So nsu fi wo nipadua mu te sɛ eyi? Momma yɛnka Capillary Leak Syndrome ho asɛm!

So woate Capillary Leak Syndrome ho asɛm pɛn? Ebia edin no bɛyɛ te sɛ nea ɛyɛ den kakra. Nanso sɛ yɛbɛka no tiawa a, ɛyɛ tebea a mogya no fã a ɛyɛ nsu a wɔfrɛ no plasma no fi mogya ntini nketenkete a ɛwɔ yɛn nipadua mu a wɔfrɛ no capillaries no mu. Saa nsu yi tu kɔ yɛn ntini, ntini, akwaa, ne yɛn nipadua mu ntokuru mu. Eyi betumi ayɛ tebea a emu yɛ den, enti ɛho hia sɛ wohu.

Dɛn ne nea wɔfrɛ no capillary leak syndrome yi?

Okay, momma yɛnkyerɛkyerɛ mu kakra bio. Fa no sɛ wo nipadua no wɔ nhyehyɛe bi a ɛma nsu fa mu. Saa paipu yi yɛ yɛn mogya ntini. Wɔfrɛ nsu afiri nketenkete a ɛyɛ fɛ yiye a ɛwɔ eyi mu no ntini nketenkete. Eyinom ne nhama a mframa pa ne aduannuru fa mu kɔ yɛn nipadua no afã horow nyinaa. Enti, wɔ `(Capillary Leak Syndrome)` mu no, mogya no fã a ɛyɛ nsu, kyerɛ sɛ , plasma , no fa saa ntini nketenkete yi mu fi mu. Ɛte sɛ nsu a ɛretu afi nsu afiri mu.

Saa nsu a ɛretu yi ma nsu boaboa ano wɔ nipadua no afã horow. Sɛ nhwɛso no, saa nsu yi tumi tu kɔ ntini, ntini, akwaa ahorow, anaa mmeae (nipadua mu ntokuru) a akwaa ahorow wɔ no mu.

Saa `(Capillary Leak Syndrome)` yi mu nsɛm betumi aba mpɛn pii afe biara, anaasɛ pɛnkoro pɛ wɔ nkwa nna mu. Nanso, sɛ wɔansa no ntɛm a, wo mogya mmoroso betumi akɔ fam mpofirim, na ama akwaa ahorow asɛe na ɛtɔ mmere bi mpo a wubewu. Enti eyi nyɛ biribi a ɛsɛ sɛ wobu no adewa.

Aduru biara nni hɔ a ɛbɛtra hɔ daa ama eyi de besi nnɛ. Nanso, ɛho hia sɛ wɔhwehwɛ ayaresa ntɛm ara na ama wɔadi yare no ho sɛnkyerɛnne ahorow no so. Ɛtɔ mmere bi a, wobetumi asiw ntua a ɛbɛba daakye ano denam nnuru a wɔbɛkɔ so de adi dwuma anaasɛ nkyene a wɔde bɛhyɛ nipadua mu no so.

So eyi ahorow bi wɔ hɔ? Ɔkwan bɛn so na ɛsono wɔn?

Yiw, `(Capillary Leak Syndrome)` ahorow atitiriw abien na ɛwɔ hɔ. Ma yɛnhwɛ nea wɔyɛ.

• Systemic Capillary Leak Syndrome: Wɔsan frɛ no ``Primary Capillary Leak Syndrome'' anaa ``Clarkson yare'', eyi yɛ tebea a ntua ba mpɛn pii , mpo wɔ obi a ɔte apɔw mu.
• Secondary Capillary Leak Syndrome: Eyi ne bere a ntua no ba pɛnkoro esiane yare, tebea, anaa nnuru foforo nti.

Sɛ yɛbɛka no tiawa a, biako yɛ biribi a ebetumi asi bere nyinaa, na biako nso yɛ biribi a esi bere tiaa bi esiane biribi foforo bi nti.

Hena na ɛda adi sɛ obenya saa tebea yi?

``Systemic Capillary Leak Syndrome'' yɛ yareɛ a ɛntaa nsi koraa.Wɔbɔ amanneɛ sɛ nnipa nnu 500 na wɔwɔ saa yare yi wɔ wiase nyinaa. Ɛtaa ba nnipa a wɔadi mfe mfinimfini mu kɛse. Ɛntaa mma koraa wɔ mmofra nkumaa mu. Nanso esiane sɛ ɛtɔ mmere bi a wodi mfomso hu sɛ nnipa a wɔwɔ saa tebea yi wɔ tebea foforo bi nti, ebia nnipa dodow ankasa a wɔwɔ saa tebea yi bɛboro saa koraa.

Nanso, Secondary Capillary Leak Syndrome betumi aba wɔ mfe biara mu. Nyarewa bi, ayaresa tebea horow, ne nnuru betumi de aba.

Sɛ eyi ba a, dɛn na ɛto nipadua no? (Afã abiɛsa) .

Wobetumi akyekyɛ nea ɛkɔ so wɔ yɛn nipadua mu wɔ saa `(Capillary Leak Syndrome)` ntua yi mu no mu abiɛsa. Ma yɛnhwɛ nea wɔyɛ.

Ɔfã a edi kan: Ansa na sɛnkyerɛnne ahorow no bɛda adi (Prodromal phase) .

Eyi ne bere a da koro anaa nnanu ansa na wɔatow ahyɛ obi so. Saa bere yi mu no, ebia wubefi ase ahu sɛnkyerɛnne ahorow bi.

• Ɔbrɛ a wɔte nka
• Nsu ho sukɔm a ɛkɔ soro
• Nneɛma te sɛ mu duru a ɛkɔ soro mpofirim betumi asi.

Ɔfã a ɛto so abien: Leak anaasɛ resuscitation fã

Eyi ne bere a ntua no ba ankasa. Nea ɛba ne sɛ nsu ne albumin (protein bi a ɛwɔ mogya no mu) fi wo ntini nketenkete mu kɔ wo ntini ahorow ntam. Eyi ma mogya a ɛde oxygen -kɔ no so tew. Wo mogya so tew, na mogya mu nkwammoaa kɔkɔɔ no boaboa ano, na ɛma wo mogya mu yɛ den. Saa nsu a ɛtwetwe yi ma mogya dodow so tew, na wɔfrɛ no hypovolemia .

Ɔfa a ɛtɔ so mmiɛnsa: Wɔ ntua no akyi `(Post-leak phase anaa recruitment phase)`

Eyi ne bere a ntua no aba awiei akyi. Nea ɛba ne sɛ wo ntini nketenkete no fi ase twetwe nsu ne albumin fi ntini ahorow no mu bio. Nanso, saa bere yi mu no, wo nipadua no betumi aboaboa nsu pii ano (nsu a ɛboro so) . Ne saa nti, wo nipadua no tumi ma nsu pii (polyuria) na nsu betumi ahyɛ w’ahurututu mu ma (pulmonary edema).

Susuw ho hwɛ, ɛte sɛ sponge a ɛtwe nsu. Nea edi kan no, nsu no fi nipadua no mu, na afei sɛ ɛsan twe no ntɛmntɛm dodo a, ɛtwe pii sen sɛnea ɛsɛ sɛ ɛtwe.

Dɛn na ɛde eyi ba?

Afei momma yɛnhwɛ nea ebetumi de saa `(Capillary Leak Syndrome)` yi aba.

Nneɛma a ɛde `(Systemic Capillary Leak Syndrome)` ba

Sɛ yɛbɛka nokware a, wɔda so ara nnim nea ɛde Systemic Capillary Leak Syndrome ba ankasa. Nhwehwɛmufo gye di sɛ ebia efi sɛnea yɛn nipadua mu tumi a ɛko tia nyarewa no yɛ n’ade wɔ yare anaa ɔyare mmoawa bi ho.

Nneɛma a ɛde `(Secondary Capillary Leak Syndrome)` ba

Nneɛma pii nti na ɛte saa. Nea ɛtaa de ba ne tebea bi a wɔfrɛ no sepsis . Ɛne sɛ, ɔhaw a ɛde nkwa to asiane mu a ɔyare mmoawa bi de ba. Nea ɛka ho no, nneɛma afoforo nso wɔ hɔ a ɛde ba:

• Nyarewa a nipadua no tumi ko tia nyarewa:Nea ɛkɔ so wɔ eyi mu ne sɛ yɛn ankasa nipadua mu tumi a ɛko tia nyarewa no tow hyɛ yɛn ankasa nkwammoaa a ɛte apɔw so.
• Differentiation syndrome: Ɔhaw a ebetumi aba bere a wɔreyɛ mogya mu kokoram ahorow bi (acute promyelocytic leukemia anaa acute myeloid leukemia) ayaresa no.
• Engraftment syndrome: Ɔhaw a ebetumi aba bere a wɔde nnompe mu ntini foforo ahyɛ obi foforo mu akyi.
• Hemophagocytic lymphohistiocytosis: Tebea a ebetumi de nkwa ato asiane mu a nipadua no mu tumi a ɛko tia nyarewa a ɛyɛ adwuma boro so na ɛde ba.
• Ovarian hyperstimulation syndrome: Ɔhaw a ebetumi aba bere a wɔreyɛ awo ho ayaresa no.
• Ricin a wɔde awuduru ayɛ.
• Ɔwɔ a wɔka wɔn.
• Viral hemorrhagic fevers: Nyarewa a wɔde yare mmoawa ba kuw bi a mmoawa de ba.

Nnuru bi te sɛ nnuru a wɔde ko tia kokoram gemcitabine (gemcitabine - Gemzar®) ne tagraxofusp (tagraxofusp - Elzonris®) , nso betumi de eyi aba (Secondary Capillary Leak Syndrome).

Nsɛnkyerɛnne bɛn na ɛba ansa na yare yi afi ase?

Mpɛn pii no, da koro anaa nnanu ansa na ``Capillary Leak Syndrome'' ntua aba, kyerɛ sɛ, wɔ ``prodromal phase'' mu no, wubetumi anya sɛnkyerɛnne ahorow te sɛ:

• Yafunu mu yaw anaa ntini mu yaw (myalgia).
• Ɔbrɛ anaa mmerɛwyɛ a ɛtra so.
• Tipaeɛ .
• Nsu ho sukɔm a ɛkɔ soro.
• Abufuw, abufuw.
• Abofono.
• Mu duru a ɛkɔ soro mpofirim.
• Nsɛnkyerɛnne a ɛkyerɛ sɛ obi anya ɔyare mmoawa anaasɛ ɔhome akwaa a ɛwɔ soro no.

Sɛ wunya yare no ho sɛnkyerɛnne te sɛ eyinom a, mfa nyɛ hwee, ka sɛ, "Oh, ebia ɛyɛ atiridii ara kwa," titiriw sɛ woanya osuahu a ɛte saa ara pɛn a.

Sɛ wowɔ yare bi a, sɛnkyerɛnne bɛn na ɛba?

Wɔ `(Capillary Leak Syndrome)` ntua mu, kyerɛ sɛ, wɔ `(leak anaa resuscitation phase)` mu no, sɛnkyerɛnne ahorow no betumi ayɛ soronko wɔ onipa biara ho. Nanso, nea edidi so yi ne sɛnkyerɛnne ahorow a ɛtaa ba a wotumi hu:

• Nipadua no a ɛho ahonhon, titiriw no akwaa (peripheral edema).
• Ayamtuo.
• Mogya mmoroso a ɛba fam (hypotension).
• Mogya a ɛtwetwe (hypercoagulability) - Eyi betumi afi mogya mu nkwammoaa kɔkɔɔ dodow a ɛkɔ soro (hematocrit) anaasɛ mogya mu nkwammoaa fitaa dodow a ɛkɔ soro (leukocytosis) mu aba.

Ɔkwan bɛn so na nnuruyɛfo hu eyi?

Oduruyɛfo bi behu Capillary Leak Syndrome denam w’aduruyɛ ho abakɔsɛm a obebisa ne nipadua mu nhwehwɛmu a ɔbɛyɛ so. Wɔbɛhwɛ sɛ wo mogya so atew anaa.

Afei nso, ansa na wobesi so dua sɛ eyi yɛ Capillary Leak Syndrome no, ɛsɛ sɛ woyi tebea afoforo fi hɔ. Ebia wɔbɛyɛ mogya mu nhwehwɛmu pii de ayɛ eyi:

• Hwɛ sɛ hematocrit (mogya mu nkwammoaa kɔkɔɔ dodow a ɛwɔ mogya no mu) dɔɔso anaa.
• Hwɛ sɛ hemoglobin (protein a ɛwɔ mogya mu nkwammoaa kɔkɔɔ mu) dɔɔso anaa.
• Hwɛ sɛ protein sua wɔ mogya no mu (hypoalbuminemia).

Bio nso, wobetumi ayɛ mogya mu nhwehwɛmu de ahwɛ sɛ protein a ɛko tia nyarewa a ɛnteɛ a wɔfrɛ no ``monoclonal gammopathy, anaa M protein'' wɔ mogya no mu anaa. Nnipa a wɔwɔ ``Capillary Leak Syndrome'' betumi anya saa ``(M protein)'' a ɛnyɛ ne kwan so yi wɔ wɔn mogya mu.

Ɔkwan bɛn so na wɔsa? So wobetumi asa no yare?

Nea ɛyɛ awerɛhow no, wonni aduru biara a ɛbɛtra hɔ daa a wɔde sa Capillary Leak Syndrome. Nnuruyɛfo bɔ mmɔden sɛ wobedi sɛnkyerɛnne ahorow no so na wɔasiw nsɛnnennen ano.

Wɔ ``Capillary Leak Syndrome'' ntua mu no, nnuruyɛfo bɔ mmɔden sɛ wobedi mogya mmoroso so na wɔakura mogya a ɛkɔ akwaa ahorow no mu yiye. Wɔbɔ mmɔden nso sɛ wobesiw ɔfe a ɛboro so ne nsu a ɛbɛboaboa ano ano. Ebia wɔde:

• Glucocorticoids: Eyinom yɛ steroid bi a ɛboa ma nsu a efi ntini nketenkete mu no so tew.
• Nsu a wɔde fa ntini mu: Wɔde nneɛma te sɛ nkyene ma na ama mogya akɔ akwaa ahorow te sɛ asaabo mu kɛse.

Mpɛn pii no, ebehia sɛ wɔde wo kɔ ayaresabea bere a wɔatow ahyɛ wo so akyi. Bere a woresa yare no, wo duruyɛfo bɛkɔ so ahwɛ nhyɛso a ɛwɔ wo ntini ne wo ntini mu no so ahwɛ ahu sɛ worennya nsu pii wɔ wo nipadua mu, na ebetumi ama woanya nsɛnnennen afoforo te sɛ ahurututu mu akisikuru ne koma a ɛbɛtɔ mpofirim.

Sɛ Capillary Leak Syndrome a wɔfrɛ no post-leak phase anaa recruitment phase a oduruyɛfo bi ba no ntua akyi no, obetumi akyerɛw wo aduru a ɛma wo ho yɛ wo hyew (aduru a ɛma woyɛ nsu pii) na ama nsu a ɛboro so a ɛwɔ wo nipadua mu no so atew.

So wobetumi asiw Systemic Capillary Leak Syndrome (SCLS) ano sɛ ɛrensan mma bio?

Worentumi nsiw Systemic Capillary Leak Syndrome ano wɔ nea edi kan no mu. Nanso, sɛ wonya ntua pɛ a, wunim sɛ wowɔ tebea no.

Nanso, nnuru a wɔnom daa anaasɛ nkyene a wɔde hyɛ nipadua mu no betumi aboa ma wɔasiw ntua a ɛbɛba daakye ano na wɔatew sɛnea emu yɛ den so. Ebia ayaresa ahorow yi bi ne:

• Nnuru a ɛko tia nyarewa (IVIG) a wɔde fa ntini mu ɔsram biara .
• Nnuru a wɔnom ma ayamtu, te sɛ theophylline (theophylline - Elixophyllin®), terbutaline (terbutaline - Brethine®), ne montelukast (montelukast - Singulair®) .
• Tew ɔfe soSteroid ahorow a wɔde yɛ nnuru.

Dɛn ne daakye ma wɔn a wɔte saa tebea yi mu no? `(Nsusuwii)`

Mpɛn pii no, wobetumi de ayaresa a wɔde siw ano adi Systemic Capillary Leak Syndrome ho dwuma. Ɛda adi sɛ ayaresa no bɛyɛ yiye bere a wohu tebea no ntɛm na nsɛnnennen no sua no. Nsɛnnennen a anibere wom a ebetumi aba wɔ Capillary Leak Syndrome ho no bi ne:

• Compartment syndrome: Nhyɛso a ɛkɔ soro wɔ ntini no mu na mogya no so tew.
• Nsu a ɛboaboa ano wɔ koma ne ahurututu no ho (koma a ɛtwetwe, koma no mu nsu a ɛtwetwe, ne ahurututu mu nsu a ɛtwetwe).
• Koma a entumi nyɛ adwuma yiye.
• Asaabo a entumi nyɛ adwuma yiye.
• Ntini mu yare.
• Ahurututu mu akisikuru.
• Rhabdomyolysis: Asaabo a entumi nyɛ adwuma yiye esiane ntini a ɛsɛe nti.
• Nnwodwoɔ.

Ebia eyinom bɛyɛ te sɛ nea ɛyɛ hu, nanso sɛnea yɛadi kan aka no, ayaresa a wɔde ma ntɛm ne ayaresa a ɛfata ho hia yiye.

Bere bɛn na ɛsɛ sɛ mekɔ oduruyɛfo nkyɛn?

Sɛ wususuw sɛ worenya Capillary Leak Syndrome a, kɔ oduruyɛfo nkyɛn ntɛm ara. Wobetumi aboa ma woadi wo yare no ho sɛnkyerɛnne ahorow ho dwuma na wɔama wo ho atɔ wo.

Kae sɛ, ɛwom sɛ eyi yɛ tebea a ɛntaa nsi de, nanso ɛho hia sɛ wuhu sɛnkyerɛnne ahorow no na sɛ w’adwene mu yɛ wo naa a, wohwehwɛ aduruyɛfo afotu ntɛm ara.

Nkrasɛm a Wɔde Kɔ Fie

Okay, enti momma yɛnsan nsusuw nsɛntitiriw a ɛho hia sen biara a yɛaka ho asɛm no ho asɛm:

• Eyi ne bere a mogya no fã a ɛyɛ nsu (plasma) no pue fi mogya ntini nketenkete (capillaries) a ɛwɔ yɛn nipadua mu no mu.
• Eyi betumi asi pɛnkoro anaa mpɛn pii.
• Sɛ wɔansa a, nsɛnnennen a emu yɛ den betumi aba, enti ɛho hia sɛ wɔkɔ ayaresabea ntɛm.
• Ɛwom sɛ wonni aduru biara a ɛbɛtra hɔ daa de, nanso ayaresa ahorow bi wɔ hɔ a wɔde siw yare no ho sɛnkyerɛnne ahorow ano na wɔasiw ntua a ɛbɛba daakye ano.
• Sɛ wususuw sɛ saa sɛnkyerɛnne yi bi wɔ hɔ a, kɔ oduruyɛfo nkyɛn ntɛm ara. Dodow a wuhu yare no ntɛm na wufi ase sa yare no, dodow no ara na hokwan a wubenya sɛ wo ho bɛtɔ wo no yɛ kɛse.

Enti, mewɔ anidaso sɛ saa nsɛm yi ho bɛba wo mfaso. Kɔ so nya apɔwmuden!

` Capillary Leak Syndrome, Plasma Leak, Mogya Nhyɛso a Ɛba Fam, Clarkson Yare, Edema, Nsuo a Ɛtu wɔ Nipadua mu