Ingabe umzimba wakho uvuza uketshezi kanje? Ake sixoxe nge-Capillary Leak Syndrome!

Wake wezwa nge-Capillary Leak Syndrome? Igama lingase lizwakale liyinkimbinkimbi kancane. Kodwa kalula nje, yisimo lapho ingxenye ewuketshezi yegazi, ebizwa ngokuthi i-plasma, ivuza khona emithanjeni yegazi emincane emizimbeni yethu, ebizwa ngokuthi ama-capillary. Lolu ketshezi luvuza emisipheni yethu, ezicutshini, ezithweni zomzimba, nasezimbotsheni zomzimba. Lesi kungaba yisimo esibi kakhulu, ngakho-ke kubalulekile ukuqaphela.

Iyini le nto ebizwa ngokuthi i-capillary leak syndrome?

Kulungile, ake sichaze kabanzi. Cabanga ukuthi umzimba wakho unesimiso samapayipi amanzi. Lawa mapayipi ayimithambo yegazi yethu. Amapayipi amancane kakhulu, amancane kulokhu abizwa ngokuthi ama-capillary. Lawa amapayipi lapho umoya-mpilo nezakhamzimba ziya khona kuzo zonke izingxenye zomzimba wethu. Ngakho-ke, ku-`(Capillary Leak Syndrome)`, ingxenye ewuketshezi yegazi, okungukuthi , i-plasma , ivuza ngalezi zinhlayiya ezincane. Kufana namanzi avuzayo epayipini lamanzi.

Lokhu kuvuza koketshezi kubangela ukuthi uketshezi luqoqeke ezingxenyeni ezahlukene zomzimba. Isibonelo, lolu ketshezi lungavuza emisipheni, ezicutshini, ezithweni ezahlukahlukene, noma ezikhaleni (izikhala zomzimba) lapho kutholakala khona izitho.

Iziqephu zalesi `(Capillary Leak Syndrome)` zingavela izikhathi eziningana ngonyaka, noma kanye nje empilweni. Kodwa-ke, uma singelashwa ngokushesha, umfutho wegazi wakho ungehla ngokuzumayo, okuholela ekuhlulekeni kwezitho zomzimba futhi ngezinye izikhathi ngisho nokufa. Ngakho-ke lokhu akuyona into okufanele ithathwe kalula.

Akukho ukwelashwa okuhlala njalo kwalokhu okwamanje. Kodwa-ke, kubalulekile ukufuna usizo lwezokwelapha ngokushesha ukuze ulawule izimpawu. Ngezinye izikhathi, kungenzeka ukuvimbela ukuhlaselwa esikhathini esizayo ngokuqhubeka nokusebenzisa imithi noma ukuthola ukuxutshwa kosawoti.

Zikhona yini izinhlobo zalokhu? Zihluke kanjani?

Yebo, kunezinhlobo ezimbili eziyinhloko ze-`(Capillary Leak Syndrome)`. Ake sibone ukuthi ziyini.

• I-Systemic Capillary Leak Syndrome: Ebizwa nangokuthi "i-Primary Capillary Leak Syndrome" noma "isifo sikaClarkson", lesi yisimo lapho ukuhlaselwa kwenzeka khona ngokuphindaphindiwe , ngisho nakumuntu ophile kahle.
• I-Secondary Capillary Leak Syndrome: Lokhu kwenzeka lapho ukuhlaselwa kwenzeka kanye ngenxa yesinye isifo, isimo, noma imithi.

Kalula nje, enye into engenzeka njalo, kanti enye into eyenzeka okwesikhashana ngesizathu esithile.

Ubani onamathuba amaningi okuthola lesi simo?

"I-Systemic Capillary Leak Syndrome" iyisifo esingavamile kakhulu.Kubikwa ukuthi abantu abangaphansi kuka-500 emhlabeni wonke banalesi simo. Sivame kakhulu kubantu abaseminyakeni ephakathi. Singavamile kakhulu ezinganeni ezincane. Kodwa-ke, ngenxa yokuthi abantu abanalesi simo ngezinye izikhathi bahlonzwa kabi njengabanesinye isimo, inani langempela labantu abanalesi simo lingase libe phezulu kakhulu.

Kodwa-ke, i-Secondary Capillary Leak Syndrome ingavela kunoma yimuphi ubudala. Ukutheleleka okuthile, izimo zezokwelapha, kanye nemithi kungabangela lokhu.

Kwenzekani emzimbeni uma lokhu kwenzeka? (Izigaba ezintathu)

Okwenzekayo emzimbeni wethu phakathi nalokhu kuhlasela kwe-`(Capillary Leak Syndrome)` kungahlukaniswa ngezigaba ezintathu. Ake sibone ukuthi ziyini.

Isigaba sokuqala: Ngaphambi kokuba kuvele izimpawu (isigaba se-Prodromal)

Lesi isikhathi sosuku noma ezimbili ngaphambi kokuhlaselwa. Phakathi nalesi sikhathi, ungase uqale ukuzwa izimpawu ezithile.

• Ukuzizwa ukhathele
• Ukomela amanzi okwandayo
• Izinto ezifana nokukhuluphala ngokuzumayo zingenzeka.

Isigaba sesibili: Isigaba sokuvuza noma sokuvuselela

Yilapho ukuhlaselwa kwenzeka khona ngempela. Okwenzekayo ukuthi uketshezi kanye ne -albumin (uhlobo lweprotheni egazini) kuvuza kusuka kuma-capillary akho kuya ezikhaleni eziphakathi kwezicubu zakho. Lokhu kunciphisa inani legazi elithwala umoya-mpilo. Umfutho wegazi wakho uyehla, futhi amangqamuzana abomvu egazi ahlangana ndawonye, ​​okwenza igazi lakho libe likhulu. Lokhu kuvuza koketshezi kubangela ukwehla kwevolumu yegazi, okubizwa ngokuthi i-hypovolemia .

Isigaba sesithathu: Ngemva kokuhlasela `(Isigaba sangemuva kokuvuza noma isigaba sokuqasha)`

Lesi yisikhathi ngemva kokuba ukuhlasela sekuphelile. Okwenzekayo ukuthi ama-capillary akho aqala ukumunca uketshezi kanye ne-albumin ezicutshini futhi. Kodwa-ke, phakathi nalesi sikhathi, umzimba wakho ungaqoqa uketshezi oluningi kakhulu (uketshezi oluningi kakhulu) . Ngenxa yalokho, umzimba wakho ungakhiqiza umchamo omningi kakhulu (i-polyuria) futhi amaphaphu akho angagcwala amanzi (i-pulmonary edema).

Cabanga ngakho, kufana nesiponji esimunca amanzi. Okokuqala, uketshezi luphuma emzimbeni, bese kuthi uma selumunca futhi ngokushesha okukhulu, lumunca okungaphezu kwalokho okufanele.

Yini ebangela lokhu?

Manje ake sibheke ukuthi yini engabangela lesi `(i-Capillary Leak Syndrome)`.

Izimbangela ze-`(Systemic Capillary Leak Syndrome)`

Uma ngikhuluma iqiniso, imbangela eqondile ye-Systemic Capillary Leak Syndrome ayikakaziwa. Abacwaningi bakholelwa ukuthi kungenzeka ukuthi ibangelwa ukusabela kwamasosha omzimba ethu ezifweni ezithile noma ekuthelelekeni.

Izimbangela ze-`(Secondary Capillary Leak Syndrome)`

Kunezizathu eziningana zalokhu. Imbangela evame kakhulu yisimo esibizwa ngokuthi i-sepsis . Okusho ukuthi, inkinga esongela ukuphila ebangelwa ukutheleleka. Ngaphezu kwalokho, kunezinye izimbangela:

• Izifo ezizenzakalelayo:Okwenzekayo kulokhu ukuthi amasosha ethu omzimba ahlasela amangqamuzana ethu aphilile.
• I-Differentiation syndrome: Inkinga engenzeka ngesikhathi sokwelashwa kwezinhlobo ezithile ze-leukemia (i-acute promyelocytic leukemia noma i-acute myeloid leukemia).
• I-Engraftment syndrome: Inkinga engenzeka ngemva kokufakelwa umnkantsha.
• I-Hemophagocytic lymphohistiocytosis: Isimo esingaba yingozi empilweni esibangelwa uhlelo lokuzivikela olusebenza ngokweqile.
• I-Ovarian hyperstimulation syndrome: Inkinga engenzeka ngesikhathi sokwelashwa kokuzala.
• Ubuthi be-ricin.
• Ukulunywa yizinyoka.
• Imfiva ebangelwa ukopha okubangelwa amagciwane: Iqembu lezifo ezithathelwanayo ezibangelwa amagciwane.

Eminye imithi, njengemithi yokulwa nomdlavuza i-gemcitabine (gemcitabine - Gemzar®) kanye ne -tagraxofusp (tagraxofusp - Elzonris®) , nayo ingabangela lokhu (Secondary Capillary Leak Syndrome).

Yiziphi izimpawu ezandulela ukuqala kwalesi sifo?

Ngokuvamile, usuku olulodwa noma ezimbili ngaphambi kokuhlaselwa yi-"Capillary Leak Syndrome", okungukuthi, ngesikhathi "sesigaba sokukhulelwa", ungase ube nezimpawu ezifana nalezi:

• Ubuhlungu besisu noma ubuhlungu bemisipha (myalgia).
• Ukukhathala noma ubuthakathaka obukhulu.
• Ikhanda elibuhlungu .
• Ukomela amanzi okwandayo.
• Ukucasuka, ukucasuka.
• Isicanucanu.
• Ukukhuluphala okungazelelwe.
• Izimpawu zokutheleleka ngegciwane noma ukutheleleka kwendlela yokuphefumula ephezulu.

Uma uzwa izimpawu ezinjengalezi, ungazithathi kalula, uthi, "O, mhlawumbe umkhuhlane nje," ikakhulukazi uma uke waba nokuhlangenwe nakho okufanayo ngaphambili.

Yiziphi izimpawu eziba khona uma unesifo?

Ngesikhathi sokuhlasela kwe-`(Capillary Leak Syndrome)`, okungukuthi, ngesikhathi `(sesigaba sokuvuza noma sokuvuselela)`, izimpawu zingase zihluke kumuntu nomuntu. Kodwa-ke, okulandelayo yizimpawu ezivamile ezingabonakala:

• Ukuvuvukala komzimba, ikakhulukazi izitho zomzimba (i-peripheral edema).
• Uhudo.
• Umfutho wegazi ophansi (hypotension).
• Ukujiya kwegazi (i-hypercoagulability) - Lokhu kungabangelwa ukwanda kwenani lamaseli abomvu egazi (i-hematocrit) noma ukwanda kwenani lamaseli amhlophe egazi (i-leukocytosis).

Odokotela bakubona kanjani lokhu?

Udokotela uzohlola i-Capillary Leak Syndrome ngokubuza ngomlando wakho wezokwelapha kanye nokuhlolwa ngokomzimba. Bazohlola ukuthi umfutho wegazi wakho uphansi yini.

Futhi, ngaphambi kokuqinisekisa ukuthi lokhu kuyi-Capillary Leak Syndrome, ezinye izimo kudingeka zikhishwe. Bangenza ukuhlolwa kwegazi okuningana ukuze benze lokhu:

• Hlola i-hematocrit ephezulu (inani lamaseli abomvu egazini).
• Hlola amazinga aphezulu e-hemoglobin (iphrotheni etholakala kumaseli abomvu egazi).
• Hlola ukuthi amaprotheni aphansi egazini (i-hypoalbuminemia).

Ngaphezu kwalokho, ukuhlolwa kwegazi kungenziwa ukuze kuhlolwe iphrotheni yokuzivikela yomzimba engavamile ebizwa ngokuthi ``i-monoclonal gammopathy, noma iphrotheni ye-M'' egazini. Abantu abane-``Capillary Leak Syndrome'' bangase babe nale phrotheni ye-M engavamile egazini labo.

Ilashwa kanjani? Ingabe ingelapheka?

Ngeshwa, ayikho ikhambi elihlala njalo le-Capillary Leak Syndrome. Odokotela bazama ukulawula izimpawu nokuvimbela izinkinga.

Ngesikhathi sokuhlaselwa yi-"Capillary Leak Syndrome", odokotela bazama ukulawula umfutho wegazi nokugcina ukugeleza kwegazi okufanele ezithweni zomzimba. Bazama futhi ukuvimbela ukuvuvukala ngokweqile nokuqongelela koketshezi. Bangase basebenzise:

• Ama-Glucocorticoids: Lawa uhlobo lwe-steroid olusiza ekunciphiseni ukuvuza koketshezi oluvela kuma-capillaries.
• Uketshezi olufakwa emthanjeni: Izinto ezifana nosawoti zinikezwa ukwandisa ukugeleza kwegazi ezithweni ezifana nezinso.

Ngokuvamile kuzodingeka ulaliswe esibhedlela ngemva kokuhlaselwa. Ngesikhathi sokwelashwa, udokotela wakho uzoqhubeka nokuqapha umfutho wegazi lakho kanye nomfutho wegazi ukuqinisekisa ukuthi awunawo uketshezi oluningi emzimbeni wakho, okungaholela kwezinye izinkinga, njengokuvuvuka kwamaphaphu kanye nokuma kwenhliziyo okungazelelwe.

Ngemva kokuhlaselwa yi-Capillary Leak Syndrome, eyaziwa ngokuthi isigaba sokuvuza ngemuva noma isigaba sokuqasha, udokotela angase akunikeze umuthi wokukhipha isisu (umuthi obangela ukuthi ukhiqize umchamo owengeziwe) ukuze unciphise inani loketshezi oluningi emzimbeni wakho.

Ingabe i-Systemic Capillary Leak Syndrome (SCLS) ingavinjelwa ukuthi ingaphinde ivele?

Awukwazi ukuvimbela i-Systemic Capillary Leak Syndrome ukuthi ingakhuli kwasekuqaleni. Kodwa, uma usuhlaselwe, uyazi ukuthi unaleso simo.

Kodwa-ke, ukuthatha imithi njalo noma ukuthola i-saline infusions kungasiza ekuvimbeleni ukuhlaselwa esikhathini esizayo futhi kunciphise ubukhali bako. Lokhu kwelashwa kungafaka:

• Ukuthola i-intravenous immune globulin (IVIG) njalo ngenyanga.
• Imithi yomlomo ye-asthma, njenge -theophylline (theophylline - Elixophyllin®), i-terbutaline (terbutaline - Brethine®), kanye ne-montelukast (montelukast - Singulair®) .
• Nciphisa ukuvuvukalaAma-steroid.

Liyini ikusasa lalabo abaphila nalesi simo? `(Outlook)`

I-Systemic Capillary Leak Syndrome ngokuvamile ingaphathwa ngemithi yokuvimbela. Ukwelashwa cishe kuyophumelela uma isimo sitholakala kusenesikhathi futhi izinkinga zincane. Ezinye zezinkinga ezinkulu ezingase zenzeke nge-Capillary Leak Syndrome zifaka:

• I-Compartment syndrome: Ukwanda kwengcindezi ngaphakathi kwemisipha kanye nokwehla kokugeleza kwegazi.
• Ukuqongelela koketshezi oluzungeze inhliziyo namaphaphu (i-cardiac tamponade, i-pericardial effusion, kanye ne-pleural effusion).
• Ukwehluleka kwenhliziyo.
• Ukwehluleka kwezinso.
• I-Neuropathy.
• Ukuvuvukala kwamaphaphu.
• I-Rhabdomyolysis: Ukwehluleka kwezinso ngenxa yokulimala kwemisipha.
• Isifo sohlangothi.

Lokhu kungase kuzwakale kusabisa, kodwa njengoba kushiwo ngaphambili, ukwelashwa okusheshayo kanye nokuphathwa okufanele kubaluleke kakhulu.

Kufanele ngimbone nini udokotela?

Uma ucabanga ukuthi uhlaselwa yi-Capillary Leak Syndrome, bona udokotela ngokushesha. Bangakusiza ekulawuleni izimpawu zakho futhi bakunike impumuzo.

Khumbula, nakuba lesi kuyisimo esingavamile, kubalulekile ukuqaphela izimpawu nokufuna iseluleko sezokwelapha ngokushesha uma ungabaza.

Umlayezo Wokuya Nawe Ekhaya

Kulungile, ake siphinde sixoxe ngamaphuzu abaluleke kakhulu esikhulume ngawo:

• Lokhu kwenzeka lapho ingxenye ewuketshezi yegazi (i-plasma) ivuza emithanjeni yegazi emincane (ama-capillaries) emzimbeni wethu.
• Lokhu kungenzeka kanye noma ngokuphindaphindiwe.
• Uma kungelashwa, kungaba nezinkinga ezinkulu, ngakho-ke kubalulekile ukuthola usizo lwezokwelapha ngokushesha.
• Nakuba kungekho ikhambi elihlala njalo, kunezindlela zokwelapha zokulawula izimpawu nokuvimbela ukuhlaselwa esikhathini esizayo.
• Uma usola noma yiziphi zalezi zimpawu, bona udokotela ngokushesha. Uma usheshe uxilonge lesi sifo bese uqala ukwelashwa, amathuba akho okululama ayanda.

Ngakho-ke, ngithemba ukuthi lolu lwazi luwusizo kuwe. Hlala uphilile!

Isifo Sokuvuza Kwe - Capillary, Ukuvuza Kwe-Plasma, Umfutho Wegazi Ophansi, Isifo SikaClarkson, Ukuvuvuka, Ukuvuza Koketshezi Emzimbeni