Ingaba umzimba wakho uvuza ulwelo ngolu hlobo? Masithethe ngeCapillary Leak Syndrome!

Ngaba wakha weva ngeCapillary Leak Syndrome? Eli gama lisenokuvakala liyinkimbinkimbi. Kodwa ngokulula, yimeko apho inxalenye yolwelo egazini, ebizwa ngokuba yiplasma, ivuza kwimithambo yegazi emincinci emizimbeni yethu, ebizwa ngokuba yi-capillaries. Olu lwelo luvuza kwimisipha yethu, kwizicubu, kumalungu omzimba, nakwimingxunya yomzimba. Le inokuba yimeko enzima, ngoko ke kubalulekile ukuba uyiqaphele.

Yintoni le nto kuthiwa yi-capillary leak syndrome?

Kulungile, masichaze kancinci. Khawucinge ukuba umzimba wakho unenkqubo yemibhobho yamanzi. Le mibhobho yimithambo yegazi yethu. Le mibhobho mincinci, intle kakhulu apha ibizwa ngokuba yi-capillaries. Le yimibhobho apho ioksijini kunye nezondlo ziya khona kuzo zonke iindawo zomzimba wethu. Ngoko ke, kwi-`(Capillary Leak Syndrome)`, inxalenye engamanzi yegazi, oko kukuthi , i-plasma , ivuza ngale mibhobho mincinci. Kufana namanzi aphuma kumbhobho wamanzi.

Oku kuvuza kolwelo kubangela ukuba ulwelo luqokelele kwiindawo ezahlukeneyo zomzimba. Umzekelo, olu lwelo lunokuvuza lungene kwimisipha, kwizicubu, kwizitho ezahlukeneyo, okanye kwiindawo apho kukho izitho.

Iziqendu zale `(Capillary Leak Syndrome)` zinokwenzeka amaxesha amaninzi ngonyaka, okanye kube kanye ebomini. Nangona kunjalo, ukuba ayinyangwa ngokukhawuleza, uxinzelelo lwakho lwegazi lunokwehla ngequbuliso, nto leyo ekhokelela ekungasebenzini kwamalungu omzimba kwaye ngamanye amaxesha nokufa. Ngoko ke oku akuyonto ifanele ithathwe lula.

Akukho nyango luhlala luhleli loku okwangoku. Nangona kunjalo, kubalulekile ukufuna uncedo lwezonyango ngokukhawuleza ukulawula iimpawu. Ngamanye amaxesha, kunokwenzeka ukuthintela ukuhlaselwa kwixesha elizayo ngokuqhubeka nokusebenzisa amayeza okanye ukufumana i-saline.

Ngaba zikho iintlobo zezi zinto? Zahluke njani?

Ewe, kukho iintlobo ezimbini eziphambili ze-`(Capillary Leak Syndrome)`. Masibone ukuba zeziphi.

• I-Systemic Capillary Leak Syndrome: Ikwabizwa ngokuba yi-"Primary Capillary Leak Syndrome" okanye "isifo sikaClarkson", le yimeko apho ukuhlaselwa kwenzeka ngokuphindaphindiweyo , nokuba umntu osempilweni.
• Isifo sokuvuza kweCapillary Secondary: Oku kwenzeka xa uhlaselo lwenzeka kanye ngenxa yesinye isifo, imeko, okanye amayeza.

Ngamafutshane, enye yinto enokwenzeka rhoqo, enye yinto eyenzeka okwethutyana ngenxa yesizathu esithile.

Ngubani onokuba nethuba elikhulu lokufumana le meko?

I-"Systemic Capillary Leak Syndrome" sisifo esingaqhelekanga kakhulu.Kubikwa ukuba bangaphantsi kwama-500 abantu kwihlabathi liphela abanale meko. Ixhaphake kakhulu kubantu abakwiminyaka ephakathi. Ayiqhelekanga kakhulu kubantwana abancinci. Nangona kunjalo, ngenxa yokuba abantu abanale meko ngamanye amaxesha babonwa gwenxa njengabanenye imeko, inani labantu abanale meko linokuba phezulu kakhulu.

Nangona kunjalo, i-"Secondary Capillary Leak Syndrome" inokwenzeka nakubantu banoma yiphi na iminyaka. Iintsholongwane ezithile, iimeko zonyango, kunye namayeza zinokubangela oku.

Kwenzeka ntoni emzimbeni xa oku kusenzeka? (Amanqanaba amathathu)

Okwenzekayo emzimbeni wethu ngexesha lohlaselo lwe-`(Capillary Leak Syndrome)` kunokwahlulwahlulwa kube ngamanqanaba amathathu. Masibone ukuba zeziphi ezo zinto.

Isigaba sokuqala: Ngaphambi kokuba iimpawu zibonakale (isigaba seProdromal)

Eli lixesha losuku okanye ezimbini ngaphambi kohlaselo. Ngeli xesha, ungaqala ukuba neempawu ezithile.

• Ndiziva ndidiniwe
• Ukomelela kwamanzi okwandileyo
• Izinto ezifana nokutyeba ngequbuliso zinokwenzeka.

Isigaba sesibini: Isigaba sokuvuza okanye sokuvuselela

Kulapho ke uhlaselo lwenzeka khona ngokwenene. Okwenzekayo kukuba ulwelo kunye ne -albumin (uhlobo lweproteni egazini) zivuza kwii-capillaries zakho ziye kwiindawo eziphakathi kwezicubu zakho. Oku kunciphisa ubungakanani begazi elithwala ioksijini. Uxinzelelo lwakho lwegazi luyehla, kwaye iiseli ezibomvu zegazi ziyahlangana, okwenza igazi lakho libe likhulu. Oku kuvuza kolwelo kubangela ukwehla komthamo wegazi, okubizwa ngokuba yi -hypovolemia .

Isigaba sesithathu: Emva kohlaselo `(Isigaba sasemva kokuvuza okanye isigaba sokuqesha)`

Eli lixesha emva kokuba uhlaselo luphelile. Okwenzekayo kukuba ii-capillaries zakho ziqala ukufunxa ulwelo kunye ne-albumin kwiithishu kwakhona. Nangona kunjalo, ngeli xesha, umzimba wakho unokuqokelela ulwelo oluninzi kakhulu (ubuninzi bolwelo) . Ngenxa yoko, umzimba wakho unokuvelisa umchamo omninzi kakhulu (i-polyuria) kwaye imiphunga yakho inokuzaliswa ngamanzi (i-pulmonary edema).

Cinga ngayo, ifana nesiponji esifunxa amanzi. Okokuqala, ulwelo luphuma emzimbeni, kwaye xa luphinda lufunxa ngokukhawuleza, lufunxa okungaphezulu kunokuba kufanele.

Yintoni ebangela oku?

Ngoku makhe sijonge ukuba yintoni enokubangela le `(Capillary Leak Syndrome)`.

Izizathu ze-`(Systemic Capillary Leak Syndrome)`

Inyaniso kukuba, imbangela echanekileyo yeSystemic Capillary Leak Syndrome ayikaziwa. Abaphandi bakholelwa ukuba isenokuba ibangelwa yindlela amasosha omzimba asabela ngayo kwisifo okanye usulelo oluthile.

Izizathu ze-`(Secondary Capillary Leak Syndrome)`

Kukho izizathu ezahlukeneyo zoku. Eyona nto ixhaphakileyo yimeko ebizwa ngokuba yi -sepsis . Oko kukuthi, ingxaki esongela ubomi ebangelwa lusulelo. Ukongeza, kukho nezinye izizathu:

• Izifo ezizikhusela ngokwazo emzimbeni:Okwenzekayo koku kukuba inkqubo yethu yokuzikhusela komzimba ihlasela iiseli zethu eziphilileyo.
• I-Differentiation syndrome: Ingxaki enokwenzeka ngexesha lonyango lweentlobo ezithile ze-leukemia (i-acute promyelocytic leukemia okanye i-acute myeloid leukemia).
• I-Engraftment syndrome: Ingxaki enokwenzeka emva kokufakelwa umongo wethambo.
• I-Hemophagocytic lymphohistiocytosis: Imeko enokuba yingozi ebomini ebangelwa kukusebenza kakhulu kwenkqubo yomzimba yokuzikhusela.
• I-Ovarian hyperstimulation syndrome: Ingxaki enokwenzeka ngexesha lonyango lokuzala.
• Ityhefu yeRicin.
• Ukulunywa ziinyoka.
• Iintsholongwane ezibangela ukopha: Iqela lezifo ezosulelayo ezibangelwa ziintsholongwane.

Amanye amayeza, afana namayeza okulwa nomhlaza i-gemcitabine (gemcitabine - Gemzar®) kunye ne -tagraxofusp (tagraxofusp - Elzonris®) , nawo anokubangela oku (Secondary Capillary Leak Syndrome).

Ziziphi iimpawu ezibonisa ukuba esi sifo siqala nini?

Ngokwesiqhelo, usuku olunye okanye ezimbini ngaphambi kohlaselo lwe-"Capillary Leak Syndrome", oko kukuthi, ngexesha le-"prodromal phase", unokufumana iimpawu ezifana nezi:

• Intlungu yesisu okanye intlungu yemisipha (myalgia).
• Ukudinwa okanye ubuthathaka obukhulu.
• Intloko ebuhlungu .
• Ukwanda kokunxanelwa amanzi.
• Ukucaphuka, umsindo okhawulezayo.
• Isicaphucaphu.
• Ukunyuka kwesisindo ngequbuliso.
• Iimpawu zosulelo lwentsholongwane okanye usulelo oluphezulu lwendlela yokuphefumla.

Ukuba ufumana iimpawu ezinje, musa ukuzithatha lula, uthi, "Owu, mhlawumbi ngumkhuhlane nje," ingakumbi ukuba ukhe waba namava afanayo ngaphambili.

Ziziphi iimpawu ezibonakala xa unesifo?

Ngexesha lohlaselo lwe-`(Capillary Leak Syndrome)`, oko kukuthi, ngexesha le-`(ukuvuza okanye isigaba sokuvuselela)`, iimpawu zinokwahluka kumntu nomntu. Nangona kunjalo, ezi zilandelayo ziimpawu eziqhelekileyo ezinokubonwa:

• Ukudumba, ingakumbi emalungeni (i-peripheral edema).
• Urhudo.
• Uxinzelelo lwegazi oluphantsi (uxinzelelo lwegazi oluphantsi).
• Ukujiya kwegazi (ukujiya kwegazi kakhulu) - Oku kunokubangelwa kukwanda kwenani leeseli ezibomvu zegazi (i-hematocrit) okanye ukwanda kwenani leeseli ezimhlophe zegazi (i-leukocytosis).

Oogqirha bayibona njani le nto?

Ugqirha uza kuhlola i-Capillary Leak Syndrome ngokubuza ngembali yakho yezonyango aze enze uvavanyo lomzimba. Baza kujonga ukuba uxinzelelo lwakho lwegazi luphantsi na.

Kwakhona, ngaphambi kokuqinisekisa ukuba le yiCapillary Leak Syndrome, ezinye iimeko kufuneka zisuswe. Banokwenza uvavanyo lwegazi oluninzi ukuze benze oku:

• Jonga ukuba i-hematocrit iphezulu na (inani leeseli ezibomvu zegazi egazini).
• Jonga amanqanaba aphezulu e-hemoglobin (iproteni efumaneka kwiiseli ezibomvu zegazi).
• Jonga ukuba iprotein iphantsi na egazini (hypoalbuminemia).

Ukongeza, uvavanyo lwegazi lunokwenziwa ukujonga iproteni yokuzikhusela engaqhelekanga ebizwa ngokuba yi-"monoclonal gammopathy, okanye iproteni ye-M" egazini. Abantu abane-"Capillary Leak Syndrome" banokuba nale protein ye-"M" engaqhelekanga egazini labo.

Inyangwa njani? Ngaba inganyangeka?

Ngelishwa, akukho nyango luhlala luhleli lweCapillary Leak Syndrome. Oogqirha bazama ukulawula iimpawu nokuthintela iingxaki.

Ngexesha lokuhlaselwa yi-"Capillary Leak Syndrome", oogqirha bazama ukulawula uxinzelelo lwegazi nokugcina ukuhamba kwegazi okufanelekileyo kumalungu omzimba. Bakwazama ukuthintela ukudumba okugqithisileyo kunye nokuqokelelwa kolwelo. Bangasebenzisa:

• IiGlucocorticoids: Ezi luhlobo lwe-steroid olunceda ekunciphiseni ukuvuza kolwelo oluvela kwii-capillaries.
• Ulwelo olufakwa kwimithambo yegazi: Izinto ezifana ne-saline zinikwa ukwandisa ukuhamba kwegazi ukuya kwizitho ezifana nezintso.

Ngokwesiqhelo kuya kufuneka ulaliswe esibhedlele emva kohlaselo. Ngexesha lonyango, ugqirha wakho uya kuqhubeka ejonga uxinzelelo lwakho lwegazi kunye noxinzelelo lwegazi ukuqinisekisa ukuba awunalo ulwelo oluninzi emzimbeni wakho, nto leyo enokukhokelela kwezinye iingxaki, ezifana nokudumba kwamaphaphu kunye nokuma kwentliziyo ngequbuliso.

Emva kokuhlaselwa yiCapillary Leak Syndrome, eyaziwa ngokuba yi-post-leak phase okanye i-recruitment phase, ugqirha unokukunika i-diuretic (iyeza elibangela ukuba uvelise umchamo omninzi) ukunciphisa ubungakanani bolwelo olongezelelweyo emzimbeni wakho.

Ngaba iSystemic Capillary Leak Syndrome (SCLS) ingathintelwa ukuba ingaphindi ivele?

Awunakuyithintela iSystemic Capillary Leak Syndrome ukuba ingenzeki kwasekuqaleni. Kodwa, wakuba uhlaselwe, uyazi ukuba unayo le meko.

Nangona kunjalo, ukuthatha amayeza rhoqo okanye ukufumana i-saline kunokunceda ukuthintela ukuhlaselwa kwixesha elizayo kunye nokunciphisa ubukhali bawo. Olu nyango lungabandakanya:

• Ukufumana i-intravenous immune globulin (IVIG) rhoqo ngenyanga.
• Amayeza omlomo e-asthma, afana ne -theophylline (theophylline - Elixophyllin®), i-terbutaline (terbutaline - Brethine®), kunye ne-montelukast (montelukast - Singulair®) .
• Nciphisa ukudumbaIi-steroids.

Liyintoni ikamva labo baphila nale meko? `(Imbono)`

I-Systemic Capillary Leak Syndrome idla ngokulawulwa ngonyango lokuthintela. Unyango lunokwenzeka ukuba luphumelele xa imeko ifunyaniswe kwangethuba kwaye iingxaki zincinci. Ezinye zeengxaki ezinkulu ezinokubakho nge-Capillary Leak Syndrome ziquka:

• Isifo segumbi: Uxinzelelo oluphezulu ngaphakathi kwemisipha kunye nokuncipha kokuhamba kwegazi.
• Ukuqokelelana kolwelo olujikeleze intliziyo nemiphunga (i-cardiac tamponade, i-pericardial effusion, kunye ne-pleural effusion).
• Ukumelwa yintliziyo.
• Ukungasebenzi kakuhle kwezintso.
• I-Neuropathy.
• Ukudumba kwepulmonary.
• I-Rhabdomyolysis: Ukungasebenzi kakuhle kwezintso ngenxa yomonakalo wemisipha.
• Istroke.

Ezi zinto zisenokuvakala zisoyikisa, kodwa njengoko bekutshiwo ngaphambili, unyango olukhawulezileyo kunye nolawulo olufanelekileyo zibaluleke kakhulu.

Ndifanele ndimbone nini ugqirha?

Ukuba ucinga ukuba unesifo seCapillary Leak Syndrome, bonana nogqirha ngoko nangoko. Banokukunceda ukulawula iimpawu zakho kwaye bakunike isiqabu.

Khumbula, nangona le yimeko engaqhelekanga, kubalulekile ukuqaphela iimpawu kwaye ufune iingcebiso zonyango ngokukhawuleza ukuba awuqinisekanga.

Umyalezo Wokuya Ekhaya

Kulungile, masiphinde sichaze amanqaku abalulekileyo esithethe ngawo:

• Oku kuxa inxalenye yegazi (iplasma) ivuza iphuma kwimithambo yegazi emincinci (ii-capillaries) emzimbeni wethu.
• Oku kungenzeka kube kanye okanye ngokuphindaphindiweyo.
• Ukuba ayinyangwa, iingxaki ezinkulu zinokubakho, ngoko ke kubalulekile ukufumana uncedo lwezonyango ngokukhawuleza.
• Nangona kungekho nyango luhlala luhleli, kukho unyango lokulawula iimpawu nokuthintela ukuhlaselwa kwixesha elizayo.
• Ukuba urhanela ukuba kukho naziphi na kwezi mpawu, bonana nogqirha ngokukhawuleza. Okukhona ufumanisa isifo ngokukhawuleza kwaye uqala unyango, kokukhona amathuba akho okuphila ngcono.

Ngoko ke, ndiyathemba ukuba olu lwazi luluncedo kuwe. Hlala usempilweni!

Isifo Sokuvuza Kwegazi Egazini, Ukuvuza Kwegazi Egazini, Uxinzelelo Lwegazi Oluphantsi, Isifo SikaClarkson, Ukudumba, Ukuvuza Kolwelo Emzimbeni