Scleroderma sune cututtuka masu kumburi da ke haifar da sclerotic thickening na fata. Akwai manyan nau'o'i guda biyu: scleroderma na gida, wanda ake kira "morphea", wanda ya shafi fata kuma wani lokaci a cikin zurfin yana samar da ƙananan ƙwayoyin musculo-aponeurotic da skeletal jiragen sama da scleroderma na tsarin da ke da alaka da fata da gabobin.

Ma'anar Scleroderma na tsarin jiki

Scleroderma cuta ce da ba kasafai take shafar mata 3 ga kowane namiji ba, yawanci tana faruwa ne tsakanin shekaru 50 zuwa 60, wanda ke haifar da fibrosis na fata da wasu gabobin jiki, musamman bangaren narkewar abinci, huhu, koda da zuciya. Shigar waɗannan gabobin 3 na ƙarshe yakan haifar da matsala mai tsanani.

Ci gabansa yawanci yana yaduwa tsawon shekaru, wanda aka yi masa alama ta tashin hankali.

Raynaud ta ciwo

Ciwon Raynaud yana da alaƙa da bleaching na wasu yatsunsu a cikin sanyi. Kusan koyaushe shine alamar farko na scleroderma, musamman ma lokacin da ya kasance na biyu, yana bayyana a gaban sauran alamun daga wasu makonni zuwa wasu shekaru (mafi ƙarancin jinkiri, mafi rashin jin daɗi) kuma yana samuwa a cikin 95% na lokuta scleroderma. .

Likita yana yin ƙusa capillaroscopy (bincike tare da gilashin ƙara ƙarfi na tasoshin cuticle da ƙusa ƙusa) yana nuna goyon baya ga scleroderma:

• wani rarefaction na capillary madaukai,
• mega-capillaries
• wani lokacin wanzuwar pericapillary edema
• Cuticular hyperkeratosis,
• erythema,
• microhemorrhages bayyane ga ido tsirara.

Skin sclerosis

Zuwa yatsu

Yatsun da farko sun kumbura kuma an murƙushe su tare da halin bacewar sawun yatsa. Sa'an nan kuma fata ta zama mai matsewa, tana ba da yanayin "tsotsewa" na ɓangarorin yatsa

Sannan yatsunsu a hankali suna matsawa suna ja da baya a murzawa.

Rikicin sclerosis, ƙwanƙwasa masu raɗaɗi masu raɗaɗi suna faruwa akan pulpitis

Sauran yankuna

Sclerosis na iya yaduwa zuwa fuska (fuskar ta yi santsi kuma ta daskare; akwai tapering na

hanci da rage buɗe baki wanda ke kewaye da ɗigon haske a cikin “aljihun jaka”), gaɓoɓi da gangar jikin suna ba da santsi da sheashed bayyanar zuwa ga kafadu, gangar jikin da gabobin.

Telangiectasias

Waɗannan ƙananan tasoshin ruwa ne waɗanda ke haɗuwa tare a cikin jakunkuna masu launin shuɗi na milimita ɗaya zuwa 2, kuma waɗanda ke tasowa a kan fuska da kuma a ƙarshen.

calcinosis

Wadannan nodules ne masu wuya, fararen fata lokacin da suke sama, wanda zai iya, lokacin da suka hadu da fata, ya bar mush mai alli. Sun fi kowa a hannu da ƙafafu.

Hannun mucosal

Mucosa na baki yakan bushe da kuma idanu. Wannan shi ake kira sicca ciwo.

Jiyya na sclerosis

Maganin narkewar abinci

Shiga cikin esophagus yana kasancewa a cikin 75% na lokuta, wanda aka bayyana ta hanyar gastroesophageal reflux, wahalar haɗiye, ko ma ciwon ciki.

Ƙananan hanji kuma yana shafar fibrosis ko ma atrophy mai banƙyama, wani lokacin da ke da alhakin ciwo na malabsorption, wanda ke ƙarfafawa ta hanyar rage jinkirin peristalsis na hanji, haifar da ƙananan ƙwayoyin cuta da kuma fallasa haɗarin ɓarna na hanji.

Huhu da zuciya

Fibrosis na huhu yana faruwa a cikin kashi 25 cikin dari na marasa lafiya, masu alhakin cututtuka na numfashi wanda zai iya haifar da gazawar numfashi na yau da kullum, babban dalilin mutuwar marasa lafiya.

Babban dalilin mutuwa na biyu shine hauhawar jini na huhu, saboda fibrosis na huhu, lalacewar jijiya na huhu ko lalacewar zuciya. Ƙarshen yana da alaƙa da ischemia na myocardial, "launi na Raynaud na myocardial" da fibrosis.

Kodan

Lalacewar koda yana haifar da mummunan hauhawar jini da gazawar koda

Na'urar Locomotor

Akwai lalacewa ga gidajen abinci (polyarthritis), tendons, kasusuwa (demineralization, lalata kasusuwa mai nisa) da tsokoki (ciwon tsoka da rauni).

Jiyya na scleroderma na tsarin

Yaki da fibrosis

Sa ido yana da mahimmanci kuma akwai magunguna da yawa waɗanda za a iya gwadawa saboda tasirin su ya bambanta sosai daga mutum zuwa mutum. Daga cikin magungunan da aka yi amfani da su, zamu iya ambaci colchicine, D-penicillamine, interferon γ, cortisone, cyclosporin, da dai sauransu.

Motsa jiki na yau da kullun, tausa da yunƙurin gyarawa don kula da motsi da yaƙi da atrophy na tsoka.

Raynaud ta ciwo

Bugu da ƙari, kariya daga sanyi da dakatar da shan taba, ana amfani da vasodilator irin su masu hana tashar calcium: dihydropyridines (nifedipine, amlodipine, da dai sauransu) ko benzothiazines (diltiazem). Idan masu hana tashar calcium ba su da tasiri, likita ya rubuta wasu vasodilators: prazosin, masu hana masu hana enzyme, sartans, trinitrin, iloprost, da dai sauransu.

Telangiectasias

Ana iya rage su ta hanyar Laser mai bugun jini mai bugun jini ko KTP.

Subcutaneous calcinosis

Likitan ya rubuta bandeji, har ma da colchicine. Fitar calcinosis na tiyata wani lokaci yakan zama dole.

Maganin bayyanar da sauran gabobin

Maganin narkewar abinci

Wajibi ne a mutunta matakan tsabta-abincin abinci na gastroesophageal reflux: kawar da abinci na acidic da barasa, cin abinci a wurin zama, yin amfani da matashin kai da yawa don barci. Likitan ya ba da umarnin masu hana ruwa na proton don iyakance acidity na ciki.

A cikin taron na malabsorption, nasaba da wani microbial yaduwa da aka fi so ta hanyar rage jinkirin peristalsis na hanji, likita ya rubuta maganin rigakafi na lokaci-lokaci da kuma cyclically mako daya zuwa biyu kowane wata (ampicillin, tetracyclines ko trimethoprim-sulfamethoxazole), hade da ƙarin ƙarfe, folic acid. da kuma bitamin B12.

Huhu da zuciya

A kan fibrosis interstitial na huhu, ana amfani da cyclophosphamide kadai ko a hade tare da cortisone. Ana kula da cututtukan huhu na biyu tare da maganin rigakafi kuma haɗarin cutar fibrosis na huhu yana iyakance ta hanyar rigakafin mura da pneumococcus.

Dangane da hauhawar jini na huhu, ana amfani da vasodilator kamar nifedipine. Iloprost da esoprostenol.

Don ban ruwa na myocardial, ana amfani da masu hana tashar calcium da masu hana ACE.

Jijiyoyi

Masu hana ACE kamar captopril ko vasodilator kamar sartans suna iyakance hauhawar hauhawar jini da gazawar koda.

Lalacewar tsoka da haɗin gwiwa

Likitan ya rubuta magungunan da ba steroidal ko steroidal anti-inflammatory (cortisone) don ciwon haɗin gwiwa