Ese hari ikibazo gikomeye mu mubiri wawe? Reka twige kuri Waterhouse-Friderichsen Syndrome!

Ese wigeze wumva ko imitsi ibiri mito mu mubiri ihagarika gukora, kandi bishobora kugira ingaruka zikomeye ku buzima bwawe? Uyu munsi tugiye kuvuga ku ndwara nk'iyi iteje akaga cyane, kandi iyo idavuwe vuba, ishobora kwica. Iyi ndwara yitwa Waterhouse-Friderichsen Syndrome. Nubwo izina rishobora gusa nkaho ari rirerure, reka tuvuge gusa icyo ari cyo, impamvu ibaho, n'uko warokoka.

Iyi ndwara ya Waterhouse-Friderichsen ni iyihe?

Mu magambo make, Waterhouse-Friderichsen Syndrome (WFS) ni indwara ikomeye cyane. Ikibaho ni uko imiterere y’uturemangingo tw’inkende , ari two tubiri duto turi hejuru y’impyiko zawe, iva amaraso (tubyita 'kuva amaraso mu nzende') kandi imwe muri izi ngirabuzimafatizo cyangwa zombi zigahagarika gukora. Akenshi, ibi biterwa n’ubwandu bukomeye. Iyo zitavuwe, izi ngirabuzimafatizo zihagarika burundu gukora imisemburo ya cortisol, ikenewe ku mubiri wacu. Ibi ni byo twita ikibazo cy’inkendezo . Mu by’ukuri, ni ikibazo cyihutirwa!

Hari irindi zina ry’ibi, ari ryo "hemorrhagic adrenalite." Ibyo bivuze ko imyakura y’inkende iva amaraso ikabyimba.

Iyi ndwara ikunze kugaragara gute?

Mu by’ukuri, indwara ya Waterhouse-Friderickson ikunze kugaragara cyane . Ubusanzwe, gusuzuma imirambo bigaragaza ko iyi ndwara ari yo nyirabayazana w’impfu zigera kuri 1% gusa. Ibi bivuze ko atari indwara yibasira buri wese, ariko iyo ibayeho, iba ari mbi cyane.

Ni ibihe bimenyetso by'iyi ndwara?

Tekereza, wanduye virusi cyangwa bagiteri mu buryo butunguranye maze ukarwara iyi ndwara ya WFS. Hanyuma ushobora gutangira kugaragaza ibimenyetso by'ubwandu mu buryo butunguranye. Uzi icyo ari cyo?

• Ndimo kurwara umuriro mwinshi.
• Umubiri wumva ubukonje kandi ugahinda umushyitsi (ubukonje).
• Umutwe wanjye urambabaza cyane.
• Ngiye kuruka, ngiye kuruka.
• Imitsi yo mu mubiri wanjye irababara, cyane cyane ahantu nko mu gice cyo hasi cy'umugongo, mu nda no mu maguru.
• Ingingo zanjye zirababara.
• Hari igihe umuntu ashobora gutakaza ubwenge (syncope).

Iyo uku kuva amaraso gutangiye kwibasira imisemburo y’intanga ngore ndetse no mu bindi bice by’umubiri, hari ibindi bimenyetso bishobora kugaragara. Ibi birimo:

• Gufungana kw'imitsi mu maraso (DIC): Ibi bisa nkaho bigoye, si byo se? Mu magambo make, ni indwara aho inzira yo kuvura amaraso mu mubiri wose ihinduka nk'iy'urubura. Iyo amaraso acitse ahantu hamwe, ntashobora guhagarika kuva amaraso ahandi.
• Uduheri ku ruhu:Hari igihe bishobora kugaragara ku ruhu nk'utudomo duto cyangwa utudomo tunini.
• Ihungabana ry'amaraso: Iyi ni indwara aho umuvuduko w'amaraso ugabanuka cyane bitewe n'ubwandu, bigatuma ingingo z'umubiri zidakira amaraso ahagije. Ibi nabyo ni bibi cyane.

Ni ibihe bimenyetso by'amaraso ava mu ngirabuzimafatizo z'inkende?

WFS ifitanye isano no kuva amaraso mu ndurwe, bishobora guherekezwa n'ibindi bimenyetso:

• Kubabara mu nda.
• Kubabara ahantu hejuru y'ikibuno, munsi y'imbavu (ikibuno).
• Kubabara mu mutwe, kumva utameze neza.
• Ubunebwe.
• Isesemi no kuruka.
• Impiswi.

Ni iki gitera ibi?

Akenshi, impamvu nyamukuru itera indwara ya Waterhouse-Friderickson ni indwara zandura bagiteri na virusi (sepsis) . Mu by'ukuri, mikorobe yinjira mu mubiri igakwirakwira mu mubiri wose nta kugenzurwa.

Hari ubwoko bumwe na bumwe bwa bagiteri bushobora kwibasirwa cyane n'iki kibazo. Dore ingero nke:

• `Pseudomonas aeruginosa`
• Bagiteri ya Meningococcus: Iyi ni yo iteje akaga cyane ishobora gutera WFS.
• `Streptococcus pneumoniae`
• `Influenzae ya Haemophilus`
• `Escherichia coli (E. coli)`
• 'Staphylococcus aureus'

Hari ubundi bwoko bwinshi bwa bagiteri bushobora gutera ibi.

Nanone, ubwoko bumwe na bumwe bwa virusi bushobora gutera ibi:

• Virusi ya Cytomegalovirus (CMV)
• Virusi ya Parvovirusi `(Parvovirusi)`
• Virusi ya Epstein-Barr
• Virusi ya Ebola `(indwara ya virusi ya Ebola)`
• Virusi ya Varicella-zoster (iyi ni yo itera indwara nka nyonko na herpes)

Uretse izi ndwara, hari n'ibindi bintu bishobora gutera WFS:

• Gukoresha imiti igabanya amaraso. Iyi miti yongera ibyago byo kuva amaraso.
• Thrombocytopenia: Ibi bivuze kugabanuka k'umubare wa platelets (uturemangingo dufasha kubumba amaraso) mu maraso.
• Udukoko tw’intanga ngabo twangiritse mu buryo runaka.

Ni nde ugerwaho n'iki kibazo cyane?

Indwara ya Waterhouse-Friderickson ikunze kugaragara mu bana bato kurusha abantu bakuru . Kubwibyo, niba umwana muto agaragaje ibimenyetso nk'umuriro n'ububabare bw'umubiri, ugomba kwitonda cyane.

Ni izihe ngorane ibi bishobora gutera?

Iki ni cyo kintu cy'ingenzi cyane. Iyo idavuwe vuba kandi neza, indwara ya Waterhouse-Friderickson irahitana. Ibyo bivuze ko ishobora gushyira ubuzima mu kaga. Bityo rero, ibi bigomba gufatwa nk'ikibazo cyihutirwa.

Iyi ndwara ipimwa ite?

Kugira ngo umenye iyi ndwara, ukeneye ubufasha bwa muganga. Muganga azakubaza ibimenyetso byawe, abaza indwara zawe za kera, hanyuma asuzume umubiri wawe.

Ariko gusuzuma WFS bishobora kugorana gato, kuko ibimenyetso byayo bisa cyane n'iby'indwara ya septic shock . Kubwibyo, kugira ngo yemeze niba ari WFS, muganga azategeka ibizamini bitandukanye.

Ni ibihe bipimo bikoreshwa mu gusuzuma indwara?

Kugira ngo yemeze niba hari ubwandu, muganga ashobora gukora ibizamini bikurikira:

Ibizamini byo gushushanya

• Isuzuma rya ultrasound cyangwa isuzuma rya CT (computed tomography) rishobora gukorwa kugira ngo harebwe niba amaraso yibumbiye mu ngirabuzimafatizo z'impyiko. Izi suzuma zifata amafoto y'imbere mu mubiri, bityo zikabasha kubona neza ahantu haviriye amaraso.

Gupima amaraso

• Gupima amaraso bishobora kugaragaza neza niba ufite ubwandu bwa bagiteri. Ibi bikubiyemo gufata urushinge ruto mu mutsi uri mu kuboko kwawe, gufata amaraso make, no kuyareba ukoresheje mikorosikopi. Ibi bizareba ibimenyetso by'ubwandu.

Ibipimo bya bagiteri ya meningococcus

Niba muganga atekereza ko impamvu ari bagiteri ya meningococcus, ashobora gukora ibizamini nk'ibi bikurikira:

• Gutobora uruti rw'umugongo/gutobora uruhu rw'umugongo: Ibi bikubiyemo gushyira urushinge ruto mu mugongo wawe wo hasi, hagati y'amagufwa abiri, no gufata amazi make yo mu ruti rw'umugongo. Ibi bishobora kumvikana nk'ibiteye ubwoba, ariko abaganga babikora bitonze.
• Isuzuma ry'uruhu: Niba ufite igisebe ku ruhu rwawe, agace gato k'uruhu kazakurwa muri icyo gisebe kagasuzumwa.
• Ikizamini cya Gram: Icyitegererezo gifatwa mu gace gakekwaho (nk'igikomere) kugira ngo harebwe bagiteri.
• Isesengura ry'inkari: Uzasabwa kunyara mu gikoresho cyihariye. Hanyuma hazapimwa ibimenyetso by'ubwandu bw'inkari.

Ibizamini by'indwara y'inkende (adrenal crisis)

Ibi bizamini bifasha kumenya niba ufite ikibazo cy’impyiko z’intanga ngabo , indwara aho impyiko z’intanga ngabo zidakora neza:

• Ikizamini cyo gukangura imisemburo ya Adrenocorticotropic (ACTH): Muri iki kizamini, muganga wawe aguha urushinge ruto rw'imisemburo yitwa ACTH. Hanyuma, nyuma y'iminota 30 kugeza kuri 60, afata ikizamini cy'amaraso kugira ngo arebe uko imisemburo yawe yakira imisemburo ya ACTH. Iki ni ikizamini gipima uburyo imisemburo yawe ya adrenal ikora.
• Ibipimo by'isukari mu maraso:Hafatwa amaraso make hanyuma hagapimwa ingano y'isukari (glucose) iri muri yo. Urugero rw'isukari rushobora kuba ruto mu gihe cy'ibibazo by'intanga ngabo.
• Ikizamini cya Cortisol: Icyitegererezo cy'amaraso yawe, inkari, amacandwe, cyangwa uruvange rwa bibiri cyangwa bitatu muri ibi bifatwa kugira ngo harebwe ingano ya cortisol ikorwa n'udukoko tw'intanga ngabo.
• Ikizamini cya pH y'amaraso: Icyitegererezo cy'amaraso gifatwa hanyuma igipimo cya aside-base (pH) kikapimwa. Ibi bishobora gukorwa hakoreshejwe ikizamini cya gaze y'amaraso mu mitsi (ABG) cyangwa agakoresho ka electrolyte. Ubusanzwe, pH y'amaraso yacu igomba kuba hagati ya 7.35 na 7.45.
• Isuzuma ry'amaraso ya Potasiyumu: Isuzuma ry'amaraso rigamije gupima ingano ya Potasiyumu mu maraso yawe. Potasiyumu ni intungamubiri ifasha imitsi n'imitsi yacu gukora neza. Izi ntera zishobora guhinduka mu gihe cy'ibibazo by'intanga ngabo.
• Isuzuma ry'amaraso rya Sodiyumu: Isuzuma ry'amaraso ripima ingano ya sodiyumu mu maraso yawe. Sodiyumu nayo ni ingenzi ku mikorere myiza y'imitsi n'imitsi yawe. Izi ngero zishobora no gutandukana.

Ibi bivurwa bite?

Niba ufite WFS, ushobora no kugira sepsis . Bityo rero, ikintu cya mbere abaganga bazakora ni ukugutangira imiti igabanya ubukana bw'ibiyobyabwenge ako kanya mu gihe bakora ibizamini kugira ngo bamenye icyateye WFS. Bazakurikirana kandi urugero rw'umunyu n'amazi yawe.

Iyo ibimenyetso bya sepsis bimaze gukemuka, abaganga bazatangira kuguha imiti yitwa glucocorticoids na mineralocorticoids . Iyi ni imisemburo ya steroid. Glucocorticoids ikora kugira ngo igabanye ububyimbirwe mu mubiri. Mineralocorticoids ikora kugira ngo igenzure urugero rw'umunyu n'amazi mu mubiri wawe. Muri make, ni nko kuguha imisemburo ikorwa n'udukoko tw'inkende (adrenal glands) ariko ntikore.

Ushobora gukenera guterwa amaraso cyangwa uburyo bwitwa angioembolization . Ibi bikubiyemo gukoresha angiogram na embolization (embolization) kugira ngo umenye kandi uhagarike imitsi itanga amaraso mu ngirabuzimafatizo z'intanga. Ibi bikorwa kugira ngo amaraso ahagarike kuva.

Icy'ingenzi kurushaho, nyuma ya WFS, abantu benshi bazakenera gufata indi miti y'imisemburo ubuzima bwabo bwose , kuko iyo adrenal glands yangiritse, ishobora kuba itakibasha gukora imisemburo neza.

Nzumva meze neza vuba gute nyuma yo kuvurwa?

Abantu benshi batangira kumva bameze neza mu cyumweru kimwe cyangwa bibiri uhereye igihe batangiriye kuvurwa. Ariko, nubwo waba umaze gukira neza, ushobora kugira ibibazo bimwe na bimwe by’umubiri cyangwa ibyo mu mutwe mu gihe cy’amezi, cyangwa se imyaka. Urugero:

• Ibiryo nta buryohe bwabyo.
• Ndananiwe cyane.
• Kugorwa no gusinzira (kubura ibitotsi).
• Ingeso yo kurwara byoroshye.
• Guhangayika.
• Kwiheba.

Kubwibyo, ni ngombwa kwibuka ko bishobora gufata igihe kugira ngo umuntu akire neza.

Ni iki wakwitega uramutse urwaye iyi ndwara?

Nkuko twabivuze mbere, iyo itavuwe, WFS iba ari indwara yica. Nta gushidikanya kuri yo.

Ariko, iyo abantu benshi bafite WFS bavuwe hakiri kare kandi neza, bakira. Ariko, ushobora gukenera ubuvuzi bwimbitse, kandi ingaruka za WFS zishobora kumara amezi menshi cyangwa imyaka. Kubwibyo, si ikintu cyo gufata nk'ikintu cyoroshye.

Ese iki kibazo gishobora kwirindwa?

Hari ibintu byinshi wakora kugira ngo ugabanye ibyago byo kurwara indwara ya Waterhouse-Friderickson:

• Gukaraba intoki zawe buri gihe kandi neza bishobora gufasha mu kwirinda kwandura. Iki ni ikintu cyoroshye cyane, ariko gishobora kugufasha kwirinda indwara nyinshi.
• Kubona urukingo rwa bagiteri ya meningococcal ni ingenzi cyane ku bana.
• Niba ukeka ko ufite ubwandu, shaka ubufasha bwihuse. Ntukirengagize umuriro cyangwa inkorora.

Ni gute wiyitaho mu gihe uri gukira?

Uko ugenda ukira, wowe na muganga wawe mugomba gukorera hamwe kugira ngo mutegure gahunda yo kugufasha mu gihe urwaye indwara ikubereye, ifite umutekano kandi ikubereye. Iyo gahunda ishobora kuba ikubiyemo ibintu nk'ibi:

• Humura bihagije. Umubiri n'ubwonko byombi birakeneye kuruhuka.
• Gukurikiza indyo yuzuye izagufasha kugarura imbaraga zawe ni igitekerezo cyiza. Byaba byiza uramutse ubonye inama ku nzobere mu by'imirire kuri ibi.
• Shyiraho intego nto. Urugero, kwicara ku buriri, guhaguruka, kwambara wenyine, kwiyuhagira, kugenda n'amaguru hafi, kuzamuka ingazi.
• Kuganira ku byiyumvo byawe n'umuryango wawe, inshuti zawe, cyangwa umuvuzi ni ingenzi muri ibi bihe bigoye.
• Kora imyitozo ngororamubiri iyo ufite imbaraga n'imbaraga. Tangira buhoro buhoro kandi ukurikize amabwiriza ya muganga wawe.

Ni ryari nkwiye kujya kwa muganga? / Ni ryari nkwiye kujya mu cyumba cy’ubutabazi bw’ibanze?

Niba utarakira neza nyuma yo kuvurwa, cyangwa niba ufite ingorane zo kugera ku ntego zawe zo kugarura ubuzima, menya neza ko wavuganye na muganga wawe.

WFS ni indwara ikomeye ishobora kwica iyo itavuwe. Niba ufite ibimenyetso bya WFS, urugero nk'ubwandu bukomeje kwiyongera kandi budashira, ugomba guhita ujya mu cyumba cy’ubutabazi bw’ibanze (ETU) .Si byiza kubitindaho.

Ni ibihe bibazo ugomba kubaza muganga wawe?

Iyo umenye ko ufite WFS, ushobora kugira ibibazo byinshi. Ntutinye, baza muganga wawe ibibazo nk'ibi kugira ngo ukemure gushidikanya kwawe:

• Wamenya ute ko mfite indwara ya Waterhouse-Friderickson?
• Niba ntarwaye indwara ya Waterhouse-Friderickson, ni iyihe ndwara yindi nagira?
• Ni iyihe mpamvu itera indwara yanjye ya Waterhouse-Friderickson?
• Ese ngomba kubagwa kugira ngo nsane imyakura yanjye y'inkondo y'umura?
• Uratekereza ko nzakira burundu?
• Ese nkeneye gufata imisemburo y'inyongera?
• Nzamara igihe kingana iki ngomba gufata izindi misemburo?

None se, ni ibihe bintu by'ingenzi tugomba kwibuka muri ibi?

Indwara ya Waterhouse-Friderichsen syndrome (WFS) ni indwara ikomeye cyane isaba ubuvuzi bwihuse. Niba ufite kimwe muri ibi bimenyetso, cyangwa niba ufite ubwandu butari bukire, ni ngombwa kujya mu cyumba cy’ubutabazi bwihuse.

Kurikiza amabwiriza yose yo kuvura wahawe na muganga wawe neza. Icyo gihe ni bwo ushobora kugenzura iyi ndwara ya WFS no gukira vuba bishoboka. Wibuke ko kuvurwa hakiri kare bishobora kurokora ubuzima! Nanone, ni ngombwa cyane kwiyitaho neza mu gihe cyo gukira.

Indwara ya Waterhouse -Friderichsen, imisemburo y'inkende, cortisol, sepsis, indwara zandurira mu bihaha, ubuvuzi bwihutirwa, imisemburo