Khawuthelekelele ukuba unomkhuhlane, iintlungu zomzimba, uze uqale ukuthatha amayeza owanikwe ngugqirha. Kuthekani ukuba, kwiintsuku ezimbalwa, mhlawumbi iveki okanye ezimbini, ngequbuliso uvela amabala abomvu emzimbeni wakho, izilonda emlonyeni wakho, emehlweni akho, nakwizitho zakho zangasese, kwaye ulusu lwakho luqala ukudumba kwaye luqhekeke ngokungathi lutshisiwe? Le yimeko eyoyikisayo, eyingozi kakhulu, kwaye ingaqhelekanga. Namhlanje siza kuthetha ngale meko ibizwa ngokuba yiStevens-Johnson Syndrome (SJS). Kubalulekile kakhulu ukuba wonke umntu aqaphele oku.
Yintoni i-SJS kunye ne-TEN? Yintoni umahluko phakathi kwezi zimbini?
I-Stevens-Johnson Syndrome (SJS) yimpendulo ebukhali yokusabela kwi-hypersensitivity, idla ngokubangelwa liyeza. Ibandakanya umonakalo kulusu lwethu kunye nee-mucous membranes, nto leyo ebangela ukuba iiseli zife kwaye ulusu luqhekeke. Ii-mucous membranes zii-mucous membranes ezithambileyo nezimanzi ezijikeleze umlomo, impumlo, amehlo, amalungu esini kunye ne-anus.
Kukho olunye uhlobo olubi kakhulu lwale meko, esilubiza ngokuba yiToxic Epidermal Necrolysis (TEN) . Ngamafutshane, i-SJS kunye ne-TEN zifana namacala amabini esi sifo esinye.
- I-SJS (Stevens-Johnson Syndrome): Kule meko , ngaphantsi kwe-10% yomphezulu wolusu lomzimba ususiwe.
- I-TEN (i-Toxic Epidermal Necrolysis): Le yimeko embi kakhulu kwaye inokuba yingozi ebomini apho ulusu lomzimba olungaphezulu kwama-30% luyalahleka.
Zombini ezi meko zinzima kakhulu, ngoko ke isigulana kufuneka silaliswe esibhedlele , ngamanye amaxesha sikwiyunithi yokhathalelo olunzulu (ICU) okanye kwicandelo lokutsha.
Ngubani onokuthi afumane esi sifo?
Nangona i-SJS inokubakho nakweyiphi na iminyaka, ixhaphake kakhulu ebantwaneni nakubantu abadala abancinci abangaphantsi kweminyaka engama-30. Ingafumaneka nakubantu abadala. I-SJS ixhaphake kancinci kubasetyhini kunakumadoda.
Kukho umahluko omncinci xa ujonga isizathu:
- Eyona nto ibangela i-SJS ebantwaneni ziimeko ezisulelayo ezifana ne -pneumonia .
- Eyona nto ibangela i-SJS/TEN kubantu abadala kukusabela kwe-allergy kumayeza .
Zithini kanye kanye iimpawu ze-SJS?
Kubaluleke kakhulu ukuzazi ezi mpawu, kuba okukhona uziqonda ngokukhawuleza, kokukhona ungakhawuleza ufune unyango. Iimpawu zihlala zibonakala kwiveki okanye ezintathu emva kokuba uqalise amayeza.
Iimpawu zokuqala ziimpawu zomkhuhlane eziqhelekileyo ezifana nomkhuhlane, iintlungu zomzimba, intloko ebuhlungu, kunye nokukhwehlela. Oku kwenza kube nzima ukuxilonga i-SJS kwiintsuku zokuqala. Kuphela emva koko kuvela iimpawu zolusu eziqatha.
Apha ngezantsi kukho iimpawu eziphambili ze-SJS.
| Uphawu | Icacisiwe ngokulula |
|---|---|
| Intlungu ebuhlungu yesikhumba | Ukuziva intlungu evuthayo kangangokuba awukwazi ukuchukumisa ulusu lwakho. |
| Umkhuhlane kunye neentlungu zomzimba | Iimpawu ziquka umkhuhlane ophezulu, iintlungu zomzimba, kunye nentloko ebuhlungu. |
| Amabala abomvu kunye namabala | Amabala abomvu okanye izilonda eziqala ebusweni nasesifubeni zize zisasazeke emzimbeni wonke. |
| Amaqhubu kunye namanxeba | Amaqhuqhuva kunye nezilonda ezibuhlungu eluswini, ngaphakathi emlonyeni, emqaleni, emehlweni, kwizitho zangasese, nasemqaleni. |
| Ukuxobuka kolusu | Amadyungudyungu ayaqhuma kwaye umaleko ophezulu wolusu uyaxobuka ube ngamaqhekeza amakhulu. |
| Ukutshiza amathe emlonyeni | Ukuvuza amathe ngenxa yezilonda emlonyeni, ukungakwazi ukugcina umlomo uvaliwe. |
| Uqhagamshelo lamehlo | Amaqhubu kunye nokudumba emehlweni, okwenza kube nzima ukuvula amehlo. |
| Intlungu ngexesha lokuchama | Intlungu ebuhlungu ngexesha lokuchama ngenxa yokudumba kwe-mucous membranes. |
Izizathu eziphambili kunye neentlobo zamachiza anokubangela i-SJS
Eyona nto ibangela i-SJS kukuba umntu angavumelani neziyobisi ezithile. Nangona kunjalo, oku akwenzeki kuzo zonke iziyobisi. Kukho iintlobo ezahlukeneyo zamayeza ezinokubangela i-SJS.
| Isizathu | Inkcazo |
|---|---|
| Ukunganyamezelani namayeza | Le yimbangela yobuninzi beemeko ze-SJS kunye ne-TEN. |
| Iintsholongwane | Ingakumbi ebantwaneni, inokubangelwa zizifo ezifana neMycoplasma pneumonia, iHerpes, kunye neHepatitis A. |
| Ezinye izizathu | Isifo se-graft-versus-host, ingxaki eyenzeka emva kokufakelwa umongo wethambo, ukugonywa (kunqabile kakhulu), kwaye ngamanye amaxesha akukho sizathu sifumanekayo. |
Amayeza anobungozi obukhulu bokubangela i-SJS
- Amayeza e-sulfa alwa neentsholongwane: Ezinye iintlobo zee-antibiotics.
- Amayeza okulwa nesifo sokuwa: Umzekelo, amayeza afana ne-`Phenytoin (Dilantin®)`, `Carbamazepine (Tegretol®)`, `Lamotrigine (Lamictal®)`, `Phenobarbital (Luminal®)`.
- I-Allopurinol: Iyeza elisetyenziselwa ukunyanga i-gout kunye nezinye iintlobo zamatye ezintso (`Aloprim®`, `Zyloprim®`).
- Iipilisi zokunciphisa iintlungu (ii-NSAID): Iipilisi zokunciphisa iintlungu ezingezizo eze-steroidal ezifana ne-`Piroxicam (Feldene®)`, `Diclofenac (Cambia®, Flector®)`. Amanye amayeza afana ne-`Nevirapine (Viramune®)`.
- Ezinye iiAntibiotics: Ezinye iintlobo zeeAntibiotics nazo zinokubangela oku.
Kubalulekile: Asinguye wonke umntu oza kuba ne-SJS kumayeza adweliswe apha. Izigidi zabantu ziyawasebenzisa. Nangona kunjalo, la mayeza afunyenwe enobungozi obukhulu bokufumana i-SJS. Ungaze uyeke ukuthatha amayeza amiselwe ngugqirha ngokusekelwe kweli nqaku.
Ukuxilongwa kunye nonyango lwesifo
Ukuba wena okanye umntu omaziyo uhlangabezana nezi mpawu zingasentla, ingakumbi ukuba usandul’ ukuqala unyango olutsha, kubalulekile ukuba uye kwiSebe leNgxamiseko (ETU) lesibhedlele esikufutshane ngoko nangoko .
Oogqirha baxilonga esi sifo ngokuthi:
- Ngokuhlola ulusu lwakho kunye neenwebu ze-mucous (ezifana nomlomo, amehlo).
- Ngokubuza malunga nenqanaba lentlungu oyivayo.
- Ngokujonga isantya ezisasazeka ngaso iimpawu zolusu kunye nokuba zisasazeke kangakanani.
- Ukuba kuyimfuneko, iqhekeza elincinci lesikhumba lingathathwa lihlolwe (i-skin biopsy).
Unyango lwe-SJS
Iinjongo eziphambili zonyango lwe-SJS kukuyeka iyeza elibangele esi sifo, ukulawula iimpawu, ukuthintela iingxaki, nokunceda ulusu luphile. Ukulaliswa esibhedlele kuyimfuneko ngenxa yoku.
Ezinye iindlela zonyango zidweliswe ngezantsi:
| Indlela yonyango | Inkcazo |
|---|---|
| Ukuyeka iyeza elibangela isifo | Eli linyathelo lokuqala nelibaluleke kakhulu. Iyeza ekucingelwa ukuba libangela i-SJS liyayekiswa ngoko nangoko. |
| Ukubonelela ngolwelo kunye neetyuwa emzimbeni | Ukuxobuka kolusu kubangela ukuba kulahleke ulwelo oluninzi emzimbeni, ngoko ke ulwelo lwe-IV lusetyenziselwa ukubonelela ngolwelo olufunekayo kunye nee-electrolytes. |
| Unyango lolusu | Ulusu olulimeleyo lugqunywe zizinto zokugquma ezikhethekileyo ezinganamatheliyo, njengokunyanga ukutsha. |
| Ukubonelela ngesondlo | Kunzima ukutya ngenxa yezilonda emlonyeni. Ekubeni kufuna amandla amaninzi ukuphiliswa, ukutya okuneekhalori eziphezulu kunikwa ngetyhubhu edlula empumlweni iye esiswini (ukutyisa ngetyhubhu). |
| Ulawulo lweentlungu | Le yimeko ebuhlungu kakhulu, ngoko ke kunikwa amayeza okudambisa iintlungu anamandla. |
| Inkonzo yezonyango ekhethekileyo | Funa uncedo kugqirha wesikhumba, kwaye ukuba amehlo achaphazelekile, cela ugqirha wamehlo. |
Iingxaki ze-SJS kunye nemiphumo emva kokululama
I-SJS yimeko embi kakhulu enokukhokelela ekufeni. Malunga ne -10% yezigulana ezine-SJS kunye ne- 50% yezigulana ezinefomu enzima kakhulu, i-TEN, ziyafa. Izizathu eziphambili zokufa ziingxaki ezinzima ezifana ne-sepsis, i-pneumonia, kunye nokusilela kwamalungu amaninzi.
Nokuba isifo sinyangekile, abanye abantu banokufumana iziphumo ezihlala ixesha elide.
- Utshintsho lolusu: Ulusu olomileyo, ukurhawuzelela, ukutshintsha kombala wolusu.
- Iingxaki zamehlo: amehlo omileyo, ukungakhululeki kwamehlo rhoqo, ukubona izinto ezingaqondakaliyo, ubunzima bokujonga ukukhanya (photophobia).
- Ezinye: Ukubila okugqithisileyo, umonakalo wemiphunga, ukulahleka okanye ukukhubazeka kwezipikili, ukulahleka kweenwele, ukuphazamiseka kwencasa.
Kubaluleke kakhulu: Ukuba uphinde wachatshazelwa liyeza elibangele i-SJS, okwesibini imeko inokuba mandundu kakhulu kuneyokuqala. Ke ngoko, kubalulekile ukukhumbula igama leyeza elibangele i-SJS kunye namayeza afanayo ubomi bakho bonke kwaye wazise ugqirha ngamnye ombonayo.
Umyalezo Wokuya Ekhaya
- I-Stevens-Johnson Syndrome (SJS) yimpendulo yolusu enzima nesongela ubomi, edla ngokubangelwa liyeza.
- Iimpawu zokuqala ziquka umkhuhlane kunye neentlungu zomzimba, kodwa kamva ziqhubekela phambili zibe ngamabala abomvu abuhlungu eluswini, amadyungudyungu, kunye nokuxobuka kolusu.
- Ukuba ufumana ezi mpawu emva kokuqalisa amayeza amatsha, yiya kwiSebe lezeMpilo eziNgxamisekileyo (ETU) esibhedlele ngoko nangoko ngaphandle kokulibazisa.
- Unyango oluphambili kukuchonga nokuyeka iyeza elibangele esi sifo, kunye nokubonelela ngonyango oluxhasayo esibhedlele.
- Khumbula igama leyeza elibangele i-SJS yakho ubomi bakho bonke kwaye wazise ugqirha wakho ngalo lonke ixesha xa usiya kunyango. Oku kungasindisa ubomi bakho.
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