Wakambova nekukuvara kudiki here kwausingakwanise kumisa kubuda ropa kwenguva yakareba? Kana kuti unowana mavanga makuru ebhuruu kunyangwe mushure mekukuvadzwa zvishoma? Dzimwe nguva tinofunga kuti izvi zvinhu zvakajairika, asi zvinogona kunge zviri chiratidzo chedambudziko diki neropa redu. Nhasi, tichataura nezvechirwere chisinganyanyi kutaurwa nezvacho asi chinowanzoitika chinokanganisa kuumbwa kweropa. Ndiro chirwere chevon Willebrand.
Zvichitaurwa zviri nyore, chii chinonzi chirwere chevon Willebrand (VWD)?
Chirwere chevon Willebrand (VWD) chirwere chinoitika kana maitiro edu ekugwamba kweropa asingashande nemazvo. Chinonyanya kuoneka sekusasimba kwemuviri wedu kupfuura chirwere.
Fungidzira, kana tikachekwa mutsinga dzeropa, karudzi kadiki kemasero (platelets) mumuviri wedu kanosvika pakumisa kubuda kweropa uye kanovhara ronda. Zvakafanana nekuzadza buri pamadziro nezvidhinha. Maplatelet aya anonamirana pamwe chete uye ane puroteni yakaita se "chingamu" muropa redu inovabatsira kuumba clot yakasimba. Ndizvo zvatinodaidza kuti von Willebrand factor (VWF) .
Munhu ane VWD anogona kunge asina puroteni iyi yeVWF yakakwana mumuviri wake, kana kuti puroteni yaanayo inogona kusashanda zvakanaka. Zvadaro, nekuda kwekuti ropa harina kuumbwa zvakanaka, zvinotora nguva yakareba kuti ropa rimire kunyangwe kubva pakukuvara kudiki.
Ichi ndicho chirwere chekubuda ropa chakajairika pasi rose. Zvinofungidzirwa kuti munhu mumwe chete pavanhu zana anogona kunge aine chirwere ichi.
Ndedzipi mhando huru dzeVWD?
Dambudziko iri rakakamurwa kuita mhando nhatu. Kunewo rudzi rusina kuzvarwa narwo asi runozobuda gare gare.
| Rudzi | Tsananguro |
|---|---|
| Rudzi 1 | Iyi ndiyo mhando inonyanya kuwanikwa (pakati pe60% - 80%). Inokonzerwa nekushomeka kweprotein yeVWF mumuviri. Zviratidzo zvinowanzova zvishoma. |
| Rudzi rwechipiri | Rudzi rwechipiri rwakajairika (pakati pe15% - 30%). Kunyangwe puroteni yeVWF iripo pano, basa rayo harina kusimba. Yakafanana negum rekare, haibatsiri kunyangwe iripo. Zviratidzo zvinogona kuva zvishoma kusvika pakati nepakati. |
| Rudzi rwechitatu | Urwu ndirwo rudzi rwakanyanya kuoma uye rusingawanzoitiki. Pano, puroteni yeVWF inenge isipo zvachose mumuviri. Saka, zviratidzo zvacho zvakanyanya. |
| VWD yakawanikwa | Ichi hachisi chinhu chaunozvarwa nacho. Chinogona kukura gare gare nekuda kwezvimwe zvirwere zvinorwisa muviri (semuenzaniso lupus), chirwere chemwoyo, mamwe marudzi ekenza, kana mishonga yaunotora. |
Ndezvipi zviratidzo zvechirwere ichi?
Zviratidzo zvinosiyana zvichienderana nerudzi rweVWD yaunayo.
Zviratidzo zviri pakati nepakati uye zvisina kusimba zverudzi rwe1 nerwe2
- Kunyangwe kukuvara kudiki kunogona kukonzera kukuvara kukuru kwebhuruu: Unoona here kuti muviri wako uri kuchinja ruvara rwebhuruu munzvimbo dzakasiyana?
- Kubuda ropa mumhino kakawanda: Vamwe vanhu vanobuda ropa mumhino kakawanda, uye zvinonetsa kumisa.
- Kubuda ropa rakawanda mushure mekuvhiyiwa kana kubviswa kwezino: Kubuda ropa hakugumi kwemaawa here mushure mekubviswa kwezino?
- Vakadzi vanobuda ropa rakawanda panguva yekutevera: Kubuda ropa kwacho kwakanyanya here zvekuti unotofanira kuchinja pedhi yako kanenge kamwe chete paawa? Kunouya nemapundu here? Nekufamba kwenguva, izvi zvinogona kukonzera anemia yekushomeka kwesimbi.
- Ropa mutsvina kana weti.
Zviratidzo zvakakomba zverudzi rwechitatu
Murudzi urwu, zviratidzo zvese zvataurwa pamusoro apa zvinogona kuva zvakanyanya. Pamusoro pezvo,
- Kubuda ropa kwakanyanya kamwe kamwe pasina chikonzero.
- Ropa rinobuda richidonhera mumajoini nenyama dzakapfava, zvichikonzera kuzvimba nekurwadziwa kwakanyanya.
Chinhu chakakosha ndechekuti havasi vese vane zviratidzo izvi vane chirwere cheVWD. Asi kana uine chimwe chezviratidzo izvi nguva dzose, zvakanaka kuti unoona chiremba kuti akupe mazano.
Unozviziva sei izvi?
Chiremba wako achatanga nekubvunza nezvezviratidzo zvako uye nhoroondo yezveutano hwemhuri yako. Nekuti ichi chirwere chenhaka, zvakakosha kuti uzive kana paine mumwe munhu mumhuri yako akambova nedambudziko rerudzi urwu rekubuda ropa.
Zvadaro, vachaita bvunzo dzakakosha kuti vaone kuti zvinotora nguva yakareba sei kuti ropa rako rigwambe uye kuti rinogwamba zvakanaka sei.
- Kuyera huwandu hweVWF protein muropa (Antigen test).
- Kuedza mashandiro epuroteni iyoyo.
Dzimwe nguva, zvinhu zvakaita sekushushikana uye kurovedza muviri zvinogona kuchinja huwandu hweVWF, saka ungangoda kuti bvunzo idzi dziitwe kanopfuura kamwe chete kuti uwane mhinduro dzakarurama.
Mishonga yacho ndeipi? Nzira yekurapa nayo sei?
Kunyange hazvo chirwere cheVWD chisingarapiki, chinogona kudzorwa uye kutarisirwa kuti chirarame hupenyu hwakajairika. Chinhu chakakosha ndechekuderedza njodzi yekubuda ropa.
1. Kudzivisa mimwe mishonga
Unofanira kudzivisa kushandisa mimwe mishonga inodzikisa ropa. Chiremba wako anowanzo kukuudza kuti usatore aspirin neNSAIDs (dzakadai se ibuprofen ne naproxen). Acetaminophen inzira yakachengeteka yekurapa kurwadziwa kana fivha. Asi iva nechokwadi chekubvunza chiremba wako usati watora chero mushonga.
2. Kurapa kwakananga
Kurapwa kunoenderana nekuoma uye rudzi rwezviratidzo zvako.
- Desmopressin Acetate (DDAVP): Iyi ndiyo nzira inonyanya kushandiswa yekurapa. Inogona kupihwa semushonga wekupfapfaidza mumhino kana jekiseni. Inoshanda nekukurudzira kuburitswa kweprotein yeVWF yakachengetwa mumasero edu muropa. Mushonga uyu unogona kukonzera kuchengetwa kwemvura mumuviri, saka chiremba wako anogona kukukurudzira kuti uderedze kunwa mvura mumuviri wako.
- Zvinhu Zvinoumba Mavhinga: Chinhu chine puroteni yeVWF inopihwa netsinga (IV). Izvi zvinowanzo shandiswa muzviitiko zvakakomba uye vasati vavhiyiwa.
- Mimwe mishonga: Kana mazino abviswa, mapiritsi kana mishonga yemvura yakaita seaminocaproic acid kana tranexamic acid inogona kupihwa kudzivirira ropa kuti risanyungudike.
- Kurapa kwakakosha kwevakadzi: Kune vakadzi vane mwedzi wakawandisa, mapiritsi ekudzivirira pamuviri anogona kuwedzera huwandu hweVWF. Kunewo nzira dzakadai sekupfeka loop ine mahormone (levonorgestrel intrauterine device) kana kubvisa dumbu rechibereko (endometrial ablation).
Chekupedzisira, kana uine chirwere chakanyanya seType 3, kana ukabuda ropa, idambudziko. Unofanira kuenda kuEmergency Department yechipatara (ETU) nekukasika. Kunonoka kunogona kuisa hupenyu panjodzi.
Mharidzo Yekuenda Nayo Kumba
- Chirwere chevon Willebrand (VWD) chirwere chinowanzoitika, chinogara nhaka chinokanganisa maitiro ekugwamba kweropa.
- Kana uine zviratidzo zvakaita sekunge uri kugara uchitsvuka, kubuda ropa mumhino, kana kubuda ropa rakawanda panguva yekuenda kumwedzi, funga nezvazvo.
- Kana uine zviratidzo izvi, usatya kuona chiremba ane hunyanzvi uye kutsvaga mazano.
- Kana wakamboonekwa uine VWD, usatore aspirin kana NSAID mishonga inonyaradza marwadzo zvachose usina kupiwa mazano nachiremba.
- Kana ukabatwa zvakanaka uye uchirapwa, unogona kurarama hupenyu hwakanaka uye hwakajairika uine chirwere ichi.
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