Kawasaki chirwere (KD), inonziwo mucocutaneous lymph node syndrome, chirwere chinokonzera chirwere chisingazivikanwi, chinowanzokonzera vana nevana. Kawasaki chirwere is self-limited illness, rinogara mazuva gumi nemaviri. Zvinosuruvarisa, zvisinei, vana vane chirwere cheKawasaki vasina kuitirwa utsinye vanogona kutambura zvinetso zvekusingaperi zvemoyo, kunyanya aneurysms yemakironi eeron , izvo zvinogona kutungamirira kukurwara kwemoyo uye kufa kamwe kwemoyo .
Zviratidzo
Zvechokwadi, zviratidzo zvechirwere cheKawasaki zvinosanganisira high fever, kuputika, kubwinya kwemaziso, kuputika lymph nodes mukati memutsipa, zvitsvuku zvitsvuku nemasero, kuputika kwemaoko netsoka, uye tachycardia (kukurumidza kwenzwi) kusina kuenzana kusvika pamwero wefivha. Ivana ava vanowanzorwara, uye vabereki vavo vanowanzoziva kukosha kwekutora kuvanachiremba.
Ichi chinhu chakanaka kubva pakuita kuti chirongwa chekuziva uye kurapa mwana nguva isati yapfuura neine muchera gamma globulin (IVIG) inogona kubatsira zvikuru mukudzivirira matambudziko emwoyo kwenguva refu.
Acute Cardiac Complications
Munguva yechirwere chakaoma, midzi yeropa mumuviri wose inopisa (chirwere chinonzi vasculitis ). Iyi vasculitis inogona kuunza matambudziko akawanda emwoyo, kusanganisira tachycardia; kuputika kwemuviri wepfungwa ( myocarditis ), iyo dzimwe nguva inogona kutungamirira kukurira, kutyisa moyo kusakundikana ; uye unyoro mitral kudzokerazve .
Kana imwe nguva chirwere chakaoma chinopera, zvinetso izvi zvinowanzotarisana.
Kutevedzana kweCardiac Complications
Muzviitiko zvakawanda, vana vane chirwere cheKawasaki, sevanorwara sezvavanenge vari, vanoita zvakanaka kana chirwere chakaoma chikaguma. Zvisinei, pamusoro pevana vashanu paine chirwere cheKawasaki chisina kubatwa neVIV chichakudziridza chirongwa cheine arteri aneurysms (CAA).
Iyi aneurysms - kuputika kwechikamu chetari - kunogona kutungamirira ku- thrombosis nekudzivirirwa kwetari, zvichiita kuti myocardial infarction (kurwisa kwemwoyo). Hondo yekurwa inogona kuitika chero nguva, asi njodzi iripamusoro pamwedzi kana maviri mushure mezvirwere zvakaoma zveKawasaki. Dambudziko racho rinoramba richikwirira kwemakore anenge maviri, saka rinowedzera zvakanyanya.
Kana imwe CAA yakaumbwa, zvakadaro, njodzi yekurwadziwa kwemoyo inoramba ichinge yakasimudzwa nokusingaperi. Uyezve, vanhu vane CAA vanoita sevanonyanya kukanganisa kukura kwematongerwo enyika asati avapo kana kuti pedyo nenzvimbo ye ane ane simba.
CAA nekuda kwechirwere cheKawasaki chinoratidzika kuva chakanyanya kune vanhu vanobva kuAsia, Pacific Islander, Hispanic, kana Native America dzinobva.
Vanhu vane chirwere chepfungwa nekuda kweAAA vanowanzosangana nematambudziko akafanana neavo vane mamwe maitiro ehutachiona hwehutano -kusanganisira mwoyo kusakatika uye kufa kamwe kwemoyo.
Kudzivirira Matambudziko eCardiac
Kurapa kwokutanga neVIV kwave kuchiratidzwa kuti inoshanda chaizvo mukudzivirira hutachiona hwematrion aneurysms. Asi kunyange apo IVIG inoshandiswa zvakajeka, zvinokosha kuongorora vana vane chirwere cheKaasaki kuitira kuti muve neCA.
Echocardiography inobatsira zvikuru munyaya iyi sezvo CAA kazhinji inogona kuonekwa nekuedzwa kwechombo.
Chirwere chekunyorwa chinofanira kuitika nokukurumidza apo kuongororwa kwechirwere cheKawasaki kuchiitwa, uyezve masvondo mashoma mashoma kwemwedzi miviri inotevera. Kana imwe CAA inowanikwa iripo, iyo nyanzvi inogona kufungidzira hukuru hwayo (makuru aneurusms ane ngozi). Zvinokwanisika kuti kuwedzerwa kuongororwa kuchadiwa, zvichida nekuedzwa kwepfungwa kana catheterization yemwoyo , kubatsira kubatsira kuongorora kusimba kweine aneurysm.
Kana imwe CAA iripo, kurapwa ne-low-dose aspirin (kudzivirira thrombosis) inowanzotaurwa. Muchiitiko ichi, mwana anofanira kunge ane gore negore zvirwere zvekupukisa kurwisa fenza uye kudzivisa Reye's Syndrome .
Pane imwe nguva aAA yakaoma zvakakwana zvokuti aroni inobvumirana nekuvhiya inofanira kufungwa.
Vabereki vevana vane CAA vanofanira kuva vakangwaririra zviratidzo zvekungina kana kushaya mwoyo. Muvana vaduku zvikuru, izvi zvinogona kuva dambudziko, uye vabereki vachafanira kutarisa kusanzwisisika kusina kutsanangurwa kana kurutsa, kusatsanangurwa pallor kana kutuka, kana kusarondedzerwa uye nguva refu yekuchema.
Summary
Nekurapa kwemazuva ano kwechirwere cheKawasaki, zvinetso zvakakomba, zvekare kwenguva refu zvinogona kudziviswa munguva zhinji. Kana chirwere cheKawasaki chinotungamirira kuAAA, zvisinei, kuongororwa nekutsvaga uye kurapwa kunogona kudzivirira migumisiro yakaipisisa.
Chinokosha chekudzivirira hutano hwemwoyo nehosha yeKawasaki ndeyevabereki kuti vaone kuti vana vavo vanokurumidzirwa kuongororwa chero chirwere chipi nechipi chinoratidzika sechirwere cheKawasaki, kana, nokuda kwechinhu ichocho, nokuda kwehosha ipi neipi inotarisa kwavari inonyanya kuoma.
Kunobva:
Newburger JW, Takahashi M, Gerber MA, et al. Kuongororwa, kurapwa, uye kutora nguva kwenguva refu chirwere cheKawasaki: chirevo chevashandi vezvehutano kubva kuKomiti yeRheumatic Fever, Endocarditis uye Kawasaki Disease, Council on Cardiovascular Disease in Young, American Heart Association. Circulation 2004; 110: 2747.
Kawasaki disease. Mune: Red Book: 2015 Nyaya yeKomiti Yezvirwere Zvinotapukisa, 30th ed, Kimberlin DW, Brady MT, Jackson MA, Long SS (Eds), American Academy of Pediatrics, Elk Grove Village, IL 2015. p.49