Ingaba umntwana wakho uneentlungu zesisu ezibuhlungu? Isenokuba yiHemolytic Uremic Syndrome (HUS)!

Ingaba umntwana wakho ebenesifo sorhudo esibuhlungu esiswini kangangeentsuku ezimbalwa? Usenokubona negazi kuso. Kuqhelekile ukuba wena, njengomzali, ukhathazeke kakhulu xa oko kusenzeka. Xa uneempawu ezinje, kunokuba yinto engaphezulu nje kwentlungu yesisu. Namhlanje siza kuthetha ngemeko enokuba yingozi, kodwa enokunyangeka kakhulu ukuba iqatshelwe kwangethuba. Yiyo leyo (iHemolytic Uremic Syndrome) , okanye (iHUS) ngamafutshane.

Yintoni iHemolytic Uremic Syndrome (HUS)? Masiyiqonde ngokulula.

Kulungile, ngoku masijonge ukuba yintoni le (HUS). Ngamafutshane, yimeko apho imithambo yegazi emincinci kwizintso zethu ivaleka khona . Cinga ngayo njengombhobho wamanzi ovalekayo aze amanzi ayeke ukuhamba. Oku kuvaleka kubangela ukuba kwenzeke izinto ezintathu eziphambili:

1. Iiseli zakho ezibomvu zegazi ziyatshatyalaliswa: Kwizonyango, oku kubizwa ngokuba yi-hemolytic anemia . Iiseli ezibomvu zegazi zezona zithwala ioksijini emizimbeni yethu. Ngoko ke xa zitshatyalaliswa, ubungakanani beoksijini efunekayo emzimbeni buyancipha.

2. Inani leeplatelet egazini liyancipha: Le meko ibizwa ngokuba yi -thrombocytopenia . Iiplatelet ziiseli ezincinci ezinceda igazi lethu ukuba lijiye xa sisopha. Xa ezi zincipha, kuba nzima ukuyeka ukopha, kwaye imivumbo inokuvela emzimbeni wonke.

3. Ukonakala kwezintso: Le yeyona nto iyingozi kakhulu. Xa izintso zingasebenzi kakuhle, azikwazi ukususa inkunkuma eqokelelana emzimbeni. Oku kukwabizwa ngokuba yi- (Acute Kidney Injury - AKI) .

Nangona i-HUS inokuchaphazela nabani na, idla ngokubangelwa lusulelo lwebhaktiriya , ingakumbi i-Escherichia coli , eyaziwa ngokuba yi -E. coli . Le bhaktiriya yimbangela yorhudo, ingakumbi urhudo olunegazi. Nangona kunjalo, isifo siqoqo lweempawu, kwaye i-HUS inokubakho ngenxa yezinye izizathu ezingezizo i-E. coli.

Le meko (HUS) ayinakuchaphazela izintso kuphela, kodwa ngamanye amaxesha nezinye izitho ezifana nentliziyo nengqondo. Nangona kunjalo, idla ngokuchaphazela izintso.

Okubaluleke kakhulu: Ukuba wena okanye umntwana wakho unesifo sorhudo esinegazi okanye unesifo sorhudo kangangeentsuku ezingaphezu kwezintathu, qiniseka ukuba ubona ugqirha. Ukuba asinyangwa, i-HUS inokuba yingozi kakhulu kwaye ide ibeke ubomi esichengeni.

Ngaba kukho iintlobo ezahlukeneyo ze-HUS?

Ewe, kukho iintlobo ezininzi eziphambili ze-(HUS). Masifunde kancinci ngazo:

1. "Eqhelekileyo" (HUS): Olu lolona hlobo luqhelekileyo . Ludla ngokubangelwa lusulelo lwebhaktheriya, ingakumbi i-E. coli, oluchaphazela amathumbu ethu amancinci kunye nekholoni.

2. "Atypical" (HUS) (aHUS): Oku kunqabile kancinci.Oku kudla ngokuba ngenxa yezizathu zemfuza, oko kuthetha ukuba ifunyanwa ngabazali kubantwana.

3. "I-Secondary" (HUS): Olu hlobo lwenzeka xa ludibene nezinye iimeko zonyango. Umzekelo, lunokubangelwa ngamayeza athile, ezinye izifo, okanye ukukhulelwa.

Masifunde okungakumbi malunga "ne-Atypical" (HUS) (aHUS)

(aHUS) yimeko engaqhelekanga kakhulu. Inokubangela iimpawu ezifanayo nezo zangaphambili:

• Ukwehla kwamanqanaba eeseli ezibomvu zegazi.
• Ukwehla kwenani leeplatelet.
• Ukungasebenzi kakuhle kwezintso ngequbuliso (ukungasebenzi kakuhle kwezintso ngokukhawuleza) .
• Uxinzelelo lwegazi oluphezulu (uxinzelelo lwegazi oluphezulu) okanye ukungakwazi ukulawula uxinzelelo lwegazi.

Le meko (aHUS) idla ngokuba sisifo semfuza . Oko kukuthi, ibangelwa lutshintsho oluthile (utshintsho) kwiimfuza zethu. Nangona kunjalo, nokuba le meko yemfuza ikhona, ibangelwa lusulelo oluthile, izifo, okanye imeko yendalo.

Ixhaphake kangakanani (i-HUS)?

Phakathi kwe-5% kunye ne-15% yabantu abafumana isifo sorhudo esibangelwa yibhaktheriya (i-E. coli) baya kuba ne-HUS . Uhlobo olubizwa ngokuba yi-(aHUS) aluqhelekanga kakhulu. Luyenzeka kumntu omnye kwisigidi.

Ziziphi iimpawu eziphambili ze-(HUS)?

Kubaluleke kakhulu ukuba uzazi ezi mpawu.

Iimpawu zokuqala ezibonakalayo:

• Urhudo: Ludla ngokuhamba negazi.
• Intlungu zesisu.
• Isicaphucaphu nokuhlanza.
• Intloko ebuhlungu .
• Ukugodola kunye nomkhuhlane.

Ezinye iimpawu ezibonakalayo:

• Ukudumba okulula.
• Ulusu oluphaphathekileyo (umbala): Ingaphakathi lempumlo kwanomlomo usenokuba mdaka.
• Ukudideka.
• Ukuhluthwa.
• Iimeko ezifana nestroke.
• Isantya sentliziyo esikhawulezayo (i-arrhythmia).

Ukuba imeko ye (HUS) iba mandundu, iiseli ezibomvu zegazi ezitshatyalalisiweyo zinokubangela amahlwili egazi kwaye zonakalise amalungu omzimba afana nezintso. Emva koko izintso azikwazi ukucoca imveliso engcolileyo ngokufanelekileyo. Oku sikubiza ngokuba yi (Acute Kidney Injury - AKI) . Nazi iimpawu zayo:

• Igazi kumchamo (i-hematuria).
• Ukwanda kwamanqanaba etyhefu egazini: Oku kunokubangela ukungakhululeki kunye nokuziva ugula.
• Igazi elonyukayo.
• Ubunzima bokuphefumla (ukuphelelwa ngamandla).
• Ukudumba: Kunokubakho ukudumba, ingakumbi emilenzeni nasemaqatheni.
• Ukuncipha kokuphuma komchamo (i-oliguria).

Zithini izizathu eziphambili ze (HUS)?

Uninzi lweemeko ze-HUS zibangelwa ziintlobo ezithile zebhaktheriya ye-E. coli. Ezi bhaktheriya zivelisa ityhefu ebizwa ngokuba yiShiga toxin . Le tyhefu yonakalisa ulwelo lwamathumbu ethu amancinci kwaye ibangele urhudo. Le tyhefu ingena nakwigazi, itshabalalise iiseli ezibomvu zegazi kwaye yonakalise nezintso.

Usethubeni elikhulu lokufumana usulelo lwe-E. coli ngenxa yezi zinto zilandelayo:

• Inyama engaphekwanga kakuhle: ingakumbi inyama yenkomo, inyama yenkomo egayiweyo.
• Ubisi neziphuzo zeziqhamo ezingafakwanga iintsholongwane: Ukwenziwa kwe-pasteurization yinkqubo yokufudumeza ethambileyo ebulala izinto eziyingozi ezifana neebhaktheriya.
• Iziqhamo nemifuno engahlanjwanga, engcolileyo.

Ezi ntlobo ze-E. coli ezivelisa ityhefu zikwabizwa ngokuba yi -Shiga toxin-producing E. coli (STEC) . Uhlobo lwe-STEC oluqhelekileyo eMntla Melika yi -E. coli O157:H7 .

Kunqabile kakhulu, amayeza athile kunye nezinto ezithile zinokubangela "i-secondary (HUS)". Imizekelo:

• Amayeza e-chemotherapy: afana ne-(bleomycin), (cisplatin), (gemcitabine).
• Amayeza okunciphisa umzimba: afana ne (cyclosporine), (tacrolimus).
• I-Quinine: Iyeza lemalariya.
• Amanye amayeza : (oxymorphone), (ecstasy), (cocaine).

Ingaba (i-HUS) iyasulela?

Hayi, i-HUS ayisuleli.

Nangona kunjalo, intsholongwane ye-E. coli inokudluliselwa. Le ntsholongwane inokudluliselwa ngokutya okanye iziselo ezingcolisiweyo, okanye ngokudibana nelindle lomntu okanye isilwanyana esinesifo sorhudo esosulelwe yi-E. coli. Ngoko ke, kubalulekile ukuba silumke kakhulu malunga nococeko.

Ngubani onokuthi abe nomhlaza (i-HUS)?

Nangona nabani na enokuba ne-HUS, aba bantu balandelayo basengozini enkulu:

• Kubantwana abangaphantsi kweminyaka emi-5 ubudala.
• Kwabo banenkqubo yomzimba yokuzikhusela ebuthathaka (abangakhuselekanga).
• Ukuba kukho umntu kusapho lwakho okhe waba ne-HUS ngaphambili (ingakumbi i-aHUS).
• Ukuba ufumana usulelo lwe-E. coli: Ingakumbi kwizinto ezifana nenyama engaphekwanga kakuhle kunye nobisi olungagayiwanga.
• Ukudibana ngqo nomntu onesifo sohudo esibangelwa yi-E. coli.

Uyazi njani ukuba unayo (i-HUS)? (Ukuxilongwa)

Xa ubona ugqirha, uya kwenza ezi zinto zilandelayo:

• Buza ngembali yakho yezonyango .
• Buza ngembali yempilo yosapho lwakho.
• Kuyenziwa uvavanyo lomzimba .

Ukuba ezi zinto ziphakamisa ukurhanelwa kwemeko ye-HUS, ugqirha uya kuyalela ezinye iimvavanyo ezininzi.

Luhlobo luni lovavanyo oluqhutywayo?

• Uhlalutyo lomchamo: Kuthathwa isampulu yomchamo wakho ize ihlolwe ukuba akukho protein okanye igazi.
• Uvavanyo lwegazi: Kuthathwa isampulu yegazi ukujonga izinto ezifana nokubalwa kweeseli ezibomvu zegazi, amanqanaba eeplatelet, kunye nokuba izintso zakho nesibindi zisebenza kakuhle kangakanani na.
• Uvavanyo lwesitulo: Kuthathwa isampulu yesitulo ize ihlolwe ukuba kukho iintsholongwane ezibangela i-HUS, ezifana ne-E. coli O157.
• Uvavanyo lwemfuza: Ngamanye amaxesha, isampulu yegazi lakho ingathunyelwa ukuze ivavanywe ngemfuza. Oku kunokunceda ekuqinisekiseni ukuba unesifo semfuza esifana ne-aHUS kunye nonyango olulungele wena.
• Uvavanyo lwezintso: Oku kuquka ukuthatha iqhekeza elincinci lezintso uze ulihlolisise ngemicroscope ukuze kubonwe ukuba likhulu kangakanani na umonakalo owenziwe kwizintso kwaye yintoni ebangele oko. Asinguye wonke umntu owudingayo lo monakalo.

Uvavanyo lunokuqinisekisa njani ukuba une-HUS?

• Kwiimvavanyo zomchamo: Ukuba kukho igazi okanye iproteni kumchamo.
• Uvavanyo lwegazi: Ukuba amanqanaba eeseli ezibomvu zegazi kunye neeplatelet aphantsi, okanye ukuba amaxabiso abonisa ukusebenza kwezintso (njenge-creatinine) aphakanyisiwe.
• Uvavanyo lwendle: Ukuba kufunyenwe iintsholongwane ezifana ne-(E. coli O157).
• I-biopsy yezintso: Umonakalo othile kwizintso unokubonwa.

Iphathwa njani (i-HUS)?

Ukuba ufunyaniswe une-HUS, kuya kufuneka ulaliswe esibhedlele kwaye unyangwe. Iindlela zonyango ziquka:

• Ukutya nge-intravenous (IV) fluids kunye/okanye ityhubhu (isondlo sangaphakathi): Oku kunceda ukuthintela ukuphelelwa ngamanzi emzimbeni kwaye kubonelele ngesondlo esifunekayo.
• Amayeza:
• Bazama ukunciphisa umonakalo kwizintso ngokunika amayeza okunciphisa uxinzelelo lwegazi (i-antihypertensive) .
• Abantu abane-aHUS banokunikwa amayeza athile afana ne -eculizumab okanye i-ravulizumab . Ngaphambi kokuba baqale la mayeza, kubalulekile ukugonyelwa izifo ze -meningococcal kunye ne -pneumococcal , njengoko la mayeza enyusa umngcipheko wokufumana ezo zifo.
• Kusenokufuneka uthabathe amayeza okubulala iintsholongwane ubuncinane iiveki ezimbini.
• Utofelo-gazi: Ukunika iiseli ezibomvu zegazi kunye neeplatelets kumntu one (HUS) kubaluleke kakhulu. Iiseli ezibomvu zegazi zinciphisa iimpawu ze-anemia, ezinje ngokuphefumla kancinci kunye nokubetha kwentliziyo ngokukhawuleza. Iiplatelets zinceda ukujiya kwegazi ngokufanelekileyo, zinciphise ukopha kunye nokukrweleka.

Ukuba izintso zonakele kakhulu, i-dialysis ingafuneka ukuze kucocwe igazi de izintso ziphinde ziphile. Ukuba izintso azisebenzi ngokupheleleyo ngenxa ye-HUS, kusenokufuneka ukuba kufakwe izintso .

Ngaba i-HUS inganyangeka ngokupheleleyo?

Ewe, abantu abaninzi bayachacha kwi-HUS ngaphandle komonakalo osisigxina kwimpilo yabo.

Nangona kunjalo, abanye abantu, ingakumbi abantwana abancinci, banokufumana isifo sezintso esinganyangekiyo (CKD) kwi-20% ukuya kwi-50%. Isifo sezintso sokugqibela (ESK) sinokukhula kwi-3% ukuya kwi-5%. Izifundo zibonisa ukuba i-CKD ichaphazela malunga ne-45% yabantu abadala.

Abantu abangaphezu kwama-85% abaphuhlisa i-HUS bayachacha ngokupheleleyo ekusebenzeni kwezintso zabo. Nangona kunjalo, nokuba bayachacha ngokupheleleyo, kukho ithuba elincinci lokuba baya kuba noxinzelelo lwegazi oluphezulu okanye ezinye iingxaki zezintso kwixesha elizayo.

Ngaba i-HUS ingathintelwa?

Nazi ezinye izinto onokuzenza ukunceda ukuthintela usulelo lwe-E. coli, unobangela omkhulu we-HUS. Ezi zibaluleke kakhulu kuwe nakusapho lwakho:

• Kuphephe ukudada kwiindawo ezingcolileyo (amachibi, imilambo), ingakumbi ukuba ucinga ukuba amanzi anamanqanaba aphezulu eebhaktheriya.
• Ukuba unesifo sorhudo, musa ukuqubha.
• Kuphephe ukusela iziselo ezingagayiwanga (eziluhlaza) (ubisi, ijusi yeziqhamo).
• Soloko ucoca kakuhle izixhobo zasekhitshini (iimela, iifolokhwe, amacephe) kunye neendawo zokulungiselela ukutya (iikhawuntara, iibhodi zokusika, izitya).
• Pheka amaqanda kunye nenyama egayiweyo kakuhle ukuya kuthi ga kwiqondo lobushushu langaphakathi eliyi-71 degrees Celsius (160 degrees Fahrenheit), kunye nenkukhu ukuya kuthi ga kwiqondo lobushushu langaphakathi eliyi-74 degrees Celsius (165 degrees Fahrenheit).
• Xa unyibilikisa inyama, yibeke kwi-microwave okanye efrijini. Musa ukuyinyibilikisa kwindawo yokulungiselela ukutya okanye emanzini ashushu.
• Gcina ukutya okuluhlaza nokuphekiweyo ngokwahlukeneyo.
• Hlamba izandla zakho kakuhle ngesepha namanzi ashushu phambi kokutya, emva kokusebenzisa indlu yangasese, emva kokutshintsha amanabukeni abantwana abancinci, nasemva kokuchukumisa izilwanyana zasefama.

Khawucinge nje, ngokulandela la manyathelo alula, unokuzikhusela kwimeko enzima efana nale.

Yintoni onokuyilindela ukuba unayo (i-HUS)?

Xa bexilongwa kwaye benyangwa ngokufanelekileyo, uninzi lwabantu abane-HUS bayachacha ngokupheleleyo ngaphandle komonakalo osisigxina kwimpilo yabo. Nangona kunjalo, kukho umngcipheko wokuba noxinzelelo lwegazi oluphezulu okanye ezinye iimeko ezichaphazela izintso kwixesha elizayo.

Amatyala aqatha e-HUS, ingakumbi ukuba achaphazela amanye amalungu omzimba, njengobuchopho, anokubulala ukuba anganyangwa.

Zithini amathuba okusinda (i-HUS)?

Xa uxilongwa kwaye unyangwa ngokufanelekileyo, abantu abangaphezu kwama-90% bayasinda kwi-HUS. Ngoko ke kubalulekile ukuba ungoyiki kwaye ufune iingcebiso zonyango ngokukhawuleza ukuba uneempawu.

Ndingazinyamekela njani?

Ukuba wena okanye umntwana wakho ninesifo sorhudo esinzima, kubaluleke kakhulu ukuzama ukubuyisela amanzi emzimbeni wenu.Iziselo zokubuyisela amanzi emzimbeni, ezifana neJeevani, zinokunceda ekubuyiseleni ii-electrolytes ezilahlekileyo. Iintsana kunye nabantwana abancinci banokufuna ukunikwa ubisi lwebele okanye ifomyula. Buza ugqirha ngeyona ndlela ingcono yokugcina umntwana wakho emanzi emzimbeni.

Ndifanele ndimbone nini ugqirha?

Bona ugqirha ngokukhawuleza ukuba unezi mpawu:

• Urhudo olunegazi.
• Urhudo oluhlala ixesha elingaphezulu kweentsuku ezintathu.
• Ukudumba komzimba.
• Ulusu olukrweleka lula.
• Ukudinwa kakhulu.

Ndingayibuza yiphi imibuzo ugqirha?

Ungambuza ugqirha le mibuzo:

• Uqinisekisa njani ukuba ndineHemolytic Uremic Syndrome?
• Ndingayifumana njani iHemolytic Uremic Syndrome?
• Ukuba andinayo iHemolytic Uremic Syndrome, zeziphi ezinye izifo endinokuba nazo?
• Loluphi unyango olucebisayo?
• Ngaba izintso zam ziya konakala ngonaphakade?
• Ngaba ndiza kuba noxinzelelo lwegazi oluphezulu okanye ezinye iingxaki zezintso kwixesha elizayo?

Yintoni i-triad yeHemolytic Uremic Syndrome?

I-triad yindibaniselwano yeempawu ezintathu eziphambili ezibonisa imeko ethile yempilo.

I-Hemolytic Uremic Syndrome triad iquka:

1. Ukonakala kweeseli zakho ezibomvu zegazi (i-microangiopathic hemolytic anemia) .

2. Ukwehla kancinci kancinci kwenani leeplatelet egazini lakho (thrombocytopenia) .

3. Ukulimala kwezintso okukhawulezileyo .

Ukuba ndinesifo sohudo, ngaba oko kuthetha ukuba ndineHemolytic Uremic Syndrome?

Ukuba unesifo sohudo akuthethi ukuba uneHemolytic Uremic Syndrome. Nangona kunjalo, ukuba unesifo sohudo esinegazi, okanye ukuba isifo sohudo sakho sibi kakhulu (ukuya kwinqanaba lohudo olumanzi okanye oluhlala iintsuku ezingaphezu kwezintathu), ngokuqinisekileyo kuya kufuneka ubone ugqirha.

Yintoni umahluko phakathi kwe (Hemolytic Uremic Syndrome) kunye ne (Thrombotic Thrombocytopenic Purpura - TTP)?

I-Hemolytic Uremic Syndrome (HUS) kunye ne-Thrombotic Thrombocytopenic Purpura (TTP) ziimeko ezimbini ezifanayo. Kwi-TTP, amahlwili egazi ayenzeka kwimithambo yegazi emincinci. Nangona oogqirha bebeqhele ukuhlanganisa i-HUS kunye ne-TTP, ngoku zithathwa njengeemeko ezahlukeneyo.

Okokugqibela, izinto ekufuneka uzikhumbule (Umyalezo Wokuya Ekhaya)

Isifo sorhudo sidla ngokuba yimeko yexesha elifutshane, kodwa engathandekiyo. Sidla ngokuba ngcono emva kosuku olunye okanye ezimbini. Nangona kunjalo, ukuba unesifo sorhudo esinegazi, okanye ukuba unesifo sorhudo kangangeentsuku ezingaphezu kwezintathu, kunye nokuziva udiniwe, ubomvu, okanye uphuma umchamo omncinci xa usiya kwigumbi lokuhlambela, lixesha lokuba ubone ugqirha ngoko nangoko.

Imeko ebizwa ngokuba yiHemolytic Uremic Syndrome ingonakalisa kakhulu izintso zakho kwaye ichaphazele nezinye izitho zomzimba.Okukhona ufumana unyango ngokukhawuleza koku, kokukhona amathuba okuba ungonzakali ixesha elide kwizintso zakho. Ngoko ke, qaphela iimpawu, gcina ucoceko olufanelekileyo, kwaye ufune iingcebiso zonyango ukuba uneengxaki. Impilo yakho ibaluleke kakhulu kuwe!

Isifo seHemolytic Uremic, i-HUS, isifo sezintso, isifo sorhudo, i-E. coli, iiseli zegazi ezibomvu, iiplatelets, impilo yomntwana