Khawuthelekelele ukuba usandul’ ukuqala ukusebenzisa amayeza amatsha okugula okuthile. Emva kweveki okanye ezimbini, uziva ungaphilanga kakuhle, ngokungathi uza kuba nomkhuhlane. Umzimba wakho uyaqaqamba, uzive unomkhuhlane, uyaqhaqhazela... Emva koko, umzimba wakho uqala ukuvela amabala abomvu ajika kancinci abe ngamaqhuqhuva amanzi, kwaye ulusu lwakho luqala ukuxobuka ngokungathi utshisiwe. Le yimeko eyoyikisayo kakhulu, ebuhlungu, kwaye enokuba yingozi ebomini. Namhlanje sithetha ngale meko iyingozi, eyiToxic Epidermal Necrolysis (TEN) .
Ngamafutshane, yintoni iToxic Epidermal Necrolysis (TEN)?
I-Toxic Epidermal Necrolysis, okanye i-TEN ngamafutshane, yimeko yolusu ebuhlungu kakhulu kwaye inokubeka ubomi esichengeni. Ibangela amadyungudyungu nokuxobuka kwiindawo ezinkulu zomzimba wakho, ngokuqhelekileyo ubuncinane i-30% yomzimba wakho. Oku kuxobuka kunokubakho nakwiindawo ezine-mucous membranes, njengomlomo, amehlo, kunye nezitho zangasese.
Le meko iyingozi idla ngokuvela njengempendulo eqatha kumayeza athile esiwasebenzisayo. Xa ulusu lonakele kakhulu, kukho umngcipheko omkhulu wokuphelelwa ngamanzi emzimbeni kunye nosulelo olukhulu.
Ukuchaneka, i-TEN lolona hlobo lubi kakhulu lwesinye isifo solusu esibizwa ngokuba yi-Stevens-Johnson syndrome (SJS). Kwi-SJS, ngaphantsi kwe-10% yolusu lomzimba luyaphela. Xa i-10% ukuya kwi-30% yomzimba ichaphazeleka, siyibiza ngokuba yi-SJS-TEN overlap condition. Ukuba ngaphezulu kwe-30% yolusu luyaphela, ithathwa njenge-TEN.
Ngubani osengozini enkulu yokuhlaselwa yile meko?
Abantu abaneenkqubo zomzimba ezibuthathaka banamathuba amaninzi okufumana isifo sikaStevens-Johnson (SJS) okanye iTEN. Kukho izizathu ezahlukeneyo zokuba inkqubo yomzimba yomzimba isenokuba buthathaka.
- Abantu abosulelwe yintsholongwane ye-human immunodeficiency virus (HIV).
- Abantu abaneemhlaza ezithile, ezifana ne-lymphoma.
Ukongeza, izinto zemfuza nazo zinokudlala indima. Imizimba yabanye abantu ayinakukwazi ukuwohloka nokuguqula amayeza athile abe semgangathweni. Oku kuvela kwiimfuza zabo. Kwiimeko ezinjalo, loo mayeza anokuqokelelana emzimbeni aze abangele iimpendulo ezinzima ezifana ne-SJS okanye i-TEN. Kwakhona, ngenxa yotshintsho (utshintsho) kwiimfuza ezithile, abanye abantu banokuba nethuba elikhulu lokusabela kumayeza athile.
Nangona i-TEN inokwenzeka nakweyiphi na iminyaka, ixhaphake kakhulu kubantu abadala. Nangona kunjalo, yimeko engaqhelekanga kakhulu .Kubalulekile ukukhumbula ukuba kwihlabathi liphela, i-SJS kunye ne-TEN xa zidibene zichaphazela abantu abamalunga nesigidi esinye okanye ezibini ngonyaka.
Zithini izizathu eziphambili ze-TEN?
Kwiimeko ezininzi, oogqirha bakholelwa ukuba amayeza athile ngawona abangela i-TEN. Makhe sijonge ukuba ngawaphi amayeza asemngciphekweni omkhulu.
| Udidi lweziyobisi | Ingcaciso elula |
|---|---|
| I-Allopurinol | Iyeza elisetyenziselwa ukunyanga izifo ezinje ngamatye ezintso kunye ne-gout. |
| Imithi yokuxhuzula | Udidi lwamayeza anikwa ukulawula iimeko ezifana nokuxhuzula. |
| Amayeza okulwa nosulelo lwe-HIV | Ingakumbi amayeza asetyenziswa ukunyanga usulelo lwe-HIV (umz. i-nevirapine). |
| IiOxicams | Ezi zididi lweziyobisi ezibulala iintlungu kunye neziyobisi ezilwa nokuvuvukala ezikwiqela lee-NSAID. |
| IiSulfonamides | Ezi luhlobo lwamayeza okubulala iintsholongwane. |
Ukongeza kula mayeza, kunqabile kakhulu ukuba kubekho usulelo okanye imijovo ethile enokubangela i-TEN. Kodwa oku kunqabile kakhulu. Ngamanye amaxesha, unobangela we-TEN awufumaneki.
Zithini iimpawu ze-TEN?
Iimpawu ezilishumi zihlala ziqala ukubonakala kwiiveki ezimbalwa emva kokuqala amayeza amatsha. Ziqala ngeempawu ezifana nomkhuhlane.
- Intlungu yomzimba
- Ukukhwehlela
- Umkhuhlane kunye nokubanda
- Intloko ebuhlungu
- Ukubomvu kwamehlo kunye nokudumba
Emva kwezi mpawu zokuqala, amabala abomvu abuhlungu (amaqhakuva) aqala ukubonakala eluswini. La mabala akhula kancinci kancinci, ajike abe ngamaqhuqhuva azele ngamanzi, kwaye ekugqibeleni ulusu luqala ukuxobuka. Amanxeba avela xa ulusu luxobuka abizwa ngokuba zii-erosions . La ngamanxeba abuhlungu kakhulu, avulekileyo abonakala ngathi kukutsha okukhulu.
Ezi zilonda ziqala ukubonakala ebusweni nasesifubeni, emva koko zinokusasazeka ziye kwezinye iindawo zomzimba.
- Amehlo: Ingaphakathi le-eyelid (conjunctiva) kunye nenxalenye engaphandle yeliso elimnyama (cornea) zinokonakala.
- Iinwebu ze-Mucous: Izilonda zinokwenzeka ngaphakathi emlonyeni, empumlweni, emqaleni, nakwindlela yokuphefumla.
- Indlela yokungena komchamo, i-anus, kunye namalungu esini: Ezi ndawo zinokwenzakala kakhulu.
Ezi zingozi zenza kube lula nokuba yimisebenzi elula njengokutya, ukuginya, ukuphefumla, ukuvala amehlo, kunye nokuchama kube buhlungu kakhulu kwaye kube nzima.
Iingxaki ezinzulu ezinokwenzeka ngenxa ye-TEN
I-TEN ayisiyonto ithathwa lula. Inokubangela iingxaki ezinkulu nezisongela ubomi.
- Iintsholongwane: Xa ulusu luqhekeka, kukho ithuba elikhulu lokuba iintsholongwane zingene emzimbeni. Ukuba ezi ntsholongwane zingena egazini, imeko eyingozi kakhulu ebizwa ngokuba yi-sepsis inokwenzeka.
- Ukungasebenzi kakuhle kwamalungu amaninzi: Ukudumba okukhulu kunye nosulelo emzimbeni kunokubangela ukuba amalungu angaphakathi anjengezintso, isibindi kunye nemiphunga angasebenzi.
- I-Pneumonia: Kukho umngcipheko okhulayo wosulelo lwemiphunga ngenxa yokwenzakala kwindlela yokuphefumla.
Ngenxa yokuba kunokwenzeka ukuba kubekho iingxaki ezinzima kangaka, umntu oneempawu ze-TEN kufuneka alaliswe esibhedlele aze anyangwe ngoko nangoko .
Oogqirha bayixilonga njani le sifo?
Ugqirha ofanelekileyo unokuxilonga i-TEN ngokuxilonga ulusu lwakho aze abuze ngeempawu zakho. Ngamanye amaxesha, kunokufuneka i-biopsy yolusu ukuqinisekisa ukuxilongwa.
Oku kuquka ukuthatha ulusu oluncinci kakhulu kwisilonda sesikhumba phantsi kwe-anesthesia uze uluhlole phantsi kwe-microscope. Olu vavanyo lunokubona ngokucacileyo ukuba kukho iiseli zesikhumba ezifileyo (iiseli ezifileyo) kunye nokuba ulusu oluphezulu (i-epidermis) luhlukene nolusezantsi.
Zithini iindlela zonyango zoku?
Okubaluleke kakhulu, i-TEN yingxamiseko yezonyango.Esi asisosifo esinokunyangwa ekhaya. Kufuneka uye kwiCandelo loNyango oluNgxamisekileyo (ETU) lesibhedlele kwangoko nje ukuba iimpawu ziqale.
Esibhedlele, isigulana sidla ngokungeniswa kwigumbi lokunyamekela abagula kakhulu (ICU) okanye kwiziko lokutsha, njengoko aba baguli befuna unyango olukhethekileyo olufana nolo lunikwa isigulana esitshileyo.
Iindlela zonyango zinokwahlulwa zibe ziinxalenye ezimbini eziphambili.
| Iindlela zonyango lwe-TEN | |
|---|---|
| Unyango olukhawulezileyo | |
| Ukuyeka iyeza elibangela | Onke amayeza ekurhanelwa ukuba abangela i-TEN ayayekiswa ngoko nangoko. |
| Ulawulo lwamanqanaba olwelo lomzimba | Ukuxobuka kwesikhumba kubangela ukuba kususwe ulwelo oluninzi emzimbeni. Ngenxa yoko, i-saline (IV fluids) inikwa ngemithambo ukuze kulawulwe amanqanaba olwelo emzimbeni. |
| Ukuthintela usulelo | Iikhrimu okanye amafutha okubulala iintsholongwane asetyenziswa kumanxeba avulekileyo. Amayeza okubulala iintsholongwane anikwa xa iimpawu zokuqala zosulelo ziqala. |
| Ezinye iindlela zonyango ezithile | |
| I-immune globulin (IVIG) | Olu lulwelo olukhutshwa ngemithambo yegazi. Lunezilwa-ntsholongwane ezithathwe kwi-plasma yegazi yabantu abaphilileyo. Ezi zinceda ekulawuleni impendulo embi yomzimba kwizifo. |
| Izinto ezithintela amasosha omzimba | Kunikwa amayeza okuthintela inkqubo yomzimba yokuzikhusela ekuhlaseleni iiseli zayo, nto leyo ewenza buthathaka umsebenzi wayo. |
| I-Plasmapheresis | Oku kuquka ukuthumela igazi lesigulana kumatshini okhethekileyo, ukwahlula nokususa ii-antibodies eziyingozi kwi-plasma yegazi, nokubuyisela igazi elicociweyo emzimbeni. |
Iziphumo zexesha elide emva kokululama
Abo basindileyo kwi-TEN banokufumana iziphumo ezithile zexesha elide. Nokuba ulusu luphola ngokupheleleyo, ezinye iingxaki zinokuvela.
- Ulusu, iinwele kunye neenzipho: ukukhula okanye ukuqhekeka kweenzipho okungaqhelekanga, amabala esikhumba (amnyama okanye amhlophe), ukulahleka kweenwele kwezinye iindawo (i-alopecia areata), ulusu olomileyo nolurhawuzelelayo, ukubila okugqithisileyo.
- Amehlo: Ukudumba okanye ukuba bomvu kwamehlo ixesha elide, amehlo omileyo, ukungaqheleki kwamehlo, ukuva ukukhanya, ukubona okufipheleyo okanye, ngokungaqhelekanga, ubumfama.
- Umlomo, impumlo kunye nenkqubo yokuphefumla: I-Bronchitis, izifo zemiphunga ezifana ne-COPD, umlomo owomileyo, isifo seentsini, ukulahlekelwa yincasa nevumba, umonakalo wemiphunga.
- Inkqubo yomchamo kunye neyokuzala: Ukwenzakala okanye ukudumba kwexesha elide kwe-urethra, i-vagina, okanye i-penis, ubunzima bokuchama, ukoma kwe-vagina kubafazi.
Kubaluleke kakhulu ukuthetha nogqirha wakho ngale miphumo yexesha elide uze ufumane unyango olufunekayo.
Umyalezo Wokuya Ekhaya
- I-Toxic Epidermal Necrolysis (TEN) yindlela enzima kakhulu, enokubangela ukufa xa kuthe kwasetyenziswa amayeza athile.
- Iqala ngeempawu eziqhelekileyo ezifana nomkhuhlane kunye neentlungu zomzimba, kodwa emva koko iqhubekela phambili ibe ngamadyungudyungu abuhlungu kunye nokutsha okubangela ukuba ulusu luxobuke.
- Le yingxamiseko yezonyango. Ukuba ufumana ezi mpawu, kufuneka uye kwiYunithi yoNyango oluNgxamisekileyo (ETU) yesibhedlele ngoko nangoko.
- Ukuba uqalisa ukuba nerhashalala eluswini, ukudumba, okanye ezinye iimpawu ezingaqhelekanga emva kokuqala amayeza amatsha, ungaze uyityeshele loo nto. Bona ugqirha wakho ngoko nangoko.
- Ukuba ukhe waba ne-allergy nakweyiphi na iyeza ngaphambili, qiniseka ukuba wazisa ugqirha wakho ngale nto nanini na xa usiya kufuna amayeza.
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