 xyoo.
Ntxiv rau kev noj tshuaj, kab mob staphylococcal tuaj yeem ua rau necrolysis.
Txoj kev loj hlob ntawm tus kab mob
Epidermal toxic necrolysis txhim kho sai heev. Nyob rau hauv cov ntaub ntawv ntawm muaj mob, lub cev tsis muaj peev xwm kom raug lees paub thiab neutralize cov tshuaj lom, nyob rau hauv peb cov ntaub ntawv, cov tshuaj. Cov tshuaj tiv thaiv kab mob muaj zog heev.
Qhov no, lub cev tiv thaiv kab mob tawm tsam ntawm daim tawv nqaij, raws li nws suav tias yog lub cev txawv teb chaws. Hauv qhov no, kev tswj hwm ntawm kev tawg ntawm cov tshuaj protein yog cuam tshuam. Toxins pib nkag mus rau hauv daim tawv nqaij,uas ua rau kom intoxication ntawm lub cev. Yog tias kho tsis tau raws sijhawm, tus neeg yuav tuag.
Ntau yam thiab Localization
Toxic epidermal necrolysis (peb twb tau txiav txim siab cov tsos mob ntawm pathology) tuaj yeem faib raws li hauv qab no:
- Idiopathic. Nws tshwm sim ntawm nws tus kheej, thiab nws qhov laj thawj yuav tsis raug tsim.
- Vim los ntawm kev cuam tshuam ntawm qee yam tshuaj.
- Ua los ntawm tus kab mob staphylococcal. Hom kab mob no tau kuaj pom hauv cov menyuam yaus. Hauv qhov no, qhov ua tau ntawm kev tuag tsis suav nrog.
- Txuas nrog lwm yam kab mob.
Kab mob tuaj yeem pom ntawm qhov chaw xws li: pob tw, xub pwg, hauv siab, plab thiab nraub qaum, qhov ncauj mucosa.
Symptoms of disease
Toxic epidermal necrolysis (Lyell's syndrome) feem ntau yog cov tsos mob hauv qab no:
- Kev cuam tshuam dav dav ntawm lub xeev ntawm lub cev, uas tshwm sim nws tus kheej hauv kev poob qab los noj mov, mob taub hau, nce basal lub cev kub. Feem ntau cov cim qhia ntawm pathology yog nqhis dej ntau ntxiv.
- Mob thiab tsis xis nyob hauv cov mucous daim nyias nyias. Nyob rau tib lub sij hawm, lawv rhiab heev yog nce. Piv txwv li, thaum noj thaum nqos, tus neeg mob hnov mob.
- Pom cov pob liab liab, pob liab liab thiab hlwv ntawm daim tawv nqaij thiab cov mucous daim nyias nyias. Feem ntau, kwv yees li 30% ntawm lub cev raug cuam tshuam, txawm tias daim duab no yuav yogloj dua.
- Exfoliation ntawm epidermis. Nyob rau hauv rooj plaub no, daim tawv nqaij pib wrinkle txawm nrog me ntsis kov. Yog tias qhov chaw cuam tshuam ntawm daim tawv nqaij raug tshem tawm, qhov txhab los ntshav yuav tshwm hauv qab nws.
- raum tsis ua haujlwm.
- txheej txheem kis mob. Qhov tseeb yog tias daim tawv nqaij tsis tuaj yeem ua haujlwm li qub thiab tiv thaiv tus neeg los ntawm cov kab mob pathogenic microorganisms. Qhov xwm txheej yuav xaus rau hauv sepsis.
- Nyob rau theem tom qab ntawm pathology, lub cev qhuav dej, tachycardia, thiab hypotension tuaj yeem pom.
- mob leeg.
- Ua npaws thiab hnoos.
- Anorexia.
- Ntaus thiab ntuav.
Nws yuav tsum tau muab sau tseg tias cov kab mob mucosal tshwm sai dua li cov kab mob ntawm daim tawv nqaij. Yog hais tias nyob rau hauv thawj theem ntawm cov tshuaj lom epidermal necrolysis, daim duab uas tsis yog rau lub plawv faint, yog faintly pom, tom qab ntawd nws yuav pom tau zoo heev.
Kev kuaj mob nta
Yog tias koj xav tias muaj tshuaj lom epidermal necrolysis, koj yuav tsum mus ntsib kws kho mob tam sim ntawd. Nws yuav tsum ua kom muaj qhov sib txawv thiab kev kuaj mob zoo heev, uas suav nrog:
- Kho cov lus tsis txaus siab ntawm tus neeg raug tsim txom. Kev mob siab rau txhua qhov pob khaus, hnov mob.
- Sau keeb kwm tus neeg mob. Ntawd yog, tus kws kho mob yuav tsum paub seb nws puas muaj kev tsis haum tshuaj uas ua rau muaj kev cuam tshuam loj heev. Yog xav paub seb tus neeg mob cov txheeb ze puas muaj teeb meem zoo sib xws.
- kuaj tus neeg mob sab nraud. Nyob rau hauv cov ntaub ntawv no, dermatologist them sai sai rau qhov ntxoov ntxoodaim tawv nqaij, muaj cov pob khaus thiab hlwv ntawm cov mucous membrane. Tus neeg mob yuav tsis teb txaus rau qhov muaj tiag.
- kuaj ntshav. Nws yuav ua rau nws muaj peev xwm txiav txim siab seb qib leukocytes nce ntxiv, seb puas muaj cov qe ntshav tsis paub qab hau, thiab qhov nrawm ntawm erythrocyte sedimentation. Yog tias cov kev txwv no mus dhau qhov kev cai, ces qhov xwm txheej qhia tias muaj cov txheej txheem inflammatory.
- ntshav biochemical tsom xam. Yog tias qhov tshwm sim yog nce qib ntawm bilirubin lossis cov protein tsawg dhau, ces tus neeg mob yuav muaj teeb meem nrog raum.
- Kev tshuaj ntsuam zis yog dav dav. Txoj kev tshawb no tseem yuav tsum tau txiav txim siab txog kev ua haujlwm ntawm lub raum. Yog muaj ntshav tso zis ces qhov teeb meem yog ntiaj teb no.
- ntsuas lub plawv dhia, ntsuas ntshav siab.
Kev kuaj mob kuj tseem tsim nyog txhawm rau txhawm rau paub qhov txawv ntawm cov tshuaj lom epidermal necrolysis los ntawm lwm yam kab mob: pemphigus, scarlet fever, erythema, bullous impetigo, lichen planus.
Txoj kev kho mob
Tus kab mob uas tshwm sim yuav tsum tau kho. Txwv tsis pub, tus neeg mob tuaj yeem cia siab tias sepsis thiab tuag. Yog tias tus neeg mob muaj cov tsos mob saum toj no, ces nws yuav tsum tau xa mus rau tsev kho mob sai. Yog tias tus kab mob hnyav heev, tus neeg raug tsim txom raug muab tso rau hauv kev saib xyuas hnyav, qhov chaw kho mob tuaj yeem muab kev saib xyuas kom raug rau nws.
pawg ntseeg uas tus neeg mob nkag mus yuav tsum yogtsis muaj menyuam, uas yuav tsis suav nrog qhov muaj peev xwm txuas tau lwm yam kab mob. Kev kho mob ntawm pathology suav nrog kev tshem tawm ntawm qhov ua rau muaj tus kab mob.
Raws li kev kho tshuaj, ces corticosteroids thiab tshuaj tiv thaiv kab mob yuav los cawm. Tsis tas li ntawd, kev kho infusion yuav tsum tau teeb tsa. Cov tshuaj tua kab mob yuav tsum tsuas yog siv yog tias tus neeg mob muaj tus kab mob thib ob.
Toxic epidermal necrolysis (koj twb paub lawm tias nws yog dab tsi) yuav tsum tau kho nrog cov tshuaj hauv zos uas yuav pab kho cov tawv nqaij zoo li qub: tshuaj loog (tshuaj kho mob), tshuaj pleev, tshuaj tua kab mob.
Ntxiv rau, koj yuav tsum ua raws li cov hauv paus ntsiab lus ntawm kev kho:
- Nws yog ib qho tsim nyog yuav tsum ntxuav lub cev ntawm cov tshuaj yav dhau los kom sai li sai tau. Enemas yog siv rau qhov no.
- Nws raug nquahu kom noj cov tshuaj uas pab kho cov metabolism hauv dej-ntsev, xws li Regidron.
- Tus kws kho mob yuav muab tshuaj los tiv thaiv daim siab, tshwj xeeb yog Gepabene.
- Kev noj tshuaj uas txo cov ntshav txhaws.
Yuav muaj teeb meem dab tsi tshwm sim?
Yog tias koj tau kuaj pom muaj tshuaj lom epidermal necrolysis, muaj teeb meem xws li:
- Kev txhim kho kab mob hnyav.
- Lub cev qhuav dej hnyav, uas tuaj yeem ua rau tus neeg mob tuag.
- poob qhov tseem ceebtus nqi ntawm daim tawv nqaij. Yog hais tias ib tug neeg poob ntau tshaj li ib nrab ntawm cov epidermis, tej yam kev tuag tos nws.
- Kev ziab ntawm daim tawv nqaij, qhov pom ntawm qhov caws pliav ntawm nws, hloov pauv ntawm pigmentation.
- -pharonic erosions ntawm cov mucous ree.
Huab cua
Yog tias kev kho mob ntawm cov kab mob tsis tau pib raws sijhawm, ces qhov kev tuag tuaj yeem ncav cuag 70%. Kev poob ntawm ib feem tseem ceeb ntawm daim tawv nqaij yuav ua rau tus neeg mob kis tau ntau yam kab mob.
Kev pib kho raws sijhawm yuav tsis tsuas yog pab tshem tawm cov kab mob xwb, tab sis tseem yuav ua rau kom tsis txhob muaj teeb meem txaus ntshai xws li los ntshav sab hauv, kev puas tsuaj rau cov kab mob genitourinary, tsis muaj peev xwm noj, raum thiab lub siab tsis ua haujlwm.
Nws yuav tsum tau muab sau tseg tias cov menyuam yaus tuag los ntawm tus kab mob no tsawg dua li cov neeg laus. Yog tias tus neeg mob tau hla lub cim 60 xyoo, ces nws qhov kev cia siab yuav poob siab. Txawm li cas los xij, kev kho kom raug tuaj yeem txhim kho nws tus mob.
Tiv thaiv kab mob
Lwm lub npe rau xws li pathology li tshuaj lom epidermal necrolysis yog Lyell's syndrome. Cov duab ntawm tus kab mob no yog qhov zoo dua tsis txhob saib cov neeg zoo siab. Qhov no yog ib qho nyuaj pathology uas tuaj yeem zam tau yog tias kev tiv thaiv kev tiv thaiv tau ua raws:
- Tshuaj yuav tsum tsuas yog noj yog tias kws kho mob tau sau tseg.
- Tus kws kho mob tshwj xeeb yuav tsum paub yog tias koj tab tom muaj kev fab tshuaj.
- Txhua yam koj muaj, koj yuav tsum tsis txhob noj ntau dua 7 tshuaj tib lub sijhawm.
- Tsis txhob noj tus kheej tshuaj staphylococcal thiab inflammatory kab mobtawv.
- Tsis txhob tiv tauj nrog txhua yam khaus uas tuaj yeem ua rau ua xua.
Raws li kev kho mob, txhua yam nyob ntawm tus yam ntxwv ntawm lub cev thiab tus neeg mob lub siab xav tawm tsam qhov teeb meem. Noj qab nyob zoo!
