Waterhouse syndrome - Friderichsen: pathogenesis, tiaki ohotata, maimoatanga

Te repe adrenal i roto i te tinana, ko te okana nui endocrine. Hormones whakaputaina e ratou pā i te tawhā o te pēhanga, me te nui o te wai komuhumuhu, te taumata o tai kohuke me microelements takitahi i roto i te auau pūkoro, ara i runga i te repe. A i roto i ngā āhuatanga i reira te te mamae i te mahi o enei repe iti, engari tino nui, te whakawhanake i te kāwanatanga, te whakawehi i nga ora me te hauora.

Whakamarama me te hītori

Waterhouse syndrome - Friderichsen - he iti hoki adrenal whakapeka, e puta i muri i whētuki ki te tinana o te pakaruhanga toto i roto i tona parenchyma. Tenei ai te maumaui rawa nui o te taiao ā-o te tinana, a taea arahi ki te mate.

Whakaahuatanga o te huru tuatahi puta i roto i te 1894, engari ko te reira iti rawa, a i roto i 1911, tāutu Waterhouse rima take, i awhinatia ki a ia te kohikohi huihui nga mongamonga katoa. E rongoa nei ki a ia ki runga, e whitu nga tau i muri mai, i roto i 1918, whakaputa hoki Frederiksen he tuhinga roa e pā ana ki tenei tukanga pathological.

take

whakaae Scientists e te syndrome Waterhouse - Friderichsen meinga toto nui i te wa ano i roto i rua repe adrenal. ope pea mōrearea - he hou, kohungahunga, tamariki me te iwi taitamariki. Te papa i roto i tenei take kotiti. Ka taea te rongo i tēnei āhua i te tuku auroa, hemokai hāora fetal tona haereraa i mua i roto i te awa whanau te whakamahi i Kuku mārua Pūunu ranei ranei. I tua atu, he wāhi nui mō te nui mate congenital, me te hapū pōauautanga o te mutunga o gestosis.

Waterhouse syndrome - Friderichsen i roto i ngā pakeke e tino maha kitea rite te pōauautanga o te mate TB. Tikanga, te kaihoko ko te meningococcus, streptococcus staphylococcus ranei. Ko haunga enei, nga take o te toto e taea e nosologies pērā i karawaka, ngangana kirika, taipō piwa, diphtheria, me neoplasms mārere, pukupuku, peritonitis hoki me Thrombosis uaua adrenal.

Ko te whanaketanga o te mate

Kua tawhiti maha kaituhi tenei syndrome hei wāhanga o te huarahi urutau o te kore i roto i te whanaketanga o te sepsis whakapeka. Ko ko reira taea e ngā tamariki taitamariki, me nga wahine hapu tino rerekē tikanga e ai whakawhanake Waterhouse syndrome - Friderichsen. Pathogenesis faaite te reira iho i roto i te necrosis hemorrhagic maha o te uho adrenal. Ko ratou e rave rahi e te tinana katoa waiwaitia i roto i te toto, i reira he hyperextension o te capsule, a tae noa ona whaturama.

Ko te pathogenesis whānui, kua whakakitea ai i roto i te puka o te sepsis:

- tōiti dilated me arterioles;
- syndrome haurangi korerotia;
- te aroaro o te meningitis te rere meningoencephalitis ranei;
- he hua i roto i taikiri rohe me te thymus.

tohutanga

Waterhouse syndrome - Friderichsen ki te mate kiriuhi kia whakawhanake ohorere i te papamuri o te pai-oranga. Kei te ahu whakamua ia kia nohopuku e taea te tangata e mate i roto i nga ra.

Te reira i katoa tīmata ki nui excitability, te kārangirangi me te pāhoahoa. Na ka uru puku mamae, whakapairuaki, ruaki me te korere. Ki te mea kaha rawa te mamae, kia whakapae i te tākuta i roto i te tūroro ki te māuiuitanga hāparapara whakapeka. I te tīmatanga, iti-māka kirika, engari tika he torutoru haora o te tīmatanga ko reira 39-40 nekehanga. Nā ki te ruaki me te korere i te tinana ka mahue te wai me ngā kohuke, e arata'i ki te rangirua o te ngakau, roro me te tahi atu whekau faufaa. I roto i te mutunga, ngaro te tangata mahara, a taka ana ki te pōroa.

He he ahua tetahi o te mate, i faaite ake i roto i te taka koi i roto i te pēhanga toto tiango ranei. e kore ai e ētahi atu tohumate kia i te katoa. Te tangata ko te tuatahi i roto i te hiamoe, engari rite hohoro hypoxia kauneke mai hiamoe, me te pōroa. Mate kahore ngå mahara.

Waterhouse syndrome - Friderichsen tamariki te whakawhanake tere atu i roto i ngā pakeke, ahakoa o te take. Homai ratou kaha e vai o te rauropi tere mauriora, a ka he tonu maha ngā pūnaha me whēkau i roto i te tukanga o te hanganga me te whanaketanga, mai te hua ra tuatahi o te tīmatanga o te mate.

tātaringa

Waterhouse syndrome - Friderichsen whakawhanake kia tere e tākuta maha e kore e whai wa ki te whakahaere i te whakamātautau ki tonu, me te kite ka ahatia ki te tangata. Ki te te ruma whawhati tata whakapae ohipa tākuta tenei māuiuitanga, ka tīmata tonu maimoatanga, me hono tātaritanga i roto i te tukanga, no te mea ko te pūkete i runga i te karaka.

Laboratory mō te whakau o te tātaritanga he tika ki te kitea i roto i te tātari whānui o te toto:

- leukocytosis me te nekehanga leftward o te tātai;
- heke i roto i te kūhuka toto;
- thrombocytopenia me te upoo- iti;
- whakaiti o electrolytes;
- hua i roto i te toto tiomimi hauota.

Heoi, e kore e motuhake enei tohu me kia tohu o te whānui o hāparapara me ngā mate pūnahanaha. Hei kia tino, e hiahia ana koe ki te āta kohikohi hītori hauora, ka kawe i te poka lumbar me ki te whakaahua i te mana neurologic. Ko meatia tenei katoa kei muri i te stabilization o te huru tangata.

tātaritanga pārōnaki

Waterhouse syndrome - Friderichsen kia kitea i hāparapara tikanga puku pērā i whēkau whakapeka, pancreatitis whakapeka, whewhe perforation o te puku duodenum ranei. Kia tino e tirohia i te tākuta mō te tohu meningeal, ki te ārai toto i roto i te roro, cavernous Thrombosis pakohu. A, no te e tauturu i te puka ECG cardiac matau koe ranei te tangata kua he whakaeke ngakau e kore ranei.

maimoatanga

I roto i te wahi tuatahi i muri i te tātaritanga "syndrome Waterhouse - Friderichsen" kia utu i te manawanui sweated electrolytes wai, me te kore o hormones adrenal. Ki tenei whakaurua te roto i te whai wāhi venous ki te hawhe te rita "hydrocortisone" ranei 120 milligrams "prednisolone" me e toru karamu o rima kūhuka ōrau me tekau milliliters o rima ōrau otinga o te waikawa ascorbic. Na ngāue tatou i runga i pathogenesis taketake, meinga Waterhouse syndrome - Friderichsen. tiaki Emergency i te wa ano whakapiki i rheology toto, i āna faarahi te reira i te nui o te inu pūnaha me whakanuia ana te pēhanga. tauturu te whakakapinga taiaki pūtaiaki ki mau tonu te pēhanga i te taumata tika.

I muri stabilization o te hormones tonu ki te kia whakahaerea intramuscularly, "Hydrocortisone" o 50-75 mg katoa haora e ono, me deoxycorticosterone tāpia runga tekau milliliters toru nga wa o te ra. Kia tino ki te whai i nga tohu o te pēhanga, me, te mea e tika ana, ki te titi ake "Epinephrine," "Mezaton" glycosides cardiac.

Ki te mea kua riro te take o te mate i te mate, pērā i kiriuhi, i roto i te tua ki te therapy tuatahi, hoatu te manawanui kei paturopi. Kia te hoki manawanui ki noa, timata hormones ki āta whakaiti i te horopeta. He mea nui ki te te faaineine tika te tinana mo te mea me hua takitahi ia glucocorticoids. Kaua e koimutu whakakore i te raau taero, i taea tīmata reira he raruraru tuarua.

He mea nui ki te whakaū i ko te manawanui tika syndrome Waterhouse - Friderichsen. Te maimoatanga ano e taea e mōrearea rite waipuke nui o te tinana ai edema pūnahanaha, tae atu edema kaka, me pota nui o hormones taea tīmata disorders hinengaro. Na reira, ko te tino nui te huru o te manawanui ki te aroturuki tonu, ka whakatika i te whakatū rite ki tona hiahia.

outlook

Waterhouse syndrome - Friderichsen - māuiuitanga tino nui, te whakakite i e kore tonu i runga i te wa i te mea o te momo o tohu kore-motuhake. E kore te hua tei anake i runga i te āhua o te pai ka whakahaere tākuta i roto i te āhuatanga ohorere, engari ano hoki i runga i te tohu o te whakangaromanga o nga repe adrenal me te kaha e vai o te rauropi. Haere pinepine mutu tenei mate he mate.

ārai

Ko te nuinga mehua anti-urutā i roto i te takuahi o te mate i roto i i pāngia te manawanui kei ki te mate kiriuhi tenei. takoto te tākuta e kua whakakitea he manawanui taua te ki whakamōhio te tirohanga Sanitary ka tutakina atu te manawanui. I roto i nga ra e toru i muri mai, he haki o tangata whakapā mo te aroaro o te mate me te taratahi i roto i te hapori mahi institution mātauranga ranei mo te wā o nga ra kotahi tekau. Ka rite ki te whakatupatotanga, iwi i roto i te whakapā tata ki te manawanui, whakahau te akoranga poto o paturopi.

mātai tahumaero

Waterhouse syndrome - Friderichsen, kāore, māuiuitanga tino noa. I roto i te whenua taepū, te pā o te mate kiriuhi he 1-3 take mō ia 100 000 taupori. A neke atu i te hawhe o te wā - tama a kōhungahunga tau. I tua atu, kua kite ia tekau tau te ara i roto i te pā. Ko te tika ki te irakētanga o te taupori tukumate me heke wātea i te mate tenei.

E kore te nuinga pea pono enei tatauranga, rite haere undiagnosed no nga tohu o te ripeka maha take. Waterhouse syndrome - Friderichsen whakawhanake na tere e kore tākuta e whai wa ki te kawe i te maha rawaka o ngā whakamātautau.