Osler kōpuku - he aha te mea tenei? Take o pathogenesis, maimoatanga

Endocarditis - he nawe o te endocardium, te ararewa roto o te ngakau. Ka taea e meinga te reira i mate i roto i te maha whekau, me ngā pūnaha o te whara te tinana tangata, take kore-hopuhopu hypercoagulable me ētahi atu. Na reira endocarditis iho he tika ratou tohu, te aroaro o e kore e Roth wahi, kōpuku Osler me ētahi atu ponana āhuatanga i runga i te tinana puta. e kore e tūroro ite te hūhi, a varavara amuamu e pā ana ki te amuamu ngakau, kirika. A anake, ki te meinga te mumura endocardial pirinoa moroiti i roto i te toto, riro te reira i te mate motuhake i huaina hopuhopu, bacteriological kitakita ranei endocarditis. kōpuku Osler - tetahi o ona tohu waho. Whakaahuatia ratou i roto i te 1885, he rata faahiahia Canadian William Osler. Infective endocarditis - he mate tino kino e tika ana ki te deformation tina heke o te ngakau, na ko reira faufaa ki te mohio he aha te mea te reira, a pehea faaite te reira iho.

Āhuatanga o te endocarditis infective

meinga tenei mate e huakita tata pathogenic katoa me harore, a ka he te tahi mau taime noa huaketo me hātare i roto i te bloodstream o te tangata. Tomo kia te endocardium i roto i hopuhopu mate romahā, rūmātiki, periodontitis, tonsillitis, kohi, urethral catheterization, tango niho, me te tahi atu whawhe. Osler kōpuku he tohu kanapa e hoatu pōauautanga mate whāriki - endocarditis infective. I roto i te nuinga o te wā, mo te tīmatanga o te mahi pirinoa o microorganisms i roto i te ngakau kia pakaru i roto i tetahi ara:

- catheters venous;

- pacemakers;

- iaia prostheses vaolo ngakau ranei;

- ngā hē ngakau;

- microtrauma;

- pokanga.

I te tahi taime ô i te huakita te endocardium me kahore kino kiko mua. Na ka hanga e abscesses, fistulas me ētahi atu mea kohakore,.

tohu

Infective endocarditis taea te whakapuaki ratou mārama me marama, a kia i te tuatahi whakakorikoria te rohirohi anake, amuamu ngakau, ngoikore whānui, me te whakapiki ake i nga tohu atu paoro āta. Ko ētahi o ēnei:

- kirika;

- Chills;

- werawera auau;

- uaua fakamamahi me hononga;

- mate taimaha;

- huringa i roto i te tae kiri (riro grayish, paku kowhai);

- he ohorere i runga i te kiriuhi mucous.

puta Osler kōpuku i muri i nga tohu i runga ake. whakaaro ētahi tohunga ki a ratou hei āhuatanga motuhake, me te mahuinga o endocarditis infective, ētahi i he faaiteraa āhua onge o reira, i roto i nei ko te mate i roto i te puka subacute.

Osler kōpuku, pathogenesis

puta ēnei hanganga i runga i te ringa, te matimati, waewae e tika ana ki te mumura meinga e mate ki te oko toto iti, me te tohu urutomo. ako Histological o knots i roto ia ratou whakaatu venules whakarei me arterioles. E ētahi wā raruraru ratou ki te hunga ponana mate pāwera te purapura ero ranei. Kia pehea te he nodules Osler, whakaatu tino mārama photo. He ohu te reira, te rahi o te pea, he iti iti hanganga pūkoro o te hue whero papura ranei ranei, i ētahi wā fakamamahi, e kore ētahi wā. hohoro ratou whakawhanake ngaro e ratou, he kore te mate motuhake, na kahore pire maimoatanga hinu ranei e rapu utu. Otiia ki te kite i te tangata i taua knots, kia kōrero tonu ia koutou tākuta mō te taiwhanga atu me rangahau haumanu.

wahi o Roth

I tua atu ki nodules Osler, i roto i te endocarditis infective kia puta hemorrhagic e hikaka te huru i runga i nga taha, me waewae, toto i raro i te pereti titi, te wahi Zhaneve puta me te kōpuku Osler, i runga i nga kapu me kapu. Otiia, i roto i te rerekē ki te nodules, he tino mamae kore, e kore e titiro rite te pea enei wahi me ko te hua o te wiwi o te toto ki nga tōiti.

I roto i te endocarditis infective, i roto i te tua ki te kiri, kanohi, me te kia kia pāngia. Ko tētahi o nga tohu tino noa o te tauhohenga ki te mumura he wahi Roth. whakaahuatia e ia to ratou tākuta Swiss Roth. Roth wahi tohu microbleeds i roto i te etine. I roto i te puka He porotītaha ranei a tawhio ki te ira ma i roto i te waenganui ratou. I roto i te tūroro, ka taea e enei ngā meinga heke kite, i muri i whakahokia nei, ko te maimoatanga o te mate whāriki.

Roth wahi ko te tohu e kore anake o endocarditis infective, engari ano hoki anemia, mate kiko tūhonohono. Na reira, ki te hanga i te tātaritanga he tika ki te whakahaere ako atu.

Ētahi atu tohu o endocarditis infective

E pā ana ki te tohu tatini suggestive o mumura o te endocardium tika ki te whakataki o te mate.

Osler kōpuku, Lukin wahi (tika-tohumate Lukin Liebman ranei), te tohu o Rock, Dmitrienko, Janeway me ētahi atu rata te tauturu tātari, rawa i roto i te wā, ina e te peroo ngaro ranei te tahi atu tohu angamaheni o te mate.

Tohumate Lukin-Liebmann ko te ahua o te ira petechiae ki te pokapū te repa i runga i nga taiepa o te kamo, me te kirikamo.

faaite Rock tohumate ake i roto i te roha o te whatupango o te kanohi maui.

Tohumate Janeway - reira mātauranga erythematous, me te kotingotingo Roth, mahi i runga i nga kapu me kapu o nga waewae, engari i roto i tenei take e iti i roto i te rahi ratou.

ngā tohumate Dmitrienko i tamarûraa o te ware reo ahau, i te mea he aha te hoki i huaina a reira "oro wereweti." kite tatou i tenei āhuatanga i roto i te wāhanga tuatahi o te mate.

maimoatanga

Hei whakapumautia te take o tetahi tohumate ngā kia he tākuta. Tikanga, titau tenei whakamātautau toto taiwhanga, ECG, echocardiography. Ko reira whakahauanga ki te kawe i roto i bakposev toto ki te tāutu i kaihoko hopuhopu. Ki te mea kua whakaaturia whakamātautau te aroaro o te endocarditis infective i roto i te manawanui, whakaritea he rongoā paturopi te te rōpū e tika ana. I roto i ngā take kino, whakamana pokanga te (kirihou, piha ngakau prosthetic).

Ki te wā tātaritanga tika, me te wā timata maimoatanga 50-90% o tūroro ora ake atu i te 5 tau. I roto i te tikanga ki te ārai i te takanga o te endocarditis infective whakawhanakehia he tikanga motuhake mō te iwi i mōrearea. He maha ngā aratau o te ārai, e hāngai ana i runga i te fariiraa o rongoā i roto i te tikanga āhuatanga tīpakohia.