Cabanga ngomuntu omaziyo, mhlawumbe ilungu lomndeni, elashwa umdlavuza. Ikakhulukazi ngolunye lwezindlela zokwelapha ezithuthukisiwe kakhulu ezitholakalayo namuhla. Ezinsukwini ezimbalwa ngemva kokuqala ukwelashwa, ngokuzumayo uba nomkhuhlane ophakeme, izinhlungu zomzimba, futhi uzizwe sengathi unomkhuhlane omubi. Sivame ukucabanga ukuthi lokhu kumane kuyimiphumela ejwayelekile yokwelashwa. Kodwa-ke, lokhu kungaba uphawu lokuthile okungathi sína kakhulu. Lesi yisimo sezokwelapha esisibiza ngokuthi i-Cytokine Release Syndrome (CRS) .
Kalula nje, iyini i-CRS?
Ukuze siqonde lokhu, ake siqale sicabange ngesimiso somzimba wethu sokuzivikela. Kufana nebutho elivikela izwe lethu. Leli butho linezithunywa ezithumela imiyalezo phakathi kwamasosha alo (amangqamuzana omzimba). Ngokufanayo, kunezinhlobo ezikhethekile zamaprotheni ezisiza amangqamuzana ethu omzimba ukuxhumana nokulawula umsebenzi wawo, abizwa ngokuthi ama-cytokine . Lawa abalulekile ohlelweni lokuzivikela olunempilo.
Kodwa ngezinye izikhathi, ikakhulukazi ngemithi ethile yokwelapha umdlavuza, njengokwelashwa nge-immunotherapy , amasosha omzimba wethu angavuseleleka ngokweqile. Lokhu kubangela ukukhululwa okungazelelwe kwalezi zithunywa, ezibizwa ngokuthi ama-cytokine, egazini. Kufana nebutho elihlaselayo futhi lithumela izinkulungwane zemiyalezo ngesikhathi esisodwa. Lokhu ngezinye izikhathi kubizwa ngokuthi "isiphepho se-cytokine." Uma ama-cytokine amaningi ekhishwa ngesikhathi esisodwa, kubangela ukuvuvukala emzimbeni wonke. Yilokho esikubiza ngokuthi i-CRS.
Yiziphi izimbangela eziyinhloko ze-CRS?
Imbangela eyinhloko nevame kakhulu ye-CRS ezinye zezindlela zokwelapha zesimanje ezisetshenziswa umdlavuza.
- Ukwelashwa Ngezifo Ezingalawuleki: Lena imbangela evame kakhulu. Ukwelashwa okufana nokwelashwa ngamaseli e-CAR-T kanye nama-antibodies amabili asengozini enkulu ye-CRS. Lokhu kwelashwa kukhuthaza amasosha omzimba ethu ukuthi alwe namaseli omdlavuza. Phakathi nale nqubo, amasosha omzimba ngezinye izikhathi asebenza ngokweqile.
- Ezinye izimbangela: Abantu abanezimo ezithile zofuzo noma izifo zokuzivikela komzimba nabo bangase babe sengozini enkulu. Isibonelo, isimo sofuzo esibizwa ngokuthi i-Hemophagocytic lymphohistiocytosis (HLH) .
Yiziphi izimpawu ezingaba khona ze-CRS?
Izimpawu ze-CRS zingafana nezomkhuhlane ovamile, ngakho-ke ngezinye izikhathi kungaba nzima ukuzibona. Kodwa-ke, lezi zimpawu zingaba zimbi kakhulu ngokushesha.
| Isibonakaliso | Incazelo |
|---|---|
| Umkhuhlane omkhulu kanye nokubanda | Lesi yisibonakaliso sokuqala esivame ukubonakala. |
| Ukudideka kanye nesiyezi | Imiphumela ebuchosheni ingabangela ukudideka nokulahlekelwa yinkumbulo. |
| Isicanucanu nokuhlanza | Lezi zimpawu zenzeka ngenxa yemiphumela ohlelweni lokugaya ukudla. |
| Ubuhlungu besisu/uhudo | Ukuqunjelwa yisinye isibonakaliso esivamile. |
| Ikhanda elibuhlungu kanye nobuhlungu bomzimba | Ubuhlungu bamalunga nemisipha bungase buvele, obufana nomkhuhlane we-dengue. |
| Ukuqhuma kwesikhumba | Abanye abantu bangase babe namabala abomvu esikhumbeni sabo. |
| Ubunzima bokugwinya | Umphimbo obuhlungu ungenza kube nzima ukugwinya. |
| Umsebenzi onzima | Ukuzizwa ukhathele kakhulu ukuthi ungenza noma yini. |
Lesi simo singaba sibi kangakanani?
I-CRS yisimo esingaba sibi kakhulu kuya esisongela ukuphila. Ukuvuvukala okweqile emzimbeni wonke kungalimaza izitho ezibalulekile njengezinso, isibindi, amaphaphu kanye nenhliziyo.
Into ebaluleke kakhulu ukuxilonga lesi simo kusenesikhathi bese uqala ukwelashwa, ngaphandle kwalokho kungaba nezinkinga ezinkulu.
Okulandelayo ezinye zezinkinga ezinkulu ezingase zenzeke:
- Imiphumela enhliziyweni: I-cardiomyopathy kanye nokwehluleka kwenhliziyo kungavela.
- Imiphumela emaphashini: Ukwehluleka kwamaphaphu kanye namazinga aphansi kakhulu omoya-mpilo egazini kungenzeka.
- Ukwehluleka Kwezinso Nesibindi: Ukulimala kwalezi zitho kungabangela ukuthi ziyeke ukusebenza.
- I-Capillary leak syndrome: Ukuvuza koketshezi emithanjeni yegazi emincane kungabangela ukwehla komfutho wegazi ngendlela eyingozi.
Odokotela bakuthola kanjani lokhu?
Ithimba lezokwelapha elikwelaphayo linolwazi olukhulu nge-CRS, ngakho-ke uma uthola ukwelashwa okufana nokwelashwa nge-immunotherapy, lizoqapha izimpawu zakho eduze.
Uma kuvela izimpawu, udokotela uzoyala ukuhlolwa okuningana ukuqinisekisa isimo.
- Inani Eliphelele Legazi (CBC): Liqapha izinguquko kumaseli egazi.
- Amazinga e-Cytokine: Linganisa inani lama-cytokine egazini.
- Ukuhlolwa kwe-C-reactive protein (CRP): Lokhu kuhlolwa kusiza ukukala izinga lokuvuvukala emzimbeni.
- Ukuhlola ukusebenza kwezinso nesibindi: Thola ukuthi lezi zitho zonakele yini.
Kuye ngokuthi isimo sibucayi kangakanani, odokotela basihlukanisa njengebanga loku-1 kuya kwelesi-4. Uma inani liphezulu, isimo siba sibi kakhulu. Lesi sigaba sinqunywa ngokubheka izici ezifana nomkhuhlane, umfutho wegazi, amazinga omoya-mpilo, kanye nokusebenza kwezitho zomzimba.
Yiziphi izindlela zokwelapha i-CRS?
Ukwelashwa kuncike ebunzimeni bezimpawu zakho. Ezimweni ezincane, izinto ezilula njengemithi yokunciphisa umkhuhlane zingase zanele. Kodwa uma isimo sibi kakhulu, kungadingeka ukwelashwa okukhethekile.
| Indlela yokwelapha | Kwenzakalani? |
|---|---|
| Ama-Corticosteroids | Ilawula ukuvuvukala okweqile emzimbeni kanye nokusebenza kwesimiso somzimba sokuzivikela. |
| Imithi ehlose ama-cytokine athile | Ihlasela futhi ivimbele ama-cytokine akhiqizwa ngokweqile. Isibonelo: i-tocilizumab, i-siltuximab, i-anakinra. |
| Ukunakekelwa Okusekelayo | Nikeza imithi yokwehlisa umfutho wegazi, nikeza umoya-mpilo, bese usebenzisa umoya-mpilo osebenza ngomshini uma kudingeka. |
Kufanele ngifune nini iseluleko sezokwelapha?
Lena yingxenye ebaluleke kakhulu.
Uma uthola ukwelashwa nge-immunotherapy yomdlavuza, futhi uba nomkhuhlane noma ezinye izimpawu ze-CRS (njengobuhlungu bamalunga, ukudideka) ngemva kokwelashwa, akuwona umqondo omuhle ukukuhlehlisa ngisho nakancane.
Lesi simo singaba sibi kakhulu ngokushesha okukhulu. Ngakho-ke, yazisa udokotela wakho noma isibhedlela ngokushesha. Uma uqala ukwelashwa ngokushesha, ingozi yezinkinga ezinkulu iyancipha.
Kuyaqondakala ukuzizwa wesaba futhi ukhungathekile ukuzwa ngento efana nale ngenkathi ulwa nomdlavuza. Kodwa khumbula, ithimba lezokwelapha elikwelaphayo lijwayelene kakhulu ne-CRS. Likubhekisisa kakhulu. Ungesabi ukubatshela nganoma yiziphi izinguquko emzimbeni wakho, ngisho nezincane kakhulu. Ngosizo lwakho, lesi simo singaphathwa ngaphambi kokuba sibe sibi kakhulu.
Umlayezo Wokuya Nawe Ekhaya
- I-CRS yisimo esibi esibangelwa amasosha omzimba asebenza ngokweqile. Ingavela, ikakhulukazi ngemva kokwelashwa ngomdlavuza nge-immunotherapy.
- Izimpawu zingase ziqale njengomkhuhlane ovamile, kodwa zingaba zimbi kakhulu ngokushesha. Izimpawu eziyinhloko umkhuhlane omkhulu, ukubanda, kanye nokudideka.
- Uma uthola ukwelashwa nge-immunotherapy, yazisa udokotela wakho ngokushesha uma uba nomkhuhlane noma ezinye izimpawu ezingavamile.
- Kunezindlela zokwelapha ezisebenzayo ze-CRS. Ukwelashwa kusenesikhathi kungavimbela izinkinga ezinkulu.
- Yazisa ithimba lakho lezokwelapha ngalokhu. Khuluma nabo ngokukhululekile ngezinto ezikukhathazayo nezimpawu zakho.
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