Thrombocytopenia thaum cev xeeb tub: ua rau, qhov tshwm sim, kev kho mob

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Thrombocytopenia thaum cev xeeb tub: ua rau, qhov tshwm sim, kev kho mob
Thrombocytopenia thaum cev xeeb tub: ua rau, qhov tshwm sim, kev kho mob

Video: Thrombocytopenia thaum cev xeeb tub: ua rau, qhov tshwm sim, kev kho mob

Video: Thrombocytopenia thaum cev xeeb tub: ua rau, qhov tshwm sim, kev kho mob
Video: Urinary Tract Infection Nursing NCLEX | UTI Symptoms Treatment Cystitis, Pyelonephritis, Urethritis 2024, Kaum ib hlis
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Thrombocytopenia thaum cev xeeb tub yog kuaj pom hauv 7% ntawm cov poj niam thiab feem ntau tshwm sim hauv peb lub hlis thib peb. Lub mechanism ntawm qhov tshwm sim ntawm no pathology tsis tau tag nrho to taub. Hauv 70% ntawm cov neeg mob, tus mob no cuam tshuam nrog kev hloov kho ntawm lub cev uas tshwm sim tom qab conception.

cov ntaub ntawv dav dav

Thrombocytopenia yog ib yam kab mob ntshav uas tshwm sim los ntawm qib qis ntawm platelets (tsim los ntawm cov pob txha liab loj heev). Lub luag haujlwm ntawm cov hlwb no yog dab tsi? Yog tias qhov txhab tsim hauv lub cev, ntau tus platelets maj nrawm rau nws thiaj li "kua nplaum" nws. Tom qab ntawd muaj kev hloov pauv hauv cov phiaj xwm lawv tus kheej thiab kev sib sau ntawm cov hlwb tshiab es tsis txhob siv yav dhau los los kaw qhov txhab. Nyob rau hauv tus kab mob no, platelets yog sai sai puas los yog synthesis nyob rau hauv me me.

thrombocytopenia thaum cev xeeb tub
thrombocytopenia thaum cev xeeb tub

Nyob hauv lub cev ntawm tus poj niam noj qab nyob zoo thaum tsis muaj cev xeeb tub, tus lej ntawm cov hlwb no txawv ntawm 200 txog 300x10 9/l. Lawv lub neej tsis pub dhau xya hnub, ces lawv siv rau hauv daim siab lossis tus po. Yog ibTus naj npawb ntawm cov hlwb no tau txo qis, tus poj niam tau kuaj pom tias muaj thrombocytopenia thaum cev xeeb tub (tus qauv yog 150x10 9/ l rau tus poj niam hauv txoj haujlwm). Cov kws kho mob suab lub tswb thaum daim duab no qis dua 140x10 9/l.

Lub luag haujlwm tseem ceeb ntawm platelets yog kev koom tes hauv cov ntshav txhaws - qhov tseem ceeb tiv thaiv lub cev. Tsis tas li ntawd, cov hlwb me me no ua rau muaj kev noj qab haus huv ntawm cov hlab ntsha sab hauv, uas ua kom nws elasticity thiab tiv thaiv ntau yam kev puas tsuaj sab nraud.

Cov poj niam hauv txoj haujlwm feem ntau ntsib cov kab mob no. Txawm li cas los xij, nws tsis tas yuav muaj kev phom sij rau tus menyuam hauv plab thiab tshwm sim nws tus kheej hauv qhov tsis zoo.

Qhov laj thawj tseem ceeb

Thrombocytopenia thaum cev xeeb tub yog qhov tshwm sim. Nws tuaj yeem txhim kho vim muaj ntau yam:

  • Hloov pauv hauv qib hormonal.
  • Ntau cov ntshav ntim.
  • Nephropathy.
  • khoom noj khoom haus tsis txaus thiab vitamin B12 deficiency.
  • Kev kis tus kab mob.
  • Kev tsis haum tshuaj thiab kab mob hauv lub cev.
  • Intrauterine fetal death.
  • Placental abruption.
  • Kev noj qee yam tshuaj.

Kev txo qis ntawm cov platelets yuav ua rau lub cev muaj zog, uas yog, tsis tseem ceeb (tsawg kawg 140x10 9/ l). Raws li txoj cai, cov xwm txheej zoo li no tsis txawv ntawm cov tsos mob pom tseeb thiab tsuas yog kuaj pom thaum lub sijhawm kuaj. Hauv qhov no, kev kho mob tsis tas yuav tsum tau, tab sis kev soj ntsuam tas li yog qhov tsim nyog. Nyob rau hauv lub pathologicalkab mob, tus kws kho mob yuav tsum xub tsim qhov ua rau ntawm lub pathology thiab tam sim ntawd muab tshuaj kho. Txwv tsis pub, txoj kev pheej hmoo ntawm kev tsim cov teeb meem txaus ntshai ntxiv.

thrombocytopenia ua rau thaum cev xeeb tub
thrombocytopenia ua rau thaum cev xeeb tub

daim duab kho mob

Thrombocytopenia thaum cev xeeb tub muaj ntau qhov kev piav qhia ntawm cov tsos mob ntau dua li lwm tus neeg mob. Rau cov poj niam nyob rau hauv txoj hauj lwm yog ib txwm:

  • Pom me me ntawm daim tawv nqaij tom qab kov.
  • Kab ntshav tawm ntawm lub tsev me nyuam.
  • Npau thiab cov pos hniav los ntshav. Cov tsos mob no tsis tuaj yeem hu ua qhov tshwj xeeb, txij li ntau tus poj niam cev xeeb tub tsim cov txheej txheem inflammatory hauv cov pos hniav vim tsis muaj cov vitamins thiab minerals.

Nws yog cov kev kho mob tshwm sim uas nrog thrombocytopenia thaum cev xeeb tub. Cov duab ntawm cov neeg mob uas yuav tsum tau ua raws li qhov kev kuaj mob no tau nthuav tawm ntau hauv cov ntawv kho mob tshwj xeeb thiab lwm yam kev pab cuam ntawm cov ncauj lus tseem ceeb.

Cov tsos mob ntawm tus kab mob no qhia tias ua txhaum loj ntawm cov txheej txheem hematopoietic. Qhov no yog qhov txaus ntshai tiag tiag, thiab tsis yog thaum lub sijhawm yug menyuam, tab sis kuj thaum yug menyuam. Tsis muaj kev kho kom raug tuaj yeem ua rau lub neej ntawm cev xeeb tub.

thrombocytopenia thaum cev xeeb tub yees duab
thrombocytopenia thaum cev xeeb tub yees duab

Secondary thrombocytopenia thaum cev xeeb tub

Secondary thrombocytopenia feem ntau kuaj pom hauv nruab nrab cev xeeb tub. Raws li txoj cai, nyob rau hauv cov ntaub ntawv no, tus kab mob tshwm sim los ntawm irradiation ntawm lub cev, lomtshuaj lom. Tsis tas li ntawd, qhov txo qis ntawm cov platelets tuaj yeem pom vim kev noj qee yam tshuaj. Tus kab mob no txaus ntshai heev rau tus menyuam, txawm li cas los xij, nrog rau kev kuaj mob raws sijhawm thiab kev kho mob raws sijhawm, qhov kev kuaj mob feem ntau yog qhov zoo rau tus menyuam thiab leej niam.

Diagnosis

Kev lees paub tus kabmob yog feem ntau raws li kev kuaj mob hauv chaw kuaj mob. Nws muaj ob peb theem:

  • Cawm anamnesis.
  • Kev kuaj mob.
  • kuaj ntshav.
  • Aspiration pob txha pob txha biopsy.

Kev kuaj ntshav yog txoj kev qhia paub tshaj plaws los txiav txim siab cov ntsiab lus ntawm cov platelets. Yog tias kev kuaj mob qhia pom pom pom tseeb ntawm tus kab mob (pob liab ntawm lub cev, hemorrhages me me), ces tus kws kho mob kuj tseem yuav sau cov pob txha pob txha. Nyob rau hauv cov ntaub ntawv ntawm ib tug loj tus naj npawb ntawm megakaryocytes nyob rau hauv lub smear, feem ntau yuav, platelets puas los yog accumulate nyob rau hauv tus po. Tsuas yog tom qab tag nrho cov kev ntsuam xyuas saum toj no, thrombocytopenia thaum cev xeeb tub tau lees paub. Kev kho mob yog sau rau ntawm tus kheej, raws li cov xwm txheej ntawm tus neeg mob, tus menyuam hauv plab.

thrombocytopenia thaum cev xeeb tub
thrombocytopenia thaum cev xeeb tub

Kev Tiv Thaiv Kev Tiv Thaiv

Cov neeg mob ntawm txoj kev loj hlob ntawm tus kab mob no, thaum muaj peev xwm ua rau muaj qhov tshwm sim loj, muaj tsawg heev. Yog hais tias pathology yog nrog los ntawm kev txo qis hauv platelets, tsis muaj kev tiv thaiv kab mob tseem ceeb hauv lub cev, tsis tas yuav kho tshwj xeeb. Thrombocytopenia thaum lub sij hawm cev xeeb tubcev xeeb tub nrog rau qhov tseem ceeb tsis muaj kev kho mob tsuas yog nyob rau hauv ib lub tsev kho mob nrog lub obligatory soj ntsuam ntawm lub txaj so kom txog rau thaum lub quantitative parameters ntawm cov ntshav rov qab mus rau qhov qub. Kev kho tshwj xeeb tsuas yog yuav tsum tau muaj tus kab mob hnyav, thaum platelet suav poob rau 20x10 9/ l. Raws li txoj cai, cov poj niam tau muab tshuaj glucocorticoids. Ib qho kev xaiv zoo tshaj plaws yog suav tias yog "Prednisone". Txhawm rau txo qhov cuam tshuam tsis zoo rau tus menyuam hauv plab, hauv txhua kis, tus kws kho mob xaiv qhov ntau npaum li cas thiab lub sijhawm ntawm cov tshuaj.

Cov kab mob hnyav heev, thaum kho tshuaj tsis zoo, kev phais raug pom zoo kom tshem tawm tus po.

Hnub no, cov kws tshaj lij sab hnub poob tab tom tsim cov tshuaj tshiab txhawm rau txhawm rau tiv thaiv cov kab mob xws li thrombocytopenia thaum cev xeeb tub. Kev tshuaj xyuas txog lawv tam sim no yog sib xyaw. Cov khoom no paub tias muaj cov tshuaj uas txhawb kev tsim cov megakaryocytes.

thrombocytopenia thaum cev xeeb tub
thrombocytopenia thaum cev xeeb tub

pab tshuaj tshuaj ntsuab

Cov kws kho mob niaj hnub no pom zoo kev kho mob raws li ib txoj hauv kev tseem ceeb los tiv thaiv tus kab mob thrombocytopenia. Thaum cev xeeb tub, kev kho mob nrog pej xeem tshuaj kuj tseem siv tau. Nws yog ib qho tseem ceeb uas yuav tsum nco ntsoov tias cov zaub mov ntawm peb cov pog koob yawg koob yog siv nrog rau cov tshuaj thiab tsuas yog nyob rau hauv kev saib xyuas ntawm kws kho mob.

Ntawm qhov zoo, feem ntau cov beets tau ua pov thawj lawv tus kheej hauv kev tawm tsam cov kab mob no. Pom zoo ua ntej pwgrate thiab sprinkle nrog qab zib. Thaum sawv ntxov, koj yuav tsum nyem cov kua txiv hmab txiv ntoo los ntawm lub plab thiab siv nws ntawm lub plab khoob. Txawm tias qhov tseeb tias qhov saj ntawm "tshuaj" nyob deb ntawm qhov qab ntxiag tshaj plaws, qhov tshwm sim yog tsim nyog.

Cov roj noob hnav roj tsis tsuas yog tswj cov platelets hauv cov ntshav, tab sis tseem ua kom cov ntshav khov sai. Kev kho mob, nws txaus los ntxiv roj rau cov zaub nyoos thaum ua noj.

thrombocytopenia thaum cev xeeb tub kho nrog pej xeem tshuaj
thrombocytopenia thaum cev xeeb tub kho nrog pej xeem tshuaj

Thrombocytopenia thaum cev xeeb tub: qhov tshwm sim thiab kev ntsuas

Feem ntau, qhov kev cia siab rau tus kab mob no yog qhov zoo. Hauv ib nrab ntawm cov xwm txheej, nws yog vim qhov hloov pauv hormonal hauv lub cev, uas yog qhov ntuj tsim rau lub sijhawm no.

Qhov phom sij loj tshaj plaws yog autoimmune thrombocytopenia thaum cev xeeb tub. Nws txhais li cas? Antibodies ntawm tus poj niam los ntawm cov placenta nkag mus rau hauv cov ntshav ntawm tus me nyuam hauv plab, provoking kev tuag ntawm platelets nyob rau hauv nws. Hauv qhov no, tom qab lees paub qhov kev kuaj mob, kev cuam tshuam ntawm obstetric thiab phais thaum yug menyuam yog txwv. Qhov tseeb yog tias cov kev phais mob no tuaj yeem ua rau mob ntshav hauv lub cev hauv tus menyuam.

Kev yug me nyuam nrog tus kab mob tsis sib haum yog ua los ntawm txoj kev khaws cia. Yog tias qhov kev kho mob tsim nyog ua tsis tiav lossis qhov xwm txheej ntawm tus poj niam cev xeeb tub hnyav zuj zus, kev txiav txim siab feem ntau yog txiav txim siab los ua ib qho chaw caesarean. Txoj hauv kev no tso cai rau koj los tiv thaiv tus menyuam hauv plab los ntawm kev raug mob thiab tswj cov ntshav poob thaum yug menyuam.

thrombocytopenia thaum cev xeeb tub
thrombocytopenia thaum cev xeeb tub

Kev Tiv Thaiv

Txhawm rau tiv thaiv kev txhim kho ntawm cov kab mob xws lithrombocytopenia thaum cev xeeb tub, nws yog ib qho tsim nyog yuav tsum txo qis txhua yam ntawm lub luag haujlwm rau kev ua haujlwm ntawm tus poj niam lub cev tiv thaiv kab mob. Nws raug pom zoo kom cais nws los ntawm cov neeg mob uas muaj ntau yam kab mob. Nws yog ib qho tseem ceeb heev thaum lub sij hawm yug me nyuam kom tsis txhob noj tej pawg tshuaj (antitumor, sulfonamides, anticoagulants, thiab lwm yam). Koj yuav tsum tau tiv thaiv lub cev kom ntau li ntau tau los ntawm cov teebmeem ntawm cov tshuaj lom, hluav taws xob. Thaum ntxov ntawm cev xeeb tub, ib qho kev sab laj ntxiv ntawm tus kws tshuaj caj ces thiab tus kws kho mob hematologist yog tias cov xwm txheej zoo sib xws ntawm tus kab mob twb tau sau tseg hauv tsev neeg.

Zoo kawg

Cov kab lus no muab cov ncauj lus kom ntxaws txog "Thrombocytopenia: ua rau thaum cev xeeb tub, cov tsos mob tseem ceeb thiab cov kev kho mob." Kev txawj ntse thiab kev kho raws sijhawm tso cai rau koj tsis nco qab txog cov kab mob no mus ib txhis. Noj qab nyob zoo!

Pom zoo: