Mū Rumatika

ʻO ka maʻi Rheumatic kahi maʻi e hiki ke ulu ma hope o kahi maʻi me ka bacteria A streptococcus pūʻulu (e like me ka ʻāʻī strep a i ʻole ke kuni ʻulaʻula). Hiki iā ia ke kumu i nā maʻi nui i ka puʻuwai, nā hono, ka ʻili, a me ka lolo.

Maʻamau ka wela o ka Rumatika i nā ʻāina i nui ka ʻilihune a me nā ʻōnaehana olakino maikaʻi ʻole. ʻAʻole pinepine ia ma ʻAmelika Hui Pū ʻIa a me nā ʻāina kūkulu ʻē aʻe. Ke hana ʻia ke kuni rumatika ma United States, pinepine ia i nā maʻi liʻiliʻi. ʻO ka laha hou loa i United States ma 1980s.

Hana ʻia ke kuni Rheumatic ma hope o nā maʻi me kahi germ a i ʻole bacteria i kapa ʻia ʻO Streptococcus pyogenes aiʻole ka hui A streptococcus. Hōʻike kēia germ i ka hoʻopunipuni ʻana i ka ʻōnaehana pale i loko o ka hoʻouka kaua ʻana i nā aʻa olakino i ke kino. Hoʻehuehu a wela paha kēia mau mea.

ʻO kēia hopena ʻano ʻē aʻe e aneane mau ana me ka ʻāʻī strep a i ʻole ke kuni kuni. ʻO nā maʻi Strep e pili ana i nā ʻāpana ʻē aʻe o ke kino me he mea lā ʻaʻole ia e hoʻomaka i ka maʻi rumatika.

Hoʻopili nui ka maʻi Rumatika i nā keiki 5 a 15 mau makahiki i loaʻa i ka maʻi puʻu a i ʻole ke kuni ʻulaʻula. Inā kū ia, ulu ia ma kahi o 14 a 28 mau lā ma hope o kēia mau maʻi.

Hiki i nā ʻōuli ke hoʻopili i nā ʻōnaehana he nui i ke kino. Pili pū nā ʻōuli laulā:

• Fiva
• Nā Nosebleeds
• ʻEha ma ka ʻōpū
• Nā pilikia puʻuwai, ʻaʻohe paha hōʻailona, ​​a i ʻole hiki ke alakaʻi i ka pōkole o ka hanu a me ka ʻeha o ka umauma

Hiki i nā ʻōuli i nā hono ke:

• Kumu ʻeha, pehu, ʻulaʻula, a mehana
• Hana nui ʻia i nā kuli, kuʻekuʻe wāwae, nā kuʻekuʻe wāwae, a me nā pūlima
• Hoʻololi a neʻe paha mai kekahi hui i kekahi

E loli paha ka ʻili, e like me:

• ʻO ka wīwī i like me ke apo a me ka nahesa ma ka kumu a ma luna o nā lima a me nā wāwae
• ʻ lumppuʻu ʻili a i ʻole nā ​​nodule

ʻO kahi kūlana e hoʻopili i ka lolo a me ka ʻōnaehana ʻōnaehana, i kapa ʻia ʻo Sydenham chorea hiki ke hana pū kekahi. ʻO nā ʻōuli o kēia ʻano:

• Ka nalowale ʻana o ke kaohi o nā manaʻo, me ka uē a me ka ʻakaʻaka ʻana
• ʻO ka neʻe wikiwiki a me ka neʻe ʻana i ka maka, nā wāwae, a me nā lima

E nānā kāu mea mālama ola iā ʻoe a e nānā pono i kou kani ʻana o ka puʻuwai, ʻili, a me nā hono.

E komo pū paha nā hoʻāʻo:

• Hōʻike koko no ka maʻi strep hou (e like me kahi hōʻike ASO)
• Helu piha koko (CBC)
• Electrocardiogram (ECG)
• Ka helu sedimentation (ESR - kahi hoʻāʻo e ana i ka lī i loko o ke kino)

Ua hoʻomohala ʻia kekahi mau kumu i kapa ʻia nā pae hoʻohālikelike nui a liʻiliʻi hoʻi e kōkua i ke kuhi ʻana i ka maʻi rumatika ma ke ʻano maʻamau.

ʻO nā pae hoʻohālikelike nui no ka hōʻoia ʻana:

• Pālahalaha i nā hui nui
• Huʻi puʻuwai
• Nodules ma lalo o ka ʻili
• Nā neʻe wikiwiki, neʻe (chorea, Sydenham chorea)
• ʻ Skinhū ʻili

ʻO nā pae hoʻohālikelike liʻiliʻi:

• Fiva
• ESR kiʻekiʻe
• ʻEha hui
• ECG maʻamau

E ʻike ʻia paha ʻoe me ka fiva rumatika inā ʻoe:

• E hālāwai me 2 pae hoʻohālikelike nui, a i ʻole 1 pae nui a me 2 pae hoʻohālikelike liʻiliʻi
• Loaʻa nā hōʻailona o ka maʻi strep i hala

Inā ʻike ʻia ʻoe a ʻo kāu keiki paha me ka maʻi fiva rumatika e mālama ʻia ʻoe me nā lāʻau ʻaloʻalo. ʻO ka pahuhopu o kēia lapaʻau ka wehe ʻana i nā koʻohune strep āpau mai ke kino.

Ma hope o ka pau ʻana o ka lāʻau mua, kuhikuhi ʻia nā lāʻau ʻiʻo ʻē aʻe. ʻO ka pahuhopu o kēia mau lāʻau lapaʻau ka mea e pale aku ai i ke kuni rumatika mai ka hoʻi hou ʻana.

• E hoʻomau nā keiki āpau i nā antibiotic a hiki i ka makahiki 21.
• Pono nā ʻōpio a me nā ʻōpio ʻōpio e lawe i nā lāʻau antibiotic no 5 mau makahiki.

Inā loaʻa iā ʻoe a me kāu keiki paha nā pilikia o ka puʻuwai i ka wā i loaʻa ai ke kuni rumatika, pono paha nā antibiotic no ka lōʻihi, no ke ola paha.

E kōkua i ka mālama ʻana i ka pehu o nā aʻa i hoʻoweliweli ʻia i ka wā o ke kuni rumatika koʻikoʻi, pono ʻia nā lāʻau e like me aspirin a i ʻole corticosteroids.

No nā pilikia me nā neʻe ʻole a i ʻole nā ​​hana maʻamau ʻole, kuhikuhi ʻia nā lāʻau e hoʻohana pinepine ai i ka hopu ʻana.

Hiki i ke kuni Rheumatic ke kumu i nā pilikia puʻuwai a me ka puʻuwai o ka naʻau.

Hiki i nā pilikia puʻuwai wā lōʻihi ke kū, e like me:

• Ka hōʻino i nā kiwikā puʻuwai. Hiki i kēia hōʻino ke kumu o ka liu i loko o ka puʻuwai puʻuwai a i ʻole ka hoʻopili ʻana e hoʻolohi i ke kahe o ke koko ma o ka va.
• Poino i ka puʻuwai puʻuwai.
• Hewa puʻuwai.
• ʻO ka maʻi o ka pale o loko o kou puʻuwai (endocarditis).
• ʻO ka pehu ʻana o ka membrane a puni ka puʻuwai (pericarditis).
• ʻO ka puʻuwai puʻuwai e wikiwiki a paʻa ʻole.
• ʻO Sydenham chorea.

Kāhea i kāu mea hāʻawi inā ʻoe a i ʻole kāu keiki e hoʻomōhala i nā ʻōuli o ke kuni rumatika. Ma muli o kekahi mau hanana ʻē aʻe i loaʻa nā hōʻailona like, pono ʻoe a me kāu keiki i ka loiloi olakino.

Inā hoʻomohala nā ʻōuli o ka ʻōpū strep, e haʻi i kāu mea hāʻawi. Pono ʻoe e nānā a mālama ʻia paha i kāu keiki inā loaʻa ka ʻāʻī strep. E hoʻēmi kēia i ka makaʻu o ka ulu ʻana i ka maʻi kōhuma.

ʻO ke ala nui e pale aku ai i ka fiva rumatika ma o ka mālama wikiwiki ʻana i ka ʻāʻī strep a me ka maʻi ʻulaʻula.

Streptococcus - rumatika wela; Strep puʻu - rumatika wela; Streptococcus pyogenes - rumatika wela; Pūʻulu A streptococcus - ke kunu rumatika

ʻO Carr MR, Shulman ST. Maʻi maʻi Rheumatic. I: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. ʻO Puka Textbook of Pediatrics ʻo Nelson. 21st ed. Piladelapia, PA: Elsevier; 2020: chap 465.

Mayosi BM. Rumatika. I: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. ʻO ka maʻi puʻuwai ʻo Braunwald: He puke aʻo no ka lāʻau Cardiovascular. Piladelapia, PA: Elsevier; 2019: chap 74.

Shulman ST, Jaggi P. Nonsuppurative poststreptococcal sequelae: rumatika fever a me glomerulonephritis. I: Bennett JE, Dolin R, Blaser MJ, hua pā. ʻO Mandell, Douglas, a me Bennett's Principle a me ka hoʻomaʻamaʻa ʻana i nā maʻi kūpilikiʻi. 9th ed. Piladelapia, PA: Elsevier; 2020: chap 198.

Stevens DL, Bryant AE, Hagman MM. Nā maʻi nonpneumococcal streptococcal a me ka fiva rumatika. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 26th ed. Piladelapia, PA: Elsevier; 2020: chap 274.