Achiri ndicho chirwere mune vakuru nevana: zvinokonzera, zviratidzo, kurapwa

Basa rinokosha pakurapa isingawanzowanikwi chirwere chinoita chirwere kuti anobvumira kusiyanisa chirwere kubva zvimwe zvirwere utano. kurapwa vachiri chirwere chiri refu, asi fungidziro wevarwere nenguva kuona nyanzvi, kazhinji zvakanaka.

Nhoroondo chirwere

First nezve chirwere muna 1897, nemhaka chiremba George Steele. Asi panguva ino Asi nehosha zvaionekwa chete rudzi dzinonzi rheumatoid arthritis. Chete muna 1971, Erik Bayuoters yakabudiswa zvidzidzo kuti kusiyanisa chirwere kubva dzinoverengeka nezvinetso zvakafanana zviratidzo.

Medical nhamba dzinoratidza kuti kurwara isingawanzowanikwi chirwere anogona zvakafanana vamiriri vanhurume. Zvisinei, varwere vakawanda raireva chiremba vane zviratidzo zvakadaro nechirwere uye akapiwa kusimbisa chirwere - vana pasi pemakore 16. Kupiwa muduku wakadaro, vakawanda varwere, nechirwere kunzwisisa nokuti vabereki vokutanga vakaona zviratidzo mwana, zvakaoma kudavira kuvapo "zera" vakadaro dambudziko.

The zvinokonzera chirwere

Kusvikira zvino, etiology chirwere kujeka. zveBhaibheri zvakawanda zvainanga kuziva zvinhu kuti wakatsamwisa Ichiri nehosha mune vana nevakuru, vakakundikana. Maererano kazhinji akagamuchira pfungwa, hosha iri nemhaka yokubatsirwa kwakaitwa muviri kana chirwere nemavhairasi vamiririri, asi uchapupu kutsigira kutaura ichi, kwete.

Doctors vakaedza rinobatanidza chirwere pamwe pamuviri, kushandisa mishonga, kusanganisira vanhukadzi hormone, mupfungwa uye zvimwewo. Maererano nemamwe mabhuku zvakadaro ndicho chirwere rinoreva autoimmune zvirwere. Zvechokwadi rakaratidza chete kuti iri basa chokutambudzika chirwere kunoratidzwa zvachinja wevasungwa pakati cytokines. Zvichida mushonga ramangwana vachakwanisa kuziva mhosva chirwere, nokudaro kurerutsa Diagnostics ayo uye kuwedzera yavaipora wevarwere.

Zviratidzo zviri chirwere Achiri vakuru

Kunyange ndicho chirwere, vane zviratidzo zvakafanana mune zvimwe zvirwere zviri chirwere ne zvinoverengeka:

• Fever kunoitika apo Still nehosha kunoratidzwa fivha, tinoberekwa zvinoverengeka zvinotapuriranwa, avo inconstancy. Setsika, tembiricha masikati wakachengetwa inowanzotorwa siyana, asi kaviri pazuva, ndichifumomuka kusvika 39 madhigirii uye pamusoro. Panguva iyoyowo imwe-cheshanu varwere richikwidibira kutonhorwa zviratidzo uye kuvandudza murwere zvakanaka haina kuchengetwa, izvo yekudyidzana zvinoomesa zviratidzo.
• At yepamusoro tembiricha yakakwirira pane murwere akaratidza ganda kwemakomo, vakapa Pink papules kana macula. Kakawanda, munhu mapundu iri hunde uye proximal kuviri, nezvahwo - mufananidzo unoratidza mapundu kumeso. Mumwe pavatatu varwere mapundu hunopfuura ganda pakavha, zvaibva kunyanya zvinhu kukweshera uye compression. chiratidzo kwakadaro anonzi Koebner chinonakidza. Hakusi nguva dzose achiperekedzwa ane mapundu, kuvaviwa, uye ayo zvikuru rakachenuruka blue ruvara uye kuti nguva nenguva kunyangarika zviratidzo imperceptible kumurwere. Doctors kuti kuongororwa yakarurama murwere kuva pasi tembiricha kunyanyisa, zvaanopa simba kuratidzwa mapundu. Zvingava inodziya nemvura kana nokuiswa inodziya machira. Atypical nekuratidza chirwere vari: alopecia, erythema nodosum, petechial hemorrhages. Asi tsika, zviratidzo zvakadai hadziwanzowaniki.

• The kutanga kwekupwanyiwa Still nehosha kunoratidzwa chitarisiko myalgia uye arthralgia. In ichi pakutanga nedambudziko rimwe chete rwakashodoka. Nokufamba kwenguva, chirwere rinotaura mamwe mapfundo, akatora chimiro polyarthritis. Zvikurukuru inokanganisa ibvi, neketani, chiningoningo, hudyu, temporomandibular, metatarsophalangeal majoini. Asi chepfungwa chirwere, kupfuura kwese kuti vazhinji kacho ndiko kukura yemajoini of distal interphalangeal zvenguvo maoko. Izvi ndizvo kunotipa kusiyanisa Still nehosha kubva rheumatic fivha, tsvuku chinonzi systemic lupus kana dzinonzi rheumatoid arthritis.
• Muna 65% kuti zviitiko hosha kunoitika pazuva pakanyorwa lymphadenopathy. Hafu varwere yakawedzera remuromo node nodes. Panguva iyoyowo, mune zvimwe zviitiko, necrotizing lymphadenitis zvinotora hunhu.
• Pakutanga chirwere, varwere akashuma nemuumbi unopfuta ari huro, inova zvachose.
• Nokuti Asi Chiri chirwere inozivikanwa uye cardio-pulmonary kuratidzwa akadai aseptic pneumonitis, cardiac tamponade, valvular vegetations kufema nenhamo syndrome.
• In varwere anyatsoona uye ophthalmic zvirwere. Izvi cataract yakaoma, corneal degeneration Blends Ribbon ziso iridocyclitis.

Achiri ndicho chirwere muvana

Symptomatology chirwere muvana rakasiyana vakura. Zvisinei, kuratidzwa Ichiri nehosha mune vana inogona lubricated, zvichitungamirira kunonoka chirwere uye kunonoka kurapwa. Dzimwe nguva yemajoini pauduku kunotungamirira kuremara. Kuti izvi zvisaitike, vabereki vanofanira kufunga chaizvo ezvinhu mwana chaiko. Zvino zviratidzo chirwere wokutanga anoreva unyanzvi Artisan. Raparurwa Zvisinei ndicho chirwere vana vanogona kukonzera disproportionate kuwedzera wamativi kuti zvinoda kuvhiya kupindira.

chirwere chirwere

Sezvo chepakarepo hapana chaizvo zviratidzo nehosha, zvokuongorora kwakaoma. Muchiitiko chimwe nechimwe, wamakumi zvakadaro ndicho chirwere chiri sevanhu fivha pamusoro zvisingazivikanwi hunhu. Mune zvimwe zviitiko, chirwere chinonzi "sepsis". Yakanga chete pashure akatevedzana kundikana mapoka asingaurayiwi kurapa uye vanoverengeka dzokuwedzera inoongorora vanachiremba vakasvika pakugumisa kuti chirwere mukuru Still ndicho. Treatment uye vapore - nguva kurapwa uye zvinoda kuramba kurapwa achitarisirwa. Izvi zvinoshandawo vana.

At chirwere chakanyorwa sezvo zviratidzo sezvo fivha, kuzvimba mapfundo, kuwedzera node nodes uye huro kuzvimba, uye zvimwe zvinhu vakawana kushandisa echocardiography, computed tomography uye Ultrasound. Fanira uye bvunzo ropa kuratidza kwevari maplatelet uye ropa masero machena. At Asi nehosha kuti murwere kunoratidzwa kudzikisa huwandu masero matsvuku eropa. In varwere mukuru, yakakwirira C-reactive mapuroteni uye ferritin. Saka assays nokuti Anti-yenyukireya antibodies uye RA chokufunga rinowanzova kunaka.

Kurapa panguva kanganwiro

Complex uye phased kurapwa kuri kuitwa yezviri chokutambudzika chirwere, kana mu kanganwiro. Muchiitiko chokutanga, muitiro akaita muchipatara, rechipiri - varwere vanogamuchira zvakafanira kurapwa, apo outpatients kana sanatoria uye utano plesieroorde. Treatment zvinosanganisira mishonga, physiotherapy, maekisesaizi marapirwo uye masaja.

Treatment munguva rikwanise chirwere

Panguva exacerbation varwere vachitora NSAIDs, immunosuppressants, glucocorticoids. Treatment anogara refu. Ndokusaka zvose murwere nemhuri yake vanofanira Stock hombe dose wokushivirira. Achiri ndicho chirwere mune vakuru nevana - chirwere chakakomba uye pakubata kunogona chete kuva nenguva chirwere uye ushandiswe kurapwa nemazvo.

mataridzikiro

Mushure kurapwa, vatatu zvinokwanisika siyana chirwere. The yakanakisisa wavo - vaingoerekana kupora kuchengetwa chimwe muzvitatu varwere isingawanzowanikwi kuongorora chirwere. Mumwe-muzvitatu varwere vane relapsing chimiro chirwere nguva nenguva. Chinonetsa chisarudzo - chirwere chirwere ari munhu mukuru Still ndicho. Treatment, kupora uye kunaya munyika iyi ingasanganisira kwete chete zvetsika kurapa, asi arthroplasty, vachibvumira kudzoreredza wakaparadzwa pamwe chirwere.