Rheumatism kwi umntwana: iimpawu, unyango, uthintelo

Kweli nqaku siza kuxubusha ngokweenkcukacha indlela umntwana kubonakaliswa rheumatism. iintlobo Iimpawu, ingakumbi unyango, isifo kunye nothintelo - imiba engundoqo eza kuxutyushwa.

Kwangoko iphawule yakho yokuba rheumatism ingaqala nanini na ubudala ngokupheleleyo. Esi sifo uhlobo esosulelayo kunye negazi. A ezahlukeneyo izinto zonyango ngenxa yokuba lo rheumatism luchaphazela hayi nayiphi na umzimba ethile, kwaye kwizicwili ekhoyo kuzo zonke imizimba yabantu. Cinga iimpawu samathambo ebantwaneni.

Yintoni na?

Siqala ibali yethu ingcamango "rheumatism". Yintoni na kwesi sifo ndinaso? Ngoko ngokuba sisifo yokukrala ochaphazela umzimba yonke ngaxeshanye (ngamanye amazwi, le nkqubo). Imvelaphi samathambo - an esosulelayo-komzimba. Uye elinye igama: Sokolowski isifo-Buyo.

Lubonakala yi izitshanguba izifo zomzimba nokuqina. Ikakhulu wathinta ancedisana nokuqina kwenkqubo sentliziyo kunye luvo. Kukho iinkcukacha-manani, nto leyo ibonisa ukuba amabhinqa amaninzi ubunzima na kwesi sifo ndinaso - ngaphezulu kathathu kunamadoda. Nangona kunjalo, lo mahluko liyalahleka sele umdala.

Ziziphi iimpawu samathambo ebantwaneni? Iimpawu kunye nonyango lwesifo ebuntwaneni ezahlukeneyo kancinci. Oku kungenxa yokuba abantwana rheumatism kwezinye izinto awohluke, ezifana:

• aqine ucaca ngakumbi nemithambo yegazi;
• utshintsho kwezinye iinkqubo kunye nemibutho;
• amathuba utshintsho ngendlela ezingapheliyo zesi sifo (ipesenti amathuba yobuntwana liphezulu kakhulu);
• kukuvela likakade.

Le fom ezingapheliyo kuboniswa ngolu hlobo lulandelayo: Emva unyango kukho ixesha aleleyo, kodwa emva kwethutyana ingxaki ubuyela. Kuyaphawuleka ukuba ukwenzeka samathambo kuvandlakanywa ebantwaneni kuqhelekile kakhulu.

Iimpawu samathambo ebantwaneni kweminyaka emi-2 okanye 10 musa kwahluka enye kwenye. Nceda uqaphele ukuba abantwana ezithandwa kakhulu sisifo ukusuka kwiminyaka esixhenxe ukuya kwelishumi elinesihlanu. Abantwana rheumatism ubuso eziliqela iingxaki, kuquka ukusilela sentliziyo. Rheumatism kaninzi iqala ukuphuhlisa emva kokosuleleka. Ezi ziquka fever nebomvu, umqala obuhlungu kunye njalo njalo.

Amaxesha amaninzi kwagxilwa ibonakele nemithambo yegazi. fever rheumatic eqhelekileyo ehlabathini, ingakumbi kumazwe ahlwempuzekileyo, apho amazinga sifo ziphezulu kakhulu.

Sithatha sihlolisise iimpawu kunye lokufunyaniswa sifo ebuntwaneni, kodwa ngoku ndifuna ukutsalela ingqalelo iikhrayitheriya Jones. Kubalulekile ukuba uqaphele ukuba umahluko phakathi iikhrayitheriya ezinkulu nezincinane. Ukuba kukho ubuncinane omnye umsebenzi osemqoka kudidi lokuqala, kwanele ukufumanisa isifo.

ndlela	criteria minor
Carditis (elibukelweyo ngowama-70% amatyala), zihlaselana (75%), erythema (10%), chorea (10%), ukuyilwa maqhuqhuva ongama (20%).	Fever, arthralgia, rheumatism anemneze, ESR ukwanda okanye CRP.

iimpawu

Ngoku cinga ngokweenkcukacha iimpawu samathambo ebantwaneni. Njengoko kuchaziwe ngaphambili, rheumatism unako ukutshabalalisa zomzimba nokuqina amalungu amaninzi. Oku ukucacisa inani elikhulu ukwenza izinto ezahlukeneyo sifo. konke kuxhomekeke kwifomu nobukhali inkqubo.

Lwegciwane rheumatism eshukumisa ukuveliswa kukho into ekuthiwa iproteni C-izidubuli. Nguye obangela nokudumba nentshabalalo kwizicwili. Kwakhona, nceda uqaphele ukuba samathambo alibonakali uphume ndawo. Inkqubo yophuhliso iqala emva kokosuleleka. Lilonke elabelwe iintlobo ezintathu sifo, siza sithethe ngazo kamva. Eyona inkalo samathambo - an ukuqala yayiyazi. Ukunyuka ziquka:

• ukwanda elibukhali kwi lobushushu emzimbeni;
• ubuthakathaka kakhulu;
• ngokonakala zempilo.

Ngoku iimpawu ezifanayo kokuqala kuluhlu. Kubantwana abancinane (iminyaka emi-2) iimpawu samathambo ingaba:

• ucaphuka;
• tearfulness;
• ubuthongo yokudla, njalo-njalo.

Ngakubo uya ngokuthe bencediswa ezinye iimpawu eziziimpawu uhlobo rheumatism. samathambo kubantwana, iimpawu kunye nonyango esinokucinga kweli nqaku, kunokuzibonakalisa ngeendlela ezahlukeneyo, kodwa nama-85% amatyala, esi sifo isongela kubunzima intliziyo.

ngezigaba

Xa iyonke kukho iintlobo ezintathu sifo:

• articular;
• intliziyo;
• luvo.

Thina ukuchaza iinkcukacha ngazo kamva kancinane.

Kubalulekile ukuphawula ukuba iimpawu fever streptococcal samathambo ebantwaneni kuyaphawulwa. Isifo usoloko neziphumo ngohlobo yeengxaki okanye rheumatism uba engapheliyo.

Iimpawu samathambo ebantwaneni iminyaka eli-10 nangaphantsi ke yinto enzima ngokupheleleyo. An professional onamava ngokulula ukuhlola isifo nakweliphi na ibakala.

samathambo lunezigaba ezibini:

• esebenzayo;
• engasebenziyo.

Zeziphi iindlela ezenziwa sifo? Ezi ziquka:

• ubungqongqo wabonakala;
• utshintsho amakishayo elebhu.

Ngokusekelwe kule, kukho izidanga ezintathu rheumatism. Bona lucaciswa kule theyibhile ilapha ngezantsi.

isidanga sokuqala	Umsebenzi minimum	Kweli nqanaba, onomoya kakhulu imiqondiso zonyango kunye elabhoratri.
besigaba sesibili	umsebenzi ngokulinganisela	bolwesibini udidi streptococcal samathambo ebantwaneni, iimpawu esele ichazwe ngokucacileyo, ukuba ngokulula sifo. Oku kubangelwa yinto yokuba lwezonyango, radiology kunye nezinye iimpawu esele ibonakala.
degree wesithathu	umsebenzi eliphezulu	iimpawu uphawu zezi: nangecesina, iimpawu isifo sentliziyo samathambo, articular syndrome, utshintsho ngesiquphe parameters zaselebhu njalo-njalo.

ifomu articular

Ngoku jonga iimpawu rheumatism umntwana ifomu joint le. Makhe siqale intloko imali encinci iinkcukacha zamanani. Iintsana awafane kolu didi. Phantse-20% of isifo samathambo ubonakala phakathi kweminyaka omnye ukuya kwiminyaka emihlanu; kwaye phantse 80% - ukususela kwiminyaka elishumi elinesihlanu.

Iimpawu amalunga samathambo ebantwaneni nga ha kombisa ngokwalo ngolu hlobo lulandelayo:

• umkhuhlane;
• yobuthathaka;
• intloko;
• ubuhlungu bamalunga;
• ububomvu kunye ekweneni namalungu njalo-njalo.

Nangona ukuba amatyala baninzi, eli gciwane nangoku ukuba uzimisele. Alithandabuzeki elokuba, rheumatism emangalisayo kwindalo. Oku usuleleko kuchaphazela ezininzi kwiindawo nkovu ise-nasopharynx. Izifo ezinxulumene nembali edlulileyo angina, ukubola kwamazinyo, ukudumba.

Kubalulekile ukuphawula ukuba kukho iingcamango ezininzi zesi sifo. rheumatism Articular kubantwana, iimpawu kunye nonyango esinokucinga kweli nqaku kuyimbono uninzi, i umlinganiswa esosulelayo-komzimba. Le ngcamango ixhaphakileyo. Ukuba ngqo nale mbono, lo rheumatism - neziphumo ziyabagulisa abantu. Ngenxa ukungena iimveliso iseli metabolic iintsholongwane kwi okuthatha kwenzeka kwakhona ephilayo. Streptococci kulo mzekelo kungabangela iimpawu ezikhankanywe apha ngasentla rheumatism.

Sele ekhankanywe ukuba unobangela rheumatism idla ihlawulwe ngaphambi nasiphi na isifo esosulelayo (ezifana fever obomvu). Nakuba kunjalo, eminye imizekelo nga kunikwa:

• emzimbeni;
• overexertion.

Ezininzi iimpawu zibonisa ukuba yinxalenye CNS (inkqubo luvo) kule nkqubo. Ezi mpawu ziquka:

• chorea;
• ukuphazamiseka motor;
• isifo sengqondo;
• izifo-luvo, njalo-njalo.

Kubalulekile ukuba kuqatshelwe ukuba zonke ezi zifo badla zikhatshwa rheumatism. Uphando lubonisa ukuba reactivity le neuron yehliswe kakhulu. Kunokuba ukuchonga lomntu ke onobu bugcisa abanezakhono ngaphandle kobunzima. Kutheni le nto isenzeka? Oku kudla iyanyaniswa excitability ukwanda kwamaziko subcortical, ethi ichaphazele umzimba uphela.

shape intliziyo

Ngoku enze kancinci ukuthetha malunga nendlela intliziyo rheumatism umntwana, iimpawu zesi sifo. Kwangoko iphawule yakho yokuba iingxaki intliziyo Usenokuqalisa ngaxeshanye uhlobo articular of rheumatism, kwakunye ukuvela kancinci. kakhulu lwe rheumatism luphawulwa yokuba iimpawu ukuphazamiseka kwentliziyo icotha kakhulu, oko kukuthi, esi sifo iphuhlisa zifihlakele.

Ngaphambili ke wathi isici esasenza rheumatism - ukuhlaselwa ngesiquphe kunye nodlame. Kukho iintlungu ezibukhali, njalo-njalo. Noko ke, abanye abantwana usenokukhalaza buhlungu kancinane kwamalunga, ukudinwa. Nakuba kulo mzekelo, ukuze aphuhlise iingxaki inhliziyo. Ukuthintela nemiphumela emibi kakhulu futhi ngokukhawuleza kuqala unyango, yiya ibhunga, ndawonye oyingcali, nkqu zikhalazo.

isifo sentliziyo rheumatism abantwana, iimpawu kunye nonyango esinokucinga kanye ngoku, ngokuba sisifo sentliziyo rheumatism. Isanda phantse akuthethi ukuzibonakalisa. Iimpawu kungabandakanya:

• nokudinwa;
• alahle imidlalo;
• ukungathandi isebenze;
• ukuphelelwa umoya;
• iyangongoza intliziyo;
• isikhumba sakuba.

uhlobo ezimandundu ikhatshwe lobushushu ophakamileyo, ngokuqhelekileyo akukho izidanga ngaphezulu kwe mathathu anesibhozo. Imeko jikelele umntwana ngexesha elifanayo mandundu mihla le.

Heart shape rheumatism inokukhokelela ekuphazanyisweni wentliziyo, lucaciswa kule theyibhile ilapha ngezantsi.

endocarditis	waphula ingaphakathi engaphakathi kwentliziyo
myocarditis	secondary
pericarditis	engaphandle
endopericarditis	zontathu

Konke oku kukhokelela kuphuhliso isifo sentliziyo, oko kukuthi, inkqubo yokukrala phambili ukuya kwemithambo. Kubalulekile ukwazi ukuba unyango kwangoko kunye nothotyelo kwirejimeni emiselweyo - ngundoqo sibe nekamva eliqaqambileyo. Abantwana abaninzi abahluphekayo iziphene intliziyo, usenokuphila ubomi obuqhelekileyo (esikolweni, ihamba kunye nabahlobo, ukutyelela iiklabhu, njalo njalo). Ukuba ityala iyaziswa, esi sifo kuthatha luhlobo kakhulu, nto leyo echaphazela impilo-ntle ngolu hlobo lulandelayo:

• ubukho ukuphazamiseka kwegazi;
• omzimba ukudumba;
• ukuphelelwa kakhulu ngumphefumlo;
• isibindi yesinye.

Enye inkalo ezikhethekileyo uhlobo kakhulu zesi sifo - abusazinge ezikhawulezileyo apha esikhumbeni. Xa iimpawu zokuqala ingqalelo yezonyango engxamisekileyo! lokwaluka kwangethuba unyango - ithuba lokuba ubomi obuqhelekileyo komntwana, nokuba nguwuphi na, ukuba awukho.

ifomu novalo

Kweli candelo nqaku siza kuqwalasela le fom ukoyika rheumatism ebantwaneni. Iimpawu kunye nonyango lwesifo - ezi imiba engundoqo ukuba iya kufikelela kweli nqaku.

A isici esasenza uhlobo ukoyika samathambo kubantwana - chorea, ilahleko kwimimandla ethile ebuchotsheni. Chorea uvela kancinane, iimpawu ukuze ziquka:

• nokushintsha;
• ucaphuka;
• tearfulness;
• twitching izihlunu (qaphela ukuba lo uphawu uyakwazi inkqubela, yaye abanye abazali bacinga ukuba umntwana enze ubuso kunye olitshijolo, nkqu ngaphandle kokwazi imeko lokwenyaniso bemicimbi);
• ukungabikho ingqeqesho;
• ngozi;
• ukutshintsha yokubhala;
• ukubonakala slurred intetho;
• iqinelwa ebhula.

Njengoko ngenxa yokunqongophala ingqeqesho kunye nokungakhathali, kufuneka kwakhona wenze ezinye kucaciswa. Enyanisweni, lo mntwana akukho tyala. Ngokwenene ayikwazi ngokuchanileyo ukuba ngempoxo up iibhutsi zabo, badla kusithwa zifolokwe, neenkamba, zokubhala kunye nezinye izinto. Nikelani ingqalelo ezi mpawu. Abaninzi siphambanise nto ukudinwa okanye ukungakhathali. Enyanisweni, lo mntwana kufuneka uncedo lwakho. Ezi mpawu ziya kuvela iinyanga ezintathu. Nikelani ingqalelo engakumbi ukuziphatha kunye nemeko umntwana, ukuze kuphoswa mzuzu ekunene ukuqalisa unyango ngexesha.

Iindaba ezilungileyo kule sifo: sisifo sentliziyo uhlobo luvo rheumatism kunye kunqabile kakhulu. Ukuba ngaba unikwa isifo okanye kwingxaki yenkqubo sentliziyo, isifo yenzeka ngokulula kakhulu. Ukuba ubona ubuncinane utshintsho abanye ukuziphatha womntwana - qhagamshelana nogqirha wakho.

Ngoku makhe uhlawule ezinye ingqalelo hyperkinesia. It is a imeko oza ukuphakama sifo. Ngeli xesha, umntu usoloko siyahamba (yena akakwazi kuhlala, ukuma okanye ulale phantsi). Kukho zokurhwaqela kwezihlunu ngokuzenzekelayo ukuba kusengaphazamisana umntwana ukusetyenziswa ukutya (ukunciphisa izihlunu ulwimi, imilebe kwaye njalo njalo). Ayasebenza namanye amaqela kwezihlunu, ezi mpawu zilandelayo zenzeke:

• ezidanyazayo esisigxina;
• ulwimi eveleleyo;
• kwenaliti.

Nceda uqaphele ukuba xa ulele zonke iimpawu hyperkinetic shwaka. Ngaphezu kwazo zonke ezi mpawu zingasentla inokufumaneka kuphando yehle kwezihlunu. Akukho mviwo ezizodwa kufuneka ngeendlela eziqatha, njengoko kunokubonwa ngeliso lenyama. Umntwana luhlobo kakhulu zesi sifo akakwazi ukubamba intloko yakhe okanye ahlale. Ngokuqhelekileyo, iimpawu kuhlala ukusuka kwiiveki ezintathu ukuya kwiinyanga ezintathu. Emva koko ke kancane kudambe. Qiniseka ukuba sikhumbule ukuba likakade baxomoloza eqhelekileyo (ixesha uphuhliso - malunga nonyaka emva cala, ngamanye amaxesha kakhulu ngaphambili).

Chorea ukuze lobushushu emzimbeni (37,5 degrees) ukwandisa kancinane. Kubonakale ukufukuka kunye neentlungu kwamalunga.

izizathu

Kweli candelo nqaku siza kuzama ukuhlalutya ngokweenkcukacha umbuzo oonobangela samathambo ebantwaneni. Njengoko kuchaziwe ngaphambili, nokuba amayeza namhlanje awukwazi ukunika impendulo ngqo lo mbuzo. Kukho iingcamango ezininzi, nokwakha phezu kwabo, sinokugqiba ukuba oonobangela baninzi izinto.

factor	Ukucacisa
Kutshanje, izifo ezosulelayo	Ezi ziquka izifo ezihlasela zosulele ngokuphefumla, tonsils, ifiva nebomvu, tonsils njalo njalo. Kubalulekile ukuqaphela ukuba zibangelwa iqela iStreptococcus A. Kuyimfuneko ukucacisa ukuba akukho nokungcoliseka isulelo imeko siphambili uphuhliso samathambo. Oku kufuna ukuba ukungasebenzi kwamajoni omzimba. Kuphela kule meko iqala ukuhlasela iiseli esempilweni. Oku kubonakala kwiimeko apho unyango yaqala emva kwexesha (emva kwexesha) okanye nje engalunganga.
Izinto yesibini - le amafa	A Inani lezifundo kunye nophando, kwafunyaniswa ukuba into ilifa idlala indima ekuphuhliseni samathambo. Kuye kwaqatshelwa ukuba isifo kwenzeka kwiintsapho.
iziphathi Long-term losulelo streptococcal	Ngokuqhelekileyo, iStreptococcus elide kuhlala nasopharynx, apho glitche amajoni omzimba. Isiphumo - nophuhliso samathambo.
factor secondary	Isimanga njengoko kusenokuba ixilongo, kodwa kukho nezinye izinto (ezizisekondari) olunokubangela uphuhliso samathambo ebuntwaneni. Ezi ziquka: emzimbeni, ukudinwa, ukungondleki kakuhle. Ingaba oku kuyichaphazela njani uphuhliso esi sifo? Kakhulu nje, ezo zinto kufuneka isiphumo esibi amajoni omzimba womntwana. Ngenxa yoko, amaxesha amaninzi kwenyusa amathuba okuba nesifo rheumatism.

ekuxilongweni

Yintoni samathambo abantwana (iimpawu, ifoto, izizathu enikwe kweli nqaku), yaye ngoku, sinethemba, kakade. Siya nisinga lokufunyaniswa kwesifo. Kuba isiqalo kufuneka ke ukuba ubukho orhanelwa yokugula komntwana ungakwazi ngokupheleleyo nabani, ukuqala abazali nootitshala, kwaye ziphethe udokotela okanye wamathambo.

Clinic of rheumatism ebantwaneni (iimpawu zonyango) tshintshwa. Kubalulekile ukwazi indlela esisiseko:

• carditis (naluphi na uhlobo);
• chorea (sifo, sahlawula eninzi ingqalelo ngaphambili);
• phambi maqhuqhuva phantsi kwesikhumba umntwana;
• erythema;
• juvenile;
• usuleleko streptococcal kutshanje;
• into njengelifa.

Ukuba umntwana wakho uye ubuncinane enye yezi mpawu, kufuneka udibane nogqirha wakho ngoko nangoko. Ukongeza kwezi nqobo, kukho abanye:

• arthralgia;
• umkhuhlane;
• iparameters igazi kuguquka.

Kuba uxilongo lokuhlola amancinci kunye uphando malunga nesigulane eso. Kuba ukuxilongwa kuyimfuneko ukwenza inani leemvavanyo elebhu, eziquka esifubeni X-reyi, ECG, echocardiography.

-X-reyi uncedo ukufumanisa uqwalaselo wentliziyo, i-ECG uya kukubonisa ukuphazamiseka wentliziyo (ukuba ikhona), echocardiography ibhaqa ubukho nesifo sentliziyo.

unyango

Siye kwakhona uxilongo kunye iimpawu samathambo ebantwaneni. Unyango kwesifo - lo mbuzo olandelayo. Kwimeko langoku kufuna ukuba kwenziwe ngendlela emanyeneyo. unyango rheumatism ijolise:

• bhetele kwizigulo;
• ukusebenza flora streptococcal.

samathambo kubantwana (iimpawu, unyango, neefoto ukuba siqwalasela) ithathwa esibhedlele. Nceda uqaphele ukuba uthomalaliso wenziwe nokuba isifo umgada.

Umntwana kufuneka:

• alale , kunye nokwanda kancinane kumsebenzi esebenzayo;
• ngokutya ukutya okusempilweni, ekutyeni iqulethe izixa ezikhulu potassium;
• umbutho efanelekileyo lwemisebenzi lokuzonwabisa.

Unyango ngamachiza isekelwe:

• amalungiselelo antibacterial;
• hormone;
• anti-ukudumba;
• izakhiwo vitamin;
• amalungiselelo potassium;
• immunostimulant.

Zonke ezi machiza ukunceda ukulwa microflora izifo. Ngenxa yoko, kuwukhulula nangokurhala, kunciphisa iimpawu zesi sifo kakhulu. Kubalulekile ukuqaphela ukuba iyeza inokuba neziphumo ebezingalindelekanga:

• uphuhliso izilonda;
• ukopha esiswini;
• ukuphazamiseka kwamadlala yonyango.

ukuvimbela

Eli candelo lunikezelwa ekuthinteleni samathambo ebantwaneni. Bodwa zamabanga nokuthintela eziziisekondari. Kwimeko yokuqala, ingqalelo ihlawulwe kuphuhliso efanelekileyo umntwana:

• lukhuni;
• nesondlo esifanelekileyo;
• umdlalo;
• ukulwa usulelo liqela iStreptococcus A.

Iinjongo Secondary nesandulela ukuhluleka:

• "Bitsilin 5" - iiyunithi 1.5 million rhoqo kwiiveki ezine besikolo;
• "Bitsilin 5" idosi million 0.75 zonke iiveki ezimbini eyodwa.

Nceda qaphela ukuba Kucetyiswa ukuba baphumeze ulondolozo othintelo lwe exacerbations unyaka wonke, nyanga zonke. Ubude ekucetyiswa - kweminyaka emihlanu.

Outlook

Oomama abaninzi bakwazi ukumelana nesi sifo, ixesha uye esibhedlele ukuba uncedo lwezonyango. Ukuba uphethe zokuthintela samathambo, ngoko ke iphinde akayi kuba ezisongela ubomi. Siye iinkcukacha umbuzo rheumatism ebantwaneni, iimpawu ncomo. Yintoni na uqikelelo?

Qaphela ukuba isifo sentliziyo rheumatic malunga nama-25 ekhulwini ixesha kunye ngenkqubo yophuhliso nesifo sentliziyo. Re-binzana ushiya akukho ithuba baphephe ukuhlukunyezwa kwemithambo. Ngenxa yoko, kufuneka utyando intliziyo. Ukufa sisifo sentliziyo nama-0.4%. Kufuneka kuqatshelwe ukuba isiphumo sifo kuxhomekeke ukuchaneka nexesha konyango.