Ntau tus menyuam nyuam qhuav tau mob hnyav, uas feem ntau cuam tshuam rau lawv txoj kev loj hlob. Ob peb xyoos dhau los, ob peb tus neeg tau hnov txog cov kab mob xws li thrombocytopenia, thiab tam sim no nws tau pom ntau dua hauv cov menyuam mos. Tab sis dab tsi yog thrombocytopenia nyob rau hauv cov me nyuam, dab tsi provokes nws txoj kev loj hlob thiab nws tshwm sim li cas?
Thrombocytopenia: qhov no yog dab tsi?
Thrombocytopenia yog ib yam kab mob txawv txawv thiab tsis paub meej uas tuaj yeem tshwm sim nws tus kheej raws li cov tsos mob qhia lwm tus kab mob loj thiab txaus ntshai rau tus neeg (mob qog noj ntshav, HIV) lossis kab mob ywj pheej. Tsis tas li ntawd, tus kab mob tuaj yeem tshwm sim nws tus kheej hauv daim ntawv ntawm kev tsis haum tshuaj ntawm lub cev rau txhua yam khoom. Tsis tas li ntawd, cov neeg uas tsim txom cawv, los yog cov uas tau txais ib koob loj ntawm cov hluav taws xob, tuaj yeem raug kev txom nyem los ntawm cov kab mob no. Raws li qhov no, peb tuaj yeem txiav txim siab tias thrombocytopenia hauv cov menyuam yaus thiab cov neeg laus tuaj yeem tshwm sim los ntawm ntau yam laj thawj, thiab tsuas yog ib tus kws kho mob uas muaj kev paub txog thiab cov kev kuaj mob niaj hnub no yuav tso cai rau koj kom paub tseeb tias qhov ua rau nws tshwm sim.
Thrombocytopenia thaum yau yog ib qho pathology thaum lub sijhawmuas nyob rau hauv cov ntshav txo cov qib ntawm platelets, thiab lawv, nyob rau hauv lem, yog lub luag hauj lwm rau cov ntshav txhaws. Platelets yog platelets uas, thaum qhov kev ncaj ncees ntawm qhov chaw ntawm lub nkoj raug ua txhaum, maj nrawm mus rau qhov chaw ntawm qhov txhab thiab kaw qhov txhab, txwv tsis pub los ntshav.
Dab tsi ua rau thrombocytopenia hauv menyuam yaus?
Feem ntau, thrombocytopenia hauv cov menyuam yaus yog cov kab mob hauv lub cev, piv txwv li, hauv Bernard-Soulier, Viscott-Aldrich, Fanconi thiab lwm yam mob. Tsis tas li ntawd thaum menyuam yaus, qhov mob no tuaj yeem tshwm sim los ntawm kev ua haujlwm ntawm tus po - hypersplenism. Thiab tag nrho vim qhov tseeb tias qhov no yog lub hauv nruab nrog cev uas cov qe ntshav uas tau ua haujlwm rau lawv lub sijhawm raug siv dua.
Tus lej platelet tsawg yuav qhia tau tias ib tus neeg muaj mob qog noj ntshav. Thaum tag nrho cov txheej txheem hematopoietic nres tag nrho hauv cov pob txha pob txha, tib lub sijhawm, tus neeg mob tsis muaj lwm yam ntshav.
Kev faib tawm ntawm thrombocytopenia
Tus kab mob no muab faib ua ob hom:
- Primary - tsuas yog nrog cov tsos mob ntawm thrombocytopenic syndrome, thaum tsis muaj lwm yam kab mob ntawm lub cev. Thrombocytopenia purpura, idiopathic thiab hemolytic uremic syndrome yog tag nrho cov pathologies ntawm thawj daim ntawv.
- Secondary manifests nws tus kheej yog ib qho teeb meem tom qab lub ntsiab pathology, xws li HIV, cirrhosis ntawm lub siab los yog leukemia.
Zoo nyob ntawm seb cov tshuaj tiv thaiv kab mob puas muaj nyob hauv qhov ua rau thrombocytopenia lossis tsis, muaj ob qho ntxivshapes:
- Immune thrombocytopenia - tshwm sim thaum kev puas tsuaj sai ntawm platelets nyob rau hauv cov tshuaj tiv thaiv. Hauv lub xeev no, tib neeg lub cev tiv thaiv tsis tuaj yeem lees paub cov platelets kom raug, coj lawv mus rau lub cev txawv teb chaws thiab tsim cov tshuaj tiv thaiv kab mob uas thaiv lawv, yog li ua rau cov neeg mob hnyav dua.
- Daim ntawv uas tsis muaj kev tiv thaiv kab mob tuaj yeem txhim kho yog tias muaj kev puas tsuaj rau cov platelets, feem ntau tshwm sim nrog cov kab mob extracorporeal los yog kab mob Marchiafava-Micheli.
Feem ntau nws yog kev tiv thaiv kab mob thrombocytopenia uas tshwm sim hauv cov menyuam yaus, thiab nws tau muab faib ua ntau pawg.
Immune thrombocytopenia pawg
Muaj 4 pawg tseem ceeb ntawm kev tiv thaiv kab mob thrombocytopenia:
- Isoimmune yog ib daim ntawv uas cov platelets raug rhuav tshem los ntawm kev tsis sib haum xeeb hauv ib qho ntawm cov kab mob ntshav. Nws kuj tseem yuav yog vim kev hloov pauv mus rau tus neeg tau txais cov platelets txawv teb chaws thaum muaj cov tshuaj tiv thaiv kab mob rau lawv lossis nkag mus rau cov tshuaj tiv thaiv rau tus menyuam hauv plab.
- Transimmune - tshwm sim thaum cov autoantibodies ntawm leej niam uas raug kev txom nyem los ntawm autoimmune daim ntawv hla mus rau hauv lub placenta, thiab thrombocytopenia tam sim ntawd tshwm nyob rau hauv cov me nyuam mos tom qab yug me nyuam.
- Heteroimmune - pawg no cuam tshuam nrog kev ua tsis tiav hauv cov qauv antigenic ntawm cov platelet, uas tshwm sim nyob rau hauv tus kab mob los yog cov tsos ntawm ib hom tshuaj tiv thaiv tshiab.
- Autoimmune yog ib pab pawg uas cov tshuaj tiv thaiv tau tsim tawm tsam ib tus kheej yam tsis hloov pauv ntawm cov tshuaj tiv thaiv kab mob.
Tab sis dab tsi provokesCov tsos mob ntawm tus kab mob, dab tsi ua rau nws, tshwj tsis yog rau qhov tshwm sim ntawm caj ces?
Ua rau thrombocytopenia
Feem ntau, thrombocytopenia hauv cov menyuam yaus tuaj yeem tshwm sim los ntawm cov laj thawj hauv qab no:
- Tsis txaus cov kab hauv lub cev.
- Kev mob siab.
- Kev tsis haum rau zaub mov los ntawm lub ntiaj teb sab nraud.
- txheej txheem autoimmune hauv lub cev.
- Lwm yam kab mob, feem ntau HIV, cirrhosis lossis leukemia.
Tab sis tsis yog kab mob thiab lwm yam tuaj yeem ua rau muaj mob, nws tuaj yeem ua rau muaj kev phom sij los ntawm kev noj tshuaj uas tau muab rau tus neeg mob.
Cov tshuaj dab tsi tuaj yeem ua rau thrombocytopenia?
Raws li kev xyaum thiab ntau qhov kev tshawb fawb ntawm cov kws tshawb fawb tau pom, feem ntau thrombocytopenia hauv cov menyuam yaus tshwm sim los ntawm kev noj tshuaj ntawm pab pawg hauv qab no:
- Tshuaj tua kab mob, feem ntau Levomycetin lossis sulfonamides.
- Diuretics - "Furosemide" lossis "Hydrochlorothiazide"
- Anticonvulsant Phenobarbital.
- Antipsychotics - Prochlorperazine lossis Meprobamate.
- tshuaj Antithyroid - "Tiamazol"
- Tshuaj tiv thaiv ntshav qab zib - Glibenclamide thiab Glipizide.
- tshuaj tiv thaiv kab mob - "Indomethacin".
Tab sisCov tsos mob dab tsi yuav qhia tau tias tus neeg mob muaj thrombocytopenia?
Symptoms of disease
Thrombocytopenia tuaj yeem sib txawv rau txhua tus neeg mob, ua rau thiab kev kho mob yog li tus neeg, tab sis feem ntau cov neeg muaj cov tsos mob zoo sib xws:
- Hemorrhages hauv daim tawv nqaij thiab mucous daim nyias nyias. Nws tshwm li me me liab. Lawv tshwj xeeb tshaj yog pom nyob rau hauv cov chaw uas cov khaub ncaws rub tawm ntawm lub cev tshaj plaws. Cov pob no tsis ua rau mob lossis tsis xis nyob, tsis txhob protrude saum npoo ntawm daim tawv nqaij los yog mucous daim nyias nyias. Lawv tuaj yeem ua ob qho tib si zoo li taw tes thiab nyob hauv thaj chaw loj. Cov tawv nqaij uas liab, xiav, lossis ntsuab-daj kuj tuaj yeem tshwm sim.
- Ntshav ntswg. Lub qhov ntswg mucosa yog nplua nuj nyob rau hauv cov ntshav, thiab muaj ntau ntawm capillaries nyob rau hauv nws. Vim tias txo cov platelet ntau lawm, capillary fragility nce, yog li txhua qhov txham, raug mob me lossis mob khaub thuas tuaj yeem ua rau los ntshav uas tuaj yeem kav ntev dua 10 feeb.
- Cov pos hniav los ntshav. Ntau tus neeg muaj cov ntshav me me thaum txhuam hniav, tab sis nyob rau hauv cov neeg mob, cov tsos mob no qhia tau meej heev, txhim kho ntau qhov chaw ntawm cov pos hniav thiab kav ntev.
- ntshav hauv plab thiab hnyuv. Lawv tshwm sim vim tsis muaj zog ntawm cov hlab ntsha, thiab txawm tias noj cov zaub mov nyuaj tuaj yeem ua rau lawv. Yog li ntawd, cov ntshav yuav dhau mus nrog quav.
- ntshavtso zis. Cov tsos mob no tshwm sim vim muaj qhov hemorrhage ntawm lub mucous daim nyias nyias ntawm lub zais zis thiab ntawm txoj kev tso zis.
- Muaj ntau thiab ntev rau cov ntxhais. Hauv lub xeev ib txwm muaj, lub sijhawm ntawm kev coj khaub ncaws yog 3-5 hnub, thiab nrog thrombocytopenia, kev coj khaub ncaws tuaj yeem kav ntev li ob lossis peb zaug, thiab los ntshav hnyav.
- Nyob los ntshav tom qab rho hniav. Hauv lub xeev ib txwm muaj, nws nres tom qab 20 feeb, thiab yog tias tus neeg mob muaj thrombocytopenia, nws tuaj yeem nyob ntev dua, thiab tag nrho vim tias muaj cov platelets tsawg hauv lub cev thiab lawv tsis tuaj yeem tiv nrog lawv txoj haujlwm sai.
Tsis txhob hnov qab tias thrombocytopenia tuaj yeem muaj qhov sib txawv kiag li. Thiab txhua txoj kev kho yog xaiv tus kheej. Tus kab mob kuj tuaj yeem tshwm sim nws tus kheej nrog cov tsos mob uas yog yam ntxwv ntawm pathology uas provoked nws. Thaum kuaj mob, lawv yuav tsum raug coj mus rau hauv tus account.
Txoj kev kuaj mob
Yog tias tus kws kho mob pom cov tsos mob ntawm tus kab mob hauv tus neeg mob, ua ntej ntawm tag nrho nws tau sau tshuaj ntsuam xyuas ntshav, uas koj tuaj yeem pom cov qib platelets hauv cov ntshav. Ua tib zoo saib xyuas cov ntsuas ntawm lwm lub cev - erythrocytes thiab leukocytes. Nws yog qhov kev txiav txim siab ntawm qib platelets uas yog txoj hauv kev tseem ceeb rau kev kuaj mob xws li thrombocytopenia hauv cov menyuam yaus hnub nyoog qis dua ib xyoos thiab laus dua.
Tam sim no, txhua tus neeg mob HIV raug txhawb kom kuaj ntshav tsis tu ncua. Cov kws kho mob pom zoo kom kuaj xyuas txhua rau lub hlis thiab, ntxiv rau qhov kev sim dav dav, kuj tseem sivLwm tus: kev tiv thaiv kab mob thiab kis kab mob.
Muaj 5 yam tseem ceeb uas cuam tshuam rau kev kuaj mob:
- Tsis muaj tsos mob thaum yau.
- Tsis muaj tsos mob ntawm cov kab mob ntawm cov kab mob thrombocytopenia.
- Yog tsis muaj kev kho mob tshwm sim hauv cov txheeb ze.
- Kev ua haujlwm ntawm glucocorticosteroid daim ntawv kho mob hauv qee yam tshuaj.
- Yog ua tau, kuaj xyuas cov tshuaj tiv thaiv kab mob antiplatelet.
Tab sis yuav ua li cas kho thrombocytopenia hauv cov menyuam yaus, cov hau kev twg zoo dua? Cov tshuaj ib txwm pab tau li cas rau kev kuaj mob thiab ua tau?
Txoj kev kho mob rau thrombocytopenia
Kev kho tus neeg mob los ntawm thrombocytopenia ncaj qha nyob ntawm seb qhov ua rau ua rau tus kab mob no. Tsuas yog kev kuaj mob kom raug xwb yuav tso cai rau koj xaiv txoj kev kho kom zoo dua. Cov kws kho mob niaj hnub no siv ntau txoj kev kho mob:
- kev noj tshuaj.
- Kev cuam tshuam kev phais.
- Kev kho mob nrog pej xeem txoj kev.
Qee zaum tus kab mob tsis tas yuav kho, nws ploj mus ntawm nws tus kheej. Piv txwv li, theem nrab me me thrombocytopenia hauv cov menyuam yaus nrog qis qis qis hauv cov qib platelet. Hauv qhov xwm txheej zoo li no, tus kws kho mob tuaj yeem sau ntawv rau tus neeg mob tsuas yog cov vitamin complex thiab npaj rau kev ntxiv dag zog rau lub cev.
Rau cov poj niam cev xeeb tub uas kuaj pom tus kab mob no, lawv yuav tsum tsis txhob ua rau muaj kev txhawj xeeb loj txog tus kab mob no. Cov poj niam uas muaj menyuam yaus feem ntau raug kev txom nyem los ntawm qhov tseeb tias lawv muaj qhov txo qis heevplatelets nyob rau hauv cov ntshav. Tom qab yug menyuam, thiab qee qhov thaum cev xeeb tub, theem ntawm lub cev no rov zoo li qub yam tsis muaj kev kho mob. Kev tiv thaiv kab mob thrombocytopenia yog suav tias yog qhov txaus ntshai tshaj plaws, nws tseem ceeb heev kom kho nws kom raug.
Tshuaj tiv thaiv kab mob thrombocytopenia
Cov kab mob tiv thaiv kab mob yog suav tias yog ib qho mob hnyav tshaj plaws, ntxiv rau, nws kuj yog qhov tshwm sim ntau tshaj. Pathology tsim tawm tsam keeb kwm yav dhau los ntawm kev tiv thaiv tsis muaj zog, tshwm sim los ntawm qhov tseeb tias tus menyuam tau mob khaub thuas, SARS, lossis yog tus neeg mob HIV. Tsis tas li ntawd, qhov tshwm sim ntawm qhov tshwm sim ntawm tus kab mob no tuaj yeem yog cov tshuaj uas tsis tau tswj los ntawm tus kws kho mob.
Ntxiv rau daim ntawv tiv thaiv kab mob, feem ntau muaj daim ntawv autoimmune, uas kuj tshwm sim vim kev ua haujlwm tsis zoo hauv lub cev tiv thaiv kab mob. Txhawm rau kho tus kab mob no, feem ntau pom zoo kom noj cov tshuaj tiv thaiv kab mob. Tsis tas li, tus kws kho mob tuaj yeem sau tshuaj glucocorticosteroid, vim nws ua tsaug rau lawv cov qib platelets nce.
Thaum cov neeg mob thrombocytopenia tshwm sim los ntawm tus kab mob lossis kis kab mob, tus kab mob uas ua rau cov platelet suav tsawg yuav tsum tau kho ua ntej. Tej zaum tom qab kho txhua yam yuav rov zoo li qub.
Cov neeg mob HIV tsim nyog tau txais kev saib xyuas tshwj xeeb. Nws tsuas yog tsim nyog rau cov niam txiv ua tib zoo saib xyuas lawv txoj kev noj qab haus huv thiab ua raws li txhua tus kws kho mob cov lus pom zoo.
Qee zaum, hauv kev kho mob ntawm thrombocytopenia, kev phais raug pom zoo, uas yog kev tshem tawm ntawm tus po. Tab sis rau txoj kev noresorted tsuas yog ib qho chaw kawg, yog tias tus neeg mob muaj kev pheej hmoo los ntshav. Raws li kev xyaum qhia, feem ntau cov menyuam yaus tom qab phais, yog tias muaj, tau txais txiaj ntsig zoo.
Tab sis tsis yog cov tshuaj ib txwm siv los pab kho mob, pej xeem txoj kev kuj tau zoo.
Cov txheej txheem pej xeem hauv kev kho mob thrombocytopenia
Kev kho mob thrombocytopenia hauv cov menyuam yaus nrog cov tshuaj pej xeem muab cov txiaj ntsig zoo, tshwj xeeb tshaj yog siv cov roj noob hnav. Nws tswj cov qib ntawm platelets hauv cov ntshav. Nws tsuas yog noj hauv cov zaub mov ntawm 10 grams txog li peb zaug hauv ib hnub.
Vervain infusion kuj pab tau. Npaj nws zoo li no: 5 g ntawm verbena yog nchuav nrog ib khob ntawm boiling dej, qhwv nyob rau hauv ib tug phuam thiab sab laug rau infuse rau 30 feeb. Noj rau ib hlis, ib khob ib hnub hauv ib feem me me.
Tsis txhob hnov qab txog kev tiv thaiv kev tiv thaiv uas yuav pab tiv thaiv thrombocytopenia.
Kev Tiv Thaiv
Cov me nyuam uas twb muaj mob los yog nyiam tus kab mob no yuav tsum ua raws li kev tiv thaiv:
- Zam txhua qhov xwm txheej uas tuaj yeem ua rau raug mob.
- Cov niam txiv yuav tsum kho lawv cov menyuam noj.
- Tsis txhob noj "Aspirin" thiab lwm yam tshuaj uas yog pawg ntawm cov tshuaj uas tsis yog-steroidal anti-inflammatory.
Cov niam txiv yuav tsum ceev faj ntxiv txog lawv cov menyuam noj dab tsi, cov tshuaj twg kws kho mob tau sau tseg. Thaum hu mus rau ib lub tsev kho mob, txawm tias muaj mob khaub thuas, tus kws kho mob yuav tsumyuav tsum paub txog qhov kev kuaj mob uas twb muaj lawm.
Zoo kawg
Summing, nws yuav tsum tau hais tias tsuas yog ua raws li txhua tus kws kho mob cov lus pom zoo, noj tag nrho cov tshuaj thiab kev tiv thaiv kev tiv thaiv yuav pab tus menyuam uas muaj thrombocytopenia zoo thiab tsis xav txog nws tus kheej ua txhaum. Cov niam txiv ntawm cov menyuam yaus yuav tsum tau saib xyuas lawv cov menyuam mos thiab niaj hnub coj lawv mus rau kws kho mob kom kuaj xyuas. Qhov tseeb, muaj ntau tus neeg mob me me hauv peb lub tebchaws no, tab sis lawv txhua tus ua lub neej puv, thiab tus kab mob tsis thab lawv.
