Цианоз: что это, причины, симптомы и формы, лечение
Многие годы безуспешно боретесь с ГИПЕРТОНИЕЙ?
Глава Института: «Вы будете поражены, насколько просто можно вылечить гипертонию принимая каждый день.
Цианоз — клинический признак целого ряда патологий, при которых кожные покровы больных приобретают синюю окраску. Причиной подобных изменений является накопление в крови дезоксигемоглобина — гемоглобина, отдавшего кислород тканям. Кровь, обедненная кислородом, становится темной, просвечивается через кожу и делает ее синюшной. Наиболее отчетливо это заметно в местах с истонченной кожей — на лице и ушах.
Цианоз возникает у лиц с нарушениями кровообращения, приводящими к генерализованной или локальной гипоксемии.
При недостаточном кровенаполнении капилляров развивается акроцианоз, который проявляется синюшностью кожного покрова пальцев рук и ног, кончика носа. Этот термин в переводе с древнегреческого языка обозначает «темно-синяя конечность».
Степень выраженности цианоза варьируется от едва заметной синюшности до фиолетового цвета кожи. Временный цианоз возникает при чрезмерной физической нагрузке, стойкий цианоз — при длительно текущих сердечных или легочных заболеваниях.
Классификация
Центральный цианоз имеет диффузный характер и максимальную степень выраженности. Он развивается при слабой артериализации крови, приводящей к гипоксии. В легких нарушается газообмен, в артериальной крови накапливается избыток углекислоты, что клинически проявляется посинением конъюнктивы глаз, неба, языка, слизистой губ и щек, кожи лица. Качественные и количественные изменения гемоглобина в крови приводят к нарушению ее транспортной функции и гипоксии.
Акроцианоз локализуется на стопах, кистях рук, кончике носа, ушах, губах. Периферический цианоз считается вариантом нормы в первые дни жизни новорожденного ребенка. Его происхождение легко объяснить не полностью ликвидированным зародышевым типом кровообращения, особенно у недоношенных детей. Синюшность кожи усиливается при пеленании, кормлении, плаче, беспокойстве. Когда грудной ребенок полностью адаптируется в окружающем мире, цианоз исчезнет.
Акроцианоз у взрослых — признак варикоза, тромбофлебита, вегето-сосудистой дистонии, атеросклероза, артериита.
- Постоянным и транзиторным, возникающим при низком уровне глюкозы в крови или воспалении мозговых оболочек,
- Тотальным или общим,
- Региональным или местным: периоральным, дистальным,
- Изолированным.
Локальный цианоз развивается в местах с наибольшим количеством кровеносных сосудов, периоральный — вокруг рта, периорбитальный — вокруг глаз. Синюшность любой части тела человека может появиться при легочной и сердечной патологии.
Выделяют несколько видов цианоза по происхождению:
- Дыхательный тип обусловлен недостаточным объемом кислорода в легких и нарушением транспортной цепочки его подачи к клеткам и тканям. Он развивается при возникновении полного или частичного нарушения движению воздуха по респираторному тракту.
- Сердечный тип — недостаточное снабжение кровью органов и тканей приводит к дефициту кислорода и посинение кожи.
- Церебральный тип развивается, когда кровь теряет способность присоединять кислород к гемоглобину и доставлять его к клеткам мозга.
- Метаболический тип развивается при нарушении поглощения кислорода тканями.
Респираторный цианоз исчезает через 10 минут после оксигенотерапии, все остальные виды сохраняются длительно. Избавиться от акроцианоза помогает массаж мочки уха.
Этиология
При дисфункции сердца и сосудов кровь не может в полном объеме доставить кислород к клеткам и тканям организма, что приводит к развитию гипоксии. При этом на фоне усталости, утомляемости, головной боли, бессонницы, боли в груди, тахикардии, одышки, дезориентации появляется цианоз.
Цианоз — клинический признак различных заболеваний внутренних органов:
- Сердца и сосудов — пороков сердца, ИБС, ТЭЛА, варикозной болезни и атеросклероза,
- Крови — полицитемии и анемии,
- Дыхательной системы — пневмонии, пневмоторакса, плеврита, отека легких, бронхиолита, дыхательной недостаточности, легочной эмболии, инфекции, ХОБЛ, эмфиземы легких, задержки дыхания, крупа, инородных тел, воспаления надгортанника,
- Отравлений ядами или медикаментами — нитритами, фенацетином, нитробензолсодержащими препаратами, сульфаниламидами, анилина, седативными препаратами, алкоголем,
- Передозировки наркотиков,
- Судорог, которые длятся долгое время,
- Эпилепсии,
- Анафилактического шока, отека Квинке,
- Пищевой токсикоинфекции,
- Особо опасных инфекций — холеры, чумы,
- Карциноида тонкого кишечника.
Существуют врожденные семейные формы метгемоглобинемии с аутосомно-рецессивным типом наследования.
У здоровых людей цианоз может возникнуть при переохлаждении, в условиях высокогорья, в душном непроветриваемом помещении, во время полета без кислородного оборудования.
Симптоматика
Цианоз — это симптом опасных для жизни заболеваний. При центральном цианозе сначала синеет кожа периорбитальной и периоральной области, затем он распространяется на участки тела с наиболее тонкой кожей. Периферический цианоз максимально выражен на участках, удаленных от сердца. Он часто сочетается с набуханием и отеком вен шеи.
В зависимости от времени возникновения цианоз бывает острым, подострым и хроническим.
Цианоз не оказывает негативного влияния на общее самочувствие больных, но в совокупности с другими признаками основной патологии становится поводом для обращения к врачу. Если цианоз возникает внезапно, быстро нарастает и имеет значительную степень выраженности, то он требует оказания неотложной помощи.
Для лечения гипертонии наши читатели успешно используют ReCardio. Видя, такую популярность этого средства мы решили предложить его и вашему вниманию.
Подробнее здесь…
Цианоз в зависимости от этиологии болезни сопровождается различной симптоматикой: сильным кашлем, одышкой, тахикардией, слабостью, лихорадкой и другими признаками интоксикации.
- Цианоз при бронхолегочных заболеваниях проявляется фиолетовым оттенком кожи и слизистых оболочек и сочетается с одышкой, влажным кашлем, лихорадкой, потливостью, влажными хрипами. Эти симптомы характерны для приступа бронхиальной астмы, острого бронхита и бронхиолита, пневмонии. При ТЭЛА интенсивный цианоз развивается на фоне боли в груди и одышки, а при инфаркте легкого он сочетается с кровохарканьем. Резкий цианоз и выраженная одышка — признаки туберкулеза и карциноматоза легких. Больные с подобной симптоматикой требуют срочной госпитализации и проведения дыхательной реанимации.
- При заболеваниях сердца цианоз является одним из основных симптомов. Он сочетается с одышкой, характерными аускультативными данными, влажными хрипами, кровохарканьем. Цианоз при пороках сердца сопровождается вторичным эритроцитозом, повышением гематокрита, развитием капиллярного стаза. У больных возникает деформация пальцев по типу барабанных палочек и ногтей по типу часовых стекол.
Цианоз носогубного треугольника у ребенка встречается как в норме, так и при патологии. У новорожденных кожа настолько тонкая, что сосуды просвечиваются через нее. Выраженный, постоянный цианоз требует срочного обращения к педиатру.
Цианоз не подлежит специальному лечению. При его появлении проводят оксигенотерапию и усиливают основное лечение. Терапия считается эффективной при уменьшении выраженности цианоза и его исчезновении.
При отсутствии своевременного и эффективного лечения заболеваний, проявляющихся цианозом, у больных возникает расстройство нервной системы, снижается общая резистентность организма, нарушается сон и аппетит, в тяжелых случаях человек может впасть в кому. Такое состояние требует оказания неотложной медицинской помощи в отделении интенсивной терапии.
Диагностика
Диагностику заболеваний, проявляющихся цианозом, начинают с выслушивания жалоб и сбора анамнеза. У больного выясняют, когда появилась синюшность кожи, при каких обстоятельствах возник цианоз, постоянный он или приступообразный. Затем определяют локализацию цианоза и уточняют, как изменяется его оттенок в течение дня.
После беседы с пациентом начинают общий осмотр, устанавливают тяжесть его состояния и наличие сопутствующих заболеваний. Врач проводит аускультацию сердца и легких.
Затем переходят к лабораторным и инструментальным методам исследования:
- Общему анализу крови,
- Анализу газового состава артериальной крови,
- Пульсоксиметрии — больному одевают на палец пульсоксиметр, который за несколько секунд определяет насыщение крови кислородом,
- Определению скорости кровотока,
- Исследованию функций сердца и легких,
- Исследованию газов выдыхаемого воздуха — капнографии,
- Электрокардиографии,
- Рентгенографии органов грудной клетки,
- Компьютерной томографии грудной клетки,
- Катетеризации сердца.
Особенности лечения
Лечение цианоза направлено на устранение основного заболевания, спровоцировавшего посинение кожи. Если больному становится трудно дышать, частота дыхания превышает 60 вдохов в минуту, он сидит сгорбившись, теряет аппетит, становится раздражительным и плохо спит, следует обратиться к врачу.
При появлении цианоза губ, учащенного сердцебиения, чувства жара, кашля, посинения ногтей и затруднения дыхания следует немедленно вызвать скорую помощь.
Кислородотерапия
Кислородная терапия позволяет уменьшить синеву кожи. Насыщение крови кислородом достигается путем использования кислородной маски или палатки.
В комплексное лечение дыхательной и сердечной недостаточности, сопровождающейся гипоксией, обязательно входит проведение кислородной терапии. Вдыхание кислорода через маску помогает улучшить общее состояние и самочувствие больных. Цианотические приступы, возникающие при выполнении физической работы или на фоне лихорадки, исчезают после кратковременного вдыхания кислорода.
Закрытая кислородная палатка — самый целесообразный метод кислородотерапии, позволяющий регулировать газовую смесь и давление вводимого кислорода. Также кислород можно вводить через кислородный баллон, маску, подушку или зонд. Централизованная подача кислорода осуществляется при применении искусственной вентиляции легких.
Кислородный коктейль устраняет цианоз и прочие последствия гипоксии. Он улучшает качество жизни многим больным, восстанавливает силы, насыщает клетки кислородом, улучшает обмен веществ, внимание и скорость реакции. Кислородный коктейль — это густая пена, наполненная молекулами кислорода. С помощью специального кислородного баллончика соки, морсы и сиропы обогащают кислородом не только в условиях лечебно-профилактических учреждений, но и дома.
В настоящее время большой популярностью пользуются кислородные концентраты, производимые в странах Европы, Америки и Азии. Они являются высоконадежными, стабильными в работе, практически бесшумными, имеют продолжительный срок службы. Особого внимания заслуживают портативные кислородные концентраты, обеспечивающие больным комфорт перемещения и ведение мобильного образа жизни.
Медикаментозное лечение
Медикаментозная терапия направлена на улучшение поступления кислорода в организм и доставки его к тканям. Для этого больным назначают препараты, усиливающие легочную и сердечную деятельность, нормализующие ток крови по сосудам, улучшающие реологические свойства крови, усиливающие эритропоэз.
Для уменьшения синюшности кожи больным назначают:
- Бронходилататоры — «Сальбутамол», «Кленбутерол», «Беродуал»,
Антигипоксанты — «Актовегин», «Предуктал», «Триметазидин»,- Дыхательные аналептики — «Этимизол», «Цититон»,
- Сердечные гликозиды — «Строфантин», «Коргликон»,
- Антикоагулянты — «Варфарин», «Фрагмин»,
- Нейропротекторы — «Пирацетам», «Фезам», «Церебролизин»,
- Витамины.
Антигипоксанты — «Актовегин», «Предуктал», «Триметазидин»,Если причиной цианоза является порок сердца, зачастую избавиться от него можно только с помощью оперативного вмешательства.
Кислородные коктейли принимают также для профилактики гипоксии у лиц, находящихся в группе риска и имеющих хронические заболевания сердца и легких. Чтобы улучшить качество жизни и не допустить наступления старости, следует выполнять элементарные правила и рекомендации: вовремя лечить хронические заболевания, вести здоровый образ жизни, много гулять на свежем воздухе, сохранять свое здоровье и любить себя.
Видео: о пороках сердца — причине цианоза у грудных детей
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У ребенка посинел подбородок
У ребенка посинел подбородок
#1 Сообщение Евдокимова » 16 дек 2015, 20:47
Любой заботливый родитель тщательно следит за здоровьем своего ребенка и тут же обращает внимание на любые изменения в его организме, которые имеют внешнее проявление.
Что делать, если появляются красные пятна на подбородке у ребенка? Рассмотрим далее основные причины их появления, а также наиболее эффективные способы устранения.
Аллергия
Как показывает практика, наиболее распространенной причиной появления красных пятен на подбородке у ребенка является наличие аллергии. Как правило, причиной этого выступает неправильное питание матери, кормящей малыша грудным молоком, а также неверно подобранная смесь или низкое качество продукта.
Некоторые медики отмечают, что порой дети рождаются с наличием красных пятен в нижней части лица — это является следствием употребления матерью запрещенных продуктов во время вынашивания плода.
Стоит отметить, что детский организм является особенно сильно подверженным к воздействию аллергии, что связано с его незрелостью. Стоит отметить, что, кроме подбородка, такие пятна могут появиться и на других участках тела.
Как показывает практика, аллергическая реакция редко проявляется только в виде пятен. Как правило, наличие таковых сопровождается тошнотой, жидким стулом, покраснением слизистых оболочек, кашлем, бронхоспазмами, чрезмерной капризностью и общим недомоганием. При наличии указанных симптомов родителям стоит как можно скорее показать малыша доктору, который пропишет наиболее подходящее медикаментозное средство или препарат местного действия.
Потница
Распространенной причиной появления красных пятен под подбородком у ребенка является потница, образование которой, как правило, связано с неспособностью детского организма работать так, как у взрослого. Также потница нередко возникает в результате перегрева тела малыша.
Как показывает практика, проявление потницы происходит в жаркие дни, когда наблюдается несоответствие баланса влаги и температуры.
Что делать родителям, если в результате потницы появились красные пятна на подбородке у ребенка? В данной ситуации надо уделить особенное внимание гигиене малыша, для чего следует:
- поддерживать нормальные температурные условия в комнате;
- регулярно и качественно купать малыша, а по окончании процедуры тщательно промакивать его кожу качественным влаговпитывающим полотенцем (кстати, в некоторых источниках отмечается, что процедуру купания в данном случае лучше всего проводить в воде, разбавленной травяными отварами);
- обеспечить малышу максимальную продолжительность принятия воздушных ванн;
- давать большое количество хорошо очищенной воды для питья, в составе которой имеются полезные компоненты;
- тщательно увлажнять воздух.
Стоит отметить, что в случае перегрева у ребенка могут наблюдаться не только кожные проблемы, но еще и нарушение терморегуляции, что негативно сказывается на общем состоянии его организма.
Дерматоз
Стоит отметить, что наличие красных пятен на подбородке ребенка может свидетельствовать о протекании дерматоза — кожного заболевания, в ходе которого активно поражается покров, покрываясь сухими шелушащимися пятнами.
Дерматоз — это кожная проблема, которая может возникать в результате грибков, вирусов, аллергии, а также на фоне авитаминоза. Также причиной такой проблемы может быть укус какого-либо насекомого.
В том случае если пятна отличаются шероховатостью, то причиной, скорее всего, является нарушение определенных метаболических процессов в организме ребенка. Что касается ощущений, то рассматриваемая проблема может сопровождаться зудом, а также присутствием пузырьков в некоторых местах.
Для того чтобы установить истинную причину появления дерматоза, родителям стоит показать своего ребенка доктору, который порекомендует сделать ряд анализов и по их результатам назначит эффективное средство.
Период появления зубов
Причиной появления розовых пятен на подбородке у ребенка может быть активизация процесса прорезывания зубов. Обусловлено это тем, что в указанное время у малыша наблюдается чрезмерное слюноотделение, из-за чего и возникает покраснение. Стоит отметить, что пятна могут образовываться не только в области подбородка, но еще и возле носа, а также на щеках.
Во избежание такой неприятности стоит регулярно промакивать область подбородка ребенка в течение всего периода появления новых зубов. Более опытные родители отмечают, что данное действие надо выполнять именно промакивающими движениями, так как натирание лица приведет к раздражению кожи. Также в такой период можно умывать ребенка теплыми отварами, созданными на основе череды или полевой ромашки.
Образование пятен в результате несоблюдения гигиены
Практика показывает, что далеко не все родители обеспечивают своего малыша нормальными условиями, при которых его гиена поддерживается на должном уровне. Как результат это может послужить причиной образования шершавого пятна на подбородке у ребенка. Стоит отметить, что нередко дети сами нарушают гигиену, пробуя на вкус окружающие их предметы.
Что же делать в том случае, если на подбородке малыша появились мелкие высыпания из-за его чрезмерной любви к познанию окружающего мира? В первую очередь надо произвести обработку пораженных мест раствором антисептика (идеально подходят фурацилин, хлоргексидин, хлорофиллипт и мирамистин). Также умывание можно произвести теплой водой, смешанной с небольшим количеством отвара, сделанного на основе лекарственных трав (календулы, зверобоя, ромашки).
Порой случается так, что пятна под подбородком у детей начинают покрываться гнойными частицами. В данной ситуации стоит незамедлительно обработать пораженные участки йодом, фукорцином или зеленкой.
Гормональные сбои в организме
Причиной появления красных пятен на подбородках у детей может послужить наличие гормональных сбоев в организме. Как показывает практика, такое явление почти не наблюдается у новорожденных малышей, но зато оно довольно часто встречается у деток, пребывающих в дошкольном возрасте.
При обнаружении такой проблемы ребенка надо незамедлительно показать доктору, который предложит сдать несколько анализов и по их результатам сделает соответствующие выводы.
Стоит отметить, что в некоторых случаях причиной появления такого образования может послужить гормональный сбой в работе эндокринной системы, проблему которого надо решать незамедлительно.
Паразитные инфекции
Нередко причиной появления красных пятен на подбородке у детей является действие паразитных инфекций, которые порождают кожные проблемы. Как показывает практика, чаще всего такое проявление обусловлено активной паразитарной деятельностью под кожей.
Для того чтобы установить данную причину, надо сдать анализы крови, мочи и кала ребенка. На основании полученных результатов педиатр назначает препараты исходя из возраста пациента, а также особенностей его организма. Нередко в качестве таковых выступают:
Дозировка средства также должна быть подобрана врачом.
В том случае если красные пятна на подбородке у ребенка вызваны деятельностью глистов в его организме, то доктор назначает энтеросорбенты из группы таких, которые оказывают минимальное токсическое воздействие на организм.
Раздражение
Стоит отметить, что пятна на подбородке у ребенка могут представлять собой проявление раздражения на воздействие определенных факторов окружающего мира. Яркими примерами таковых являются:
- нарушение работы ЖКТ;
- резкая смена климатических условий;
- ослабление иммунитета;
- использование косметических средств, не подходящих для кожи ребенка;
- воздействие ультрафиолетового излучения.
Стоит отметить, что для устранения покраснений, образовавшихся на фоне указанных выше факторов, родителям надо сменить условия на более благоприятные, исключив из них присутствие раздражителя.
Стоит отметить, что при обнаружении на подбородке у ребенка красного шелушащегося пятна родителям стоит отдать предпочтение более щадящим средствам, предназначенным для очистки кожи детского лица. Как показывает практика, в таких ситуациях отлично помогают отвары, сделанные на основе лекарственных растений — их надо использовать для умывания малыша. Рассмотрим далее рецепт приготовления наиболее эффективного из их числа, который к тому же является полностью безвредным для детей любого возраста.
Ромашковый лосьон
В домашних условиях можно приготовить эффективный ромашковый лосьон, в структуру которого будут включены только натуральные компоненты, оказывающие положительное воздействие на кожу ребенка.
Для создания отвара надо залить литром крутого кипятка ложку сушеных соцветий полевой ромашки, после чего плотно накрыть крышкой и дать массе хорошенько настояться около получаса. Готовый отвар следует процедить и, смочив в нем ватные диски, протереть ими проблемные участки кожи ребенка.
Хранить такой ромашковый лосьон можно в холодильнике на протяжении 3-4 дней.
Стоит отметить, что аналогичным образом можно использовать отвар, сделанный из листьев зеленого чая. Регулярное протирание им также способствует снятию воспалений и раздражений, которые могут появиться на лице ребенка.
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