Ðe kuxi gã aɖe le wò ŋutilã mea? Mina míasrɔ̃ nu tso Waterhouse-Friderichsen Dɔlélea ŋu!

Èse kpɔ be lãkusi sue eve siwo le ŋutilãa me dzudzɔ dɔwɔwɔ, eye ate ŋu akpɔ ŋusẽ gã aɖe ɖe wò agbenɔnɔ dzia? Egbea míele nu ƒom tso nɔnɔme sia tɔgbe si me afɔku le ŋutɔ ŋu, eye ne womedae kaba o la, ate ŋu awu ame. Woyɔa esia be Waterhouse-Friderichsen Dɔléle. Togbɔ be ŋkɔa adze abe ɖe wòdidi vie ene hã la, mina míaƒo nu tso nusi wònye, nusita wòdzɔna, kple alesi míawɔ atsi agbe ŋu ko.

Nukae nye Waterhouse-Friderichsen Dɔléle sia?

Kpuie ko la, Waterhouse-Friderichsen Dɔléle (WFS) nye dɔléle si nu sẽ ŋutɔ. Nusi dzɔna enye be wò adrenal glands , siwo nye gland sue eve siwo le wò ayiku tame, ʋuna (míeyɔa esia be `adrenal hemorrhage`) eye gland siawo dometɔ ɖeka alo evea siaa dzudzɔa dɔwɔwɔ. Zi geɖe la, dɔlékui sesẽ aɖe gbɔe esia tsona. Ne womewɔ atike na adrenal gland siawo o la, wodzudzɔa lãmetsi si nye cortisol, si le vevie na míaƒe ŋutilã, la wɔwɔ keŋkeŋ kloe. Esiae nye nusi míeyɔna be adrenal crisis . Ne míagblɔe tututu la, nudzɔdzɔ kpatae wònye!

Ŋkɔ bubu aɖe hã li na esia, si nye ``hemorrhagic adrenalitis.'' Ema fia be ʋu si dona le adrenal glands me eye wozua abi.

Aleke gbegbee nɔnɔme sia bɔe?

Le nyateƒe me la, Waterhouse-Friderickson ƒe dɔlélea mebɔ kura o . Zi geɖe la, amekukudzraɖoƒewo kpɔnɛ be nɔnɔme sia gbɔe ame siwo kuna ƒe 1% lɔƒo tsona. Esia fia be menye dɔléle si dzea amesiame dzi o, gake ne edzɔ la, afɔku le eme ŋutɔ.

Nukae nye dɔléle sia ƒe dzesiwo?

Bu eŋu kpɔ, kasia dɔlékui alo dɔlékui aɖe dze dziwò eye WFS dɔléle sia va dze dziwò. Emegbe àte ŋu adze dɔlékui aɖe ƒe dzesiwo ɖeɖefia gɔme zi ɖeka. Ènya nusi ema nyea?

• Asrã sesẽ aɖe le fu ɖem nam.
• Ŋutilãa fa miamiamia eye wòʋuʋuna (Chills).
• Nye ta le veve sem ŋutɔ.
• Me le ʋuʋum, me le ʋuʋum.
• Lãmetsi siwo le nye ŋutilã me le veve sem, vevietɔ le teƒewo abe nye akɔta, ƒodo, kple afɔwo ene.
• Nye ƒunukpeƒewo nɔ veve sem.
• Ɣeaɖewoɣi la, ate ŋu adzɔ be ame ƒe susu nabu (syncope).

Ne menye adrenal glands ɖeɖekoe ʋudodo sia dze egɔme le o ke boŋ ŋutilã ƒe akpa bubuwo hã la, dzesi bubuwo ate ŋu adze. Esiawo dometɔ aɖewoe nye:

• Disseminated intravascular coagulation (DIC): Esia ɖi nya sesẽ aɖe vie, alo? Kpuie ko la, enye dɔléle si me ʋu ƒe sisi le ŋutilã bliboa me gblẽna le. Ne ʋu ƒe sisi le teƒe aɖe la, mate ŋu adzudzɔ ʋudodo le teƒe bubu o.
• Ŋutilã ƒe ʋuʋudedi:Ɣeaɖewoɣi la, woate ŋu adze le ŋutigbalẽa dzi abe teƒe suesuesuewo alo teƒe gãwo ene.
• Septic shock: Esia nye nɔnɔme si me ʋu ƒe sisi ɖiɖina le mɔ si me afɔku le le dɔlékuiwo ta, si wɔnɛ be ŋutilãa ƒe ŋutinuwo mexɔa ʋu si sɔ o. Esia hã nye afɔku gã aɖe.

Nukae nye ʋu si dona le adrenal gland me ƒe dzesiwo?

WFS do ƒome kple ʋu si dona le ʋuka me, si ate ŋu akplɔ dzesi bubuwo ɖo:

• Dɔgbo ƒe vevesese.
• Vevesese le teƒe si le akɔta tame, akɔta (akɔta) te.
• Malaise, seselelãme be yemele dedie o.
• Kuviawɔwɔ.
• Aɖuɖɔtoe kple ʋuʋudedi.
• Dɔmetɔtrɔ.

Nukae hea esia vɛ?

Zi geɖe la, nusi koŋ gbɔ Waterhouse-Friderickson ƒe dɔlélea tsonae nye dɔlékuiwo kple dɔlékuiwo ƒe dɔlékuiwo (sepsis) . Ne míagblɔe tututu la, dɔlékui aɖe gena ɖe ŋutilãa me hekakana ɖe ŋutilã bliboa me evɔ womekpɔa ŋusẽ ɖe edzi o.

Dɔlékui ƒomevi aɖewo ate ŋu axɔ esia bɔbɔe. Kpɔɖeŋu ʋɛ aɖewoe nye esi:

• `Pseudomonas aeruginosa ƒe lã si woyɔna be aeruginosa`
• Meningococcus dɔlékui: Esiae nye esi me afɔku le wu si ate ŋu ahe WFS vɛ.
• `Streptococcus aklãdɔlékuiwo`
• `Haemophilus influenzae`
• `Escherichia coli (E. coli)`
• `Atike si woyɔna be Staphylococcus aureus`

Dɔlékui ƒomevi bubu geɖewo ate ŋu ahe esia vɛ.

Azɔ hã, dɔlékui ƒomevi aɖewo ate ŋu ahe esia vɛ:

• Dɔlékuiwutike si woyɔna be Cytomegalovirus (CMV) .
• Parvovirus `(Dɔlékuiwutike)`
• Epstein-Barr dɔlékui aɖe
• Ebola dɔlékui `(Ebola dɔlékui ƒe dɔléle)`
• Varicella-zoster dɔlékui (esiae hea dɔlélewo abe koklozi kple herpes ene vɛ) .

Tsɔ kpe ɖe dɔlékui siawo ŋu la, afɔku bubu aɖewo li siwo ate ŋu ana woaxɔ WFS:

• Atike siwo tsia ʋumenugbagbeviɣidɔ nu zazã. Esiawo dzia ʋu ƒe dodo ƒe afɔkua ɖe edzi.
• Thrombocytopenia: Esia fia be ʋumenugbagbevi dzĩwo (lãmenugbagbevi siwo kpena ɖe ʋu ŋu) ƒe xexlẽme dzi ɖena kpɔtɔna le ʋua me.
• Wogblẽ nu le adrenal glands ŋu le mɔ aɖe nu.

Ameka dzie nɔnɔme sia gblẽa nu le wu?

Waterhouse-Friderickson ƒe dɔlélea ate ŋu adze ɖevi suewo dzi wu ame tsitsiwo . Eyata ne dzesiwo abe asrã kple ŋutilã ƒe veve ene dze ɖevi sue aɖe dzi la, ele be nàɖɔ ŋu ɖo ŋutɔ.

Kuxi kawoe esia ate ŋu ahe vɛ?

Esiae nye nu vevitɔ kekeake. Ne womedae kaba eye womewɔ atike nɛ nyuie o la, Waterhouse-Friderickson ƒe dɔlélea wua ame. Ema fia be ate ŋu ade ame ƒe agbe afɔku me. Eyata ele be woabu esia be enye nusi dzɔ kpata.

Aleke wokpɔa dɔléle sia dzea sii?

Be nàte ŋu anya dɔléle sia la, èhiã ɖɔkta ƒe kpekpeɖeŋu godoo. Ðɔktaa abia nya wò tso wò dzesiwo ŋu, abia wò dɔléle siwo nèdze va yi, eye emegbe wòado wò ŋutilã kpɔ.

Gake WFS ƒe dzesiwo didi ate ŋu asesẽ vie, elabena eƒe dzesiwo ɖi septic shock tɔ ŋutɔ . Eyata be ɖɔktaa naɖo kpe edzi nenye be WFS ye la, abia be woawɔ dodokpɔ vovovowo.

Dodokpɔ kawoe wozãna tsɔ dea dzesi dɔlélea?

Be ɖɔktaa naɖo kpe edzi be dɔlékui aɖe le eŋu hã la, ate ŋu awɔ dodokpɔ siwo gbɔna:

Nɔnɔmetatawo ɖeɖe ƒe dodokpɔwo

• Woate ŋu awɔ ultrasound scan alo CT (computed tomography) scan atsɔ akpɔe ɖa be ʋu ƒo ƒu ɖe adrenal glands me hã. Scan siawo ɖea foto ametia ƒe akpa si le eme, ale be woate ŋu akpɔ teƒe siwo ʋu le dodom le la nyuie.

Ʋudodokpɔwo

• Ʋudodokpɔ ate ŋu anyae kple kakaɖedzi ne dɔlékui aɖe le ŋuwò. Esia bia be nàɖe aŋe sue aɖe tso ʋuka aɖe si le wò alɔnu me, axɔ ʋu sue aɖe, eye nàlé ŋku ɖe eŋu le nusuekpɔmɔ̃ me. Esia adi dzesi siwo fia be dɔlélea le ame ŋu.

Meningococcus dɔlékui dodokpɔwo

Ne ɖɔktaa susu be meningococcus dɔlékui gbɔe wòtso la, ekema woate ŋu awɔ dodokpɔwo abe esiawo ene:

• Spinal tap / lumbar puncture: Esia bia be nàde aŋe tsɛ aɖe wò akɔta ƒe akpa si le anyime, le akɔtaƒu eve dome, eye nàno tsi sue aɖe le aklã me. Esia aɖi vɔvɔ̃, gake ɖɔktawo wɔa esia nyuie.
• Ŋutilã ƒe lãmenugbagbeviwo ɖeɖe: Ne abi aɖe le wò ŋutigbalẽ ŋu la, woaɖe ŋutigbalẽ sue aɖe le abi la me adoe kpɔ.
• Gram stain test: Woɖea kpɔɖeŋu aɖe tso teƒe si wosusu be (abe abi ene) be woatsɔ adi dɔlékuiwo.
• Aɖuɖɔtoe me dzodzro: Woabia tso asiwò be nàɖe aɖuɖɔ ɖe nugoe tɔxɛ aɖe me. Emegbe woado aɖuɖɔ si woɖe tso eme la akpɔ be dɔléle ƒe dzesiwo le eŋu hã.

Adrenal ƒe kuxi sesẽ dodokpɔwo

Dodokpɔ siawo kpena ɖe ŋuwò nènya nenye be èle adrenal crisis , si nye nɔnɔme si me adrenal glands mewɔa dɔ nyuie o la me tom:

• Adrenocorticotropic hormone (ACTH) stimulation test: Le dodokpɔ sia me la, wò ɖɔkta doa lãmetsi aɖe si woyɔna be ACTH ƒe atike sue aɖe wò. Emegbe le miniti 30 va ɖo 60 megbe la, woɖea ʋu be yewoakpɔ alesi wò adrenal glandwo wɔa nu ɖe ​​ACTH ŋui. Esia nye dodokpɔ si dzidzea alesi wò adrenal glands le dɔ wɔm nyuie.
• Suklidɔ dodokpɔ le ʋu me:Woɖea ʋu sue aɖe eye wodzidzea sukli (glucose) si le eme. Sukli ƒe agbɔsɔsɔ ate ŋu aɖiɖi le adrenal ƒe kuxi aɖe me.
• Cortisol dodokpɔ: Woɖea wò ʋu, aɖuɖɔ, aɖuɖɔ, alo esiawo dometɔ eve alo etɔ̃ ƒokpli tsɔ léa ŋku ɖe cortisol agbɔsɔsɔme si wò adrenal glandwo le wɔwɔm ŋu.
• pH dodokpɔ: Woɖea ʋu ƒe kpɔɖeŋu eye wodzidzea eƒe acid-base ƒe agbɔsɔsɔ (pH). Woate ŋu awɔ esia to ʋuka me ʋu ƒe gas (ABG) dodokpɔ alo elektrikŋusẽ ƒe ʋuƒo dzi. Zi geɖe la, ele be míaƒe ʋu ƒe pH nanɔ 7.35 va ɖo 7.45 dome.
• Potassium ʋudodokpɔ: Ʋudodokpɔ si wowɔna tsɔ dzidzea potassium agbɔsɔsɔme si le wò ʋu me. Potassium nye nunyiame si kpena ɖe míaƒe lãmekawo kple lãmekawo ŋu be woawɔ dɔ nyuie. Agbɔsɔsɔ siawo ate ŋu atrɔ le adrenal ƒe kuxi aɖe me.
• Sodium ʋudodokpɔ: Ʋudodokpɔ dzidzea sodium agbɔsɔsɔme si le wò ʋu me. Sodium hã le vevie na wò lãmekawo kple lãmekawo ƒe dɔwɔwɔ nyuie. Agbɔsɔsɔme siawo hã ate ŋu ato vovo.

Aleke wowɔa nu ɖe ​​esia ŋui?

Ne WFS le ŋuwò la, àte ŋu axɔ dɔlékuiwutike hã . Eyata nu gbãtɔ si ɖɔktawo awɔe nye be nàdze dɔlékuiwutikewo zazã gɔme na wò enumake esime wole dodokpɔwo wɔm be yewoanya nusi tututu he WFS vɛ. Woalé ŋku ɖe wò elektrikŋusẽ (dze) kple tsi ƒe agbɔsɔsɔ hã ŋu.

Ne wonya ɖu dɔlékuiwutikewo ƒe dzesiwo dzi ko la, ɖɔktawo adze atike siwo woyɔna be glucocorticoids kple mineralocorticoids . Esiawo nye steroid lãmetsiwo. Glucocorticoids wɔa dɔ tsɔ ɖea abi si le ŋutilãa me dzi kpɔtɔna. Mineralocorticoids wɔa dɔ tsɔ ɖɔa wò ŋutilã ƒe dze kple tsi ƒe agbɔsɔsɔ ɖo. Ne míagblɔe bɔbɔe la, wole abe lãmetsiŋusẽ siwo wòle be wò adrenal glandwo nawɔ, gake womele wɔwɔm o la nana wò ene.

Ðewohĩ ahiã be woado ʋu na wò alo awɔ dɔ aɖe si woyɔna be angioembolisation . Esia bia be woazã angiogram kple ʋu ƒe sisi (embolization) atsɔ ade dzesi ʋuka siwo naa ʋu yia adrenal glands eye woaxe mɔ na wo. Wowɔa esia be ʋua natɔ te.

Vevietɔ wu la, le WFS megbe la, ahiã be ame geɖe nano lãmetsiŋusẽtike bubuwo le woƒe agbemeŋkekewo katã me , elabena ne adrenal glandwo nya gblẽ ko la, ɖewohĩ womagate ŋu awɔ lãmetsiŋusẽwo nyuie o.

Aleke gbegbee nye lãme asẽ kaba le atikewɔwɔ vɔ megbe?

Ame akpa gãtɔ ƒe lãme sẽna le kwasiɖa ɖeka alo eve me tso esime wodze atikewɔwɔ gɔme. Gake ne èhaya keŋkeŋ gɔ̃ hã la, ŋutilã alo susu me kuxi aɖewo ate ŋu anɔ ŋuwò ɣleti geɖe, alo ƒe geɖe gɔ̃ hã. Le kpɔɖeŋu me:

• Nuɖuɖua mevivina o.
• Ðeɖi te eŋu ŋutɔ.
• Alɔ̃dɔdɔ sesẽ (alɔ̃madɔmadɔ).
• Dɔléle bɔbɔe ƒe nɔnɔme.
• Dzitsitsi.
• Teteɖeanyi.

Eya ta ele vevie be míaɖo ŋku edzi be ate ŋu axɔ ɣeyiɣi aɖe hafi wòahaya keŋkeŋ.

Nukae nàte ŋu akpɔ mɔ na ne dɔléle sia dze dziwò?

Abe alesi míegblɔe va yi ene la, ne womewɔ atike na WFS o la, enye dɔléle si wua ame. Ðikeke aɖeke mele eme o.

Gake ne wowɔ atike na wo kaba, nyuie eye wogbugbɔ wo ɖo la, amesiwo ŋu WFS le ƒe akpa gãtɔ hayana. Gake ɖewohĩ ahiã be woakpɔ egbɔ vevie, eye WFS ƒe ŋusẽkpɔɖeamedzi ate ŋu anɔ anyi ɣleti geɖe, ƒe geɖe gɔ̃ hã. Eyata menye nusi woabu nu tsɛee wònye o.

Ðe woate ŋu axe mɔ ɖe nɔnɔme sia nua?

Nu geɖe li nàte ŋu awɔ atsɔ aɖe afɔku si le Waterhouse-Friderickson ƒe dɔlélea xɔxɔ me dzi akpɔtɔ:

• Asiklɔ edziedzi kple nyuie ate ŋu akpe ɖe ŋuwò nàxe mɔ ɖe dɔlékuiwo xɔxɔ nu. Esia nye nu bɔbɔe aɖe ŋutɔ, gake ate ŋu aɖe wò tso dɔléle geɖe me.
• Meningococcal dɔlékuiwo ƒe atike xɔxɔ le vevie ŋutɔ na ɖeviwo.
• Ne èsusu be dɔlékui aɖe le ye ŋu la, di atike nɛ enumake. Mègaŋe aɖaba ƒu dzoxɔxɔ alo kɔdzi vi aɖe dzi o.

Aleke nèléa be na ɖokuiwò esime nèle hayahayam?

Ne èle hayahayam la, ele be mia kple wò ɖɔkta miawɔ ɖeka awɔ ɖoɖo si asɔ na wò, si le dedie, eye wòanyo na wò. Ðoɖo ma ate ŋu alɔ nusiwo le abe:

• Gbɔ ɖe eme geɖe. Ŋutilã kple susu siaa hiã gbɔɖeme.
• Nuɖuɖu si da sɔ si akpe ɖe ŋuwò nàgakpɔ ŋusẽ ake la dzi wɔwɔ nye susu nyui aɖe. Anyo ŋutɔ ne àte ŋu axɔ aɖaŋuɖoɖo tso nuɖuɖuŋutinunyala gbɔ le esia ŋu.
• Ðo taɖodzinu suewo. Le kpɔɖeŋu me, anyinɔƒe ɖe aba dzi, tsitretsitsi, awudodo le ɖokuiwò si, tsilele, azɔlizɔzɔ kpuie, atrakpui aɖe lialia.
• Nuƒoƒo tso wò seselelãmewo ŋu na wò ƒometɔwo, xɔlɔ̃wo, alo atikewɔla le vevie le ɣeyiɣi sesẽ siawo me.
• De kame ne ŋusẽ kple ŋusẽ le ŋuwò. Dze egɔme blewu eye nàde kame le wò ɖɔkta ƒe mɔfiamewo nu.

Ɣekaɣie wòle be makpɔ ɖɔkta? / Ɣekaɣie wòle be mayi xɔ si me wowɔa dɔ kpata le?

Ne wò lãme megale lãmesẽ me kokoko le atikewɔwɔ vɔ megbe o, alo ne ele sesẽm na wò be nàɖo wò ɖɔɖɔɖo ƒe taɖodzinuwo gbɔ la, kpɔ egbɔ be yeƒo nu kple wò ɖɔkta.

WFS nye dɔléle sesẽ aɖe si ate ŋu awu ame ne womewɔ atike nɛ o. Ne WFS ƒe dzesi aɖewo le ŋuwò, le kpɔɖeŋu me, dɔléle si le sesẽm ɖe edzi si medzona o la, ekema ele be nàyi xɔ si me wowɔa dɔ kpata le (ETU) enumake.Menyo be míahe esia ɖe megbe o.

Nya kawoe wòle be nàbia wò ɖɔkta?

Ne èva nya be WFS le ye ŋu la, nyabiase geɖe ate ŋu anɔ ye si. Mègavɔ̃ o, bia nya siawo tɔgbe wò ɖɔkta be wòaɖe wò ɖikekewo ɖa:

• Aleke nàwɔ anya ne Waterhouse-Friderickson ƒe dɔlélea le ŋunye?
• Ne Waterhouse-Friderickson ƒe dɔlélea mele ŋunye o la, nɔnɔme bubu kae ate ŋu anɔ ŋunye?
• Nuka gbɔe nye Waterhouse-Friderickson ƒe dɔlélea tso?
• Ðe wòahiã be woawɔ dɔ nam atsɔ aɖɔ nye adrenal glands ɖoa?
• Èsusu be nye lãme asẽ bliboea?
• Ðe wòahiã be mano lãmetsiŋusẽ bubuwoa?
• Ɣeyiɣi didi kae wòahiã be mano lãmetsiŋusẽ bubuwo?

Eyata nu vevi kawo dzie wòle be míaɖo ŋkui tso esia me?

Waterhouse-Friderichsen ƒe dɔléle (WFS) nye dɔléle sesẽ aɖe ŋutɔ si hiã be woakpɔ egbɔ enumake. Ne dzesi siawo dometɔ aɖe le ŋuwò, alo ne dɔlékui aɖe le ŋuwò si mele nyonyom ɖe edzi o la, ele vevie be nàyi xɔ si me wowɔa dɔ kpata le kaba ale si nàte ŋui.

Wɔ ɖe atikewɔwɔ ŋuti mɔfiame siwo katã wò ɖɔkta na wò dzi pɛpɛpɛ. Ema ko hafi nàte ŋu aɖu WFS ƒe nɔnɔme sia dzi eye nàhaya kaba ale si nàte ŋui. Ðo ŋku edzi be atikewɔwɔ kaba ate ŋu axɔ ame aɖe ɖe agbe! Azɔ hã, ele vevie ŋutɔ be nàlé be na ɖokuiwò nyuie le wò hayahayaɣi.

` Waterhouse-Friderichsen ƒe dɔléle, adrenal glands, cortisol, sepsis, dɔlékuiwo, beléle kpata, lãmetsiwo