Anaphylactoid tshua: cov tsos mob, mob thiab cais

Cov tshwm sim ntawm kev tsis haum (anaphylactic) tshua tshwm sim los ntawm exogenous sawv cev, thiab nws khiav cov yam ntxwv ntawm tam sim ntawd yam npau taws me ntsis. Raws li ib tug txoj cai, tsiag ntawv los ntawm lub cev lo lus teb yuav ua tau rau koj txoj sia mob ntawm daim tawv nqaij, ua pa thiab cardio-leeg tshav zog. Tom qab thawj kev sib cuag nrog lub antigen pib tiam IgE tshuaj hais rau nws npaj lub hom phiaj. Lawv hauj lwm ua ke nrog rau lub hlwb lub luag hauj lwm rau kev tiv thaiv dab, thiab muaj yog sensitization mus rau lub antigen.

Yuav ua li cas yog ib tug tsis haum cov tshuaj tiv thaiv?

Lwm hit txhawb qhov kev tso tawm ntawm lub allergen lub luag hauj lwm rau lub cev lub hlwb zog ntawm bioactive tshuaj, tshwj xeeb tshaj yog histamine. Thaum lub sij hawm ntawm qhov kev hloov los ntawm tshuaj dab rau pathological physiology unnatural hloov reflected feem ntau nyob rau hauv cov hlab ntsha, cov qog ntshav, bronchial du nqaij uas muaj txhawb rau txoj kev loj hlob thiab thaum ntxov manifestation ntawm cov syndromes:

• yuav txo tau ntawm vascular laus;
• cia li contraction ntawm tus nqaij ntawm cov hnyuv, bronchi, tsev menyuam;
• krovosvortyvaemosti ua txhaum;
• o thiab o ntawm cov hlab ntsha.

Nyob rau hauv sib piv rau lub tsis haum, anaphylactoid cov tshuaj tiv thaiv, uas yog feem ntau hu ua pseudo-kev kho mob, tsis muaj IgE-kho hom haum xeeb antibody nrog basophils. Txawm tias kev zoo sib thooj ntawm cov tsos mob teb txheej txheem, neb ob leeg yeej ces ntawm generalized meem kev txhawj xeeb teb ntawm tus kab mob.

Tshuaj kev tsis haum tshuaj ua rau anaphylactoid tshua

Anaphylactoid tshua - nws tseem yog ib qhov kev tso tawm ntawm histamine, feem ntau twb nyob rau hauv thawj kev sib cuag nrog ib tug irritant. Pseudoallergic tam sim no sawv cev rau ib tug ncaj ntau yam. Paradoxically, qhov no tshuaj tiv thaiv ntawm lub cev yog feem ntau rooj plaub thaum lub sij hawm ntawm kev noj cov tshuaj, relieves kev ua xua.

Anaphylactic thiab anaphylactoid tshua tam sim ntawd yam tshwm sim feem ntau heev tom qab cov kev taw qhia ntawm nqaij hnaiv, tshuaj tua kab mob, ua kom loog tshuaj, opioids, lub zos anesthetics tshuaj, txhaj tshuaj tiv thaiv, tshuaj kho, atropine thiab B vitamins rau allergens kuj muaj xws li ntshiab, antigens siv nyob rau hauv cov kev kho mob thiab kuaj mob hom phiaj mus ntes daim tawv nqaij, venereal cov kab mob. Cov neeg mob ua xua rau looj khoom. Ib tug ntau tshwm sim yog suav tias yog anaphylactoid cov tshuaj tiv thaiv rau lidocaine raws li ib tug hauv zos ua kom loog tshuaj siv feem ntau, tab sis nws txoj tshuaj nyob tus yeees yuav ua phiv txawm nyob rau hauv ib tug noj qab nyob zoo kab mob, uas nws tsis haum cov tshuaj Cheebtsam yog tsis raug.

Nemedikametoznye stimuli

Yog hais tias peb xav txog cov neeg ntawm cov lus teb ntawm lub cev mus rau stimuli uas tsis yog-pharmacological xwm, muaj feem ntau yog "teeb meem" yuav ua tau khoom noj khoom haus:

• txiv pos nphuab;
• shellfish;
• zib mu;
• ceev;
• nceb;
• Ib txhia ntawm ntau yam ntses;
• qe;
• citrus.

Anaphylactoid tshua zaum yuav tshwm sim thaum ib tug kab tom los yog lom invertebrate fauna. Cov neeg mob tas li muaj kev tsis haum tshuaj uas tsis yog-lam xwm, muaj ib tug lossis loj uas yuav ntawm anaphylaxis nyob rau hauv cov ntaub ntawv ntawm kev phais nyob rau hauv kev tshuaj loog.

kev faib ntawm anaphylaxis

Li no nws tshwm sim thiab cais ntawm kev tsis haum tshuaj loj. Tus thawj tsev muaj xws li ib tug ntau yam ntawm anaphylactic tshua uas yog muab faib ua kho hom haum xeeb IgE, IgG kho hom haum xeeb thiab IgE-kho hom haum xeeb thiab lub cev load. Pseudoallergy anaphylactoid tshua kho hom haum xeeb los ntawm ib tug yooj yim kev tso tawm ntawm kev sib kho, raws li los ntawm ib tug hu txhais los ntawm qhov kev txiav txim ntawm cov tshuaj, raug rau cov zaub mov thiab lub cev yam. Ib tug cais qeb protrude anaphylactoid tshua nrog mastocytosis; kho hom haum xeeb tiv thaiv kab mob ceg, immunoglobulin aggregates thaum muab antisera thiab antibody kho hom haum xeeb cytotoxic, radiopaque tshuaj.

Yuav ua li cas yog anaphylaxis?

Morphine thiab ntau barbiturates, nqaij hnaiv, pethidine yuav cuam tshuam rau roj hlwb, ua rau qhov kev tso tawm ntawm histamine. Nyob rau hauv no soj ntsuam daim duab nyob ntawm lub ntau npaum thiab cov inflow tus nqi mus rau hauv lub cev ntawm lub active cov khoom xyaw. Xyaum qhia tau hais tias cov tshuaj tiv thaiv yuav siv sij hawm qhov chaw feem ntau benign, tsuas qhia rau ntawm daim tawv nqaij.

Anaphylactoid tshua (ICD-10 muab tsub no pathological syndrome) yog tsiag ntawv los ntawm unpredictability ntawm yav tom ntej txoj kev loj hlob thiab muaj ib tag tsis muaj ntaub ntawv hais txog yav dhau los tsis haum teb tiv thaiv antigens. Txij li thaum cov teebmeem ntawm anaphylaxis crane txaus ntshai rau kev noj qab nyob thiab lub neej, nws yog ib qho tseem ceeb rau kom tau thaum ntxov ntawm teeb meem thiab coj kom tsim nyog kev txiav txim. Txawm li cas los ntawm lub mechanism los yog anaphylactic pseudoallergic stimulus cov tsos mob yuav sib txawv ho. Looj ib purely neeg xwm, ces tej zaum yuav yog los ntawm me ntsis dhia nyob rau hauv cov ntshav siab thiab daim tawv nqaij sawv pob mus rau mob hnyav bronchospasm thiab lub cev qhuav dej ntawm lub hauj lwm ntawm cov hlab plawv system.

Rau ntawm no theem, nws yog ib qho yooj yim kom nco ntsoov lwm txawv psevdoallergenov txiav txim nyob rau hauv lub cev. Meanwhile, anaphylactoid tshua, cov tsos mob uas yuav yuav ntes tau ib lub zuj zus los yog ua nyob rau hauv ib tug ntau yam ntawm ob peb ua ke, nws yog tsis muaj tsawg txaus ntshai.

Symptomatology anaphylactoid cov tshuaj tiv thaiv

Tej yam tshwm sim ntawm ib tug tsis haum cov tshuaj tiv thaiv nyob rau hauv ib tug neeg mob yog suav tias yog nyob rau hauv lub waking lub xeev:

• kiv taub hau;
• tag nrho lub cev tsis muaj zog;
• lub plawv atherosclerosis ntshawv siab (tachycardia, fibrillation);
• txos cov ntshav siab;
• ua tsis taus pa, hawb pob, thiab broncho-laryngospasm, pulmonary edema thiab lub caj pas;
• daim tawv nqaij mob, khaus pob, ua xua, lossis puas liab liab integuments, angioedema ;
• plab hnyuv tu-sauv, xeev siab, raws plab, ntuav;
• tsis muaj ib tug mem tes;
• plawv cev qhuav dej;
• deceleration thiab siv ceev xwmphem ntawm lub plawv.

Tej zaum mob tom qab anaphylactoid tshua

Qhov loj tshaj kev hem thawj rau nws tus kheej ntawd ib tug poob siab, ua ke nrog bronchospasm. Tom qab ib tug tej lub sij hawm ntawm lub sij hawm (los ntawm 30 vib nas this rau ib teev, tej zaum 2-3 teev) lub antigen nkag mus hauv lub cev yeej txhawb tsis haum pathological dab nyob rau hauv lub cev. Lom zem ntau rau cov tshuaj tiv thaiv nyob rau hauv tus duab ntawm lub stimulus allergic (lus los yog parenterally). Ceev ceev txoj kev loj hlob yog feem ntau qhov ua rau ntawm kev tuag, yuav ua tau rau cia li mob ua pa insufficiency, tseem ceeb heev perfusion siab nco, uas tshwm sim vim cov cia li tsis ua hauj lwm ntawm lub plawv, cerebral hemorrhage los yog edema, impaired muaj nuj nqi ntawm qia, arterial thrombosis.

On thib ob hnub tom qab kev txom nyem ib tug poob siab kev hem thawj rau lub neej thiab rov qab yog concomitant kab mob kev vam meej tshwm sim los ntawm ib tug tsis haum cov tshuaj tiv thaiv tiv thaiv tom qab. Txawm tias tom qab ib tug ob peb lub lis piam, qhov uas yuav muaj teeb meem yog tseem siab. Lus, tom qab anaphylaxis , cov kws kho mob kuaj xws cov kab mob thiab ua hauj lwm:

• mob ntsws muaj dej;
• vasculitis;
• raum thiab hepatic tsis ua hauj lwm, kab mob siab, glomerulonephritis;
• epidermal necrolysis;
• myocarditis;
• kev mob caj dab.

Zoo ib yam li los yuav hem ob anaphylactic thiab anaphylactoid tshua. Tsis zoo li anaphylactic poob siab cov pathologies yog hais tias lub caij nyoog kawg no yuav tsum tau ua ntej sensitization thiab yog tsis muaj peev xwm tsim nyob rau hauv thawj lub rooj sib tham nrog cov tshuaj yeeb dej caw-allergen.

anaphylaxis kev kho mob

Txoj cai los mus ua kom muaj xwm ceev kho mob regimen raws li tus mob yuav tsuas keeb kwm, vim li ntawd nws yog ib qho tseem ceeb los mus sau nws. Kev tsis haum tshuaj symptomatology, piv txwv li. E. Cov soj ntsuam daim duab, kuj plays ib qho tseem ceeb luag hauj lwm nyob rau hauv kev ua ib tug hais kev txiav txim siab. Txawm li cas los, feem ntau txhim khu kev qha thiab ua kom tiav cov lus teb rau cov lus nug txog kev kuaj mob yuav tsuas yuav tau tom qab lub cov ua xua thiab Immunology kuaj kev tshawb fawb. Nyob rau tib lub sij hawm, nyob rau lub hauv paus ntawm lub tseem ceeb heev lub xeev ntawm tus neeg mob, tshwj xeeb tshaj yog nws tam sim ntawd kev pab kho mob yuav tsum tau muab, raws li nyob rau hauv cov ntaub ntawv ntawm mob raug ntes los yog ua pa ntes - Ntsujplig yuav hloov lub kev txiav txim.

Nyob rau theem ntawm paub txog qhov pib ua rau tsis haum teb, lub cev ua hauj lwm yog nqa tawm rau tag nrho cov-scale kho mob differential mob. Qhov no hom ntawm daim ntawv ntsuam xyuas no yog npaj mus cais tau tus ntawm yam tsis txuam nrog histamine tso tawm.

Xws li ib tug tshuaj tiv thaiv ntawm tus kab mob mus rau lwm cov uas tsis yog-kev tsis haum ua rau

Feem ntau cov feem ntau, anaphylactic thiab anaphylactoid tshua (nws yog dab tsi thiab qhov ntau txaus ntshai tus kab mob, nws yog ib qho tseem ceeb kom paub tias cov neeg uas yog cov nquag mus txawm lub feem ntau innocuous thaum xub thawj siab ib muag, kev tsis haum tshuaj nyob rau hauv daim ntawv ntawm cov txhaws ntswg) tau zoo sib xws nrog lwm yam, uas muaj peev xwm mus ua bronchospasm, hypotension:

• overdose ntawm anesthetics;
• thrombosis raws li ib tug tshwm sim ntawm huab cua entrapment los yog atherosclerosis;
• hnyav aspiration ntawm pais plab txheem syndrome;
• myocardial infarction, pericardial tamponade;
• lub taub dej khawb poob siab;
• pulmonary edema thiab lwm yam kev mob tsis txuam nrog kev ua xua.

Thaum muaj xwm ceev kho mob thaum lub sai tsim raws li ib tug anaphylactic los yog anaphylactoid cov tshuaj tiv thaiv suab tsis txawv los ntawm lub complex ntawm kev ua aimed ntawm tshem tawm thiab kev kho mob ntawm anaphylactic poob siab.

Tus txheej txheem rau ceev txiav txim

Nrog rau kev vam meej ntawm kev ua xua peev xwm ntawm cov kws kho mob thiab muab kev pab nyob rau hauv lub feem ntau nyob ze yav tom ntej yog tus yuam sij rau kev vam meej kev kho mob. Highlights ntawm anaphylaxis nyem tam sim ntawd yam yog yuav tsum tau tso cai ntawm lub ob peb theem:

1. Introduction unconfirmed tab sis uas yus antigen yuav tsum tau txiav.
2. Anaphylactic los yog anaphylactoid tshua (yees duab nyob rau hauv tsab xov xwm qhia feem ntau cov tsos mob thiab cov tsos mob ntawm tus kab mob), uas muaj thaum lub sij hawm tshuaj loog los yog thaum lub sij hawm kev lag luam, yuav tsum tau tus tam sim ntawd ncua kev kawm ntawv. Nws yuav tsum tau ua ib tug zoo daim tshev rau lub fact ntawm cov kev taw qhia ntawm allergens. Nrog ib tug ntse dhia nyob rau hauv cov ntshav siab cia rau cuam tshuam cov mov ntawm kev ua kom loog. Nyob rau hauv cov ntaub ntawv ntawm bronchospasm yuav tsum tau siv cov nqus tau cov pa anesthetics.
3. Chaw dim pa thiab caj pas yuav tsum tau xyuas kom muaj txawm nyob rau hauv uas tsis nyob ntev, thaum tus neeg mob yog tsis yig qub. Lub intubation ntsws xav tau lossi, kom txog thaum ces, kom txog thaum nws yog kiag li tseeb hais tias cov caj pas muab los ntawm lub cev xwb.
4. Anaphylactoid tshua, uas kho mob yuav tsum tau tso dej thawj coj ntawm adrenaline, poses ib tug uas yuav rau tus neeg mob, txawm ob peb teev tom qab qhov kev tshem tawm ntawm bronchospasm. Ntau npaum li rov thawj coj ntawm epinephrine yuav muab ntau zog vim hais tias cov tshuaj yeeb dej caw muaj ib tug zoo ntxim rau cov stabilization ntawm mast hlwb, txo vascular permeability ntawm endothelium, uas yog qhov tseem ceeb nyob rau hauv cov kev kho mob ntawm anaphylaxis.
5. Nyob rau hauv lub mob yuav tsum tau rau resuscitation yog tseem ceeb heev rau kom qhov ntim ntawm lub circulating kua nyob rau hauv lub cev. Rau lub hom phiaj no, cov kws kho mob muab ib tug loj inch catheter intravenously (Vienna siv tej zaum yuav tsis yeej ib txwm qhov chaw - nyob rau ntawm lub sij hawm ntawm nws nrhiav ua si tiv thaiv tus neeg mob tus mob) thiab ncuav nyob rau hauv ib tug ob peb litres ntawm crystalloid.
6. Thaum nws yog tsis yooj yim sua mus ntes allergens, uas tshwm sim raws li ib tug tshwm sim ntawm anaphylactoid cov tshuaj tiv thaiv, yuav tsum xyuam xim rau siv thaum lub sij hawm cov neeg mob looj cov khoom. Phais hnab looj tes, tshuaj, recruited los ntawm ib tug latex hau vials, urinary catheters - tag nrho cov no yuav ua rau muaj mob anaphylaxis.

Tom qab thaum muaj xwm ceev kev kho mob ntawm anaphylactoid tshua (raws li tau zoo raws li anaphylactic) yuav tsum tau ib tug ntev kawg ntawm txoj kev kho nyob rau hauv thiaj li yuav tiv thaiv kom txhob rov muaj dua ntawm tus kab mob. Cov kev tsis saib xyuas ntawm cov lus qhia ntawm cov kws kho mob tsub kom qhov uas yuav kom muaj ntau yam ntawm tej allergens.

Ua raws li-up kev kho mob

Cov tshuaj kho kev pab cuam bronchospasm tseem ceeb luag hauj lwm yog mus rau yeeb tshuaj "Salbutomol" yuav hloov nws, "aminophylline". Yog hais tias tau, ib qho ntxiv resort rau nqus tau pa siv isoproterenol los yog ortsiprenalina. Txij li thaum anaphylactoid tshua - yog ib tug soj ntsuam manifestation ntawm muaj quag, nyob rau hauv uas cov tsos mob tej zaum yuav complex, nws yog tsim nyog los siv glucocorticoids (e.g., "Dexamethasone" "hydrocortisone") constraining txheej txheem plawv cev qhuav dej.

Feem ntau cupping anaphylactic poob siab nrog tom ntej nruam vigilance cov kws kho mob. Qhov tseeb hais tias txoj kev loj hlob ntawm lig kawg thiaj li yuav muaj ib qho chaw, yog li muaj ib yam degree ntawm heev ntawm tus neeg mob pw tsev kho mob yog ib tug ntshiab tov. Yuav Tsum thiab cov kws kho mob ntseeg tau tias cov tuaj ntawm daim tawv nqaij kev tshawb fawb nyob rau hauv cov nrhiav kom tau ntawm tej tshuaj.

Prophylaxis ntawm anaphylactic thiab anaphylactoid cov tshuaj tiv thaiv

Txhij txhua kev kho mob keeb kwm - qhov zoo tshaj plaws kev ntsuas ntawm kev tiv thaiv thiab kev tiv thaiv ntawm re-anaphylaxis. Tom qab sib sau ua ke tag nrho cov ntaub ntawv tsim nyog txog rau thaum kawg ntawm tus kab mob no, yuav qhia tau cov neeg mob uas muaj feem yuav thiab los mus txiav txim yog dab tsi nws yuav fim re-anaphylactoid tshua. Ua li cas nws txhais li cas?

Txij li thaum txhua tom ntej nres tau coj qhov chaw ntau cev ntas cov neeg mob yuav tsum tau ceevfaj heev xaiv ntawm cov tshuaj thiab cov tshuaj loog, thiab thaum lub sij hawm intensive kev saib xyuas. Ua ntej ntxiv ntshav rau cov neeg nws mus anaphylaxis, nqa tawm ib txoj kev kuaj kev xeem rau compatibility nrog rau tej kev tso ntshav.

Haum latex khoom predetermines lub neej yav tom ntej tus cwj pwm ntau yam manipulations tsis muaj kev siv ntawm tej nyiaj.