Anaphylactoid kuita: zviratidzo, kuongorora chirwere uye kupatsanura

The panowanikwa sema (anaphylactic) Zvinoitwa anokonzerwa exogenous nevasori, uye ayo kubuda hunhu pakarepo mhando hypersensitivity. Kazhinji, dzinoratidzwa muviri wacho anogona kuva zvinouraya zvokurapa ezvinhu ganda, kufema uye cardio-vascular mabasa. Mushure kuonana pamwe antigen rinotanga chizvarwa IgE antibodies chaicho chinangwa chahwo. Ivo Kubatanidza pamwechete masero anokonzera kutapata pezvakaitwa, uye pane sensitization kuti antigen.

sei munhu sema kuita?

Chimwe raparadza inosimudzira kusunungurwa allergen anokonzera zvirwere masero simba bioactive zvinhu, kunyanya histamine. Panguva kuchinja kubva zvemakemikari pezvakaitwa kusvika pathological physiology tyisa kuchinja zvinoratidzwa zvikurukuru mune midziyo ropa, iro node nodes, Árbol kumeso tsandanyama chinowedzera kukura uye mangwanani nekuratidzwa syndromes izvi:

• kuderera kwemitambo vascular matauriro;
• pakarepo marwadzo ose anotsvedzerera tsandanyama rinenge riri ura, principales, dumbu;
• krovosvortyvaemosti kutyorwa;
• kuzvimba uye mumatenhere nemidziyo ropa.

Kusiyana sema, anaphylactoid maitiro, iyo inowanzonzi ekunyebera zvokurapa, hapana IgE-yairevererwa antibody pamwe basophils. Pasinei kufanana zviratidzo akapindura muitiro, vose vari kuratidzwa generalized hypersensitivity kwaiita nhengo.

Drug chisimbwa anokonzera anaphylactoid siyana

Anaphylactoid siyana - zviri zvakare kusunungurwa histamine, kazhinji kare pakutanga kuonana ane irritant. Pseudoallergic parizvino vanomiririra zvakanaka siyana. Ndezvokuti, ichi zvakaitwa muviri zvinowanzoitwa panguva achitora chinodhaka, anobatsira Kurwara.

Anaphylactic uye anaphylactoid siyana pakarepo mhando kuitika kazhinji pashure pakatanga tsandanyama relaxants, nemishonga, rufimbi mishonga, opioids, zvomunharaunda dzokutindivadza mishonga, kubaya, kemikari kurapa, atropine uye B mavhitaminzi kuti allergens zvinosanganisirawo serum, maantigen akashandiswa zvokurapa uye chirwere zvinangwa kuziva ganda, venereal zvirwere. The nyaya chisimbwa kuti latex zvigadzirwa. A inozivikanwa anoonekwa anaphylactoid kwomusikirwo lidocaine somunhu munharaunda rufimbi mushonga kushandiswa kakawanda, asi ayo kunzwisisa makemikari anoumba kunogona kukonzera marwadzo kunyange muviri utano, vane chisimbwa kuti mushonga hurongwa haisi zvemo.

Nemedikametoznye mikana yakawanda yokukurudzira

Kana isu funga zviitiko mhinduro muviri kune mikana yakawanda yokukurudzira vasiri pharmacological hunhu, pane kunyanya "dambudziko" rinogona kuva zvokudya:

• mastrawberry;
• dzemugungwa;
• uchi;
• nzungu;
• howa;
• Vamwe akasiyana hove;
• mazai;
• Citrus.

Anaphylactoid siyana zvingaitika kana mumwe zvipembenene nokuruma kana muchetura invertebrate fauna of. Varwere vari kuramba kusangana neutachiona dzisiri somushonga hunhu, vane guru mukana anaphylaxis panyaya pakuvhiya pasi vakawanda yokutindivadza.

kupatsanura pakati anaphylaxis

Nokudaro zvinoitika uye kupatsanura pakati neutachiona. Wokutanga chikwata chinosanganisira zvakasiyana siyana anaphylactic siyana izvo rakakamurwa yairevererwa IgE, IgG yairevererwa uye IgE-yairevererwa uye mumuviri mutoro. Pseudoallergy anaphylactoid siyana yairevererwa nyore kusunungurwa nevamiririri, zvichiteverwa kudanwa kukonzerwa kuitwa zvinodhaka, kugara zvokudya uye mumuviri zvinhu. A yoga chikamu protrude anaphylactoid siyana pamwe mastocytosis; yairevererwa masoja zvivako, immunoglobulin aggregates kana achiita antisera uye antibody yairevererwa cytotoxic, radiopaque zvinhu.

Sei anaphylaxis?

Morphine uye barbiturates zhinji, tsandanyama relaxants, pethidine kunogona kukanganisa mafuta masero, achiita kusunungurwa histamine. Mumufananidzo uyu kurapwa kunobva chipimo chemushonga uye inflow mwero mukati mutumbi unorapa. Practice inoratidza kuti kuita kunoitika vakawanda benign, ndinonetsekana chete anoratidza paganda.

Anaphylactoid siyana (ICD-10 paakavapa ichi pathological chirwere) inozivikanwa nokuda unpredictability ramangwana kukura uye zvimwe kusava mashoko yapfuura sema mhinduro pamusoro maantigen zvakakwana. Sezvo migumisiro anaphylaxis Crane ngozi dzoutano uye upenyu, zvinokosha kuti pakutanga vasabatwa yematambudziko uye chiito chakakodzera. Pasinei mashandiro kana anaphylactic pseudoallergic anotikurudzira zviratidzo zvinogona siyana yekudyidzana. Kupfeka evasingatombonamati nomumwe hunhu, anokuzviratidza Ingasiyana kubva zvishomanana kusvetuka BP uye ganda mapundu kuti zvikuru bronchospasm uye pokuwa kushanda kumwoyo.

Panguva iyi, zviri nyore kuona mumwe musiyano psevdoallergenov chiito pamusoro muviri. Zvichakadai, anaphylactoid siyana, zviratidzo izvo zvinogona kuonekwa nomumwe kana kuita zvakasiyana siyana, hachisi zvishoma ngozi.

Symptomatology anaphylactoid kuita

Zviratidzo sema nezvinoita murwere munyaya kutsinzina wehurumende:

• dzungu;
• zvachose muviri simba;
• mwoyo mutinhimira zvinetso (tachycardia, fibrillation);
• BP;
• kupfupika mweya, asima kurwiswa, uye broncho-laryngospasm, pulmonary edema uye pahuro;
• ganda unopfuta, kuvaviwa mapundu, mikoko, akatsvuka integuments, angioedema ;
• intestinal chinyamunhari chinorwadza, kuda kurutsa, manyoka, kurutsa;
• kusavapo kufamba kweropa;
• zvemwoyo dhirika;
• deceleration uye paimira mwoyo.

Fungidzira yematambudziko pashure anaphylactoid siyana

Nengozi huru pacharo zvinokonzera kuvhunduka, pamwe bronchospasm. Pashure imwe nguva (kubva masekondi 30 kusvika awa dzimwe nguva 2-3 maawa) ari antigen akapinda muviri kunoita sema pathological pezvakaitwa mumuviri. Zvikuru nokuti maitiro kunoenderana Maumbirwe vakurukurirane kupinda (nomuromo kana parenterally). Rapid kukura kazhinji chinokonzera rufu, kukonzera kungoerekana chakasimba kufema insufficiency, kutsoropodza perfusion kufurirwa inodonha, kunoitika nokuda kamwe kukundikana kweropa, chepfungwa ropa kana edema, havachanyatsogoni kushanda hunde, arterial thrombosis.

Pazuva rechipiri pashure kutambura ndisingafungiri kukanganisa upenyu uye kupora riri concomitant kunoita chirwere anokonzerwa ane sema maitiro tikafunga. Kunyange pashure vaviri wamavhiki, mukana yematambudziko achiri kumusoro. Kakawanda, pashure anaphylaxis , vanachiremba rokuongorora zvirwere uye dysfunction akadai:

• nemabayo;
• vasculitis;
• renal uye hepatic kukundikana, hepatitis, glomerulonephritis;
• epidermal necrolysis;
• myocarditis;
• chearthritis.

Similar Migumisiro anogona kuisa zvose anaphylactic uye anaphylactoid siyana. Kusiyana anaphylactic kuvhunduka pathologies izvi ndechokuti yokupedzisira zvinoda risati sensitization uye haisi kukwanisa kuva musangano wokutanga nefuma-allergen.

anaphylaxis kurapwa

Right kuti nechimbichimbi kurapwa zvaiitwa maererano nechirwere kuchangoita nhoroondo, saka zvakakosha kuti anoatora. Chisimbwa symptomatology, kureva. E. The kunotoda mufananidzo, unoitawo basa rinokosha pakuita kunokurumidza chisarudzo. Zvisinei, chakavimbika kupfuura uye kwakakwana mhinduro yomubvunzo pamusoro nechirwere kunogona kuwanika pashure pakutsvakurudza chisimbwa uye immunology murabhoritari. Panguva iyoyowo, pahwaro dzinonetsa mamiriro murwere, kunyanya ake pakarepo rubatsiro rwekuchipatara inofanira akapa, sapamazuva nyaya cardiac kusungwa kana kufema kusungwa - anomutsiridza chiito.

Panguva padariro kuziva zvinokonzera sema akapindura, muviri basa ndiko kuita renguva pamwero zvokurapa differential kuongorora chirwere. Izvi rworudzi Ongororo zvichiitirwa hazvibatanidzi zvichibvira simba zvinhu asina chokuita histamine kusunungurwa.

maitiro akadaro ari muviri nevamwe vasiri sema zvinokonzera

Kakawanda, anaphylactic uye anaphylactoid siyana (chii uye chirwere nengozi zvikuru, zvakakosha kuziva vanhu vari kuita kunyange Hakuna Basa Pakutanga, neutachiona muchimiro rhinitis) vane zvakafanana nevamwe zvinhu, vanokwanisa kukwanisa kukonzera bronchospasm, hypotension:

• ovhadhozi dzokutindivadza;
• thrombosis somugumisiro mhepo entrapment kana atherosclerosis;
• rinorema chido zviri gastric zviri urwere;
• myocardial infarction, pericardial tamponade;
• septic kugwinha;
• pulmonary edema nezvimwe zviratidzo asina chokuita nezvimwe zvinhu.

Emergency kutarisirwa kana kukurumidza kukura sechinhu anaphylactic kana anaphylactoid maitiro kushanda haana kumbosiyana kubva zvakaoma zvinoitwa zvainanga kubviswa uye vabatwe anaphylactic kuvhunduka.

Nzira kuti kukurumidza kuita

With kuchiita Kurwara zvinodiwa kuvarapi uye kutarisira rinonyanya pfupi ndiyo shanguriro akabudirira kurapwa. Zvimwe anaphylaxis Mufananidzo pakarepo mhando vari fanira ndima mumatanho akawanda:

1. Nhanganyaya unconfirmed asi nengozi antigen anofanira vakarega.
2. Anaphylactic kana anaphylactoid siyana (mufananidzo munyaya varatidze rakajairika zviratidzo uye nezviratidzo chirwere), iyo anova panguva yokutindivadza kana panguva oparesheni, zvinoda pakarepo kuturika. Zvinofanira kuitwa unhu kuongorora chokwadi pamusoro pakatanga allergens. Unopinza kusvetuka BP pasi kuti vasavhiringidza nerubatsiro rufimbi. Kana bronchospasm fanira kushandiswa inhaled dzokutindivadza.
3. Kufefetedza uye kufema zvinofanira nechokwadi kunyange panguva ichocho, kana murwere haasi yekudyidzana kunetse. The intubation mapapu vanofanira nguva dzose, kusvikira zvino, kusvikira zviri pachena chose kuti kufema inopiwa muviri pachayo.
4. Anaphylactoid kuita, izvo kurapwa kunoda intravenous kwokubatsira adrenaline, zvinokonzera njodzi kuti murwere, kunyange maawa akawanda pashure kubviswa bronchospasm. Chipimo chemushonga pamusoro akadzokorora kwokubatsira epinephrine anogona ngazviwedzerwe nokuti fuma kunobatsirawo pamusoro Kudzikamiswa pamusoro pedanda rechikepe masero, kuderera vascular permeability pamusoro endothelium, izvo zvinokosha pakurapa anaphylaxis.
5. Mugore chenjera kudiwa nokumutswa Zvinokoshawo kuwedzera Vhoriyamu achiparadzira mvura mumuviri. Nokuti chinangwa ichi, vanachiremba akaisa guru dhayamita anobudisa mushonga zvishoma nezvishoma nomutsinga (Vienna inoshandiswa hapasi kuva musimboti - panguva yaro kutsvaka anogona kuridza kurwisa murwere nemamiriro) ugodira mashoma marita ose crystalloid.
6. Kana hazvibviri kuziva allergens, kwakaitika somugumisiro anaphylactoid kuita, vanofanira kuteerera kushandisa panguva murwere kuonana latex zvinhu. Nzira magiravhusi, zvinodhaka, basa kuburikidza latex chivharo ndiro, Urinary catheters - izvi zvose zvinogona kukonzera anaphylaxis.

Pashure chimbichimbi Mabatirwo anaphylactoid siyana (uyewo anaphylactic) kunoda refu nzira yokurapa kuitira kudzivirira dzokororo zvirwere. The kusaongorora mirayiridzo vanachiremba kunowedzera ngozi kuwedzera kuwanda zvinogona allergens.

Tevera-up kurapwa

Pakati zvinodhaka jekiseni chirongwa bronchospasm rinokosha ndohwaJehovha mushonga "Salbutomol" ungavapa, "aminophylline". Kana zvichibvira, chimwezve kuita inhalation kushandisa isoproterenol kana ortsiprenalina. Sezvo anaphylactoid siyana - ndiyo chiremba aratidze systemic, umo zvingaratidza kuva yakaoma, zvakakodzera kushandisa glucocorticoids (semuenzaniso, "Dexamethasone" "hydrocortisone") constraining muitiro zvemwoyo akawisa.

Yemanyorero cupping anaphylactic kuvhunduka pamwe nekutambira kuramba takasvinurira n'anga. Chokwadi kuti kukura vachangobva dysfunction anogona nguva dzose kuva nzvimbo, saka chero mwero kwokuomerwa murwere muchipatara chinhu pachena mhinduro. Fanira uye vanachiremba vanodavira kuuya pakutsvakurudza ganda riri kuonekwa nezvevamwe antibodies.

Prophylaxis kuti anaphylactic uye anaphylactoid maitiro

Kwazvo nhoroondo zvokurapa - yakanakisisa mwero kudzivirira uye kudzivirirwa kunenge anaphylaxis. Pashure kuunganidza zvose zvakafanira mashoko ari pamusoro kosi yacho chirwere, vangazivikanwa varwere pangozi uye kusarudza chii aizorwiswa apiwa anaphylactoid siyana. Zvinorevei?

Sezvo Kurwisa neimwe vaivapo anogona kutora nzvimbo varwere zvikuru kwakanyanya zvinoda akangwarira vakasarudzwa zvinodhaka uye yokutindivadza, uye panguva yevanorwara zvikuru. Pamberi ropa kuti vanhu kubatira anaphylaxis, vaite muedzo kuongorora kuti kugarisana nevamwe zvinogadzirwa neropa.

Chisimbwa kuti latex zvigadzirwa zvichaitwa ramangwana mufambiro manipulations siyana pasina kushandisa mari yakadaro.