Koj daim tawv nqaij puas hloov liab, ua pob, thiab tawv? Cia peb kawm txog tus kab mob Stevens-Johnson Syndrome (SJS) uas txaus ntshai no?

Koj puas tau pom, lossis koj puas tau muaj dua, muaj pob khaus sai sai ntawm koj lub cev uas hloov xim liab, zoo li pob khaus, tom qab ntawd cov pob khaus tshwm sim thiab daim tawv nqaij tev tawm? Cov qhov txhab no kuj tuaj yeem tshwm sim hauv qhov ncauj, hauv qhov muag, thiab hauv thaj chaw ntawm lub cev. Qhov no tsis yog ib qho yooj yim, thiab tuaj yeem yog ib qho mob hnyav uas yuav tsum tau mus pw hauv tsev kho mob tam sim ntawd . Hnub no, peb yuav tham txog qhov mob no hu ua Stevens-Johnson Syndrome (SJS).

Kab mob Stevens-Johnson Syndrome (SJS) yog dab tsi?

Hais yooj yim xwb, Stevens-Johnson Syndrome (SJS) thiab Toxic Epidermal Necrolysis (TEN) yog ob yam mob tawv nqaij loj heev. Qhov tshwm sim yog koj daim tawv nqaij cia li pib liab, khaus, uas tom qab ntawd ua pob thiab tev tawm. Nws kuj tseem tuaj yeem cuam tshuam rau koj lub qhov muag, qhov chaw mos, thiab cov ntaub so ntswg hauv koj lub qhov ncauj. Yog tias koj muaj cov mob no, koj yuav tsum tau mus pw hauv tsev kho mob kom tau txais kev kho mob.

Muaj ib txhia kws kho mob xav tias SJS thiab TEN yog ob hom kab mob sib cais, thaum lwm tus hais tias lawv yog cov theem sib txawv ntawm tib hom kab mob. SJS yog ib hom kab mob uas tsis hnyav npaum li TEN. Piv txwv li, hauv SJS, tsawg dua 10% ntawm daim tawv nqaij ntawm tag nrho lub cev yuav ploj mus. Hauv TEN, ntau dua 30% ntawm daim tawv nqaij yuav ploj mus. Txawm li cas los xij, nws yog ib qho tseem ceeb uas yuav tsum nco ntsoov tias ob qho tib si tuaj yeem ua rau tuag taus .

SJS muaj lwm lub npe dab tsi ntxiv?

Yog, nws muaj ntau lub npe sib txawv. Piv txwv li:

• Lyell's Syndrome
• Stevens-Johnson syndrome/toxic epidermal necrolysis
• Stevens-Johnson syndrome tshuaj lom epidermal necrolysis spectrum

Qee zaum, lub npe yuav hloov pauv nyob ntawm seb ua rau mob li cas. Yog tias nws yog los ntawm ib yam tshuaj, nws tuaj yeem hu ua "drug-induced Stevens-Johnson syndrome", thiab yog tias nws yog los ntawm ib qho kab mob hu ua "Mycoplasma", nws tuaj yeem hu ua "mycoplasma-induced Stevens-Johnson syndrome".

Leej twg yuav muaj feem mob SJS ntau dua?

Feem ntau pom muaj tus kab mob SJS rau cov tub ntxhais hluas hnub nyoog qis dua 30 xyoo thiab cov menyuam yaus. Txawm li cas los xij, nws tuaj yeem tshwm sim rau cov neeg txhua lub hnub nyoog, tshwj xeeb tshaj yog cov neeg laus. Cov poj niam muaj feem yuav mob SJS ntau dua li cov txiv neej.

Xav txog seb, yog tias ib tug me nyuam yaus tau txais kev kis kab mob xws li mob ntsws thiab tom qab ntawd muaj teeb meem ntawm daim tawv nqaij zoo li no ... nws yuav yog SJS. Qhov ua rau muaj SJS hauv cov menyuam yaus yog kev kis kab mob xws li mob ntsws. Tab sis rau cov neeg laus, SJS/TEN feem ntau yog los ntawm cov tshuaj uas lawv noj.

Cov yam uas ua rau muaj tus kab mob SJS yog dab tsi?

Tsis muaj ib qho ua rau muaj tus kab mob no, tab sis muaj ntau yam ua ke. Qhov tseem ceeb tshaj plaws yog kev xeeb tub los ntawm noob caj noob ces. Yog li ntawd, koj cov noob caj noob ces yuav muaj qee yam cuam tshuam. Qee yam ib puag ncig kuj tuaj yeem ua rau cov noob caj noob ces no ua haujlwm. Ib qho ntawm cov yam ntxwv ntawm noob caj noob ces no yog cov feem tshwj xeeb ntawm peb lub cev hu ua '(Human Leukocyte Antigens - HLAs). Cov neeg uas muaj qee yam sib txawv ntawm cov '(HLAs)' no muaj feem yuav mob SJS lossis TEN ntau dua li lwm tus.

Cov tsos mob ntawm SJS yog dab tsi?

Muaj ntau yam tsos mob uas yuav tshwm sim tau rau tus kab mob SJS. Nws yog ib qho tseem ceeb uas yuav tsum paub txog cov no:

• Mob hnyav heev rau ntawm daim tawv nqaij: Ua ntej, daim tawv nqaij pib mob.
• Kub taub hau: Koj muaj kub taub hau.
• Mob lub cev: Zoo li koj lub cev mob tag nrho.
• Cov pob liab los yog cov thaj ua rau ntawm daim tawv nqaij: Cov pob liab los yog cov thaj ua rau tshwm sim ntawm daim tawv nqaij.
• Hnoos.
• Cov pob khaus thiab mob: Cov pob khaus thiab mob tsis yog tsuas yog tshwm sim rau ntawm daim tawv nqaij xwb, tab sis kuj tshwm sim rau ntawm cov ntaub so ntswg hauv qhov chaw xws li lub qhov ncauj, caj pas, qhov muag, qhov chaw mos, thiab lub qhov quav. Xav txog, cov pob khaus hauv lub qhov ncauj ua rau nws tsis yog tsuas yog nyuaj rau noj xwb tab sis kuj nyuaj rau tham.
• Kev Tshem Tawm ntawm daim tawv nqaij: Daim tawv nqaij tev tawm ntawm cov hlwv.
• Qaug dej: Vim yog qhov mob hauv qhov ncauj, cov qaub ncaug tawm los thaum koj tsis tuaj yeem kaw koj lub qhov ncauj.
• Qhov muag o: Cov pob khaus thiab o hauv qhov muag ua rau qhov muag o heev uas lawv tsis tuaj yeem qhib tau.
• Mob thaum tso zis: Cov pob khaus hauv cov ntaub so ntswg ua rau mob hnyav thaum tso zis.

Xav txog koj pib noj tshuaj tshiab, thiab ob peb hnub tom qab ntawd koj xav tias koj tsis xis nyob, kub taub hau, thiab mob, thiab tom qab ntawd mam li muaj cov pob liab tshwm sim ntawm koj daim tawv nqaij thiab cov pob liab tshwm sim ... Thaum ntawd koj yuav tsum pib xav tias qhov no yog SJS.

Dab tsi ua rau muaj SJS?

Muaj ntau yam ua rau mob SJS:

• Kev ua xua rau tshuaj: Qhov no yog qhov ua rau feem ntau ntawm SJS thiab txhua rooj plaub TEN. Qhov no tuaj yeem tshwm sim yog tias koj tsis nco qab noj tshuaj uas koj tab tom noj.
• Cov kab mob: Piv txwv li, cov kab mob xws li Mycoplasma pneumonia, Herpes virus, thiab Hepatitis A.
• Kab mob Graft-versus-host: Qhov no yog ib qho mob uas tuaj yeem tshwm sim, tshwj xeeb tshaj yog tom qab hloov pob txha.
• Tsis pom muaj laj thawj dab tsi: Qee zaum SJS tuaj yeem tshwm sim yam tsis muaj laj thawj pom tseeb.

Yog koj muaj SJS vim yog siv tshuaj, cov tsos mob feem ntau yuav pib tshwm sim hauv ib, ob, lossis peb lub lis piam tom qab pib siv tshuaj. Tej zaum koj yuav pib kub taub hau, hnoos, thiab mob taub hau, ua raws li tawv nqaij ua pob thiab tawv nqaij tawv. Rau qee tus neeg uas muaj TEN, cov plaub hau thiab cov rau tes yuav poob tawm. Tsis tshua muaj neeg paub tias SJS yog los ntawm kev txhaj tshuaj tiv thaiv kab mob tsis ntev los no.

Cov tshuaj twg feem ntau yuav ua rau muaj SJS?

Muaj qee cov tshuaj uas muaj feem yuav ua rau muaj SJS ntau dua. Cov no suav nrog:

• Cov tshuaj tua kab mob sulfa.
• Cov tshuaj tiv thaiv kab mob qaug dab peg: Piv txwv li suav nrog Phenytoin (Dilantin®), Carbamazepine (Tegretol®), Lamotrigine (Lamictal®), thiab Phenobarbital (Luminal®).
• `(Allopurinol (Aloprim®, Zyloprim®))`: Qhov no yog ib yam tshuaj siv rau mob gout thiab pob zeb hauv lub raum.
• Cov tshuaj tiv thaiv kev o uas tsis yog steroidal (NSAIDs): Piv txwv li suav nrog Piroxicam (Feldene®), Nevirapine (Viramune®), thiab Diclofenac (Cambia®, Flector®).
• Lwm yam tshuaj tua kab mob.

Tseem Ceeb: Qhov no tsis tau txhais hais tias txhua tus neeg uas noj cov tshuaj no yuav muaj tus kab mob SJS. Txawm li cas los xij, cov tshuaj no tau pom tias muaj feem cuam tshuam nrog kev pheej hmoo ntawm kev muaj tus kab mob SJS.

Puas muaj lwm yam uas ua rau muaj feem mob SJS ntau ntxiv?

Yog, muaj qee yam mob uas ua rau muaj feem yuav mob SJS ntau ntxiv. Lawv yog:

• Tau muaj kev hloov pob txha.
• Muaj cov kab mob autoimmune xws li 'Systemic lupus erythematosus - SLE'.
• Kev kis tus kab mob HIV (human immunodeficiency virus).
• Lwm yam kab mob ntev ntawm cov pob qij txha thiab cov ntaub so ntswg sib txuas.
• Mob qog noj ntshav.
• Muaj lub cev tiv thaiv kab mob tsis muaj zog.
• Yog tias muaj ib tug neeg hauv koj tsev neeg tau muaj tus kab mob SJS (keeb kwm tsev neeg) yav dhau los.
• Muaj ib qho variant ntawm ib tug gene tshwj xeeb hu ua "Human Leukocyte Antigen-B - HLA-B".

Cov kws kho mob kuaj mob SJS no li cas ?

Cov kws kho mob kuaj mob SJS thiab TEN los ntawm kev xav txog cov yam no:

• Kev kuaj xyuas daim tawv nqaij thiab cov ntaub so ntswg uas raug mob: Feem ntau tsawg kawg yog ob daim ntaub so ntswg raug mob.
• Nyob ntawm seb koj mob npaum li cas.
• Nyob ntawm seb koj daim tawv nqaij raug cuam tshuam sai npaum li cas.
• Nyob ntawm seb koj daim tawv nqaij raug cuam tshuam npaum li cas.
• Kev kuaj tawv nqaij: Qee zaum, yuav muab ib daim tawv nqaij me me coj mus kuaj hauv qab lub tshuab microscope kom paub meej tias puas muaj mob.

Yuav kho tus kab mob SJS li cas ?

SJS yog ib yam mob uas yuav tsum tau mus pw hauv tsev kho mob thiab kho mob tam sim ntawd. Kev sim kho nws hauv tsev tuaj yeem ua rau qhov mob hnyav dua. Cov hauv qab no yog qee yam kev kho mob:

• Tsum tam sim ntawd cov tshuaj uas xav tias ua rau muaj teeb meem: Qhov no yog thawj qhov yuav tsum ua.
• Cov kua dej hauv cov hlab ntsha (IV) los kho cov electrolytes: Qhov no yog ua los tswj kev poob kua dej ntawm lub cev thaum daim tawv nqaij tev tawm.
• Siv cov ntaub qhwv uas tsis nplaum rau ntawm daim tawv nqaij uas raug mob.
• Muab cov khoom noj uas muaj calorie ntau kom sai dua rau kev rov zoo: Qee zaum, yuav tsum tau siv txoj raj pub mis.
• Yog tias tsim nyog, muab tshuaj tua kab mob los tiv thaiv kev kis kab mob.
• Muab tshuaj tua kab mob.
• Kev kho mob hauv tsev kho mob, tej zaum hauv Chav Saib Xyuas Mob Hnyav (ICU) lossis Chav Kub Hnyiab.
• Nrhiav kev pab los ntawm cov pab pawg tshwj xeeb xws li Dermatology thiab Ophthalmology (yog tias qhov muag raug cuam tshuam).
• Muaj tej lub sij hawm, tej kev kho mob tshwj xeeb xws li IV immunoglobulin, cyclosporine, IV steroids, lossis amniotic membrane grafts (rau lub qhov muag).

Cov teeb meem uas yuav muaj tau ntawm SJS yog dab tsi?

Vim tias SJS thiab TEN yog cov mob hnyav, cov teeb meem tuaj yeem hnyav heev.

• Kev Tuag: Qhov no yog qhov teeb meem loj tshaj plaws. Kwv yees li 10% ntawm cov neeg mob uas muaj SJS thiab kwv yees li 50% ntawm cov neeg mob uas muaj TEN tuaj yeem tuag tau.
• Mob ntsws o.
• Sepsis: Qhov no yog ib qho kab mob loj heev, zoo ib yam li kev lom ntshav.
• Xeev siab '(Shock)'.
• Kev ua tsis tiav ntawm ntau lub cev.

Vim yog cov teeb meem loj no ua rau cov mob SJS/TEN yuav tsum tau mus pw hauv tsev kho mob tam sim ntawd.

Puas tiv thaiv tau tus kab mob SJS?

Qhov tseeb, feem ntau, SJS tsis tuaj yeem tiv thaiv tau. Vim tias nws feem ntau yog los ntawm kev tsis haum tshuaj uas tsis tau xav txog, tsis muaj txoj hauv kev los paub seb qhov no puas yuav tshwm sim ua ntej noj tshuaj.

Txawm li cas los xij, yog tias koj raug kuaj pom tias muaj mob los ntawm tshuaj, qhov tseem ceeb tshaj plaws yog tsis txhob siv cov tshuaj ntawd lossis lwm yam tshuaj zoo sib xws dua. Nws yog ib qho tseem ceeb heev uas yuav tsum qhia rau koj tus kws kho mob txog qhov no thiab sau cia rau hauv koj cov ntaub ntawv kho mob.

Yuav ua li cas rau ib tus neeg uas muaj SJS? (Outlook)

Tsis yog txhua tus neeg uas muaj SJS muaj cov tsos mob zoo ib yam. Ib txhia neeg yuav zoo li qub hauv ob peb lub lis piam. Txawm li cas los xij, yog tias cov tsos mob hnyav heev, nws yuav siv sijhawm ntau lub hlis kom zoo tag nrho. Ib txhia neeg yuav muaj cov teeb meem mus sij hawm ntev. Piv txwv li:

• Tawv Nqaij: Tawv nqaij qhuav, khaus, tawv nqaij hloov xim.
• Qhov Muag: o thiab/lossis qhuav ntau zaus, qhov muag o ntau zaus, pom kev tsis meej, rhiab rau lub teeb (photophobia).
• Tawm hws ntau dhau.
• Kev puas tsuaj rau lub ntsws: Cov mob xws li kab mob ntsws ntev (COPD), hawb pob.
• Cov rau tes poob los yog hloov pauv.
• Kev poob plaub hau (Alopecia).
• Qhov qhuav ntawm cov ntaub so ntswg: Qhov no tuaj yeem ua rau muaj teeb meem xws li tso zis nyuaj.
• Mob qaug zog ntev.
• Kev hloov pauv ntawm saj.

Qhov tseem ceeb, tus kab mob no tuaj yeem rov qab los dua yog tias tus neeg ntawd rov qab noj cov tshuaj uas ua rau muaj SJS thaum xub thawj. Yog tias qhov ntawd tshwm sim, cov tsos mob feem ntau yuav hnyav dua rau zaum ob.

Kwv yees li 10% ntawm cov neeg mob SJS thiab 30% ntawm cov neeg mob TEN tuag, feem ntau yog vim sepsis, acute respiratory distress syndrome (ARDS), thiab ntau lub cev tsis ua haujlwm.

Nov yog qee yam uas koj yuav tsum nco ntsoov los ntawm qhov peb tau tham txog (Cov Lus Coj Mus Tsev):

Zoo, yog li peb tau tham ntau txog qhov mob txaus ntshai no hu ua SJS. Nov yog qee yam uas koj yuav tsum nco ntsoov:

• Stevens-Johnson Syndrome (SJS) thiab Toxic Epidermal Necrolysis (TEN) yog cov mob tawv nqaij loj heev, txawm tias yuav ua rau tuag taus.
• Yog koj muaj cov tsos mob xws li mob tawv nqaij, liab liab, ua pob liab, tawv nqaij tawv tawv, lossis mob qhov ncauj lossis qhov muag tom qab pib noj tshuaj tshiab, tshwj xeeb tshaj yog li ntawm ib lossis ob lub lis piam, nrhiav kev pab kho mob tam sim ntawd. Tej zaum nws yog SJS.
• Qhia rau koj tus kws kho mob yog tias koj tau muaj kev tsis haum tshuaj lossis kev tsis haum tshuaj loj heev rau ib yam tshuaj ua ntej.
• Tsis txhob siv tshuaj lossis cov tshuaj zoo sib xws uas tau txheeb xyuas tias ua rau muaj SJS dua.**
• Yog koj xav tias muaj tus mob no, tsis txhob nyob hauv tsev, mus rau tsev kho mob tam sim ntawd. Kev kho mob sai sai tuaj yeem cawm koj txoj sia.

Vam tias cov ntaub ntawv no yuav pab tau koj. Nyob zoo!

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