He raruraru nui kei roto i tō tinana? Me ako tātou mō te mate Waterhouse-Friderichsen!

Kua rongo kē koe i te kōrero mō te mutu o te mahi a ngā repe iti e rua o te tinana, ā, ka pā nui ki tō oranga? I tēnei rā ka kōrero tātou mō tētahi mate tino morearea, ā, ki te kore e tere te rongoā, ka mate pea. Ko te ingoa o tēnei ko te Waterhouse-Friderichsen Syndrome. Ahakoa te ahua roa o te ingoa, me kōrero noa tātou mō te aha, te take e puta ai, me pēhea te ora.

He aha tēnei mate Waterhouse-Friderichsen?

He māmā noa iho, he mate tino kino te Waterhouse-Friderichsen Syndrome (WFS). Ko te mea ka tupu, ka toto ō repe adrenal , arā, ngā repe iti e rua kei runga ake i ō whatukuhu (e kiia ana tēnei ko te 'toto adrenal') ā, ka mutu te mahi a tētahi, e rua rānei o ēnei repe. I te nuinga o te wā, ka puta tēnei i tētahi mate kino. Ki te kore e rongoatia, ka tata mutu katoa te whakaputa a ēnei repe adrenal i te homoni cortisol, he mea nui mō tō tātou tinana. Koinei te mea e kiia nei e tātou he raruraru adrenal . Hei tika, he āhuatanga ohorere tēnei!

Tērā tētahi atu ingoa mō tēnei, ko te "hemorrhagic adrenalitis." Ko te tikanga ka toto ngā repe adrenal, ka mumura.

He pēhea te noa o tēnei āhuatanga?

Ina hoki, he tino onge te mate Waterhouse-Friderickson. I te nuinga o te wā, ka kitea e ngā tātaritanga tūpāpaku ko tēnei mate te take o te 1% noa iho o ngā matenga. Ko te tikanga ehara i te mate e pā ana ki te katoa, engari ki te puta, he tino morearea.

He aha ngā tohu o tēnei mate?

Whakaarohia, i pāngia koe e te huaketo, e te huakita rānei, ā, ka puta mai tēnei mate WFS. Kātahi ka tīmata ohorere koe ki te whakaatu i ngā tohu o te mate. E mōhio ana koe he aha tēnā?

• Kei te pāngia ahau e te kirika nui.
• Ka mātao, ka wiriwiri te tinana.
• Mamae rawa tōku mahunga.
• Ka ruaki ahau, ka ruaki ahau.
• Ka mamae ngā uaua o tōku tinana, inā koa ngā wāhi pēnei i tōku tuara o raro, tōku puku, me ōku waewae.
• Mamae ana ōku hononga.
• I ētahi wā ka ngaro pea te māramatanga (syncope).

Ina tīmata te toto ki te pā ki ngā repe adrenal me ētahi atu wāhanga o te tinana, ka puta pea ētahi atu tohu. Ko ētahi o ēnei ko:

• Te toto toto totoro kua horapa (DIC): He ahua uaua tēnei, kāore? He māmā noa iho, he mate tēnei e kore ai e pai te tukanga totoro toto puta noa i te tinana. Ina puta he toto totoro i tētahi wāhi, kāore e taea te aukati i te toto i tētahi atu wāhi.
• Ponana kiri:I ētahi wā ka puta mai i runga i te kiri he ira iti, he ira nui rānei.
• Te ohorere toto: He āhuatanga tēnei e tino heke ai te toto toto nā te mate urutā, ā, kāore e nui te toto e whiwhihia ana e ngā whekau o te tinana. He tino morearea hoki tēnei.

He aha ngā tohu o te toto o te repe adrenal?

E pā ana te WFS ki te totohu adrenal, ka haere tahi pea me ētahi atu tohu:

• Mamae puku.
• Te mamae i te rohe i runga ake i te hope, i raro i ngā rara (hope).
• Te koretake o te manawa, te ahua o te kore whakamarie.
• Te puhoi.
• Whakapairuaki me te ruaki.
• Te korere.

He aha te take o tēnei?

I te nuinga o te wā, ko te tino take o te mate Waterhouse-Friderickson ko ngā mate kitakita me ngā mate huaketo (sepsis) . Hei whakamārama, ka uru mai he iroriki ki te tinana ka horapa puta noa i te tinana, kāore e taea te whakahaere.

Tērā pea ka tino pāngia ētahi momo huakita e tēnei. Anei ētahi tauira:

• Pseudomonas aeruginosa
• Huakita Meningococcus: Koinei te mea tino morearea ka taea te whakaputa i te WFS.
• 'Streptococcus pneumoniae'
• `Rewharewha Haemophilus`
• `Escherichia coli (E. coli)`
• 'Staphylococcus aureus'

Ka taea e ētahi atu momo huakita te whakaputa i tēnei.

Waihoki, ka taea e ētahi momo huaketo te whakaputa i tēnei:

• Te huaketo Cytomegalo (CMV)
• Parvovirus `(Parvovirus)`
• huaketo Epstein-Barr
• Te huaketo Ebola `(te mate huaketo Ebola)`
• te huaketo Varicella-zoster (koinei te pūtake o ngā mate pēnei i te rewharewha me te herpes)

Haunga ēnei mate urutā, kei reira anō ētahi atu āhuatanga mōrearea mō te whanaketanga o te WFS:

• Te whakamahi i ngā rongoā ārai toto. Ka piki ake te mōrearea o te toto i ēnei.
• Thrombocytopenia: Ko te tikanga tēnei he hekenga o te maha o ngā pereti toto (ngā pūtau e āwhina ana ki te totoka) i roto i te toto.
• Kua pakaru ngā repe adrenal i tētahi ara.

Ko wai te mea tino pāngia e tēnei āhuatanga?

He nui ake te tūponotanga ka pāngia ngā tamariki nohinohi e te mate Waterhouse-Friderickson i ngā pakeke . Nō reira, me tino tupato koe mēnā ka pāngia tētahi tamaiti nohinohi e ngā tohu pēnei i te kirika me te mamae o te tinana.

He aha ngā raruraru ka pā mai i tēnei?

Koinei te mea tino nui. Ki te kore e tere te rongoā me te tika, ka mate te mate Waterhouse-Friderickson. Arā, ka mate pea. Nō reira me whakaaro tēnei he āhuatanga ohorere.

Me pēhea te tautuhi i tēnei mate?

Hei tautuhi i tēnei mate, me rapu āwhina koe i te tākuta. Ka pātai atu te tākuta ki a koe mō ō tohumate, ka pātai atu mō ō mate o mua, kātahi ka tirotirohia tō tinana.

Engari he uaua pea te tautuhi i te WFS, nā te mea he rite tonu ōna tohu ki ērā o te septic shock . Nō reira, hei whakaū mēnā he WFS, ka whakaritea e te tākuta he maha ngā whakamātautau.

He aha ngā whakamātautau e whakamahia ana hei tautuhi i te mate?

Hei whakaū mēnā he mate pāwera, ka whakahaerehia pea e te tākuta ngā whakamātautau e whai ake nei:

Ngā whakamātautau whakaahua

• Ka taea te whakahaere i te matawai ultrasound, i te matawai CT rānei (computered tomography) hei tirotiro i te hanganga toto i roto i ngā repe adrenal. Ka tangohia e ēnei matawai ngā whakaahua o roto o te tinana, kia kitea mārama ai ngā wāhi e toto ana.

Ngā whakamātautau toto

• Mā te whakamātautau toto ka taea te tino mōhio mēnā he mate huakita tōu. Ko te tikanga o tēnei ko te tango i tētahi ngira iti mai i tētahi uaua i tō ringa, te tango i tētahi toto iti, kātahi ka tirohia i raro i tētahi karuārai. Mā tēnei ka rapua ngā tohu o te mate.

Ngā whakamātautau huakita Meningococcus

Ki te whakaaro te tākuta ko te huakita meningococcus te take, ka whakahaerehia pea e rātou ēnei whakamātautau:

• Te pokanga tuaiwi / te weronga hope: Ko te werohanga o tētahi ngira angiangi ki roto i tō tuara o raro, i waenganui i ngā tuaiwi e rua, me te tango i tētahi wai tuaiwi iti. Ahakoa te āhua whakamataku o tēnei, ka āta mahi ngā tākuta i tēnei mahi.
• Kohikohi kiri: Mena he whara kei tō kiri, ka tangohia he wahi kiri iti mai i te whara ka tirotirohia.
• Whakamātautau tae Gram: Ka tangohia he tauira mai i tētahi wāhi e whakapaetia ana (pēnei i te patunga) hei rapu i ngā huakita.
• Te tātari mimi: Ka tonoa koe kia mimi ki roto i tētahi ipu motuhake. Kātahi ka whakamātauria te tauira mimi mō ngā tohu o te mate.

Ngā whakamātautau raruraru adrenal whakapeka

Mā ēnei whakamātautau ka taea te whakatau mēnā kei te pāngia koe e te mate adrenal , he āhuatanga e kore ai e mahi tika ngā repe adrenal:

• Whakamātautau whakaohooho homoni Adrenocorticotropic (ACTH): I tēnei whakamātautau, ka werohia koe e tō tākuta ki tētahi werohanga iti o tētahi homoni e kiia nei ko te ACTH. Kātahi, 30 ki te 60 meneti i muri mai, ka tangohia he tauira toto hei tirotiro i te urupare a ō repe adrenal ki te ACTH. He whakamātautau tēnei e ine ana i te pai o te mahi a ō repe adrenal.
• Ngā whakamātautau huka toto:Ka tangohia he toto iti, ā, ka inehia te nui o te huka (huka) kei roto. Ka iti pea ngā taumata huka i te wā o te raruraru repeure.
• Whakamātautau Cortisol: Ka tangohia he tauira o tō toto, mimi, huware, he huinga rānei o ēnei e rua, e toru rānei hei tirotiro i te nui o te cortisol e whakaputaina ana e ō repe adrenal.
• Whakamātautau toto pH: Ka tangohia he tauira toto, ā, ka inehia tōna taumata waikawa-pūtake (pH). Ka taea tēnei mā te whakamātautau hau toto uaua (ABG) me te whakamātautau ine irahiko. I te nuinga o te wā, me noho te pH o ō tātou toto i waenga i te 7.35 me te 7.45.
• Whakamātautau toto pāhare pākawa: He whakamātautau toto hei ine i te nui o te pāhare pākawa i roto i tō toto. He matūkai te pāhare pākawa e āwhina ana i ō tātou io me ngā uaua ki te mahi tika. Ka rerekē pea ēnei taumata i te wā o te raruraru repeure.
• Whakamātautau toto konutai: Ka ine te whakamātautau toto i te nui o te konutai i roto i ō toto. He mea nui hoki te konutai mō te mahi tika o ō io me ō uaua. Ka rerekē pea ēnei taumata.

Me pēhea te rongoā mō tēnei?

Mena kei a koe te WFS, tera pea kei a koe anō te sepsis . Nō reira, ko te mea tuatahi ka mahia e ngā tākuta ko te tīmata tonu i a koe ki te tango i ngā paturopi i a rātou e whakahaere ana i ngā whakamātautau hei rapu i te tino pūtake o te WFS. Ka aroturukihia hoki e rātou ō taumata electrolyte (tote) me te wai.

Kia mutu ngā tohu o te sepsis, ka tīmata ngā tākuta ki te hoatu rongoā ki a koe e kiia nei ko ngā glucocorticoids me ngā mineralocorticoids . He homoni steroid ēnei. Ka mahi ngā glucocorticoids ki te whakaiti i te mumura i roto i te tinana. Ka mahi ngā mineralocorticoids ki te whakahaere i ngā taumata tote me te wai o tō tinana. I roto i ngā kupu ngāwari, he rite ki te hoatu i ngā homoni ki a koe e tika ana kia hangaia e ō repe adrenal, engari kāore.

Tērā pea ka hiahiatia he whakawhiti toto , he tikanga rānei e kiia nei ko te angioembolization . Ko te tikanga o tēnei ko te whakamahi i tētahi angiogram me tētahi toto totoka (embolization) hei tautuhi me te aukati i ngā uaua e tuku toto ana ki ngā repe adrenal. Ka mahia tēnei hei whakamutu i te toto.

Ko te mea nui, i muri i te WFS, he tokomaha te hunga e hiahia ana ki te tango i ētahi atu rongoā homoni mō te toenga o ō rātou oranga , nā te mea i te wā kua pakaru ngā repe adrenal, kāore pea e taea e rātou te whakaputa tika i ngā homoni.

Kia pēhea te tere o taku pai ake i muri i te maimoatanga?

Ka tīmata te nuinga o te tangata ki te pai ake i roto i te wiki, i ngā wiki e rua rānei o te tīmatanga o te maimoatanga. Heoi, ahakoa kua tino ora koe, tera pea ka pā tonu ētahi raruraru tinana, hinengaro rānei ki a koe mō ngā marama, tae noa ki ngā tau. Hei tauira:

• Kāore he reka o te kai.
• Tino ngenge.
• Te uaua ki te moe (te kore moe).
• Te āhua o te pāngia e te mate.
• Te manukanuka.
• Te pouri.

Nō reira, he mea nui kia mahara he roa pea te wā e ora ai te tinana.

He aha ngā mea ka taea e koe te tumanako mēnā ka pangia koe e tēnei mate?

E ai ki tā mātou i kōrero ai i mua, ki te kore e rongoatia, he mate whakamate te WFS. Kāore he ruarua mō tēnā.

Heoi, mā te maimoatanga wawe, tika, me te whakaora anō hoki, ka ora te nuinga o te hunga whai WFS. Heoi anō, me hiahia pea koe ki te tiaki hauora nui, ā, ka roa pea ngā pānga o te WFS mō ngā marama, tae noa ki ngā tau. Nō reira, ehara i te mea hei mea ngāwari.

Ka taea te ārai i tēnei āhuatanga?

He maha ngā mea ka taea e koe te mahi hei whakaiti i tō tupono ki te whakawhanake i te mate Waterhouse-Friderickson:

• Mā te horoi i ō ringaringa i ngā wā katoa, me te horoi pai hoki, ka āwhina i te ārai i ngā mate urutā. He mea tino māmā tēnei, engari ka taea e ia te whakaora i a koe i ngā mate maha.
• He mea tino nui te whiwhi kano ārai mate mō te huakita meningococcal mō ngā tamariki.
• Ki te whakaaro koe kei te pāngia koe e te mate, rapua tonutia he rongoā. Kaua e warewarehia te kirika iti, te maremare rānei.

Me pēhea koe e tiaki ai i a koe anō i a koe e whakaora ana?

I a koe e ora ake ana, me mahi tahi kōrua ko tō tākuta ki te whakawhanake i tētahi mahere whakaora e tika ana, e haumaru ana, e pai ana hoki mōu. Tērā pea kei roto i taua mahere ngā mea pēnei i:

• Kia nui te okiokinga. Me okioki te tinana me te hinengaro.
• He whakaaro pai te whai i tētahi kai taurite hei āwhina i a koe ki te whakahoki mai i tō kaha. He mea pai mēnā ka taea e koe te rapu tohutohu mai i tētahi tohunga kai mō tēnei.
• Whakatakotoria he whāinga iti. Hei tauira, te noho ake i runga i te moenga, te tū ake, te whakakakahu i a koe anō, te kaukau, te hikoi poto, te piki i ngā arawhata.
• He mea nui te kōrero mō ō kare ā-roto ki tō whānau, ki ō hoa, ki tētahi kaiwhakaora hinengaro rānei i ēnei wā uaua.
• Whakakorikori tinana ina kei a koe te kaha me te hihiko. Tīmata mārire, ka whakakorikori tinana kia rite ki ngā tohutohu a tō tākuta.

Āhea ahau me haere ki te tākuta? / Āhea ahau me haere ki te rūma ohorere?

Mena kei te pai tonu tō āhua i muri i te maimoatanga, kei te uaua rānei koe ki te whakatutuki i ō whāinga whakaora, me kōrero koe ki tō tākuta.

He mate kino te WFS, ā, ka mate pea koe mēnā kāore e rongoatia. Mēnā kei a koe ētahi tohu o te WFS, hei tauira, he mate kino e kore e memeha, me haere tonu koe ki te rūma whawhati tata (ETU) .Kāore i te pai te whakaroa i tēnei.

He aha ngā pātai me pātai atu koe ki tō tākuta?

Ina kitea e koe he WFS tōu, tera pea he maha āu pātai. Kaua e mataku, pātai atu ki tō tākuta i ēnei pātai hei whakamārama i ō feaa:

• Me pēhea koe e mōhio ai kei a au te mate Waterhouse-Friderickson?
• Mena kāore he mate Waterhouse-Friderickson kei ahau, he aha atu anō ngā mate ka pā mai ki ahau?
• He aha te take o taku mate Waterhouse-Friderickson?
• Me pokanga ahau hei whakatika i aku repe adrenal?
• E whakaaro ana koe ka ora katoa ahau?
• Me tango e au ētahi atu homoni?
• Kia pēhea te roa me tango e au ētahi atu homoni?

Nā, he aha ngā mea tino nui hei maumahara mā tātou i tēnei?

He mate tino kino te mate Waterhouse-Friderichsen (WFS) e hiahia ana kia arohia wawetia e te rata. Mena kei a koe tētahi o ēnei tohu, kei a koe rānei tētahi mate kāore e pai ake, he mea nui kia haere wawe atu koe ki te rūma whawhati tata.

Whāia ngā tohutohu maimoatanga katoa a tō tākuta. Mā reira anake ka taea e koe te whakahaere i tēnei mate WFS me te ora wawe tonu. Kia maumahara, mā te maimoatanga wawe ka taea te whakaora i te ora! He mea tino nui hoki kia tiakina pai koe i a koe anō i a koe e ora ana.

Te mate Waterhouse-Friderichsen, ngā repe adrenal, te cortisol, te sepsis, ngā mate pāwera, te tiaki ohorere, ngā homoni