Koj puas muaj mob tawv nqaij sai sai thiab hnyav heev? Cia peb kawm txog Pyoderma Gangrenosum!

Koj puas tau muaj ib qho pob me me lossis ib qho liab ntawm koj daim tawv nqaij uas pib ua ib qho pob me me lossis ib qho liab thiab mam li hloov mus ua ib qho mob loj thiab mob? Nws tuaj yeem tshwm sim ntau qhov chaw, tab sis nws kuj tuaj yeem tshwm sim ntau qhov chaw ntawm koj lub cev. Qhov no yog ib qho mob uas xav tau kev saib xyuas thiab tuaj yeem nyuaj me ntsis. Hnub no peb yuav tham txog ib qho mob ntawm daim tawv nqaij hu ua Pyoderma Gangrenosum, uas yog ib qho mob tsis tshua muaj tab sis tseem ceeb heev uas yuav tsum paub txog. Tsis txhob txhawj, cia peb ua kom yooj yim.

Pyoderma Gangrenosum yog dab tsi?

Hais yooj yim xwb, pyoderma gangrenosum yog ib yam mob uas mob ntev thiab rov tshwm sim dua ntawm daim tawv nqaij. Qhov uas tshwm sim yog koj daim tawv nqaij pib muaj cov pob me me, tsis muaj xim (tej zaum liab, ntshav, xiav, xim av, lossis dub), lossis cov pob uas muaj kua dej (bullae). Qhov txaus ntshai tshaj yog tias cov no tuaj yeem loj sai sai, sib sau ua ke, thiab dhau los ua cov pob tob, qhib (ulcers) .

Xav txog seb nws yuav zoo li cas yog tias ib yam dab tsi pib ua pob me me thiab tsis pub dhau ob peb hnub nws hloov mus ua ib qho mob qog nqaij hlav loj npaum li ib lub npib tsib xees? Qhov ntawd yog qhov tshwm sim ntawm no. Ib txhia neeg tsuas muaj ib qho qog nqaij hlav xwb, tab sis thaum muaj mob hnyav, ntau qhov qog nqaij hlav yuav tshwm sim ib zaug. Cov qog nqaij hlav no tuaj yeem mob heev .

Qhov tseem ceeb, pyoderma gangrenosum feem ntau cuam tshuam nrog lwm yam kab mob hauv lub cev , txhais tau tias nws tsis yog teeb meem ntawm daim tawv nqaij xwb.

Leej twg yuav muaj feem tau qhov no tshaj?

Kab mob Pyoderma gangrenosum tuaj yeem tshwm sim rau txhua lub hnub nyoog, tab sis nws tsis tshua muaj rau cov menyuam yaus . Nws feem ntau tshwm sim rau cov poj niam hnub nyoog ntawm 20 thiab 50 xyoo. Koj kuj tseem yuav muaj feem ntau dua rau kev mob pyoderma gangrenosum yog tias koj muaj ib qho ntawm cov mob hauv qab no:

• Mob pob qij txha rheumatoid - Qhov no yog ib qho kab mob uas ua rau mob pob qij txha.
• Ulcerative colitis - Ib qho mob o uas muaj cov qhov txhab hauv txoj hnyuv loj.
• Kab mob Crohn - Lwm yam mob o uas tshwm sim hauv txoj hnyuv.
• Qee hom mob qog noj ntshav, piv txwv li, mob qog ntshav ntshav xws li leukemia lossis lymphoma.

Lawv hais tias nws tshwm sim rau kwv yees li ib ntawm ib puas txhiab tus neeg hauv Tebchaws Meskas . Qhov ntawd txhais tau tias nws tsis yog qhov tshwm sim ntau.

Qhov no cuam tshuam li cas rau lub cev? Cov tsos mob yog dab tsi?

Kab mob Pyoderma gangrenosum ua rau muaj cov pob me me, tsis muaj xim thiab o, uas txhais tau tias o thiab liab, ntawm koj daim tawv nqaij. Cov pob no tuaj yeem tshwm sim txhua qhov chaw ntawm lub cev, tab sis feem ntau pom ntawm ob txhais ceg, pob luj taws, thiab taw (qhov chaw qis dua) .

Cov hlwv no tuaj yeem tawg sai sai, hloov mus ua cov qhov txhab loj, mob, thiab kis mus rau lwm qhov.Cov tsos mob tseem ceeb yog:

• Cov pob khaus me me, tsis muaj xim (liab, ntshav, xiav, xim av, lossis dub). Cov no loj sai sai .
• Yuav muaj cov qhov txhab qhib (ulcers). Cov npoo ntawm cov qhov txhab no nce siab thiab pom tseeb .
• O thiab mob hnyav nyob ib puag ncig qhov txhab.
• Ib txhia neeg yuav kub taub hau .
• Tej zaum yuav mob pob qij txha thiab.

Cov qhov txhab no qee zaum loj thiab tob heev , thiab qhov mob yuav tsis tuaj yeem ua rau mob tau.

Qee qhov kev tshawb fawb tau qhia tias txog li 70% ntawm cov neeg uas muaj tus kab mob pyoderma gangrenosum yuav muaj ntau dua ib yam mob (comorbidities) tib lub sijhawm. Thaum tus kab mob pyoderma gangrenosum raug sib xyaw nrog lwm yam mob, nws tau hais tias qhov kev pheej hmoo ntawm kev tuag tuaj yeem nce mus txog 30%. Yog li ntawd, qhov no tsis yog ib yam dab tsi uas yuav tsum tau saib maj mam.

Qhov no puas yog tus kab mob autoimmune?

Yog, pyoderma gangrenosum ntseeg tau tias yog ib yam kab mob autoimmune . Hais yooj yim xwb, koj lub cev tiv thaiv kab mob, lub cev tiv thaiv kab mob, tawm tsam koj cov tawv nqaij. Rau qee tus neeg, pyoderma gangrenosum ploj mus thaum lwm yam mob uas tau hais los saum toj no raug kho.

Vim li cas pyoderma gangrenosum thiaj li tshwm sim?

Cov kws kho mob tseem tsis tau paub qhov ua rau muaj qhov no , tab sis ntau dua ib nrab ntawm cov neeg uas muaj pyoderma gangrenosum muaj lwm yam mob (xws li mob pob qij txha, mob ntshav dawb, thiab mob Crohn), raws li tau hais ua ntej.

Ntxiv rau, pyoderma gangrenosum kuj tseem tuaj yeem tshwm sim tom qab raug mob ntawm daim tawv nqaij, raug khawb, lossis phais (pathergy) . Xav txog qhov khawb me me ntawm koj txhais tes, lossis phais me me, thiab qhov no yog qhov uas tus kab mob no tuaj yeem pib. Qee zaum cov qhov txhab no kuj tshwm sim nyob ib puag ncig qhov chaw stoma tom qab phais. Qhov no hu ua peristomal pyoderma gangrenosum.

Qhov no puas kis tau?

Tsis yog. Pyoderma gangrenosum tsis sib kis tau . Nws tsis tuaj yeem kis tau ntawm ib tus neeg mus rau lwm tus los ntawm kev sib chwv ntawm daim tawv nqaij. Qhov no yog qhov kev txhawj xeeb uas ntau tus neeg muaj, yog li nws yog ib qho tseem ceeb uas yuav tsum paub meej txog qhov no.

Cov kws kho mob paub qhov no li cas?

Yog hais qhov tseeb, kev kuaj mob pyoderma gangrenosum yuav nyuaj me ntsis . Tsis muaj kev kuaj mob tseeb uas tuaj yeem lees paub tias nws yog tus mob. Yog li ntawd, cov kws kho mob feem ntau ua kev kuaj mob kom tshem tawm lwm yam mob uas tuaj yeem ua rau muaj teeb meem zoo sib xws ntawm daim tawv nqaij. Ntawd yog, lawv xub xyuas kom meej tias lwm yam mob uas muaj cov tsos mob zoo sib xws tsis muaj. Piv txwv li:

• Ntau yam kab mob sib txawv.
• Mob qog nqaij tawv.
• Kev o ntawm cov hlab ntsha ntawm daim tawv nqaij.
• Kab mob Lupus.
• Ib yam mob hu ua Sweet syndrome.

Cov kev ntsuam xyuas rau qhov no yuav suav nrog:

• Kev kuaj ntshav.
• Muab ib daim tawv nqaij me me coj mus kuaj (Biopsy).
• Kev kuaj cov pob txha - tshwj xeeb yog tias muaj tej yam xws li mob qog ntshav.
• Kev kuaj mob Proctoscopy.
• Kev kuaj mob plab hnyuv - yog tias xav tias muaj mob xws li kab mob Crohn.

Tsuas yog tom qab ua tiav tag nrho cov kev kuaj no thiab txhua yam tsis tau txiav txim siab lawm, tus kws kho mob thiaj li xaus lus tias nws yog pyoderma gangrenosum.

Cov kev kho mob yog dab tsi?

Muaj ntau txoj kev kho mob rau pyoderma gangrenosum. Kev kuaj mob thaum ntxov thiab kev kho mob yog qhov tseem ceeb kom tiv thaiv kev caws pliav .

Kev kho mob rau cov mob uas tshwm sim ntau, tsis hnyav heev

Yog tias cov qhov txhab tsis hnyav heev, tus kws kho mob yuav sau ntawv kom siv cov tshuaj pleev lossis tshuaj pleev rau sab nraud. Cov no suav nrog:

• Cov tshuaj Corticosteroids: Cov no yog cov tshuaj uas txo qhov o. Lawv tuaj yeem siv rau ntawm cov qhov txhab ua tshuaj pleev lossis noj ua tshuaj ntsiav. Piv txwv li: cortisone, prednisone. Txawm li cas los xij, cov no tuaj yeem muaj cov kev mob tshwm sim xws li kev noj zaub mov ntau ntxiv, qhov hnyav nce, kev hloov pauv ntawm lub siab, pob txuv, thiab pw tsis tsaug zog.
• Cov tshuaj nonsteroidal anti-inflammatory drugs (NSAIDs): Cov no yog cov tshuaj loog mob. Piv txwv li: aspirin, ibuprofen. Cov no tuaj yeem ua rau muaj roj , o, mob plab, xeev siab, ntuav, raws plab, thiab cem quav.
• Tshuaj pleev tawv nqaij Silver sulfadiazine: Qhov no yog tshuaj tua kab mob uas siv rau ntawm qhov kub hnyiab kom tiv thaiv kev kis kab mob. Qee zaum nws kuj siv rau qhov mob no thiab. Nws tuaj yeem ua rau khaus, kub taub hau, txias, mob tawv nqaij, thiab ua xua rau lub hnub.

Ib me ntsis hnyav?

Yog tias qhov raug mob hnyav dua, tus kws kho mob yuav sau ntawv kho mob zoo li no:

• Cov tshuaj tiv thaiv kab mob: Cov no ua haujlwm los ntawm kev txo qhov peev xwm ntawm koj lub cev tiv thaiv kab mob kom ua puas rau nws lub cev. Piv txwv li: mycophenolate, cyclosporine.
• Cov tshuaj tua kab mob: Cov no yog cov tshuaj tshiab dua. Lawv ua haujlwm los ntawm kev tsom mus rau cov protein tshwj xeeb hauv lub cev uas ua rau mob o. Piv txwv li: infliximab, adalimumab, ustekinumab.
• Kev kho mob oxygen hyperbaric: Qhov no suav nrog kev muab 100% oxygen rau hauv ib lub chamber tshwj xeeb. Lawv hais tias nws yuav ua rau cov nqaij ntawm lub cev kho sai dua.

Cia peb kawm txog kev phais mob thiab.

Muaj tej lub sij hawm, kev phais tshem cov nqaij tuag tawm ntawm qhov txhab (debriding) yuav pab tau. Txawm li cas los xij, qhov no kuj muaj kev pheej hmoo .Vim tias kev puas tsuaj ntawm daim tawv nqaij (pathergy) tuaj yeem ua rau cov tsos mob ntawm pyoderma gangrenosum hnyav dua, qhov no yuav tsum tau ua nrog kev ceev faj heev thiab raws li kev txiav txim siab ntawm koj tus kws kho mob.

Qee zaum yuav muaj kev hloov daim tawv nqaij . Qhov no txhais tau tias daim tawv nqaij raug coj los ntawm ib feem ntawm lub cev noj qab haus huv thiab hloov mus rau qhov chaw raug mob.

Ua ib tug neeg uas muaj tus mob no, koj yuav tsum paub dab tsi?

Yog tias koj muaj pyoderma gangrenosum, txhua yam kev raug mob rau koj daim tawv nqaij - txiav, khawb, thiab mob - tuaj yeem ua rau koj cov tsos mob hnyav dua . Yog li koj yuav tsum ceev faj li sai tau. Xav txog koj ua haujlwm hauv lub vaj lossis hauv chav ua noj, thiab txawm tias qhov khawb me me tuaj yeem ua teeb meem loj.

Tsis tas li ntawd xwb, kev khaws cov qhov txhab kom huv yog qhov tseem ceeb kom tiv thaiv kev kis kab mob .

• Ntxuav cov qhov txhab kom huv si nrog dej huv thiab xab npum.
• Tom qab ntawd, ua tib zoo npog qhov txhab nrog daim ntaub qhwv uas tsis nplaum. Qhov no yuav tiv thaiv cov av thiab cov kab mob kom tsis txhob nkag mus.
• Koj tus kws kho mob tawv nqaij yuav muab cov ntaub ntawv ntxiv rau koj txog yuav ua li cas kom lub qhov txhab huv thiab yuav ua li cas siv cov ntaub qhwv. Ua raws li cov lus qhia ntawd kom zoo.
• Yog koj tau txais tshuaj pleev, ntxuav qhov txhab, muab tshuaj pleev rau, thiab tom qab ntawd qhwv nws.

Rau cov qhov txhab hnyav, koj tus kws kho mob yuav pom zoo kom siv daim ntaub qhwv hydrocolloid . Cov no tiv thaiv qhov txhab kom tsis txhob sib txhuam thiab kis kab mob ntxiv. Lawv yuav "yaj" rau hauv daim tawv nqaij hauv ob mus rau peb hnub.

Yuav siv sijhawm ntev npaum li cas thiaj kho tau?

Kab mob Pyoderma gangrenosum yog ib yam mob uas nyuaj kho . Txawm tias kho tau zoo los, cov qhov txhab yuav siv sijhawm ntau lub lis piam, qee zaum ntau lub hlis, kom zoo. Yog li ntawd, koj yuav tsum ua siab ntev.

Qhov no puas tiv thaiv tau?

Vim tias qhov ua rau mob tsis paub meej, nws nyuaj rau hais meej tias yuav tiv thaiv nws li cas . Txawm li cas los xij, yog tias koj muaj cov yam txaus ntshai xws li mob ntshav dawb lossis mob plab hnyuv, thiab koj muaj teeb meem ntawm daim tawv nqaij tshiab (tshwj xeeb tshaj yog cov qhov txhab uas loj sai) , qhia rau koj tus kws kho mob tam sim ntawd . Thov koj tus kws kho mob xa koj mus rau kws kho mob tawv nqaij lossis lwm tus kws tshwj xeeb uas muaj kev paub txog pyoderma gangrenosum.

Kuv yuav tsum mus ntsib kws kho mob thaum twg?

Koj yuav tsum tau mus ntsib kws kho mob hauv cov xwm txheej no:

• Yog tias koj muaj kab mob plab hnyuv, mob pob qij txha, lossis mob ntshav thiab muaj cov hlwv lossis cov qhov txhab uas loj sai .
• Yog tias koj qhov txhab zoo li muaj kab mob (liab, ntshav, grey lossis dawb, o, lossis mob).
• Yog koj muaj cov tsos mob tshiab .
• Yog tias koj muaj kev phiv loj heev tom qab noj tshuaj.

Cov lus nug tseem ceeb uas yuav tsum nug koj tus kws kho mob

Thaum koj mus ntsib kws kho mob, nws yog ib qho tseem ceeb heev uas yuav tsum nug cov lus nug no:

• Ua cas koj thiaj hais tias kuv muaj pyoderma gangrenosum?
• Yog tias kuv tsis muaj pyoderma gangrenosum, nws yuav yog lwm yam kab mob ntawm daim tawv nqaij dab tsi?
• Koj xav ua cov kev ntsuam xyuas zoo li cas?
• Koj pom zoo kom siv tshuaj lossis kev kho mob hom twg?
• Koj puas muab tau tshuaj pleev rau kuv siv los yog tshuaj haus?
• Cov tshuaj thiab kev kho mob no muaj cov kev mob tshwm sim tag nrho li cas?
• Kuv yuav tsum ua dab tsi ntxiv kom txo tau kuv cov tsos mob?
• Kuv puas yuav tsum mus ntsib kws kho mob tawv nqaij, kws phais yas, kws kho mob plab hnyuv, kws kho mob tiv thaiv kab mob, lossis lwm tus kws tshwj xeeb?

Nws yog ib qho tseem ceeb heev uas yuav tsum nug cov lus nug no thiab nkag siab meej txog koj qhov xwm txheej.

Qhov txawv ntawm Pyoderma Gangrenosum thiab Ecthyma Gangrenosum yog dab tsi?

Ob lub npe no zoo sib xws me ntsis, yog li lawv tuaj yeem tsis meej pem.

Kab mob ecthyma gangrenosum yog ib qho kab mob tsis tshua muaj uas tshwm sim los ntawm Pseudomonas bacteremia, ib hom kab mob uas feem ntau pom muaj nyob hauv dej thiab av. Nws kuj tseem tuaj yeem ua rau mob tawv nqaij thiab ua rau cov nqaij nyob ib puag ncig puas tsuaj. Feem ntau nws cuam tshuam rau cov neeg uas lub cev tiv thaiv kab mob tsis muaj zog .

Kab mob Pyoderma gangrenosum kuj ua rau mob tawv nqaij. Tsis paub meej tias yog vim li cas. Nws xav tias yog kab mob autoimmune. Txawm li cas los xij, nws tsis yog ib qho mob uas cuam tshuam rau cov neeg uas lub cev tiv thaiv kab mob tsis muaj zog .

Puas muaj ntau hom mob pyoderma gangrenosum sib txawv?

Yog, muaj plaub hom mob pyoderma gangrenosum tseem ceeb:

• Kab mob pyoderma gangrenosum uas ib txwm muaj: Qhov no yog hom kab mob uas feem ntau tshwm sim. Cov qhov mob feem ntau tshwm sim rau ntawm ob txhais ceg.
• Mob pob khaus pyoderma gangrenosum uas tsis zoo li qub lossis mob hnyav: Hom mob no zoo li cov pob khaus uas muaj kua dej nyob hauv. Feem ntau pom ntawm tes. Nws feem ntau pom rau cov neeg uas muaj mob leukemia.
• Kab mob gangrenosum uas ua rau mob: Zoo li cov pob me me uas puv nrog kua qaub (pustules) rau ntawm tes thiab taw. Qhov no feem ntau tshwm sim rau cov neeg uas muaj kab mob o ntawm txoj hnyuv.
• Cov kab mob pyoderma gangrenosum uas tsis muaj zog: Hom kab mob no feem ntau tsis mob.

Thaum kawg, tej yam uas yuav tsum nco ntsoov

Pyoderma gangrenosum yog ib yam mob uas pib ua cov pob me me ntawm daim tawv nqaij thiab tuaj yeem hloov mus ua cov qhov txhab loj sai sai. Nws tuaj yeem nyuaj rau kuaj mob thiab kho , yog li koj thiab koj tus kws kho mob yuav tsum ua siab ntev.

Nco ntsoov, nws yog ib qho tseem ceeb heev uas yuav tsum ceev faj txog kev raug mob rau koj daim tawv nqaij, vim qhov no tuaj yeem ua rau muaj cov qhov txhab tshiab.

Yog tias pyoderma gangrenosum hnyav heev thiab koj muaj lwm yam kab mob sib koom ua ke, nws tuaj yeem ua rau mob hnyav, caws pliav, thiab txawm tias muaj teeb meem txog lub neej. Yog li ntawd, yog tias koj muaj tus kab mob autoimmune thiab tab tom ntsib cov qhov txhab ntawm daim tawv nqaij uas loj hlob sai, nrhiav kev kho mob tam sim ntawd. Kev kuaj pom thiab kho thaum ntxov tuaj yeem pab koj zoo dua. Tsis txhob ntshai , tab sis ceev faj.

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