Felty kuti Syndrome: Zviratidzo, kuongorora chirwere

Under Felty kuti chirwere inoreva kuomesa kwakaita dzinonzi rheumatoid arthritis, kunoitika muna chete 1% wevarwere zvose nechirwere. Nefivha, tsandanyama atrophy, pigmentation uye susceptibility kune zvirwere zvirwere hunhu - zvose izvi zvinhu kazhinji kuenda Felty kuti syndrome. Zvokurwara chirwere inobva nhoroondo dzinonzi rheumatoid arthritis, yakaoma ndohwavo rabhoritari parameters. Treatment kunosanganisira yaunodya pamusoro corticosteroids, splenectomy. Kwenguva refu nguva imwe zvokurwara dzinoratidzwa isingagari hunhu uye kunotoda mufananidzo. Muna 1929, AP Felty akarondedzera chirwere. Kubvira chirwere akanga kusiyaniswa sezvo yakazvimirira nosology.

Felty chirwere: chii?

The chirwere chinorondedzerwa nokuvapo vatatu mawa pathologies: kuti dzinonzi rheumatoid arthritis, kuwedzere chirwatata uye leucopenia (pasi chena muropa masero). chirwere ichi Kazhinji chirwere vanhu vakuru makore 40, kazhinji zviri akanaka pabonde.

Nyanzvi dzinoti kuti hwaro chirwere chiri autoimmune chichingoitwa. It rinobuda pamwe zvakananga kunobatanidza lymphoid nyama uye haizopereri inotungamirwa masoja zvivako uyewo dzakananga antibodies. Zvokurwara akaratidza sezvo neutropenia ane fanira zvinoderedza kurwisa zvirwere vakawanda, uye kana zvaitika - kutadza. Saka nhasi ndiro splenectomy (nokubviswa chirwatata) rinozivikanwa nzira inoshanda chete pakurapwa.

Felty kuti chirwere kunoratidzwa siyana, kazhinji atypical. Chirwere anogona asati makore akawanda (5 kusvika 10) zvirwere inonzi RA polyarthritis pamwe mawa munyaya pathological muitiro interphalangeal majoini, pamwe kunosiyana inosiyana zvakaoma.

Ukuwo, ruzhinji varwere nechirwere ichi takatsunga ne mifananidzo kuratidzwa connective tishu. Izvi zvingava fivha, paumbwe subcutaneous nodules, myocarditis, kurasikirwa uremu, poliserozita.

The zvikonzero

The etiology chirwere harizivikanwi. Havasi varwere vose vane chirwere kuti "dzinonzi rheumatoid arthritis" riri kukura zvokurwara ichi. In mumwongo ane utano munhu akaramba zvinoberekwa ropa masero machena. Varwere chirwere ichi, pasinei hwakanyatsorwisa yakaderera makopi, leukocytes vari kuumbwa. Vanogona -wedzera mune yakawandisa ari chirwatata.

Ndezvipi zviratidzo akaperekedza chirwere Felty mune vakuru?

• Articular syndrome (yemajoini pamusoro mapfundo diki).
• Kuwedzera kukura chiropa.
• Generalized lymphadenopathy (chirwere muna 50% nyaya).
• The mberi kuwedzera chirwatata kukura (akatsunga nokuda palpation).
• Polyneuropathy.
• Pigmentation paganda, maronda ari shins.
• Diffuse pulmonary fibrosis.
• Rheumatoid nodules.

Ose pamusoro zvinhu zvinoita rokuongorora Felty kuti syndrome. Zviratidzo zvose varwere vanoonekwa zvakasiyana. Somuenzaniso, dzimwe nguva akawedzera chirwatata iri kuchengetwa chete gare gare nzendo chirwere kukura.

kuongorora chirwere

Hwaro hwokurevererwa kwokupedzisira nokusimbisa kunotoda nechirwere pamusoro mawa mubatanidzwa splenomegaly uye dzinonzi rheumatoid arthritis. Blood kunovhenekwa kunoratidzwa kupererwa, leukopenia, neutropenia. The immunoassay yemanyorero anoona RF dzakakwirira titers, ari CEC, kuvapo antinuclear antibodies. Maererano zvabuda myelogram myeloid mwongo hyperplasia isiri yekenza iri nechirwere iya akananga saibva cellular okunze. Instrumental nzira kuferefeta (MRI, CT, Ultrasound pamusoro mapfundo) ingangowanikwa kupa ruzivo shoma. Felty kuti chirwere kunokosha zvikuru kusiyanisa pamwe cirrhosis uye sarcoidosis.

Basic misimboti kurapwa

Zvipatara, muchiitiko ichi kunosanganisira misoro nzira. Dzinonzi rheumatoid arthritis ikarapwa sezvo pomureza. Zvipatara nekorasi zvirwere, uye hosha yemajoini kusanganisira zvinodhaka kuti vabatsire rheumatism ( "Azathioprine", "MTX").

Varwere zvirwere zvakakomba Zvinokurudzirwa kuti majekiseni yevhiki nevhiki chinhu, izvo zvinosimudzira granulocyte yaitongwa. It anowedzera uwandu masero eropa machena.

mishonga Basic anogona kuderedza symptomatology iyo pamwe arthritis, Felty urwere zvakananga. zvinosanganisira Idzi dzinosanganisira: "Methotrexate", "Penicillamine".

Glucocorticoids dzinobudirira chete pamatunhu dosages. Zvikasadaro, zviri kuwedzera mukana wokuti wava kusvutazve. Ukuwo, kushandiswa kwenguva yakareba glucocorticoids kungaita kuti pave intercurrent zvirwere.

Nzira dzekuziva nadzo kubudirira mishonga:

• Kuwedzera granulocytes kusvika 2000 / mm.
• Zvinoderedza kuitika zvinotapuriranwa yematambudziko zvakasikwa.
• Rutapudzo nefivhiri kurwiswa.
• Rutapudzo nemaronda paganda kuratidzwa.

Kana Kuvhiya inokurudzirwa?

Sei zvimwe unogona kukunda Felty kuti chirwere? Utsinye Kuvhiya inokurudzirwa kana zvinodhaka kurapa kwakanga basa kana nokuda chipi chikonzero, zvinonzi contraindicated. Muchiitiko chino, kazhinji mubvunzo kuti splenectomy. Zvakakosha kuyeuka kuti muna 25% Muzviitiko neutropenia kuripo pashure nzira iyi.

Under splenectomy zvinoreva kuvhiyiwa, panguva iyo chiremba iri zvachose kana zvishomanana anobvisa chirwatata. Nhasi, pane mikana maviri nzira yakadaro: laparoscopic uye rakavhurika splenectomy.

Laparoscopy rinoitwa kushandisa talk yokutindivadza. Panyaya iyi, nokushanda kunosanganisira kushanda nhete huchashandiswa kamera kuguma, iyo inonzi laparoscope. The chiremba anoita akawanda cheka diki mudumbu kuburikidza iyo otaura maturusi kuti tevera manipulations. The kupora nguva, sezvinoita mutemo, haatarisiri nguva yakawanda.

Open splenectomy kunosanganisira guru incision pazasi mbabvu, kuburikidza iyo chiremba anobvisa chirwatata. Pashure kubviswa muviri mano muviri kuti dzinobvisa panze utachiona uye mavhairasi kubva ropa chaizvo ipfupi.

zvinogoneka yematambudziko

Matambudziko vari apo neapo chirwere uye anogona kuoneka muchimiro munhu ruptured chirwatata, kukura dzinonzi portal neBP, gastrointestinal kubuda ropa zvakanyanyisa kuitika yechipiri noutachiona.

mhedziso

Felty kuti chirwere - a dererei chirwere, asi kutoti kuomesa munhu wose boka pathologies nhasi vari chirwere kazhinji. Izvi hazvirevi kuti tinokwanisa kuregeredza kurapwa ake uye kwete kutsvaka rubatsiro anokwanisa kuti chiremba rakakodzera. Primary Zviratidzo vanofanira kuona munhu wose uye kuva chikonzero kutsvaka mazano kubva mazvikokota. Zvikasadaro, zviri kuwedzera mukana wokuti Kushatiswa mukuru wehurumende uye kusimudzira zvakakwana utano matambudziko, izvo zvinosanganisira atsamwira yacho chirwatata pachayo. The chete inoshanda mishonga Ipfungwa rinozivikanwa zvino somunhu splenectomy.

Tinovimba kuti vose mashoko munyaya ino panyaya kwaizova chaizvoizvo kubatsira iwe. Stay utano!