Herpetic keratitis: incazelo, amafomu, izimbangela, izimpawu kanye nokwelashwa

izinqubo ukuvuvukala kule cornea kungahle kubangelwe keratitis endogenous futhi exogenous. Esimweni sokuqala, ukuhola ekuthuthukeni kwabo yangaphakathi nezinqubo. Exogenous keratitis cuphuluza iziphi izici zangaphandle. Yazi izimbangela ukuthi kwaholela ekwakhekeni lesi sifo, nokuhloma ukusazi ngokunembile isifo esikuphethe kumelwe Udokotela wezifo zamehlo.

Incazelo yenkinga

Herpetic keratitis - isifo esithathelanayo ukuthi kuthinta cornea. It kungadalwa omunye 5 izinhlobo herpes amagciwane. ukusabalala kakhulu HSV-1. Lokhu herpes simplex virus uhlobo 1 amasosha ke zitholakala 90% wesibalo sabantu. Kuthinta njengoba umthetho, engxenyeni engaphezulu kuphela yomzimba. zithinteka kakhulu umuntu.

Kodwa imbangela herpes keratitis kungaba futhi:

- herpes simplex virus uhlobo 2;

- herpes zoster (kudala shingles futhi upokisi);

- Epstein-Barr igciwane;

- cytomegalovirus.

Kodwa avame ushaya Ilihlo HSV-1.

Herpetic keratitis libhekene iqiniso lokuthi ulwelwesi samehlo babe esinamafu. Ngenxa kokunqotshwa a Iso lomuntu liwumsebenzi zimbi kakhulu, lokho kungase kubangele ngisho nobumpumputhe.

izimpawu

Igciwane kungathinta kokubili abadala kanye nezingane abangekho ngisho iminyaka 5. Izimpawu eyinhloko ukubonakala kwawo yilezi:

- Amehlo akhalayo;

- blepharospasm (isimo lapho Isivalo zivaliwe spasm okungalindelekile);

- photophobia.

Kodwa lokhu akulona uhlu oluphelele izici, okungase ukunquma keratitis herpetic. Izimpawu zesifo kungabandakanya:

- ububomvu samehlo;

- umuzwa okuthola nomzimba angaphandle;

- esivuthayo;

- ubuhlungu esweni.

Phakathi ukutheleleka okuyisisekelo zingavela anamabhamuza ijwabu leso futhi conjunctiva. It uphulukisa ngaphandle nezibazi. I-cornea iyona lesion eyinhloko kungukuhlasela ezimweni eziningi isetshenzwe.

Ukuvuselelwa igciwane kubangela yansukuzonke keratitis herpetic. Umlando lesi sifo, izinhlobo isifo zibalulekile ukuze uthole okunye amasu ukuxilongwa kanye nokwelashwa. Igciwane esicashile nophikelelayo ganglia sezinzwa. Lapho ukuvuselelwa it is uyiswa eziyimpumelelo kwenzwa ke kukhona isifo inhlamvu yeso.

izinhlobo isifo

Kuye isithombe yomtholampilo, ukukhomba izinhlobo eziningana izilonda. Classic isifo herpetic livela ekhelini izilonda ku-cornea. Lokhu okuthiwa EPITHELIAL keratitis herpetic. Kuthinta kuphela olwelwesini cornea, esakhiwa flat amaseli EPITHELIAL.

Ochwepheshe ukukhomba isihlahla kanye nohlobo kwendawo isifo. Sifo kusekelwe indlela okwandile ukusabela ukuvuvukala. Kubalulekile nokuthi zonakala izicubu corneal.

Odokotela kutholakala ukuthi uphethwe yini "keratitis isihlahla-herpetic" ezimweni lapho izilonda ku-cornea efanayo emagatsheni ezihlahla. Kancane nakakhulu kunjalo, uma udokotela ethi mayelana ukunqotshwa kwezwe. Lokhu kusho ukuthi i-cornea lilimele kanzima. Indawo epithelium wabhubhisa abalulekile, futhi isimo sabo sifana ukumelwa olotshiwe wesakhiwo amazwekazi phezu amakhadi.

Stromal keratitis libizwa discoid. Kulesi isifo alithintwa olwelwesini cornea, futhi ubuso bayo kwangaphakathi - stroma. Uhlobo eziyingozi kakhulu is necrotizing stromal keratitis. Nge lolu hlobo sifo yisishiso ethuthuka ngokushesha. Kungabangela ukubhujiswa kwezicubu corneal. Ekugcineni, lokhu kungaholela ngobumpumputhe.

Okokuqala okubili izinhlobo keratitis herpetic (isihlahla nokuma kwezwe) nge ukwelashwa okufanele ephelele yokutakula sekupheleni.

ukuhlola

Ukuvimbela ukuthuthukiswa yezinkinga kuyadingeka lapho kuqubuka loxhumana naye isifo kudokotela wezifo zamehlo. Angaba lokwenza ukuxilongwa bese ukhetha ukwelashwa okufanele kakhulu.

Udokotela Uhlaziya isimo lesiguli, ubheka kuwukubonakaliswa sifo. Iphinde alinganise ingcindezi intraocular. Ukuze kutholakale umsuka wendaba yesihluku umonakalo kuyadingeka iconsa ku iso fluorescein. Lena reagent ekhethekile kuyabonakala ngaphansi kwe-ultraviolet. Ingasetshenziselwa ahlaziye ukuthi keratitis herpetic ezilimele ebusweni corneal.

Futhi uphethwe lembula kahle hle ukuthi yiziphi izingqimba igciwane wamshaya. Kuye lokhu kuzoshiwo amaqhinga yokwelashwa.

zocwaningo laboratory

Ezimweni eziningi, isithombe emtholampilo keratitis libizwa. Kodwa zikhona izimo lapho ngisho ngosizo ukuhlolwa okukhethekile awutholi ukusazi ngokunembile isifo esikuphethe. Khona-ke ungase udinge zocwaningo laboratory. Kuyadingeka uma igciwane herpes simplex izilonda izinsana.

Ukuze enze lokhu uvivinyo lungeza swabs kusukela cornea. Kodwa lesi sifundo ukuzwela ongaphakeme. Okuningi ulwazi kuyinto ukuhlolwa DNA. Nokho, kuyinto luhlolo ngempela eqolo, ngakho-ke isetshenziswa kakhulu kuyaqabukela. ukuhlolwa Serological bayafundisa ku lesion eyinhloko: babonisana amasosha omzimba ukwandisa. Kodwa ziba engenamsebenzi lapho ukuvuselelwa igciwane.

Izimbangela zesifo

Herpetic keratitis iso iyathelelwana. Esikhathini lesion eyinhloko herpes simplex virus ezimweni eziningi aliveli izimpawu. Ngezinye izikhathi ungase uzizwe amabhamuza ejwayelekile emhlabeni izindebe.

Uma emzimbeni, igciwane njalo uhlala emangqamuzaneni emsipheni trigeminal. Kuyinto esimweni esicashile. Kodwa ngezikhathi ezithile kungaba isebenze. Kulokhu, pathogen uqala ngenkuthalo ziyanda. Amagciwane angahamba ukuze izicubu ubuso namehlo.

Herpetic keratitis ngokuvamile ibonakala ngemuva nje ukuvuselelwa igciwane. Uma ku-cornea esweni, igciwane uyaqhubeka wanda.

Kodwa ukubhujiswa izicubu iqala ngenxa yokusabela kwesimiso somzimba sokuzivikela ezifweni. Ngale nje kwalokho, unesibopho ukuthuthukiswa ukusabela ukuvuvukala. amasosha omzimba kunezifo akwazi ukuzibona kuphela futhi ibulale ama-virus izicubu atheleleke. Ngezinye izikhathi umonakalo kusuka ukuzivikela komzimba kuba kunamanje isenzo igciwane uqobo.

Okuholela ukuvuselelwa igciwane?

Cishe u-90% abantu abathwali igciwane herpes simplex. Kodwa akubona bonke bavele keratitis herpetic. Abacwaningi bakholelwa ukuthi ukutheleleka kungenzeka ukuthuthukisa ngaphansi kwethonya izici ezithile nezimo ezithinta umzimba.

Kwaphela isikhathi eside, odokotela babekholelwa ukuthi igciwane icushiwe on isizinda zokucindezeleka. Kodwa iqembu labantu inhlolovo waphikisa lokhu nokucabanga. Ngakho-ke, odokotela abakwazi ukusho ngokuthe ngqó ukuthi ikhona yini imbangela lolu hlobo keratitis.

Kodwa wathola ukuthi usengozini yokuthola lesi sifo abantu abaye babhekana ezihlukahlukene ukuhlinzwa. Lokhu kungaba laser umbono ukulungiswa, cataract, ukufiphala kwamehlo ukufakelwa corneal.

amacebo yokwelashwa

ukwelashwa Kudingeka ingasatshenziswa kuphela emva ukuhlolwa kudokotela wezifo zamehlo. Kufanele uqinisekise uphethwe "herpetic keratitis iso." Ukwelashwa futhi ukukhethela uchwepheshe.

Uma i-herpes abathintekayo kuphela amajwabu amehlo, khona-ke kuyoba okwanele nje ukusebenzisa iphilisi "Acyclovir" noma "Valacyclovir." Badinga ukuphuza izinsuku 5. Ukuze ekwelapheni keratitis EPITHELIAL udinga ukuthenga gel iso, equkethe 0.15% gantsilovira noma lehla nge-1% trifluridine. Wamafutha "Acyclovir" lingahunyushwa nangokuthi kunikezelwe. Kuyadingeka ukuba abeke phezu ijwabu leso engezansi izikhathi okungenani 5 ngosuku.

Treatment kwaqhubeka waze ukuphulukiswa ephelele. kuphela "Acyclovir" ithebhulethi kwanele ukuthatha kwezinye izimo. Uma lokhu kwelashwa ingaphumeleli, bese usebenzisa amathonsi nge interferon.

keratitis Stromal aphathe kuyinkimbinkimbi. Ezinsukwini zokuqala ezimbili amaphilisi esabelwe 'Acyclovir "(2 g ngosuku) noma" Valaciclovir "(1 g nsuku zonke). Kulesi umthamo badinga ukuba uphuze 2 amaviki. Uma izinsuku ezimbili zokuqala Yiqiniso sifo ngeke uthuthuka, eminye ukutusa ukusetshenziswa iconsi 0.1% dexamethasone. Okokuqala babeqathaza izikhathi 8 ngosuku, kodwa kancane kancane ukunciphisa imvamisa yokusetshenziswa zonke izinsuku 3-6 ukuze 1 iconsi. Ukuphathwa kanjalo kufanele siqhubeke ezinyangeni ezimbalwa.