HELP syndrome (HELLP-syndrome) - kwingxaki eyingozi kwithuba leenyanga ezintathu III zokukhulelwa: oonobangela, isifo, unyango

Kubomi wonke umntu ekugqibeleni okomzuzwana leyo enyanzelisa ukuba babuyele uncedo ngaphandle. Amaninzi abancedisi kwiimeko ezinjalo lezi. Oku kwenzeka xa umzimba womntu unolungenelelo sifo singanyangekiyo, kwaye ukumelana nazo akwenzeki. Wonke umntu uyazi ukuba imeko abonwabileyo zokukhulelwa - akukho sisifo, kodwa omama elizayo abafuna uncedo lwezonyango kunye nasengqondweni.

"Nceda!", Okanye apho igama sifo

Tsalela uncedo ngeelwimi ezahlukeneyo isandi ezahlukeneyo. Umzekelo, kwi IsiNgesi yimizamo Russian, "Uncedo!" Libizwa like "Uncedo". HELP syndrome (HELLP) phantse kwazenzekela nenkcubeko kunye nesicelo ngoku ngamazwe uncedo.

Iimpawu kunye neziphumo zalo ingxaki ngexesha lokukhulelwa kangangokuba ingqalelo yezonyango engxamisekileyo kubalulekile. HELLP segama lonke uluhlu iingxaki zempilo: esibindini, kunye igazi ekunqandeni kunye nengozi yokuba ukopha. Ngaphandle kungasentla, HELLP-syndrome ebangela ukungasebenzi izintso ukuphazamiseka uxinzelelo lwegazi, ngokwenjenjalo mandundu kakhulu ikhondo yokukhulelwa.

Umfanekiso we sifo kakhulu kangangokuba kukho ukukhanyela isibakala yomzimba nokuzala, ukusilela sokuhlasela kwenzeka. Le nto yenzeka xa ukucima kombane lilonke umzimba nemazi xa zokuzikhusela azivumi kusebenza, uqengqa ukuxinezeleka kunawo, ebunayo ukuthanda seempumelelo ubomi baqhubeke nomzabalazo. Igazi ayithethi ihlwili, isilonda akazange aphilise, ukopha akupheli, kwaye isibindi ayikho nako ukwenza imisebenzi yayo. Kodwa imeko ebalulekileyo efanele ukulungisa zonyango.

imbali yezonyango

HELP syndrome kuchazwa kwi kwenkulungwane ye-19. Kodwa kuphela ngo-1978 Gudlin wabophelela loo ngezifo samathambo ye pre-eclampsia ngexesha lokukhulelwa. Kwaye ngo-1985, enkosi Weinstein, iimpawu saa ziye zadityaniswa phantsi igama elinye: HELLP-syndrome. Kuyaphawuleka ukuba oovimba zonyango zasekhaya, le yingxaki enkulu nesele abachazwa. Kuphela nje ezimbalwa anesthetists Russian kunye neengcali labagula kakhulu ukunika iinkcukacha ngokupheleleyo eli ingxaki kakhulu yokukhulelwa.

Ngelo xesha, HELP syndrome ngexesha lokukhulelwa ukuzuza ngokukhawuleza amandla kwaye kuthatha kude kakhulu ubomi.

Thina achaza kama ngasinye ngokwahlukeneyo.

hemolysis

HELP syndrome ngokuyintloko kuquka intravascular hemolysis. Esi sifo umngcangcazelisi luphawulwa kukutshatyalaliswa ngokupheleleyo esiseleni. Ukutshatyalaliswa kunye ekugugeni iiseli ezibomvu zegazi ibangela icesina, senyongo ulusu, yimbonakalo igazi kwizifundo umchamo. Eyona emibi ezisongela ubomi - umngcipheko ukopha enzima.

Ubungozi thrombocytopenia

Ilungu elandelayo nezishunqulelo syndrome - thrombocytopenia. Le meko iphawulwa ukuncipha zegazi count kwifomula igazi, ekugqibeleni ebangela ukopha kulogo. Misa le nkqubo ibe kuphela esibhedlele, kwaye ngexa lokukhulelwa, le meko iyingozi. Isizathu ingaba ukuphazamiseka ezinzima omzimba, nto leyo ekhokelele ekubeni anomaly apho umzimba alwe nawo ngokwawo, batshabalalisa iiseli negazi kunempilo abomvu. Iluphawu isoyikiso kubomi Kwavela kwisiqalo yeenguqu inani ziiplatelets ekunqandeni ukuphazamiseka.

intwasahlobo ezoyikekayo: Ukwanda enqanda esibindini

Le ezimbi ezintsonkothileyo zifakiwe kwi HELP syndrome, akathweswa sithsaba olo phawu krakra njengoko nokwanda enzyme zesibindi. Oomama abakhulelweyo oko kuthetha ukuba omnye amalungu ibalulekileyo umzimba womntu kukho iimpazamo ezinzulu. Ngapha koko, isibindi hlantswa nje umzimba ityhefu kwaye inceda ukuphunyezwa umsebenzi wokudla, kodwa ichaphazela kwisigaba ngokwasengqondweni iimvakalelo. Amaxesha amaninzi utshintsho kwalo olunjalo zafunyanwa ngexesha uvavanyo lwegazi lwesiqhelo, nto leyo yenziwa umfazi okhulelweyo. Xa yokukhulelwa nzima amanani UNCEDO syndrome kwahluka kakhulu kwisiqhelo, ebonisa umfanekiso esisongela. Ngoko ke, iingcebiso zobugqirha - inkqubo yokuqala, inyanzelekile ukuba abulawe.

Ingakumbi kwithuba leenyanga ezintathu lesithathu

3 ezintathu ukukhulelwa ibaluleke kakhulu ukwenzela ikamva yokumitha kweenkonzo. iingxaki rhoqo zezi nokudumba, heartburn nokuphazamiseka yokwetyisa.

Oku kwenzeka ngenxa yokuba zokungahambi kakuhle nezintso nomhlehlo wesibindi. wesibeleko landile akanayo uxinzelelo ayihlekisi kwi izitho zokugaya, apho kungenxa yokuba ukuba aqalise ukuqhekeka. Kodwa gestosis ukuze kuvele imeko ekuthiwa pre-eclampsia kunye eclampsia, leyo ungayenzi mandundu buhlu- epigastrium, musani ukubacaphukisa ukubonakala isicaphucaphu, ukugabha, nokudumba, uxinzelelo oluphezulu lwegazi. Ngokuchasene imvelaphi yeengxaki luvo kwenzeke ukuxhuzula. iimpawu ezinobungozi ukwandisa, ngamanye amaxesha phantse okombane, ibangela umonakalo omkhulu umzimba, ezisongela ubomi umama okhulelweyo kunye olungekazalwa. Ngenxa yokukhulelwa kakhulu, nto leyo edla ihambisana ibe ezintathu 3 zokukhulelwa, abantu basoloko syndrome kunye isithethi ebizwa UNCEDO.

iimpawu eziqaqambileyo

HELLP-syndrome: picture lwezonyango, uphethwe, amaqhinga yokubelekisa - umxholo ingxoxo yanamhlanje. Okokuqala, kufuneka bazi inani iimpawu ezingundoqo ezihamba nale ingxaki ezoyikekayo.

1. Ngomhla inxalenye yenkqubo luvo. Inkqubo luvo iphendula ezi ukuphazamiseka ukuxhuzula, ebuhlungu kakhulu, ongaboniyo.
2. Job yegazi aphazanyiswa ngenxa nokudumba izicwili nokwehla nokuhamba kwegazi.
3. iinkqubo zemigudu ngokubanzi aphulwe, kodwa nokudumba yemiphunga kunokwenzeka emva ekubelekeni.
4. Ngakwicala hemostasis kunye thrombocytopenia waphawula nokunyhashwa zegazi component ezisebenzayo zomsebenzi.
5. Ukuncipha umsebenzi kwesibindi, ngamanye amaxesha ukufa zaso. Ayifane waphawula ezizenzekelayo komsipha hepatic, nto leyo ekhokelela ekufeni.
6. Ukophulwa kwenkqubo genito-wokuchama: oliguria, kwekhono sezintso.

HELP syndrome esibonakala ezahlukeneyo iimpawu:

• kabi esibindini;
• ukuphalaza;
• ikhanda olunamandla;
• zesifo;
• imeko yicesina;
• ukuphazamiseka lokuqonda;
• insufficiency womchamo;
• inyama edematous;
• uxinzelelo enxamnye noko bekumiselwe;
• hemorrhages ezininzi kwiindawo yokuntlokothiswa;
• yellowness.

isifo Laboratory kuboniswa thrombocytopenia, hematuria, ekufumanekeni of iiprothini umchamo negazi, ihemoglobin ephantsi, ukwanda yibilirubin kuvavanyo kwegazi. Ngoko ke, ukuba ukucacisa uxilongo bokuphela yonke iimvavanyo esimbaxa elebhu kuya kufunwa.

Indlela ukuqaphela iingxaki?

Ukuze babone ngexesha nokunqanda iingxaki kakhulu, nako kuthwalelwa phandle umntu iingcebiso zonyango apho bayacetyiswa nabondli elizayo ukufika rhoqo. ingcali okhulelweyo ubeka kwirekhodi, uze ngokusondeleyo esweni utshintsho emzimbeni yomfazi ngexesha lonke. Ngaloo ndlela, a ugqirha ngexesha ukulungisa ezinxaxhileyo okungafunwayo athathe amanyathelo afanelekileyo.

Ukuba amtyhile utshintsho zophendlo lwezifo ngokusebenzisa iimvavanyo elebhu. Umzekelo, umchamo iiproteins kuya kusinceda ukubona ukuba kukho enye. Ukwanda izalathisi protein inani leukocytes lubonisa yezitenxo iqapheleka emsebenzini nezintso. Phakathi kwezinye izinto, kungakhona unciphiso elibukhali kwi kwimali umchamo, kunye nokwanda kakhulu nokudumba.

Iingxaki esibindini sibonakalalisiwe nje kuphela intlungu ekunene ikota yesangqa ephezulu, ukugabha, kodwa kukho utshintsho egazini (ukwanda izixa enqanda kwesibindi), kunye zesibindi ukukhula kwi Ngokucofa ziviwa ngokucacileyo.

Thrombocytopenia kwakhona ukubonwa laboratory kuvavanya igazi umfazi omithiyo, apho ngokwenene ingozi UNCEDO syndrome.

Ukuba ukrokrela eclampsia kunye UNCEDO syndrome ulawulo olusisinyanzelo uxinzelelo lwegazi ngenxa spasm kwemithambo yegazi kunye egazi igazi komsebenzi wayo ukwandisa kakhulu.

diagnosis umehluko

Nendlela mihla BANCEDE syndrome uphethwe ku nokubeleka iye yaphinda yathandwa, ngoko ngokufuthi uyibeke iphutha. Amaxesha amaninzi ukufihla ngasemva kulo izifo ezahlukeneyo ngokupheleleyo, hayi ngaphantsi kuyingozi, kodwa ezingenamsebenzi ngakumbi kokuhlambeleyo:

• gastritis;
• hepatitis load;
• zomzimba lupus;
• urolithiasis;
• nokudumba angama;
• izifo kwesibindi (ezinamanqatha, ukuqina);
• purpura thrombocytopenic of umyalezo engaziwayo;
• kwezintso.

Ngoko umehluko. Uxilongo kufuneka ithathele ingqalelo ezahlukeneyo ongazikhetha. Ngako oko, eziboniswe ngasentla triad - hyperenzymemia wesibindi, hemolysis kunye thrombocytopenia - ayisoloko ibonisa ubukho kule ingxaki.

Izinto ezibangela HELP-syndrome

Ngelishwa, ubungozi aziqondwa kakuhle, kodwa kukho amacebiso bandiqumbisayo UNCEDO syndrome isenokuba zizathu zilandelayo:

• izifo zengqondo;
• hepatitis-eyabangelwa iziyobisi;
• utshintsho genetic enzymatic esibindini;
• prolificacy.

Ngokubanzi syndrome eyingozi kwenzeka xa ingqalelo laneleyo yokukhulelwa nzima ikhosi - eclampsia. Kubalulekile ukwazi ukuba esi sifo uziphethe engalindelekanga kakhulu: ibizwa ukuphuhlisa ngesantya umbane, iyalahleka ngokwayo.

amanyathelo zonyango

Xa zonke iimvavanyo wenziwe kwaye umahluko. sifo, ungenza kwizigqibo ezithile. Xa ufaka i "syndrome UNCEDO" unyango diagnosis ejoliswe uzinzo imeko umfazi omithiyo umntwana olungekazalwa, kwakunye nokunikezelwa olungele izimele kwikota. imisebenzi Medical zenziwa kunye uncedo obstetrician-ugqirha, iqela ngokumphefumlela, lo anesthesiologist. Ukuba kuyimfuneko, qhagamshela ezinye iingcali: emine okanye zamehlo. Ubukhulu becala bayiyeka zomzimba ezininzi, yaye amanyathelo othintelo ukwenzela ukuthintela iingxaki kunokwenzeka.

Phakathi common nzima ikhondo yezonyango yokungenelela, kungathiwa:

• lamabutho placental;
• yokopha;
• nokudumba ubuchopho;
• nokudumba pulmonary;
• ukusilela renal;
• utshintsho isibindi enobungozi kwaye umsantsa;
• ukopha alawule.

Xa uxilongo ngokuchanekileyo nangexesha babencedisile yobungcali amathuba okugula luzobe ubuncinane.

iqhinga angama

Amacebo izenzo nokubeleka ngokunxulumene iintlobo ngokuqatha yokukhulelwa, le syndrome UNCEDO nzima ngakumbi, ucacile: ukusetyenziswa kwicandelo ngoqhaqho. Xa oqolileyo ukulungela ukuzala zendalo, esebenzisa prostaglandins nesibophelelayo ebulewe esibelekweni.

Kwiingozi ezimasikizi, Uqhaqho isetyenziswa zomzimba kuphela endotracheal.

Ubomi emva kokubeleka

Iingcali waphawula ukuba sifo kwenzeka kuphela ngexesha leenyanga ezintathu lesithathu, kodwa iyakwazi ukwenza inkqubela kwiintsuku ezimbini emva ukubatshabalalisa umthwalo.

Ngoko ke, BANCEDE syndrome emva kokuzalwa - ziyenzeka kunokwenzeka kakhulu uthetha wakhetha esweni ngokusondeleyo kamama nomntwana kwithuba Kukudandatheka. Ingakumbi kumayelana amabhinqa kakhulu elibaleka yokukhulelwa ngexesha lokukhulelwa.

Ngubani na obange noko ukwenza ntoni?

HELP syndrome - zophazamiseko phantse onke amalungu kunye neenkqubo yomzimba ababhinqileyo. Ngexesha sifo kukho ongenza olumandla nemfezeko amathuba eliphezulu ekufeni, kunye ukungaqheleki intrauterine ezingekazalwa. Ngoko ke, ukususela kwiveki 20 wasekwayo umama okhulelweyo kuyimfuneko ukuqhuba idayari zokuzibeka iliso, okubangela zonke iinguqu ezenzeka emzimbeni. ingqalelo ekhethekileyo kufuneka ihlawulwe kwezi ngongoma zilandelayo:

• uxinzelelo lwegazi: ukuba uyehla na uye phezulu ngapha kwamaxesha amathathu kufuneka uqaphele;
• ubunzima ayaguquka: ukuba wayeza kuvuka kakhulu, mhlawumbi, isizathu leyo ukudumba;
• intshukumo Palsy kukhulu kakhulu, okanye, icala, intshukumo ndiwuzolise - ngokucacileyo isizathu sokuba unyango kwagqirha;
• ubukho nokudumba: ukufukuka enkulu izicwili lubonisa kwekhono sezintso;
• nesisu esibuhlungu okungaqhelekanga: ingakumbi ebalulekileyo kummandla kwesibindi;
• Uhlalutyo rhoqo konke oko ndikumiselweyo, kufuneka senziwe ngomoya omhle kwaye ekuhambeni kwexesha, njengoko kufuneka ukuba kuxhamle kanye umama nomntwana engekazalwa.

Zonke iimpawu ezilumkisayo kufuneka ngoko nangoko ingxelo kugqirha wakho, ugqirha nje kuphela ukwazi ukuhlola ngokwaneleyo imeko ze athathe isigqibo esifanelekileyo.