Ib qho teeb meem tseem ceeb ntawm kev coj ua menyuam yaus niaj hnub no yog kev ua xua rau cov menyuam yaus, uas tshwm sim hauv 2, 3-6, 8% ntawm cov neeg mob. Raws li kev txheeb cais, qhov tshwm sim siab tshaj plaws tshwm sim thaum muaj hnub nyoog 1-13 xyoos, tab sis tam sim no muaj ntau thiab ntau tus neeg mob pob khaus hauv cov menyuam mos.
Kab lus no yuav saib cov tsos mob thiab kev kho mob urticaria hauv menyuam yaus.
khaub thuas yog dab tsi?
Urticaria yog ib lub npe uas muaj xws li ib pawg ntawm cov kab mob heterogeneous pathological tshwm sim los ntawm kev loj hlob ntawm ib qho kev txwv los yog diffuse pob nrog lub xub ntiag ntawm lub ntsiab morphological - papule (khaus khaus ntawm ntau qhov ntau thiab tsawg), uas yog ib qho edema ntawm txheej dermal ntawm daim tawv nqaij nrog hyperemia raws periphery thiab ib qho chaw daj ntseg hauv qhov chaw. Qhov loj ntawm no edema nyob rau hauv txoj kab uas hla yuav txawv ntawm 1 hli mus rau 2 cm. Qhov no tsim muaj ib ntustus cwj pwm thiab yuav ploj hauv ib hnub. Yog tias cov txheej txheem pathological kis mus rau cov txheej txheem sib sib zog nqus ntawm daim tawv nqaij, cov ntaub so ntswg subcutaneous thiab mucous daim nyias nyias, aponeurotic edema tsim.
Raws li lub sijhawm kawm, kev ua xua urticaria hauv cov menyuam yaus tau muab faib ua mob ntev thiab mob. Lub sij hawm ntawm pathology nyob rau hauv daim ntawv mob, tus yam ntxwv ntawm spontaneous kev loj hlob, yog kwv yees li 1.5 lub hlis. Yog tias tus menyuam pob khaus tshwm sim ntev dua 7 lub lis piam, qhov kev kuaj mob yog "urticaria."
Daim duab ntawm cov menyuam yaus uas muaj qhov tsis haum urticaria nthuav tawm.
Clinical Forms
Hives tuaj ntau yam:
- lub cev, uas tshwm sim nyob rau hauv kev cuam tshuam ntawm lwm yam;
- Nyob zoo ib tsoom phooj ywg;
- contact.
Tus kab mob urticaria mob hnyav hauv tus menyuam tuaj yeem yog tus kab mob ywj pheej lossis cov tsos mob ntawm lwm tus kab mob.
Kev tshwm sim
Yam uas ua rau muaj kev loj hlob ntawm kev tsis haum urticaria hauv cov menyuam yaus:
- zaub mov (txiv ntseej, nqaij nruab deg, txiv hmab txiv ntoo, citrus txiv hmab txiv ntoo, khoom noj khoom haus, thiab lwm yam);
- kab tshuaj lom;
- tshuaj lom cov tshuaj lom thiab stinging nroj tsuag;
- kis kab mob thiab kab mob;
- tsis nkag siab rau qee yam tshuaj, tshuaj radiopaque;
- ib puag ncig yam xwm txheej (cua, dej, huab cua txias, kev co, insolation);
- kab mob autoimmune (collagenoses);
- kab mob endocrine;
- kab mob kab mob;
- bronchial hawb pob, atopicdermatitis, hay fever.
Lub txheej txheem ntawm kev txhim kho ntawm kev ua xua urticaria yog vim kev ua kom cov hlwb mast thiab tso tawm cytoplasmic granules tam sim no nyob rau hauv lawv mus rau hauv cov ntaub so ntswg ib puag ncig.
Symptoms
Urticaria yog cov txheej txheem pathological uas ua pob khaus ntawm daim tawv nqaij ntawm txhua qhov ntawm lub cev, suav nrog ob txhais taw, xib teg thiab taub hau. Nws yuav tsum tau muab sau tseg tias ntau tshaj plaws ntawm mast hlwb nyob rau hauv lub caj dab thiab lub taub hau, thiab yog li ntawd cov cheeb tsam no yog yus muaj los ntawm qhov khaus tshaj plaws.
Raws li txoj cai, kev tsis haum urticaria hauv cov menyuam yaus tshwm sim sai sai. Thaum pib, khaus khaus heev tshwm sim nyob rau ntau qhov chaw ntawm daim tawv nqaij, thiab tom qab ntawd cov hlwv pib tsim. Papules tuaj yeem tsim tsis tau tsuas yog ntawm daim tawv nqaij, tab sis kuj ntawm cov mucous daim nyias nyias. Feem ntau, xws li kev ua xua pob liab liab yog nrog los ntawm o ntawm daim di ncauj, daim tawv muag, ob txhais ceg, thiab txawm pob qij txha. Ib yam li papules, puffiness tuaj yeem kav ntev txog ib hnub, tab sis tib lub sijhawm, qee zaum, nws tuaj yeem nyob ntev txog 72 teev.
Cov tsos mob ntawm kev tsis haum urticaria hauv cov menyuam yaus yuav tsum tsis txhob raug ignored. Qhov txaus ntshai tshaj plaws thiab mob hnyav yog kev txhim kho ntawm angioedema, uas qee tus kws kho mob hu ua urticaria loj heev. Qhov no mob yog nrog los ntawm qhov tob tshaj o ntawm daim tawv nqaij thiab xoob subcutaneous ntaub so ntswg. Ib qho txaus ntshai heev yog o ntawm cov mucous ntawm cov kab mob ua pa. Nws cov yam ntxwv muaj xws li ua pa nyuaj, hawb pob, xiav nasolabial daim duab peb sab thiabhnoos heev paroxysmal. Hauv qhov xwm txheej zoo li no, tus menyuam xav tau kev kho mob sai, vim tias tsis muaj kev kho mob txaus, qhov tshwm sim ua rau tuag taus.
Yog tias angioedema cuam tshuam rau cov mucous ntawm lub plab zom mov, tus neeg mob tuaj yeem ntuav ntuav, xeev siab, thiab raws plab nyob rau lub sijhawm luv. Nrog kev puas tsuaj rau lub meninges thiab pob ntseg sab hauv, mob taub hau, inhibition ntawm cov tshuaj tiv thaiv, thiab xeev siab.
Tus kab mob hauv nws daim ntawv mob hnyav yog ua npaws mus txog 38 ° C, mob taub hau, malaise. Yog tias, thaum ua raws li kev noj haus thiab ua raws li lwm cov lus pom zoo kho mob, daim tawv nqaij pob hauv tus menyuam tsis ploj mus, mob urticaria raug kuaj pom. Tus mob no, uas tshwm sim, raws li txoj cai, nrog rau lub sij hawm ntawm remissions thiab exacerbations, thaum kis tau tus kab mob thib ob, yuav tig mus rau dermatitis.
Kev kuaj kab mob
Kev tshawb nrhiav kev kuaj mob suav nrog cov npe ntawm cov haujlwm hauv qab no:
- Sau cov anamnesis (txiav txim siab qhov ua rau provoked kev loj hlob ntawm kev tsis haum urticaria thiab qhia meej cov anamnesis ntawm kev tsis haum tshuaj hauv tsev neeg).
- Kev kuaj lub cev, uas ntsuas qhov tshwm sim ntawm cov pob liab liab, qhov chaw thiab qhov loj ntawm papules. Tsis tas li ntawd, thaum lub sij hawm kev sab laj, cov kev xav ntawm tus neeg mob, lub sij hawm ntawm ploj mus ntawm pathological tshwm sim ntawm daim tawv nqaij thiab muaj peev xwm muaj hnub nyoog me ntsis ntawm qhov chaw ntawm cov pob liab liab..
- Kev ntsuas kev ua haujlwm ntawm cov txheej txheem pathological, uastsim los siv qhov ntsuas tshwj xeeb Urticaria Cov qhab nia.
- Kev kuaj thiab lwm yam kev kuaj sim uas tsim nyog los txiav txim seb qhov ua rau ntawm daim tawv nqaij ua pob liab liab. Cov no suav nrog kev kuaj ntshav thiab zis, daim siab enzymes, kuaj nrog atopic allergens lossis autologous serum, tag nrho fibrinogen, immunoglobulin, cationic eosinophilic protein.
Txhawm rau kom paub meej qhov kev kuaj mob ntawm "kev tsis haum urticaria", uas tshwm sim tawm tsam keeb kwm ntawm lub cev kub, yog ua tiav:
- kev sim ntsuas (kev sim siab);
- dermographism tau lees paub los ntawm cov tawv nqaij tawv nqaij;
- hnub ci urticaria los ntawm phototesting;
- aquagenic urticaria los ntawm kev siv dej compresses;
- khaub thuas urticaria tau lees paub los ntawm Duncan kuaj (siv lub thawv dej khov rau ntawm lub dab teg);
- ncua urticaria tshwm sim ob peb teev tom qab lub siab ntawm daim tawv nqaij - ncua kev sim.
Yog tias tsim nyog, txhawm rau txiav txim siab qhov ua rau tuaj yeem ua rau pom cov pob liab liab ntawm daim tawv nqaij, kev tshuaj xyuas txuas ntxiv raug pom zoo (kom txiav txim siab lub ntsiab lus ntawm tus kab mob parasitic, fungal, kab mob lossis kab mob, autoimmune lossis endocrine pathology).
Kev tshawb nrhiav kev kuaj mob: X-ray ntawm lub qhov ntswg thiab lub hauv siab, ultrasound ntawm lub hauv nruab nrog cev, ECG, endoscopy.
Yog tias kev tshawb fawb kuaj tsis pom qhov ua rau muaj kev tsis haum urticaria hauvtus me nyuam, nws raug suav hais tias yog idiopathic.
Kev pab ib zaug
Raws li txoj cai, nyob rau hauv cov ntaub ntawv mob ntawm cov txheej txheem pathological no, cov pob khaus ntawm daim tawv nqaij ploj ntawm lawv tus kheej tom qab 2 hnub, feem ntau tsis muaj kev pab sab nraud. Txawm li cas los xij, nyob rau hauv qhov xwm txheej zoo li no, qhov teeb meem tseem ceeb tsis yog pob khaus, tab sis khaus uas nws provokes. Yog li ntawd, thaum muab kev pabcuam thawj zaug, cov niam txiv raug pom zoo kom coj mus rau nws tshem tawm.
Thawj kauj ruam yog tiv thaiv kom tsis txhob kis tus kab mob, uas tuaj yeem yog zaub mov, tshuaj lossis tsiaj. Tsis tas li ntawd, txhawm rau txo qhov kev siv ntawm khaus ntawm daim tawv nqaij ntawm tus menyuam, nws raug nquahu kom siv cov tshuaj uas tsis yog tshuaj hormonal antiallergic pom zoo siv rau cov menyuam yaus hnub nyoog qis dua (Fenistil, Skin Cap, Gistan, Elidel, Desitin, Potopik thiab. etc.).
Thaum tsis muaj tshuaj, koj tuaj yeem siv cov tshuaj pleev thaiv hnub tshav uas txo qhov khaus, lossis siv lub tshuab txias txias rau thaj tsam ntawm daim tawv nqaij.
Yog tias koj muaj qhov ua xua, koj yuav tsum ua tib zoo saib xyuas kom tus menyuam tsis khawb ntawm daim tawv nqaij, uas yog qhov tsim nyog los tiv thaiv kev khawb thiab kis kab mob. Cov khaub ncaws paj rwb zoo rau txo qhov khaus thiab khaus.
Yog tias tus menyuam mob o thiab lwm yam tsis zoo tshwm sim (dyspepsia, palpitations, hws txias, ua pa tsis ua haujlwm, ua tsis taus pa), nws yuav tsum tau hu xov tooj mus rau kev pab kho mob thiabmuab tus me nyuam haus dej (me ntsis alkaline ntxhia dej) thiab muab ib qho enterosorbent (ib yam tshuaj rau kev khi thiab tshem tawm cov allergens ntawm lub plab zom mov). Yog hais tias qhov o tshwm sim tom qab txhaj tshuaj los yog kab tom, nws yog ib qho tsim nyog yuav tsum tau ceev cov ntaub qhwv qhov chaw tshaj qhov txhaj tshuaj los yog tom.
Kev kho mob urticaria hauv menyuam yaus
Thaum xaiv txoj kev kho mob, cov laj thawj tseem ceeb thiab cov qauv ntawm cov txheej txheem pathological raug coj mus rau hauv tus account hauv thawj qhov chaw. Cov hauv paus ntsiab lus tseem ceeb ntawm kev kho mob siv hauv kev kho mob los tiv thaiv kev tsis haum tshuaj urticaria hauv menyuam yaus suav nrog kev tshem tawm (txhim kho lossis tshem tawm cov kev cuam tshuam los ntawm kev cuam tshuam), noj tshuaj, thiab kho lwm yam kab mob uas tuaj yeem ua rau kev loj hlob ntawm daim tawv nqaij pob.
Raws li cov tshuaj kho mob yooj yim, ntsiav tshuaj tshuaj tiv thaiv kab mob yog siv los txo cov tsos mob ntawm tus mob urticaria. Nyob rau hauv cov ntaub ntawv loj ntawm tus kab mob, cov neeg mob tau pom tias parenteral siv cov classical thawj tiam antihistamine fat-soluble tshuaj, nrog rau glucocorticosteroids.
Tam sim no, cov kws kho mob hauv kev kho mob ntawm kev tsis haum tshuaj urticaria hauv cov menyuam yaus tsis tshua muaj tshuaj tiv thaiv thawj tiam, nyiam cov tshuaj histamine receptor blockers niaj hnub. Qhov no yog vim qhov tseeb tias txawm tias siv sijhawm luv luv ntawm cov tshuaj tiv thaiv kab mob tuaj yeem ua rau muaj kev phiv tshwm sim (qhuav ntawm lub qhov ncauj mucosa, nce hnoos qeev tawm tsam keeb kwm ntawm bronchial hawb pob,nce intraocular siab, kev hloov hauv kev paub thiab kev xav ntawm lub cev, kev quav dej quav cawv, tso zis tso quav, thiab lwm yam). Nyob rau tib lub sijhawm, cov tshuaj tiv thaiv kab mob thib ob yog qhov txawv ntawm qhov tsis muaj qhov tshwm sim tsis zoo, muaj kev nyab xeeb siab thiab siv tau yooj yim heev.
Tsuas kho mob urticaria rau menyuam yaus, txhua tus niam txiv yuav tsum paub.
Yog tias cov kab mob tshwm sim los ntawm cov khoom noj, nrog rau kev siv cov tshuaj uas cuam tshuam cov teebmeem ntawm cov tshuaj histamines dawb, tus menyuam raug muab tshuaj sorbents los ntxuav cov hnyuv (Laktofiltrum, Enterosgel, Smekta, thiab lwm yam).
Kho rau urticaria suav nrog kev ua raws li kev noj zaub mov tshwj xeeb hypoallergenic thiab siv cov tshuaj npaj tshuaj uas tau pom zoo hauv kev kho mob ntawm lwm hom mob urticaria. Hauv kev siv cov tshuaj intoxication, cov menyuam yaus raug tshuaj hemodez (drip), mos sorbents, thiab, yog tias tsim nyog, digestive enzymes. Tib lub sijhawm, kev kho mob tau ua tiav.
Cov menyuam yaus uas muaj mob urticaria xav tau cov tshuaj tas li txhawm rau txhawm rau txo cov teebmeem ntawm cov tshuaj histamine dawb.
Yog hais tias muaj kev nyuaj ntawm autoimmune urticaria, tus menyuam yuav tsum tau mus pw hauv tsev kho mob. Hauv qhov no, plasmapheresis tau ua thaum kho (ib qho txheej txheem rau kev tshem tawm cov ntshav hemacorrection raws li kev tshem tawm ib feem ntawm cov ntshav nrog rau cov tshuaj tiv thaiv rau qeb E immunoglobulins). Nrog rau kev txhim kho ntawm kev tiv thaiv kev kho mob classical, kev tswj hwm ntawm immunoglobulins yog qhov tsim nyog,activating cyclosporin A thiab T-suppressors uas inhibit mast cell degranulation.
Puas muaj peev xwm da dej tus menyuam uas muaj qhov tsis haum urticaria?
Thaum lub sijhawm muaj mob, da dej tus menyuam yog ua tau, txawm tias tsim nyog. Nws tsis cuam tshuam qhov kis ntawm pob khaus.
Kev noj zaub mov kom tsis haum urticaria hauv menyuam yaus
Daim ntawv teev cov khoom noj txwv tsis pub muaj kev tsis haum urticaria suav nrog:
- chocolate;
- seafood;
- smoked meats;
- fish;
- qe;
- spices;
- muffin;
- niam;
- nceb;
- nqaij qaib;
- citrus;
- txiv lws suav;
- berries;
- ntxawm.
kwv yees cov ntawv qhia
Breakfast - buckwheat porridge nrog mis nyuj, tsev cheese, tshuaj yej, txiv apple ntsuab.
Lunch - neeg tsis noj nqaij noodle kua zaub, steamed nqaij nyug patty, boiled mov, compote.
Snack - fermented mis nyuj haus los yog yogurt.
noj hmo - zaub qhwv tshiab nrog zaub roj, boiled qos yaj ywm, nqaij.
Tiv thaiv cov tsos mob ntawm kev tsis haum urticaria hauv cov menyuam yaus yog qhov tseem ceeb heev.
Kev Tiv Thaiv
Nws lub hom phiaj yog tshem tawm txhua yam uas ua rau muaj kev fab tshuaj. Nws yog ib qho tseem ceeb uas yuav tau ua cov hauv qab no:
- khoom noj rau khaus khaus.
- Kev cais cov tshuaj tiv thaiv kab mob sib kis.
- Txiav kev sib cuag nrog latex, pollen allergen, tsiaj.
- Rehabilitation ntawm foci ntawm tus kab mob.
- chav ntsuas kub zoo.
- Kev cais tawm ntawm cov xwm txheej ntxhov siab.
- Rau qee hom mob urticaria, txwv kev ua lub cev.
Peb tau tshuaj xyuas cov tsos mob, kev kho mob thiab tiv thaiv kev tsis haum urticaria hauv menyuam yaus.
