Kodi mukudziwa za vuto la Sickle Cell? Tiyeni tikambirane za vuto lopweteka ili!

Ngati muli ndi matenda a sickle cell, mwina munamvapo kapena munakumanapo ndi ululu woopsa mwadzidzidzi. Uwu ndi umene timautcha kuti sickle cell crisis. Ungakhale vuto losautsa komanso lopweteka kwambiri. Koma musadandaule, tikambirana mwatsatanetsatane lero.

Kodi vuto la sickle cell limeneli ndi chiyani?

Mwachidule, matenda a sickle cell ndi pamene 'sickle cells' ya thupi lanu, kapena maselo ofiira ooneka ngati sickle, amamatira mumtsempha wamagazi, zomwe zimachedwetsa kapena kuletsa kuyenda kwa magazi. Mukudziwa, maselo athu ofiira amagazi ndi omwe amanyamula mpweya m'thupi lonse. Chifukwa chake, mukakhala ndi matenda a sickle cell, minofu yanu ndi ziwalo zanu sizilandira mpweya wokwanira. Izi zingayambitse ululu waukulu ndi mavuto ena .

Taganizirani ngati dothi laling'ono likamamatirira mu chitoliro cha madzi, madzi amachepa. Koma chomwe chimamatirira apa ndi maselo ofiira amagazi ooneka ngati chikwakwa. Awa sapindika mosavuta ngati maselo ofiira amagazi ozungulira, ndipo sadutsa m'malo ang'onoang'ono. Ndicho chifukwa chake amayesa kumamatirira.

Nthawi zina vutoli lingathe kuthetsedwa kunyumba, koma ngati zizindikiro zake zili zazikulu, mungafunike kukhala m'chipatala kwa masiku angapo kuti mupeze chithandizo.

Kodi mitundu ya matenda a sickle cell ndi iti?

Pali mitundu inayi ikuluikulu ya vuto la sickle cell. Tiyeni tiwone zomwe zili:

• Vuto la Vaso-occlusive crisis: Mtundu uwu ndi wofala kwambiri. Chomwe chimachitika apa ndi chakuti ma sickle cell amamatira mu mitsempha yanu yamagazi kapena mitsempha ina yaying'ono yamagazi, zomwe zimachepetsa kuyenda kwa magazi kupita ku minofu ndi ziwalo zanu. Izi ndi zomwe zimayambitsa kupweteka kwakukulu. Mitundu ina imakhudza madera enaake a thupi.

• Vuto la aplastic: Apa ndi pamene mafupa anu (malo omwe ali mkati mwa mafupa anu omwe amapanga maselo amagazi) mwadzidzidzi amasiya kupanga maselo ofiira amagazi. Izi nthawi zambiri zimachitika chifukwa cha matenda ena a mavairasi, makamaka parvovirus B19.

• Matenda a Hyperhemolytic: Apa ndi pamene kuchuluka kwa hemoglobin yanu (puloteni yomwe ili m'maselo ofiira amagazi yomwe imanyamula mpweya) kumatsika mwadzidzidzi. Izi zimachitika chifukwa maselo ofiira amagazi anu amawonongeka mofulumira kwambiri. Izi zitha kuchitikanso mutapatsidwa magazi, omwe ndi mankhwala ofala a matenda a sickle cell.

• Kuchotsa ma splenic sequestration: Apa ndi pamene ma sickle cell amakakamira mu ndulu yanu (chiwalo chomwe chili kumtunda kumanzere kwa mimba yanu), zomwe zimapangitsa kuti nduluyo ikule mwadzidzidzi ndikutupa mopweteka . Izi zitha kukhala zoopsa kwambiri kwa ana aang'ono, chifukwa magazi ambiri amatha kusonkhana mu ndulu, zomwe zimapangitsa kuti magazi azikhala ochepa.

Kodi zizindikiro za izi ndi ziti?

Zizindikiro za matenda a sickle cell zimatha kusiyana malinga ndi komwe ali m'thupi. Zizindikiro zodziwika bwino ndi izi:

• Chizungulire.
• Kutopa kwambiri, kutopa.
• Mutu.
• Jaundice (kutuluka kwachikasu kwa khungu ndi maso).
• Ululu (ichi ndiye chizindikiro chachikulu komanso choopsa kwambiri).
• Kuvuta kupuma.
• Kufooka.

Ululu wa matenda a sickle cell ukhoza kukhala wofooka, wakuthwa, wobaya, kapena wobaya . Ukhoza kukhala kwa maola, masiku, kapena milungu ingapo. Ululuwu ukhoza kuchitika kulikonse m'thupi, pamalo amodzi kapena m'malo angapo. Mwachitsanzo:

• M'manja kapena m'manja.
• Mu chifuwa.
• Mu miyendo kapena mapazi.
• Mu msana wapansi.
• M'mimba.

N’chifukwa chiyani vuto la sickle cell limachitika?

Matenda a sickle cell amapezeka pamene maselo ofiira a magazi ooneka ngati sickle amasonkhana pamodzi ndikutseka mtsempha wamagazi. Komabe, akatswiri nthawi zambiri sadziwa chomwe chimayambitsa izi.

Komabe, pali zinthu zina zomwe zimayambitsa vutoli:

• Kusowa madzi m'thupi : Thupi likasowa madzi, magazi amakhuthala ndipo maselo amakhala ndi mwayi wotsekeka.
• Kupita kumadera okwera kwambiri (chifukwa mpweya wochepa umakhala m'malo okwera kwambiri).
• Matenda : Matenda aliwonse, monga chimfine kapena fuluwenza.
• Mimba.
• Kusuta kapena kusuta fodya.
• Kuchita masewera olimbitsa thupi mopitirira muyeso.
• Kupsinjika maganizo : Kuda nkhawa kwambiri komanso mantha.
• Kusintha kwadzidzidzi kwa kutentha kwambiri (monga kusamba m'madzi ozizira mutakhala pamalo otentha kwambiri).
• Kusowa kwa mavitamini ena, mwachitsanzo folate.

Kodi izi zingayambitse mavuto otani?

Kuopsa kwa vuto la sickle cell kumadalira komwe mtsempha wamagazi watsekeka. Ngati mitsempha yamagazi yatsekeka m'minofu kapena ziwalo zanu, mavuto monga:

• Matenda a chifuwa chachikulu : Ichi ndi vuto lalikulu, lomwe limayambitsa imfa lomwe limapezeka pachifuwa. Zizindikiro zake ndi monga malungo, kupweteka pachifuwa, komanso kupuma movutikira.
• Magazi amaundana.
• Ululu wosatha (ululu wopitirira).
• Kukulira kwa ndulu ndi matenda ena okhudzana ndi ndulu.
• Mabala osachiritsa pa miyendo.
• Matenda a chiwindi.
• Matenda a m'mapapo, mwachitsanzo, kuthamanga kwa magazi m'mapapo.
• Necrosis : Kufa kwa mafupa kapena minofu chifukwa cha kutayika kwa magazi (makamaka m'malo monga m'chiuno).
• Kupweteka kwa mbolo (komwe kumatchedwanso 'priapism' mwa amuna).
• Stroke : Imachitika chifukwa cha kutsekeka kapena kusweka kwa mtsempha wamagazi womwe umapereka magazi ku ubongo.

Kodi mumazindikira bwanji izi?

Ngati muli ndi matenda a sickle cell, mwina mumapita kale kwa dokotala wanu miyezi 6 iliyonse kapena kamodzi pachaka kuti akakuyezeni magazi. Koma ngati muli ndi vuto la sickle cell, muyenera kuyesedwa magazi onse. Izi zingaphatikizepo:

• Kuyezetsa mtundu wa magazi (ngati mukufuna kuikidwa magazi).
• Kuchuluka kwa Magazi (CBC) (Complete Blood Count) : Izi zimayesa kuchuluka kwa hemoglobin ndi kuchuluka kwa maselo ofiira ndi oyera m'magazi.
• CMP (Comprehensive Metabolic Panel) : Mndandanda wathunthu wa mayeso a kagayidwe kachakudya omwe amayang'ana momwe ziwalo monga impso ndi chiwindi zimagwirira ntchito.
• Mayeso a ntchito ya chiwindi .
• Kuchuluka kwa ma reticulocyte : Izi zimayesa kuchuluka kwa maselo ofiira amagazi omwe angopangidwa kumene. Izi zingapereke lingaliro la momwe mafuta a m'mafupa akugwirira ntchito.

Kuphatikiza apo, dokotala wanu angachite kafukufuku wathunthu ndi mayeso ojambula zithunzi monga:

• Doppler ultrasound : Onani momwe magazi amayendera kudzera m'mitsempha yamagazi.
• MRI : Makamaka ngati pali kukayikiridwa kuti pali vuto monga sitiroko.
• Ultrasound : Kuyang'ana zinthu monga ziwalo zam'mimba ndi ndulu.
• X-ray ya pachifuwa : Kufufuza matenda monga acute chest syndrome.

Kodi imachiritsidwa bwanji?

Ngati muli ndi vuto la sickle cell, mungafunike mankhwala ochepetsa ululu kuti muchepetse zizindikiro zosasangalatsa. Ngati ndi kotheka, mutha kuthana ndi vutoli kunyumba pogwiritsa ntchito mankhwala ogulitsidwa kunja monga acetaminophen (monga Panadol®, Tylenol®) kapena ibuprofen (monga Advil®, Brufen®).

Komabe, ngati mukumva kupweteka kwambiri, mungafunike kukhala m'chipatala kwa masiku angapo. Madokotala angakupatseni mankhwala amphamvu ochepetsa ululu (monga morphine), madzi a m'mitsempha (kuti magazi anu aziyenda bwino), ndi mpweya ngati pakufunika.

Kuphatikiza apo, chithandizo cha matenda a sickle cell chimasiyana malinga ndi ziwalo za thupi zomwe zakhudzidwa ndi kuopsa kwa zizindikiro. Madokotala angagwiritse ntchito mankhwala, kuika magazi, kuika mafupa, kapena kuphatikiza njira zimenezi.

Mankhwala ochizira matenda kwa nthawi yayitali

Pali mitundu ingapo ya mankhwala omwe madokotala amagwiritsa ntchito pochiza mavuto a sickle cell kwa nthawi yayitali ndikuchepetsa kuchuluka kwa matendawa:

• Hydroxyurea: Mankhwalawa amapangitsa maselo ofiira a m'magazi kukhala akulu, amawonjezera mphamvu zawo zopindika, komanso amawonjezera mtundu wa hemoglobin wotchedwa fetal hemoglobin. Izi zimachepetsa kuuma kwa maselo.
• Crizanlizumab `(Crizanlizumab)`:Uwu ndi mtundu wa monoclonal antibody. Umatha kuletsa maselo ofiira a magazi anu kuti asamamatire kumakoma a mitsempha yanu yamagazi.
• L-glutamine: Ichi ndi amino acid yomwe imathandiza kuchepetsa kuwonongeka kwa maselo ofiira a magazi.
• Voxelotor: Mankhwalawa amaletsa maselo ofiira a magazi anu kuti asamamatire pamodzi.

Kuika magazi

Madokotala angagwiritse ntchito magazi pochiza mavuto a aplastic kapena hyperhemolytic sickle cell. Mankhwalawa amatha kubwezeretsanso maselo ofiira athanzi anu ndikuchepetsa chiopsezo cha zovuta za sickle cell. Anthu ena angafunike kupatsidwa magazi pafupipafupi.

Zomera zina

Kuika mafupa kapena kuyika maselo oyambira kungakhale njira yokhayo yochiritsira matenda a sickle cell nthawi zina. Komabe, kupeza wopereka wofanana naye (monga m'bale wanu) kungatenge nthawi. Komanso, kuyika mafupa kungayambitse mavuto ena akuluakulu, monga matenda a graft vs. host (GvHD). Pachifukwa ichi, madokotala nthawi zambiri samachita opaleshoni yoika mafupa akamachiritsa mavuto a sickle cell. M'malo mwake, cholinga chachikulu ndikuchiza zizindikiro zanu ndikuchepetsa ululu wanu.

Kodi izi zingapewedwe?

Mavuto a sickle cell sangathe kupewedwa nthawi zonse. Komabe, pali zinthu zina zomwe zingathandize kuchepetsa chiopsezo:

• Pewani kusuta fodya kotheratu.
• Ngati muli pamalo ozizira, valani zovala zofunda. Kuzizira kumatha kutsekereza mitsempha yamagazi ndikuyambitsa vuto.
• Chepetsani kumwa mowa kapena siyani konse . Mowa ungayambitse kusunga madzi m'thupi.
• Imwani magalasi osachepera 8-10 a madzi patsiku (khalani ndi madzi okwanira).
• Imwani mapiritsi a folic acid tsiku lililonse kuti muwonjezere kupanga maselo ofiira m'magazi (izi ziyenera kuchitika motsatira malangizo a dokotala).
• Sambani m'manja mwanu ndi sopo nthawi zonse kuti muchepetse chiopsezo cha matenda.
• Pezani katemera wonse wofunikira pa nthawi yake (monga katemera wa chimfine, katemera wa chibayo).
• Pewani kuchita masewera olimbitsa thupi mopitirira muyeso, koma kuchita masewera olimbitsa thupi pang'ono n'kwabwino.
• Pezani njira zochepetsera nkhawa (monga yoga, kusinkhasinkha).

Kodi ndimadzisamalira bwanji (pamene vuto lachitika)?

Ngati inu kapena munthu wina wapafupi nanu ali ndi vuto la sickle cell, kuchita zinthu izi kungathandize kuchepetsa zizindikiro:

• Sungani kutentha. Kusamba ndi madzi otentha kapena kuyika chotenthetsera pamalo opweteka kudzakulitsa mitsempha yamagazi yanu ndikupangitsa kuti magazi aziyenda bwino. Kutenthako kudzathandizanso kutonthoza minofu yopweteka.(Musagwiritse ntchito ma paketi a ayezi. Kuzizira kungayambitse ululu. Choncho ndi bwino kukhala otentha momwe mungathere.)
• Imwani madzi ambiri. Mukamwa madzi okwanira, maselo ofiira a m'magazi anu amachepa, zomwe zimapangitsa kuti azitha kuyenda mosavuta m'njira zosiyanasiyana.
• Pezani kutikita minofu. Kutikita minofu pang'ono kungathandize kuti magazi aziyenda bwino, kumasula minofu, komanso kuchepetsa ululu.
• Yesetsani kusamala. Kafukufuku wasonyeza kuti kuyang'ana kwambiri cholinga chimodzi kwa kanthawi kochepa kungathandize kusokoneza ubongo wanu ndikuchepetsa ululu wokhudzana ndi matenda a sickle cell. Ngakhale chinthu chosavuta monga kuyang'ana kwambiri kupuma kwanu chingathandize.
• Imwani mankhwala ochepetsa ululu omwe amaperekedwa ndi dokotala. Izi zikuphatikizapo paracetamol, ibuprofen, kapena naproxen (monga Aleve®). Koma musamwe mankhwala ochulukirapo kuposa momwe dokotala wanu wanenera.

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

Ngati muli ndi zizindikiro izi, pitani ku Dipatimenti Yodzidzimutsa (ETU) yapafupi nthawi yomweyo :

* Ngati muli ndi ululu waukulu mwadzidzidzi womwe sungathetsedwe ndi mankhwala apakhomo.

* Kuvuta kupuma kapena kupweteka pachifuwa.

* Malungo aakulu (oposa 101°F kapena 38.3°C).

* Kufooka mwadzidzidzi, kuvutika kulankhula, kugwada kwa mbali imodzi ya nkhope (zizindikiro za sitiroko).

* Kupweteka kwambiri m'mimba kapena kudzimbidwa.

* Ngati jaundice yawonjezeka.

* Kwa amuna, kukhwima kwa chiberekero kumakhala kowawa komwe kumatenga maola opitilira 4.

Musachedwe. Kuyamba chithandizo msanga kungachepetse chiopsezo cha mavuto a nthawi yayitali.

Zinthu zofunika kwambiri zomwe muyenera kukumbukira

Ngati muli ndi matenda a sickle cell, kuganiza za vuto lalikulu kungakhale kovuta pang'ono. Matendawa angayambitse zizindikiro zosasangalatsa komanso mavuto a moyo wanu wonse. Ngati munakhalapo ndi vuto la sickle cell, mukudziwa momwe nthawi ilili yofunika kwambiri.

Ngati zizindikiro zanu sizikuchepa ndi mankhwala ochepetsa ululu omwe amaperekedwa ndi dokotala kapena mankhwala anu achizolowezi opezeka kunyumba, ndi nthawi yoti mukaonane ndi dokotala wanu. Ali pano kuti akuthandizeni. Musaope kulankhula ndi dokotala wanu za vuto lanu. Chithandizo choyambirira ndi chabwino kwambiri. Gwirani ntchito ndi dokotala wanu kuti mupange dongosolo lothandizira ululu lomwe lingakuthandizeni.

Vuto la Maselo a Sickle, Matenda a Maselo a Sickle, Maselo Ofiira a Magazi, Ululu, Mitsempha ya Magazi, Mpweya wa Oksijeni