Whakaarohia kei te pāngia koe e te kirika, e mamae ana te tinana, ā, ka tīmata koe ki te tango i tētahi rongoā i tohua e te tākuta. A, mēnā, i roto i ētahi rā, i roto i te wiki, i ngā wiki e rua rānei, ka puta whakarere mai he whero i roto i tō tinana, he mate pukupuku i roto i tō waha, i ō kanohi, i roto hoki i ō ira tangata, ā, ka tīmata tō kiri ki te pupuhi me te tihore me te mea kua wera? He tino whakamataku, he tino morearea, he onge hoki tēnei mate. I tēnei rā ka kōrero tātou mō tēnei mate e kiia nei ko te Stevens-Johnson Syndrome (SJS). He mea tino nui kia mōhio te katoa ki tēnei.
He aha te SJS me te TEN? He aha te rerekētanga i waenganui i ngā mea e rua?
Ko te Stevens-Johnson Syndrome (SJS) he tauhohenga tino pāwera, he rongoā te nuinga. Ka pāngia tō tātou kiri me ngā kiriuhi mucous, ka mate ngā pūtau, ka tihore te kiri. Ko ngā kiriuhi mucous ko ngā kiriuhi ngawari, makuku e whakarārangi ana i tō tātou waha, ihu, kanohi, ira tangata, me te nono.
Tērā tētahi atu momo kino o tēnei mate, e kiia nei e mātou ko te Toxic Epidermal Necrolysis (TEN) . Ki te kī māmā noa, he rite te SJS me te TEN ki ngā taha e rua o te mate kotahi.
- SJS (Stevens-Johnson Syndrome): I tēnei āhuatanga , iti iho i te 10% o te mata kiri o te tinana ka tangohia.
- TEN (Toxic Epidermal Necrolysis): He mate tino kino tēnei, ā, he mate morearea pea, e ngaro ai te neke atu i te 30% o te kiri o te tinana.
He tino kino ēnei āhuatanga e rua, nō reira me kawe te tūroro ki te hōhipera , i ētahi wā ki te wāhanga tiaki nui (ICU) te wāhanga rānei e wera ana.
Ko wai te mea tino tūpono ka pāngia e tēnei mate?
Ahakoa ka taea te pāngia e te SJS i ngā tau katoa, he mea noa iho tēnei i roto i ngā tamariki me ngā taiohi kei raro iho i te 30 tau te pakeke. Ka taea hoki te pāngia e te hunga kaumātua. He paku noa ake te pāngia e te SJS e ngā wāhine i ngā tāne.
He rerekētanga iti tēnei ina tirohia te take:
- Ko te tino take o te SJS i roto i ngā tamariki ko ngā mate hopuhopu pērā i te niumōnia .
- Ko te tino take o te SJS/TEN i roto i ngā pakeke he mate pāwera ki tētahi rongoā .
He aha tonu ngā tohu o te SJS?
He mea tino nui kia mōhio koe ki ēnei tohu, nā te mea ko te wawe o tō kitenga i a rātou, ko te wawe hoki o tō rapu maimoatanga. Ko te tikanga ka puta ngā tohu i roto i te wiki, i te toru rānei o te tīmatanga o te rongoā.
Ko ngā tohu tuatahi ko ngā tohu makariri noa pērā i te kirika, te mamae o te tinana, te ānini, me te mare. Nā tēnei ka uaua te tautuhi i te SJS i ngā rā tōmua. Kātahi ka puta mai ngā tohu kiri kino.
Kei raro nei ngā tohu matua o te SJS.
| Tohu | He whakamārama ngāwari noa iho |
|---|---|
| Mamae kiri nui | Ka rongo koe i te mamae wera nui, kāore e taea te pā ki tō kiri. |
| Te kirika me te mamae o te tinana | Ko ngā tohu ko te kirika nui, te mamae o te tinana, me te ānini. |
| Ngā ira whero me ngā wahi whero | He ira whero, he whara rānei e tīmata ana i te mata me te uma, ka horapa puta noa i te tinana. |
| Ngā mirumiru me ngā patunga | He pupuhi me he mariao mamae ki te kiri, ki roto i te waha, i te korokoro, i ngā kanohi, i ngā ira tangata, me te pūkahukahu. |
| Te tihore kiri | Ka pakū ngā mirumiru, ā, ka tihore te paparanga kiri o runga hei maramara nui. |
| Te tuwha i te huware mai i te mangai | Te huka o te waha nā te mate pukupuku, te kore e taea te kati i te waha. |
| Te whakapā kanohi | He pupuhi me te mimi i roto i ngā kanohi, e uaua ai te whakatuwhera i ngā kanohi. |
| Te mamae i te wā e mimi ana | Te mamae nui i te wā e mimi ana nā te pupuhi o ngā kiriuhi mucous. |
Ngā take matua me ngā momo rongoā ka pāngia ai te SJS
Ko te tino take o te SJS he mate pāwera ki tētahi rongoā. Heoi, kāore tēnei e puta mō ngā rongoā katoa. He maha ngā momo rongoā ka nui ake te tūponotanga ka puta te SJS.
| Take | Whakaahuatanga |
|---|---|
| Mate pāwera ki ngā rongoā | Koinei te tino take o te nuinga o ngā take SJS me te TEN. |
| Ngā mate urutā | Tērā pea i roto i ngā tamariki, ka puta mai i ngā mate pēnei i te Mycoplasma pneumonia, te Herpes, me te Hepatitis A. |
| Ētahi atu take | Ko te mate grafting-versus-host, he raruraru ka puta i muri i te whakawhitinga wheua wheua, te werohanga kano (he tino onge), ā, i ētahi wā kāore e kitea te pūtake. |
Ngā rongoā he nui ake te mōrearea ki te whakaputa SJS
- Ngā rongoā sulfa paturopi: Ētahi momo paturopi.
- Ngā rongoā ārai-haurangi: Hei tauira, ngā rongoā pēnei i te `Phenytoin (Dilantin®)`, `Carbamazepine (Tegretol®)`, `Lamotrigine (Lamictal®)`, `Phenobarbital (Luminal®)`.
- Allopurinol: He rongoā e whakamahia ana hei rongoā i te kauti me ētahi momo kōhatu tākihi (`Aloprim®`, `Zyloprim®`).
- Ngā rongoā whakamamae mamae (NSAID): Ngā rongoā whakamamae mamae kore-steroidal pēnei i te `Piroxicam (Feldene®)`, `Diclofenac (Cambia®, Flector®)`. Ētahi atu rongoā pēnei i te `Nevirapine (Viramune®)`.
- Ētahi atu Paturopi: Ka taea hoki e ētahi atu momo paturopi te whakaputa i tēnei.
He mea nui: Ehara i te katoa ka pāngia e te SJS mai i ngā rongoā kua whakarārangihia i konei. E miriona ngā tāngata e whakamahi ana i ēnei. Heoi, kua tautuhia ēnei rongoā he nui ake te mōrearea ki te pāngia e te SJS. Kaua rawa e mutu te tango i tētahi rongoā kua tohua e te tākuta i runga i tēnei tuhinga.
Te tātaritanga me te maimoatanga o te mate
Mena ka pāngia koe, tetahi atu rānei e mōhio ana koe e ngā tohu o runga ake nei, inā koa kua tīmata koe ki te tango i tētahi rongoā hou, he mea nui kia haere tonu koe ki te Tari Whawhati Tata (ETU) o te hōhipera tata .
Ka tātaritatia tēnei mate e ngā tākuta mā te:
- Mā te tirotiro i tō kiri me ngā kiriuhi mucous (pērā i te waha, ngā kanohi).
- Mā te pātai atu mō te nui o te mamae e pā ana ki a koe.
- Mā te titiro ki te tere o te horapa o ngā tohu kiri me te nui o taua horapa.
- Ki te tika, ka taea te tango i tētahi wahi iti o te kiri hei tirotiro (koiora kiri).
Te maimoatanga mō te SJS
Ko ngā whāinga matua o te maimoatanga mō te SJS he whakamutu i te rongoā i puta ai te mate, te whakahaere i ngā tohu, te ārai i ngā raruraru, me te āwhina i te kiri kia ora. He mea whakahau te whakauru ki te hōhipera mō tēnei.
Kei raro nei ētahi tikanga maimoatanga:
| Tikanga maimoatanga | Whakaahuatanga |
|---|---|
| Te whakamutua o te rongoā pūtake | Koinei te taahiraa tuatahi, te taahiraa tino nui hoki. Me whakamutu tonu te rongoā e whakapaetia ana hei take o te SJS. |
| Te whakarato i ngā wai me ngā tote ki te tinana | Ka ngaro te nui o te wai i te tinana i te tihorenga kiri, nō reira ka whakamahia ngā wai IV hei whakarato i ngā wai me ngā electrolytes e tika ana. |
| Te maimoatanga kiri | Ka hipokina te kiri kua whara ki ngā takai motuhake kāore e piri, he rite ki te rongoā i te weranga. |
| Te whakarato kai | He uaua ki te kai nā te mea he mate waha. Nā te mea he nui te kaha e hiahiatia ana hei whakaora, ka hoatu he kai nui-kaiora mā te ngongo e tukuna ana mā te ihu ki roto i te puku (whāngai ngongo). |
| Te whakahaere mamae | He tino mamae tēnei āhua, nō reira ka hoatu ngā rongoā whakamamae mamae kaha. |
| Ratonga hauora motuhake | Rapua te āwhina a te tākuta kiri, ā, ki te pāngia ngā kanohi, rapua he tākuta kanohi. |
Ngā raruraru o te SJS me ngā pānga i muri i te whakaoranga
He mate tino kino te SJS, ā, ka mate pea. Tata ki te 10% o ngā tūroro e pāngia ana e te SJS, tae atu ki te 50% o ngā tūroro e pāngia ana e te momo TEN kino rawa atu, ka mate. Ko ngā tino take o te mate ko ngā raruraru kino pērā i te sepsis, te niumōnia, me te ngoikore o ngā okana maha.
Ahakoa kua ora te mate, ka pāngia pea ētahi tāngata e ngā pānga mō te wā roa.
- Ngā huringa kiri: Kiri maroke, mākūkū, rerekē te tae o te kiri.
- Ngā raruraru kanohi: ngā kanohi maroke, te mamae pinepine o ngā kanohi, te tirohanga pōuri, te uaua ki te titiro ki te mārama (photophobia).
- Ētahi atu: Te werawera nui, te kino o ngā pukahukahu, te ngaronga, te āhua rerekē rānei o ngā maikuku, te ngaronga o te makawe, te raruraru o te reka.
He mea tino nui: Ki te pāngia anō koe e te rongoā i puta ai te SJS, ka nui ake te kino o te mate i te tuatahi i te wā tuarua. Nō reira, he mea nui kia maumahara ki te ingoa o te rongoā i puta ai te SJS me ngā rongoā rite mō te toenga o tō oranga, me te whakamōhio atu ki ngā tākuta katoa e toro atu ana koe.
Karere Tangohia ki te Kāinga
- Ko te mate Stevens-Johnson (SJS) he mate kiri kino, e morearea ana ki te ora, i te nuinga o te wā ka puta mai i te rongoā.
- Ko ngā tohu tuatahi ko te kirika me te mamae o te tinana, engari i muri mai ka whanake haere hei whero me te mamae o te kiri, he pupuhi, me te kiri e tihore ana.
- Ki te pāngia koe e ēnei tohu i muri i te tīmatanga o tētahi rongoā hou, haere tonu ki te Tari Whawhati Tata (ETU) o te hōhipera.
- Ko te maimoatanga matua ko te tautuhi me te whakamutu i te rongoā i puta ai te mate, me te whakarato i te manaaki tautoko i te hōhipera.
- Kia maumahara ki te ingoa o te rongoā i puta ai tō SJS mō te toenga o tō oranga, ā, me whakamōhio atu ki tō tākuta i ia wā ka haere koe ki te maimoatanga. Mā tēnei pea ka ora ai koe.
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