Myocarditis emntwaneni: diagnosis, Iimpawu kunye nonyango loko. Heart Abantwana Centre

Myocarditis ngendlela umntwana sifo kuthelekiswa rhoqo yezonyango mihla. Kufuneka ngoko nangoko ukuba oku sifo yingozi kwaye xa sithe asanyangwa kungakhokelela kubunzima ezinzulu. Yiloo nto, abazali abaninzi banomdla ulwazi malunga nesifo. Kutheni sisifo onjalo kukhulisa nkqu kwiintsana, yaye ziziphi iimpawu kufuneka ndikhangela? wenza njani unyango kunye noko ke iingqikelelo ukuba izigulane luncinane?

Iimpawu kunye iimpawu zesi sifo

Igama elithi "myocarditis 'ukuthini sisifo sikhatshwa ukudumba izihlunu zentliziyo. Esi sifo olufunyanwa izigulane yobudala eyahlukeneyo. Myocarditis emntwaneni okanye okwishumi elivisayo kunganzima ukuba zingathathwa ngokuba ityala esinqabileyo.

Ubangelwa ezitshangubeni yokukrala myocardium yahluke kakhulu, ukusukela umthondo ibe izifo zeethishu ziphethe ngayo namachiza okanye nezidlo kunye intoxications. Lidla kukukrala iquka kuphela izihlunu intliziyo, kodwa izakhiwo ezikufutshane, kuquka pericardium, imithambo yegazi kunye namanye amaziko.

Eyona eziphambili ezibangela myocarditis

Kucingwa ukuba ukudumba imisipha lwentliziyo kuqhagamshelaniswa phantse naluphi na uhlobo ezaziwayo losuleleko:

• Kwiimeko ezininzi, i "aboni" of myocarditis na iintsholongwane - adenovirus, enterovirus Coxsackie, kunye parvovirus, cytomegalovirus, iintsholongwane hepatitis, kunye neAvian.
• Ukudumba myocardium, yaye ngamanye amaxesha abe imvelaphi yebhaktiriya. Isifo ukuvela kwisiqalo lwesifo sephepha, iBrucellosis, elingena meningitis. Inkqubo yokukrala lwenzeka xa ukusebenza usulelo streptococcal.
• Hlula kokuphilayo rickettsial kukhokelela ukudumba izihlunu zentliziyo. Imiba yomngcipheko ziquka Q fever, yesifo ifiva, iintaba enamatye.
• Xa indima pathogen enze umngundo yayintsholongwane eyosulela, kowazo ingakumbi nomngundo Candida.
• Kukho myocarditis protozoal, ukuphuhlisa kwi imvelaphi toxoplasmosis, imalariya, leishmaniasis.
• Helminths (Echinococcus, Trichinella) naye evusa komtshiso oko.
• Kukho myocarditis ityhefu okubangelwa nokudla iarseniki, mercury, carbon monoxide.
• Ngamanye amaxesha sifo senzeka kwi amayeza, okanye emva kokuba ukuqaliswa zisigonyelwe sera.

• Imiba yomngcipheko ziquka inyoka kunye izinambuzane.
• neziphumo ezibonakalayo, ezifana emzimbeni kakhulu, nokushisa, ukungakhuseleki kwi ionizing radiation emzimbeni nako kudale komtshiso oko.
• I eminye imiba ziquka systemic lupus zomzimba, isifo samathambo kunye nezinye izifo ezithile sokuhlasela.

Njengoko ubona, kukho izizathu ezininzi ekuphuhliseni myocarditis. Uxilongo kufuneka ibandakanye uluhlu isifo ephambili njengoko kuchaphazela impumelelo unyango.

Iifom kunye ntlobo sifo

Kukho iinkqubo yokuhlelwa kwesi sifo. Kuye Sele kuxoxiwe iinketho lokuqulunqa esi sifo, kuxhomekeka unobangela. Kodwa ngexesha leengcali diagnosis ukutsalela ingqalelo kwezinye izinto:

• Ukuba sithetha ngexesha lesi sifo, myocarditis kunokuba etsolo, subacute okanye engapheliyo.
• Kuxhomekeka ubuzaza sifo kunokuba nobulali, eliphakathi okanye kakhulu.
• Ugqirha itsalela ingqalelo wabonakala lwezonyango - abantwana kungabonwa uhlobo obabuthandwa nangokurhala, kwakunye ityekile kwaye nazimpawu.
• Kwaye ixabiso le nobungakanani inkqubo yokukrala - kule meko focal ekwanti (apho uyazimela, isiza olunye ukudumba) kunye myocarditis ehlasela (ngezifo isebenza wonke umsipha).

Njani na myocarditis ebantwaneni? main isigaba

umntwana Myocarditis senzeka kwizigaba ezininzi - amayeza namhlanje ezintathu:

1. Sigaba viremia - amasuntswana wentsholongwane egazini (okanye ezinye izifo) kweyela myocardium. Okokuqala, ukuba njo kumphezulu weeseli izihlunu, uze zingene myocytes. Kweli nqanaba, kukho ukusebenza kwamajoni omzimba, nto leyo sikhatshwa i njini ukwanda kunye nokukhululwa interferon.
2. sigaba komzimba apho ngcono kakhulu impendulo yeseli omzimba kunye namanqanaba nokwanda antikardialnyh antibodies ukuba yande myocardium, echaphazela kakubi emsebenzini wayo. Kweli nqanaba iyasebenza abalamli arhabaxa. Kukho ukonakalisa microvasculature.
3. Ukuba isifo kwamkelekile, ngoko kukho ukuncitshiswa nokudumba kunye nokusekwa kweendawo fibrotic kwi imisipha entliziyweni. Ukuba unyango alinikwa neziphumo ezincumisayo (okanye engekho), isigulo uba ezingapheliyo. Xa ukudumba ezingapheliyo ngcembe ukuphuhlisa iingxaki, kuquka ukusilela intliziyo, cardiomegaly, Cardio.

Inkqubo loxilongo kunye zoviwo umntwana ukunceda ugqirha ufumanise uhlobo sifo, ezingunobangela zayo, kwakunye inqanaba lophuhliso - kuphela emva kokufumana idata ukudala irejimeni yonyango olusebenzayo ngokwenene.

Iimpawu zesi sifo ngosana

Iimpawu zesi sifo kuxhomekeke kwizinto ezininzi - kubalulekile kuthathelwa ingqalelo yomntwana iminyaka, imvelaphi kunye nohlobo sifo. Ingakumbi myocarditis obukhulu ezisanda kuzalwa. Kid chu kokufumana ubunzima, abe ecubhukile kunye baphola, njengoko nkqu naloo nkqubo ukondla ke kuyakhathaza. isikhumba A sana libunile, ngokufuthi unenxaxheba ithinti hina.

Olunye uphawu ithathwa mfutshane ngumphefumlo. Yena kuqala ivela ngamaxesha msebenzi - itakane ngokukhawuleza kwaye ephefumlayo kakhulu ngelixa yokuxhela, ukuhlamba, iintshukumo kwesisu, ukutya. Njengoko esi sifo iingxaki uphefumla inokubonwa sele sikarhulumente quiescent. Ngenxa yokuba nesifo senhliziyo kuvela nokudumba - ngamanye amaxesha ziba namandla, ngenxa apho ubunzima usana kuyanda kakhulu. iimviwo yomntwana elivelisa isibindi zikhulisiwe udakada.

umfanekiso lwezonyango komntwana kwiminyaka engaphezu emibini

Xa abantwana abadala, umfanekiso lwezonyango ibonakala ezahlukeneyo. Kwisithuba seeveki 2-3 emva myocarditis usulelo lokuqala ayiboniswanga. Ke iimpawu zibe ucaca ngakumbi. Iimpawu zesi sifo ziquka:

• isiyezi yesikhumba integument;
• ukudinwa, ubuthathaka, ukunyuka okungephi kobushushu;
• Ukunyamalala wokutya yoko zokunciphisa ubunzima;
• iintlungu kwizihlunu kunye namalungu, kwaye ngamanye amaxesha esiswini;
• njengoko sifo, abantwana baqala ezikhala buhlungu intliziyo;
• ukuphelelwa umoya kunye nentliziyo iyangongoza.

Myocarditis: Sifo izifo

Ekubeni sifo ubaluleke kakhulu uxilongo echanekileyo. Usana kungcono uqhagamshelane neziko zentliziyo yabantwana. Ezi nkqubo zilandelayo kufuneka moshilongo:

• Ukuze ukuqala komntwana nabazali bakhe baba uhlolisiso ukwenza imbali, ukufumanisa ubukho iimpawu ezithile.
• Kakade ngethuba loviwo, ugqirha Basenokukrokrela myocarditis - ingcaphephe ukubukela lipholi, nokuba ulusu cyanosis, izinga intliziyo ngokukhawuleza, phambi nokudumba kwakunye nokubamba-bamba umphefumlo.
• Enze uvavanyo lwegazi hormone serological egqiba ubukho yosulelo kunye nokudumba.
• Chest X-ray ivumela yingcali ukubona ukwandiswa kwemida zentliziyo kunye nobukho ekuma igazi iimpahla emiphungeni, nto leyo engqina ubukho ukudumba kwi myocardium.

• Ngokuyimfuneko eyenziwa electrocardiography kunye echocardiography - ezi nkqubo zinika ithuba lokuhlola intliziyo uze uvavanye iqondo lomonakalo.
• A biopsy le myocardium iboniswa kuphela kwiimeko ezininzi kakhulu kuba inceda kugqiba ubungakanani inkqubo arhabaxa.

Unyango lwe sifo: ukuba oogqirha ngawo?

Kakade ke, unyango ixhomekeke unobangela kunye nobungakanani nophuhliso isifo. Ngokomzekelo, phambi kwezifo kufuneka nemithi, ngoxa izilonda wentsholongwane egazini iyaboniswa kufumana amachiza antiviral. Kwakhona, abantwana ezimiselweyo immunomodulators, evumela ukubuyisela umsebenzi iindlela zokhuselo.

Ukuphelisa izigulane ukudumba uthathe iziyobisi nonsteroidal anti-ukudumba ( "Voltaren", "Brufen", "Indomethacin"). Kwiimeko kakhulu, ukusetyenziswa amayeza hormone steroid ukuba zinempumelelo ethe kratya ekulweni komtshiso oko. Ukuphelisa womchamo nokudumba asetyenziswa, evumela ukuba balahle ulwelo kwemfuneko. Kubalulekile kwakhona ukubandakanya kwisikimu ngamalungiselelo unyango vitamin. Ukuba yinkqubo esingapheliyo, eboniswe unyango Spa. Ukuba kukho arrhythmia ezingisayo, nto leyo efanele unyango ngamachiza, kusenokufuneka i umzila pacemaker.

Unyango lwenziwa kwindawo esibhedlele, uyacebiswa ukuba ukukhetha iziko zentliziyo yabantwana olungileyo noonesi elungileyo. Emva kokugqiba le khosi unyango umntwana kufuneka ahlolwe rhoqo-ups - ekuqaleni qho kwiinyanga ezimbalwa emva koko kabini ngonyaka (umbandela kakuhle kwesi sifo). Echo kunye electrocardiography, isifuba X-reyi, iimvavanyo zegazi kufuneka kwenziwe rhoqo - kuphela indlela uqaphele ubukho iingxaki okanye ukuphinda.

ekudleni komntwana kunye myocarditis

Abazali abaninzi babe nomdla namhlanje imibuzo malunga kutheni noko kukhulise na myocarditis ebantwaneni. Iimpawu kunye nonyango esi sifo, kubangelwa - kodwa ngokuqinisekileyo iingongoma ezibalulekileyo. Kodwa ke into ekufaneleke ukuba siyicinge kukuba xa unyango womntwana kufuneka batye ukutya okuthile (ukuba akukho malunga iintsana).

Iingcali Siyaleza swi carbohydrate - kufuneka ukuba unike umntwana wakho muffin, itshokolethi, isonka esimhlophe, pasta. Zingakotshwa indawo ngaphandle namakhekhe nagwele. Kwakhona, musa kakubi ukutya ezinetyuwa kwaye okuneziqholo, inyama okunamafutha kunye nentlanzi, isuphu broths nokuqhama - ngcono ukuba adle inkuku angamarhoqorhoqo, wesibindi (endleleni, kungakuhle ukulungiselela ukutya ukuze isibini). Intlanzi uvumelekile, kodwa kuphela ukuba kukho iintlobo ephantsi-fat. Inani amaqanda kufuneka ibe kuphela.

Yokudla kufuneka kuquka iimveliso zobisi, iziqhamo kunye nemifuno (ngaphandle nabantwana, quince, amapere nzima kunye nama-apile, iidiliya). Chocolate kunye nezinye iilekese na indawo ubusi, jam, marmalade kunye marshmallow.

Uqikelelo ku myocarditis

Myocarditis kwi umntwana ngakumbi yingozi kwiinyanga zokuqala yobomi - kweli qela lobudala yezigulane, okona kufa waphawula rhoqo. Abantu abane ixhomekeka kwifomu kunye neqondo ubukhulu sifo. Umzekelo, uhlobo ezolileyo sesi sifo yaye ngamanye amaxesha akafuni kufuna unyango. ukudumba bacteria iSADC unyango lula, kodwa xa izilonda wentsholongwane egazini ngeziphumo sifo kuba kuhle kakhulu.

Phakathi kwabantwana esikolweni abaneminyaka kunye elivisayo kubhalwe enqabile iziganeko ezibi - ngokuqhelekileyo abantwana ngokukhawuleza kwakhona uze ubuyele ubomi obuqhelekileyo. Noko ke, maxa wambi ngexesha myocarditis intliziyo ezimile kwiindawo sclerotic enokunceda kubekho ukusilela intliziyo sele umdala.

iyeza lokunqanda

Ngelishwa, akukho ndlela yokuba myocarditis. Noko ke, iingcali bacebisa ukuba balandele imigaqo. Umfazi okhulelweyo kufanele ukuba ingqalelo kwimpilo yabo, ukuthintela ukunwenwa kwezifo ezosulelayo, ukunqanda ukudibana ityhefu bavavanywe rhoqo.

Kuba urhulumente usana kufuneka zibekwe esweni ngokusondeleyo - sisifo esosulelayo kwaye ukudumba kufuneka ene kwaye ukhawuezelwe ngonyango. Ngexesha uqhambuko ngengqele kangangoko kunokwenzeka akukho mfuneko ukuvumela qhagamshelana yomntwana abantu abosulelekileyo. Kakuhle imeko amajoni omzimba kuchaphazela ukutya efanelekileyo, nocwangciso ecacileyo ngemihla, umsebenzi ngokulinganisela kunye lukhuni.