'O ka wai - ka ma'i Frideriksen: ka pākiko, ka ho'omalu'ana i nā pilikia, ka lā'au

'O nā'ōle'a adrenal i loko o ke kino, he mea nui i ka lā'au endocrine. 'O nā hormones i ho'opuka'ia e lākou e pili ana i nā'ilikala kaomi a me ka nui o ka holo'ana o ka wai, ka nui o nā pa'akai kolake a me nā kumu o kēlā me kēia'ano, ke'ano o ka mīkini hana,'o ia ho'i ka hana a ka pituitary gland. A i nā manawa kahi e kaumaha ai ka hana a kēia mau li'ili'i li'ili'i a nui loa, nā kūlana e hō'eha'eha ai i ke ola a me ka ola kino.

Ka wehewehe a me ka mo'aukala

'O ka Waterhouse-Frideriksen Syndrome ka mea kūpono o ke ku'una ma'amau i hana'ia ma hope o ka ho'opili'ana i ke kino me ka hemorrhage i loko o kona parenchyma. 'O kēia ke kumu o ka uhaki nui loa'ana i ke kūpa'a o ke kino o loko o ke kino a hiki i ka make.

Ua'ike'ia ka wehewehe'ana o kēia'ano i ka manawa mua i ka makahiki 1894, akā,'a'ole i lawa, a ma ka makahiki 1911 ua'ike'ia e ka Waterhouse nā ma'i he'umikumamālima o ka ma'i, a ua kōkua iā ia e hō'ili'ili i nā'ike a pau. 'A'ole'o ia i ha'alele i hope ona,'ehiku mau makahiki ma hope mai, i ka makahiki 1918, kākau pū'o Frederiksen i kahi palapala kākau no kēia hana pilikino.

Nā kumu

Ua'ae nā kānaka'epekema'o ka ma'i Waterhouse-Frideriksen ka hopena o ka ma'i nui ma nā manawa'elua. 'O nā mea pili i ka hopena o nā keiki hou, nā keiki, nā keiki, a me nā'ōpio. 'A'ole pono ka hihia ma kēia hihia. Hiki ke ho'onāuki'ia kēia'ano ma ka hānau hānau lō'ihi, ka pōloli o oxygen o ka hānai a i'ole ka pi'i'ana ma o ke kahawai hānau e ho'ohana i nā pu'upu'u a i'ole ka extractor video. Eia kekahi, he nui ke'ano o nā ma'i ma muli o ka ma'i ma'amau, a me ka ho'opi'i'ana o ka'ōpū me ke kā'ili'ana o ke kino.

'O ka ma'i o Waterhouse - Frideriksen i loko o nā mākua ke hō'ike pinepine'ia e like me ka hō'ailona o kahi ma'i ma'i. 'O ka mea ma'amau, he maningococcus kono, he streptococcus, he staphylococcus paha. Eia na'e nā kumu o ka hemorrhage e hiki ke lilo i nā nosolo e like me ke kōmā, ka'ulama ulaula, ka ma'i typhoid, diphtheria, a me nā ma'i pūpū, nā pūpū, a me ka DIC-syndrome me ka thrombosis veinal verenal.

Ka ulu'ana o ka ma'i

He nui nā mea kākau e ho'omaopopo i kēia ma'i ma ke'ano he hana nui o ka hana ho'ololi i ka ho'omohala'ana i nā sepsis. Akā, hiki i nā keiki'ōpiopio a me nā wāhine hāpai ke'ano like'ole kahi e ulu ai ka ma'i o Waterhouse - Frideriksen. Hō'ike'ia kona pilikino i loko o nā necrosis hemorrhagic i loko o ka ulupala'ona. Nui nā mea o lākou i ho'onā'ia ke kino a pau me ke koko, ho'oku'u ka capsule, a me kona pu'upu'u ho'i.

No ka lapa'au ma'amau, ke hō'ike nei iā ia iho ma ke'ano o nā lepsis:

- ua ho'olālā'ia nā capillaries a me nā arterioles;
- ho'olaha ma'i hō'eha;
- ke hiki mai o ka maleingitis a me ka maleingoencephalitis;
- ka pi'i'ana o ka momona a me nā kōpana o ka hopena.

Nā Symptomatics

'O ka ma'i o Waterhouse - Frideriksen me ka ma'i maningococcal e hiki ke ho'ololi koke i ka hope o ka noho maika'i piha'ana. Hele koke'o ia e hiki i ke kanaka ke make i loko o ho'okahi lā.

Ho'omaka mua ia me ka nui o ka hiki'ole, ka huhū a me ke po'o. A laila, ka'eha i loko o ka'ōpū, keusea, ka lua'i'ana a me ka ma'i pēpē. Inā nui ka ikaika o ka ma'i'eha, hiki i ke kauka ke kānalua i ka mea ma'i o nā ma'i ma'i pilikino. I ka mua, ua emi ke ana wela, akā he mau hola wale nō mai ka ho'omaka'ana o ka ma'i, he 39-40 nākelē. Ma muli o ka lua'i a me ka pehe'ana, ha'alele ka wai a me nā'enela i ke kino, a i ka hopena o ka na'au, ka lolo a me nā mea ola'ē a'e. A i ka hopena, ua nalowale kekahi kanaka a hā'ule i loko o kahi mele.

Aia kekahi'ano o kēia ma'i, i hō'ike'ia i kahi hāmole māmā o ke koko a hā'ule paha. 'O nā kumu'ē a'e'a'ole loa. 'O ka mea mua i loko o ka pupule, akā, i ka holo'ana o ka hypoxia, hiki koke mai ka cox a me coma. Make me ka'ike hou'ole.

Ke ulu nei ka ma'i Waterhouse-Frideriksen i nā keiki ma mua o ka po'e mākua, me ka'ole o ke kumu. Ma muli o ka wikiwiki o ka ho'opau'ia'ana o nā mea e ho'opa'i'ia ai ke kino, a he nui nā'ōnaehana a me nā'ōpena i ke ka'ina hana a me ka ho'omohala'ana,'o ka hopena ma mua o ka lā ma hope o ka ho'omaka'ana o ka ma'i.

Nā diagnostics

Ke ulu koke nei ka ma'i o Waterhouse - Frideriksen no laila hiki'ole i nā kauka ke loa'a ka manawa e hana i ka noi'i piha a ho'omaopopo i ka mea e hana nei i ka mea. Inā ka pilikia lumi dute kauka hoʻomaka i kēia pathology, lapaʻau hoʻomaka koke, a me kaʻike, pili ana i loko o ke kaʻina hana, no ka mea, o ka mooolelo mea ma luna o ka huahelu.

'O ka papa hana no ka ho'opa'a'ana i ka hō'ailona ke loa'a i loko o ka ho'ā'o'ana i ke koko:

- leukocytosis a ho'ololi i ka huahana i ka hema;
- E ho'emi i ka glucose koko;
- Thrombocytopenia a me ka coagulation ha'aha'a;
- ka ho'ēmi o nā mea kohopili;
- Ho'onui i ka wai'opa a me ka'Ura.

Eia naʻe, i kēia mau nā hoailona mea i ho'ākāka 'ia, a hiki e hōʻike ana i ka laulā huahelu oʻoki lāʻau lapaʻau a me ka systemic maʻi. Ia eʻoiaʻiʻo, e pono e akahele ohi 'inikua mōʻaukala, a lawe mai i ka lumbar puncture, a, e wehewehe i ka neurologic kūlana. Akā, ua hana'ia kēia mau mea ma hope o ka ho'omaha'ana o ke kūlana o ke kanaka.

'Ike'ike'ole

'O ka Waterhouse-Frideriksen syndrome ka mea e'ike'ia mai nā ma'i palupalu ma'i like e like me ka appendicitis nui, ka pancreatitis nui, ka'ōpū o ka'ōpū a me ka ma'i ulupala ululā'au. E hōʻoia i ka kauka e kaha no meningeal symptoms, e pale aku kahe ana ke koko i loko o ka lolo, cavernous sinus thrombosis. Me ke'ano o ka ma'i ma'amau, e kōkua ka ECG i ka ho'omaopopo'ana i ke kani'ana o ka na'au a'a'ole'ole.

Hana

Ma ka mua wahi ma hope o kaʻike, "maʻi pale Waterhouse - Friderichsen" E compensate i ka hoʻomanawanui kaheʻana o ke kinowai electrolytes a me ka nele o adrenal hormones. No ka hana'ana i kēia, ma kahi o nā mea'ona hihiu e komo i ka hapalua o ka lita o "Hydrocortisone" ai'ole 120 milligrams o "Prednisolone", a laila'ekolu mau kīmomi o ka'elima'ākene glucose a me nā mililitua he'umi o ka haneli'elima o ka waika ascorbic. No laila, e hana mākou i nā pilina nui o ka pathogenesis, ke kumu o ka syndrome of Waterhouse - Frideriksen. Ho'oma'i kūpono nā pilikia ma kahi manawa e ho'oikaika i ka rheology o ka toto, ho'ololi'ia ia, ho'onui i ka nui o ke ola pūnaewele a ho'onui i ke kahe o ke koko. Hiki ke ho'ololi i nā hormones steroid e kōkua i ka ho'okau'ia ma ka pae makemake.

Ma hope o ka ho'oikaika'ana i ke kūlana, e ho'omau'ia ka hoholo'ia o ka hormones intramuscularly: "Hydrocortisone" 50-75 milligrams kēlā me kēlā me kēia hola'eono, a'o ka deoxycorticosterone acetate he'umi mililiters'ekolu manawa i ka lā. Mai poina e hahai i nā nā hoailona o ka puʻuwai, a, ina he pono, e Pin mai "Epinephrine," "Mezaton" cardiac glycosides.

Inā he kumu ma'i ke kumu o ka ma'i, e like paha, me ka maleingococcal, a laila, me ka ho'ohui'ana i ka papahana, ke lawelawe'ia nei nā lā'au'alopelo e ka mea ma'i. I ka manawa e ho'i ai ka ma'i o ka ma'i i ka mea ma'amau, hiki ke ho'oemi mālie i nā kolo o nā hormones. He mea nui i ka ho'omākaukau pono'ana i ke kino no ka pono e hana pono i nā glucocorticosteroids. 'A'ole hiki ke ho'onele koke i nā hana, hiki iā ia ke ho'onāukiuki i kahi pilikia nui.

He mea nui e hō'oia i ka ma'i o ka ma'i Waterhouse-Friderichsen. 'O kahi ma'amau wale nō e hiki ke pilikia, no ka nui o ka waipikipiki o ke kino e ho'opau ai i ka loloma, e like me ka edema cerebral, a me nā kumu nui o nā hormones hiki ke ho'onāukiuki i nā ma'i na'au. No laila, he mea nui e nānā mau i ka ma'i o ka mea ho'omanawanui a ho'ololi i nā koho e like me kona mau pono.

Ka wānana

'O ka Waterhouse-Frideriksen Syndrome ka mea ma'alahi loa,'a'ole hiki ke'ike'ia i ka manawa no ka nui o nā hō'ailona waha'ole. 'O ka hopena ma muli o ke'ano o ka hana a ke kauka ma kahi pilikia, akā, ma muli nō ho'i o ke kūlana o ka hō'eha'ana i nā'ōpū a me nā mea ho'opa'i o ke kino. 'O ka hopena pinepine o kēia ma'i pilikino he hopena hopena.

'O kahi palekana

'O ka mea ma'amau,'o kēia nā hō'ailona hō'ailona e pili ana i ka ma'i, kahi i'ike'ia ai ka mea ma'i i ka ma'i maningococc. 'O ke kauka nāna i ho'omaopopo i ka mea ma'i e koi'ia e ho'omaopopo i ka lawelawe o ka ma'i epidemiological a ho'oka'awale i ka mea ma'i. I nā lā'ekolu e hiki mai ana, ua nānā'ia nā mea hulina no ka hiki'ana o ka ma'i a ho'oku'u'ia ka haunaele i ka hui hana a i'ole kahi kula ho'ona'auao no kekahi mau lā he'umi. Ma ke'ano he hiki ke pale, hiki i nā po'e e pili kokoke ana me ka mea ma'i ke kauoha'ia i kahi papa hana pokole.

Ho'oponopono āpau

'O ka ma'i o Waterhouse - Frideriksen, he mea pōmaika'i, he ma'i ma'amau. I nā'āina i kūkulu'ia,'o ka pi'i'ana o ka ma'i maningococcia he 1-3 mau hihia no 100,000 o ka heluna kānaka. A'o ka hapalua o ka po'e ma'i, he mau keiki'ōpiopio. Eia kekahi, i kēlā me kēia makahiki he nui ka nui o ka pō'ino. 'O kēia ke kumu o ka ho'ololi'ana o ka ma'i ma'i a me ka emi'ana o ka ma'i āpau o ka lāhui.

'A'ole pololei kēia mau helupilihelu, no ka mea, nui nā hihia i koe i'ole e hō'ike i nā hō'ailona. Ke ho'omaka koke nei ka ma'i Waterhouse-Frideriksen i hiki'ole i nā kauka ke lawa ka manawa e hana ai i nā hō'oia he nui.