Tshuaj Necrolysis Hmoov Puas Yog Dab Tsi (TEN)?

Zoo Siab

• Ua rau
• Cov tshuaj noj
• Kab mob
• Cov tsos mob
• Siv piv txwv
• Txuas nrog Stevens-Johnson syndrome
• Yam pheej hmoo
• Kev kuaj mob
• Kev Kho Mob
• Outlook
• Nqa Nyiaj

Cov mob hu ua Toxic epidermal necrolysis (TEN) yog ib hom tawv nqaij muaj tsawg thiab mob hnyav. Feem ntau, nws tshwm sim los ntawm qhov tshwm sim tsis zoo rau cov tshuaj xws li anticonvulsants lossis tshuaj tua kab mob.

Cov tsos mob tseem ceeb yog ua rau tawv nqaij tshiav thiab hlwv. Cov tev hlob zuj zus sai, ua rau muaj qhov nqaij nyoos loj dua uas yuav ua paug lossis quaj. Nws tseem cuam tshuam cov leeg ntawm lub plab, nrog rau lub qhov ncauj, caj pas, qhov muag, thiab thaj av.

Vim tias TEN loj hlob sai, nws tseem ceeb uas yuav tau nrhiav kev pab sai li sai tau. TEN yog ib qho xwm txheej kub ntxhov ceev uas xav tau kev kho mob sai sai.

Nyeem rau txhawm rau tshawb txog cov laj thawj thiab cov tsos mob ntawm TEN, nrog rau yuav kho nws li cas.

Ua rau

Vim tias TEN muaj tsawg heev, nws tsis tau nkag siab. Nws ib txwm muaj vim kev phiv tshuaj tsis zoo. Qee zaum, nws tsis yooj yim los txheeb xyuas qhov pib vim li cas ntawm TEN.

Cov tshuaj noj

Feem ntau ua rau TEN yog qhov txawv txav ntawm kev siv tshuaj. Nws kuj tseem paub tias yog hom phom sij txaus ntshai, thiab muaj lub luag haujlwm txog 95 feem pua ​​ntawm TEN mob.

Feem ntau, cov mob tshwm sim hauv thawj 8 lub lim tiam ntawm kev noj tshuaj.

Cov tshuaj hauv qab no feem ntau cuam tshuam nrog TEN:

• tshuaj thaiv kab mob
• oxicams (nonsteroidal anti-inflammatory tshuaj)
• sulfonamide tshuaj tua kab mob
• allopurinol (rau gout thiab kev tiv thaiv ntawm lub raum pob zeb)
• nevirapine (tshuaj tiv thaiv HIV)

Kab mob

Muaj qee zaus, muaj tus mob TEN zoo li txuas rau tus mob los ntawm cov kab mob hu ua Mycoplasma mob ntsws, uas ua rau muaj kab mob ua pa.

Cov tsos mob

Cov tsos mob ntawm TEN txawv rau txhua tus neeg. Hauv cov theem thaum ntxov, nws feem ntau ua rau cov tsos mob zoo li ua npaws. Qhov no yuav suav nrog:

• ua npaws
• mob ib ce
• liab, ple lub qhov muag
• teeb meem nqos
• los ntswg
• kev hnoos
• mob caj pas

Tom qab 1 mus rau 3 hnub, daim tawv nqaij qhwv tawm nrog lossis tsis muaj qhov tawm los. Cov tsos mob no tuaj yeem vam meej li ntawm ob peb teev lossis hnub.

Lwm cov tsos mob muaj xws li:

• thaj ua pob liab liab, paj yeeb, lossis paj yeeb
• mob tawv nqaij
• loj, thaj tsam ntawm daim tawv nqaij (tawv nqaij)
• cov tsos mob kis mus rau lub qhov muag, qhov ncauj, thiab ntawm lub cev

Siv piv txwv

Cov tsos mob thawj zaug ntawm TEN yog pleev xim tawv nqaij tawm. Raws li cov mob zuj zus, tev tawm sai thoob plaws hauv lub cev.

Hauv qab no yog cov piv txwv pom ntawm TEN.

Txuas nrog Stevens-Johnson syndrome

Stevens-Johnson syndrome (SJS), zoo li TEN, yog ib qho tawv nqaij hnyav heev los ntawm cov tshuaj los yog, tsis tshua muaj, cuam tshuam nrog kev kis mob. Ob qho xwm txheej nyob rau tib lub spectrum ntawm tus kab mob thiab txawv raws qhov sib txawv ntawm daim tawv nqaij.

SJS tsis muaj qhov hnyav dua. Piv txwv, hauv SJS, tsawg dua 10 feem pua ​​ntawm lub cev raug cuam tshuam los ntawm daim tawv nqaij tawv. Hauv TEN, ntau dua 30 feem pua ​​cuam tshuam.

Txawm li cas los xij, SJS tseem yog ib qho mob hnyav. Nws kuj yuav tsum tau txais kev kho mob maj nrawm.

SJS thiab TEN feem ntau sib tshooj, yog li ntawd cov xwm txheej qee zaum hu ua Stevens-Johnson syndrome / mob siab rau epidermal necrolysis, lossis SJS / TEN.

Yam pheej hmoo

Txawm hais tias leej twg noj tshuaj pab tau tsim muaj TEN, qee cov neeg muaj kev pheej hmoo siab dua.

Cov kev pheej hmoo txaus ntshai muaj xws li:

• Muaj hnub nyoog laus dua. TEN tuaj yeem cuam tshuam rau tib neeg txhua lub hnub nyoog, tab sis nws yuav cuam tshuam ntau dua rau cov laus.
• Tub los ntxhais. Cov pojniam yuav muaj feem ntau TEN.
• Lub cev tsis muaj zog tiv thaiv kab mob. Cov neeg uas lub cev tsis muaj zog tiv thaiv kab mob hauv lub cev feem ntau yuav tsim kom muaj TEN. Qhov no yuav tshwm sim vim cov xwm txheej zoo li mob qog lossis HIV.
• AIDS. SJS thiab TEN yog 1,000 npaug ntau zaus rau cov neeg mob AIDS.
• Noob caj noob ces. Txoj kev pheej hmoo yog siab dua yog tias koj muaj HLA-B * 1502 allele, uas yog cov neeg nyiam ntawm Cov Neeg Esxias Qab Teb Hnub Tuaj, Suav, thiab Neeg Qhab. Tus gene yuav ua kom koj muaj feem ntau nrog TEN thaum koj noj qee yam tshuaj.
• Keeb kwm tsev neeg. Koj yuav muaj feem ntau los tsim TEN yog tias ib tus neeg txheeb ze tau muaj tus mob.
• Cov tshuaj tiv thaiv dhau los. Yog tias koj tau tsim TEN tom qab siv qee yam tshuaj, koj muaj kev pheej hmoo siab yog tias koj noj tib yam tshuaj.

Kev kuaj mob

Tus kws kho mob yuav siv ntau yam kev kuaj mob txhawm rau txheeb xyuas koj cov tsos mob. Qhov no yuav suav nrog:

• Kev soj ntsuam lub cev. Thaum kuaj lub cev, kws kho mob yuav tshuaj xyuas koj cov tawv nqaij ua tawv nqaij, tawv, mos, thiab ua paug.
• Keeb kwm kho mob. Yuav kom nkag siab txog koj li kev noj qab haus huv tag nrho, tus kws kho mob yuav nug txog koj li keeb kwm kev kho mob Lawv kuj tseem yuav xav paub seb koj siv yam tshuaj twg, nrog rau kev siv tshuaj tshiab ob lub hlis dhau los, nrog rau kev fab tshuaj koj muaj.
• Nqaij xyoob tawv nqaij. Thaum kuaj cov tawv nqaij me me, ib daim qauv ntawm daim tawv nqaij cuam tshuam tawm ntawm koj lub cev thiab xa mus rau chav kuaj ntshav. Tus kws tshaj lij yuav siv lub tshuab tsom tsom los tshawb cov ntaub so ntswg thiab saib cov cim ntawm TEN.
• Kuaj ntshav. Kev kuaj ntshav tuaj yeem pab txheeb xyuas cov cim qhia ntawm kev kis lossis lwm yam teeb meem nrog cov kabmob hauv nruab nrog.
• Lwm Haiv Neeg. Tus kws kho mob kuj tseem tuaj yeem saib xyuas tus kabmob los ntawm kev tso ntshav lossis tawv nqaij los ntawm kev coj noj coj ua.

Thaum tus kws kho mob feem ntau tuaj yeem kuaj TEN nrog kev kuaj mob lub cev ib leeg, kuaj cov tawv nqaij ib ce feem ntau ua kom paub meej tias kuaj mob.

Kev Kho Mob

Hauv txhua qhov xwm txheej, kev kho mob suav nrog txiav tawm cov tshuaj uas ua rau koj cov tshuaj tiv thaiv.

Lwm hom kev khomob nyob ntawm ntau yam, xws li:

• koj lub hnub nyoog
• koj li kev noj qab haus huv thiab keeb kwm kev kho mob
• qhov mob heev ntawm koj tus mob
• cov nqaij cuam tshuam
• koj lub siab ntev ntawm qee cov txheej txheem

Txoj kev kho yuav koom nrog:

• Tsev Kho Mob. Txhua tus neeg nrog TEN xav tau txais kev saib xyuas hauv chav kub hnyiab.
• Tshuaj pleev thiab cov ntaub qhwv. Tu cov qhov txhab kom zoo yuav tiv thaiv daim tawv nqaij puas ntxiv thiab tiv thaiv daim tawv nqaij kom tsis txhob ua kua dej thiab kis kab mob. Txhawm rau tiv thaiv koj cov tawv nqaij, pawg kws kho mob hauv tsev kho mob yuav siv tshuaj pleev pleev thiab pleev qhov txhab.
• Tso dej (IV) kua thiab electrolytes. Tshaj tawm hlawv-zoo li daim tawv nqaij ploj, tshwj xeeb tshaj yog nyob rau hauv TEN, ua rau cov kua dej tsis txaus thiab electrolyte tsis txaus. Koj yuav tau muab cov tshuaj IV thiab electrolytes kom txo qis kev pheej hmoo. Pab pawg neeg kho mob yuav saib xyuas koj cov roj ntsha, cov xwm txheej ntawm koj cov plab hnyuv siab raum, thiab koj cov kua dej tas nrho.
• Muab cais nyob ib leeg. Txij li thaum daim tawv nqaij TEN puas ua rau muaj kev pheej hmoo kis tus mob, koj yuav cais tawm ntawm lwm tus thiab muaj peev xwm kis mob tau.

Cov tshuaj siv los kho TEN suav nrog:

• Tshuaj tua kab mob. Yuav luag txhua tus neeg uas muaj TEN txhaj tshuaj tiv thaiv los tiv thaiv los yog kho tus kab mob.
• Tso tshuaj immunoglobulin G (IVIG). Immunoglobulins yog cov tshuaj tiv thaiv kab mob uas pab koj lub cev tiv thaiv kab mob. Qee zaum IVIG siv tau los tswj cov tshuaj tiv thaiv. Qhov no yog kev siv lub npe-4 ntawm IVIG.
• TNF alpha inhibitor etanercept thiab immunosuppressant cyclosporine. Cov no yog kev cia siab kho uas feem ntau pom zoo los ntawm cov kws paub txog kev kho mob ntawm TEN. Nov yog kev siv tag nrho cov tshuaj.

Lub cev tshwj xeeb hauv lub cev yuav xav tau kev kho mob sib txawv. Piv txwv li, yog tias koj lub qhov ncauj muaj kev cuam tshuam, cov tshuaj yaug qhov ncauj tshwj xeeb yuav siv ntxiv rau lwm qhov kev kho mob.

Pab neeg tu koj hauv tsev kho mob kuj yuav saib xyuas koj ob lub qhov muag thiab qhov chaw mos rau cov paib. Yog tias lawv pom ib qho paib, lawv yuav tau siv cov tshuaj pleev tshwj xeeb los tiv thaiv teeb meem, xws li tsis pom kev thiab pom pob.

Tam sim no, tsis muaj cov qauv kev kho mob rau TEN. Txoj kev kho yuav txawv nyob ntawm tsev kho mob. Piv txwv, qee lub tsev kho mob yuav siv IVIG, thaum lwm tus siv tau kev sib txuas ntawm etanercept thiab cyclosporine.

Etanercept thiab cyclosporine tsis tau pom zoo tam sim no los ntawm Lub Chaw Tswj Xyuas Khoom Noj thiab Tshuaj (FDA) los kho TEN. Txawm li cas los xij, lawv tuaj yeem siv cov ntawv sau npe rau lub hom phiaj no. Kev siv daim ntawv lo npe txhais tau tias koj tus kws kho mob tuaj yeem sau tshuaj rau ib qho mob uas nws tsis pom zoo rau yog tias lawv xav tias koj yuav tau txais txiaj ntsig los ntawm cov tshuaj. Kawm ntxiv txog kev siv tshuaj uas tsis nyob ntawm daim ntawv lo.

Outlook

Kev tuag ntawm TEN yog kwv yees li 30 feem pua, tab sis tuaj yeem muaj peev xwm siab dua. Txawm li cas los xij, ntau yam cuam tshuam rau koj tus kheej qhov kev xam pom, suav nrog koj:

• muaj hnub nyoog
• noj qab haus huv tag nrho
• Ntawm koj tus mob, suav nrog qhov chaw nyob rau sab
• kev kho mob

Feem ntau, kev kho kom rov zoo li qub yuav siv li 3 txog 6 lub lis piam. Cov tshwm sim mus sij hawm ntev muaj xws li:

• tawv nqaij ntxiv
• caws pliav
• qhuav ntawm daim tawv nqaij thiab cov qog ua kua
• plaub hau poob
• teeb meem tso zis
• tsis hnov ​​qab
• kev ua haujlwm ntawm qhov chaw mos
• hloov qhov muag pom, suav nrog poob

Nqa Nyiaj

Tshuaj lom neeg mob lom neeg mob nhyav (TEN) yog ib qho mob hnyav heev. Ua rau lub neej cuam tshuam txog tawv nqaij mob, nws tuaj yeem ua rau lub cev qhuav dej thiab kis tau tus mob. Tau txais kev kho mob tam sim ntawd yog tias koj lossis tus neeg koj paub muaj cov tsos mob ntawm TEN.

Kev kho mob suav nrog kev mus pw hauv tsev kho mob thiab nkag rau chav tsev kub hnyiab. Koj pawg neeg hauv tsev kho mob yuav saib xyuas qhov ua kom mob, kho dej thiab tswj qhov mob. Nws tuaj yeem siv li 6 lub lis piam kom tau zoo dua, tab sis kev kho thaum ntxov yuav ua kom koj txoj kev zoo rov qab los thiab pom kev zoo.