Ingabe futhi wopha kakhulu ngisho nasenxebeni elincane? Ake sibheke i-ITP (Immune Thrombocytopenia)!

Ingabe ngezinye izikhathi uyazibuza ukuthi kungani ngisho nokulimala okuncane kuphenduka ukuqhuma okukhulu, noma ukuthi kungani ukusika okuncane kungayeki ukuphuma kwegazi? Noma ingabe uhlangabezana nezinto ezifana nokuphuma kwegazi ekhaleni ngaphandle kwesizathu, noma ukuphuma kwegazi ezinsinini lapho uxubha amazinyo akho? Uma lezi zinto zikwehlela kaningi, mhlawumbe kubaluleke kakhulu ukuthi uqaphele isimo esikhuluma ngaso namuhla esibizwa ngokuthi i-ITP (Immune Thrombocytopenia). Ungakhathazeki, ake sixoxe ngalokhu kalula.

Kuyini i-ITP (Immune Thrombocytopenia)?

Kalula nje, i-ITP (Immune Thrombocytopenia) yisimo lapho igazi lakho linenani elincane lamaseli amancane abizwa ngokuthi ama-platelet . Lawa ma-platelet yiwo asiza ekumiseni ukopha lapho sithola ukulimala endaweni ethile emzimbeni wethu. Akha i- clot futhi amise ukopha . Ngakho-ke, lapho inani lala ma-platelet lehla, igazi lakho alivali kalula. Yingakho ngisho nokulimala okuncane kungabangela ukopha ngokweqile, noma ungamane ulimale umzimba wakho.

Lokhu kubizwa ngokuthi i-ITP, futhi igama elithi `Immune` lisho okuthile okuhlobene nesimiso sokuzivikela komzimba. `I-Thrombocytopenia` isho ama-platelet aphansi. Ngakho-ke, okwenzekayo kulokhu ukuthi isimiso sakho sokuzivikela komzimba , amasosha asivikela ezifweni, acabanga ngephutha ukuthi amangqamuzana akho e-platelet ayizitha zangaphandle bese ewahlasela futhi awabhubhise. Kufana nokuhlasela umuntu endlini yakho, ucabanga ukuthi uyisela.

Ngezinye izikhathi i-ITP ingelashwa ngemithi noma ngaphandle kwayo futhi iba ngcono ngokuhamba kwesikhathi. Kodwa kwabanye abantu, kungaba yisimo esingamahlalakhona . Lokhu kusho ukuthi nakuba izimpawu zingalawulwa, kunzima ukwelapha ngokuphelele. Kubantu abanjalo, ukwelashwa kungadingeka impilo yabo yonke.

Yimaphi amanye amagama e-ITP?

Uma uya kudokotela, bangasebenzisa amanye amagama ngaphandle kwe-ITP. Ngakho-ke kuwumqondo omuhle ukukhumbula la magama futhi:

• "I-Autoimmune Thrombocytopenic Purpura"
• "Immune Thrombocytopenic Purpura"
• `Idiopathic Thrombocytopenic Purpura` (Leli gama lalisetshenziswa kakhulu esikhathini esidlule, `Idiopathic` lisho ukuthi imbangela eqondile ayaziwa)
• `Isifo sikaWerlhof`
• `I-Autoimmune Thrombocytopenia`

Kungakhathaliseki ukuthi uyiqamba liphi igama, ivame ukubhekisela esimweni esifanayo sezokwelapha.

Ivame kangakanani i-ITP?

Empeleni, i-ITP iyisimo esingavamile . Akusona isifo esithinta wonke umuntu. Ngokwezibalo, ezweni elifana neMelika, cishe izingane ezine kweziyikhulu (4/100,000) kanye nabantu abadala abathathu kweziyikhulu (3/100,000) batholakala benalesi simo minyaka yonke. Lesi simo siyabonakala naseSri Lanka, kodwa kunzima ukuthola izibalo eziqondile ngaso. Kodwa-ke, uma umuntu enalesi simo, kungaba yinkinga enkulu kuye, akunjalo?

Ingabe zikhona izinhlobo ze-ITP?

Yebo, i-ITP ingahlukaniswa ngezinhlobo ezimbili eziyinhloko:

1. I-ITP Eyinhloko:Yilapho isimiso sakho somzimba sokuzivikela sihlasela ama-platelet akho ngaphandle kwesizathu esibonakalayo. Cishe amaphesenti angama-80 (80%) eziguli ze-ITP zinalolu hlobo. "Kuyisifo sokuzivikela komzimba esizenzakalelayo", okusho ukuthi sibangelwa ukungasebenzi kahle kwesimiso somzimba sokuzivikela komzimba.

2. I-ITP yesibili: Lokhu kwenzeka lapho inani lama-platelet lehla njengomphumela ongemuhle wesinye isimo sezokwelapha esiyisisekelo, ukutheleleka, noma imithi. Isibonelo:

• Ezinye izifo ezihlala isikhathi eside, njenge-HIV, i-Hepatitis C, noma i-H. pylori (ibhaktheriya ebangela izilonda zesisu)
• Umdlavuza wegazi
• Ezinye '(izinkinga zokuzivikela komzimba)' (isib. i-lupus - SLE)
• Kungase futhi kube ngenxa yemithi ethile.

Odokotela baphinde bahlukanise i-ITP ngokusekelwe ekutheni isibe khona isikhathi esingakanani:

• I-Acute ITP: Lokhu kuvame ukuba ngcono zingakapheli izinyanga ezintathu. Kuvame kakhulu ezinganeni.
• I-ITP Eqhubekayo: Lokhu kungahlala kusukela ezinyangeni ezintathu kuya ezinyangeni eziyishumi nambili (unyaka owodwa).
• I-ITP Engapheli: Lokhu kuhlala isikhathi esingaphezu konyaka. Kuvame kakhulu kubantu abadala.

Ziyini izimpawu ze-ITP?

Abanye abantu bangase babe ne-ITP ngaphandle kwezimpawu. Kodwa-ke, uma izimpawu zivela, zingase zivele kancane kancane noma ngokuzumayo. Izimpawu eziyinhloko yilezi:

• I-Petechiae: Lokhu kwenzeka lapho ubona amabala amancane abomvu noma ansomi esikhumbeni sakho, ikakhulukazi emilenzeni engezansi. Abukeka njengokuqhuma. Lokhu akupheli ngokwako.
• I-Purpura: Ama-petechiae okukhulunywe ngawo ngaphambili ayahlangana ukuze akhe amabala amakhulu abomvu, onsomi, noma ansundu. Lawa mancane kunokulimala, kodwa makhulu kunalawo mabala. Lokhu kubangelwa inani elincane legazi eliphuma emithanjeni yegazi emincane ngaphansi kwesikhumba.
• Kuphuka kalula: Ngisho neqhubu elincane noma kuphi lingabangela ukuphuka okukhulu noma ukuphuka. Ngezinye izikhathi, ukuphuka kungavela ngaphandle kwesizathu esibonakalayo.
• Izinsini eziphuma igazi: Izinsini zakho zingase zophe igazi uma uxubha amazinyo akho noma uma nje unganyakazi. Izinsini zakho zingase zibonakale zivuvukele.
• Igazi elisendle: Uma indle yakho ibukeka imnyama kakhulu, njengethayela, kungaba ukopha ngaphakathi.
• Igazi elisemchameni: Uma amanzi esitsheni sendlu yangasese ebukeka epinki noma ebomvu uma uchama, kungenzeka ukuthi kukhona igazi emchameni.
• Ukuya esikhathini okukhulu kwabesifazane: Uma ukuya kwakho nyanga zonke kuthatha izinsuku ezingaphezu kweziyisikhombisa, noma uma wopha kakhulu kunokujwayelekile (`Menorrhagia`), lokho kungaba uphawu lwe-ITP.
• Ukopha igazi njalo.
• Ukulimala okukhulu (Hematoma): Ngezinye izikhathi ukuvuvukala okukhulu (`Hematoma`) kungakheka lapho igazi eliningi liqoqana endaweni eyodwa.
• Ukuzizwa ukhathele kakhulu (Ukukhathala).

Okubalulekile: Uma unesinye noma ngaphezulu salezi zimpawu, kubaluleke kakhulu ukubona udokotela ngokushesha ukuze uthole iseluleko.

Yiziphi izimbangela ze-ITP?

Njengoba sesixoxile ngaphambili, i-ITP yenzeka lapho amasosha omzimba wakho enza ama-antibodies ngephutha ngokumelene nama-platelet akho, abese etshela amanye amangqamuzana omzimba ukuthi awabhubhise. Lapho umthambo wegazi emzimbeni wakho wonakele, ama-platelet yiwo afika endaweni, anamathele ndawonye, ​​akhe ihlule legazi, futhi amise ukuphuma kwegazi. Lokhu kubizwa ngokuthi "i-hemostasis eyinhloko".

Kodwa-ke, ngisho nochwepheshe abakacaci kahle ukuthi kungani lesi simiso somzimba sokuzivikela siqala ukuhlasela ama-platelet aso.

Kodwa-ke, ucwaningo oluthile luthole:

• Kulabo abangenwe yi-`(HIV)` (i-Human Immunodeficiency Virus)
• Kubantu abanesifo esibangelwa yibhaktheriya esibizwa ngokuthi `(H. pylori)` (Helicobacter pylori) (lokhu kuvame ukuhlotshaniswa nezilonda zesisu kanye ne-gastritis)
• Kubantu abanesifo sesibindi esibizwa ngokuthi `(Hepatitis C)`

Kukhona ingozi eyengeziwe yokuthola i-ITP. Lokhu kungaholela ku-ITP yesibili.

Itholakala kanjani i-ITP?

Ngaphambi kokuba udokotela anqume ukuthi une-ITP, uzoqala ngokuhlolisisa umzimba ukuze ahlole izimpawu zokopha, ukuklwebheka, namabala anjenge-petechiae ne-purpura. Bazobe sebebuza ngomlando wakho wezokwelapha odlule, imithi oyiphuzayo, nokuthi ngabe kukhona yini emndenini wakho oke waba nezinkinga zokopha.

Ngenxa yokuthi izimpawu ze-ITP zingafana nezezinye izinkinga zokujiya kwegazi noma izifo ezingathi sína kakhulu njengomdlavuza wegazi, udokotela uzokhipha zonke ezinye izimbangela (ukuxilongwa kokukhishwa) ngaphambi kokwenza ukuxilongwa okuqondile kwe-ITP.

Yiziphi izivivinyo ezisetshenziswa ukuxilonga i-ITP?

Odokotela bavame ukwenza lezi zivivinyo:

• Ukubalwa Kwegazi Okuphelele (i-CBC): Lokhu kuhlola inani lezinhlobo ezahlukene zamaseli egazini lakho, okuhlanganisa amaseli abomvu, amaseli amhlophe, futhi ikakhulukazi ama-platelet . Ku-ITP, lawa ma-platelet angase abe phansi kakhulu.
• Ukuskena Kwegazi Okungaphandle: Kulolu vivinyo, kuthathwa ithonsi legazi, lisakazwe kuslayidi yengilazi, bese lihlolwa ngaphansi kwe-microscope ukuze kubonakale ukuthi ukuma nobukhulu bama-platelet kujwayelekile yini, noma kukhona okunye ukukhubazeka.

Uma udokotela wakho ecabanga ukuthi usengozini yokuthola i-HIV, i-Hepatitis C, noma i-H. pylori, angase enze nokuhlolwa kwalezo zifo. Ngezinye izikhathi kungenziwa i-bone marrow biopsy, kodwa lokhu akwenziwa yiwo wonke umuntu.

Yiziphi izindlela zokwelapha i-ITP?

Isikhathi esiningi,Uma izingane zithola i-ITP, uma izimpawu zingembi kakhulu, zizoba ngcono ngaphandle kokwelashwa. Kodwa-ke, abantu abadala bavame ukudinga ukwelashwa, ikakhulukazi uma inani lama-platelet abo liphansi kakhulu noma uma kunengozi yokopha.

Uma udinga ukwelashwa, udokotela wakho angase akunike imithi yokwandisa inani lama-platelet akho noma ukuvimba amasosha omzimba wakho ekuhlaseleni ama-platelet akho. Izinhlobo eziyinhloko zemithi esetshenziswayo yilezi:

• Ama-Corticosteroids: (isib. i-Prednisolone). Lawa asebenza ngokumisa okwesikhashana ukukhiqizwa kwama-antibodies abhubhisa ama-platelet. Lokhu kuyindlela yokwelapha yokuqala.
• I-Immunoglobulin (IVIg): Lona umuthi onikezwa ngemithambo yegazi. Uphinde ushintshe indlela amasosha omzimba asebenza ngayo futhi unciphise ukubhujiswa kwama-platelet.
• Ama-agonist e-Thrombopoietin receptor (ama-TPO-RA): Le mithi isiza umzimba ukuthi wakhe ama-platelet amaningi.
• Ama-immunosuppressants: (isib. i-Rituximab, i-Mycophenolate). Lawa anciphisa ukusebenza kwesimiso somzimba sokuzivikela futhi amise ukubhujiswa kwama-platelet.

Ngaphezu kwale mithi, udokotela angase ancome nezinye izindlela zokwelapha:

• Ukwelapha ukutheleleka okuyisisekelo: Ezimweni ze-ITP yesibili, inani lama-platelet lingabuyela esimweni esijwayelekile uma ukutheleleka okubangele ukwelashwa sekwelashwe.
• Ukuyeka imithi ethile: Uma uthatha noma yimiphi imithi yokunciphisa igazi, njenge-aspirin, eyandisa ingozi yokopha, udokotela wakho angase akucele ukuthi uyeke ukuyisebenzisa.
• Ukumpontshelwa Ama-platelet: Uma ukopha kwakho kukhulu kakhulu futhi inani lama-platelet akho liphansi kakhulu, ungase unikezwe ama-platelet ngomnikelo womunye umuntu. Kodwa-ke, lesi yisisombululo sesikhashana.
• Ukususwa kwe-splenectomy: I-spleen iyingxenye yomzimba esusa amangqamuzana egazi amadala nawonakele, kanye nama-platelet abekwe uphawu lwe-antibodies. Kwabanye abantu, uma ezinye izindlela zokwelapha zihluleka ukulawula lesi sifo, i-spleen isuswa ngokuhlinzwa. Lokhu kungalawula kakhulu isimo se-ITP. Kodwa-ke, ukususa i-spleen kungandisa ingozi yakho yokuthola izifo ezithile.

Imiphumela emibi yokwelashwa

Njenganoma yimuphi umuthi noma ukwelashwa, ukwelashwa kwe-ITP kungabangela imiphumela emibi . Isibonelo, ama-corticosteroids angabangela ukukhuluphala, ukuvuvukala kobuso, ukuqwasha, kanye nokushintshashintsha kwemizwelo. Udokotela wakho uzochaza ukuthi ziyini lezi zinto nokuthi zibukeka kanjani kuwe. Ngale ndlela, ungazazi kusengaphambili futhi ukhulume ngazo uma unezinkinga.

Iyini inhloso ye-ITP?

Umbono/isibikezelo siyahlukahluka kumuntu nomuntu, kuye ngohlobo lwe-ITP.

• KwabantwanaUma kuvela i-ITP ebukhali, abantu abaningi bazolulama ngokuphelele ngaphandle kokwelashwa phakathi namasonto noma izinyanga ezimbalwa.
• Uma abantu abadala benesifo i-ITP esingamahlalakhona, kungaba yisimo sokuphila konke. Kodwa, asikho isidingo sokukhathazeka. Iningi labantu lingakwazi ukulawula izimpawu zabo kahle ngemithi kanye nezinye izindlela zokwelapha futhi baphile impilo evamile. Nakuba odokotela bengenakuyelapha ngokuphelele i-ITP, abantu abaningi abane-ITP esingamahlalakhona baphila kahle nalesi simo amashumi eminyaka.

Ngizinakekela kanjani?

Uma une-ITP, kungadingeka ukuthi uphuze imithi impilo yakho yonke ukuze uqinisekise ukuthi umzimba wakho wenza ama-platelet anele. Kuzodingeka futhi ugweme imisebenzi nemikhuba ekubeka engcupheni yokulimala nokopha. Cabanga ngakho, ngisho nokuwa okuncane kungaba yinkinga enkulu, akunjalo? Ngakho-ke qaphela lezi zinto:

• Gwema imidlalo yokuthintana ehilela ukushaya, ukuwa, kanye nokuthintana komzimba okunzima , njengebhola, i-rugby, isibhakela, i-karate, i-basketball, kanye ne-ice hockey, ngangokunokwenzeka.
• Uma ingane yakho ine-ITP, qiniseka ukuthi igqoka izinto zokuzivikela njengesigqoko sokuzivikela, ama-knee pad, nama-elbow pad lapho yenza noma yimuphi umsebenzi, njengokugibela ibhayisikili, ukugibela i-skateboard, noma ukuskeyitha nge-roller.
• Uma uhamba ngemoto noma ngeveni, gqoka ibhande lesihlalo njalo , futhi ungakhohlwa ukulibopha kahle noma ukulibeka esihlalweni semoto lengane yakho.
• Uma uthatha noma yimiphi imithi noma izithasiselo zamakhambi ezitholakala ngaphandle kwemithi kadokotela, khuluma nodokotela wakho ngazo bese uthola imvume yakhe . Eminye imithi yokwelapha izinhlungu, njenge-aspirin ne-ibuprofen, kanye neminye imithi yamakhambi, ingandisa ingozi yokopha.

Kufanele ngimbone nini udokotela?

Uma kutholakale ukuthi une-ITP futhi uthola ukwelashwa, udokotela wakho uzokuxilonga njalo. Kodwa-ke, okwamanje:

• Uma ubona imivimbo emisha ,
• Uma unamachashazi amancane abomvu (`petechiae`) esikhumbeni sakho,
• Uma uzizwa sengathi uphuma igazi kalula kunokujwayelekile,

Lokhu kusho ukuthi isimo sakho singase sibe sibi kakhulu, noma inani lama-platelet akho lingase libe liphansi. Uma kunjalo, bona udokotela wakho ngokushesha okukhulu. Angahlola kabusha amazinga e-platelet akho futhi alungise ukwelashwa kwakho uma kudingeka.

Kufanele ngiye nini eMnyangweni Wezimo Eziphuthumayo (i-ETU) ?

Lokhu akuvamile kakhulu, kodwa ngezinye izikhathi i-ITP ingabangela ukuthi inani lama-platelet akho lehle kakhulu bese uqala ukopha ngokungalawuleki. Isibonelo, uma unomopho ongapheli, umlomo owopha igazi, ukopha kakhulu kokuya esikhathini, noma isilonda esingayeki ukopha ngisho nalapho usicindezela, kuyisimo esiphuthumayo sezokwelapha.Esimweni esinjalo, kufanele uye ngokushesha egumbini lezimo eziphuthumayo lesibhedlela esiseduze. Futhi, uma ushaya ikhanda lakho, noma uma unezimpawu zokopha ngaphakathi kobuchopho, njengekhanda elibuhlungu, ukuhlanza, noma izinguquko embonweni, iya esibhedlela ngokushesha.

Yimiphi imibuzo okufanele ngiyibuze udokotela wami?

Uma uthola ukuthi une-ITP, ungase ube nemibuzo eminingi. Ungesabi noma ube namahloni okubuza udokotela wakho ngayo yonke. Nansi eminye imibuzo ongayibuza:

• Uhlobo luni lwe-ITP enginalo? (Esibuhlungu, esingamahlalakhona, esiyinhloko, esesibili?)
• Yikuphi ukwelashwa ongangincoma khona? Kungani?
• Kuzothatha isikhathi esingakanani ukuthi lezo zindlela zokwelapha ziveze ikhambi/umphumela?
• Ingabe kuzodingeka ngithathe lokwelashwa nsuku zonke?
• Uma ukwelashwa kokuqala kungaphumeleli, kuzolandela ini?
• Yiziphi imiphumela emibi yalezi zindlela zokwelapha? Yini okufanele ngiyenze uma zenzeka?
• Yiziphi izinguquko okufanele ngizenze ekudleni kwami ​​​​nasendleleni yami yokuphila?
• Yimiphi imithambo efanele ukuba ngiyenze? Yimiphi imithambo efanele ukuba ngiyenze?

Kwenzekani uma ngikhulelwa ngenkathi ngine-ITP?

Uma ukhulelwe noma uhlela ukukhulelwa, ukwazi ukuthi une-ITP kungaba yinto eyesabekayo kakhulu. Kodwa ungaduduzeka ngokwazi lokhu: I-ITP ngokuvamile ayithinti ngqo ingane yakho engakazalwa.

Inani lama-platelet engane lingase libe liphansi kancane lapho izalwa, kodwa lokhu kuvame ukuba okwesikhashana futhi kuzokwanda phakathi nezinsuku ezimbalwa. Odokotela bazohlola amazinga ama-platelet engane.

Uma une-ITP encane ngesikhathi sokukhulelwa, futhi izimpawu zakho zingembi kakhulu, ungase ungadingi ukwelashwa. Kodwa-ke, uma inani lama-platelet akho liphansi kakhulu noma usengozini yokopha, ungase udinge ukwelashwa. Ezimweni ezinjalo, udokotela wakho wezifo zokubeletha kanye nodokotela wezifo zofuba bazosebenzisana ukukhetha ukwelashwa okuphephile kuwe kanye nomntwana wakho . Bazophinde banakekele ngokukhethekile ngesikhathi sokubeletha.

Okokugcina, izinto okufanele uzikhumbule (Umyalezo Wokuya Ekhaya)

Kulungile, manje usuyaqonda kahle lokho ebesikhuluma ngakho, i-ITP (Immune Thrombocytopenia). Nazi ezinye izinto ezibalulekile okufanele uzikhumbule:

• I-ITP yisimo lapho amasosha omzimba wakho ebhubhisa khona ama-platelet akho, okubangela ukwehla kokujiya kwegazi.
• Izimpawu zingase zihlanganise ukudumba okulula, amabala abomvu esikhumbeni, kanye nokopha njalo.
• Uma lokhu kwenzeka ezinganeni, kuvame ukuba ngcono ngokuhamba kwesikhathi. Abantu abadala bangadinga ukwelashwa kwesikhathi eside.
• Nakuba i-ITP ingelapheki ngokuphelele, ngokwelashwa okuhle, izimpawu zingalawulwa futhi izinga lempilo lingafinyelelwa.
• Uma unalezi zimpawu, ungesabi ukubona udokotela. Uzokunikeza iseluleko kanye nokwelashwa okudingayo.
• Zivikele ekulimaleni, landela iseluleko sezokwelapha, futhi uphuze imithi yakho njengoba uyalelwe.

I-ITP ingaba yisimo esesabekayo, ikakhulukazi uma umane uphuma igazi. Kodwa awuwedwa. Kukhona odokotela abangakusiza futhi bakunakekele. Ngakho-ke, bhekana nalesi simo ngesibindi. Uma unenkinga, qiniseka ukuthi ukhuluma nodokotela wakho.

I- ITP, i-Immune Thrombocytopenia, ama-platelet, ukujiya kwegazi, ukopha, amasosha omzimba, ukuminyana, i-petechiae, i-purpura