Koj lub cev puas xau kua dej zoo li no? Cia peb tham txog Capillary Leak Syndrome!

Koj puas tau hnov ​​txog Kab Mob Capillary Leak Syndrome? Lub npe yuav zoo li nyuaj me ntsis. Tab sis hais yooj yim xwb, nws yog ib qho mob uas cov kua ntawm cov ntshav, hu ua plasma, tawm ntawm cov hlab ntsha me me hauv peb lub cev, hu ua capillaries. Cov kua no tawm mus rau hauv peb cov leeg, cov nqaij, cov kabmob, thiab cov qhov hauv lub cev. Qhov no tuaj yeem yog ib qho mob hnyav, yog li nws yog ib qho tseem ceeb uas yuav tsum paub txog nws.

Qhov mob capillary leak syndrome no yog dab tsi?

Zoo, cia peb piav qhia ntxiv me ntsis. Xav txog tias koj lub cev muaj ib lub cev kav dej. Cov kav dej no yog peb cov hlab ntsha. Cov kav dej me me hauv qhov no hu ua capillaries. Cov no yog cov kav dej uas cov pa oxygen thiab cov as-ham mus rau txhua qhov ntawm peb lub cev. Yog li, hauv '(Capillary Leak Syndrome)', qhov kua ntawm cov ntshav, uas yog , cov plasma , xau tawm los ntawm cov capillaries me me no. Nws zoo li dej xau tawm ntawm cov kav dej.

Qhov dej ntws tawm no ua rau cov kua sib sau ua ke rau ntau qhov chaw ntawm lub cev. Piv txwv li, cov kua no tuaj yeem ntws mus rau hauv cov leeg, cov nqaij, ntau yam kabmob, lossis qhov chaw (qhov chaw hauv lub cev) uas cov kabmob nyob.

Cov kab mob "Capillary Leak Syndrome" no tshwm sim tau ntau zaus hauv ib xyoos, lossis tsuas yog ib zaug hauv ib sim neej xwb. Txawm li cas los xij, yog tias tsis kho sai sai, koj cov ntshav siab tuaj yeem poob qis tam sim ntawd, ua rau lub cev tsis ua haujlwm thiab qee zaum txawm tias tuag. Yog li qhov no tsis yog ib yam dab tsi uas yuav tsum tau saib yooj yim.

Tseem tsis tau muaj tshuaj kho tau qhov mob no mus tas li. Txawm li cas los xij, nws yog ib qho tseem ceeb uas yuav tsum nrhiav kev kho mob sai sai kom tswj tau cov tsos mob. Qee zaum, nws muaj peev xwm tiv thaiv kev mob yav tom ntej los ntawm kev siv tshuaj lossis noj cov tshuaj saline.

Puas muaj tej hom no thiab? Lawv txawv li cas?

Yog, muaj ob hom kab mob tseem ceeb ntawm '(Capillary Leak Syndrome)'. Cia peb saib seb lawv yog dab tsi.

• Kab Mob Ntshav Tawm Hauv Lub Cev: Kuj hu ua "Primary Capillary Leak Syndrome" lossis "Clarkson's disease", qhov no yog ib qho mob uas cov ntshav tawm ntau zaus , txawm tias yog ib tus neeg noj qab nyob zoo los xij.
• Kab Mob Ntshav Tawm Thib Ob: Qhov no yog thaum qhov kev tawm tsam tshwm sim ib zaug vim yog lwm yam kab mob, mob, lossis tshuaj.

Hais yooj yim xwb, ib qho yog ib yam uas tshwm sim tau tas mus li, thiab lwm qhov yog ib yam uas tshwm sim ib ntus vim lwm yam laj thawj.

Leej twg yuav muaj tus mob no ntau dua?

"Systemic Capillary Leak Syndrome" yog ib qho kab mob tsis tshua muaj.Muaj tsawg dua 500 tus neeg thoob ntiaj teb tau tshaj tawm tias muaj tus mob no. Feem ntau nws tshwm sim rau cov neeg hnub nyoog nruab nrab. Nws tsis tshua muaj rau cov menyuam yaus. Txawm li cas los xij, vim tias cov neeg uas muaj tus mob no qee zaum raug kuaj mob tsis raug tias muaj lwm yam mob, tus lej tiag tiag ntawm cov neeg uas muaj tus mob no yuav ntau dua.

Txawm li cas los xij, Kab mob Capillary Leak Syndrome thib ob tuaj yeem tshwm sim rau txhua lub hnub nyoog. Qee yam kab mob, mob nkeeg, thiab tshuaj tuaj yeem ua rau muaj qhov no.

Thaum qhov no tshwm sim, yuav muaj dab tsi tshwm sim rau lub cev? (Peb theem)

Thaum muaj qhov teeb meem '(Capillary Leak Syndrome)' no, muaj peb theem uas tshwm sim hauv peb lub cev. Cia peb saib seb lawv yog dab tsi.

Theem Ib: Ua ntej cov tsos mob tshwm sim (Theem Prodromal)

Nov yog lub sijhawm ib lossis ob hnub ua ntej muaj mob. Thaum lub sijhawm no, koj yuav pib muaj qee cov tsos mob.

• Xav tias nkees
• Nqhis dej ntau ntxiv
• Tej yam zoo li qhov hnyav nce sai sai tuaj yeem tshwm sim.

Theem Ob: Theem xau lossis theem ua kom rov qab muaj sia nyob

Qhov no yog thaum qhov kev tawm tsam tiag tiag tshwm sim. Qhov tshwm sim yog tias cov kua dej thiab albumin (ib hom protein hauv cov ntshav) tawm ntawm koj cov hlab ntsha mus rau hauv qhov chaw ntawm koj cov nqaij. Qhov no txo ​​cov ntshav uas nqa oxygen. Koj cov ntshav siab poob qis, thiab cov qe ntshav liab sib sau ua ke, ua rau koj cov ntshav tuab dua. Cov kua dej tawm no ua rau cov ntshav tsawg dua, uas hu ua hypovolemia .

Theem Peb: Tom qab kev tawm tsam `(Theem Tom Qab Xaus lossis Theem Nrhiav Neeg Ua Haujlwm)`

Nov yog lub sijhawm tom qab qhov kev tawm tsam tas lawm. Qhov tshwm sim yog tias koj cov hlab ntsha pib nqus cov kua dej thiab albumin los ntawm cov nqaij dua. Txawm li cas los xij, thaum lub sijhawm no, koj lub cev tuaj yeem khaws cov kua dej ntau dhau (fluid overload) . Yog li ntawd, koj lub cev tuaj yeem tsim cov zis ntau dhau (polyuria) thiab koj lub ntsws tuaj yeem puv nrog dej (pulmonary edema).

Xav txog nws, nws zoo li daim txhuam cev nqus dej. Ua ntej, cov kua dej tawm hauv lub cev, thiab tom qab ntawd thaum nws nqus nws dua sai dhau, nws nqus ntau dua li nws yuav tsum tau.

Dab tsi ua rau qhov no?

Tam sim no cia peb saib seb dab tsi ua rau muaj qhov '(Capillary Leak Syndrome)' no.

Ua rau muaj '(Systematic Capillary Leak Syndrome)'

Yog hais qhov tseeb, qhov ua rau muaj Systemic Capillary Leak Syndrome tseem tsis tau paub meej. Cov kws tshawb fawb ntseeg tias nws yuav yog vim peb lub cev tiv thaiv kab mob teb rau qee yam kab mob lossis kev kis kab mob.

Ua rau muaj '(Secondary Capillary Leak Syndrome)'

Muaj ntau yam ua rau qhov no. Qhov ua rau feem ntau yog ib yam mob hu ua sepsis . Uas yog, ib qho teeb meem uas ua rau tuag taus los ntawm kev kis kab mob. Tsis tas li ntawd, muaj lwm yam ua rau:

• Cov kab mob autoimmune:Qhov tshwm sim hauv qhov no yog tias peb lub cev tiv thaiv kab mob tawm tsam peb cov hlwb noj qab haus huv.
• Kab mob sib txawv: Ib qho teeb meem uas tuaj yeem tshwm sim thaum kho qee hom kab mob leukemia (acute promyelocytic leukemia lossis acute myeloid leukemia).
• Engraftment syndrome: Ib qho teeb meem uas tuaj yeem tshwm sim tom qab hloov pob txha.
• Hemophagocytic lymphohistiocytosis: Ib qho mob uas yuav ua rau tuag taus los ntawm lub cev tiv thaiv kab mob ua haujlwm ntau dhau.
• Kab mob zes qe menyuam hyperstimulation syndrome: Ib qho teeb meem uas tuaj yeem tshwm sim thaum lub sijhawm kho mob fertility.
• Kev lom ricin.
• Kab tom.
• Kab mob ua los ntawm cov kab mob viral hemorrhagic: Ib pawg kab mob sib kis uas tshwm sim los ntawm cov kab mob viruses.

Qee cov tshuaj, xws li cov tshuaj tiv thaiv kab mob qog noj ntshav gemcitabine (gemcitabine - Gemzar®) thiab tagraxofusp (tagraxofusp - Elzonris®) , kuj tuaj yeem ua rau qhov no (Secondary Capillary Leak Syndrome).

Cov tsos mob ua ntej tus kab mob no pib muaj yog dab tsi?

Feem ntau, ib lossis ob hnub ua ntej muaj mob "Capillary Leak Syndrome", uas yog, thaum lub sijhawm "prodromal phase", koj yuav muaj cov tsos mob xws li:

• Mob plab los yog mob nqaij (myalgia).
• Qaug zog heev los yog tsis muaj zog.
• Mob taub hau .
• Nqhis dej ntau ntxiv.
• Kev chim siab, kev chim siab.
• Xeev siab.
• Qhov hnyav nce sai sai.
• Cov tsos mob ntawm kev kis tus kab mob viral lossis kev kis tus kab mob ntawm txoj hlab pa sab saud.

Yog tias koj muaj cov tsos mob zoo li no, tsis txhob xav tias nws yooj yim, hais tias, "Auj, tej zaum nws tsuas yog mob khaub thuas xwb," tshwj xeeb tshaj yog tias koj tau muaj cov kev paub zoo sib xws ua ntej.

Thaum koj muaj mob, koj muaj cov tsos mob dab tsi?

Thaum lub sijhawm muaj tus kab mob "(Capillary Leak Syndrome)", uas yog, thaum lub sijhawm "(theem xau lossis cawm siav"), cov tsos mob yuav txawv ntawm ib tus neeg mus rau ib tus neeg. Txawm li cas los xij, cov tsos mob uas pom tau feem ntau yog cov hauv qab no:

• Lub cev o, tshwj xeeb tshaj yog cov ceg (peripheral edema).
• Mob raws plab.
• Ntshav siab qis (hypotension).
• Ntshav txhaws (hypercoagulability) - Qhov no tuaj yeem tshwm sim los ntawm kev nce ntxiv ntawm cov qe ntshav liab (hematocrit) lossis kev nce ntxiv ntawm cov qe ntshav dawb (leukocytosis).

Cov kws kho mob paub qhov no li cas?

Tus kws kho mob yuav kuaj mob Capillary Leak Syndrome los ntawm kev nug txog koj keeb kwm kev kho mob thiab kuaj lub cev. Lawv yuav kuaj seb koj cov ntshav siab puas qis.

Tsis tas li ntawd xwb, ua ntej yuav paub tseeb tias qhov no yog Capillary Leak Syndrome, yuav tsum tshem tawm lwm yam mob. Lawv yuav ua ntau yam kev kuaj ntshav los ua qhov no:

• Xyuas seb puas muaj hematocrit ntau (tus naj npawb ntawm cov qe ntshav liab hauv cov ntshav).
• Tshawb xyuas seb puas muaj cov hemoglobin ntau (ib qho protein uas pom muaj nyob rau hauv cov qe ntshav liab).
• Xyuas seb puas muaj protein tsawg hauv cov ntshav (hypoalbuminemia).

Ntxiv mus, kev kuaj ntshav tuaj yeem ua tau los xyuas seb puas muaj cov protein tiv thaiv kab mob tsis zoo hu ua "monoclonal gammopathy, lossis M protein" hauv cov ntshav. Cov neeg uas muaj "Capillary Leak Syndrome" yuav muaj cov "M protein" tsis zoo no hauv lawv cov ntshav.

Yuav kho li cas? Puas kho tau?

Tu siab kawg li, tsis muaj tshuaj kho tau tus kab mob Capillary Leak Syndrome mus tas li. Cov kws kho mob sim tswj cov tsos mob thiab tiv thaiv kom tsis txhob muaj teeb meem ntxiv.

Thaum muaj tus kab mob "Capillary Leak Syndrome", cov kws kho mob yuav sim tswj cov ntshav siab thiab tswj cov ntshav kom zoo mus rau cov kabmob. Lawv kuj sim tiv thaiv kom tsis txhob o thiab cov kua dej ntau dhau. Lawv yuav siv cov tshuaj no:

• Glucocorticoids: Cov no yog ib hom tshuaj steroid uas pab txo cov kua dej tawm ntawm cov hlab ntsha.
• Cov kua dej hauv cov hlab ntsha: Cov khoom xws li saline yog muab los ua kom cov ntshav ntws mus rau cov kabmob xws li lub raum.

Feem ntau koj yuav tsum tau mus pw hauv tsev kho mob tom qab muaj mob plawv nres. Thaum lub sijhawm kho mob, koj tus kws kho mob yuav txuas ntxiv saib xyuas koj cov ntshav siab thiab ntshav siab kom paub tseeb tias koj tsis muaj dej ntau dhau hauv koj lub cev, uas tuaj yeem ua rau muaj lwm yam teeb meem, xws li mob ntsws o thiab lub plawv nres tam sim ntawd.

Tom qab muaj kev tawm tsam ntawm Capillary Leak Syndrome, hu ua theem post-leak lossis recruitment phase, tus kws kho mob yuav sau ntawv kom noj tshuaj diuretic (tshuaj uas ua rau koj tsim zis ntau dua) kom txo cov kua dej ntxiv hauv koj lub cev.

Puas tuaj yeem tiv thaiv tau qhov Systemic Capillary Leak Syndrome (SCLS) kom tsis txhob rov tshwm sim dua?

Koj tsis tuaj yeem tiv thaiv tau tus kab mob Systemic Capillary Leak Syndrome kom tsis txhob tshwm sim thaum xub thawj. Tab sis, thaum koj muaj kev tawm tsam, koj paub tias koj muaj tus mob no.

Txawm li cas los xij, kev noj tshuaj tsis tu ncua lossis kev txhaj tshuaj saline tuaj yeem pab tiv thaiv kev mob yav tom ntej thiab txo lawv qhov hnyav. Cov kev kho mob no suav nrog:

• Tau txais kev txhaj tshuaj tiv thaiv kab mob immune globulin (IVIG) txhua hli.
• Cov tshuaj noj rau mob hawb pob, xws li theophylline (theophylline - Elixophyllin®), terbutaline (terbutaline - Brethine®), thiab montelukast (montelukast - Singulair®) .
• Txo qhov oCov tshuaj steroid.

Yav tom ntej rau cov neeg uas muaj tus mob no yuav zoo li cas? `(Outlook)`

Feem ntau cov kab mob Systemic Capillary Leak Syndrome no yeej kho tau los ntawm kev siv tshuaj tiv thaiv. Kev kho mob yuav zoo dua yog tias kuaj pom tus mob thaum ntxov thiab muaj teeb meem tsawg heev. Qee qhov teeb meem loj uas yuav tshwm sim nrog Capillary Leak Syndrome muaj xws li:

• Kab mob Compartment syndrome: Muaj kev ntxhov siab ntau ntxiv hauv cov leeg nqaij thiab cov ntshav ntws tsawg dua.
• Cov kua dej sib sau ua ke nyob ib puag ncig lub plawv thiab lub ntsws (cardiac tamponade, pericardial effusion, thiab pleural effusion).
• Lub plawv tsis ua haujlwm.
• Kev ua haujlwm tsis zoo ntawm lub raum.
• Kab mob hlwb.
• Mob ntsws o.
• Rhabdomyolysis: Lub raum tsis ua haujlwm vim yog kev puas tsuaj ntawm cov leeg nqaij.
• Mob stroke.

Tej zaum cov no yuav zoo li txaus ntshai, tab sis zoo li tau hais ua ntej lawm, kev kho mob sai thiab kev tswj hwm kom zoo yog qhov tseem ceeb heev.

Kuv yuav tsum mus ntsib kws kho mob thaum twg?

Yog koj xav tias koj muaj tus kab mob Capillary Leak Syndrome, mus ntsib kws kho mob tam sim ntawd. Lawv tuaj yeem pab tswj koj cov tsos mob thiab muab kev pab rau koj.

Nco ntsoov tias, txawm hais tias qhov no yog ib qho mob tsis tshua muaj, nws yog ib qho tseem ceeb kom paub txog cov tsos mob thiab nrhiav kev pab kho mob sai sai yog tias koj tsis paub meej.

Cov Lus Qhia Txog Kev Coj Mus Tsev

Zoo, yog li cia peb rov hais dua cov ntsiab lus tseem ceeb tshaj plaws uas peb tau tham txog:

• Qhov no yog thaum cov kua ntawm cov ntshav (plasma) xau tawm ntawm cov hlab ntsha me me (capillaries) hauv peb lub cev.
• Qhov no tuaj yeem tshwm sim ib zaug lossis ntau zaus.
• Yog tias tsis kho, tej zaum yuav muaj teeb meem loj tshwm sim, yog li ntawd, kev kho mob sai sai yog qhov tseem ceeb.
• Txawm hais tias tsis muaj kev kho mob mus tas li los xij, muaj kev kho mob los tswj cov tsos mob thiab tiv thaiv kev mob yav tom ntej.
• Yog koj xav tias muaj cov tsos mob no, mus ntsib kws kho mob tam sim ntawd. Thaum koj kuaj pom tus kab mob thiab pib kho sai npaum li cas, koj yuav muaj feem zoo dua.

Yog li ntawd, kuv vam tias cov ntaub ntawv no yuav pab tau koj. Nyob kom noj qab nyob zoo!

Kab mob Capillary Leak Syndrome, Plasma Leak, Ntshav Siab Qis, Kab mob Clarkson, Edema, Kua dej tawm hauv lub cev