Puas muaj teeb meem loj hauv koj lub cev? Cia peb kawm txog Waterhouse-Friderichsen Syndrome!

Koj puas tau hnov ​​​​tias ob lub qog me me hauv lub cev tsis ua haujlwm, thiab nws tuaj yeem muaj kev cuam tshuam loj rau koj lub neej? Hnub no peb yuav tham txog ib qho mob txaus ntshai heev, thiab yog tias tsis kho sai, nws tuaj yeem ua rau tuag taus. Qhov no hu ua Waterhouse-Friderichsen Syndrome. Txawm hais tias lub npe yuav zoo li ntev me ntsis, cia peb tham txog nws yog dab tsi, vim li cas nws tshwm sim, thiab yuav ua li cas kom dim.

Qhov no yog Waterhouse-Friderichsen Syndrome li cas?

Hais yooj yim xwb, Waterhouse-Friderichsen Syndrome (WFS) yog ib qho mob hnyav heev. Qhov uas tshwm sim yog koj cov qog adrenal , uas yog ob lub qog me me nyob saum koj lub raum, los ntshav (peb hu qhov no tias 'adrenal hemorrhage') thiab ib lossis ob qho ntawm cov qog no tsis ua haujlwm. Feem ntau, qhov no yog los ntawm kev kis kab mob hnyav. Yog tias tsis kho, cov qog adrenal no yuav luag tsis tsim cov tshuaj cortisol, uas yog qhov tseem ceeb rau peb lub cev. Qhov no yog qhov peb hu ua adrenal crisis . Yog hais meej, nws yog ib qho xwm txheej ceev!

Muaj lwm lub npe rau qhov no, uas yog "hemorrhagic adrenalitis." Qhov ntawd txhais tau hais tias cov qog adrenal los ntshav thiab o.

Tus mob no feem ntau tshwm sim li cas?

Qhov tseeb, Waterhouse-Friderickson syndrome tsis tshua muaj . Feem ntau, cov kws kuaj lub cev pom tias tus mob no tsuas yog ua rau muaj li ntawm 1% ntawm kev tuag xwb. Qhov no txhais tau tias nws tsis yog ib yam kab mob uas cuam tshuam rau txhua tus, tab sis yog tias nws tshwm sim, nws txaus ntshai heev.

Cov tsos mob ntawm tus kab mob no yog dab tsi?

Xav txog seb, koj cia li muaj tus kab mob lossis cov kab mob me me thiab pib muaj tus mob WFS no. Ces koj mam li pib muaj cov tsos mob ntawm tus kab mob. Koj puas paub qhov ntawd yog dab tsi?

• Kuv kub taub hau heev.
• Lub cev txias thiab tshee hnyo (Chills).
• Kuv lub taub hau mob heev.
• Kuv yuav ntuav, kuv yuav ntuav.
• Cov leeg nqaij hauv kuv lub cev mob, tshwj xeeb tshaj yog nyob rau ntawm qhov chaw xws li kuv nraub qaum qis, plab, thiab ob txhais ceg.
• Kuv cov pob qij txha mob.
• Qee zaum yuav muaj kev poob siab (syncope).

Thaum qhov kev los ntshav no pib cuam tshuam tsis yog rau cov qog adrenal xwb tab sis kuj rau lwm qhov ntawm lub cev, lwm cov tsos mob yuav tshwm sim. Cov no suav nrog:

• Kev ntshav txhaws hauv cov hlab ntsha (Disseminated intravascular coagulation - DIC): Qhov no zoo li nyuaj me ntsis, puas yog? Hais yooj yim xwb, nws yog ib qho teeb meem uas cov ntshav txhaws thoob plaws lub cev tsis ua haujlwm zoo. Thaum cov ntshav txhaws tsim nyob rau hauv ib qho chaw, nws tsis tuaj yeem tiv thaiv kev ntshav ntws mus rau lwm qhov chaw.
• Mob pob khaus ntawm daim tawv nqaij:Qee zaum lawv tuaj yeem tshwm sim ntawm daim tawv nqaij ua cov pob me me lossis cov pob loj.
• Kab mob Septic shock: Qhov no yog ib qho mob uas cov ntshav siab poob qis heev vim muaj kab mob, ua rau lub cev cov kab mob tsis tau txais ntshav txaus. Qhov no kuj yog ib qho txaus ntshai heev.

Cov tsos mob ntawm kev los ntshav ntawm cov qog adrenal yog dab tsi?

WFS cuam tshuam nrog kev los ntshav hauv adrenal, uas tej zaum yuav muaj lwm cov tsos mob nrog:

• Mob plab.
• Mob rau thaj tsam saum lub duav, hauv qab cov tav (lub duav).
• Kev mob nkeeg, kev xav tsis xis nyob.
• Kev qeeb qeeb.
• Xeev siab thiab ntuav.
• Mob raws plab.

Dab tsi ua rau qhov no?

Feem ntau, qhov ua rau muaj tus kab mob Waterhouse-Friderickson syndrome yog cov kab mob bacterial thiab viral (sepsis) . Yog hais kom meej, cov kab mob nkag mus rau hauv lub cev thiab kis mus thoob plaws lub cev yam tsis muaj kev tswj hwm.

Qee hom kab mob me me yuav raug tus kab mob no yooj yim kis tau. Nov yog ob peb yam piv txwv:

• Kab mob Pseudomonas aeruginosa
• Cov kab mob Meningococcus: Qhov no yog qhov txaus ntshai tshaj plaws uas tuaj yeem ua rau WFS.
• 'Streptococcus pneumoniae'
• Haemophilus influenzae
• `Escherichia coli (E. coli)`
• Kab mob Staphylococcus aureus

Muaj ntau hom kab mob bacteria uas ua rau muaj qhov no.

Tsis tas li ntawd xwb, qee hom kab mob tuaj yeem ua rau qhov no:

• Kab mob Cytomegalovirus (CMV)
• Kab mob Parvovirus (Parvovirus)
• Tus kab mob Epstein-Barr
• Kab mob Ebola (kab mob Ebola)
• Kab mob Varicella-zoster (qhov no ua rau muaj kab mob xws li mob qhua pias thiab mob herpes)

Ntxiv rau cov kab mob no, muaj qee yam ua rau muaj kev pheej hmoo rau kev mob WFS:

• Siv cov tshuaj anticoagulant. Cov no ua rau muaj kev pheej hmoo ntawm kev los ntshav.
• Thrombocytopenia: Qhov no txhais tau tias cov platelets (cov hlwb uas pab cov ntshav txhaws) hauv cov ntshav txo qis.
• Cov qog adrenal tau raug puas tsuaj rau qee txoj kev.

Leej twg raug kev cuam tshuam ntau tshaj plaws los ntawm qhov xwm txheej no?

Kab mob Waterhouse-Friderickson feem ntau yuav tshwm sim rau cov menyuam yaus dua li cov neeg laus . Yog li ntawd, yog tias ib tug menyuam yaus muaj cov tsos mob xws li kub taub hau thiab mob lub cev, koj yuav tsum ceev faj heev.

Qhov no ua rau muaj teeb meem dab tsi?

Qhov no yog qhov tseem ceeb tshaj plaws. Yog tias tsis kho sai thiab kom raug, Waterhouse-Friderickson syndrome yuav ua rau tuag taus. Qhov ntawd txhais tau tias nws tuaj yeem ua rau tuag taus. Yog li qhov no yuav tsum tau kho raws li qhov xwm txheej ceev.

Yuav kuaj tus kab mob no li cas?

Yuav kom paub tseeb tias koj muaj tus kab mob no, koj yuav tsum tau kev pab los ntawm kws kho mob. Tus kws kho mob yuav nug koj txog koj cov tsos mob, nug txog koj cov kab mob yav dhau los, thiab tom qab ntawd kuaj koj lub cev.

Tiamsis kev kuaj mob WFS yuav nyuaj me ntsis, vim nws cov tsos mob zoo ib yam li cov tsos mob ntawm septic shock . Yog li ntawd, txhawm rau kom paub tseeb tias nws puas yog WFS, tus kws kho mob yuav xaj ntau yam kev kuaj mob.

Cov kev kuaj twg siv los kuaj mob?

Yuav kom paub tseeb tias puas muaj kev kis kab mob, tus kws kho mob yuav ua cov kev kuaj mob hauv qab no:

Kev kuaj duab

• Yuav ua tau ib daim ultrasound scan los yog CT (computed tomography) scan los xyuas seb puas muaj ntshav sib sau ua ke hauv cov qog adrenal. Cov scan no thaij duab sab hauv lub cev, yog li lawv thiaj pom tau cov cheeb tsam uas los ntshav.

Kev kuaj ntshav

• Kev kuaj ntshav tuaj yeem qhia tau tseeb tias koj puas muaj kab mob bacterial. Qhov no suav nrog kev rho ib rab koob me me los ntawm cov leeg ntshav hauv koj txhais caj npab, rho me ntsis ntshav, thiab saib nws hauv qab lub tshuab microscope. Qhov no yuav nrhiav cov cim qhia tias muaj kab mob.

Kev kuaj mob meningococcus

Yog tias tus kws kho mob xav tias qhov ua rau yog cov kab mob meningococcus, ces lawv yuav ua cov kev kuaj mob zoo li no:

• Kev siv lub koob txhaj rau hauv koj lub pob txha caj qaum / lub duav: Qhov no yuav tsum tau muab ib rab koob nyias nyias ntxig rau hauv koj lub nraub qaum qis, nruab nrab ntawm ob lub pob txha caj qaum, thiab txhaj me ntsis cov kua dej hauv pob txha caj qaum. Qhov no yuav zoo li txaus ntshai, tab sis cov kws kho mob ua tib zoo.
• Kev kuaj tawv nqaij: Yog tias koj muaj qhov txhab ntawm koj daim tawv nqaij, yuav muab ib daim tawv nqaij me me ntawm qhov txhab ntawd coj mus kuaj.
• Kev kuaj xim av (Gram stain test): Yuav muab ib qho qauv los ntawm thaj chaw uas xav tias muaj kab mob (xws li qhov txhab) coj mus kuaj seb puas muaj kab mob.
• Kev Kuaj Zis: Koj yuav raug hais kom tso zis rau hauv ib lub thawv tshwj xeeb. Tom qab ntawd yuav kuaj cov zis seb puas muaj cov cim qhia tias muaj kab mob.

Kev kuaj mob adrenal crisis mob hnyav

Cov kev kuaj no pab txiav txim siab seb koj puas tab tom ntsib teeb meem adrenal , uas yog ib qho mob uas cov qog adrenal tsis ua haujlwm zoo:

• Kev kuaj mob Adrenocorticotropic hormone (ACTH): Hauv qhov kev kuaj no, koj tus kws kho mob muab ib qho tshuaj hormone me me rau koj hu ua ACTH. Tom qab ntawd, 30 txog 60 feeb tom qab, lawv coj cov ntshav mus kuaj seb koj cov qog adrenal teb li cas rau ACTH. Qhov no yog ib qho kev kuaj uas ntsuas seb koj cov qog adrenal ua haujlwm zoo npaum li cas.
• Kev kuaj ntshav qab zib:Yuav muab me ntsis ntshav thiab ntsuas seb muaj piam thaj (glucose) npaum li cas. Cov piam thaj yuav qis thaum muaj teeb meem adrenal.
• Kev kuaj Cortisol: Ib qho qauv ntawm koj cov ntshav, zis, qaub ncaug, lossis kev sib xyaw ua ke ntawm ob lossis peb yam no raug coj los xyuas seb koj cov qog adrenal tsim cortisol ntau npaum li cas.
• Kev kuaj ntshav pH: Yuav muab cov ntshav coj los kuaj thiab ntsuas nws cov kua qaub-pH. Qhov no ua tau los ntawm kev kuaj roj ntshav hauv cov hlab ntsha (ABG) lossis kuaj electrolyte. Feem ntau, pH ntawm peb cov ntshav yuav tsum nyob nruab nrab ntawm 7.35 thiab 7.45.
• Kev kuaj ntshav Potassium: Kev kuaj ntshav los ntsuas qhov ntau ntawm potassium hauv koj cov ntshav. Potassium yog ib yam khoom noj khoom haus uas pab peb cov hlab ntsha thiab cov leeg ua haujlwm tau zoo. Cov theem no tuaj yeem hloov pauv thaum muaj teeb meem adrenal.
• Kev kuaj ntshav Sodium: Kev kuaj ntshav ntsuas qhov ntau ntawm sodium hauv koj cov ntshav. Sodium kuj tseem ceeb rau kev ua haujlwm zoo ntawm koj cov hlab ntsha thiab cov leeg. Cov theem no kuj tuaj yeem sib txawv.

Qhov no kho li cas?

Yog koj muaj WFS, koj kuj yuav muaj sepsis . Yog li, thawj qhov uas cov kws kho mob yuav ua yog pib noj tshuaj tua kab mob rau koj tam sim ntawd thaum lawv ua kev kuaj mob kom paub seb yog dab tsi ua rau WFS. Lawv kuj yuav saib xyuas koj cov electrolyte (ntsev) thiab dej.

Thaum cov tsos mob ntawm sepsis raug tswj hwm lawm, cov kws kho mob yuav pib muab cov tshuaj rau koj hu ua glucocorticoids thiab mineralocorticoids . Cov no yog cov tshuaj hormones steroid. Glucocorticoids ua haujlwm los txo qhov o ntawm lub cev. Mineralocorticoids ua haujlwm los tswj koj lub cev cov ntsev thiab dej. Hauv cov lus yooj yim, lawv zoo li muab cov tshuaj hormones rau koj uas koj cov qog adrenal yuav tsum tsim tawm, tab sis tsis yog.

Tej zaum koj yuav xav tau kev hloov ntshav los yog ib txoj kev kho mob hu ua angioembolization . Qhov no suav nrog kev siv angiogram thiab kev siv ntshav txhaws (embolization) los txheeb xyuas thiab thaiv cov hlab ntsha uas muab ntshav rau cov qog adrenal. Qhov no yog ua kom tsis txhob los ntshav.

Qhov tseem ceeb tshaj plaws, tom qab WFS, ntau tus neeg yuav tsum tau noj cov tshuaj hormones ntxiv rau lawv lub neej , vim tias thaum cov qog adrenal puas lawm, lawv yuav tsis muaj peev xwm tsim cov tshuaj hormones kom raug.

Kuv yuav zoo dua sai npaum li cas tom qab kho tas?

Feem ntau cov neeg pib zoo dua hauv ib lossis ob lub lis piam tom qab pib kho mob. Txawm li cas los xij, txawm tias tom qab koj zoo tag nrho lawm los xij, koj tseem yuav muaj teeb meem ntawm lub cev lossis lub hlwb rau ntau lub hlis, lossis txawm tias ntau xyoo. Piv txwv li:

• Cov zaub mov tsis qab.
• Nkees heev.
• Nyuaj siab pw tsaug zog (tsis tsaug zog).
• Tus cwj pwm yuav mob tau yooj yim.
• Kev ntxhov siab.
• Kev nyuaj siab.

Yog li ntawd, nws yog ib qho tseem ceeb uas yuav tsum nco ntsoov tias nws yuav siv sijhawm me ntsis kom rov zoo tag nrho.

Yog koj kis tus kab mob no, koj yuav cia siab li cas?

Zoo li peb tau hais ua ntej lawm, yog tias tsis kho, WFS yog ib qho mob uas ua rau tuag taus. Tsis muaj kev ua xyem xyav txog nws.

Txawm li cas los xij, yog tias kho thiab rov zoo thaum ntxov, feem ntau cov neeg uas muaj WFS yuav zoo. Txawm li cas los xij, koj yuav xav tau kev kho mob hnyav, thiab cov teebmeem ntawm WFS tuaj yeem kav ntev li ntau lub hlis, txawm tias ntau xyoo. Yog li ntawd, nws tsis yog ib yam dab tsi uas yuav tsum tau saib yooj yim.

Puas tiv thaiv tau qhov teeb meem no?

Muaj ntau yam uas koj ua tau los txo koj txoj kev pheej hmoo ntawm kev mob Waterhouse-Friderickson syndrome:

• Ntxuav koj txhais tes tsis tu ncua thiab kom huv si yuav pab tiv thaiv kev kis kab mob. Qhov no yog ib qho yooj yim heev, tab sis nws tuaj yeem cawm koj ntawm ntau yam kab mob.
• Kev txhaj tshuaj tiv thaiv kab mob meningococcal yog qhov tseem ceeb heev rau cov menyuam yaus.
• Yog koj xav tias koj muaj kab mob, nrhiav kev kho mob tam sim ntawd. Tsis txhob tsis quav ntsej me ntsis kub taub hau lossis hnoos.

Koj saib xyuas koj tus kheej li cas thaum koj rov zoo?

Thaum koj rov zoo, koj thiab koj tus kws kho mob yuav tsum ua haujlwm ua ke los tsim ib txoj kev npaj kho kom rov zoo uas tsim nyog, muaj kev nyab xeeb, thiab zoo tshaj plaws rau koj. Txoj kev npaj ntawd yuav suav nrog cov yam xws li:

• So kom txaus. Lub cev thiab lub siab ob leeg xav tau so.
• Kev noj zaub mov kom muaj txiaj ntsig zoo yuav pab kom koj rov qab muaj zog yog ib lub tswv yim zoo. Yuav zoo heev yog tias koj nrhiav tau lus qhia los ntawm tus kws noj zaub mov txog qhov no.
• Teem cov hom phiaj me me. Piv txwv li, zaum saum txaj, sawv ntsug, hnav khaub ncaws koj tus kheej, da dej, taug kev luv luv, nce ntaiv.
• Kev tham txog koj txoj kev xav nrog koj tsev neeg, cov phooj ywg, lossis tus kws kho mob yog qhov tseem ceeb thaum lub sijhawm nyuaj no.
• Ua si thaum koj muaj zog thiab muaj zog. Pib maj mam thiab ua si raws li koj tus kws kho mob cov lus qhia.

Thaum twg kuv yuav tsum mus ntsib kws kho mob? / Thaum twg kuv yuav tsum mus rau chav kho mob ceev?

Yog tias koj tseem tsis xis nyob tom qab kev kho mob, lossis yog tias koj muaj teeb meem ua tiav koj lub hom phiaj kho kom rov zoo, nco ntsoov nrog koj tus kws kho mob tham.

Kab mob WFS yog ib yam mob loj heev uas yuav ua rau tuag taus yog tias tsis kho. Yog tias koj muaj cov tsos mob ntawm WFS, piv txwv li, tus kab mob zuj zus tuaj thiab tsis ploj mus, ces koj yuav tsum mus rau chav kho mob ceev (ETU) tam sim ntawd.Tsis zoo rau muab qhov no tso tseg.

Koj yuav tsum nug koj tus kws kho mob li cas?

Thaum koj paub tias koj muaj tus kab mob WFS, tej zaum koj yuav muaj ntau lo lus nug. Tsis txhob ntshai, nug koj tus kws kho mob cov lus nug zoo li no kom tshem tawm koj qhov kev tsis ntseeg:

• Koj paub li cas yog tias kuv muaj tus mob Waterhouse-Friderickson syndrome?
• Yog tias kuv tsis muaj Waterhouse-Friderickson syndrome, kuv yuav muaj lwm yam mob dab tsi ntxiv?
• Ua cas kuv tus mob Waterhouse-Friderickson syndrome thiaj li ua rau kuv muaj?
• Kuv puas yuav tau phais kho kuv cov qog adrenal?
• Koj puas xav tias kuv yuav zoo tag nrho?
• Kuv puas yuav tsum tau noj cov tshuaj hormones ntxiv?
• Kuv yuav siv sijhawm ntev npaum li cas los hloov cov tshuaj hormones?

Yog li ntawd, tej yam tseem ceeb tshaj plaws uas peb yuav tsum nco ntsoov ntawm qhov no yog dab tsi?

Kab mob Waterhouse-Friderichsen syndrome (WFS) yog ib yam mob hnyav heev uas yuav tsum tau kho mob tam sim ntawd. Yog tias koj muaj ib qho ntawm cov tsos mob no, lossis yog tias koj muaj kab mob uas tsis zoo dua, nws yog ib qho tseem ceeb uas yuav tsum mus rau chav kho mob ceev ceev sai li sai tau.

Ua raws li cov lus qhia kho mob uas koj tus kws kho mob muab kom raug. Tsuas yog thaum ntawd koj thiaj li tswj tau qhov mob WFS no thiab rov zoo sai li sai tau. Nco ntsoov tias, kev kho mob thaum ntxov tuaj yeem cawm tau ib tug neeg txoj sia! Tsis tas li ntawd, nws yog ib qho tseem ceeb heev uas koj yuav tsum saib xyuas koj tus kheej zoo thaum koj rov zoo.

` Kab mob Waterhouse-Friderichsen, cov qog adrenal, cortisol, septic, kev kis kab mob, kev kho mob thaum muaj xwm txheej ceev, cov tshuaj hormones