Wò ŋutilã ƒe dɔlélenutsiŋutete nye ametakpɔnu wɔnuku aɖe. Gake ɣeaɖewoɣi la, ɖoɖo sia te ŋu wɔa dɔ le mɔ bubu nu vie. Ɣeaɖewoɣi la, ate ŋu awɔ nu wòagbɔ eme eye wòagblẽ nu le mía ŋutɔwo míaƒe ŋutilã ŋu, alo ɣeaɖewoɣi la, ehiãna be woakpe ɖe mía ŋu míawɔ avu kple futɔwo abe kansa lãmenugbagbeviwo ene. Le nɔnɔme mawo me la, míele nu ƒom tso dɔdamɔnu tɔxɛ aɖe si kpena ɖe míaƒe dɔlélenutsiŋutete ŋu eye wòkpɔa eƒe dɔwɔwɔ dzi. Emae nye fotoɖemɔ̃ (photopheresis).
Kpuie ko la, nukae nye fotoɖemɔ̃?
Photopheresis nye atike si zãa kekeli tsɔ trɔa wò ʋumenugbagbevi ɣiwo ƒe dɔwɔwɔ, si woyɔna be ʋumenugbagbevi dzĩwo. Lãmenugbagbevi siawo, siwo woyɔna be lymphocytes, ye nye míaƒe dɔlélenutsiŋutete ƒe asrafo vevitɔwo. Woawoe tsrɔ̃a nuwo abe kansa lãmenugbagbeviwo, dɔlékuiwo, kple dɔlékuiwo ene. Eyata ne kuxi aɖe le ʋumenugbagbevi siawo ŋu la, fotoɖemɔ̃ zazã ɖea vi ŋutɔ.
Bu eŋu ale. Woɖea wò ʋu ƒe ɖe, tsɔa wo dea mɔ̃ me, eye ʋumenugbagbevi ɣi siwo woyɔna be ʋumenugbagbevi dzĩwo koe ɖea wo ɖa. Emegbe, wotsakae kple atike tɔxɛ aɖe hetsɔe de UV-klẽ me, si trɔa alesi lãmenugbagbevi mawo wɔa dɔe. Mlɔeba la, wogatsɔa lãmenugbagbevi siawo siwo ŋu wowɔ atike ɖo la dea wò ŋutilã me kpe ɖe wò ʋu susɔea ŋu.
To mɔnu sia dzi la, míate ŋu ado ŋusẽ míaƒe dɔlélenutsiŋutete, alo aɖu edzi ne ele nu wɔm le mɔ si míedi o nu. Ne míagblɔe bubui la, ŋutete le atikewɔwɔ sia ŋu be ‘wòaʋu dzodoƒea ahatsi’ dɔlélenutsiŋutetea ne ehiã.
Nɔnɔme kawoe wozãa atikewɔwɔ sia na?
Photopheresis nye dɔlélenutsiŋutete ƒe dɔdamɔnu ƒomevi aɖe. Eyae nye be enye mɔnu si dzi míato ada dɔlélewo to mía ŋutɔwo ƒe dɔlélenutsiŋutete zazã me. Zãnu vevi geɖewo li na esia.
| Atikewɔwɔ ƒe nɔnɔme | Numeɖeɖe bɔbɔe aɖe |
|---|---|
| T-cell lymphoma si le ŋutigbalẽ me (CTCL) . | Esia nye ʋumenugbagbeviɣidɔ ƒomevi aɖe si mebɔ o si gblẽa nu le ŋutigbalẽ ŋu. Woto fotopheresis zazã vɛ zi gbãtɔ be wòanye dɔléle sia dada. Ne wogatsɔ ʋumenugbagbevi dzĩ siwo ŋu wowɔ atike ɖo la de ŋutilãa me la, wokpena ɖe ame ŋu be wogblẽa kansa lãmenugbagbeviwo. |
| Dɔléle si nye Graft versus Host (GVHD) . | Le nane abe ƒumeŋuɖui dodo ene megbe la, lãmenugbagbevi yeye siwo woxɔ la ate ŋu adze wò ŋutɔ wò ŋutilã dzi dzedze gɔme abe ‘futɔ’ ene. Atikewɔwɔ sia ate ŋu atɔ te amedzidzedze ma si womedi o alo aɖu edzi. |
| Gbegbe be woado ŋutinuwo na ame bubuwo | Ne wodo ŋutinu gã aɖe, abe aɖu, aklã, alo dzi ene vɔ la, ŋutilãa ƒe dɔlélenutsiŋutete ate ŋu agbe ŋutinu yeyea. Atikewɔwɔ sia kpena ɖe ame ŋu be woaxe mɔ ɖe ema nu. |
Atikewɔwɔ ƒe nɔnɔme bubuwo
Tsɔ kpe ɖe nɔnɔme vevi siawo ŋu la, ɖɔktawo ate ŋu aɖo aɖaŋu be woawɔ fotoɖemɔ̃ na atikewɔwɔ me dɔléle bubu geɖe.
- Crohn ƒe dɔlélea
- Eczema (Atopic dermatitis) ƒe dɔléle .
- Scleroderma ƒe dɔléle
- Psoriasis, si nye ŋutigbalẽdɔléle
- Suklidɔ ƒomevi 1 lia
Aleke wòle be míadzra ɖo hafi awɔ atike na mí?
Wò ɖɔkta aɖe nya sia me na wò. Zi geɖe la, woabia tso asiwò be nàlé be na nusiawo hafi woawɔ atike na wò.
- No tsi geɖe: No tsi kplu 8 ya teti gbesiagbe hena ŋkeke eve hafi nàdae. Esia akpe ɖe wò ʋu ŋu be wòazɔ nyuie, si ana wòanɔ bɔbɔe be nàhe ʋu le atikewɔwɔ me.
- Ƒo asa na caffeine kple aha sesẽ: Nu siwo le abe tii, kɔfi, kple aha sesẽ ene ate ŋu ana tsi nagbɔ le ŋutilãa me, si wɔnɛ be ʋu ƒe sisi nagbɔdzɔ.
- Ƒo asa na nuɖuɖu siwo me ami le: Ne èɖu nuɖuɖu siwo me ami sɔ gbɔ ɖo, abe nuɖuɖu siwo wofli kple nu viviwo ene la, ate ŋu asesẽ vie na mɔ̃ si ɖea ʋumenugbagbevi ɣiwo ɖa tso ʋua gbɔ be wòawɔ eƒe dɔ.
Aleke atikewɔwɔ sia wɔa dɔe?
Dɔ sia katã yia edzi esime nèmlɔ aba dzi nyuie. Enye dɔdamɔnu si me vevesese aɖeke mele o.
1. Ʋuɖeɖe: Dɔnɔdzikpɔla alo ɖɔkta aɖe ʋu tso ʋuka aɖe si le wò alɔnu me alo ato mɔ̃ tɔxɛ aɖe (catheter) si woda ɖe wò akɔta me. Ne ehiã la, woate ŋu atsɔ atike si naa ame ƒe lãme gbãna la asisi ɖe teƒea be wòagase veve o.
2. Lãmenugbagbeviwo ƒe mama:Ʋu si nèxɔ la gena ɖe mɔ̃ tɔxɛ aɖe me tẽ. Ʋumenugbagbevi ɣi siwo woyɔna be lymphocytes koe mɔ̃ sia ma tso ʋumenugbagbevi dzĩwo kple ʋumenugbagbevi dzĩ siwo le wò ʋu me gbɔ.
3. Atikewo dede eme: Wotsɔa gbetike si le dedie si woyɔna be `8-methoxypsoralen (8-MOP)` dea ʋumenugbagbevi ɣi siwo woɖe ɖe vovo la me. Ne wodoe ɖe kekeli me ko hafi atike sia wɔa dɔ.
4. Kekeli ƒe atikewɔwɔ: Fifia, ʋumenugbagbevi ɣi siwo le atike sia ŋu la doa go kekeli si woyɔna be ultraviolet A (UVA light) si le mɔ̃a me. Emegbe, atike la dzea dɔwɔwɔ gɔme eye wòtrɔa ʋumenugbagbevi ɣiawo ƒe dɔwɔwɔ.
5. Gbugbɔgadodo: Mlɔeba la, wogbugbɔa ʋumenugbagbevi ɣi siwo ŋu wowɔ atike ɖo alea la dea wò ŋutilã me, tsɔ kpe ɖe ʋumenugbagbevi bubu siwo woɖe ɖe vovo tsã ŋu.
Dɔ sia katã ate ŋu axɔ abe gaƒoƒo 3-4 ene.
Nukawoe nye eƒe nugbegblẽ le ame ŋu kple nu siwo ŋu wòle be míanya nu tsoe?
Wobu fotopheresis be enye atike si le dedie ŋutɔ , eye ame akpa gãtɔ mekpɔa eƒe nugbegblẽ le ame ŋu o.
Ke hã, ɣeaɖewoɣi la, nu suesuesuewo ate ŋu adzɔ.
- Wò ʋu ƒe sisi ate ŋu aɖiɖi vie le atikewɔwɔ me. Ne edzɔ alea la, woate ŋu ana tsi wò le ʋuka me be wòagaɖo nɔnɔme nyuitɔ me.
- Àte ŋu ase le ɖokuiwò me be yeƒe lãme le ʋuʋum, taɖuame, alo vuvɔ anɔ ye ƒom, abe alesi ko ne èle ʋu nam ene. Ne èse le ɖokuiwò me alea la, gblɔe na dɔnɔdzikpɔla enumake.
- Àte ŋu akpɔ dzodzro, taɖuame, alo dzoxɔxɔ le gaƒoƒo 6-8 le atikewɔwɔ vɔ megbe. Ne wò dzoxɔxɔa nu sẽ wu Celsius degree 37.8 (Fahrenheit 100) la, gblɔe na wò ɖɔkta. Ate ŋu aɖo aɖaŋu be woano atike aɖe abe paracetamol ene.
Nusiwo ŋu wòle be míaɖɔ ŋu ɖo vevietɔ le atikewɔwɔ vɔ megbe
Esia le vevie ŋutɔ. Photopheresis-dɔdamɔnu nana wò ŋutigbalẽ kple ŋkuwo sea ɣe ƒe keklẽ gɔme ŋutɔ.
Ƒo asa na ɣe ƒe keklẽ tẽ kple esi mele tẽ o ƒe keklẽ gaƒoƒo 24 le atikewɔwɔ vɔ megbe. Ɣe ƒe keklẽ si metso tẽ o nye kekeli si tso fesre alo xɔmetsovɔ me.
- Ne èdo go la, do awu si atsyɔ wò ŋutilã bliboa dzi. Zã ɣe ƒe keklẽŋusẽtike si ƒe SPF nye 30 alo esi wu nenema.
- Do ɣe ƒe ŋkumewu siwo kpɔa ame ta tso UVA ƒe keklẽ me, le xɔ me kple egodo siaa, gaƒoƒo 24 sɔŋ. "wraparound" ɣe ƒe ŋkumewu siwo tsyɔ ŋku eveawo dzi la nyo wu.
Ɣeyiɣi didi kae wòxɔna hafi wokpɔa emetsonuwo?
Esia ato vovo le wò nɔnɔmea kple atikewɔwɔ ƒe agbɔsɔsɔme nu. Ame aɖewo kpɔa ŋgɔyiyi ɖedzesi aɖe le woƒe dzesiwo me le ɣleti 3-4 me. Le nɔnɔme aɖewo (abe scleroderma ene) gome la, ate ŋu axɔ ɣleti 6-12 hafi dzesiawo nanyo ɖe edzi. Eyata dzigbɔɖi le vevie le atikewɔwɔ sia me. Bia wò ɖɔkta tso ɣeyiɣi si nàte ŋu akpɔ mɔ be yeakpɔ emetsonuwo le wò nɔnɔmea nu ŋu.
Gbedasi si Wotsɔ Yi Aƒeme
- Photopheresis nye atike si le dedie si zãa kekeli tsɔ daa wò ŋutɔ wò ʋumenugbagbevi ɣiwo eye wòkpɔa dɔlélenutsiŋutete ƒe dɔwɔwɔ dzi.
- Wozãa esia koŋ na nuwo abe CTCL kansa, GVHD nɔnɔmewo, kple mɔxexe ɖe gbegbe nu le ŋutinuwo dodo vɔ megbe.
- Atikewɔwɔa mevea ame o, gake ele be woakpɔ ame ta tso ɣe ƒe keklẽ me gaƒoƒo 24 le atikewɔwɔ vɔ megbe.
- Ate ŋu axɔ ɣeyiɣi aɖe hafi woakpɔ emetsonuwo, eyata ele vevie be nàgbɔ dzi ɖi ahadi atike.
- Ðo dze kple wò ɖɔkta gaglãa tso kuxi, vɔvɔ̃, alo ɖikeke ɖesiaɖe si le mewò le go sia me ŋu.
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