Osler ISIZINDA - Iyini? Izimbangela pathogenesis, ukwelashwa

Endocarditis - yisishiso endocardium, ulwelwesi yenhliziyo. Kungabangela isifo kwezitho zomzimba eziningi izinhlelo wokulinyazwa umzimba womuntu, izimbangela hypercoagulable nabanye abangewona ezithathelwanayo. Ngakho-ke uqobo endocarditis nje izimpawu zabo, khona lapho Roth izindawo, Osler ISIZINDA nezinye ukuqubuka isici emzimbeni akubonakali. Iziguli angase angabi nomuzwa ukungakhululeki, futhi kuyaqabukela akhononde nokububula inhliziyo, imfiva. Futhi kuphela uma ukuvuvukala endocardial okubangelwa yisinanakazana amagciwane egazini, kuba nesifo elihlukile okuthiwa endocarditis ezithathelwanayo, bacteriological noma virus. Osler ISIZINDA - omunye yezibonakaliso zayo zangaphandle. Wawachaza 1885, elincomekayo udokotela Canadian uWilliam Osler. Infective endocarditis - isifo esiyingozi kakhulu ukuthi kuholela ukusonteka engelapheki kwenhliziyo, ngakho-ke kubalulekile ukwazi ukuthi iyini nokuthi kuzibonakalisa.

Izici endocarditis infective

Lesi sifo ezibangelwa amagciwane cishe zonke pathogenic nesikhunta, futhi ngezinye izikhathi ngisho amagciwane lenyama kukhona esegazini yomuntu. Zingene may endocardium e izifo ezithathelwanayo zokuphefumula, rheumatism, periodontitis, namathansela, isifo sofuba urethral catheterization, izinyo ukususwa kanye nezinye manipulations. Osler ISIZINDA kukhona isignali eliqhakazile wanika ecashile isifo inkinga - endocarditis infective. Ezimweni eziningi, ukuze kuqale umsebenzi yisinanakazana of nezilwanyana ezincane kufanele inhliziyo lilimele nganoma iyiphi indlela:

- catheters emithambo yegazi;

- elawula ukushaya kwenhliziyo;

- lokufakelwa kwezitho noma valve inhliziyo semithambo;

- ukukhubazeka inhliziyo ezihlukahlukene;

- microtrauma;

- ukuhlinzwa.

Ngezinye izikhathi ama-bacterium zingene endocardium futhi ngaphandle umonakalo izicubu ngaphambi. Khona-ke kwamiswa abscesses, fistulas nezinye zamehlo.

izimpawu

Infective endocarditis ativete ngokucacile futhi ngokugqamile, futhi kungenzeka ekuqaleni ukuphazamisa ukukhathala kuphela, ikhononda inhliziyo, ubuthakathaka jikelele, kanti izimpawu nengwenya more ukwandisa kancane kancane. Lezi zihlanganisa:

- umkhuhlane;

- Ukugodola;

- ukujuluka kakhulu;

- imisipha ubuhlungu nezihlanganiso;

- kwesisindo;

- izinguquko ibala (iba lemicu empunga elinamathela othini, kancane aphuzi);

- ukuqubuka ku nolwelwesi lwamafinyila.

Osler ISIZINDA avele emva izimpawu ngenhla. Abanye ochwepheshe ababheke njengezinto isici esiphawuleka futhi ezibalulekile endocarditis infective, kuyilapho abanye ukubonakaliswa ayeyivelakancane ngakho, lapho lesi sifo ngesimo subacute.

Osler ISIZINDA, pathogenesis

Letakhi ivele izandla, kalula, izinyawo ngenxa kwamathambo okubangelwa yi-ukutheleleka ngezitsha encane igazi amelela ngesinyenyela. cwaningo histological kwamafindo kuzo abonise ama-venule olukhuthaziwe arteriole. Ngezinye izikhathi kudidaniswe i ukuqubuka iguliswa noma purpura ukonakala. kanjani Izigaxana Osler, isithombe sikhombisa bha. Kuyinto convex, nenkundla ipea noma ngaphansi ukwakheka kancane mobile luhlaza bomvu noma nsomi, ngezinye izikhathi ubuhlungu, ngezinye izikhathi ngeke. Batfutfukisa anyamalala ngokushesha bebodwa, ungeyena isifo ahlukile, ngakho ke amaphilisi indlela yokwelashwa noma abone yokugcoba asidingi. Kodwa uma umuntu waphawula emafindweni enjalo, kufanele ngokushesha uxhumane nodokotela wakho for laboratory eyengeziwe futhi izifundo zokwelapha.

izindawo Roth sika

Ngaphezu Izigaxana Osler, e endocarditis infective kungenzeka ukuqubuka oluhambisana uhlamvu ezinhlangothini nasemilenzeni, ukopha ngaphansi ipuleti nail, amabala Zhaneve ezivukayo kanye Osler ISIZINDA, phezu kwezintende zezandla kanye ematheni. Kodwa, ngokungafani kuya Izigaxana, lezi izindawo baqiniseka kobuhlungu, akusho ngifane ipea futhi zibangelwa nje hawu igazi liphuma kuma-capillary.

Ngo endocarditis infective, ngaphezu isikhumba, amehlo kanye zingase zithinteke. Omunye izimpawu ezivamile kakhulu yokusabela kuya ukuvuvukala kukhona izindawo Roth. Wachaza kudokotela wabo Swiss Roth. Roth izindawo amelela microbleeds kwe-retina. Ngesimo zingabantu okusaqanda noma round nge dot emhlophe phakathi. In iziguli, lezi zokwakheka kungabangela kwehle umbono, okuyinto, emva kokwelashwa lesi sifo ecashile kubuyiselwa.

Roth izindawo kukhona uphawu hhayi kuphela endocarditis infective, kodwa futhi kwegazi, zezinzwa izicubu isifo. Ngakho-ke, ukwenza uphethwe kuyadingeka ukuze baqhube izifundo ezengeziwe.

Ezinye izimpawu of endocarditis infective

Kukhona cishe izimpawu kweshumi ezisikisela ukuvuvukala endocardium ngenxa ukwethulwa ukutheleleka.

Osler ISIZINDA, Lukin izindawo (noma kwesokudla uphawu Lukin Liebman), izimpawu Rock, Dmitrienko, Janeway kanye nabanye odokotela usizo ukuxilonga, ikakhulukazi ezimweni lapho nezinye izimpawu ejwayelekile zesifo buzofiphaliswa noma sahlukene nalo.

Uphawu Lukin-Liebmann Akukhona ukubukeka petechiae iphuzu nge isikhungo olumhlophe ku emphethweni Isivalo kanye conjunctiva.

Rock uphawu kuzibonakalisa ukunwetshwa Umfundi esweni ngakwesokunxele.

Uphawu Janeway - ke imfundo erythematous, kanye amabala Roth, uthatha isinyathelo neyamasundu amathe ezinyawo, kodwa kulokhu zingabantu yayincane.

Uphawu Dmitrienko liqukethe ukuthambisa we ithoni iphimbo mina, yingakho ibizwa nangokuthi "velvet ithoni." Sabona lesi sici nasezigabeni zokuqala zalesi sifo.

ukwelashwa

Ukuze kutholakale imbangela iyiphi uphawu oluthile kungenzeka udokotela. Ngokuvamile, lokhu kudinga igazi ukuhlolwa laboratory, ECG, echocardiography. Kuphoqelekile lokufeza bakposev igazi ukuhlonza ejenti ezithathelwanayo. Uma ukuhlola okuye kwabonisa khona endocarditis infective e isiguli, ama-antibiotic ezinqunyiwe iqembu ezifanele. Ezimweni ezimbi kakhulu, ukuhlinzwa wenziwa (plastic, wokufakelwa inhliziyo valve).

Nge ngesikhathi esifanele okuyikona futhi ifike ngesikhathi kuqalile ukwelashwa 50-90% eziguli aphile iminyaka engaphezu kuka-5. Ukuze uvimbele okuvela endocarditis infective athuthukile isu elikhethekile abantu engozini. It has izindlela eziningana zokuvimbela, esekelwe reception kwemithi akhethiwe izimo imiklamo.