Kawasaki kab mob yog ib qho mob uas tshwm sim feem ntau hauv cov menyuam yaus hnub nyoog qis dua tsib xyoos. Tus kab mob no yog ib qho tsis tshua muaj kev tiv thaiv kab mob los yog kis kab mob, uas yog tus cwj pwm los ntawm qhov muaj qhov txhab ntawm cov hlab ntsha, thiab ntxiv rau, qhov tshwm sim ntawm kub taub hau, conjunctivitis thiab lwm yam tsos mob hnyav. Kev kho tus kab mob no yog ua nyob rau hauv chaw kho mob uas siv tshuaj.
tus kab mob no yog dab tsi?
Tus kab mob no tau tshawb pom xyoo 1961. Nws tau qhib los ntawm tus kws kho menyuam yaus Japanese Kawasaki, tom qab uas nws tau txais nws lub npe. Tus kws kho mob tau tsim cov kab mob ntawm lub plawv, thiab ntxiv rau, ntawm cov hlab ntsha coronary, uas tau ua ke rau hauv cov kab mob nyuaj hu ua "Kawasaki Syndrome".
Tawm tsam keeb kwm ntawm cov kab mob no, vasculitic lesions ntawm ntau cov hlab ntsha thiab cov hlab ntsha tshwm sim, ntawm lwm yam, aneurysms tshwm sim. Lub ntsiab provoking yam yognce qib ntawm T-lymphocytes vim muaj cov antigens rau streptococci thiab staphylococci, txawm li cas los xij, niaj hnub no tsuas yog qhov kev xav uas tseem tsis tau lees paub los ntawm kev tshawb fawb.
Kab mob Kawasaki hauv cov menyuam yaus feem ntau tshwm sim thaum muaj hnub nyoog ntxov, nruab nrab ntawm ib thiab tsib xyoos. Ntxiv mus, nws tshwm sim peb caug zaus ntau zaus hauv cov neeg sawv cev ntawm haiv neeg Mongoloid. Raws li kev txheeb cais, yim caum feem pua ntawm cov neeg mob yog cov menyuam yaus hnub nyoog qis dua peb xyoos. Hauv cov tub hluas, cov kab mob no tau pom ib thiab ib nrab zaus ntau dua li cov ntxhais.
Hauv kev kho mob, muaj cov kab mob no ntawm cov neeg laus uas muaj hnub nyoog tshaj peb caug xyoo.
Ua rau kab mob
Tsis muaj ib qho lus piav qhia tshwj xeeb rau qhov pom ntawm cov kab mob no. Tab sis cov kws tshaj lij tau txheeb xyuas qee cov qauv nrog rau qhov xwm txheej ntawm qhov tshwm sim ntawm tus kab mob no, xws li raws caij nyoog, uas yuav qhia tau tias yuav kis tus kab mob no.
Tsis tas li ntawd, kev kuaj mob ntawm cov neeg mob tau pom tias muaj cov seem ntawm cov kab mob uas tsis paub hauv cov ntshav, uas zoo li qee yam kab mob. Yog li, cov kab mob hauv qab no suav tias yog cov kab mob tseem ceeb: spirochetes, staphylococcus, parvoviruses, streptococcus, rickettsia, herpes, Epstein-Barr virus thiab retrovirus.
Raws li lwm txoj kev xav, qhov ua rau tus kab mob no tuaj yeem nyob hauv lub cev tiv thaiv kab mob, thiab ntxiv rau, nyob rau hauv cov yam ntxwv ntawm cov noob caj noob ces, vim tias cov neeg Esxias raug tus kab mob no ntau dua li lwm tus. Qhov yuav yog vim li cas rau qhov noCov xwm txheej xav txog lub cev cov tshuaj tiv thaiv rau tus kab mob, ua rau cov txheej txheem ntawm cov kab mob loj heev.
Kev nthuav qhia thiab cov tsos mob
Feem ntau, cov neeg uas muaj Kawasaki syndrome mus txog peb theem hauv qab no:
- Mob febrile theem uas kav xya mus rau kaum hnub.
- Subacute theem kav ntev li ob mus rau peb lub lim tiam.
- Lub sijhawm rov qab los ntawm ib hlis mus rau ntau xyoo.
Kawasaki kab mob cov tsos mob muaj nyob hauv qab no.
Ua ntej, ib tug neeg muaj kub taub hau, ib yam li cov kab mob otolaryngological, ces kub taub hau pib. Thaum tsis muaj kev kho mob tsim nyog, nws tuaj yeem kav ntev txog ob lub lis piam. Lub sijhawm no ntev dua, lub sijhawm tsawg dua yuav rov qab los.
Tom ntej no, cov teeb meem ntawm daim tawv nqaij pib los ntawm cov pob liab liab mus rau ntawm daim tawv nqaij o, hlwv thiab pob khaus. Thickening ntawm daim tawv nqaij ntawm ob txhais taw, thiab nyob rau hauv tas li ntawd, ntawm xib teg, yog tsis cais, thaum, raws li txoj cai, kev txav ntawm cov ntiv tes txo qis. Cov tsos mob no tshwm sim li ntawm peb lub lis piam, tom qab ntawd daim tawv nqaij pib tev tawm.
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Tsis tas li ntawd, muaj kev puas tsuaj rau lub qhov ncauj mucosa thiab qhov muag. Hauv thawj lub lim tiam, cov neeg mob tsim mob conjunctivitis ntawm ob lub qhov muag yam tsis muaj paug. Lub mucous daim nyias nyias ntawm lub qhov ncauj raug kev txom nyem los ntawm dryness thiab los ntshav, piv txwv li, los ntawm cov pos hniav. Nyob rau tib lub sijhawm, daim di ncauj tawg, tawg, thiab tus nplaig ua crimson, tonsils, tig,nce loj. Nyob rau hauv ib nrab ntawm cov neeg mob, ib qho kev nce ntxiv ntawm qhov loj ntawm lub ncauj tsev menyuam qog nqaij hlav. Los ntawm sab ntawm coronary system, nrog rau lub plawv, cov tsos mob hauv qab no tshwm sim:
- Kev txhim kho ntawm myocarditis.
- Kev mob plawv tsis ua haujlwm, arrhythmia thiab tachycardia.
- Nyob hauv siab.
- Vascular aneurysms nrog rau myocardial infarction thiab pericarditis.
- Kev txhim kho ntawm mitral insufficiency.
Nyob rau hauv txhua qhov thib peb ntawm txoj kev loj hlob ntawm cov kab mob no, cov neeg mob muaj kev puas tsuaj rau cov pob qij txha hauv thaj tsam ntawm lub hauv caug, tes thiab pob taws. Mob plab tsis raug txiav tawm nrog rau mob plab, xeev siab thiab ntuav. Qee zaum, meningitis lossis urethritis tshwm sim.
YKev kuaj mob ntawm pathology
Hauv kev kho mob, nws ntseeg tau tias qhov muaj tus mob npaws tsis tu ncua ntev li tsib hnub lossis ntau dua yog qhov qhia tau tias yuav muaj tus kab mob Kawasaki. Tsis tas li ntawd, tsawg kawg yog plaub ntawm tsib cov tsos mob hauv qab no yuav tsum muaj:
- Kev muaj kab mob conjunctivitis ntawm ob lub qhov muag.
- Pom pob khaus hauv pliaj, thiab ntxiv rau, ntawm ko taw thiab nraub qaum.
- mob ntawm qhov ncauj mucosa, daim di ncauj thiab tus nplaig.
- o ntawm tes thiab ko taw.
- Enlarged tonsils thiab lymph nodes.
Yog hais tias tus neeg mob muaj aneurysm ntawm coronary hlab ntsha, tsuas yog peb lub cim yuav txaus. Laboratory kev tshawb fawb muab cov ntaub ntawv me me. Tab sis, raws li txoj cai, nrog kev txhim kho ntawm tus kab mob no hauv tus neeg mobtheem ntawm leukocytes thiab platelets nce, cov ntshav biochemistry qhia txog qhov ntau ntawm immunoglobulin nrog rau transaminase thiab seromucoid. Tib lub sijhawm, leukocyturia thiab proteinuria tau pom hauv cov zis.
Raws li ib feem ntawm kev kuaj mob ntxiv, ECG ntawm lub plawv tau ua nrog rau X-ray ntawm cheeb tsam thoracic thiab ultrasound. Tsis tas li ntawd, angiography ntawm cov hlab ntsha coronary yog ua. Hauv qee qhov xwm txheej, yuav tsum tau txhaj tshuaj lumbar. Txhawm rau cais cov kab mob Kawasaki (cov duab ntawm cov neeg mob nyob rau hauv tsab xov xwm), lwm cov kev tshawb fawb kuj tau ua, nws yog ib qho tseem ceeb kom paub qhov txawv ntawm cov kab mob no los ntawm qhua pias, rubella, nrog rau cov kab mob ua npaws thiab lwm yam kab mob uas muaj cov tsos mob zoo sib xws.
Muaj feem cuam tshuam thiab teeb meem
Pathology vim lub cev tsis muaj zog lossis kev kho tsis raug tuaj yeem ua rau muaj kev txhim kho myocarditis, mob caj dab, coronary aneurysm, gangrene, hydrops ntawm gallbladder, valvulitis, otitis media, aseptic meningitis thiab raws plab.
Cov lus qhia kho mob rau tus kab mob Kawasaki yog dab tsi?
YTxoj kev kho kab mob
Radical txoj kev kho tsis muaj nyob niaj hnub no. Tus kab mob no tsis kho nrog steroids lossis tshuaj tua kab mob. Tib txoj kev kho kom zoo rau tus kab mob Kawasaki yog txhaj tshuaj acetylsalicylic acid thiab immunoglobulin rau tib lub sijhawm.
Ua tsaug rau immunoglobulin, pathologies tshwm sim hauv cov hlab ntsha nrog rau cov txheej txheem inflammatory raug tso tseg, uas yog li tiv thaiv kev tsim ntawm aneurysms. Acetylsalicylic acid, nyob rau hauv lem, txokev pheej hmoo ntawm cov ntshav txhaws, muaj cov nyhuv anti-inflammatory. Tsis tas li ntawd, ob qho tshuaj pab txo qis lub cev kub, tshem tawm ua npaws thiab txo tus neeg mob tus mob. Tsis tas li ntawd, tus neeg mob yuav tau muab tshuaj anticoagulants raws li tus kws kho mob cov lus qhia txhawm rau tiv thaiv qhov tshwm sim ntawm thrombosis. Cov no feem ntau yog Warfarin thiab Clopidogrel.
Huab cua: Kuv puas tuaj yeem tau zoo dua?
Kab mob Kawasaki txaus ntshai npaum li cas rau cov neeg laus?
Nyob rau hauv feem ntau ntawm cov xwm txheej, kev kwv yees yog qhov zoo. Cov kev kho mob feem ntau kav txog peb lub hlis. Kev tuag los ntawm tus kab mob Kawasaki yog kwv yees li peb feem pua, feem ntau yog los ntawm vascular thrombosis, nrog rau vim lawv qhov rupture tom qab los yog lub plawv nres.
Kwv yees li nees nkaum feem pua ntawm cov neeg mob uas muaj tus kab mob no tau txais kev hloov pauv hauv cov hlab ntsha, uas yav tom ntej yog ua rau atherosclerosis nrog rau plawv ischemia thiab muaj kev pheej hmoo ntawm myocardial infarction. Txhua tus neeg uas muaj tus mob no yuav tsum nyob rau hauv kev saib xyuas ntawm kws kho mob plawv thoob plaws hauv lawv lub neej thiab raug kuaj xyuas lub plawv thiab cov hlab ntsha tsawg kawg ib zaug txhua tsib xyoos.
Recommendations
Vim qhov ua rau tus kab mob Kawasaki tseem tsis paub txog tshuaj, tsis muaj cov lus pom zoo tshwj xeeb hauv qhov no. Nws tsuas yog yuav tsum tau mus nrhiav kev kho mob rau cov kab mob sib kis raws sij hawm thiab, ntawm cov tsos mob me ntsis, nrhiav kev pab kho mob. Yog li, nws yog ib qho tseem ceeb kom ua tib zoo kawm qhov nomob nyob rau hauv thiaj li yuav paub nws nyob rau hauv lub sij hawm thiab mus ntsib kws kho mob. Nyob rau theem pib, tus kab mob no tau kho, thiab tom qab theem, kev tsim cov ntshav txhaws nrog rau cov tsos mob ntawm aneurysm tuaj yeem ua rau tuag taus.
