Nepritic Syndrome yog ib qho kev phom sij txaus ntshai uas cuam tshuam nrog glomeruli ntawm ob lub raum. Qhov no pathology yog tus cwj pwm los ntawm kev nce qib ntawm nitrogen hauv cov ntshav. Nws yog ib nqi sau cia hais tias ntau confuse nephritic thiab nephrotic syndrome. Cov no yog ob hom kab mob raum sib txawv, sib txawv ntawm ib leeg hauv pathogenesis thiab kev kho mob tshwm sim. Hauv thawj kis, peb tab tom tham txog kev mob ntawm lub cev, thiab hauv qhov thib ob - hais txog kev puas tsuaj rau lub raum cov ntaub so ntswg. Txawm li cas los xij, tsis muaj qhov sib txawv ntawm ob lub tswv yim no. Nephritic syndrome thiab nephrotic syndrome yog cov kab mob ntsig txog, tshwm sim los ntawm cov tsos mob sib txawv tawm tsam keeb kwm ntawm cov kab mob ntawm cov kab mob excretory.
kab mob
Nepritic syndrome tau muab faib ua peb hom raws li qhov xwm txheej ntawm chav kawm:
- subacute - pathology txhim kho rauntev, qee zaum muaj cov tsos mob luv luv;
- mob hnyav - daim ntawv no tshwm sim nws tus kheej dheev nrog qhov mob hnyav hauv nraub qaum;
- chronic - nyob rau hauv daim ntawv no, relapses yog hloov los ntawm remissions vim yog raug rau provoking yam.
Dab tsi ua rau lub raum nephritis
Feem ntau, qhov ua rau tus kab mob yog kab mob streptococcal. Mob nephritic syndrome tsis tshwm sim nws tus kheej tam sim ntawd, tab sis nrog cov nquag nquag ntawm cov kab mob ntawm lub raum, cov tsos mob tshwm sim ntawm xob laim. Nws yog ib qho tsim nyog sau cia lwm qhov tseem ceeb nuance: qhov mob pathological no yeej tsis tshwm sim hauv tus neeg mob lub raum noj qab haus huv. Rau qhov tshwm sim ntawm nephritis, ib qho kev mob zoo yog tsim nyog - txhua lub raum tsis ua haujlwm.
Kab mob streptococcus yog deb ntawm tib yam uas tuaj yeem ua rau kev loj hlob ntawm tus kab mob. Ntxiv nrog rau kev nkag mus ntawm cov kab mob, cov kab mob autoimmune, xws li vasculitis, lupus, tuaj yeem dhau los ua lub zog rau qhov tshwm sim ntawm tus kab mob. Nyob rau hauv cov ntaub ntawv no, nephritis tshwm tawm tsam keeb kwm yav dhau ntawm tsub zuj zuj ntawm glomerular complement nyob rau hauv qab daus daim nyias nyias. Ib daim ntawv teev npe nrog rau lwm yam ua rau muaj mob muaj xws li hauv qab no:
- poststreptococcal glomerulonephritis (nephritic syndrome tsim tawm tsam keeb kwm ntawm cov kab mob ua rau cov ntaub so ntswg sib sib zog nqus ntawm lub cev);
- meningococcus;
- pneumococcus;
- typhoid;
- endocarditis;
- sepsis;
- kab mob kis kab mob (kab qaib, kab mob siab, mumps, rubella, qhua pias, kis kab mob mononucleosis, syphilis, thiab lwm yam);
- autoimmuneua txhaum cai.
Muaj feem cuam tshuam ib txhij ntawm ntau yam ntawm cov xwm txheej no. Txawm li cas los xij, txhua hom nephritic syndrome tuaj yeem ua rau muaj teeb meem thiab qhov tshwm sim tsis zoo.
Los ntawm cov cim qhia kom paub
Kev kuaj mob nephritic syndrome, raws li txoj cai, tsis nyuaj rau cov kws kho mob tshwj xeeb. Tus kab mob yog tus cwj pwm los ntawm ntau cov tsos mob tshwj xeeb uas tuaj yeem tsis meej pem nrog rau lwm cov kab mob hauv lub raum nrog rau qhov tsis tshua muaj tshwm sim. Lub caij no, kev saib xyuas tshwj xeeb yog them rau qhov kev kuaj mob sib txawv ntawm nephritic syndrome los ntawm nephrotic.
Tus neeg mob yuav hnov cov tsos mob thawj zaug ntawm nephritis qee lub sij hawm tom qab tus kab mob nkag mus rau hauv lub cev. Lub sijhawm ntawm lub sijhawm incubation yog nyob ntawm hom kab mob. Piv txwv li, streptococcus manifests nws tus kheej 10-15 hnub tom qab kis kab mob.
Txhua cov cim ntawm jade tau muab faib ua classical thiab dav. Thawj pab pawg suav nrog kev tshwm sim uas tshwm sim hauv txhua tus neeg mob uas muaj tus mob nephritic:
- Kev muaj ntshav ntau hauv cov zis (hematuria). Nyob rau hauv daim ntawv loj ntawm tus kab mob, tag nrho hematuria yog ua tau (cov zis yog xim maroon nyob rau hauv cov xim, tau ib tug thicker sib xws), tab sis cov tsos mob no tshwm sim nyob rau hauv ib feem peb ntawm cov neeg mob.
- Hypocomlementimia - focal thiab segmental necrosis nrog kev loj hlob ntawm cov hlwb epithelial ntawm lub raum glomeruli.
- o ntawm lub ntsej muag thiab qis qis. Lub ntsej muag thiab caj dab pib o nyob rau hauv thawj ib nrab ntawm lub hnub, thiab ob txhais ceg nyob rau hauv lub thib ob; tom qabThaum sawv ntxov nyob rau hauv cov neeg mob pom mob plawv o ntawm lub plab mog thiab pob qij txha.
- Kev txhim kho ntawm arterial hypertension.
- mob tsis txaus ntawm sab laug ventricle thiab atrium, qhia los ntawm lub plawv dhia thiab pulmonary edema.
- Cov zis tso zis tsawg zuj zus.
Cov tsos mob tsis tshwj xeeb
Lawv yog yam ntxwv ntawm ntau yam kab mob. Feem ntau, cov tsos mob no tshwm sim thawj zaug. Cov no suav nrog:
- ncua ntev tsis qab los noj mov thiab ua rau poob phaus;
- mob taub hau;
- dej tuav hauv lub cev thiab o ntawm lub cev;
- ua npaws, 37-38°;
- mob hnyav ntawm palpation thiab lub teeb siab ntawm thaj tsam lumbar thiab plab;
- nausea, ntuav.
Qhov tshwm sim loj tshaj plaws ntawm nephritic syndrome hauv cov menyuam yaus yog nws txoj kev hloov mus rau hauv daim ntawv ntev. Qhov xwm txheej tsis tu ncua ntawm chav kawm ntawm tus kab mob tuaj yeem txaus ntshai heev. Mob nephritic syndrome yog latent, thiab yog li nws muaj peev xwm paub txog kev rov qab los thiab pib kho raws sijhawm nkaus xwb hauv cov neeg sib cais.
Puas muaj qhov sib txawv ntawm nephritis thiab nephrosis
Raws li twb tau sau tseg lawm, nephritic thiab nephrotic syndromes yog cov kab mob sib txawv ntawm cov tsos mob uas tshwm sim rau lawv tus kheej hauv kev txhim kho lub raum pathology. Ob qho xwm txheej no muaj cov yam ntxwv zoo sib xws thiab tshwm sim tawm tsam keeb kwm yav dhau los ntawm cov kab mob uas twb muaj lawm lossis kis kab mob. Txij li thaum ob qho tib si cov txheej txheem pathological muaj ib qho chaw hauv zos, cov tsos mob yog xyaumyog tib yam rau nephritic thiab nephrotic syndrome. Qhov sib txawv yuav yog nyob rau hauv cov txiaj ntsig ntawm kev sim thiab lwm yam cim ntawm kev puas tsuaj rau lub excretory system. Raws li cov tsos mob dav dav, chav kawm ntawm nephrotic syndrome yog nrog los ntawm o, kev qaug zog, mob nraub qaum thiab pallor ntawm integument.
qhov sib txawv tseem ceeb
Nephrotic thiab nephritic syndromes yog qhov tseem ceeb ntawm lwm yam kab mob raum. Ob qho tib si kab mob muaj ntau tus yam ntxwv, txawm li cas los xij, vim qhov sib txawv ntawm cov chav kawm, cov kws kho mob tshwj xeeb tswj kom sib txawv ntawm lawv ib leeg, ua qhov kev kuaj mob kom raug thiab sau ntawv kho kom raug.
Qhov txawv ntawm qhov kuaj pom yog qhov sib txawv tseem ceeb ntawm nephritic thiab nephrotic syndrome. Koj tuaj yeem pom koj tus kheej paub txog cov yam ntxwv ntawm txhua tus kab mob hauv cov lus hauv qab no.
|
Differential cwj pwm |
Nepritic Syndrome | Nephrotic Syndrome Neb |
| Yuav ua li cas | Jade | Nebrosis |
| qauv tam sim no | Arises unexpectedly, tsim ntawm xob laim | Muaj sluggish, protracted flow |
| kuaj ntshav | siab eosinophils, qis hemoglobin | Kev muaj nyob hauv cov ntshavplatelets thiab leukocytes |
| Kev kuaj zis tso zis | Hematuria paub tseeb (ntshav hauv zis) | tso zis ntau dua 10 npaug li qub, qib lipid siab |
| Ultrasound data | raum o, heterogeneous parenchyma qauv | kuaj pom sclerotic foci |
Diagnosis
txhawm rau paub meej qhov kev kuaj mob, tus neeg mob tau tso zis thiab kuaj ntshav, cov txiaj ntsig ntawm kev txiav txim siab ntawm oliguria, proteinuria, tus lej ntawm erythrocytes thiab leukocytes, kev hloov pauv hauv AT titer, thiab txo qis hauv kev ua haujlwm hemolytic. ntawm ib co complements.
Yog tsis ua tsis tiav, tus neeg mob raug xa mus rau kev kuaj ultrasound thiab kuaj X-ray - ntsuas ntsuas ntsuas yuav muab cov ntaub ntawv tseeb ntawm qhov loj ntawm lub raum thiab tus nqi ntawm cov txheej txheem pom hauv glomeruli.
Cov ntsiab cai yooj yim thiab cov txheej txheem rau kev kho
Cov lus pom zoo kho mob rau nephritic syndrome los rau ib yam - kev sib ntaus tawm tsam lub hauv paus. Tus kws kho mob tuaj koom kos cov kev noj zaub mov nruj rau tus neeg mob, uas txhais tau hais tias txwv tsis pub ntsev thiab txwv tsis pub noj cov zaub mov protein. Cov dej ntim txhua hnub kuj raug txo kom tsawg. Tsis tas li ntawd, cov txuj lom, dej qab ntsev, tshuaj yej dub, kas fes, kib thiab cov kaus poom tsis suav nrog cov khoom noj.
tseem ceeb heev hauv kev kho mob nephriticSyndrome los xyuas kom meej txaus noj cov vitamins thiab muaj txiaj ntsig kab hauv lub cev. Cov khoom siv ua tiav thiab cov khoom noj ceev yuav tsum tau tso tseg. Nrog nephritic syndrome, carrots thiab lettuce muaj vitamin A, txiv ntseej, beets thiab txiv apples, nyob rau hauv uas vitamin B yog tam sim no, yuav tsum muaj nyob rau hauv kev noj haus, ascorbic acid, uas yog nplua nuj nyob rau hauv citrus txiv hmab txiv ntoo, zaub qhwv, tswb peppers thiab rosehips, yuav tsum tau. pab txhawb kev tiv thaiv kab mob. Vitamin E muaj nyob rau hauv taum thiab zaub roj.
Tsis zoo li nephritic syndrome, nephrotic syndrome yog tshwm sim los ntawm kev tuav cov kua thiab ntsev hauv lub cev ntau dua. Txawm li cas los xij, cov kws kho mob tshwj xeeb tau sau cov tshuaj los kho cov metabolism hauv dej ntsev thiab diuretics hauv ob qho tib si. Yog tias nephritis lossis nephrosis dhau mus rau theem mob hnyav, cuam tshuam los ntawm kev txhim kho lub raum tsis ua haujlwm, tus neeg mob tau pom kev lim ntshav thiab ntsuas qhov tsim nyog resuscitation. Kev kho mob yog ua raws li kev saib xyuas tas li ntawm cov neeg ua haujlwm kho mob.
Drug therapy
Rau cov tsos mob ntawm kev kho mob nephritic syndrome, tus neeg mob tau muab tshuaj ntawm cov pab pawg hauv qab no:
- YDiuretics.
- cov khoom muaj calcium.
- YAntiallergic.
- Vitamin-mineral complex (ascorbic acid, rutin).
- Tshuaj tua kab mob (nyob rau hauv lub xub ntiag ntawm kev mob siab rau hauv lub cev).
- Cov tshuaj tiv thaiv kab mob siab thiab mob plawv.
Rau nephritic syndrome, siv cov tshuaj diuretics, xws li:
- Thiazides. "Hypothiazide" (analogous rau "Dichlothiazide") yog tshuaj nyob rau hauv ib koob.1 mus rau 4 ntsiav tshuaj txhua hnub.
- Furosemide thiab ethacrynic acid. Cov tshuaj "Lasix" rau kev kho mob ntawm cov tsos mob ntawm nephritic syndrome yog noj los ntawm qhov ncauj los yog txhaj tshuaj ntawm ib koob ntawm tsis ntau tshaj 200 mg ib hnub twg. Qhov ncauj, cov tshuaj tau noj rau ntawm lub plab khoob, tag nrho cov koob tshuaj yog siv ib txhij thiab nrog cov tshuaj infusion. "Uregit" (cov khoom xyaw tseem ceeb yog ethacrynic acid). Lub hauv paus ntsiab lus ntawm kev ua yog zoo ib yam li yav dhau los cov tshuaj, uas yog raws li nyob rau hauv lub active tshuaj furosemide. "Uregit" yog tshuaj tom qab noj mov, pib nrog 50 mg ib hnub twg (1 ntsiav tshuaj). Maj mam nce qhov koob tshuaj kom ntau tshaj 200 mg.
- YPotassium-sparing diuretics. Cov pab pawg no suav nrog cov tshuaj "Aldactone" thiab "Veroshpiron" - zoo aldosterone antagonists. Cov tshuaj no kuj raug sau tseg rau kev kho mob nephritic syndrome, tsis nrog hyperkalemia.
Nrog rau ntshav siab, Anaprilin tau sau rau kev kho mob. Txawm li cas los xij, cov tshuaj no tsis haum rau bradycardia. Feem ntau cov kws kho mob tau sau tseg ntawm 60-160 mg / hnub. Rau cov neeg mob uas lub plawv tsis ua hauj lwm nrog nephritic syndrome, glycosides yuav tsum tau. Ua ntej muab tshuaj rau tus neeg mob noj cov tshuaj ntawm pab pawg no, qib ntawm cov poov tshuaj hauv cov ntshav ntshav yuav tsum tau txiav txim siab, vim tias cov tshuaj no yog contraindicated nrog tus nqi qis (tsawg dua 3.5 mmol / l). Thaum lub sij hawm tshem tawm tus kab mob no, nyob hauv thaj chaw uas muaj huab cua qhuav yuav tau txais txiaj ntsig.
Muaj Teeb Meem
Nrog rau qhov tsis paub meej pathogenesis ntawm nephritic syndrome, nws tsis yooj yim rau kov yeej tus kab mob. Vim lub sij hawm ntev ntawm tus kab mob, lub raum hlwb pib tuag. Lub cev txo qis hauv qhov loj me thiab maj mam poob nws txoj haujlwm. Yog tias lub raum ua haujlwm tsis tuaj yeem rov qab los, tus neeg mob raug xa mus rau hemodialysis. Qhov kev txiav txim siab los tswj kev ua haujlwm ntawm lub excretory system txhais tau tias tsuas yog ib qho - tus neeg mob xav tau kev hloov pauv hauv nruab nrog cev ceev. Kev hloov lub raum yog ib qho kev phais kim heev uas yuav tsum tau siv sijhawm ntev.
Ua ke nrog cov txheej txheem pathological hauv ob lub raum, kev ua haujlwm ntawm cov hlab plawv tau cuam tshuam, vim yog cov ntshav tsis zoo. Cov hlab ntsha ua thinner, qeeb necrotic hloov pauv tau pom hauv cov hlwb myocardial. Nyob rau tib lub sijhawm, kev tuag hauv nephritic syndrome yog qhov tshwm sim tsis tshua muaj tshwm sim. Feem ntau, kev tuag tshwm sim rau cov neeg laus uas mob plawv tsis ua haujlwm.
Huab cua
Vim qhov kev kuaj mob sib txawv raws sijhawm ntawm nephrotic syndrome, cov neeg mob yuav muaj kev rov zoo sai dua yam tsis muaj teeb meem. Feem ntau, kev kwv yees rau cov neeg mob yog qhov zoo. Nws yog ib qho tseem ceeb kom nrhiav kev pab los ntawm cov kws kho mob tshwj xeeb ntawm thawj cov tsos mob ntawm tus kab mob - kev kho mob yuav pab normalize lub raum ua haujlwm nyob rau hauv ob peb lub hlis. Cov chav kawm ntawm tus kab mob no feem ntau nyob ntawm theem ntawm tus kab mob, lub hnub nyoog ntawm tus neeg mob thiab muaj cov kab mob ntev uas tuaj yeem ua rau cov duab kho mob hnyav dua.
Feem ntau, qhov kev tshem tawm ntawm cov txheej txheem inflammatory tau ua tiavyog ib qho kev ruaj khov ntawm cov ntshav siab, tab sis qhov no tsuas yog tshwm sim yog tias qhov ua rau mob ntshav siab yog lub raum muaj teeb meem, thiab tsis yog lwm yam kab mob, nrog rau cov tsos mob tib yam.
Nyob rau hauv cov chav kawm ntawm nephritic syndrome, txuam nrog cov teeb meem loj (uremic coma, mob plawv tsis ua hauj lwm, cerebrovascular kev huam yuaj, thiab lwm yam), prognosis yog unfavorable. Ntawm qhov tshwm sim tshwm sim ntau tshaj plaws, nws tsim nyog sau tseg ib hom mob ntshav qab zib hnyav thiab rov tshwm sim hypertensive crises.
kev kho neeg zoo
kab mob raum tau ntev tau kho nrog tshuaj ntsuab. Txawm hais tias cov thev naus laus zis niaj hnub thiab kev nce qib hauv kev lag luam kho mob, ntau tus neeg tseem raug kev txom nyem los ntawm cov kab mob ntawm cov kab mob excretory niaj hnub no. Tib lub sijhawm, kev kho mob ib txwm tsis yog ib txwm ua tau zoo thiab muaj kev nyab xeeb txaus - ntau yam tshuaj muaj ntau yam contraindications thiab phiv.
Cov tshuaj xaiv kom raug, uas tau npaj hauv tsev raws li cov zaub mov ntawm cov kws kho mob ib txwm muaj, pab daws tus neeg mob tus mob. Rau kev kho mob pej xeem, ntau yam decoctions thiab infusions ntawm tshuaj ntsuab yog siv. Cov kws kho mob feem ntau sau lwm txoj hauv kev rau cov neeg mob ib txhij nrog tshuaj rau nephritic syndrome. Raws li cov kws kho mob cov lus pom zoo, qhov ua tau zoo tshaj plaws yog cov khoom npaj raws li cov zaub mov nram qab no:
- Rosehip infusion. Cov dej haus yog npaj raws li nram no: ob tablespoons qhuav txiv hmab txiv ntoo yog poured rau hauv 500 ml ntawm boiling dej. Tom qab ntawd cov khoom yog sab laug rau 1 teev kom infuse. Cov dej txias thiab txias tau txaisthaum nruab hnub, txhua ob teev, ob peb lub sips.
- Infusion ntawm birch nplooj. Cov khoom nyoos yog nchuav nrog dej kub hauv qhov sib piv ntawm 1: 2. Nws yuav siv sij hawm ob peb teev kom infuse nplooj, yog li nws yog qhov zoo tshaj plaws los npaj cov infusion nyob rau yav tsaus ntuj thiab tawm mus txog thaum sawv ntxov, npog nrog lub hau. Txoj kev kho yog noj ib nrab khob peb zaug hauv ib hnub tom qab noj mov.
- YInfusion ntawm calendula paj, knotweed, tawv tawv, dej lily, St. John's wort, chamomile, chicory paj, immortelle. Tag nrho cov khoom siv sib npaug (1 tablespoon txhua), sib tov thiab ncuav rau hauv 1 liter dej kub boiled. Infusion yog qaug cawv ua ntej noj tshais thiab noj hmo, 100 ml txhua.
- Ntxhais nkauj ntsuab thiab dais pob ntseg. Cov nplooj qhuav birch qee zaum ntxiv rau tshuaj ntsuab. Npaj cov tshuaj zoo ib yam li yav dhau los. Nws yuav siv sij hawm tsawg kawg ib nrab teev kom infuse cov dej haus. Koj yuav tau haus cov tshuaj txhua hnub rau ib nrab khob ntawm lub plab khoob.
Kev Tiv Thaiv
Feem ntau, tus kws kho mob uas muaj qib me me ntawm nephritic syndrome pom zoo siv cov tshuaj pej xeem los tiv thaiv. Txawm li cas los, nyob rau hauv cov ntaub ntawv no, decoctions thiab infusions yog npaj nyob rau hauv ib tug qis concentration ntawm active khoom xyaw. Kev siv cov dej haus tshuaj ntsuab qhia tau hais tias ua raws li cov koob tshuaj raws li lub hnub nyoog, qhov hnyav thiab lwm tus yam ntxwv ntawm tus neeg mob. Tsis tas li ntawd, qhov yuav tshwm sim ntawm kev ua xua thiab intolerance rau qee yam tshuaj tsis tuaj yeem txo qis.
Feem ntau, kev tiv thaiv ntawm nephritic syndrome yog tiv thaiv kab mob hauv qab. NtawmKab mob kis kab mob thiab kab mob tuaj yeem ua rau lub plawv tsis ua haujlwm, uas cuam tshuam rau lub raum ua haujlwm tsis zoo.
Nws yog ib qho tseem ceeb uas yuav tsum ua raws li tag nrho cov tshuaj thiab cov lus pom zoo ntawm kws kho mob. Nws tsis tuaj yeem cuam tshuam kev kho mob raum. Txawm tias cov neeg mob uas tau ua tiav tag nrho rov qab los yuav tsum tau noj tshuaj ntev thiab ua raws li kev tswj hwm tshwj xeeb.
Nco ntsoov tias lub raum yog hom lim uas pab peb lub cev tshem tawm cov co toxins thiab cov khoom tsis zoo. Kho koj txoj kev noj qab haus huv nrog kev saib xyuas thiab tsis txhob kho tus kheej!
