Waterhouse syndrome - Friderichsen: pathogenesis, mberede na-elekọta, ọgwụgwọ

The adrenal glands na ahụ bụ ihe dị mkpa endocrine ngwa. Homonụ na-emepụta site na ha emetụta afọ nke nsogbu na ego nke-ekesa ọmụmụ, larịị nke ịnweta salts na onye microelements na metabolic ọnụego, ọbụna na pituitary gland. Na na ọnọdụ ebe ndị ọrụ nke ndị a obere ma nnọọ mkpa gland na-ata ahụhụ, ịzụlite steeti, egwu ndụ na ahụ ike.

Definition na akụkọ ihe mere eme

Waterhouse syndrome - Friderichsen - nnukwu adrenal insufficiency, nke pụtara mgbe trauma ka aru nke a hemorrhage ya parenchyma. Nke a na-akpata oké imebi nke esịtidem na gburugburu ebe obibi nke ahu na ike iduga ọnwụ.

Description of ọnọdụ mbụ pụtara na 1894, ma, ọ bụ ezughi oke, na na 1911, Waterhouse achọpụta iri na ise mgbe, nke nyeere ya aka na-anakọta niile iberibe ọnụ. Ịnọgide na ya, afọ asaa mgbe e mesịrị, na 1918, Frederiksen nwekwara ebipụta ihe edemede banyere nke a enweghị nchịkwa usoro.

ihe

Ọkà mmụta sayensị na-ekweta na syndrome Waterhouse - Friderichsen mere oke hemorrhage n'otu oge ma adrenal glands. Nwere ize ndụ nkeji - a mụrụ nwa ọhụrụ, ụmụ ọhụrụ, na ụmụaka na-eto eto. The n'ala na nke a na-adịghị mkpa. Nke a na steeti nwere ike triggered site ruo ogologo oge nnyefe, nwa ebu n'afọ na oxygen agụụ ma ọ bụ ọganihu site na omumu kanaal iji forceps ma ọ bụ agụụ extractor. Ke adianade do, òkè dị mkpa maka oké congenital ọrịa, na ime sikwuoro nke mbubreyo gestosis.

Waterhouse syndrome - Friderichsen okenye esiwak hụrụ ka a sikwuoro nke ọrịa na-efe ọrịa. A, gị n'ụlọnga bụ a meningococcus, streptococcus ma ọ bụ Staphylococcus. Ma, e wezụga ihe ndị a, ndị na-akpata nke hemorrhage nwere ike ịbụ nosologies dị ka Measles, acha uhie uhie ahụ ọkụ, ịba ahụ ọkụ, diphtheria, nakwa ajọ neoplasms, etuto ahụ, peritonitis DIC na thrombosis adrenal veins.

Mmepe nke ọrịa

Ọtụtụ ndị nwere dịpụrụ adịpụ a syndrome dị ka akụkụ nke na-agbanwe usoro ọdịda na mmepe nke nnukwu sepsis. Ma, ọ bụ omume na-eto eto ụmụ na ụmụ nwaanyị dị ime kpamkpam dị iche iche usoro nke-amalite Waterhouse syndrome - Friderichsen. Pathogenesis gosipụtara ya na ọtụtụ hemorrhagic necrosis nke adrenal cortex. Ha bụ ndị ọtụtụ na aru dum tinye ke ọbara, e nwere hyperextension nke Capsule, na ọbụna ya agbawa.

Ma n'ozuzu pathogenesis, ọ na-egosipụta na ụdị sepsis:

- dilated capillaries na arterioles;
- akpọ igbu egbu syndrome;
- ọnụnọ nke concomitant meningitis ma ọ bụ meningoencephalitis;
- na-abawanye na mpaghara Lymph na thymus.

symptomatology

Waterhouse syndrome - Friderichsen na meningococcal ọrịa nwere ike ịzụlite na mberede na ndabere nke ọdịmma. Ọ na-enwe ọganihu ngwa ngwa na a na mmadụ nwere ike ịnwụ n'ime ụbọchị.

Ọ niile amalite na oké excitability, ogwe na isi ọwụwa. Ahụ, sonyere abdominal mgbu, ọgbụgbọ, vomiting na afọ ọsịsa. Ọ bụrụ na ihe mgbu bụ kwa ufiop, dọkịta nwere ike-enyo enyo na ọrịa na nnukwu ịwa ahụ daa ọrịa. Ná mmalite, ala-ọkwa fever, ma dị nnọọ awa ole na ole nke mmalite na ọ bụ 39-40 degrees. N'ihi vomiting na afọ ọsịsa si ahụ ahapụ mmiri na mineral, nke na-eduga-emeghasịkwa nke obi, ụbụrụ na ndị ọzọ dị oké mkpa akụkụ. Na njedebe, onye na-efunari nsụhọ na adaghị a amaghị onwe ya.

E nwere ihe ọzọ n'ụdị nke ọrịa, nke na-egosipụta onwe ya na a nkọ ọdịda ọbara mgbali ma ọ bụ ida. Mgbaàmà ndị ọzọ nwere ike ịbụ na niile. Man bụ nke mbụ na a stupor, ma dị ka hypoxia na-aga n'ihu ọsọ ọsọ na-abịa stupor na amaghị onwe ya. Nwụrụ enweghị nwetaghachiri.

Waterhouse syndrome - Friderichsen ụmụaka na-enwe ngwa ngwa karịa ndị okenye, n'agbanyeghị ihe na-akpata. Nyere ha compensatory ike nke organism ngwa ngwa depleted, na ọtụtụ usoro na akụkụ ndị ka na usoro nke na e guzobere na mmepe, na n'ihi na-abịa n'ụbọchị ndị mbụ nke mmalite nke ọrịa.

nchọpụta nsogbu

Waterhouse syndrome - Friderichsen emepe ngwa ngwa nke na dọkịta na-adịghị enwe oge na-eduzi a full nnyocha na-ahụ ihe na-eme mmadụ. Ọ bụrụ na ndị mberede ụlọ ọrụ dọkịta chee a daa ọrịa, ọgwụgwọ na-amalite ozugbo, nchoputa enyekwara na usoro, n'ihi na ihe ndekọ ahụ bụ na elekere.

Laboratory maka nkwenye nke nchoputa bụ mkpa iji chọta na n'ozuzu analysis of ọbara:

- leukocytosis na leftward mgbanwe nke usoro;
- ọnụ ke ọbara glucose;
- thrombocytopenia na ala clotting;
- Mbelata electrolytes;
- abawanye na ọbara urea nitrogen.

Otú ọ dị, ndị a na-egosi na-adịghị kpọmkwem na ike indicative nke a dịgasị iche iche nke ịwa ahụ na systemic ọrịa. Iji jide n'aka na, i kwesịrị ọma na-anakọta ọgwụ akụkọ ihe mere eme, na-ebu a lumbar mgbapu na ịkọwa neurologic ọnọdụ. Ma ihe niile a na-arụ ma stabilization nke ọnọdụ mmadụ.

esi nchoputa

Waterhouse syndrome - Friderichsen ike oké site ịwa abdominal ọnọdụ ndị dị otú ahụ dị ka nnukwu appendicitis, nnukwu pancreatitis, ọnyá afọ perforation nke afo ma ọ bụ duodenum. Jide n'aka na dọkịta ga-elele maka meningeal mgbaàmà, iji gbochie na-agba ọbara na ụbụrụ, cavernous imi thrombosis. Mgbe gbasara obi ECG ụdị ga-enyere gị aka ịghọta ma onye nwere a nkụchi obi ma ọ bụ.

ọgwụgwọ

Ke akpa itie mgbe nchoputa "syndrome Waterhouse - Friderichsen" kwesịrị chefuo onye ọrịa sweated mmiri mmiri electrolytes na enweghi nke adrenal homonụ. Iji a na ẹkenam site venous ohere ọkara a liter "hydrocortisone" ma ọ bụ 120 milligrams "prednisolone" na atọ grams nke glucose ise percent iri milliliters nke ise percent ngwọta nke ascorbic acid. Ya mere anyị na-eme bụ isi pathogenesis, na-eme Waterhouse syndrome - Friderichsen. Emergency elekọta n'otu oge mma ọbara rheology, dilutes ọ enwekwu ego nke usoro ọmụmụ na-enwekwu ndị nsogbu. A steroid hormone nnọchi na-enyere aka ịnọgide na-enwe nsogbu na nri larịị.

Mgbe stabilization nke homonụ-anọgide na-ndinọ intramuscularly, "Hydrocortisone" nke 50-75 mg ọ bụla awa isii, na deoxycorticosterone acetate na iri milliliters ugboro atọ n'ụbọchị. Jide n'aka na-na-eso egosi nke nsogbu na, ma ọ bụrụ na ọ dị mkpa, ka tunye "Epinephrine," "Mezaton" gbasara obi glycosides.

Ọ bụrụ na ihe na-akpata ọrịa aghọwo ihe ọrịa, dị ka meningococcal, na mgbakwunye na isi ọrịa, ọrịa e nyere ọgwụ nje. Ozugbo ndidi o kwesịrị, homonụ na-amalite nwayọọ nwayọọ belata dose. Ọ dị mkpa ka kwesịrị ekwesị kwadebe ahu maka ihe ọ ga-onwe-emepụta glucocorticoids. Ekwela inikiet inikiet kagbuo ọgwụ ọjọọ, ọ nwere ike ịkpalite a abụọ nsogbu.

Ọ dị mkpa iji gosi na onye ọrịa ahụ dị nnọọ Waterhouse syndrome - Friderichsen. The ọgwụgwọ onwe ya pụrụ ịdị ize ndụ dị ka ahụ oké idei mmiri akpata systemic edema, gụnyere ọrịa edema, na nnukwu doses nke homonụ nwere ike ịkpalite ọrịa uche. Ya mere, ọnọdụ nke ndị ọrịa dị ezigbo mkpa ka mgbe niile nyochaa ma kpatụ emek dị ka ya mkpa.

ele ihe anya

Waterhouse syndrome - Friderichsen - nnọọ oké daa ọrịa, na-ekpughe na ọ bụghị mgbe niile na oge n'ihi na nke dịgasị iche iche nke na-abụghị kpọmkwem ihe mgbaàmà. -Ekpebi bụghị naanị na otú ọma ga na-akpa àgwà dọkịta na ihe mberede ọnọdụ, ma na-na na ogo mbibi nke ndị na adrenal glands na compensatory ike nke organism. Agachi agwụcha ọrịa a na-egbu egbu.

mgbochi

Nke a bụ tumadi mgbochi ọrịa jikoro na ụsọ ọkụ nke ọrịa na nke onye ọrịa na-chọpụtara na meningococcal ọrịa. The dọkịta onye kpugheere ndị dị otú ahụ a-enwe ndidi na iwu ji ya gwa Sanitary nnyocha ma na-anọrọ onye ọrịa. Na ọzọ ụbọchị atọ, a ego nke na kọntaktị mmadụ n'ihi na ọnụnọ nke ọrịa na kwarantaini na-arụ ọrụ obodo ma ọ bụ izi alụmdi maka oge nke ụbọchị iri. Dị ka ihe nchebe, ndị mmadụ na-akpachi anya, ọrịa, nye iwu ka a obere N'ezie nke ọgwụ nje.

Epidemiology

Waterhouse syndrome - Friderichsen, dị mwute ikwu, ezi ọsọ daa ọrịa. Na mba ndị mepere emepe, ihe omume nke meningococcal ọrịa 1-3 ikpe kwa 100 000 bi. Na ihe karịrị ọkara nke ikpe - ụmụ ụlọ akwụkwọ ọta akara afọ. Ke adianade do, onye ọ bụla afọ iri hụrụ a ịrị elu na omume. Nke a bụ n'ihi na a mutation nke nje ahụ bi na adalata ọgụ.

Ndị a ọnụ ọgụgụ na-yikarịrị na-abụghị eziokwu, dị ka ọtụtụ mgbe na-aga undiagnosed n'ihi na mgbaàmà nke cross. Waterhouse syndrome - Friderichsen emepe ngwa ngwa nke na dọkịta enweghị oge na-ebu a zuru ezu ọnụ ọgụgụ nke ule.