Felty ta ciwo: Bayyanar cututtuka, ganewar asali

Karkashin Felty ta ciwo tana nufin wani wahala na rheumatoid amosanin gabbai, wanda ya auku a kawai 1% na dukan marasa lafiya da cuta. Fever, tsoka atrophy, pigmentation da laulayi dauke da kwayar cutar cututtuka yanayi - duk wadannan dalilai yawanci bi Felty ta ciwo. Pathology ganewar asali dogara ne a kan wani tarihi na rheumatoid amosanin gabbai, da muhimmanci ne da dakin gwaje-gwaje sigogi. Jiyya ya shafi ci daga corticosteroids, splenectomy. Na dogon lokaci a Pathology halin da bai tabbata yanayi da kuma na asibiti hoto. A shekara ta 1929, AP Felty bayyana rashin lafiya. Tun bayan cutar da aka bambanta matsayin mai zaman kanta nosology.

Felty ciwo: abin da yake da shi?

Cutar da ake tsare ta gaban uku lokaci daya pathologies: da rheumatoid amosanin gabbai, kara girman baƙin ciki , kuma leucopenia (low farin jini Kwayoyin). Wannan ciwo ana bincikar lafiya a mutane girmi shekaru 40, yawanci a cikin adalci jima'i.

Masana sun bayar da shawarar cewa dalilin da cuta ne wani autoimmune tsari. Yana fitowa tare da kai tsaye hannu na lymphoid tsokoki da kuma m samuwar rigakafi gidaje, kazalika da takamaiman antibodies. Pathology bayyana a matsayin neutropenia tare da wani m raguwa a jure mafi cututtuka, da kuma lokacin da suka auku - mai tsanani. To, a yau ne wani splenectomy (kau na baƙin ciki) an gane kawai tasiri Hanyar magani.

Felty ta ciwo ne halin da] imbin bambancin, sau da yawa atypical. Rashin lafiya na iya riga shekaru da dama (5 zuwa game da 10) cututtuka da ake kira rheumatoid polyarthritis da lokaci daya da hannu a pathological aiwatar interphalangeal gidajen abinci, da sãɓãwar launukansa digiri na tsanani.

A daya hannun, masu rinjaye da marasa lafiya tare da wannan ganewar asali ne m da hankula manifestations connective nama. Wannan na iya zama wani zazzabi, da samuwar subcutaneous nodules, myocarditis, asarar nauyi, poliserozita.

Babban dalilai

A etiology da cuta ne ba a sani ba. Ba dukan marasa lafiya da ganewar asali "rheumatoid amosanin gabbai" yana bunkasa wannan Pathology. A cikin bargo na da lafiya mutum ke ci gaba da samar da farin jini Kwayoyin. Marasa lafiya tare da wannan ciwo, duk da mun gwada low wurare dabam dabam, leukocytes ma kafa. Suna iya tara a matsanancin yawa a cikin baƙin ciki.

Abin da ãyõyi tare Felty ta ciwo a manya?

• Articular ciwo (amosanin gabbai da kananan gidajen abinci).
• Kara girman da hanta.
• Jimlace lymphadenopathy (kamu a 50% na lokuta).
• The m karuwa a baƙin ciki size (as ƙaddara da palpation).
• Polyneuropathy.
• Pigmentation a kan fata, miyakunsa a shins.
• Yaxuwa na huhu fibrosis.
• Rheumatoid nodules.

All sama siffofin sa shi yiwuwa a gane asali Felty ta ciwo. A bayyanar cututtuka na duk marasa lafiya suna nuna daban. Alal misali, wani lokacin kara girma daga cikin baƙin ciki an kiyaye kawai a baya, saukarwa na cuta ci gaba.

ganewar asali

Dalili na karshe tabbaci na asibiti ganewar asali na lokaci daya hade da splenomegaly da rheumatoid amosanin gabbai. Jini gwaji ne halin da anemia, leukopenia, neutropenia. A immunoassay yawanci tana gano RF high titers, da CEC, gaban antinuclear antibodies. Bisa ga sakamakon myelogram myeloid bargo hyperplasia an kamu da wani motsi zuwa ga m salula abubuwa. Instrumental hanyoyin gudanar da bincike (MRI, CT, duban dan tayi na gidajen abinci) ne mafi kusantar su samar da kadan bayanai. Felty ta ciwo ne mai muhimmanci sosai a bambance da cirrhosis da sarcoidosis.

Ka'idodi na magani

Far, a cikin wannan yanayin ya shafi wani m m. Rheumatoid amosanin gabbai da aka bi a matsayin misali. Far maimaituwa cututtuka, da amosanin gabbai ciki har da kwayoyi da cewa taimaka rheumatism ( "Azathioprine", "MTX").

Marasa lafiya da tsanani cututtuka shi ne shawarar yin mako-mako injections na factor, wanda stimulates granulocyte mallaka. Yana qara yawan farin jini Kwayoyin.

Basic kwayoyi iya rage symptomatology wanda bi amosanin gabbai, Felty ciwo kai tsaye. Wadannan sun hada da hada da: "Methotrexate", "Penicillamine".

Glucocorticoids ne tasiri ne kawai a high dosages. In ba haka ba, shi ne kara da alama na sake komowa. A daya hannun, da shafe tsawon amfani da glucocorticoids iya kai ga ci gaban da intercurrent cututtuka.

A sharudda ga tasiri na far:

• Kara yawan granulocytes zuwa 2000 / mm.
• Rage a cikin abin da ya faru na dauke da kwayar cutar da rikitarwa yanayi.
• Akan rage zazzabi kai hare-hare.
• Akan rage ulcers a kan fata manifestations.

Lokacin da tiyata bada shawarar?

Ta yaya kuma za ka shawo kan Felty ta ciwo? Jiyya da aikin tiyata da aka bada shawarar idan miyagun ƙwayoyi far ya m ko saboda wani dalili, shi ne contraindicated. A wannan yanayin, shi ne yawanci wata tambaya na splenectomy. Yana da muhimmanci a tuna cewa a 25% na lokuta da neutropenia Ɗ bayan wannan hanya.

Karkashin splenectomy nufin tiyata, a lokacin da likita ne gaba daya, ko kuma partially kawar da baƙin ciki. Yau, akwai yiwuwa guda biyu na irin wannan hanya: laparoscopic da kuma bude splenectomy.

Laparoscopy aka yi amfani da janar maganin sa barci. A wannan yanayin, da aiki ya shafi aikace-aikace na bakin ciki kayan aiki da kamara a kan karshen, wanda aka kira a laparoscope. Likita sa da dama kananan incisions a ciki ta hanyar abin da ya gabatar da kayayyakin aiki, don m jan. A dawo da lokaci, kamar yadda mai mulkin, ba ya bukatar lokaci mai yawa.

Open splenectomy ya shafi wani babban incision kasa da karankarman ƙirji, ta hanyar abin da Likita kawar da baƙin ciki. Bayan kau na jiki jiki ta ikon tace fitar da kwayoyin cuta da ƙwayoyin cuta daga jini ne markedly rage.

zai yiwu rikitarwa

Matsalolin ne musamman rare cutar da kuma iya bayyana kanta a cikin nau'i na wani ruptured baƙin ciki, da ci gaban da ake kira portal hauhawar jini, gastrointestinal zub da jini sosai faruwa sakandare cututtuka.

ƙarshe

Felty ta ciwo - a gwada rare cuta, sai dai mai wahala da cikkaken kungiyar na pathologies wanda a yau ake bincikar lafiya da wuya. Wannan ba ya nufin cewa ba za mu iya yin sakaci da magani da kuma ba a neman kwararrun taimako ga dace likita. Primary cututtuka kamata faɗakar da kowa da kowa da kuma zama wani dalili ga neman shawara daga wani gwani. In ba haka ba, shi ne kara da alama na tabarbarewar da janar jihar da kuma ci gaban da isasshe m ga kiwon lafiya rikitarwa, da suka hada da katsewa na baƙin ciki da kanta. The kawai tasiri magani zaɓi ne yanzu gane a matsayin splenectomy.

Muna fatan cewa duk bayar bayanai a wannan labarin, a kan topic zai zama gaske amfani a gare ku. Zauna lafiya!