Liphetoho Anaphylactoid: matšoao a, phumano le tlhophiso

The ketsahalo ea alejiki (anaphylactic) liphetoho bakoang ke mahlahana exogenous, le phallo bath ea eona ea hang-hang mofuta hypersensitivity. E le busa, tšoauoa ka e le karabelo ea 'mele e ka ba behang bophelo kotsing ya kalafi boemo ba letlalo la, ho hema le mesebetsi cardio-vascular. Holim 'a pepesehela pele ba ho fana ka tlhahiso antigen qala IgE lisireletsi itseng tsa morero oa eona a ne a rerile. Ba kopane le lisele le boikarabelo ba ho e hlophisitsweng, maloetseng, 'me ho na le sensitization ho antigen ena.

Joang ho itšoara joang alejiki?

thutsoe mong o kgothaletsa ho lokolloa ha allergen nang le boikarabelo bakeng sa lisele tse sa 'mele matla a ya dintho bioactive, haholo-holo histamine. Ka nako ya phetoho ea ho tloha e hlophisitsweng, lik'hemik'hale ho pathological physiology liphetoho e seng ea tlhaho li bonahatsa haholo-holo ka methapo ea mali, lisele tsa mmele nodes, bronchial boreleli mesifa hore e thusa ho ntshetsa pele le ponahalo ea pele ea syndromes ana:

• phokotso ea molumo vascular;
• tšohanyetso khutsufatso ea mesifa boreleli dinama tse nyenyane tse ea intestine, bronchi, popelo;
• ditlolo krovosvortyvaemosti;
• ho ruruha le ho ruruha ea methapo ea mali.

Ka lehlakoreng le leng ho alejiki, anaphylactoid itšoara joang, eo hangata ho thoeng pseudo-ea bongaka, ho na IgE-go ranolelwang kwa antibody le basophils. Ho sa tsotellehe ho tšoana matšoao Karabo thulaganyong, ka bobeli ba liponahatso tsa karabelo generalized ho hypersensitivity ea 'mele ea.

allergy lithethefatsi baka liphetoho anaphylactoid

liphetoho Anaphylactoid - ke e boetse e le ho lokolloa ha histamine, hangata se a ntse a ka ka ikopanya le pele le halefisang e. Pseudoallergic jwale emela e mengata e fapaneng ka toka ka bophara. Ho makatsang, sena itsoara joang ka ea 'mele, hangata ho le joalo ka nako ya ho nka lithethefatsi, lopollang kulisoa.

Anaphylactic le anaphylactoid liphetoho mofuta hang-hang etsahala hangata ha ho ka mora ho qaloa ho relaxants mesifa, lithibela-mafu, thethefatsa meriana, opioids, ea moo thethefatsang meriana, ente, phekolo hormone, atropine le divithamini B ho allergens hape e kenyeletsa serum, antigens sebelisitsoe ka merero ea bongaka le tekotshupo ho lemoha ea letlalo, mafu venereal. The maemo a ho allergy ho Latex lihlahisoa. A ketsahalo neng li tloaelehile ho nkoa anaphylactoid itsoara joang ho lidocaine ka ea moo lithethefatsi thethefatsa sebelisoa hangata, empa lik'hemik'hale tse rarahaneng tsa lona ho hlophisoa ka etsa hore liphello tse esita le ka phelang bophelo bo botle, eo allergy ho dikarolo lithethefatsi ha tloaelehileng.

Nemedikametoznye susumetsa ba bang

Ha u nahana ka mabokosana likarabo tsa 'mele ho susumetsa ba bang lintho tsa tlhaho batho bao e seng diokobatsi, ho na le hangata "bothata" e ka ba le lijo:

• fragole;
• morue;
• mahe a linotši;
• linate;
• li-mushroom;
• Ba bang mefuta e sa tsoaneng ea litlhapi;
• mahe;
• dilamunu.

liphetoho Anaphylactoid ka 'na ho etsahala'ng ha le likokoanyana loma kapa chefo invertebrate liphoofolo. Bakuli ba nako le nako nang kulisa mofuta bao e seng folisa, ba kotsing e khōlō ea anaphylaxis tabeng ea ho buuoa tlas'a thethebatso kakaretso.

tlhophiso ea anaphylaxis

Kahoo e se etsahala le tlhophiso ea kulisa. Unit pele e akarelletsa tse fapa-fapaneng a itšoare anaphylactic tse arotswe mojaro go ranolelwang kwa IgE, IgG go ranolelwang kwa le IgE-go ranolelwang kwa le 'meleng. Pseudoallergy liphetoho anaphylactoid go ranolelwang kwa ke e bonolo lokolloa ha mediators, lateloa ke pitso e bakoa ke ketso ea lithethefatsi, ho pepesehela lijo le lintho tsa nama. A sehlopha arohaneng protrude liphetoho anaphylactoid le mastocytosis; go ranolelwang kwa mehahong boitshireletso, immunoglobulin aggregates ha tsamaisoa antisera le antibody go ranolelwang kwa cytotoxic, radiopaque dintho.

Joang anaphylaxis?

Morphine le barbiturates tse ngata, relaxants mesifa, pethidine e ka ama lisele mafura, a etsa hore ho lokolloa ha histamine. Kahoo setshwantsho ea tleleniki itšetlehile ka litekanyetso li behoa 'me tekanyo ea fihla' meleng oa metsoako mafolofolo. Itloaetseng ho bontša hore ba itšoara joang nka sebaka bogolosegolo nang kotsi, feela lipontšo feela ho letlalo.

liphetoho Anaphylactoid (ICD-10 fuoa lefu lena pathological) e tšoauoa ka sa unpredictability ea ho hōla nakong e tlang 'me mohlomong le ho hloka ka ho feletseng tlhahisoleseding e mabapi le ka karabelo fetileng alejiki khahlanong antigens. Ho tloha ka liphello tsa anaphylaxis Crane kotsi ho bophelo bo botle le bophelo, ke habohlokoa hore ba bonoa pele tsa mathata 'me u nke bohato e loketseng. Ho sa tsotellehe hore ka mochine kapa anaphylactic matšoao a pseudoallergic hlasimollang ka fapana haholo. Apere ka tlhaho feela motho, liponahatso e ka Range ho tloha ho qhoma hanyenyane ka khatello ea mali le letlalo lekhopho ho bronchospasm haholo le ho putlama ha ea ka tšebetso ea tsamaiso ea pelo le methapo.

Mothating ona, ho bonolo ho ela hloko e mong le phapang psevdoallergenov bohato ka 'mele. Ho sa le joalo, liphetoho anaphylactoid, matšoao a e ka lemoha batho ka bomong kapa ho etsa lintho tse fapa-fapaneng tlhakantsuke, ha ho ka tlaase ho moo kotsi.

Symptomatology anaphylactoid karabelong

Lipontšo tsa e alejiki itsoara joang ka mamello ho nkoa ka mmuso Together:

• ho tsekela;
• palo yohle 'mele bofokoli;
• mafu a pelo ea morethetho (tachycardia, fibrillation);
• theola khatello ea mali;
• bokhutšoanyane phefumoloho, litlhaselo le asma e, 'me broncho-laryngospasm, edema methapo le qoqotho;
• letlalo tukang, ho hlohlona lekhopho, hives, redness integuments, angioedema ;
• mala cramps, ho nyekoa ke pelo, letšollo, ho hlatsa;
• sieo ha pulse length ka;
• pelo le methapo putlama;
• deceleration le emisitsoeng ba pelo.

mathata Probable mor'a liphetoho anaphylactoid

Tšokelo e khōlō ka boeona e beha ea tšosa, ho kopantswe le bronchospasm. Ka mor'a nako e itseng (ho tloha ka metsotsoana e 30 ho ea ho ea hora, ka linako tse ling 2-3 lihora tse) antigen ho kena 'meleng o kgothaletsa alejiki dithulaganyo pathological' meleng. Haholo-holo bakeng sa itšoara joang itšetlehile ka sebopeho sa susumetsang ho kenella ka hare (ka molomo kapa parenterally). ntshetsopeleng potlako hangata sesosa sa lefu, a etsa hore ka tšohanyetso a hlobaetsang le ho hema insufficiency, mahlonoko tseo ho leng perfusion khatello ea lerotholi, e leng le hlaha ka lebaka la ho hlōleha ha ka tšohanyetso ha ho potoloha ha mali, bokong hemorrhage kapa edema, phytoteratology mosebetsi wa bakoang, thrombosis ea bohlokoa.

Ka letsatsi la bobeli ka mor'a a utloa bohloko a le kotsi tšosa bophelo le ho hlaphoheloa ke pataganeng lefu letotong bakoang ke e alejiki itšoara joang khahlanong le morao. Esita le ka mor'a libeke tse 'maloa, monyetla oa hore mathata a ntse a le phahameng. Hangata, ka mor'a anaphylaxis , lingaka hlahloba mafu a joalo le ho se sebetse:

• serame sa matšoafo;
• vasculitis;
• renal le e amanang le sebete ho hloleha, lefu la sebete, glomerulonephritis;
• epidermal necrolysis;
• myocarditis;
• ramatiki.

litla tšoanang ka sokela bobeli anaphylactic le liphetoho anaphylactoid. Ho fapana le makala anaphylactic pathologies tsena ke hore bobeli hloka sensitization pele le e sa khone ho hlahisa ka sebokeng sa pele le ntho-allergen.

anaphylaxis kalafo

Tokelo ya ho etsa kalafo tshohanyetso Melao ea ho ea ka tepelletse maikutlong ke histori feela, kahoo, ho ke ea bohlokoa ho bokella eona. Allergy symptomatology, ke hore,. E. Setšoantšo tlelenike, hape phetha karolo ea bohlokoa ka ho etsa qeto e potlakang. Leha ho le joalo, ka ho fetisisa e ka tšeptjoang le e feletseng karabo ho botsa potso ka tepelletse maikutlong le ka feela fumanehe ka mor'a ho etsa lipatlisiso allergy le ea matla a laboratoring. Ka nako e tšoanang, ka lebaka la puso mahlonoko tseo ho leng ea mamello, haholo-holo ka thuso ea hae tsa bongaka hang-hang lokela ho fana ka eona, joaloka tabeng ea ho tšoaroa cardiac kapa matšoafo a tšoaroa - revives ketso.

Ka ho ba sethaleng sa kamohelo ya lisosa tse ka sehloohong tsa ka karabelo alejiki, mosebetsi ea 'mele ea ho phetha ka botlalo ka tekanyo ya kalafi differential tepelletse maikutlong. mofuta ona wa phuputso e entsoeng e reretsoe ho qhelela ka thōko tšusumetso khoneha mabaka se amanang le histamine ho lokolloa.

Joalo ba ikutloa ka tsela ea phelang ho bakang a mang bao e seng alejiki

Hangata ka ho fetisisa, anaphylactic le anaphylactoid liphetoho (ho ke ke hore na le lefu le kotsi le ho feta, ke habohlokoa ho tseba batho ba le tšekamelo ea ho esita le innocuous fetisisa ka chebo ea mahlo, kulisa ka mokgwa wa rhinitis) na ho tšoana le lintho tse ling, 'nang a khona ho etsa hore bronchospasm, hypotension:

• overdose ea thethefatsang;
• thrombosis ka lebaka la moea entrapment kapa atherosclerosis;
• boima aspiration la tse ka hare gastric lefu;
• myocardial infarction, pericardial tamponade;
• maswe makala;
• edema methapo le matšoao a tse ling tse se amanang le kulisoa.

tlhokomelo ea Emergency ha ka potlako ho ntshetsa pele e le anaphylactic kapa anaphylactoid itsoara joang ka hoo e batlang e ha e fapana ho ea ka e rarahaneng tsa liketso tsa ikemiseditse ho felisoa le kalafo ea makala anaphylactic.

Tsamaiso ya bohato e potlakileng

Le letotong la kulisoa mangolo tsa lingaka le ho fana ka tlhokomelo ea nakong e tlang e haufi ka ho fetisisa ke senotlolo sa ho kalafo atlehileng. Lintlha-khōlō Tsa imolohile anaphylaxis ea mofuta hang-hang ke e tlamang feta ha mekhahlelo 'maloa:

1. Selelekela unconfirmed empa kotsi antigen lokela ho khaotsa.
2. Anaphylactic kapa anaphylactoid liphetoho (photo photo photo photo ka eena sehloohong se bontša matšoao a tloaelehileng haholo le matšoao a lefu), e develops nakong thethebatso kapa nakong ea sebetsa, e hloka ho fanyeha hang-hang. Ho lokela ho etsoa cheke boleng ka hantle tsa selelekela tsa allergens. Le ho qhoma bohale khatello ea mali ho fihlela kena hanong phepelo ea thethefatsa. Tabeng ea bronchospasm tšebeliso e tlamang ea thethefatsang hema.
3. Ventilation le airway tlameha ho etsa bonnete ba esita le e jele moo, ha ba le mamello e sa haholo bo ntse bo mpefala. The intubation matšoafo hloka kamehla, ho fihlela ka nako eo, ho fihlela ho hlakile ka ho feletseng hore airway fanoe ke 'mele oa ka boeona.
4. liphetoho Anaphylactoid, eo kalafo hloka tsamaiso intravenous adrenaline, beha kotsing ho mokuli, esita le lihora tse 'maloa ka mor'a hore ho tlosa bronchospasm. Litekanyetso li behoa holim 'a tsamaiso khafetsa epinephrine ka e ile ea eketseha hobane ntho e nang le tšusumetso e ntle ho tsitsisoa ea lisele palo, fokotseha vascular e lumellang metsi ho kena ya endothelium, eo ke ntho ea bohlokoa ka ho phekola anaphylaxis.
5. Ka hore ho hlokahala a hlobaetsang le ho resuscitation e boetse ke bohlokoa ho eketsa molumo oa mokelikeli e potoloha 'meleng. Bakeng sa morero ona, lingaka beha kgolo bophara catheter entoe (Vienna sebediswa e ka hase kamehla ho ba setsi - ka nako ya ho batla tsa lona ka ho bapala khahlanong le boemo ba mokuli) 'me le tšollele ka a etsang dilitara tse seng kae tsa crystalloid.
6. Ha ho ke ke ha khoneha ho lemoha allergens, e hlahile ka lebaka la itšoara joang anaphylactoid, lokela ho ela hloko ho sebelisa nakong dintho le mamello ho ikopanya le sika latex. Ho buoa litlelafo, lithethefatsi, thaothoa ka vials sika cap,, catheters mosese - tsohle ena ka mo lakalisa anaphylaxis.

Ka mor'a kalafo ya tshohanyetso a itšoare anaphylactoid (hammoho le anaphylactic) hloka tsela e telele ea phekolo e le hore ho thibela boipheto maloetse. The ho hlokomolohuoa sa litaelo tsa lingaka ho eketsa kotsi ea ho atolosa fapaneng ya allergens hlahelang.

Latela-up kalafo

Har'a phekolo lithethefatsi lenaneo bronchospasm bohlokwa ke ea lithethefatsi "Salbutomol" ka nkela sebaka, "aminophylline". Haeba ho khoneha, e hotel eketsehileng ho inhalation sebelisa isoproterenol kapa ortsiprenalina. Kaha liphetoho anaphylactoid - ke ponahatso ea tleleniki ea systemic, eo ho eona le matšoao a ka 'na ba e rarahaneng, e ke ho hlokahala hore ho sebelisa glucocorticoids (mohlala, "Dexamethasone" "hydrocortisone") constraining thulaganyou e pelo e putlame.

Ka tloaelo ho cupping anaphylactic makala tsamaea le morago ga moo e lingaka tsoelang pele falimehile. 'nete ea hore tsoelo-pele ea ho se sebetse morao ka kamehla ba le sebaka, kahoo le lengolo la e' ngoe ea ho tiea tsa bookelong mamello ke tharollo e hlakileng. E tlamang 'me lingaka lumela ho tla ha a go dira patlisiso letlalo ka bonoa ba lisireletsi itseng.

Prophylaxis tsa anaphylactic le anaphylactoid karabelong

lefapha la bongaka le histori ka ho phethahetseng - molemo ka ho fetisisa tekanyo e itseng ho thibela le ho thibela botjha anaphylaxis. Ka mor'a ho bokella boitsebiso bohle hlokahala ka tsela ea lefu lena, ka ho tsejoa bakuli kotsing le ho fumana hore na seo a tla tobana le liphetoho botjha anaphylactoid. E bolela eng?

Kaha e mong le e tlhaselo morago ga moo e ka nka sebaka bakuli haholo boima hloka hloko kgetho ya lithethefatsi le thethebatso, 'me nakong tlhokomelo e matla. Pele ho tšelo ea mali bakeng sa batho ba le tšekamelo ea ho anaphylaxis, etsa tlhahlobo ho hlahloba ka ho sebeletsana le lihlahisoa tse itseng mali.

Allergy ho lihlahisoa sika predetermines bokamoso boitšoaro manipulations tse fapa-fapaneng ntle le ho sebelisa chelete e joalo.