Toxic Epidermal Necrolysis: he aha ia, nā ʻōuli a pehea e hana ʻia ai ka lāʻau

Anter

• Nā hōʻailona NET
• Nā kumu nui
• Pehea e hana ai i ka lāʻau
• Pehea e hana ʻia ai ke kuhi

ʻO ka necrolysis epidermal ʻōnaehana, a i ʻole NET, kahi maʻi ʻili laha ʻole i ʻike ʻia e ke kū ʻana o nā leona a puni ke kino e hiki ai i ka ʻili mau ʻana o ka ʻili. Hoʻokumu nui ʻia kēia maʻi e ka hoʻohana ʻana i nā lāʻau e like me Allopurinol a me Carbamazepine, akā hiki ke hopena i nā maʻi bacteria a viral paha, no ka laʻana.

He ʻeha ka NET a hiki ke make ma kahi o 30% o nā hihia, no laila ke kū mai nā ʻōuli mua, he mea nui e nīnau aku i ka dermatologist i mea e hōʻoia ai ka ʻike a hoʻomaka ka lāʻau.

Lawe ʻia ka lāʻau i loko o ka Intensive Care Unit a hana nui ʻia me ka hoʻomaha ʻana o ka lāʻau e loaʻa ai ka maʻi. Hoʻohui ʻia, ma muli o ka hōʻike ʻia o ka ʻili a me ka mucosa, hana ʻia nā mea e pale aku ai e hōʻalo i nā maʻi o ka haukapila, kahi e hiki ai ke hoʻololi hou i ke kūlana maʻi o ka mea maʻi.

Nā hōʻailona NET

ʻO ka ʻōuli nui loa o ka ʻemarkisis epidermal ʻino ka ʻinoʻino o ka ʻili ma mua o 30% o ke kino i hiki ke kahe a hūnā i nā wai, makemake i ka make wai a me nā maʻi.

ʻO nā ʻōuli nui e like me ka flu, ʻo kahi laʻana:

• Malaise;
• Wela wela;
• Cough;
• ʻEha ʻeha a me ka ʻeha pū.

Eia naʻe kēia mau ʻōuli, nalo ma hope o 2-3 mau lā a ukali ʻia e:

• ʻEha nā ʻili, hiki ke hoʻokahe ke koko a ʻeha hoʻi;
• Nā wahi Necrosis a puni nā leona;
• ʻIliʻili ʻili;
• Pāhili;
• Hoʻololi i ka ʻōnaehana digestive ma muli o ke kū ʻana o nā leona i ka mucosa;
• Ke kū ʻana o nā ulcer i ka waha, ka ʻāʻī a me ka anus, emi pinepine;
• Pehu o nā maka.

Hana ʻia nā leona mai ka ʻemrolisis epidermal ʻino i loko o ke kino holoʻokoʻa, ʻokoʻa ka Stevens-Johnson Syndrome, ʻoiai me ka like o nā hōʻike olakino like, ka hōʻoia ʻana a me ka mālama ʻana, ʻoi aku ka nui o nā leona i ka pahu, ka maka a me ka umauma. E aʻo hou aʻe e pili ana iā Stevens-Johnson Syndrome.

Nā kumu nui

Hoʻokumu nui ʻia ka nexic epidermal necrolysis e nā lāʻau, e like me Allopurinol, Sulfonamide, anticonvulsants a i ʻole antiepileptics, e like me Carbamazepine, Phenytoin a me Phenobarbital, no ka laʻana. Hoʻohui ʻia, ʻo ka poʻe i loaʻa nā maʻi autoimmune, e like me Systemic Lupus Erythematosus, a i ʻole i loaʻa i kahi ʻōnaehana pale pale kūpikipiki, e like me ka maʻi SIDA, ʻoi aku ka loaʻa o nā ʻili lesiona ʻili o ka necrolysis.

Hoʻohui ʻia i nā lāʻau lapaʻau, hiki i nā leheleheʻili ke hana ma muli o nā maʻi i loaʻa i nā virus, fungi, protozoa a i ʻole bacteria a me ke kū ʻana o nā tumors. Hiki ke hoʻohuli ʻia kēia maʻi e ka ʻelemakule a me nā ʻikepili.

Pehea e hana ai i ka lāʻau

Hana ʻia ka lāʻau lapaʻau o ka necrolysis epidermal ʻino i loko o kahi Unit Care Intensive no ka puhi ʻana a me ka hoʻopau ʻia ʻana o ka lāʻau e hoʻohana ʻia nei e ka mea maʻi, ʻoiai ka hopena o ka NET ka hopena o nā hopena maikaʻi ʻole i kekahi mau lāʻau.

Hoʻohui ʻia, hoʻololi ʻia o nā wai a me nā electrolytes i nalowale ma muli o ka nui o nā ʻili o ka ʻili e hana ʻia e ke komo ʻana i ka serum i loko o ka uaua. Hana ʻia nā mālama ʻeha i kēlā me kēia lā e kahi kahu hānai e hōʻalo i ka ʻili a i ʻole nā ​​maʻi ākea, i hiki ke koʻikoʻi a hoʻonui hou i ka olakino o ka mea maʻi.

Ke hiki i nā leona i ka mucosa, hiki i ka hānai ke lilo i paʻakikī no ke kanaka a, no laila, lawelawe ʻia ka meaʻai a hiki i ka loaʻa hou ʻana o nā membrane mucous.

I mea e hōʻemi ai i ka hōʻoluʻolu o nā leona, hiki ke hoʻohana ʻia i nā kaomi wai anuanu a i ʻole ka hoʻohana ʻana i nā kalima kūleʻa e hāpai i ka hydration o ka ʻili. Eia hou, hiki i ke kauka ke koi aku i ka hoʻohana ʻana i nā anti-allergens, corticosteroids a i ʻole nā ​​lāʻau ʻalopika, no ka laʻana, inā i hoʻokumu ʻia ka NET e nā bacteria a inā ua loaʻa ka maʻi i kahi maʻi ma muli o ka maʻi a e hōʻeha paha i ka maʻi maʻi. .

Pehea e hana ʻia ai ke kuhi

Hoʻokumu nui ʻia ka hōʻailona ma muli o nā ʻano o nā leona. ʻAʻohe hōʻike hoʻokolohua e hiki ke hōʻike i nā lāʻau i kuleana no ka maʻi a ʻaʻole hōʻike ʻia nā hōʻike stimulus i kēia hihia, no ka mea hiki ke hoʻonui i ka maʻi. No laila, he mea nui e hoʻomaopopo ke kanaka i ke kauka inā he maʻi kona a i ʻole inā hoʻohana ʻo ia i kekahi lāʻau, i hiki ai i ke kauka ke hōʻoia i ke kuhi o ka maʻi a hoʻomaopopo i ka mea causative agents.

Eia hou, no ka hōʻoia ʻana i ke kuhi, noi pinepine ke kauka i kahi biopsy o ka ʻili, i ka hoʻohui ʻana i ka helu piha o ke koko, nā hoʻokolohua microbiological o ke koko, ka mimi a me ka huna ʻana o ka ʻeha, e nānā ai no nā maʻi āpau, a me nā hana o kekahi mau kumu kuleana no ka pale pane.