Fungidzira kuti une fivha, kurwadziwa kwemuviri, wotanga kutora mushonga wawakanyorerwa nachiremba. Ko kana, mukati memazuva mashoma, pamwe vhiki imwe kana maviri, ukangoerekana wava nemavanga matsvuku pamuviri wako, maronda mumuromo mako, mumaziso ako, uye munhengo dzako dzesikarudzi, uye ganda rako rotanga kusviba nekubuda serakatsva? Ichi chirwere chinotyisa zvechokwadi, chine njodzi zvikuru, uye chisingawanzoitiki. Nhasi tichataura nezvechirwere ichi chinonzi Stevens-Johnson Syndrome (SJS). Zvakakosha kuti munhu wese azive izvi.
Chii chinonzi SJS neTEN? Ndeupi musiyano uripo pakati pezviviri izvi?
Stevens-Johnson Syndrome (SJS) chirwere chinokonzerwa nekusagadzikana kwakanyanya mumuviri, kazhinji nemushonga. Izvi zvinosanganisira kukuvara kweganda redu nemukati me ...
Kune imwe mhando yakakomba yechirwere ichi, yatinodaidza kuti Toxic Epidermal Necrolysis (TEN) . Zvichitaurwa zviri nyore, SJS neTEN zvakafanana nemativi maviri echirwere chimwe chete.
- SJS (Stevens-Johnson Syndrome): Muchiitiko ichi , pasi pe10% yeganda remuviri rinobviswa.
- TEN (Toxic Epidermal Necrolysis): Ichi chirwere chakakomba uye chinogona kuisa hupenyu panjodzi umo ganda remuviri rinodarika 30% .
Matambudziko ese aya akakomba zvikuru, saka murwere anofanira kuendeswa kuchipatara , dzimwe nguva muchikamu chevarwere vane chirwere chakanyanya (ICU) kana muchikamu chekutsva.
Ndiani ane mukana mukuru wekuwana chirwere ichi?
Kunyange zvazvo SJS ichigona kuitika chero pazera ripi zvaro, inonyanya kuitika kuvana nevechidiki vari pasi pemakore makumi matatu. Inogonawo kuitika kuvanhu vakuru. SJS inowanikwa zvishoma muvakadzi kupfuura varume.
Pane musiyano mudiki pakutarisa chikonzero:
- Chikonzero chikuru cheSJS muvana zvirwere zvinotapukira zvakaita sepneumonia .
- Chikonzero chikuru cheSJS/TEN muvanhu vakuru imhaka yekuti munhu ane allergy kana anwa mushonga .
Ndezvipi chaizvo zviratidzo zveSJS?
Zvakakosha kuziva zviratidzo izvi, nekuti kana ukangozviziva nekukurumidza, ndipo paunokwanisa kutsvaga kurapwa nekukurumidza. Zviratidzo zvinowanzoonekwa mukati mevhiki imwe kana nhatu mushure mekutanga kushandisa mushonga.
Zviratidzo zvekutanga zviratidzo zvechikosoro chakajairika zvakaita sefivha, kurwadziwa kwemuviri, musoro, uye kukosora. Izvi zvinoita kuti zviome kuona SJS mumazuva ekutanga. Ndipo chete panobva zviratidzo zveganda zvakakomba.
Heano zviratidzo zvikuru zveSJS.
| Chiratidzo | Zvakatsanangurwa zviri nyore |
|---|---|
| Kurwadziwa kwakanyanya kweganda | Kunzwa kurwadziwa kwakanyanya zvekuti haugone kubata ganda rako. |
| Fivha nekurwadziwa kwemuviri | Zviratidzo zvinosanganisira fivha yakanyanya, kurwadziwa kwemuviri, uye musoro. |
| Mavara matsvuku nematamba | Mavara matsvuku kana maronda anotangira pachiso nepachipfuva opararira mumuviri wese. |
| Maronda nemaronda | Maronda nemaronda anorwadza paganda, mukati memuromo, pahuro, mumaziso, panhengo dzesikarudzi, uye mudura. |
| Kubviswa kweganda | Maronda anoputika uye ganda repamusoro rinobuda kuita maburi makuru. |
| Kusvipa mate kubva mumuromo | Kudonhedza mate nekuda kwemaronda emuromo, kutadza kuvhara muromo. |
| Kutarisa maziso | Mapundu nekuzvimba mumaziso, zvichiita kuti zviome kuvhura maziso. |
| Marwadzo panguva yekuzviitira weti | Kurwadziwa kwakanyanya panguva yekuzviitira weti nekuda kwekuputika kwematumbu emudumbu. |
Zvikonzero zvikuru uye mhando dzemishonga inogona kukonzera SJS
Chikonzero chikuru cheSJS imhaka yekuti munhu ane allergy kune mumwe mushonga. Zvisinei, izvi hazviitike nemishonga yese. Kune mhando dzakasiyana dzemishonga dzinogona kukonzera SJS.
| Chikonzero | Tsananguro |
|---|---|
| Kurwara nemishonga | Izvi ndizvo zvinokonzera nyaya zhinji dzeSJS neTEN. |
| Utachiona | Kunyanya kuvana, zvinogona kukonzerwa nehutachiona hwakadai seMycoplasma pneumonia, Herpes, uye Hepatitis A. |
| Zvimwe zvikonzero | Chirwere chegraft-versus-host, dambudziko rinowanzoitika mushure mekuisirwa mubofu, majekiseni (kashoma), uye dzimwe nguva hapana chikonzero chingawanikwe. |
Mishonga ine njodzi yakakura yekukonzera SJS
- Mishonga yesulfa inorwisa mabhakitiriya: Mamwe marudzi emishonga inorwisa mabhakitiriya.
- Mishonga yekurwisa pfari: Semuenzaniso, mishonga yakaita se`Phenytoin (Dilantin®)`,`Carbamazepine (Tegretol®)`,`Lamotrigine (Lamictal®)`,`Phenobarbital (Luminal®)`.
- Allopurinol: Mushonga unoshandiswa kurapa gout nemamwe marudzi ematombo eitsvo (`Aloprim®`, `Zyloprim®`).
- Mishonga inouraya marwadzo (NSAIDs): Mishonga inouraya marwadzo isiri steroidal yakaita se'Piroxicam (Feldene®)`, `Diclofenac (Cambia®, Flector®)`. Mimwe mishonga yakaita se'Nevirapine (Viramune®)`.
- Mamwe Mishonga Inorwisa Mabhakitiriya: Mamwe marudzi emishonga inorwisa mabhakitiriya anogonawo kukonzera izvi.
Zvakakosha: Havasi vese vanozowana SJS kubva pamishonga yakanyorwa pano. Mamiriyoni evanhu vanoishandisa. Zvisinei, mishonga iyi yakaonekwa seine njodzi huru yekubatwa neSJS. Usamborega kutora mushonga wakanyorerwa nachiremba zvichibva pane chinyorwa chino.
Kuongororwa uye kurapwa kwechirwere ichi
Kana iwe kana mumwe munhu waunoziva akasangana nezviratidzo zviri pamusoro apa, kunyanya kana uchangotanga mushonga mutsva, zvakakosha kuti uende kuEmergency Department (ETU) yechipatara chiri pedyo nekukurumidza .
Vanachiremba vanoongorora chirwere ichi ne:
- Nekuongorora ganda rako nemukati memukati (semuromo, maziso).
- Nekubvunza nezvekurwadziwa kwauri kunzwa.
- Nekutarisa mwero wezvinoratidza ganda uye kuti zvapararira zvakadii.
- Kana zvichidikanwa, ganda diki rinogona kutorwa roongororwa (biopsy yeganda).
Kurapa kweSJS
Chinangwa chikuru chekurapa SJS ndechekumisa mushonga wakakonzera chirwere, kudzora zviratidzo, kudzivirira matambudziko, uye kubatsira ganda kuti ripore. Kupinda muchipatara kwakakosha kuti izvi zviitike.
Dzimwe nzira dzekurapa dzakanyorwa pazasi:
| Nzira yekurapa | Tsananguro |
|---|---|
| Kurega mushonga unokonzera chirwere | Iri ndiro danho rekutanga uye rinokosha zvikuru. Mushonga unofungidzirwa kuti unokonzera SJS unomiswa ipapo ipapo. |
| Kupa muviri mvura nemunyu | Kubviswa kweganda kunoita kuti mvura yakawanda irasikirwe mumuviri, saka mvura inobuda mutsinga dzeropa inoshandiswa kupa mvura inodiwa uye ma electrolytes. |
| Kurapa ganda | Ganda rakakuvara rinofukidzwa nemachira asina kunamira, sekurapa kutsva. |
| Kupa chikafu | Zvakaoma kudya nekuda kwemaronda emuromo. Sezvo zvichitora simba rakawanda kuti zvipore, chikafu chine macalorie akawanda chinopihwa kuburikidza nechubhu inopfuudzwa nemumhino ichipinda mudumbu (kudyisa munhu nechubhu). |
| Kudzora marwadzo | Ichi chirwere chinorwadza zvikuru, saka mishonga ine simba yekurwadziwa kwemusoro inopihwa. |
| Basa rekurapa renyanzvi | Tsvaga rubatsiro kubva kuna chiremba weganda, uye kana maziso akanganiswa, tsvaga chiremba wemaziso. |
Matambudziko eSJS uye migumisiro mushure mekupora
SJS chirwere chakakomba zvikuru chinogona kutokonzera rufu. Vanenge 10% yevarwere vane SJS uye vanosvika 50% yevarwere vane fomu yakaipisisa, TEN, vanofa. Zvikonzero zvikuru zverufu matambudziko akakomba akadai se sepsis, pneumonia, uye kutadza kushanda kwenhengo dzakawanda dzemuviri.
Kunyangwe chirwere chikarapwa, vamwe vanhu vanogona kusangana nemigumisiro yenguva refu.
- Kuchinja kweganda: Ganda rakaoma, kuvaviwa, ganda kuchinja ruvara.
- Matambudziko emaziso: maziso akaoma, kusanzwa zvakanaka kwemaziso nguva nenguva, kuona zvisizvo, kuoma kutarisa chiedza (photophobia).
- Zvimwe: Kudikitira zvakanyanya, kukuvara kwemapapu, kurasikirwa kana kuremara kwenzara, kurasikirwa nebvudzi, kusagadzikana kwekunaka.
Zvakakosha: Kana ukadzoserwa kumushonga wakakonzera SJS, kechipiri chirwere chacho chinogona kunge chakanyanya kuipa kupfuura chekutanga. Saka, zvakakosha kuyeuka zita remushonga wakakonzera SJS nemishonga yakafanana kweupenyu hwako hwese uye kuzivisa chiremba wese waunoona.
Mharidzo Yekuenda Nayo Kumba
- Stevens-Johnson Syndrome (SJS) chirwere cheganda chinouraya, chinowanzo konzerwa nemushonga.
- Zviratidzo zvekutanga zvinosanganisira fivha nekurwadziwa kwemuviri, asi gare gare zvinozoguma zvaita mavanga matsvuku anorwadza paganda, maronda, uye ganda rinotanga kusvuuka.
- Kana ukaona zviratidzo izvi mushure mekutanga mushonga mutsva, enda kuchipatara kuEmergency Department (ETU) nekukasika pasina kunonoka.
- Kurapa kukuru ndekwekuona nekumisa mushonga wakakonzera chirwere ichi, uye kupa rubatsiro rwekutsigira muchipatara.
- Rangarira zita remushonga wakakonzera SJS yako kweupenyu hwako hwese uye zivisa chiremba wako nezvazvo pese paunoenda kunorapwa. Izvi zvinogona kuponesa hupenyu hwako.
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