Tangoganizani kuti muli ndi malungo, kupweteka kwa thupi, ndipo mwayamba kumwa mankhwala omwe dokotala wakupatsani. Nanga bwanji ngati, patangopita masiku ochepa, mwina sabata imodzi kapena ziwiri, mwadzidzidzi mumakhala mawanga ofiira pathupi lanu, zilonda mkamwa mwanu, m'maso mwanu, ndi m'ziŵalo zanu zoberekera, ndipo khungu lanu limayamba kutupa ndi kung'ambika ngati kuti lapsa? Uwu ndi matenda oopsa kwambiri, owopsa kwambiri, komanso osowa. Lero tikambirana za matenda awa otchedwa Stevens-Johnson Syndrome (SJS). Ndikofunikira kwambiri kuti aliyense adziwe izi.
Kodi SJS ndi TEN ndi chiyani? Kodi kusiyana pakati pa ziwirizi ndi kotani?
Matenda a Stevens-Johnson (SJS) ndi vuto lalikulu la hypersensitivity, nthawi zambiri chifukwa cha mankhwala. Limakhudza kuwonongeka kwa khungu lathu ndi nembanemba ya mucous, zomwe zimapangitsa kuti maselo afe komanso khungu lichotsedwe. Nembanemba ya mucous ndi nembanemba yofewa komanso yonyowa yomwe imaphimba pakamwa pathu, mphuno, maso, ziwalo zoberekera, ndi thako.
Palinso mtundu wina woopsa wa vutoli, womwe timautcha Toxic Epidermal Necrolysis (TEN) . Mwachidule, SJS ndi TEN zili ngati mbali ziwiri za matenda omwewo.
- SJS (Stevens-Johnson Syndrome): Pankhaniyi , khungu lochepera 10% la thupi limachotsedwa.
- TEN (Toxic Epidermal Necrolysis): Iyi ndi vuto lalikulu kwambiri komanso lomwe lingayambitse imfa pomwe khungu la thupi loposa 30% limatayika.
Matenda onsewa ndi oopsa kwambiri, choncho wodwalayo ayenera kugonekedwa m'chipatala , nthawi zina m'chipinda chosamalira odwala kwambiri (ICU) kapena chipinda chotenthedwa.
Ndani amene ali ndi mwayi waukulu wopeza matendawa?
Ngakhale kuti matenda a SJS amatha kuchitika pa msinkhu uliwonse, amapezeka kwambiri mwa ana ndi achinyamata osakwana zaka 30. Amapezekanso mwa okalamba. Matenda a SJS amapezeka kwambiri mwa akazi kuposa amuna.
Pali kusiyana pang'ono poyang'ana chifukwa chake:
- Chifukwa chachikulu cha matenda a SJS mwa ana ndi matenda opatsirana monga chibayo .
- Chifukwa chachikulu cha SJS/TEN mwa akuluakulu ndi kusamvana ndi mankhwala .
Kodi zizindikiro za SJS ndi ziti kwenikweni?
Ndikofunikira kwambiri kudziwa zizindikiro izi, chifukwa mukazindikira msanga, mudzapeza chithandizo msanga. Zizindikiro nthawi zambiri zimawonekera mkati mwa sabata imodzi kapena zitatu mutayamba kumwa mankhwala.
Zizindikiro zoyamba ndi zizindikiro zofala za chimfine monga kutentha thupi, kupweteka kwa thupi, mutu, ndi chifuwa. Izi zimapangitsa kuti zikhale zovuta kuzindikira matenda a SJS masiku oyambirira. Pamenepo ndi pomwe zizindikiro zazikulu za pakhungu zimawonekera.
Pansipa pali zizindikiro zazikulu za SJS.
| Chizindikiro | Kufotokoza mwachidule |
|---|---|
| Kupweteka kwambiri pakhungu | Kumva ululu woyaka kwambiri moti simungathe kukhudza khungu lanu. |
| Malungo ndi kupweteka kwa thupi | Zizindikiro zake ndi monga kutentha thupi kwambiri, kupweteka thupi, komanso mutu. |
| Madontho ofiira ndi mabala | Madontho ofiira kapena zilonda zomwe zimayambira pankhope ndi pachifuwa ndikufalikira thupi lonse. |
| Matuza ndi mabala | Matuza ndi zilonda zopweteka pakhungu, mkati mwa pakamwa, pakhosi, m'maso, m'mimba, ndi m'matumbo. |
| Kuchotsa khungu | Matuza amaphulika ndipo khungu la pamwamba limatuluka ngati ma flakes akuluakulu. |
| Kutulutsa malovu mkamwa | Kutulutsa madzi chifukwa cha zilonda pakamwa, kulephera kutseka pakamwa. |
| Kuyang'ana maso | Matuza ndi kutupa m'maso, zomwe zimapangitsa kuti zikhale zovuta kutsegula maso. |
| Ululu pokodza | Ululu waukulu panthawi yokodza chifukwa cha kutupa kwa nembanemba ya mucous. |
Zifukwa zazikulu ndi mitundu ya mankhwala omwe angayambitse SJS
Chifukwa chachikulu cha SJS ndi kusamvana ndi mankhwala enaake. Komabe, izi sizimachitika ndi mankhwala onse. Pali mitundu ingapo ya mankhwala omwe angayambitse SJS.
| Chifukwa | Kufotokozera |
|---|---|
| Matenda a chifuwa cha mankhwala | Ichi ndi chomwe chimayambitsa milandu yambiri ya SJS ndi TEN. |
| Matenda | Makamaka kwa ana, izi zitha kuchitika chifukwa cha matenda monga Mycoplasma pneumonia, Herpes, ndi Hepatitis A. |
| Zifukwa zina | Matenda a graft-versus-host, vuto lomwe limachitika pambuyo poika mafupa enaake, katemera (kawirikawiri), ndipo nthawi zina palibe chifukwa chomwe chingapezeke. |
Mankhwala omwe ali ndi chiopsezo chachikulu choyambitsa SJS
- Mankhwala oletsa mabakiteriya otchedwa sulfa: Mitundu ina ya maantibayotiki.
- Mankhwala oletsa khunyu: Mwachitsanzo, mankhwala monga `Phenytoin (Dilantin®)`, `Carbamazepine (Tegretol®)`, `Lamotrigine (Lamictal®)`, `Phenobarbital (Luminal®)`.
- Allopurinol: Mankhwala ogwiritsidwa ntchito pochiza gout ndi mitundu ina ya miyala ya impso (`Aloprim®`, `Zyloprim®`).
- Mankhwala oletsa ululu (NSAIDs): Mankhwala oletsa ululu osagwiritsa ntchito steroidal monga `Piroxicam (Feldene®)`, `Diclofenac (Cambia®, Flector®)`. Mankhwala ena monga `Nevirapine (Viramune®)`.
- Maantibayotiki Ena: Mitundu ina ya maantibayotiki ingayambitsenso izi.
Chofunika: Si aliyense amene angatenge matenda a SJS kuchokera ku mankhwala omwe atchulidwa pano. Anthu mamiliyoni ambiri amagwiritsa ntchito mankhwalawa. Komabe, mankhwala awa apezeka kuti ali ndi chiopsezo chachikulu chotenga matenda a SJS. Musasiye kumwa mankhwala omwe dokotala wakupatsani malinga ndi nkhaniyi.
Kuzindikira ndi kuchiza matendawa
Ngati inu kapena munthu amene mumamudziwa akukumana ndi zizindikiro zomwe zili pamwambapa, makamaka ngati mwangoyamba kumene kumwa mankhwala atsopano, ndikofunikira kupita ku Dipatimenti Yodzidzimutsa (ETU) ya chipatala chapafupi nthawi yomweyo .
Madokotala amazindikira matendawa pochita izi:
- Mwa kufufuza khungu lanu ndi nembanemba ya mucous (monga pakamwa, maso).
- Mwa kufunsa za kuchuluka kwa ululu womwe mukumva.
- Poona momwe zizindikiro za pakhungu zimafalikira komanso kuchuluka kwa kufalikira kwake.
- Ngati kuli kofunikira, chidutswa chaching'ono cha khungu chikhoza kutengedwa ndikuyesedwa (kujambula khungu).
Chithandizo cha SJS
Zolinga zazikulu za chithandizo cha SJS ndikuletsa mankhwala omwe amayambitsa matendawa, kuwongolera zizindikiro, kupewa mavuto, komanso kuthandiza khungu kuchira. Kugonekedwa kuchipatala ndikofunikira pa izi.
Njira zina zochiritsira zalembedwa pansipa:
| Njira yochizira | Kufotokozera |
|---|---|
| Kusiya kugwiritsa ntchito mankhwala oyambitsa matendawa | Iyi ndi sitepe yoyamba komanso yofunika kwambiri. Mankhwala omwe akuganiziridwa kuti amayambitsa SJS amasiya nthawi yomweyo. |
| Kupereka madzi ndi mchere m'thupi | Kutuluka kwa khungu kumapangitsa kuti madzi ambiri atuluke m'thupi, choncho madzi a m'mitsempha amagwiritsidwa ntchito kupereka madzi ndi ma electrolyte ofunikira. |
| Chithandizo cha khungu | Khungu lovulala limakutidwa ndi zomatira zapadera zosamatira, monga momwe zimachitira ndi kupsa. |
| Kupereka zakudya | Kudya n'kovuta chifukwa cha zilonda za m'kamwa. Popeza zimafunika mphamvu zambiri kuti munthu achire, chakudya chokhala ndi ma calories ambiri chimaperekedwa kudzera mu chubu chomwe chimadutsa m'mphuno kupita m'mimba (kuyamwitsa m'chubu). |
| Kulamulira ululu | Uwu ndi vuto lopweteka kwambiri, choncho mankhwala amphamvu ochepetsa ululu amaperekedwa. |
| Utumiki wachipatala wapadera | Funsani thandizo kwa dokotala wa khungu, ndipo ngati maso akhudzidwa, funsani dokotala wa maso. |
Mavuto a SJS ndi zotsatira zake mutachira
Matenda a SJS ndi matenda oopsa kwambiri omwe angayambitse imfa. Pafupifupi 10% ya odwala omwe ali ndi matenda a SJS ndi 50% ya odwala omwe ali ndi matenda oopsa kwambiri, TEN, amafa. Zomwe zimayambitsa imfa ndi mavuto aakulu monga sepsis, chibayo, komanso kulephera kwa ziwalo zambiri.
Ngakhale matendawa atachiritsidwa, anthu ena akhoza kukhala ndi zotsatirapo zake kwa nthawi yayitali.
- Kusintha kwa khungu: Khungu louma, kuyabwa, kusintha mtundu wa khungu.
- Mavuto a maso: maso ouma, kusamva bwino kwa maso pafupipafupi, kusawona bwino, kuvutika kuyang'ana kuwala (photophobia).
- Zina: Kutuluka thukuta kwambiri, kuwonongeka kwa mapapo, kutayika kapena kupunduka kwa misomali, kutayika tsitsi, kusokonezeka kwa kukoma.
Chofunika Kwambiri: Ngati mwakumananso ndi mankhwala omwe adayambitsa SJS, kachiwiri vutoli likhoza kukhala loopsa kwambiri kuposa loyamba. Chifukwa chake, ndikofunikira kukumbukira dzina la mankhwala omwe adayambitsa SJS ndi mankhwala ena ofanana nawo kwa moyo wanu wonse ndikudziwitsa dokotala aliyense amene mumapita naye.
Uthenga Wopita Nawo Kunyumba
- Matenda a Stevens-Johnson (SJS) ndi vuto lalikulu la khungu lomwe limaika moyo pachiswe, lomwe nthawi zambiri limayamba chifukwa cha mankhwala.
- Zizindikiro zoyamba zimaphatikizapo malungo ndi kupweteka kwa thupi, koma pambuyo pake zimakhala ndi mawanga ofiira opweteka pakhungu, matuza, ndi khungu lotupa.
- Ngati mukumva zizindikiro izi mutayamba kumwa mankhwala atsopano, pitani ku Dipatimenti Yothandiza Anthu Odwala Mwadzidzidzi (ETU) ya chipatala nthawi yomweyo.
- Chithandizo chachikulu ndi kuzindikira ndi kuletsa mankhwala omwe amayambitsa matendawa, ndikupereka chithandizo chothandizira kuchipatala.
- Kumbukirani dzina la mankhwala omwe adayambitsa matenda anu a SJS kwa moyo wanu wonse ndipo dziwitsani dokotala wanu za izi nthawi iliyonse mukapita kukalandira chithandizo. Izi zitha kupulumutsa moyo wanu.
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