Polycythemia lokwenyaniso. Oonobangela, Iimpawu, diagnosis, Treatment

Polycythemia - loo nto sisifo leyo kumiselwa ngokujonga kuphela ebusweni loo mntu. Kwaye ukuba ukuphumeza iimviwo zokuxilonga, yokuthandabuza kwaye angahlali. Kule ncwadi zonyango kukho ezinye amagama kule ngezifo: erythremia, isifo Vakeza. Enoba kwekota, esi sifo ibanga ingozi enkulu ebomini bomntu. Kweli nqaku siza kuxubusha ngokweenkcukacha ezininzi indlela ukwenzeka kwayo, iimpawu zaseprayimari, zigaba kwaye unyango ezifundiswayo.

ulwazi jikelele

Phantsi polycythemia ibhekisela myeloproliferative umhlaza igazi apho wamathambo uvelisa iiseli ezibomvu zegazi izixa kakhulu. Ukuze isiXhosa ukwanda amanye amacandelo enzyme emsebenzini, ezizezi leucocytes neeplatelets.

Iiseli ezibomvu egazini (aqoqiwe ngenye indlela), okroqiweyo ioksijini, zonke iiseli yabantu, ngokumhlangula ukusuka nemiphunga iindlela izibilini. Kwakhona uxanduva ukususwa carbon dioxide ancedisana nokuyihambisa emiphungeni kuba ingumphunga elandelayo.

Erythrocytes ziveliswa ngokuqubekayo kwindlela umongo wethambo. It is a kwinyama Spongiform Ukuba kwisininzi lobulali ngaphakathi ithambo, kwaye linoxanduva inkqubo hematopoiesis.

Leukocytes - iiseli ezimhlophe zegazi ezinceda zizifo ekulweni. IiPlatelets iziqwenga iseli anuclear ngu ingqibelelo lokuphazamiseka nemithambo. Bona bayakwazi ngqo omnye komnye kwaye occlude nokuvulwa, ngaloo ndlela ukuyeka ukopha.

Polycythemia lokwenyaniso luphawulwa imveliso ngokugqithisileyo iiseli ezibomvu zegazi.

ukwanda

Le ngezifo idla olufunyanwa abadala, kodwa unako kwenzeka abafikisayo nabantwana. Isifo ukungavakali kangangexesha elide, oko kukuthi nazimpawu. Ngokutsho izifundo, ubudala umndilili izigulana isusela ukusuka kuma-60 ukuya kwiminyaka emalunga 79. Abantu Abaselula mancinane amathuba okuba agule kakhulu, kodwa ke esi sifo ubaleka kwabo nzima kakhulu. Abameli besini ngokomelela, ukuba ukholelwa manani, izihlandlo eziliqela rhoqo une polycythemia.

Pathogenesis

Uninzi iingxaki zempilo ezinxulumene nesi sifo, kwenzeka ngenxa yokwanda okuqhubekayo kwenani iiseli ezibomvu zegazi. Ngenxa yoko, igazi uba obukhulu ngokugqithiseleyo.

Kwelinye icala, ukwanda viscosity yayo kuphakamisa ukuyilwa egazi (thrombi). Bayakwazi kuphazamise ukuhamba kwegazi eziqhelekileyo ngokusebenzisa imithambo ngemithambo. Isimo esinjalo kudla unobangela kwamalungu omzimba kunye isifo sentliziyo. Eyona nto kukuba igazi elingqingqwa kwimikhumbi kade eziliqela. Intliziyo kufuneka sizame ukuba amsunduze ngokoqobo kuye.

Linyuke yokumpompoza kwegazi awukuvumeli izibilini ukuze bafumane imali efunekayo ye-oksijini. Oku kuquka uphuhliso sisifo sentliziyo, intloko ebuhlungu, angina, ubuthathaka kunye nezinye iingxaki zempilo, nguwuphi na zishiywe.

nokubekwa kwezifo

• I. I isanda.

1. Buhlala iminyaka emi-5 okanye ngaphezulu.
2. Le spleen olingene.
3. iimvavanyo zegazi abonisa ukwanda ngcathu inani iiseli ezibomvu zegazi.
4. Ezinobuzaza kunqabile sifo.

• II A. inyathelo polycythemic.

1. Ubude ukusuka 5 ukuya kwiminyaka eli-15.
2. Kukho ukwanda nge-amanye amalungu (udakada, isibindi), ukopha kunye thrombosis.
3. Iindawo Ithumba kwi udakada ngokwayo ayinayo.
4. Ukopha kungabangela ayoni emzimbeni.
5. Ekuhlalutyeni igazi kukho ukwanda ziqhubeke iiseli ezibomvu, iiseli ezimhlophe neeplatelets.

• II step B. polycythemic kunye myeloid metaplasia udakada.

1. Cazulula bonisa umxholo ukwanda zonke iiseli igazi, ngaphandle lymphocyte.
2. Kukho inkqubo neoplastic kwi udakada.
3. Lo mfanekiso kwe oyile livela, thrombosis, ukopha.
4. Umongo ithambo ukwakheka kancane emibi.

• III. sigaba igazi.

1. Egazini, kukho ukuhla okukhulu erythrocytes, neeplatelets kunye leukocytes.
2. Kukho ukunyuka ngokukhawuleza kwi ubungakanani udakada wesibindi.
3. Esi sigaba ngokuqhelekileyo eyenzeke kwiminyaka engama-20 emva kokuqinisekiswa kwesifo.
4. Isifo ingaguqulwa njani na ibe leukemia oyingozi okanye engapheliyo.

Izinto ezibangela izifo

Ngelishwa, ngoku iingcali abakwazi ukuthetha into izinto kukhokelela kuphuhliso kwezifo ezifana polycythemia lokwenyaniso.

Uthambekele ukuba ingcamango wentsholongwane egazini-yemfuza. Ngokutsho kwakhe, iintsholongwane ezikhethekileyo (kukho malunga 15 pieces) ebiqaliswe kwi umzimba womntu phantsi kwempembelelo eminye imibandela echaphazela kakubi ngayo umzimba, angene kulo umongo kunye zamanzi. Iiseli ke ngoko endaweni emuncu ngokukhawuleza aqale ukukhula nande, wakha iziqwenga ezintsha.

Kwelinye icala, polycythemia isizathu ukuba yayihleli phezu sifuze amafa. Izazinzulu ziye kubonakele ukuba esi sifo uvel ukuvala izalamane zomntu ogulayo, kunye nabantu kunye nesakhiwo kakuhle zofuzo.

Predisposing ezintweni sifo

• X-reyi zokukhanya, ionizing radiation.
• izifo emathunjini.
• Virus.
• Tuberculosis.
• Surgery.
• zeleka rhoqo.
• ukusetyenziswa Long-term amaqela athile iziyobisi.

picture clinical

Ukususela Inqanaba lesibini kwesi sifo, kwinkqubo zophendlo lwezifo azotywe phantse zonke iinkqubo nezibilini. Zidweliswe apha ngezantsi imvakalelo ayinyani yesigulana.

• Ubuthathaka kunye ingqiqo yanto ukukhathala.
• ukubila Ukwandiswa.
• Ukucutheka okukhulu yokusebenza.
• intloko ebuhlungu engapheliyo.
• imemori sokunciphisa.

Polycythemia lokwenyaniso kwakhona sikhatshwe mpawu zilandelayo. Kwimeko nganye lazo buyahluka.

• Emithanjeni kwaye utshintshe i nombala esikhumbeni. Izigulane qaphela ubukho emithanjeni kuchazwe ngokucacileyo. Kulo sifo ulusu esibonakala cherry sayingqombela tinged, oko oqaphelekayo ingakumbi kwiindawo ubuze omzimba (ulwimi, izandla, ubuso). Imilebe luhlaza, amehlo akhe wayebonakala anozizi. Olu tshintsho kwinkangeleko kungenxa ukuphuphuma kwemithambo yegazi kwamanzi, kunye nokwehla iphawulwe promotion yayo.
• isikhumba silume. Le uphawu kwenzeka ngo-40% yamatyala.
• Rodonalgia (iintlungu elivuthayo zezomzuzwana kwi iincam iminwe neenzwane, leyo zikhatshwa anozizi kwesikhumba). Ukuvela kwalo uphawu lu dityanisiwe kumanqanaba ze zegazi kunye nokusekwa mikrotrombov.
• Ukwandisa ubungakanani udakada.
• Imbonakalo izilonda esiswini. Ngenxa yokuba umzimba isitya thrombosis isifo encinane uphelelwa ukuxhathisa yayo Helicobacter pylori.
• egazi. izinto zawo wachaza okwandileyo viscosity igazi kunye notshintsho kweendonga nemithambo. Njengomgaqo, kwimeko enjalo kukhokelela ekuphazanyisweni kwenkqubo igazi lihambe nemilenze, ebuchotsheni kunye neempahla ivaleke.
• Ubuhlungu emilenzeni.
• ukopha esindayo iintsini.

ekuxilongweni

Ubukhulu becala ugqirha uqokelela imbali yezonyango epheleleyo. Yena ungabuza inani ekucaciseni imibuzo: xa wabonakala nobunzima / Ukuphelelwa / ubuhlungu buhlungu, njl Kubalulekile ngokufanayo ukuqinisekisa ubukho zizifo ezingapheliyo, imikhwa emibi, qhagamshelana kunokwenzeka kunye izinto eziyityhefu ...

Emva koko, ukuxilongwa ngokwasemzimbeni. Yingcali limisa umbala yesikhumba. Ngokucofa kunye olujoliswe elivelisa udakada eyandisiweyo okanye isibindi.

Ukuqinisekisa esi sifo a iimvavanyo zegazi mandatory abaqeshwayo. Ukuba isigulana na le ngezifo, iziphumo zovavanyo zezi zilandelayo:

• Ukwandisa inani iiseli ezibomvu zegazi.
• Ephakamileyo iparameters hematocrit (ipesenti iiseli ezibomvu zegazi).
• iparameters mpilo High.
• amazinga aphantsi erythropoietin. Le hormone linoxanduva ukukhuthazwa umongo wethambo ekuveliseni iiseli ezintsha abomvu.

Uxilongo kukwaquka biopsy kwengqondo aspirate. Inguqulelo yokuqala phando ibandakanya ukutya inxalenye engamanzi lobuchopho, kunye biopsy - amalungu esiqinileyo.

isifo polycythemia kungqinwe uvavanyo gene wezakhi.

Yintoni ekufuneka ziphathwe?

Ngokupheleleyo ukoyisa isifo ezifana polycythemia oyinyaniso, oko akwenzeki. Kungenxa yoko le nto uthomalaliso lujolise ngokukodwa ekunciphiseni wabonakala zonyango kunye nokwehlisa iingxaki thrombotic.

Izigulane zaye ikakhulu babelwa nomkhuba. Le nkqubo kukwaquka ukususwa Umthamo omncinane wegazi (200 ukusa malunga 400 ml) ngenjongo kuliyeza. Kuyimfuneko ukuba kuqheleke ukuba ubuninzi Ipharamitha igazi nokunciphisa viscosity yayo.

Izigulane zidla emiselweyo "aspirin" ukwenzela ukunciphisa ingozi yokuba iintlobo ezahlukeneyo iingxaki thrombotic.

Chemotherapy Isetyenziswa ukulondoloza hematocrit eziqhelekileyo, xa kukho ukurhawuzelela kakhulu, okanye thrombocytosis ukwanda.

Bone lomongo abohlukeneyo lwenziwa kwesi sifo kunqabile kakhulu, ukususela ngezifo kwimeko unyango eyaneleyo ayikho olubulalayo.

Kufuneka kuqatshelwe irejimeni yonyango ethile kwimeko nganye okhethiweyo ngamnye. Uthomalaliso echazwe ngasentla kukuba ngenjongo yolwazi kuphela. Ayikhuthazwa ukuzama ukumelana nesi sifo.

iingxaki kunokwenzeka

Esi sifo kakhulu ngokwaneleyo, ngoko musa Xabisa ngonyango. Kungenjalo, zanda amathuba iingxaki ezingemnandi. Ezi ziquka oku kulandelayo:

• egazi. Oonobangela kwenkqubo zophendlo lwezifo ukuba kungenzeka ekwandiseni viscosity igazi, ukwandisa inani iiseli ezibomvu, neeplatelets.
• Urolithiasis kunye sifo.
• Ukopha, nasemva kokuba iinkqubo minor yotyando. Njengomgaqo, ingxaki enjalo bajamelana emva izinyo.

Outlook

isifo Vakeza - isifo esinqabileyo. Iimpawu ezithe zenzeka xa nisaqala wophuhliso lwawo, kufuneka isizathu sokuba uviwo kwangoko kunye nonyango alandele-up. Xa engekho unyango olwaneleyo, ukuba isifo zange kwafunyaniswa ngendlela ngexesha, ukufa kwenzeka. Oyena nobangela wokufa kaninzi oku bekwenza iingxaki nemithambo okanye inguqu sifo ibe leukemia esinganyangekiyo. Noko ke, unyango enobuchule kunye nokubambelela olungqongqo iingcebiso ezivela ugqirha kakhulu sandise ubomi yomguli (iminyaka 15-20).

Siyathemba ukuba yonke ingcaciso enikwe kweli nqaku kuya kuba luncedo ngokwenene kuwe. Hlala uphilile!