Tsɔe be asrã le ŋuwò, wò ŋutilã le veve sem, eye nèdze atike si ɖɔkta ŋlɔ na wò la nono gɔme. Ke ne, le ŋkeke ʋɛ aɖewo, ɖewohĩ kwasiɖa ɖeka alo eve me la, kasia teƒe dzĩwo va le wò ŋutilã ŋu, abi le wò nu me, wò ŋkuwo, kple wò vidzinuwo me, eye wò ŋutigbalẽ te ʋuʋudedi kple ʋuʋu abe ɖe wòtɔ dzoe ene ya ɖe? Esia nye nɔnɔme si dzi ŋɔ, si me afɔku le ŋutɔ, eye mebɔ o vavã. Egbea míele nu ƒom tso nɔnɔme sia si woyɔna be Stevens-Johnson Syndrome (SJS) ŋu. Ele vevie ŋutɔ be amesiame nanya esia.
Nukae nye SJS kple TEN? Vovototo kae le wo ame evea dome?
Stevens-Johnson Syndrome (SJS) nye dɔléle si nu sẽ akpa, zi geɖe la, atike aɖe zazã. Ebia be míaƒe ŋutigbalẽ kple lãkusiwo gblẽna, si wɔnɛ be lãmenugbagbeviawo kuna eye ŋutigbalẽa ƒuna. Mucous membranes nye lãkusi tsɛ siwo le tsia dzi siwo le míaƒe nu, ŋɔti, ŋku, vidzinuwo, kple aɖuɖɔtoe me.
Nɔnɔme sia ƒe ƒomevi sesẽ bubu aɖe hã li, si míeyɔna be Toxic Epidermal Necrolysis (TEN) . Kpuie ko la, SJS kple TEN le abe dɔléle ɖeka ƒe akpa eve ene.
- SJS (Stevens-Johnson Syndrome): Le go sia me la , woɖea ŋutilã ƒe ŋutigbalẽ ƒe akpa si mede 10% o .
- TEN (Toxic Epidermal Necrolysis): Esia nye nɔnɔme sesẽ aɖe ŋutɔ eye ate ŋu ade ame ƒe agbe afɔku me si me ŋutilã ƒe ŋutigbalẽ si wu 30% buna le.
Esi wònye be nɔnɔme siawo evea siaa nu sẽ ŋutɔ ta la, ele be woaxɔ dɔnɔa ɖe kɔdzi , ɣeaɖewoɣi le dɔnɔdzikpɔƒe si wokpɔa dɔnɔwo gbɔ vevie (ICU) alo dzobibi ƒe dɔwɔƒe.
Amekae ate ŋu axɔ dɔléle sia wu?
Togbɔ be SJS ate ŋu adzɔ le ƒe ɖesiaɖe me hã la, ebɔ ɖe ɖeviwo kple sɔhɛ tsitsi siwo mexɔ ƒe 30 haɖe o dzi wu. Ate ŋu adzɔ le ame tsitsiwo hã me. SJS bɔ ɖe nyɔnuwo me vie wu ŋutsuwo.
Vovototo vi aɖe le eme ne míelé ŋku ɖe susua ŋu:
- Nusi koŋ gbɔ SJS tsona le ɖeviwo ŋue nye dɔléle siwo xɔa ame abe aklãdɔ ene .
- Nusi koŋ gbɔ SJS/TEN tsona le ame tsitsiwo ŋue nye atike aɖe ƒe nulɔdɔ .
Nukawo tututue nye SJS ƒe dzesiwo?
Ele vevie ŋutɔ be nànya dzesi siawo, elabena zi alesi nède dzesi wo kaba la, zi nenemae nàte ŋu adi atike kabae. Zi geɖe la, dzesiawo dzena le kwasiɖa ɖeka alo etɔ̃ me tso esime wodze atike aɖe zazã gɔme.
Dzesi gbãtɔwoe nye vuvɔ ƒe dzesi siwo bɔ abe dzoxɔxɔ, ŋutilã ƒe vevesese, taɖuame, kple kɔdzi. Esia wɔnɛ be esesẽna be woakpɔ SJS le gɔmedzedzea me. Ema ko hafi ŋutigbalẽ ƒe dzesi sesẽwo dzena.
SJS ƒe dzesi veviwo le ete.
| Dzesi si dzena | Woɖe eme kpuie |
|---|---|
| Ŋutilã ƒe vevesese sesẽ | Vevesese si nu sẽ ale gbegbe be màte ŋu aka asi wò ŋutigbalẽ ŋu o la sese le ɖokuiwò me. |
| Asrã kple ŋutilã ƒe vevesese | Dzesiawo dometɔ aɖewoe nye asrã sesẽ, ŋutilã ƒe veve, kple taɖuame. |
| Teƒe dzĩwo kple teƒeteƒewo | Teƒe dzĩwo alo abi siwo dzea egɔme tso mo kple akɔta eye wokakana ɖe ŋutilã bliboa me. |
| Aɖuɖɔtoewo kple abiwo | Aɖuɖɔtoewo kple abi siwo le veve sem le ŋutigbalẽa, nu me, ŋɔti me, ŋkuwo, vidzinuwo, kple dɔgbo me. |
| Ŋutilã ƒe ʋuʋu | Aɖuɖɔtoeawo gbãna eye ŋutigbalẽa ƒe akpa si le etame la ʋuʋuna wòzua ƒuƒu gãwo. |
| Aɖuɖɔ si dona le nu me | Aɖuɖɔɖɔɖɔ le nu me ƒe abi ta, ŋutetemanɔamesi be wòaxe nu me. |
| Ŋkuléle ɖe ame ŋu | Ŋkuwo me ʋuʋudedi kple vuvu, si wɔnɛ be ŋkuwo ʋuʋu sesẽna. |
| Vevesese le aɖuɖɔɖɔɖɔɣi | Vevesese sesẽ le aɖuɖɔtoeɣi le aɖuɖɔtoewo ƒe ʋuʋudedi ta. |
Nu vevi siwo gbɔ wòtsona kple atike ƒomevi siwo ate ŋu ahe SJS vɛ
Nu vevitɔ si gbɔ SJS tsonae nye atike aɖe ƒe nulɔdɔ. Gake esia medzɔna le atikewo katã gome o. Atike ƒomevi vovovowo li siwo ate ŋu ahe SJS vɛ wu.
| Susu | Nuɖᴐɖᴐ |
|---|---|
| Atikewo ƒe nulɔdɔwo | Esia gbɔe SJS kple TEN ƒe dɔléle akpa gãtɔ tso. |
| Dɔlékuiwo | Vevietɔ le ɖeviwo gome la, ate ŋu atso dɔlékuiwo abe Mycoplasma pneumonia, Herpes, kple Hepatitis A gbɔ. |
| Susu bubuwo tae | Graft-versus-host dɔléle, si nye kuxi si dona le ƒumeŋuɖui dodo, atikewɔmɔnu (ƒã ŋutɔ), eye ɣeaɖewoɣi la, womate ŋu akpɔ nusi gbɔ wòtso o. |
Atike siwo me afɔku le wu be woahe SJS vɛ
- Sulfa atike siwo wua dɔlékuiwo: Dɔlékuiwutike ƒomevi aɖewo.
- Atike siwo tsia asrãdɔ nu: Le kpɔɖeŋu me, atikewo abe `Phenytoin (Dilantin®)`, `Carbamazepine (Tegretol®)`, `Lamotrigine (Lamictal®)`, `Phenobarbital (Luminal®)`.
- Allopurinol: Atike si wozãna tsɔ daa gout kple ayiku me kpe ƒomevi aɖewo (`Aloprim®`, `Zyloprim®`).
- Vevesesenutsitikewo (NSAIDs): Vevesesenutsitike siwo menye steroid o abe `Piroxicam (Feldene®)`, `Diclofenac (Cambia®, Flector®)`. Atike bubuwo abe `Nevirapine (Viramune®)`.
- Dɔlékuiwutike Bubuwo: Dɔlékuiwutike ƒomevi bubu aɖewo hã ate ŋu ahe esia vɛ.
Vevietɔ: Menye amesiamee axɔ SJS tso atike siwo woŋlɔ ɖe afisia me o. Ame miliɔn geɖe zãa wo. Gake wokpɔe be atike siawo ate ŋu axɔ SJS wu. Mègadzudzɔ atike si ɖɔkta ŋlɔ na wò si wotu ɖe nyati sia dzi la nono gbeɖe o.
Dɔlélea didi kple edada
Ne wò alo ame aɖe si nènya kpɔ dzesi siwo le etame, vevietɔ ne èdze atike yeye zazã gɔme teti koe nye ema la, ele vevie be nàyi kɔdzi si te ɖe ŋuwò ƒe Dɔwɔƒe si Kpɔa Nudzɔdzɔ Kpatawo Gbɔ (ETU) enumake .
Ðɔktawo dea dzesi dɔléle sia to:
- To wò ŋutigbalẽ kple wò lãkusiwo (abe nu, ŋkuwo ene) me dzodzro me.
- To vevesese si gbegbe nèle sesem le ɖokuiwò me ŋu biabia me.
- To ŋkuléle ɖe alesi ŋutigbalẽ ƒe dzesiwo kakae kple alesi gbegbe wokakae ŋu me.
- Ne ehiã la, woate ŋu axɔ ŋutigbalẽ sue aɖe adoe kpɔ (skin biopsy).
SJS ƒe atikewɔwɔ
Taɖodzinu vevi siwo le SJS dada ŋue nye be woatɔ te atike si he dɔlélea vɛ, aɖu dzesiwo dzi, axe mɔ ɖe kuxiwo nu, eye woakpe ɖe ŋutigbalẽa ŋu wòahaya. Kɔdziyiyi nye sedziwɔwɔ le esia ta.
Woŋlɔ atikewɔwɔmɔnu aɖewo ɖe ete:
| Atikewɔwɔ ƒe mɔnu | Nuɖᴐɖᴐ |
|---|---|
| Atike si hea dɔlélea vɛ la zazã dzi ɖeɖe kpɔtɔ | Esiae nye afɔɖeɖe gbãtɔ kple vevitɔ kekeake. Wodzudzɔa atike si wosusu be eyae hea SJS vɛ la enumake. |
| Lãmetsi kple dze nana ŋutilãa | Ŋutilã ƒe ʋuʋu nana tsi gbogbo aɖe buna le ŋutilãa me, eyata wozãa tsi siwo wodona le ʋuka me tsɔ naa tsi kple elektrikŋusẽ siwo hiã. |
| Ŋutilã ƒe atikewɔwɔ | Wotsɔa nu tɔxɛ siwo meléna ɖe nu ŋu o tsyɔa ŋutigbalẽ si xɔ abi la dzi, abe alesi wodaa dzobibi ene. |
| Nunyiame nana ame | Esesẽna be woaɖu nu le nu me ƒe abi ta. Esi wònye be ebia ŋusẽ geɖe hafi wòada gbe le ame ŋu ta la, wotsɔa nuɖuɖu si me nunyiame sɔ gbɔ ɖo toa mɔ̃ aɖe si toa ŋɔti me yia dɔgboa me (tube-feeding) me. |
| Vevesese dzi ɖuɖu | Esia nye nɔnɔme si me vevesese le ŋutɔ, eyata wonaa vevesesenutsitike sesẽwo. |
| Atikewɔwɔ ƒe dɔwɔƒe bibi aɖe | Di kpekpeɖeŋu tso ŋutigbalẽŋutinunyala gbɔ eye ne edze ŋkuawo dzi la, bia ŋkudɔdala. |
SJS ƒe kuxiwo kple nusiwo wògblẽna le ame ŋu le hayahaya megbe
SJS nye nɔnɔme sesẽ aɖe ŋutɔ si ate ŋu ahe ku gɔ̃ hã vɛ. Dɔnɔ siwo ŋu SJS le ƒe 10% lɔƒo kple dɔnɔ siwo ŋu dɔlélea nu sẽ wu, si nye TEN, ƒe 50% kuna. Nusiwo koŋ gbɔ ku tsonae nye kuxi sesẽwo abe dɔlékuiwutike, aklãdɔ, kple ŋutinu geɖe ƒe dɔmawɔmawɔ nyuie.
Ne woda dɔa hã la, ame aɖewo ate ŋu akpɔ ŋusẽ ɖe ame dzi ɣeyiɣi didi.
- Ŋutilã ƒe tɔtrɔ: Ŋutilã ƒe ƒuƒu, ʋuʋudedi, ŋutigbalẽ ƒe amadede ƒe tɔtrɔ.
- Ŋku ƒe kuxiwo: ŋku ƒe ƒuƒu, ŋku ƒe vevesese enuenu, ŋku ƒe nukpɔkpɔ si me kɔ o, kekeli kpɔkpɔ sesẽ (fotovɔvɔ̃).
- Bubuwo: Fifia fũu akpa, lãkusi ƒe gbegblẽ, ɖa ƒe vuvu alo eƒe nɔnɔme madeamedzi, ɖa ƒe vuvu, vivisese ƒe tɔtɔ.
Vevietɔ ŋutɔ: Ne ègazã atike si na SJS la, zi evelia la, nɔnɔmea ate ŋu asẽ wu gbãtɔa sã. Eyata ele vevie be nàɖo ŋku atike si he SJS kple atike mawo tɔgbe vɛ ƒe ŋkɔ dzi le wò agbemeŋkekewo katã me eye nàna ɖɔkta ɖesiaɖe si nàkpɔ la nanya.
Gbedasi si Wotsɔ Yi Aƒeme
- Stevens-Johnson Syndrome (SJS) nye ŋutigbalẽ ƒe dɔléle sesẽ aɖe si dea ame ƒe agbe afɔku me, eye zi geɖe la, atike aɖe gbɔe wòtsona.
- Dzesi gbãtɔwo dometɔ aɖewoe nye dzoxɔxɔ kple ŋutilã ƒe vevesese, gake emegbe yia edzi va zua ŋutigbalẽa ƒe amadede dzĩ siwo le veve sem, ʋuʋudedi, kple ŋutigbalẽ si le ʋuʋum.
- Ne èkpɔ dzesi siawo le atike yeye zazã gɔme vɔ megbe la, yi kɔdzi ƒe Dɔwɔƒe si Kpɔa Nudzɔdzɔ Kpatawo Gbɔ (ETU) enumake kaba.
- Atikewɔwɔ vevitɔe nye be woade dzesi atike si he dɔlélea vɛ eye woadzudzɔ, eye woana kpekpeɖeŋu si akpe ɖe ame ŋu le kɔdzi.
- Ðo ŋku atike si na wò SJS la ƒe ŋkɔ dzi le wò agbemeŋkekewo katã me eye nàna wò ɖɔkta nanya nu tso eŋu ɣesiaɣi si nèyi atikewɔƒe. Esia ate ŋu axɔ wò agbe.
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