I-edema kaQuincke yinkinga enzima, lapho kukhona ukuvuvukala okuphawulekayo kwezingqimba zesikhumba namafutha angaphansi, ngezinye izikhathi kuhilela inqubo ye-pathological of the membranes. Lesi sifo sabizwa ngokuthi udokotela uG. Quinke, owaqala ukusichaza ngo-1882. Igama lesibili le-pathology li-angioedema.
I-Edema ka-Quincke - izimbangela
Njengama-hives, i-edema ka-Quincke ihlotshaniswa ne-vasodilation kanye nokwanda kwe-permeability yayo ephakathi kwegazi, kodwa kulokhu, ukukhukhumezeka akubonakali ngaphandle, kodwa ezindaweni ezijulile zesikhumba, izicubu ezinamaqabunga, ungqimba lwamafutha angaphansi. Ukuqoqwa kwezicubu ze-fluid interstitial fluid efakazela i-edema. Ukwandiswa kwe-Vascular kanye nokwanda kwimizimba yabo ngenxa yokukhishwa kwempahla ngenxa yokukhishwa kwezinto eziphilayo ezisebenzayo (bradykinin, histamine, njll), okwenzeka ngenxa yokuphendula kwamagciwane ngenxa yezinto ezithile.
I-angioedema ingase ihluke, futhi ivame ukucasulwa yizici ezilandelayo:
- isenzo sezifo;
- ukuphazamiseka komsebenzi wesistimu yokugaya ukudla;
- ukuphazamiseka kwesistimu ye-endocrine;
- ukuthatha imithi ethile (izakhi zokubeletha ngomlomo, ama-analgesics, ama-antibiotics, i-ACE inhibitors, imishanguzo, izinsimu);
- izifo ze-tumor;
- izifo zegazi;
- izilonda ezinamagciwane nezifo zomzimba;
- ukuphazamiseka kokuzalwa komzimba emzimbeni;
- umehluko emcindezini yomoya, izinga lokushisa emoyeni, njll.
I-edered Hereditary yaseQuincke
Enye yezinhlobonhlobo ezingavamile ze-pathology okucatshangelwayo i-angioedema yefa, ehambisana nesifo esihambisana nesistimu ehambisana nefa. Uhlelo lokuhlanganisa, oluhlanganisa ukuhlanganisa izakhiwo zamaphrotheni, luyingxenye ebalulekile yesimiso somzimba sokuzivikela, okubandakanyeka ekusebenziseni ukuvuvukala nokuvuza. Ukulawulwa kwalesi simiso kungenxa yezimo eziningi ze-enzyme, phakathi kwazo - inhibitor C1. Uma le-enzyme ingekho, ukulawulwa okungalawulwayo kuhambisana nokusebenza nokukhishwa okukhulu kwezinto ezibangela i-edema kwenzeka.
Izimpawu zokuqala ze-edema ye-Quinck's edematous zingabonakala ngisho nasebuntwaneni, kodwa ezimweni eziningi ziqala esikhathini sokukhulelwa noma eminyakeni yobudala. Ukuthuthukiswa kokuhlaselwa kuvame ukulandelwa ngenye yezenzakalo ezivusa amadlingozi:
- ukutheleleka;
- ukucindezeleka okukhulu ngokomzwelo;
- ukuhlinzwa okuhlinzekwayo;
- ukulimala;
- ukuthatha noma yimiphi imithi.
I-Edema ye-Allergic Quincke
Izifo zofuzo yisona sizathu esivame kakhulu se-angioedema. Ngaphezu kwalokho, ngokuvamile lesi sifo sihlangene nezinye izifo ezinokwemvelo - i-pollinosis, i-asthma ye-bronchial, i-urticaria, i- atopic dermatitis , njll. Uma indlela yokubukeka kwe-pathology ebuzwayo ingezwani, i-edema ka-Quincke iyisimo sempendulo. Njengoba izici ezicasulayo kungaba:
- imikhiqizo yokudla nezithasiselo kubo (izinhlanzi, izithelo ze-citrus, uju, amantongomane, ushokoledi, ama-flavour, amabalabala, ama-preservatives, njll);
- impova ;
- izimpaphe nezinyoni zezinyoni;
- izinwele zezilwane ;
- ubuthi kanye namathele ezinambuzane;
- uthuli lwamagumbi;
- izindlela zezimpahla zamakhemikhali zasendlini;
- imisebe yelanga;
- ukushisa okuphakeme noma okuphansi;
- imithi, njll.
Idiopathic Quincke's Edema
Kukhona i-angioedema ye-idiopathic, engakwazi ukuchazwa. Kulokhu, ukuhlaselwa kokungeneli okwanele kwenyama akukwazi ukuxhunyaniswa nanoma yiziphi izici ezandulele. Leli fomu lokukhubazeka, ochwepheshe abaningi bathi bayingozi kunazo zonke, ngoba, bengakwazi ukuthi yini evuselela ukuvuvukala, awukwazi ukuvimbela ukubonakala kwayo nokuqeda isimo-into.
I-Quincke's Edema - izimpawu
Izimpawu ze-Angioedema zibikwa, okuyinto kunzima ukungayinaki, kubandakanya ngoba bayakwazi ukulimaza kakhulu futhi banqande ukusebenza kwezinye izingxenye zomzimba. I-Edema endaweni ethintekile iyabonakala ngamehlo enqunu, isikhumba (noma i-membrane yamangcwaba) sibonakala siguqile, kuyilapho singasishintshi i-hue yayo (kamuva kuphela ingashintsha umhlophe).
Izindawo ezivamile zendawo yendawo:
- umuntu;
- isikhala somlomo;
- ulimi;
- i-larynx;
- i-trachea;
- intamo;
- izitho zangasese;
- izitho ezingenhla nezingezansi;
- izitho zangaphakathi (isisu, isisu, isambiso, ukukhuluma, njll).
Endaweni ethintekile, iziguli zithola ukuhlukunyezwa, ukuqina, ukukhathazeka okuncane, ukuvutha, ukulinganisa, okungajwayelekile - ukushaya. Izitho zangaphakathi ezithintekayo zingabangela ukusabela okunjengokuhlukunyezwa kwesisu, isisindo sokuhlanza, ukuhlanza, isifo sohudo, umchamo, ikhanda, njll. Ipheshana eliphefumulayo elibhekene nokuphefumula, ukukhwehlela, ukuphefumula kanzima, kungabangela ukuphefumula. I-edema ye-allergen yokugulisa ivame ukuhambisana nokubukeka kwemifino ebomvu. Ukunciphisa ukukhwabanisa kungase kube ukushisa okuncane nokubamba.
Kwenzeka kanjani ngokushesha ukuba i-edema yeQuincke?
Ezimweni eziningi, uma ukuphendula okweqile kuyingxenye yendlela yokuthuthukiswa, ukukhukhumeza kukaQuincke kubonakala ngokushesha, kuqala ngokuzumayo. Izimpawu ziqala phakathi kwemizuzu engu-5-30, futhi isinqumo kufanele silindele emva kwamahora amaningana noma izinsuku ezingu-2-3. Ngokwemvelo engeyona ingozi ye-pathology, ukukhukhuma ngokuvamile kuvame ngaphakathi kwamahora angu-2-3 futhi kuyanyamalala ngemuva kwezinsuku ezingu-2-3.
I-Angioedema ye-larynx
I-Angioedema yomphimbo ibeka ingozi enkulu emzimbeni futhi ingase ibangele nokufa kungazelelwe. Emaminithini ambalwa nje, izindiza zomoya zingavinjelwa ngokuphelele ngenxa yezicubu ezivuvukala. Izimpawu eziyingozi, okumele kube yisizathu esiphuthumayo sokubiza i-ambulensi, yilokhu:
- isikhumba esibomvu ebusweni;
- isondo esinamandla;
- ukudonsa okubukhali ekucindezeni kwegazi;
- ukuxuba.
I-Angioedema yobuso
Ebusweni, i-edema kaQuincke, isithombe sayo esibonisa uphawu oluphawulekayo, kuvame ukutholakala endaweni yamajwabu amehlo, izihlathi, impumulo, izindebe. Ngesikhathi esifanayo, ama-eye slits anganciphisa, amapulangwe angama-nasolabial angasetshenziswa, okukodwa noma kokubili izindebe zingakhula ngokukhulu. I-Edema ingathuthela ngokushesha entanyeni, ithinte izinyathelo zomoya futhi ivimbele ukungena emoyeni. Ngakho-ke, ukuvuvukala kweQuincke ebusweni kufanele kumiswe ngokushesha ngangokunokwenzeka.
I-Angioedema yamaphethelo
Izimpawu ze-edema kaQuincke, ezitholakala ezandleni nasezinyaweni, zivame ukubonwa ngemuva kwezinyawo nezintende zezandla. Lolu hlobo lokuphendula aluvamile kakhulu kunalokhu luchazwe ngenhla futhi alusongo oluthile ekusebenzeni komzimba, nakuba kubangela ukungakhululeki okukhulu. Ngaphezu kokubukeka kwezindawo ezinqunyelwe ukuhlanganiswa emlenzeni, isikhumba singase sibe no-bluish tint.
Yini okufanele uyenze ngokukhukhumeza kukaQuincke?
Iziguli eziye zathola isiqephu sokuvuvukala okungazelelwe komzimba noma ingxenye ethile yomzimba okungenani kanye empilweni yazo kufanele zikwazi ukususa ukuvuvukala kweQuincke, ngoba ukukhubazeka kungavela futhi ngokuzumayo. Okokuqala, kufanele ubize i-ambulensi, ikakhulukazi uma kukhona ukuvuvukala emoyeni noma kukhona ukusola kokutholakala kwamathambo ezitho zangaphakathi. Ngaphambi kokufika kwabasebenzi bezempilo, izinyathelo zokusiza kuqala kumele zithathwe.
U-Edema Quincke - Usizo Lokuqala
Ukunakekelwa okuphuthumayo kokuvuvukala kukaQuinck, okungatholakala ngaphambi kokuba i-ambulensi ifike, kufaka izigaba ezilandelayo:
- Ukuhlukaniswa kwesisulu esenzweni sesisusa (uma sifakiwe).
- Ukunikeza ukufinyelela mahhala ukuhlanza umoya.
- Ukukhululwa kwesiguli ngokuchoboza izingubo nezesekeli.
- Ukuhlelwa kwesiguli endaweni ehleliwe noma ehlezi ukuze kube lula ukuphefumula.
- Ukugcina indawo ezolile, ukuvimbela ukwesaba.
- Ukumiswa kokucindezeleka okubandayo kwisayithi le-lesion.
- Nikeza ukuphuza okuningi (okungcono u-alkaline).
- Imithi: amaconsi e-vasoconstrictive ekhaleni (Naphthyzin, Otryvin), ama-antihistamines (i-Fenistil, i-Suprastin) kanye ne-sorbents (i-Enterosgel, i-Atoxil) ngaphakathi.
Izinyathelo ezingenhla, ezihlinzeka ngosizo lokuvuvukala kweQuincke, ziyadingeka, okokuqala, uma zibonwa:
- ukuvuvukala kwempumu;
- ukuvuvukala kwezindebe;
- ukuvuvukala kwe-mucosa yomlomo;
- ukuvuvukala komphimbo, i-larynx;
- ukuvuvukala entanyeni;
- i-edema yezitho zangaphakathi.
Indlela yokuphatha angioedema?
Imithi ephuthumayo yokuqeda i-edema enzima futhi ubuyisele imisebenzi ebalulekile ingafaka ukusetshenziswa kwezidakamizwa:
- I-Adrenaline - ngokuncipha kwegazi;
- I-Prednisolone, i- Dexamethasone - esimweni se-edema ka-Quinck, ukubonakaliswa okuyinhloko kususiwe;
- I-glucose, i-Haemodez, i-Reopoliglyukin - ukuqeda ukushaqeka nokukhishwa kwe-toxin;
- I-Dimedrol, i-Suprastin injection - ne-reaction ofergic;
- I-Furosemide, i-Mannitol - ekucindezelekeni okuvamile nokuphakanyiswa ukukhipha uketshezi okweqile kanye nezifo;
- Eufillin ngeDexamethasone - ukususwa kwe-spasm ye-bronchial, njll.
I-edema ye-edemia yokwelapha i-Quincke ihlukile, ngezinye izikhathi eyenziwa nge-transfusion ye-plasma yegazi kanye nokusetshenziswa kwezidakamizwa:
- I-Z-aminocaproic acid;
- I-Counter.
Ngaphandle kwesigaba esibucayi, ukwelashwa kungafaka:
- ukukhishwa kwe-irritants esungulwe;
- Izifundo ezimfushane zokwelashwa kwe-hormonal (Prednisolone, Dexazone);
- ukusetshenziswa kwezidakamizwa ukuqinisa isimiso sezinzwa nokunciphisa ukutholakala kwemisipha (Ascorutin, calcium, vitamin complexes);
- ukuthatha ama-antihistamines (i-Loratadine, i-Suprastin, i-Cetirizine).
I-Quincke's Edema - imiphumela
Iziguli ezitholwa ukuthi zine-angioedema ephindaphindiwe enenkambo engapheli kufanele zihlale zilungele ukugwema izinkinga futhi zithwale izidakamizwa ezidingekayo zokuvimba ukuhlaselwa. Uma kukhona ukuvuvukala kweQuincke, izimpawu kanye nokwelashwa okungakunaki noma ukwelashwa okwanele kwenziwa, lokhu kusongela imiphumela yezempilo nempilo. Phakathi kwabo:
- ukuphazamiseka kwe-anaphylactic;
- i-asphyxia;
- izinkinga zezinzwa;
- i-cystitis enzima;
- ukuvimbela emathunjini;
- i-peritonitis.