Kulephera kwa Mafupa: Tiyeni tikambirane izi mwatsatanetsatane!

Mafupa ndiye malo ofunikira opangira magazi m'thupi lanu. Ali ngati fakitale. Fakitale iyi imapanga zinthu monga maselo ofiira a magazi, maselo oyera a magazi, ndi ma platelet omwe amathandiza matupi athu kuundana. Tangoganizirani zomwe zingachitike ngati fakitale iyi itasiya kugwira ntchito mwadzidzidzi, kapena ngati sinagwire ntchito bwino? Ndicho chimene chimachititsa kulephera kwa mafupa. Tiyeni tikambirane za izi mwatsatanetsatane .

Kodi Kulephera kwa Marrow ku Bone ndi Chiyani?

Mwachidule, kulephera kwa mafuta m'mafupa kumachitika pamene mafuta m'mafupa anu akulephera kupanga maselo ofiira a magazi, maselo oyera a magazi, kapena ma platelet okwanira okwanira m'thupi. Mtundu uliwonse wa maselo amenewa uli ndi ntchito yakeyake m'thupi lathu.

• Maselo ofiira a m'magazi ndi omwe amanyamula mpweya m'thupi lonse. Ngati ali ochepa, mungatope komanso kuoneka ngati wotumbululuka.
• Maselo oyera a m'magazi ali ngati gulu lankhondo la thupi lathu. Ndiwo omwe amalimbana ndi matenda. Ngati ali ochepa, mwayi woti adwale umakhala waukulu.
• Ma platelets amathandiza kuti magazi aziundana, zomwe zikutanthauza kuti amasiya kutuluka magazi mukavulala. Ngati kuchuluka kwa ma platelet m'magazi anu kumatsika, ngakhale bala laling'ono lingayambitse kutuluka magazi ambiri.

Kulephera kwa mafupa nthawi zambiri kumakhala vuto la matenda ena. Koma nthawi zina zimatha kuchitika popanda chifukwa chomveka. Madokotala amatha kuthana ndi zizindikiro pogwiritsa ntchito mankhwala ndi njira zosiyanasiyana zochiritsira. Komabe, chithandizo chokhacho cha nthawi yayitali cha vutoli ndi kusamutsidwa kwa maselo oyambira a allogeneic .

Kodi mitundu ikuluikulu ya vutoli ndi iti?

Pali mitundu iwiri ikuluikulu ya kulephera kwa mafupa:

1. Kupezeka: Akatswiri sakudziwa chomwe chimayambitsa vutoli. Koma kafukufuku wasonyeza kuti likhoza kuyambitsidwa ndi matenda enaake, kukhudzana ndi mankhwala enaake, kapena kugwiritsa ntchito mankhwala enaake. Mtundu uwu umakula pang'onopang'ono pakapita nthawi.

2. Cholowa: Izi zimachitika ngati mwalandira kusintha kwa majini (masinthidwe) kuchokera kwa kholo limodzi kapena onse awiri. Madokotala amatcha Bone Marrow Failure Syndrome .

Kodi vutoli ndi lofala bwanji?

Izi si zachilendo kwenikweni. Mwachitsanzo, pafupifupi ana 65 mwa ana miliyoni aliwonse obadwa ku United States chaka chilichonse amakhala ndi vuto la kulephera kwa mafupa. Chitsanzo china ndi vuto la kulephera kwa mafupa lotchedwa ``Fanconi Anemia.'' Limakhudza pafupifupi munthu m'modzi mwa asanu mwa ana miliyoni aliwonse. Kotero mutha kuwona, izi ndizosowa kwambiri.

Kodi zizindikiro zake zingakhale zotani?

Zizindikiro zimatha kusiyana malinga ndi chifukwa chomwe chimayambitsa kulephera kwa mafupa. Mwachitsanzo, munthu amene ali ndi vuto la mafupa lobadwa nalo angayambe kusonyeza zizindikiro ali ndi zaka ziwiri. Komabe, kafukufuku akusonyeza kuti munthu amene ali ndi vuto limeneli angayambe kusonyeza zizindikiro ali ndi zaka zapakati pa 20 ndi 25, kapena atafika zaka 65. Kaya limayamba liti, zizindikiro zodziwika bwino ndi izi:

• Ululu m'mafupa
• Kutuluka magazi ambiri (monga kutuluka magazi m'mphuno, kutuluka magazi m'kamwa, kutuluka magazi ambiri m'mimba)
• Kutopa kwambiri komanso kutopa
• Malungo obwerezabwereza
• Matenda opatsirana pafupipafupi a bakiteriya
• Mutu
• Kuvuta kupuma (Dyspnea)
• Khungu likuchepa kwambiri kuposa masiku onse
• Madontho ofiira ang'onoang'ono pansi pa khungu (Petechiae)
• Kutupa thupi popanda chifukwa chodziwika

Ngati mukupitiriza kukhala ndi chimodzi kapena zingapo mwa zizindikirozi, onetsetsani kuti mwaonana ndi dokotala.

N’chifukwa chiyani mafuta a m’mafupa amenewa amalephera kugwira ntchito? Kodi zimayambitsa chiyani?

Zinthu zotsatirazi zingakuthandizeni kukhala ndi chiopsezo cholephera kugwira ntchito ya mafupa:

• Muli ndi Bone Marrow Failure Syndrome (yomwe imabadwa nayo).
• Muli ndi khansa ya m'magazi, matenda ena a m'magazi, kapena matenda ena a m'magazi, khansa, kapena matenda (izi zimayamba pambuyo pake, ndiko kuti, ndi za mtundu wa `(Acquired)`).
• Kukumana ndi mankhwala ndi mankhwala ena (izi zimagweranso mu gulu la `(Zopezeka)`).

Nthawi zina, vutoli limatha kuchitika popanda chifukwa chomveka. Madokotala amalitchanso kuti "kulephera kwa mafupa komwe kumachitika chifukwa cha idiopathic bone marrow." Ofufuza amakhulupirira kuti pali mgwirizano pakati pa autoimmune immunity ndi kulephera kwa mafupa. Autoimmune ndi pamene chitetezo cha mthupi lanu chimaukira mafupa anu molakwika.

Matenda Obadwa Nawo a Bone Morrow Failure

Izi ndi zina mwa matenda omwe amabadwa nawo, okhudzana nawo, kapena omwe ali ndi zizindikiro zofanana:

• Congenital Agranulocytosis (Kostmann Syndrome): Izi zimakhudza mtundu wa maselo oyera a magazi otchedwa neutrophils.
• Congenital Amegakaryocytic Thrombocytopenia (CAMT): Pa vutoli, pali kuchepa kwa maselo otchedwa megakaryocytes, omwe amathandiza kupanga ma platelet, mu fupa lanu.
• Kuchepa kwa magazi m'thupi kwa Diamond-Blackfan (Diamond-Blackfan Anemia): Imeneyi ndi matenda osatha omwe amakhudza kupanga maselo ofiira a magazi.
• Dyskeratosis Congenita (Dyskeratosis Congenita - `(Dyskeratosis Congenita)`):Zizindikiro za vutoli zikuphatikizapo kusintha kwa khungu, komwe kungakhale chizindikiro choyamba cha kulephera kwa mafupa.
• Fanconi Anemia (Fanconi Anemia): Iyi ndi matenda ofala kwambiri a mafupa.
• Kusokonekera kwa Ma Reticular Dysgenesis (Kusokonezeka kwa Ma Reticular Dysgenesis): Iyi ndi mtundu wa Severe Combined Immunodeficiency (SCID). Mu mkhalidwe uwu, thupi lanu silipanga maselo T okhwima okwanira.
• Matenda Osatha a Congenital Neutropenia (Severe Congenital Neutropenia): Mu mkhalidwe uwu, ma neutrophils anu, mtundu wa maselo oyera a magazi, amakhala otsika kuposa mwachizolowezi.
• Matenda a Shwachman-Diamond (Shwachman-Diamond Syndrome): Matendawa amakhudza kapamba wanu, mafuta am'mafupa, ndi mafupa.

Ngati m'modzi mwa makolo anu ali ndi vutoli komanso zizindikiro zake (izi zimatchedwa ``Autosomal Dominant''), muli ndi mwayi wa 50% wopeza vutoli ndikukhala ndi vuto la kulephera kwa mafupa.

Komabe, ngati makolo anu onse awiri ali ndi kusintha kwa majini komwe kumakhudzana ndi mtundu womwewo wa matenda a bone marrow failure syndrome, koma palibe aliyense wa iwo amene ali ndi zizindikiro (izi zimatchedwa ``Autosomal Recessive''), chiopsezo chanu chotenga matendawa chimachepa kufika pa 25%.

Khansa ya Magazi

Muli pachiwopsezo chachikulu cha kulephera kwa mafupa ngati muli ndi mtundu umodzi mwa mitundu iyi ya khansa:

• Lymphoma
• Myeloma yambiri
• Matenda a Myelodysplastic

Matenda Ena a Magazi

Anthu ena amabadwa ndi matenda amenewa. Ena amakula nawo pakapita nthawi. Izi zikuphatikizapo:

• Aplastic Anemia (Aplastic Anemia): Imeneyi ndi matenda osowa magazi. Amawononga mafupa anu ndipo amalepheretsa kupanga maselo atsopano a magazi ndi ma platelet. Madokotala angagwiritse ntchito mawu akuti "aplastic anemia" akamanena za kulephera kwa mafupa.
• Cytopenias (Cytopenias): Izi zikuphatikizapo matenda monga autoimmune neutropenia, idiopathic neutropenia, ndi large granular lymphocyte leukemia.
• Paroxysmal Nocturnal Hemoglobinuria (Paroxysmal Nocturnal Hemoglobinuria): Mu mkhalidwe uwu, chitetezo chanu cha mthupi chimawononga maselo ofiira a magazi.
• Aplasia ya Maselo Ofiira Oyera (Pure Red Cell Aplasia): Iyi ndi matenda obadwa nawo omwe amakhudza kupanga maselo ofiira a magazi.

Matenda a Virus

Matenda otsatirawa a mavairasi angakuthandizeninso kukulitsa chiopsezo chanu:

• Cytomegalovirus `(Cytomegalovirus)`
• Kachilombo ka Epstein-Barr
• Kachilombo ka HIV (Human Immunodeficiency Virus)
• Parvovirus B19 `(Parvovirus B19)`
• Matenda a chiwindi a virus

Chithandizo cha khansa ndi/kapena chithandizo cha radiation chingathandizenso kukulitsa chiopsezo chanu cha kulephera kwa mafupa. Komanso, kukhudzana ndi mankhwala ndi zosungunulira zomwe zimagwiritsidwa ntchito mu mankhwala ena ophera tizilombo ndi mankhwala ophera tizilombo kungakulitse chiopsezo chanu.

Kodi mavuto a vutoli ndi otani?

Uwu ndi matenda oopsa omwe angawononge moyo . Ngakhale mutalandira chithandizo, mavuto otsatirawa angachitike:

• Matenda a bakiteriya kapena mavairasi
• Kutuluka magazi
• Khansa ya m'magazi, mwachitsanzo, khansa ya m'magazi ya myeloid kapena myelodysplasia
• Matenda ena a khansa, mwachitsanzo osteosarcoma ndi rhabdomyosarcoma
• Khansa ya Cell Squamous

Kodi mumazindikira bwanji izi?

Dokotala adzakufunsani kaye za zizindikiro zanu, mbiri yanu yachipatala, ndi mbiri yachipatala ya banja lanu. Adzakupimiraninso thupi. Akhozanso kuyitanitsa mayeso a magazi ndi zithunzi.

Mayeso a Magazi

Mayeso a magazi angaphatikizepo:

• Mayeso a Ceruloplasmin
• Kuchuluka kwa Magazi Onse (CBC)
• Mayeso a Ferritin
• Mayeso a Kusowa kwa Folate
• Mayeso a Kusowa kwa Vitamini B12

Mayeso Ojambula

Mayeso ojambula zithunzi angaphatikizepo:

• Kujambula kwa Magnetic Resonance (MRI - `(Kujambula kwa Magnetic Resonance)` scan)
• Kujambula kwa Positron Emission Tomography (PET - `(Positron Emission Tomography)` scan)
• Kufufuza kwa Ultrasound `(Ultrasound)`

Kutengera ndi zotsatira za mayeso a magazi ndi zithunzi, dokotala wanu angakulangizeni kuti mupange biopsy ya mafupa . Angakulangizeninso kuti mupange mayeso a majini kuti mudziwe kusintha kwa majini komwe kumayambitsa kulephera kwa mafupa.

Dokotala wanu angafunenso kuyitanitsa mayeso kuti adziwe matenda enaake kapena kuchotsa matenda ena. Adzakufotokozerani chifukwa chake akuchita mayeso aliwonse komanso zomwe mayesowo angasonyeze.

Kodi mankhwala ake ndi otani?

Chithandizo chomwe mudzalandira chidzadalira zinthu zingapo, kuphatikizapo:

• Mtundu wa kulephera kwa mafupa (monga ngati ndi cholowa kapena chopezeka).
• Kuopsa kwa vuto lanu.
• Zaka zanu ndi thanzi lanu lonse.
• Zizindikiro zanu.

Njira zochiritsira zingaphatikizepo:

• Mankhwala opha tizilombo toyambitsa matenda , mankhwala opha tizilombo toyambitsa matenda, ndi mankhwala opha tizilombo toyambitsa matenda kuti tithane ndi matenda.
• Kuika magazi kuti kuwonjezere kuchuluka kwa maselo ofiira m'magazi ndikuchepetsa zizindikiro monga kutuluka magazi ndi kutopa.
• Zinthu zolimbikitsa mafupa zimathandiza mafupa anu kupanga maselo ambiri a magazi.
• Mankhwala oletsa chitetezo chamthupi amathandiza kuti chitetezo chamthupi chanu chisaukire mafupa anu.
• Kusamutsa maselo a tsinde la allogeneic (Bone Marrow) .

Kodi pali zotsatirapo kapena zovuta zilizonse za chithandizo? (Zovuta Zochizira)

Mavuto ndi zotsatira zake zimasiyana malinga ndi chithandizo, koma kusintha maselo oyambira (mafupa) ndiko komwe kungayambitse mavuto akuluakulu. Izi zikuphatikizapo matenda a graft-versus-host (GVHD) ndi matenda opatsirana.

Kodi moyo udzakhala bwanji ndi vutoli? (Zomwe zidzachitike)

Zimene mungayembekezere mutalandira chithandizo (kuzindikira matenda) zimadalira zinthu zingapo, kuphatikizapo mtundu wa matenda, zaka zanu ndi thanzi lanu lonse, komanso momwe thupi lanu limayankhira chithandizocho.

Kawirikawiri, anthu omwe ali ndi vuto la mafupa amafunika chithandizo chamankhwala nthawi zonse . Koma si onse omwe ali ofanana. Dziwani bwino momwe mulili, ndipo funsani dokotala wanu zomwe zingachitike pambuyo pa chithandizo chanu choyamba.

Kodi kulephera kwa mafuta m'mafupa ndi vuto lakupha? (Kodi ndi vuto lomaliza?)

Uwu ndi matenda oopsa kwambiri komanso oopsa kwambiri . Anthu ambiri omwe ali ndi vuto la mafupa amachiritsidwa ndi akatswiri odziwa bwino ntchito monga madokotala a khansa ndi akatswiri a magazi.

Kodi tinganene chiyani za nthawi ya moyo wa odwalawa? (Chiyembekezo cha Moyo)

Chiyembekezo cha moyo ndi kuyerekezera kwa nthawi yomwe munthu adzakhala ndi moyo pambuyo polandira chithandizo cha matenda enaake. Chiyembekezo cha moyo cha anthu omwe ali ndi vuto la mafupa chikhoza kukhala kuyambira miyezi ingapo mpaka moyo wonse.

Koma, ndinu wapadera, ndipo zomwe mwakumana nazo zingakhale zosiyana ndi za ena onse. Funsani dokotala wanu za zomwe mungayembekezere, komanso nthawi yomwe mungayembekezere kukhala ndi moyo. Iwo ndi omwe angakuthandizeni kudziwa zambiri, chifukwa amadziwa inu ndi matenda anu.

Kodi chiopsezochi chingachepe? (Kuchepetsa Chiwopsezo)

Mwatsoka, palibe njira yochepetsera chiopsezo cha kulephera kwa mafupa obadwa nawo. Komabe, kupewa mankhwala omwe amadziwika kuti amachepetsa ntchito ya mafupa opangidwa kungachepetse chiopsezo cha kulephera kwa mafupa opangidwa ndi mafupa. Komanso, chithandizo choyambirira chingathandize kuchepetsa zizindikiro zanu ndikukweza moyo wanu.

Kodi ndimadzisamalira bwanji? (Kudzisamalira)

Chinthu chabwino kwambiri choti muchite ndikusamalira thanzi lanu lonse . Mwachitsanzo, musagwiritse ntchito fodya, musachepetse kumwa mowa kapena kusiya kumwa mowa. Nazi malingaliro ena:

• Pitani kwa dokotala nthawi zonse. Kulephera kugwira ntchito kwa mafupa kungakhale vuto la moyo wanu wonse. Mungafunike chithandizo chopitilira. Zingayambitsenso mavuto atsopano azaumoyo. Chifukwa chake ndikofunikira kuti muyezedwe nthawi zonse. Dokotala wanu adzayang'anira thanzi lanu lonse ndikuchiza mavuto aliwonse atsopano.
• Idyani zakudya zabwino. Zizindikiro zanu ndi zotsatirapo zake zomwe zingakupangitseni kuti musamadye kapena kutaya chilakolako chanu. Ngati simukudziwa ngati mukudya zakudya zomwe mukufuna, lankhulani ndi katswiri wa zakudya. Angakupatseni malangizo oyenera.
• Chitani masewera olimbitsa thupi. Kukhala ndi vuto lalikulu la thanzi monga kulephera kwa mafupa kumatha kukhala kovuta. Kuchita masewera olimbitsa thupi ndi njira yabwino yochepetsera nkhawa. Onetsetsani kuti mwalankhula ndi dokotala wanu musanayambe kuchita masewera olimbitsa thupi atsopano.

Kodi ndi liti pamene muyenera kupita ku Emergency Treatment Unit (ETU) ?

Ngati muli ndi vuto la mafupa, muli pachiwopsezo chachikulu cha matenda ndi mavuto otuluka magazi. Muyenera kupita kuchipatala chadzidzidzi ngati mukukumana ndi zotsatirazi:

• Kukhala ndi malungo omwe satsika ngakhale mutamwa mankhwala ochepetsa ululu
• Kumva kuzizira komanso kunjenjemera (Chills)
• Kutuluka magazi kosalekeza

Ndi mafunso ati omwe ndiyenera kufunsa dokotala?

Mungakhale ndi vuto la mafupa chifukwa cha matenda enaake obadwa nawo. Koma nthawi zina zimatha kuchitika popanda chifukwa chomveka. Mutha kufunsa dokotala wanu mafunso monga awa:

• Kodi mukudziwa chifukwa chake ndili ndi vuto la mafupa?
• Kodi ndi njira ziti zochiritsira zomwe ndili nazo?
• Kodi ndiyenera kumwa mankhwala kwamuyaya?
• Kodi izi zitha kuchiritsidwa?

Ngati muli ndi vuto la mafupa, mwina mukukumana kale ndi vuto lalikulu la thanzi, monga matenda obadwa nawo, matenda a magazi, kapena khansa. Matenda atsopanowa akhoza kukubweretserani mafunso ndi nkhawa zambiri zatsopano, zomwe zingakhale zovuta kwambiri. Ndizachibadwa kukhala ndi nkhawa chifukwa izi zitha kukhala vuto lomwe lingawononge moyo wanu. Lankhulani ndi gulu lanu lachipatala za zomwe mungayembekezere komanso zomwe mungachite pambuyo pake. Adzasangalala kuyankha mafunso anu.

Kumbukirani mwachidule (Uthenga Wopita Nawo Kunyumba)

Kulephera kwa mafupa ndi vuto lalikulu komanso lovuta . Koma kumbukirani kuti pali zifukwa zambiri zomwe zingachitike, ndipo pali njira zosiyanasiyana zochiritsira ndi njira zochizira. Chofunika kwambiri ndikupeza matenda msanga, kufunafuna chithandizo kuchokera kwa akatswiri oyenera, ndikupitiriza kutsatira malangizo amenewo.Ngati muli ndi mafunso kapena nkhawa zilizonse pankhaniyi, musaope kulankhula ndi dokotala wanu. Iwo alipo kuti akuthandizeni.

Kulephera kwa Mafupa , Maselo Ofiira a Magazi, Maselo Oyera a Magazi, Mapulateleti, Kusamutsa Maselo Oyambira, Matenda a Mafupa