Ngaba kukho ingxaki enkulu emzimbeni wakho? Masifunde ngeWaterhouse-Friderichsen Syndrome!

Ngaba wakha weva ukuba amadlala amabini amancinci emzimbeni ayayeka ukusebenza, kwaye anokuba nefuthe elikhulu ebomini bakho? Namhlanje siza kuthetha ngesimo esiyingozi kangaka, kwaye ukuba asinyangwa ngokukhawuleza, sinokubulala. Oku kubizwa ngokuba yiWaterhouse-Friderichsen Syndrome. Nangona igama lisenokubonakala lide kancinci, masithethe nje ngokuba yintoni, kutheni isenzeka, kunye nendlela yokusinda.

Yintoni le Waterhouse-Friderichsen Syndrome?

Ngamafutshane, iWaterhouse-Friderichsen Syndrome (WFS) yimeko enzulu kakhulu. Okwenzekayo kukuba amadlala akho e-adrenal , angamadlala amabini amancinci akwindawo engaphezulu kwezintso zakho, ayopha (esikubiza ngokuba yi-'adrenal hemorrhage') kwaye elinye okanye omabini la madlala ayeke ukusebenza. Ngokuqhelekileyo, oku kubangelwa lusulelo olunzima. Ukuba anganyangwa, la madlala e-adrenal aphantse ayeke ngokupheleleyo ukuvelisa i-hormone cortisol, ebaluleke kakhulu emzimbeni wethu. Oku sikubiza ngokuba yingxaki ye-adrenal . Ukuchaneka, yingxamiseko!

Kukho elinye igama lale nto, elithi ``hemorrhagic adrenalitis.'' Oko kuthetha ukuba amadlala e-adrenal ayopha aze avuvuke.

Ixhaphake kangakanani le meko?

Enyanisweni, i-Waterhouse-Friderickson syndrome ayiqhelekanga . Ngokwesiqhelo, ukuvavanywa kwezidumbu kufumanisa ukuba le meko ibangela malunga ne-1% kuphela yokufa. Oku kuthetha ukuba ayisosifo esichaphazela wonke umntu, kodwa ukuba siyenzeka, siyingozi kakhulu.

Zithini iimpawu zesi sifo?

Khawucinge nje, ngequbuliso wafumana intsholongwane okanye iintsholongwane waza wahlakulela le meko ye-WFS. Emva koko ungaqalisa ukubonisa iimpawu zosulelo ngequbuliso. Uyazi ukuba yintoni leyo?

• Ndifumana umkhuhlane ophezulu.
• Umzimba uziva ubanda kwaye uqhaqhazela (iiNqabaka).
• Intloko yam ibuhlungu kakhulu.
• Ndiza kuhlanza, ndiza kuhlanza.
• Izihlunu emzimbeni wam ziyaqaqamba, ingakumbi kwiindawo ezifana nomqolo wam osezantsi, isisu, kunye nemilenze.
• Amalungu am abuhlungu.
• Ngamanye amaxesha kunokubakho ukulahleka kwengqondo (i-syncope).

Xa oku kuphuma kwegazi kuqala ukuchaphazela kungekuphela nje amadlala e-adrenal kodwa nakwezinye iindawo zomzimba, ezinye iimpawu zinokuvela. Ezi ziquka:

• Ukuqhekeka kwegazi okusasazeka ngaphakathi kwemithambo yegazi (DIC): Oku kuvakala kuyinkimbinkimbi, akunjalo? Ngamafutshane, sisifo apho inkqubo yokuqhekeka kwegazi emzimbeni wonke iba yingxaki. Xa ihlwili legazi lenzeka kwindawo enye, alinakumisa ukopha kwenye indawo.
• Ukuqhambuka kwesikhumba:Ngamanye amaxesha zinokubonakala eluswini njengamachaphaza amancinci okanye amabala amakhulu.
• Ukothuka kweSeptic: Le yimeko apho uxinzelelo lwegazi luyehla kakhulu ngenxa yosulelo, nto leyo ebangela ukuba amalungu omzimba angafumani gazi laneleyo. Oku kuyingozi kakhulu.

Zithini iimpawu zokopha kwe-adrenal gland?

I-WFS inxulunyaniswa nokopha kwe-adrenal, okunokuhambisana nezinye iimpawu:

• Isisu esibuhlungu.
• Intlungu kwindawo engaphezulu kwesinqe, ngaphantsi kweembambo (izinqe).
• Ukungabi namdla, ukuziva ungakhululekanga.
• Ubuvila.
• Isicaphucaphu nokuhlanza.
• Urhudo.

Yintoni ebangela oku?

Kwiimeko ezininzi, eyona nto ibangela i-Waterhouse-Friderickson syndrome kusulelo lweentsholongwane kunye neentsholongwane (i-sepsis) . Ngokuchanekileyo, intsholongwane ingena emzimbeni ize isasazeke emzimbeni wonke ngaphandle kokulawulwa.

Ezinye iintlobo zeebhaktheriya zinokuba semngciphekweni kakhulu koku. Nazi imizekelo embalwa:

• `Pseudomonas aeruginosa`
• Ibhaktheriya yeMeningococcus: Le yeyona iyingozi kakhulu enokubangela i-WFS.
• `I-Streptococcus pneumoniae`
• `Umkhuhlane weHaemophilus`
• `I-Escherichia coli (E. coli)`
• `I-Staphylococcus aureus`

Ezinye iintlobo ezininzi zeebhaktheriya zinokubangela oku.

Kwakhona, ezinye iintlobo zeentsholongwane zinokubangela oku:

• I-Cytomegalovirus (CMV)
• I-Parvovirus `(Parvovirus)`
• Intsholongwane ka-Epstein-Barr
• Intsholongwane ye-Ebola `(isifo sentsholongwane ye-Ebola)`
• Intsholongwane yeVaricella-zoster (yile nto ibangela izifo ezifana ne-chickenpox kunye ne-herpes)

Ukongeza kwezi zifo, kukho nezinye izinto ezinokubangela ukuphuhliswa kwe-WFS:

• Ukusebenzisa amayeza okunciphisa ukugabha kwegazi. La mayeza andisa umngcipheko wokopha.
• I-Thrombocytopenia: Oku kuthetha ukwehla kwenani leeplatelets (iiseli ezinceda ukujiya kwegazi) egazini.
• Iindlala ze-adrenal zonakele ngandlela thile.

Ngubani ochaphazeleka kakhulu yile meko?

I-Waterhouse-Friderickson syndrome inokwenzeka kakhulu kubantwana abancinci kunakwabantu abadala . Ngoko ke, ukuba umntwana omncinci uba neempawu ezifana nomkhuhlane kunye neentlungu zomzimba, kufuneka ulumke kakhulu.

Zeziphi iingxaki ezinokubangela oku?

Le yeyona nto ibalulekileyo. Ukuba ayinyangwa ngokukhawuleza nangendlela efanelekileyo, i-Waterhouse-Friderickson syndrome iyabulala. Oko kuthetha ukuba inokuba yingozi ebomini. Ngoko ke oku kufanele kuphathwe njengengxamiseko.

Sifunyaniswa njani esi sifo?

Ukuze ufumanise esi sifo, ngokuqinisekileyo uya kufuna uncedo kugqirha. Ugqirha uza kukubuza ngeempawu zakho, akubuze ngezifo zakho zangaphambili, aze emva koko ahlole umzimba wakho.

Kodwa ukufumanisa i-WFS kunokuba nzima kancinci, njengoko iimpawu zayo zifana kakhulu nezo zokothuka kwe-septic . Ke ngoko, ukuqinisekisa ukuba yi-WFS na, ugqirha uya kuyalela iimvavanyo ezahlukeneyo.

Zeziphi iimvavanyo ezisetyenziswayo ukufumanisa isifo?

Ukuqinisekisa ukuba kukho usulelo, ugqirha angenza ezi mvavanyo zilandelayo:

Uvavanyo lokufota

• Iskeni ye-ultrasound okanye i-CT (computed tomography) ingenziwa ukujonga ukuba igazi liqokelelene na ngaphakathi kwi-adrenal glands. Ezi skeni zithatha imifanekiso yangaphakathi emzimbeni, ukuze zibone ngokucacileyo iindawo apho igazi liphuma khona.

Uvavanyo lwegazi

• Uvavanyo lwegazi lunokubonisa ngokuqinisekileyo ukuba unentsholongwane. Oku kuquka ukuthatha inaliti encinci emthanjeni osengalweni yakho, ukuthatha igazi elincinci, uze ulijonge phantsi kwemakroskopu. Oku kuya kukhangela iimpawu zosulelo.

Uvavanyo lwebhaktheriya yeMeningococcus

Ukuba ugqirha ucinga ukuba imbangela yintsholongwane ye-meningococcus, banokwenza uvavanyo olufana nolu:

• Ukubhoboza umqolo/i-lumbar puncture: Oku kuquka ukufaka inaliti encinci kumqolo wakho ongezantsi, phakathi kwamathambo amabini, kunye nokuthatha ulwelo lomqolo oluncinci. Oku kunokuvakala kusoyikisa, kodwa oogqirha bakwenza ngononophelo.
• I-biopsy yolusu: Ukuba unesilonda eluswini lwakho, kuya kuthathwa iqhekeza elincinci lesikhumba esilondayo lize lihlolwe.
• Uvavanyo lwe-Gram stain: Isampulu ithathwa kwindawo ekrokrelwayo (njengenxeba) ukuze kukhangelwe iintsholongwane.
• Uhlalutyo lomchamo: Uza kucelwa ukuba uchamele kwisitya esikhethekileyo. Isampulu yomchamo iya kuvavanywa ukuze kubonwe iimpawu zosulelo.

Uvavanyo lwe-adrenal crisis olukhawulezileyo

Olu vavanyo lunceda ekuqinisekiseni ukuba unengxaki ye-adrenal , imeko apho amadlala e-adrenal angasebenzi kakuhle:

• Uvavanyo lokukhuthaza i-Adrenocorticotropic hormone (ACTH): Kolu vavanyo, ugqirha wakho ukunika inaliti encinci ye-hormone ebizwa ngokuba yi-ACTH. Emva koko, emva kwemizuzu engama-30 ukuya kwengama-60, bathatha isampuli yegazi ukuze babone ukuba amadlala akho e-adrenal asabela njani kwi-ACTH. Olu luvavanyo olulinganisa ukuba amadlala akho e-adrenal asebenza kakuhle kangakanani.
• Uvavanyo lweswekile egazini:Kuthathwa igazi elincinci kwaye kulinganiswa ubungakanani beswekile (iglucose) kulo. Amanqanaba eswekile anokuba sezantsi ngexesha lengxaki ye-adrenal.
• Uvavanyo lweCortisol: Kuthathwa isampulu yegazi lakho, umchamo, amathe, okanye indibaniselwano yezimbini okanye ezintathu zezi zinto ukuze kuhlolwe ukuba ingakanani na i-cortisol eveliswa zi-adrenal glands zakho.
• Uvavanyo lwegazi lwe-pH: Kuthathwa isampulu yegazi kwaye kulinganiswa inqanaba layo le-acid-base (pH). Oku kungenziwa ngovavanyo lwegesi yegazi ye-arterial (ABG) okanye iphaneli ye-electrolyte. Ngokwesiqhelo, i-pH yegazi lethu kufuneka ibe phakathi kwe-7.35 kunye ne-7.45.
• Uvavanyo lwegazi lePotassium: Uvavanyo lwegazi lokulinganisa ubungakanani bepotassium egazini lakho. IPotassium sisondlo esinceda imithambo-luvo kunye nemisipha yethu isebenze kakuhle. La manqanaba anokutshintsha ngexesha lengxaki ye-adrenal.
• Uvavanyo lwegazi leSodium: Uvavanyo lwegazi lulinganisa ubungakanani besodium egazini lakho. Isodium ibalulekile ekusebenzeni kakuhle kwemithambo-luvo kunye nemisipha yakho. La manqanaba anokwahluka.

Iphathwa njani le nto?

Ukuba une-WFS, usenokuba ne -sepsis . Ngoko ke, into yokuqala abaya kuyenza oogqirha kukuqalisa amayeza okubulala iintsholongwane ngoko nangoko ngelixa besenza uvavanyo lokufumanisa ukuba yintoni kanye kanye ebangele i-WFS. Baza kujonga amanqanaba akho e-electrolyte (ityuwa) kunye namanzi.

Xa iimpawu ze-sepsis zilawulekile, oogqirha baya kuqala ukukunika amayeza abizwa ngokuba yi-glucocorticoids kunye ne-mineralocorticoids . Ezi zii-hormone ze-steroid. Ii-Glucocorticoids zisebenza ukunciphisa ukudumba emzimbeni. Ii-Mineralocorticoids zisebenza ukulawula amanqanaba etyuwa namanzi emzimbeni wakho. Ngamafutshane, zifana nokukunika ii-hormone ekufuneka ziveliswe zii-adrenal glands zakho, kodwa zingaveliswa.

Usenokufuna utofelo-gazi okanye inkqubo ebizwa ngokuba yi -angioembolization . Oku kuquka ukusebenzisa i-angiogram kunye ne-blood clot (embolization) ukuchonga nokuvala imithambo yegazi ehambisa igazi kwi-adrenal glands. Oku kwenziwa ukuze kumiswe ukopha.

Okubaluleke kakhulu, emva kwe-WFS, abantu abaninzi kuya kufuneka bathathe amayeza eehomoni ongezelelweyo ubomi babo bonke , kuba xa ii-adrenal glands zonakele, zisenokungakwazi ukuvelisa iihomoni ngokufanelekileyo.

Ndiza kuziva ngcono ngokukhawuleza kangakanani emva konyango?

Uninzi lwabantu luqala ukuziva ngcono kwiveki okanye ezimbini emva kokuqala unyango. Nangona kunjalo, nokuba sele uphilile ngokupheleleyo, usenokuba neengxaki zomzimba okanye zengqondo kangangeenyanga, okanye iminyaka. Umzekelo:

• Ukutya akunancasa.
• Sindwe kakhulu.
• Ubunzima bokulala (ukungalali).
• Ukuthambekela kokugula lula.
• Ixhala.
• Uxinzelelo.

Ngoko ke, kubalulekile ukukhumbula ukuba kungathatha ixesha elithile ukuba umntu aphile ngokupheleleyo.

Yintoni onokuyilindela ukuba unesifo esi?

Njengoko besitshilo ngaphambili, ukuba ayinyangwa, i-WFS yimeko ebulalayo. Akukho mathandabuzo ngayo.

Nangona kunjalo, ngonyango oluchanekileyo nolusebenzayo kwangethuba, uninzi lwabantu abane-WFS luyaphila. Nangona kunjalo, unokufuna unyango olunzulu, kwaye iziphumo ze-WFS zinokuhlala iinyanga, kwaneminyaka. Ngoko ke, asinto ifanele ithathwe lula.

Ngaba le meko ingathintelwa?

Kukho izinto ezininzi onokuzenza ukunciphisa umngcipheko wakho wokuba ne-Waterhouse-Friderickson syndrome:

• Ukuhlamba izandla zakho rhoqo nangokucokisekileyo kunokunceda ekuthinteleni usulelo. Le yinto elula kakhulu, kodwa inokukusindisa kwizifo ezininzi.
• Ukufumana isitofu sokugonyela intsholongwane ye-meningococcal kubaluleke kakhulu ebantwaneni.
• Ukuba ukrokrela ukuba unosulelo, funa unyango ngoko nangoko. Musa ukungawunaki umkhuhlane okanye ukukhwehlela okuncinci.

Uzinyamekela njani ngelixa ululama?

Njengoko ululama, wena nogqirha wakho kufuneka nisebenzisane ukwenza isicwangciso sokubuyisela impilo esifanelekileyo, esikhuselekileyo, nesikulungeleyo. Eso sicwangciso sinokubandakanya izinto ezifana nezi:

• Phumla ngokwaneleyo. Umzimba nengqondo zifuna ukuphumla.
• Ukulandela ukutya okunesondlo okuya kukunceda ubuyisele amandla akho kwakhona licebo elihle. Kungangcono ukuba ungafumana iingcebiso kwingcali yesondlo ngale nto.
• Zibekele usukelo oluncinci. Umzekelo, ukuhlala ebhedini, ukuma, ukuzinxibisa wedwa, ukuhlamba, ukuhamba umgama omfutshane, ukunyuka izinyuko.
• Ukuthetha ngeemvakalelo zakho nosapho lwakho, abahlobo, okanye ingcali yezonyango kubalulekile ngeli xesha linzima.
• Zilolonge xa ​​unamandla namandla. Qala kancinci uze uzilolonge ngokwemiyalelo kagqirha wakho.

Ndifanele ndimbone nini ugqirha? / Ndifanele ndiye nini kwigumbi likaxakeka?

Ukuba awukaziva kakuhle emva konyango, okanye ukuba unengxaki yokufikelela kwiinjongo zakho zokubuyisela impilo yakho kwimeko yesiqhelo, qiniseka ukuba uthetha nogqirha wakho.

I-WFS yimeko embi kakhulu enokuba yingozi ukuba ayinyangwa. Ukuba uneempawu ze-WFS, umzekelo, usulelo oluya lusiba mandundu olungapheliyo, kuya kufuneka uye kwigumbi likaxakeka (ETU) ngoko nangoko.Akulunganga ukuyihlehlisa le nto.

Yeyiphi imibuzo omele uyibuze ugqirha wakho?

Xa ufumanisa ukuba une-WFS, unokuba nemibuzo emininzi. Musa ukoyika, buza ugqirha wakho imibuzo efana nale ukuze ucime amathandabuzo akho:

• Uyazi njani ukuba ndinesifo iWaterhouse-Friderickson syndrome?
• Ukuba andinayo i-Waterhouse-Friderickson syndrome, zeziphi ezinye izifo endinokuba nazo?
• Yintoni unobangela we-Waterhouse-Friderickson syndrome yam?
• Ngaba kuya kufuneka ndityandwe ukuze kulungiswe amadlala am e-adrenal?
• Ucinga ukuba ndiza kuphila ngokupheleleyo?
• Ngaba kuya kufuneka ndithathe iihomoni ezongezelelweyo?
• Kuza kufuneka ndithathe iihomoni ezongezelelweyo ixesha elingakanani?

Ngoko ke, zeziphi izinto ezibalulekileyo ekufuneka sizikhumbule koku?

I-Waterhouse-Friderichsen syndrome (WFS) yimeko enzima kakhulu efuna unyango olukhawulezileyo. Ukuba unayo nayiphi na kwezi mpawu, okanye ukuba unentsholongwane engaphucukiyo, kubalulekile ukuya kwigumbi likaxakeka ngokukhawuleza.

Landela yonke imiyalelo yonyango oyinikwe ngugqirha wakho ngokuchanekileyo. Kuphela emva koko unokulawula le meko ye-WFS kwaye uphile ngokukhawuleza. Khumbula, unyango lwangethuba lunokusindisa ubomi! Kwakhona, kubaluleke kakhulu ukuba uzinyamekele kakuhle ngexesha lokuchacha kwakho.

I- Waterhouse-Friderichsen syndrome, ii-adrenal glands, i-cortisol, i-sepsis, usulelo, unyango olungxamisekileyo, iihomoni