PAB syndrome (HELLP-syndrome) - ib tug txaus ntshai yam tab kaum nyob rau hauv lub III peb lub hlis uas cev xeeb tub: ua, mob, kev kho mob

Nyob rau hauv lub neej ntawm txhua tus neeg inevitably los ib pliag uas forces tig mus rau sab nraum pab. Feem ntau pab nyob rau hauv tej lub sijhawm yog cov paramedics. Qhov no tshwm sim thaum tib neeg lub cev yog invaded insidious kab mob, thiab mus rau tiv nrog lawv yog tsis tau. Sawv daws yeej paub hais tias kev zoo siab lub xeev ntawm cev xeeb tub - yog tsis yog ib tug kab mob, tab sis hais tias yav tom ntej tus poj niam kuj nyob rau hauv particular xav tau ntawm kev kho mob thiab puas siab puas ntsws pab.

"Pab!", Los yog qhov twg lub npe ntawm tus kab mob

Hu rau kev pab nyob rau hauv lwm yam lus suab sib txawv. Piv txwv li, nyob rau hauv lus Askiv ib tug xav ua kom tau Lavxias teb sab, "Pab!" Yog cov lus hais zoo li "PAB". PAB syndrome (HELLP) yuav luag los ntawm lub caij nyob rau hauv tune nrog lub tam sim no thoob ntiaj teb kev lees kev pab.

Cov tsos mob thiab kev rau txim ntawm no yam tab kaum lub sij hawm cev xeeb tub xws li hais tias ceev kev kho mob yog ib qho tseem ceeb. HELLP tsiaj ntawv rau ib tug tag nrho ntau yam ntawm cov teeb meem mob: nyob rau hauv lub siab, nrog rau cov ntshav txhaws thiab kev raug mob ntawm los ntshav. Dhau li ntawm tus saum toj no, HELLP-syndrome ua malfunction ntawm ob lub raum thiab ntshav siab mob, li no zoo heev thab plaub rau thaum kawg ntawm cev xeeb tub.

Daim duab ntawm tus kab mob no yog li ntawd hnyav hais tias muaj yog ib tug tsis kam muab qhov tseeb ntawm procreation lub cev, autoimmune tsis ua hauj lwm tshwm sim. Qhov no qhov teeb meem no tshwm sim thaum tag nrho overload ntawm tus poj niam lub cev thaum defenses tsis kam mus ua hauj lwm, rolls qhov loj tshaj plaws kev nyuaj siab, fading yuav rau lub neej ua tau thiab mus txuas ntxiv rau nriaj. Cov ntshav los tsis txawj tu, lub qhov txhab yeej tsis kho, los ntshav tsis nres, thiab lub siab yog tsis muaj peev xwm mus ua nws zog. Tab sis nws yog ib qho tseem ceeb mob amenable mus kho mob kho.

kho mob yav dhau

PAB syndrome piav nyob rau hauv lub lig 19th caug xyoo. Tab sis, tsuas nyob rau hauv 1978 Gudlin khi lub autoimmune pathology ntawm pre-eclampsia thaum lub sij hawm cev xeeb tub. Thiab nyob rau hauv 1985, ua tsaug rau Weinstein, lub disparate cov tsos mob tau merged nyob rau hauv ib tug lub npe: HELLP-syndrome. Nws yog noteworthy tias nyob rau hauv lub domestic kev kho mob qhov chaw, qhov no yog ib tug loj teeb meem suab tsis tau piav. Tsuas yog ib tug ob peb Lavxias teb sab anesthetists thiab intensive kev saib xyuas tshwj xeeb muab nthuav dav ntxiv rhuav no loj mob preeclampsia.

Meanwhile, PAB syndrome thaum lub sij hawm cev xeeb tub yog sai muaj zog thiab yuav siv sij hawm tam sim ntawd ib tug ntau ntawm lub neej.

Peb piav qhia txog txhua yam tab kaum nyias.

hemolysis

PAB syndrome feem ntau muaj xws li intravascular hemolysis. Qhov no txaus ntshai tus kab mob yog tsiag ntawv los ntawm tag nrho cov kev puas tsuaj ntawm lub cell. Cov kev puas tsuaj thiab kev laus ntawm cov ntshav liab ua kub taub hau, daj ntseg ntawm daim tawv nqaij, lub tsos ntawm cov ntshav nyob rau hauv cov zis cov kev tshawb fawb. Qhov tseem lub neej-hem txim - kev pheej hmoo ntawm hnyav los ntshav.

Risk ntawm thrombocytopenia

Cov tom ntej no kev tivthaiv ntawm cov syndrome abbreviations - thrombocytopenia. Qhov no mob yog yus muaj los ntawm ib tug txo nyob rau hauv platelet suav nyob rau hauv cov mis ntawm cov ntshav, nws thiaj li ua rau tshwm sim los ntshav. Tsis txhob tus txheej txheem no yuav tsuas yuav nyob rau hauv lub tsev kho mob, thiab thaum lub sij hawm cev xeeb tub, tus mob no yog tshwj xeeb yog txaus ntshai. Yog vim li cas yuav ua tau ib tug nyuaj tiv thaiv kab mob mob, uas coj mus rau lub anomaly nyob rau hauv uas lub cev fights nrog nws tus kheej, rhuav tseg noj qab nyob zoo ntshav liab. Nws nruab nrab yog ib tug kev hem thawj rau lub neej cia li sawv nyob rau hauv lub keeb kwm yav dhau ntawm kev hloov nyob rau hauv lub xov tooj ntawm platelets txhaws kev ntshawv siab.

Txaus ntshai harbinger: nce nyob rau hauv daim siab enzymes

Lub complex pathologies muaj nyob rau hauv lub PAB syndrome, crowned xws kaj siab kos npe rau raws li ntau zog siab enzymes. Rau expectant niam uas txhais tau tias nyob rau hauv ib tug ntawm cov tseem ceeb tshaj plaws hauv nruab nrog cev ntawm tus tib neeg lub cev muaj mob loj faults. Tom qab tag nrho, lub siab tsis tau tsuas yog ntxuav lub cev ntawm toxins thiab yuav pab kom cov kev siv ntawm cov digestive muaj nuj nqi, tab sis kuj muaj feem xyuam rau lub psycho-lub siab lub ntsws kheej. Feem ntau xws undesired hloov yog kuaj thaum lub sij hawm niaj hnub mus kuaj ntshav, uas yog los siv rau cov poj niam. Thaum preeclampsia nyuab los ntawm syndrome PAB nuj nqis txawv ho los ntawm lub cai, pom ib tug tuag duab. Yog li ntawd, kev kho mob cov tswv yim pab - tus thawj txoj kev, uas yog yuav tsum tau rau tiav.

Tshwj xeeb tshaj yog lub thib peb peb lub hlis

3 peb lub hlis uas cev xeeb tub yog qho tseem ceeb heev rau lub neej yav tom ntej ntawm hnub thiab tus me nyuam. Nquag teeb meem yog edema, kub siab thiab digestive kawg.

Qhov no tshwm sim vim hais tias ntawm irregularities nyob rau hauv ob lub raum thiab lub siab. Mob lub tsev me nyuam twb tsis muaj luag siab rau lub digestive kabmob, uas yog vim li cas lawv yuav pib mus rau unravel. Tab sis nyob rau hauv gestosis zaum yuav tshwm sim mob hu ua pre-eclampsia thiab eclampsia, uas thab kev mob kev nkeeg nyob rau hauv epigastrium, ntxias cov tsos ntawm xeev siab, ntuav, edema, ntshav siab. Tiv thaiv lub keeb kwm ntawm neurological teeb meem yuav tshwm sim tau qaug dab peg. Nyaum cov tsos mob ntxiv, tej zaum yuav luag zoo li xob laim, ua zoo raug mob rau lub cev, hem lub neej ntawm lub expectant niam thiab cov me nyuam hauv plab. Vim mus rau mob hnyav preeclampsia, uas feem ntau yog cov uas muaj nws ib tug 3 peb lub hlis uas cev xeeb tub, muaj yog feem ntau ib tug syndrome nrog cov lus hu ua PAB.

kaj tsos mob

HELLP-syndrome: soj ntsuam daim duab, mob, obstetric tactics - lub ntsiab ntawm hnub no lub kev sib tham. Ua ntej, koj yuav tsum qhia hais tias ib tug xov tooj ntawm cov tub ntxhais cov tsos mob uas nrog no txaus ntshai yam tab kaum.

1. Nyob rau hauv ib feem ntawm lub hauv paus poob siab system. Lub paj hlwb teb rau cov qaug dab peg mob, mob siab heev mob taub hau, pom tau qhov sib puas.
2. Txoj hauj lwm plawv system yog ntxhov vim edema ntawm ntaub so ntswg thiab tsis cov ntshav ncig.
3. Ua pa dab feem ntau yog tsis tau ua txhaum, tab sis koj muaj teebmeem kev edema yuav tshwm sim tom qab tau me nyuam.
4. Nyob rau hauv ib feem ntawm hemostasis thiab thrombocytopenia cai ua txhaum ntawm platelet haumxeeb feem ntawm cov chaw ua hauj lwm.
5. Txo siab muaj nuj nqi, tej zaum txoj kev tuag ntawm nws hlwb. Tsis tshua cai txawj hepatic rupture, uas ua rau yus tuag.
6. Kev ua txhaum ntawm lub genito-urinary system: oliguria, raum tsis ua hauj lwm.

PAB syndrome yus muaj los ntawm ib tug ntau yam ntawm cov tsos mob:

• tsis xis nyob rau hauv lub siab;
• ntuav;
• mob mob taub hau;
• qaug dab peg;
• feverish mob;
• ntxaug nco qab;
• urinary insufficiency;
• edematous cov ntaub so ntswg;
• lus siab;
• ntau hemorrhages nyob rau hauv qhov chaw ntawm manipulation;
• yellowness.

Kuaj tus kab mob yog manifested los ntawm thrombocytopenia, hematuria, lub nrhiav kom tau cov protein nyob hauv cov zis thiab ntshav, tsis tshua muaj hemoglobin, ib qho kev nce ntawm bilirubin nyob rau hauv cov ntshav mus kuaj. Yog li ntawd, hais qhov tseem mob ntawm tag nrho cov complex kuaj ntsuam xyuas yuav tsum yuav tsum tau.

Yuav ua li cas kom paub txog qhov teeb meem?

Nyob rau hauv thiaj li yuav raws sij hawm ntes thiab tiv thaiv kom txhob mob, thiab nqa tawm kev kho mob nyob rau hauv uas yav tom ntej mums yuav tsum tau mus txog tsis tu ncua. cev xeeb tub tus kws txo nws hwj rau cov ntaub ntawv, thiab ces zoo saib xyuas cov kev hloov nyob rau hauv ib tug poj niam lub cev thaum lub sij hawm tag nrho lub sij hawm. Yog li, ib tug gynecologist raws sij hawm txhim kho pliaj hloov thiab coj kom tsim nyog kev txiav txim.

Yuav kom qhia cov pathological kev hloov los ntawm kev siv kuaj ntsuam xyuas. Piv txwv li, zis protein yuav pab ntes yog hais tias muaj yog ib tug. Qhov nce nyob rau hauv protein ntsuas thiab tus naj npawb ntawm leukocytes qhia pronounced irregularities nyob rau hauv lub chaw ua hauj lwm ntawm ob lub raum. Ntawm lwm yam, tej zaum yuav muaj ib tug ntse txo nyob rau hauv tus nqi ntawm cov zis, thiab ib tug tseem ceeb nce nyob rau hauv edema.

Teeb meem nyob rau hauv lub siab yog manifested tsis tsuas nyob rau hauv txoj cai qaum quadrant mob, ntuav, tab sis kuj yog ib tug kev hloov nyob rau hauv cov ntshav (nce nqi ntawm daim siab enzymes), thiab daim siab o rau palpation yog muaj kom meej meej.

Thrombocytopenia yog tseem kuaj tau los ntawm laboratory kuaj cov ntshav ntawm ib tug cev xeeb tub poj niam, rau cov uas qhov tiag kev hem thawj PAB syndrome.

Yog hais tias koj xav eclampsia thiab PAB syndrome yuav tsum tau tswj los ntawm cov ntshav siab raws li ib tug tshwm sim ntawm spasm ntawm cov hlab ntsha thiab ntshav txhaws ntawm nws kev ua tau zoo muaj peev xwm tiag kom.

differential mob

Fashionable nta PAB syndrome mob nyob rau hauv Obstetrics muaj gained tej chaw, li ntawd, feem ntau muab tso rau nws wrongly. Feem ntau nkaum tom qab nws yog txawv kiag li cov kab mob, tsis tsawg txaus ntshai, tab sis ntau mundane thiab ntau:

• gastritis;
• kab kab mob siab;
• mauj lupus erythematosus;
• urolithiasis;
• obstetric sepsis;
• cov kab mob ntawm lub siab (fatty, mob npuas paug);
• thrombocytopenic purpura tsis paub hais tias etiology;
• raum tsis ua hauj lwm.

Yog li ntawd txawv. Mob yuav tsum coj mus rau hauv tus account ib tug ntau yam ntawm kev xaiv. Raws li, qhov qhia saum toj no triad - hyperenzymemia siab, hemolysis thiab thrombocytopenia - tsis yeej ib txwm qhia hais tias muaj cov no yam tab kaum.

Ua rau PAB-syndrome

Tu siab, muaj tej yam tsis zoo to taub, tab sis muaj cov tswv yim uas ntxias PAB syndrome tej zaum yuav raws li nram no yog vim li cas:

• psychosomatic kab mob;
• tshuaj hob kab mob siab;
• enzymatic genetic hloov nyob rau hauv lub siab;
• prolificacy.

Nyob rau hauv kev txaus ntshai syndrome tshwm sim thaum tsis txaus xim rau preeclampsia nyuab chav kawm - eclampsia. Nws yog ib qho tseem ceeb kom paub tias tus kab mob behaves heev unpredictable: nws yog tsim ntawm xob ceev, nws disappears rau nws tus kheej.

kho ntsuas

Thaum uas tag nrho cov kev ntsuam xyuas nqa tawm thiab cov differential. mob, koj muaj peev xwm ua tej yam kev xaus lus. Thaum koj nruab ib lub mob "KEV PAB syndrome" kev kho mob aimed ntawm stabilizing hauv lub xeev ntawm lub cev xeeb tub poj niam thiab tus me nyuam hauv plab, raws li zoo raws li pab tus me nyuam yog yus lub sij hawm. Kev kho mob ua ub no yog nqa tawm nrog kev pab los ntawm ib tug obstetrician-gynecologist, lub resuscitation pab neeg, cov anesthesiologist. Yog hais tias tsim nyog, txuas lwm yam tshwj xeeb: ib tug neurologist los yog ophthalmologist. Feem ntau tshem tawm ntau hloov khoom nruab nrog tsis ua hauj lwm, thiab muab kev tiv thaiv nyob rau hauv kev txiav txim kom tsis txhob tau yam mob.

Ntawm cov ntau complicating lub chav kawm ntawm kev kho mob kev pab, muaj peev xwm yuav qhia tau:

• placental detachment;
• hemorrhage;
• lub hlwb edema;
• pulmonary edema;
• mob raum tsis ua hauj lwm;
• neeg tuag taus siab hloov thiab cov kis;
• indomitable los ntshav.

Thaum qhov tseeb mob thiab raws sij hawm muab kev pab mus rau lub yuav ua rau muaj morbidity nyhav mus rau ib tug tsawg kawg nkaus.

obstetric zoo

Tactics xyaum Obstetrics nyob rau hauv relation mus lub loj heev ntaub ntawv ntawm preeclampsia, qhov ntau nyuab syndrome PAB, yog tseeb: kev siv ntawm caesarean seem. Thaum paub tab lub tsev me nyuam npaj txhij rau tej yam ntuj tso tau me nyuam, siv prostaglandins thiab ruaj epidural.

Nyob rau hauv loj heev zaum, caesarean seem yog siv heev dua lwm yam endotracheal tshuaj loog.

Lub neej tom qab muab yug

Tshwj xeeb sau tseg tias tus kab mob no tshwm sim tsis tau tsuas yog thaum lub sij hawm peb peb lub hlis, tab sis kuj muaj peev xwm ua tau zoo nyob rau hauv ob hnub tom qab tau txais tshem ntawm cov xwm txheej.

Yog li ntawd, PAB syndrome tom qab yug tus me nyuam - lub phenomenon yog heev tau hais tias hais lus nyob rau hauv dej siab ntawm cov nyob ze xyuas ntawm leej niam thiab tus me nyuam nyob rau hauv lub postpartum lub sij hawm. Tshwj xeeb tshaj yog nws kev txhawj xeeb cov poj niam nrog ntau ntws preeclampsia thaum lub sij hawm cev xeeb tub.

Leej twg yog los liam thiab yuav ua li cas?

PAB syndrome - ib tug muaj kev cuam tshuam ntawm yuav luag tag nrho cov nruab nrog cev thiab tshuab ntawm cov poj niam lub cev. Thaum lub sij hawm tus kab mob no muaj ib tug intensive outflow ntawm kev loj hlob thiab ib tug siab ntau yam ntawm txoj kev tuag, thiab intrauterine me nyuam hauv plab kev txawv txav. Yog li ntawd, los ntawm lub 20 th lub lim tiam ntawm lub expectant niam yog tsim nyog los ua kev cai rau nws tus kheej saib xyuas chaw muag mis nyuj, uas nqa tag nrho cov kev hloov uas tshwm sim nyob rau hauv lub cev. Kev mloog yuav tsum tau them mus rau lub ntsiab lus nram qab:

• ntshav siab: nws jumps upward ntau tshaj peb lub sij hawm yuav tsum ceeb toom rau;
• hnyav metamorphosis: yog hais tias nws yog sawv sharply, tej zaum, yog vim li cas rau cov uas yog o;
• me nyuam hauv plab zog heev mob siab heev, los yog, conversely, stilled zog - kom meej meej ib yog vim li cas rau kev kho mob rau cov kws kho mob;
• xub ntiag ntawm edema: ib tug loj o ntawm ntaub so ntswg qhia raum tsis ua hauj lwm;
• txawv txawv mob plab: tshwj xeeb tshaj yog tseem ceeb nyob rau hauv lub cheeb tsam ntawm lub siab;
• Tsis tu ncua tsom xam ntawm tag nrho cov uas yog taw, yuav tsum tau ua nyob rau hauv txoj kev ntseeg zoo thiab nyob rau hauv lub sij hawm, raws li nws yuav tsum tau rau cov kev pab ntawm lub heev leej niam thiab tus me nyuam hauv plab.

Tag nrho cov kev ceeb toom tej yam tshwm sim yuav tsum tau tam sim ntawd qhia rau koj tus kws kho mob, kws tshuaj kuaj pojniam li tsuas muaj txaus ntsuam xyuas qhov teeb meem no thiab coj txoj kev txiav txim.