'O nā nodules o Osler? Nā kumu o ka nānā'ana, ka pathogenesis, ka ma'i

'O ka Endocarditis ka wela o ka endocardium, ka pūpū o loko o ko kākou na'au. Hiki ke ho'onā'ia i nā ma'i ma'i i loko o nā'ano a me nā'ōnaehana o ke kino o ke kanaka, ka trauma, ka hypercoagulation a me nā kumu pilikino'ē a'e. No laila,'o endocarditis wale nō ka hō'ailona, ma ke alo o kahi kiko o Rota,'o nā nodules o Osler a me nā hala ma'amau'ē a'e ma ke kino'a'ole i'ike'ia. Hoʻomanawanui iki mai paha i haha aku i ka discomfort, a kākaʻikahi hoʻopiʻi e pili ana i ka ohumu naʻau, kuni. A inā wale nō i ka hopena o ka endocardium i hana ai nā microorganisms e ho'opili'ia ana i loko o ke koko, lilo ia i ma'i kū'oko'a a kapa'ia'o endocarditis,'ele'ele, bacteria, a me septic. 'O nā nodules o Osler kekahi o kona mau hi'ohi'ona waho. I wehe'ia i ka makahiki 1885 e ke kāpena hō'ala Kanada'o William Osler. Infective endocarditis - he pilikia loa maʻi e hiki aku ai i ka irreversible deformation o ka naʻau, no laila ia mea e pōʻino ke ike i ia mea, a pehea e hoike mai ai ia ia.

Nā'ano o ka endocarditis ho'opili

'O kēia ma'i ka hopena o nā ma'i āpau a me nā hamo, a i kekahi manawa ma nā huakō a me nā protozoa i loko o ke koko o kekahi. Hiki iā lākou ke ho'okomo i ka endocardium me nā ma'i'eha o ka hanu hanu, ka rumatika, ka timeontitis, ka tonsillitis, ka ma'i tuma, ka ho'ohālike'ana i ka urethra, ka huki'ana o ka niho a me nā lima. 'O nā nodules o Osler he hō'ailona māmā ia i ke kumu o ka ma'i i ho'okau'ia i ka hopena - endocarditis. I ka hapanui o nā hihia, e ho'omaka i ka hana pā'ani o nā microorganisms, pono e hō'eha i ka na'au:

- nā kimehe anu;

- nā mea hana ki'i;

- Ho'opiha i nā kī'aha koko ai'ole nā pahū o ka na'au;

- nā pilikia'eha o nā na'au;

- micro-trauma;

- Ka hana 'ana.

I kekahi manawa, komo kekahi bacteria i loko o ka endocardium a me ka hō'ino'ole o nā kino. A laila, ua ho'okumu'ia nā absceses, fistulas a me nā hewa'ē a'e.

Nā hō'ailona

Infective endocarditis hiki ka hoike ana ia lakou iho pono a me ka maopopo loa, a hiki i mua hoopilikia wale ka luhi, naau ohumu mai ai me, mau nawaliwali, a me ka nui formidable symptoms mahuahua i nā. Eia kēia mau mea:

- wela;

- ke kani;

- ka wela nui;

- ka palupalu o nā'i'o a me nā hui;

- ka poho kaumaha;

- ka ho'ololi i ka'ili o ka'ili (lilo i hina hina, he lahilahi ka li'ili'i);

Hāmele ma luna o nā membrane mucous.

Hō'ea nā nodules o Osler ma hope o nā hō'ailona ki'eki'e. Ke'ike nei kekahi mau mea iā lākou he hō'ailona'ano a me ka hiki'ole ke ho'omaopopo'ia o endocarditis ka hopena,'o kekahi, ma ke'ano'ē a'e, he hō'ike'ano li'ili'i o ia, kahi ma'i'ole o ia ma'i.

Nodes o Osler, pathogenesis

Hō'ike'ia kēia mau papa ma nā poho, nā pīpī o nā manamana lima, nā wāwae no ka ho'olālā i loa'a i ka ma'i o nā paia o nā kī'aha koko li'ili'i a me ka pani'ana i kahi komo. Ma ka hō'ike ho'omana'o no nā nodules, hō'ike lākou i nā mea momona nui a me nā kola. I kekahi manawa ua pilikia pū lākou me kahi ma'i palekana a i'ole nā puriko septic. Ke'ano o nā nodules o Osler, e hō'ike maopopo ana ke ki'i. He kūpono kēia,'o ka nui o kahi pea a i'ole nā wahi pūnaewele pūnaewele iki paha o kahi hue'ula'ula a poni paha, i kekahi manawa he'eha, i kekahi manawa'a'ole. Ke ulu nei lākou i ka wikiwiki, nalowale lākou wale nō,'a'ole lākou he ma'i'ē a'e, no laila,'a'ole pono ka mālama'ana me nā papa ai'ole nā mea'aila. Akā inā ua'ike kekahi i nā'ano nodules, pono e nīnau koke'o ia i ke kauka no kahi ho'olālā'ē a'e a me nā ho'okolohua'oko'a.

'O kahi kiko o Rota

Ma waho aʻeo ia nodules Osler, ma infective endocarditis kānāwai lapuwale ia hemorrhagic ano ma na aoao a me nā wāwae, kahe ana ke koko ma lalo o ke kui papa, na kiko Zhaneve i kupu mai e like me Osler aka wahi, ma na poho a me na puupuu wawae. Akā, e like me nā nodules, he mau mea'ino'ole kēia mau kiko,'a'ole e like me ka pua a'o ka hopena o ke kahe o ke koko i nā capillaries.

I loko o ka ma'i endocarditis, ma waho a'e o ka'ili, hiki ke ho'opili'ia nā maka. 'O kekahi o nā hō'ailona ma'amau o ke'ano o ka pane'ana i ka līmū, he mau kikowa'i Lota. 'Ike'ia e ko lākou kahunapule Diana Roth. 'O ka'ōpū o Rota he microcirculation ma ke retina o nā maka. Ma ke'ano, he oval a puni paha me kahi ke'oke'o i waenakonu. Ma nā ma'i, hiki i kēia mau papahana ke ho'ēmi i ka'ike, a, ma hope o ka mālama'ana i ka ma'i i ho'oikaika'ia, e ho'iho'i'ia.

'O kahi o kahi o Rota he hō'ailona o ka endocarditis ka hopena, akā he anemia ho'i, collagenosis. No laila, e hana hou'ia nā mea hō'ailona no ka hō'ailona.

'O kekahi mau ma'i'ē a'e me kahi endocarditis ma'i

Aia'ane'ane he'umikumamālua mau hō'ailona e hiki ai i kekahi ke no'ono'o i kahi ho'olālā endocardial ma muli o ka ma'i.

Nā nodules o Osler, nā kikoo o Lukin (ai'ole ka Lukin-Liebman maika'i pololei),'o nā hō'ailona o Roca, Dmitrienko, Janoye a me nā mea'ē a'e e kōkua i nā kauka diagnose,'oiai ke'ano o nā hi'ohi'ona'ano'ē a'e o ka ma'i i'ole e hele.

'O ka hō'ailona o Lukin-Liebman ka'ike'ana o kahi petechiae me ka kikowaena me kahi kikowaena ma luna o ka pāpū a me ka pū'ulu.

'O ke'ano o Roca ke hō'ike'ia i loko o ka wehe'ana o ka haumāna o ka maka hema.

'O ka hō'ailona o Janeway ka papahana erythematous, e like me nā kiko o Roth, e kahe ana ma nā pāpū a me nā wāwae, i kēia manawa he'u'uku wale nō lākou.

'O Symptom Dmitrienko, ma kahi ha'aha'a o ka leo ke kani au, no ka mea i kapa'ia ai'o ia "ke kani o ka'elihi." Ke'ike'ia kēia ma'i i nā manawa mua o ka ma'i.

Hana

'O ke kumu o ka'ike'ana o kekahi'ōuli kiko'ī hiki ke ho'oholo wale'ia e ke kauka. 'Oiai, he koi kēia i nā hō'ailona o ka labo, ECG, echocardiography. Ho'olālā'ia nā'ili wai kūpono no ka ho'omaopopo'ana i ka mea ho'opuka hopena o ka ma'i. Inā hō'ike ka hō'ailona i ka endocarditis pono'ole o ka ma'i, pono'ia nā lā'au'alopelo o ka hui kūpono. I nā hihia ko'iko'i, hana'ia ka hana'onikala (plastic, pulp cardiac valve).

Me ka ho'oponopono kūpono o ka hō'ailona kūpono a me ka ho'olālā kūpono i ho'omaka'ia, 50-90% o nā ma'i ola ma mua o 5 mau makahiki. I mea e pale ai i ka hopena o ka endocarditis o ka ma'i, ua ho'omohala'ia kekahi ala kūikawā no nā po'e i pilikia. He nui nā'ano āpau o ka pale'ana e pili ana i ka lawe'ana o nā lā'au lapa'au ma kahi i'ike'ia.