Ukusabela Anaphylactoid: izimpawu, uphethwe futhi ngezigaba

Okuvela iguliswa (anaphylactic) ukusabela kubangelwa ejenti exogenous, futhi ukugeleza yayo nobuntu uhlobo ngokushesha hypersensitivity. Njengomthetho, libhekene ukusabela komzimba kungaba isimo esisongela ukuphila yezokwelapha kwesikhumba, zokuphefumula nemisebenzi cardio-semithambo. Ngemva Ungowokuqala okuxhunyanwa naye ne antigen iqala isizukulwane Ige omzimba athile inhloso yazo. Bona uhlangane ne amaseli obhekene amasosha omzimba izinqubo, futhi kukhona sensitization kuya antigen.

Kanjani ukusabela iguliswa?

Enye hit ikhuthaza ukukhululwa kwe-allergen obangela ukubulawa amasosha omzimba ngamandla izinto bioactive, ikakhulukazi histamine. Ngesikhathi aphuma yezinqubo zamakhemikhali ukuze izitho zomzimba sokugembula izinguquko ezingezona ezemvelo ziyabonakala ikakhulukazi imithambo yegazi,-lymph, bronchial imisipha bushelelezi ukuthi kunomthelela ukuthuthukiswa nokubonakaliswa ekuqaleni lezi syndromes:

• nokwehlisa ithoni semithambo;
• ukusikwa okungazelelwe ka bushelelezi kwemisipha izicubu emathunjini, bronchi, kwesibeletho;
• ukwephulwa krovosvortyvaemosti;
• ukuvuvukala nokuvuvukala imithambo yegazi.

Ngokungafani umzimba uxabane nawo, ukuphendula anaphylactoid, okuyinto evame ukubizwa ngokuthi mbumbulu yezokwelapha, akukho omzimba Ige aqashwe nge basophils. Naphezu ukufana kwezimpawu impendulo inqubo, kokubili zenzo ziwukubonakaliswa generalized hypersensitivity impendulo umzimba.

Izidakamizwa yokungezwani komzimba okubangela ukusabela anaphylactoid

ukusabela Anaphylactoid - liphinde ukukhululwa kwe histamine, ngokuvamile kakade Ungowokuqala okuxhunyanwa naye nge ecasulayo. Pseudoallergic okwamanje ukumela ububanzi sasivumela ububanzi. Kuyindida lokhu ukusabela komzimba ngokuvamile kunjalo ngesikhathi ukuthatha izidakamizwa, aqede komzimba.

Anaphylactic futhi anaphylactoid ukusabela uhlobo ngokushesha kwenzeke kaningi emva kusungulwa imisipha relaxants, imithi elwa namagciwane, imithi ebulala izinzwa, opioids, nemithi wendawo imithi yokubulala izinzwa, lokugoma, ukwelashwa i-hormone, atropine kanye B amavithamini ku nomzimba futhi zihlanganisa serum, antigen asetshenziswe ngezinhloso zokwelapha kanye kusebenta kwahulumende ukuthola isikhumba, izifo Venereal. I amacala yokungezwani komzimba ukuze latex imikhiqizo. A Kuyaziwa kubhekwa ukuphendula anaphylactoid ukuba lidocaine njengoba lendawo izidakamizwa izinzwa esetshenziswa ngokuvamile, kodwa yayo eyinkimbinkimbi amakhemikhali ukwakheka kungabangela imiphumela emibi ngisho umzimba uphilile, ogama yokungezwani komzimba ukuze yezingxenye izidakamizwa akusilo ejwayelekile.

Nemedikametoznye ezishukumisa

Uma sicabangela izimo izimpendulo yomzimba ezishukumisa bemvelo-non-kwemithi, kukhona ikakhulukazi "inkinga" kungaba ukudla:

• strawberry;
• shellfish;
• isinkwa kungekho kuswela;
• nati;
• amakhowe;
• Ezinye izinhlobo zezinhlanzi;
• amaqanda;
• ezisawolintshi.

ukusabela Anaphylactoid kungenzeka uma i bite isinambuzane noma enobuthi ezilwane ezingenamgogodla nezilwane. Iziguli njalo uhlangabezana komzimba isimo sokungakhethi kwesikhwama okwelapha, abe ingozi enkulu anaphylaxis esimweni ukuhlinzwa ngaphansi izinzwa jikelele.

Ukwahlukaniswa anaphylaxis

Ngakho kwenzeka kanye ngezigaba komzimba nezinto. Iyunithi yokuqala kuhlanganisa ukusabela okuhlukahlukene anaphylactic okuyinto zihlukaniswe umthwalo umlamuleli Ige, IgG umlamuleli futhi Ige aqashwe nokungokwenyama. ukusabela anaphylactoid Pseudoallergy ayengumlamuleli waso ukukhululwa okulula ukuba balamuli, kulandelwa ucingo senziwa isenzo izidakamizwa, ukuchayeka ukudla izici ezingokomzimba. A wodwana aphume ashone ukusabela anaphylactoid nge mastocytosis; umlamuleli izakhiwo mzimba, immunoglobulin lokubolekwa lapho antisera ehanjiswa omzimba umlamuleli cytotoxic, izinto radiopaque.

kuyinto anaphylaxis kanjani?

Morphine futhi barbiturates eziningi, imisipha relaxants, pethidine kungathinta amaseli fat, okubangela ukukhululwa kwe histamine. Kulesisithombe emitholampilo kuncike umthamo kanye inflow izinga emzimbeni izithako ezisebenzayo. Prakthiza ebonisa ukuthi ukusabela senzeka ogxile kungavamile ukuba ingozi, kungagcini ekhombisa kuphela ezihlala esikhumbeni.

ukusabela Anaphylactoid (ICD-10 ukhishwa yilesi sifo sokugembula) libhekene Ukungaqiniseki saleso senzakalo esizayo futhi mhlawumbe ukungabakhathaleli nhlobo ulwazi mayelana odlule impendulo iguliswa ngokumelene antigen. Njengoba imithelela anaphylaxis crane yingozi impilo nokuphila, kubalulekile ukuba sisheshe yezinkinga bese sithatha izinyathelo ezifanele. Kungakhathaliseki ukuthi indlela noma anaphylactic pseudoallergic izimpawu zokusimama ingahluka kakhulu. Egqoke imvelo luyingxenye ngazinye, ukubonakaliswa zingaba phakathi gxuma okuncane blood pressure kanye ukuqubuka kwesikhumba ukuze bronchospasm ezinzima nokuwa ukusebenza uhlelo senhliziyo nemithambo yegazi.

Kulesi sigaba, kulula ukuba uqaphele omunye umehluko psevdoallergenov isinyathelo emzimbeni. Phakathi naleso sikhathi, ukusabela anaphylactoid, izimpawu zazo kungatholakala ngamunye noma isenzo ezihlukahlukene inhlanganisela, akusona kancane kuyingozi.

Symptomatology ukuphendula anaphylactoid

Izimpawu ukusabela komzimba isiguli kubhekwa isimo, angavaleki;

• isiyezi;
• Imininingwane buthaka umzimba;
• inhliziyo isigqi iziyaluyalu (tachycardia, fibrillation);
• ukwehlisa umfutho wegazi;
• iphika, ukuhlaselwa kwakhe isifuba somoya, futhi broncho-laryngospasm, edema yamaphaphu nomphimbo;
• isikhumba esivuthayo, ukulunywa ukuqubuka, isifuba ububomvu integuments, angioedema ;
• amajaqamba emathunjini, isicanucanu, uhudo, ukuhlanza;
• ukungabikho ishayela;
• nciphisa zenhliziyo;
• deceleration futhi kokusebenza inhliziyo.

yezinkinga kungenzeka emva ukusabela anaphylactoid

Usongo olukhulu ngokwako buyingozi ukushaqeka, kuhlangene bronchospasm. Ngemva kwenkathi ethile yesikhathi (imizuzwana 30 ihora, ngezinye izikhathi 2-3 amahora) le antigen langena umzimba ikhuthaza izinqubo iguliswa sokugembula emzimbeni. Ikakhulu ngoba ukusabela incike ukuma Ukungena umfutho (ngomlomo noma parenterally). ngokuvamile ukuthuthukiswa Rapid iyona imbangela yokufa, okubangela okungazelelwe acute esingamahlalakhona zokuphefumula, ezibucayi perfusion ingcindezi iconsi, okuyinto eyenzeka ngenxa yokwehluleka ngokuzumayo kwegazi, ukopha palsy noma edema, umsebenzi kahle ka-stem, thrombosis ekhipha igazi enhliziyweni.

Ngosuku lwesibili ngemuva kokushaywa yisifo usongo ukushaqeka ekuphileni futhi yokuthola concomitant ukuqhubekela phambili kwesifo kubangelwa ukusabela iguliswa ngokumelene ngemuva. Ngisho nangemva kokuba kwamasonto ambalwa, ingozi yezinkinga namanje okusezingeni eliphezulu. Ngokuvamile, ngemva anaphylaxis , odokotela ukuxilonga izifo ezifana nokuphazamiseka okuhambisana:

• i-pneumonia,
• vasculitis;
• ukwehluleka kwezinso futhi hepatic, isifo sokusha kwesibindi, glomerulonephritis;
• epidermal necrolysis;
• myocarditis;
• Arthritis.

imiphumela Okufanayo zingayisongela kokubili anaphylactic nezimpendulo anaphylactoid. Ngokungafani ukushaqeka anaphylactic lezi pathologies ukuthi yokugcina kudinga sensitization ngaphambi futhi akakwazi ukuthuthukisa emhlanganweni wokuqala ngalolu ketshezi-allergen.

ukwelashwa anaphylaxis

Ilungelo lokwenza ukwelashwa okuphuthumayo lwemithi ngokuvumelana uphethwe kuthanda kuphela umlando, ngakho-ke kubalulekile ukuqoqa ke. Allergy symptomatology, isb. E. Isithombe emitholampilo, futhi udlala indima ebalulekile ekwenzeni isinqumo ngokushesha. Nokho, impendulo enokwethenjelwa kakhulu futhi ephelele umbuzo mayelana uphethwe kungenziwa kuphela etholwe emva ucwaningo yokungezwani komzimba kanye komzimba ezifweni laboratory. Ngesikhathi esifanayo, ngesisekelo isimo esibucayi isiguli, ikakhulukazi usizo lwakhe ngokushesha yezokwelapha lokumele aniketwe, njengoba kwaba njalo endabeni ka-ukuboshwa inhliziyo noma ukuboshwa zokuphefumula - dlweza senzo.

At the stage of ukuqashelwa netimbangela impendulo nomzimba, umsebenzi umzimba sika afeze ngokugcwele umehluko yezokwelapha uphethwe. Lolu hlobo inhlolovo senzelwe ukukhipha ithonya kungenzeka yezici ongakaphathelani histamine ukukhululwa.

ukusabela okunjalo umzimba ezinye izimbangela non-iguliswa

Ngokuvamile, anaphylactic futhi anaphylactoid ukusabela (ukuthi iyini futhi isifo esiyingozi nakakhulu, kubalulekile ukwazi abantu abanemizimba ngisho innocuous kakhulu unganakile, ziyabagulisa ifomu rhinitis) zifana nezinye izici, okunamandla wakwazi ukubangela bronchospasm, hypotension:

• ukweqisa izidakamizwa imithi yokubulala izinzwa;
• thrombosis ngenxa emoyeni ukubhajwa noma isifo sokuqina kwemithambo yegazi;
• nenshisekelo osindayo esiswini okuqukethwe syndrome;
• isilethikusebenza, tamponade pericardial;
• ukushaqeka ukonakala;
• edema yamaphaphu kanye nezinye izimpawu ayihlobene abanomzimba ongezwani nezinto ezithile.

ukunakekelwa eziphuthumayo lapho ithuthuka ngokushesha njengoba ukusabela anaphylactic noma anaphylactoid cishe akahlukile eyinkimbinkimbi yezenzo okuhloswe ngaso ukuqedwa kanye nokwelashwa ukushaqeka anaphylactic.

Inqubo athathe isinyathelo ngokuphuthumayo

Nge ukuqhubeka komzimba ziqu lodokotela ukuze sihlinzeke usizo esikhathini esizayo esiseduze kakhulu kuyisihluthulelo eyinhloko yokwelashwa okuphumelelayo. Imibiko Evelele Yonyaka impumuzo anaphylaxis ohlobo ngokushesha kukhona ndima esiyisibopho izigaba eziningana:

1. Isingeniso antigen ezingaqinisekisiwe kodwa yingozi kufanele inqanyulwe.
2. ukusabela Anaphylactic noma anaphylactoid (isithombe esihlokweni khombisa izimpawu ezivamile futhi izimpawu zesifo i), okuyinto eba phakathi izinzwa noma ngesikhathi ukuhlinzwa, kudinga ukumiswa ngokushesha. Kufanele kwenziwe ukuhlola izinga eqinisweni ukwethulwa nomzimba. Nge gxuma abukhali wegazi phansi uphazamisa supply imithi ebulala izinzwa. Endabeni ka bronchospasm ukusetshenziswa saziso imithi yokubulala izinzwa imuncwe.
3. Ukupholisa umgudu Kumele kucinisekiswe ngisho ngaleso sikhathi, lapho isiguli hhayi kakhulu sawohloka. Amaphaphu intubation kudingeka njalo, kuze kube yileso sikhathi, kuze kuyacaca ngokuphelele ukuthi umgudu olunikezwa umzimba ngokwawo.
4. ukusabela Anaphylactoid, okuyinto ukwelashwa kudinga ekuphathweni emthanjeni adrenaline, buyingozi isiguli, ngisho amahora amaningana emva ukususwa bronchospasm. Isikali phezu ekuphathweni okuphindiwe epinephrine zingandiswa ngoba izidakamizwa kuye kwaba nomphumela omuhle phezu kuqiniswa of insika amaseli, wehlise permeability semithambo ka endothelium, okuyinto ebalulekile ekwelapheni anaphylaxis.
5. Ngo isidingo ahlekise yokusiza umuntu ukuba aphefumule futhi kubalulekile ukwandisa umthamo uketshezi afundwa kakhulu emzimbeni. Ngenxa yale njongo, odokotela ufake ubukhulu ipayipi elikhulu ngemithambo yegazi (Vienna esetshenziswa kungenzeka kungahlali isikhungo - ngesikhathi zokusesha ungadlala ngokumelene isimo lesiguli) futhi uthele amalitha ambalwa crystalloid.
6. Lapho akunakwenzeka ukuthola izinto ezixabana nomzimba, okwenzeka ngenxa yokusabela anaphylactoid, kufanele sinake zisebenzisa ngesikhathi nesineke contact latex izinto. amagilavu Steel, izidakamizwa, waqoqa ngokusebenzisa izitsha eziyisikhombisa latex cap, catheters urinary - konke lokhu babekwazi kubangele anaphylaxis.

Ngemva ukwelashwa okuphuthumayo ukusabela anaphylactoid (kanye anaphylactic) kudinga Yiqiniso eside yokwelapha ukuze kuvinjelwe Ukuphinda izifo. Ngazishaya indiva imiyalelo odokotela kwandisa ingozi ekwandiseni uhla nomzimba ezingaba khona.

Izifundo zokulandelisa ukwelashwa

Phakathi ukwelashwa Uhlelo bronchospasm indima ebalulekile kungokwalabo izidakamizwa "Salbutomol" okungathatha indawo yalokho, "aminophylline". Uma kungenzeka, i-resort ezengeziwe inhalation usebenzisa isoproterenol noma ortsiprenalina. Njengoba ukusabela anaphylactoid - siwukubonakaliswa basemtholampilo letindzala, lapho izimpawu zingase zibe yinkimbinkimbi, kubalulekile ukusebenzisa glucocorticoids (isb, "Dexamethasone" "hydrocortisone") constraining inqubo nciphisa zenhliziyo.

Ngokuvamile cupping ukushaqeka anaphylactic ephelezelwa okwalandela okuqhubekayo siqaphile odokotela. Iqiniso lokuthi ukuthuthukiswa nezinkinga sekwephuzile kungaba njalo endaweni, njalo kwesinye degree of kobukhulu esibhedlela nesineke yisisombululo ecacile. Okuphoqelekile kanye odokotela bakholelwa kube sekufikeni ucwaningo isikhumba ukuthola omzimba athile.

Prophylaxis ka anaphylactic kanye yokusabela anaphylactoid

umlando Obuphelele yezokwelapha - esilinganisweni engcono lokuvikela kanye nokuvimbela kabusha anaphylaxis. Emva ukuhlangana lonke ulwazi olufanele mayelana Yiqiniso lesi sifo, bungabonakala iziguli engozini futhi ukunquma ukuthi wayezobhekana kabusha anaphylactoid ukusabela. Kusho ukuthini?

Njengoba ukuhlaselwa ngasinye okwalandela kungathatha indawo iziguli ngoyisiwula kusinda kakhulu zidinga Ukukhetha ngokucophelela izidakamizwa izinzwa, futhi ngesikhathi esegumbini labagula kakhulu. Ngaphambi ukumpontshelwa igazi abantu othambekele anaphylaxis, afeze luhlolo yokuhlola ukuhambisana imikhiqizo ethile yegazi.

Allergy imikhiqizo latex predetermines ukuziphatha manipulations ezihlukahlukene esikhathini esizayo ngaphandle kokusebenzisa lezo zimali.