Ingabe umkhuhlane wengane yakho awukapheli izinsuku ezingaphezu kwezinhlanu? Ingabe kukhona amabala abomvu emzimbeni wayo wonke? Ingabe amehlo ayo abomvu nezindebe zayo ziqhekekile? Sesaba kangakanani njengabazali ngezikhathi ezinje? Ngisho noma ucabanga ukuthi umkhuhlane nje ojwayelekile noma umkhuhlane, ngezinye izikhathi kungaba yinto engathi sína kakhulu. Namuhla, sizokhuluma ngesimo esingavamile esithinta izingane ezincane esidinga ukuxilongwa nokwelashwa ngokushesha. Leso yisifo sikaKawasaki.
Siyini isifo seKawasaki?
Kalula nje, isifo se-Kawasaki yisimo lapho imithambo yegazi (imithambo yegazi) emzimbeni wethu ivuvukala, okungukuthi, ivuvukala futhi ibe bomvu. Kwezokwelapha, lokhu sikubiza ngokuthi i-vasculitis . Cabanga ngemithambo yegazi emzimbeni wethu wonke njengamapayipi athwala amanzi. Kwenzekani uma la mapayipi evuvukala ngaphakathi? Ukugeleza kwegazi kuyavinjelwa, futhi izindonga zalawo mapayipi nazo zingaba buthaka.
Nakuba lesi sifo singathinta noma yimuphi umthambo wegazi emzimbeni, njengodokotela, sikhathazeke kakhulu ngemithambo yenhliziyo, ehlinzeka ngegazi enhliziyweni. Ngoba inhliziyo iyinjini yomzimba wethu. Imithambo eyinhloko ehlinzeka ngegazi kuleyo njini ibizwa ngokuthi imithambo yenhliziyo. Uma le mithambo ivuvukala noma ibuthakathaka, ukusebenza kwenhliziyo kungonakala kakhulu.
Lesi sifo sivame kakhulu ezinganeni eziphakathi kwezinyanga eziyisithupha neminyaka emihlanu . Kodwa-ke, into engcono kakhulu ukuthi uma lesi sifo sitholakala ngesikhathi esifanele futhi kuqalwe ukwelashwa okufanele, izingane eziningi zizolulama ngokuphelele zingakapheli izinyanga ezimbili. Ngakho-ke, kubalulekile ukungesabi futhi uqaphele izimpawu.
Sivame kangakanani lesi sifo?
Isifo iKawasaki siyisifo esingavamile kakhulu. Emazweni afana ne-United States neCanada, sithinta izingane eziphakathi kuka-10 no-20 kwezingu-100,000 ezingaphansi kweminyaka emi-5. Kodwa-ke, emazweni ase-Asia afana neJapan neKorea, leli nani liphakeme kancane. Into ebaluleke kakhulu ukuthi isifo iKawasaki sesibe yimbangela ehamba phambili yesifo senhliziyo esitholakala ezinganeni emazweni athuthukile.
Ziyini izimpawu zalesi sifo? Sizibona kanjani?
Njengomzali, kufanele uqaphele kakhulu ngalokhu. Ngoba lezi zimpawu zingafana kancane nezomkhuhlane ovamile wegciwane. Kodwa yilapho lezi zimpawu zihlangana khona lapho kufanele unake kakhulu.
Uphawu olubaluleke kakhulu umkhuhlane ophezulu ohlala izinsuku ezi-5 noma ngaphezulu. Lo mkhuhlane ungase ungancishiswa ngokuphelele ngemithi ejwayelekile efana ne-paracetamol.
Ake sibheke ezinye izici eziyinhloko ngale ndlela ukuze kube lula ukuzikhumbula.
| Isibonakaliso | Incazelo (lokho okubonayo) |
|---|---|
| Umkhuhlane ohlala izinsuku ezingaphezu kwezi-5 | Lolu uphawu oluyinhloko nolusobala kakhulu. Umkhuhlane ungase ube ngaphezu kuka-38.3°C. |
| Ukubomvu kwamehlo | Amehlo amhlophe aphenduka abe pinki noma abe bomvu, kodwa akukho ukuphuma kwe-mucus noma ubomvu emehlweni. |
| Izinguquko emlonyeni, ezindebeni, nasolimini | Izindebe ziba bomvu ngokugqamile, ziqhekeke, futhi zome. Ulimi luba bomvu njenge-strawberry futhi lungase lube namaqhubu amancane (ulimi lwe-strawberry). Umphimbo ungase ube bomvu futhi. |
| Izinguquko ezandleni nasezinyaweni | Izintende zezandla nezinyawo zengane ziba bomvu futhi zivuvuke. Lokhu kuvuvukala kungenza kube nzima ngengane ukuhamba noma ukubamba izinto ngezandla zayo. |
| Ukuqhuma kwesikhumba | Amaqhubu abomvu avame ukuvela esifubeni, esiswini, kanye nasesinqeni. Lokhu kungafana nesimungumungwane. |
| Ama-lymph node avuvukele entanyeni | I-lymph node (i-nodule) evuvukele ohlangothini olulodwa lwentamo, ngokuvamile inkulu kune-1.5 centimeters. |
| Ukuxebuka kwesikhumba | Emasontweni ama-2-3 ngemuva kokuqala kwalesi sifo, isikhumba siqala ukuxebuka kusukela ezinzwaneni nasezinzwaneni. |
| Ukungaphumuli ngokweqile | Ingane ikhala kakhulu kunokujwayelekile futhi ibonakala ingaphilile kahle. |
Ezinye izingane azibonisi zonke lezi zimpawu ngesikhathi esisodwa. Uma kuboniswa izimpawu ezimbalwa kuphela, sizibiza ngokuthi isifo se-Kawasaki esingaphelele . Kodwa-ke, kubaluleke kakhulu ukuyisa ingane yakho kudokotela ngokushesha, noma ngabe inesinye noma ezimbili zalezi zimpawu kanye nomkhuhlane.
Kungani lesi sifo sivela? Ingabe siyathelelana?
Eqinisweni, odokotela abakayitholi imbangela eqondile yesifo iKawasaki, kodwa kunemibono eminingana.
- Ukusabela ekuthelelekeni: Abanye abacwaningi bakholelwa ukuthi lapho igciwane noma amagciwane engena emzimbeni, amasosha ethu omzimba ayasabela ngokweqile kulo, okubangela umonakalo emithanjeni yegazi.
- Izici zemvelo: Lesi sifo sivame ukubikwa ngezikhathi ezithile zonyaka, ikakhulukazi ekupheleni kobusika nasekuqaleni kwentwasahlobo.
- Ukuthambekela kwezakhi zofuzo: Kukholelwa ukuthi izingane ezinezakhi zofuzo ezithile zingase zibe sengozini enkulu yokuthuthukisa lesi sifo.
Into ebaluleke kakhulu ukuthi isifo sikaKawasaki asithelelani. Lokhu kusho ukuthi uma ingane yakho inalesi sifo, asikho isidingo sokukhathazeka ngokusisabalalisa kwabanye abantwana ekhaya noma esikoleni.
Ubani osengozini enkulu?
- Izingane zesilisa zisengozini enkulu kancane kunezingane zesifazane.
- Izingane ezingaphansi kweminyaka emi-5 ubudala.
- Kwabantwana bozalo lwase-Asia noma lwasePacific Islander.
Yiziphi izinkinga ezingenza isifo seKawasaki sibe yingozi?
Lena yingxenye okudingeka siyinake kakhulu. Uma ingelashwa noma yelashwa sekwephuzile, izinkinga ezingase zivele, ikakhulukazi lezo ezihlobene nenhliziyo, zingaba yingozi.
- Ama-aneurysms emithambo yegazi: Lena inkinga ebucayi kakhulu futhi eyingozi. I-aneurysm iwukuvuvukala odongeni lwemithambo yegazi oluye lwaba buthaka ngenxa yokuvuvukala. Lokhu kungavuvukala futhi ngezinye izikhathi kuqhume.
- Ukuhlaselwa yinhliziyo: Uma ihlule legazi lenzeka ngaphakathi kwe-aneurysm futhi livimbele ukugeleza kwegazi enhliziyweni, kungenzeka ukuhlaselwa yinhliziyo.
- I-Myocarditis: Ukuvuvukala kwemisipha yenhliziyo.
- Izinkinga zamavalvu enhliziyo: Amavalvu enhliziyo angonakala futhi angavuleki noma angavaleki kahle.
- Ukwehluleka kwenhliziyo: Ukungakwazi kwenhliziyo ukupompa igazi elanele emzimbeni wonke.
Ukuzwa ngalezi zinkinga kungase kukwethuse. Kodwa khumbula, iningi lalezi zinkinga lingavinjelwa uma ukwelashwa kuqalwa zingakapheli izinsuku eziyi-10 zokuqala kwezimpawu. Yingakho sithi uma unomkhuhlane kanye nezimpawu ezishiwo ngenhla, bona udokotela ngokushesha.
Udokotela usithola kanjani lesi sifo ngqo?
Akukho ukuhlolwa kwegazi okukodwa noma ukuskena okungaqinisekisa isifo sikaKawasaki. Udokotela wenza ukuxilongwa ngokuhlola ngokucophelela izimpawu zengane. Lokhu sikubiza ngokuthi ukuxilongwa kwezokwelapha .
Udokotela uzoxilonga isifo seKawasaki ngokuhlola ingane, abheke ukuthi umkhuhlane usunezinsuku ezingaki, yiziphi ezinye izimpawu ezikhona, futhi aqinisekise ukuthi azikho ezinye izifo ezingadala izimpawu (isib. isimungumungwane, umkhuhlane obomvu).
Izigaba ezintathu zesifo
Isifo seKawasaki sivame ukuqhubeka ngezigaba ezintathu.
1. Isigaba 1 - Esiphuthumayo: Lesi yisonto lokuqala noma ngaphezulu. Izimpawu eziyinhloko ezifana nomkhuhlane, ukuqubuka, amehlo abomvu, kanye nokushintsha komlomo konke kuyatholakala phakathi nalesi sikhathi. Ingane ayihlaliseki kahle phakathi nalesi sigaba.
2. Isigaba 2 - I-Subacute: Ihlala amasonto amabili kuya kwamane. Ngalesi sikhathi, umkhuhlane usuphelile. Kodwa-ke, izimpawu ezifana nobuhlungu besisu, isifo sohudo, kanye nobuhlungu bamalunga zingase zivele. Okubaluleke kakhulu, isikhumba seminwe nezinzwane siqala ukuqhekeka phakathi nalesi sikhathi. Ingozi yokuthola i-aneurysms yemithambo yenhliziyo iphezulu kakhulu kulesi sigaba.
3. Isigaba 3 - Ukululama: Lokhu kungahlala inyanga eyodwa noma ezimbili. Zonke izimpawu ziyanyamalala kancane kancane. Kodwa-ke, ingane ingase izizwe ikhathele kancane. Kuthatha isikhathi ukuthi umonakalo emithanjeni yegazi uphole.
Yiziphi izivivinyo ezenziwayo?
Ngisho noma isifo singenakuqinisekiswa, udokotela angase acele ukuhlolwa okuningana ukuze anqume ukuthi lesi sifo sibucayi kangakanani futhi akhiphe ezinye izimo.
- Ukuhlolwa kwegazi: Funa izinto ezifana ne-CRP kanye ne-ESR, ezibonisa izinga lokuvuvukala emzimbeni.
- Ukuhlolwa komchamo
- I-Echocardiogram: Lolu vivinyo olubaluleke kakhulu. Lolu uhlolo lwe-ultrasound. Lungabona ngokucacile ukusebenza kwenhliziyo, isimo sama-valve, futhi ikakhulukazi ukuthi imithambo yenhliziyo yonakele noma ukuthi i-aneurysms yakheke yini.
- I-Electrocardiogram (EKG): Lokhu kusiza ukubheka umsebenzi kagesi (isigqi) senhliziyo.
Iphathwa kanjani?
Lapho nje kusolwa ukuthi unesifo iKawasaki, ingane ingeniswa esibhedlela. Ukwelashwa kuqala esibhedlela. Kunezinhloso ezine eziyinhloko zokwelashwa:
1. Ukunciphisa umkhuhlane nokuvuvukala emzimbeni.
2. Vimbela noma unciphise umonakalo emithanjeni yegazi, ikakhulukazi emithanjeni yenhliziyo.
3. Ukuvimbela izinkinga zenhliziyo.
4. Ukuvimbela ukuqhekeka kwegazi.
Izindlela ezimbili eziyinhloko zokwelapha zisetshenziswa:
- I-Intravenous Immunoglobulin (IVIG): Lokhu ukwelashwa okuyinhloko. Kalula nje, kuyinto equkethe ama-antibodies athathwe kubantu abaphilile. Inikezwa ingane nge-intravenous (IV) njenge-saline. Isebenza ngokulawula impendulo yomzimba esebenzayo ngokweqile kanye nokunciphisa umonakalo emithanjeni yegazi. Ukunikeza lokhu kwelashwa ezinsukwini zokuqala eziyi-10 kunganciphisa ingozi yezinkinga zenhliziyo kusuka ku-25% kuya ngaphansi kuka-5%.
- I-aspirin: Ngokuvamile asinikezi izingane ezinemfiva ebangelwa amagciwane i-aspirin. Kodwa-ke, esifweni i-Kawasaki, i-aspirin inikezwa ekuqaleni ngemithamo ephezulu ukunciphisa umkhuhlane nokuvuvukala, bese kuba ngemithamo ephansi ukuvimbela ukujiya kwegazi amasonto ambalwa.
Ngaphezu kwalokhu kwelashwa, ingane inikezwa nezinto ezifana nosawoti ukuvimbela ukuphelelwa amanzi emzimbeni, kanye nemithi yobuhlungu nokuvuvukala.
Kwenzekani ngemva kokubuyela ekhaya usuka esibhedlela?
Uma umkhuhlane wengane usuphelile ngokuphelele futhi isikwazi ukuphuza uketshezi oluphuzwayo kanye nemithi, ingathunyelwa ekhaya isuka esibhedlela. Kodwa umsebenzi awukapheli ngemva kokubuyela ekhaya. Ingane idinga ukubhekwa ngokucophelela.
Kuzodingeka uqhubeke nokuvakashelwa okulandelayo nodokotela wezingane kanye nodokotela wenhliziyo.
- Uzoya ekhaya uyohlolwa inhliziyo ngemva kwesonto elilodwa noma amabili, bese uphinda futhi ngemva kwamasonto angu-4-6 ukuze ubone ukuthi inhliziyo yakho injani.
- Uma kube khona umonakalo emithanjeni yenhliziyo, kuzodingeka ube ngaphansi kokuqashwa kwezokwelapha isikhathi eside, futhi kungase kudingeke nokuba uhlolwe njalo empilweni yakho yonke.
Ingabe isifo sikaKawasaki singalapheka ngokuphelele?
Iningi lezingane liyalulama ngokuphelele. Izimpawu zingase zihlale cishe amasonto angu-4-6. Ingane ingase izizwe ikhathele futhi ingaphumuli cishe izinyanga ezimbili. Akuvamile kakhulu (cishe ngo-2-3%) ukuthi lesi sifo singaphinde sibuye.
Ngemva kokwelashwa, cishe u-50% womonakalo emithanjeni uzophola phakathi nonyaka noma emibili. Kodwa-ke, uma umonakalo umkhulu, njenge-aneurysm, kungaba yinkinga yempilo yonke.
Yini ongayenza njengomzali?
Siyaqonda ukucindezeleka nokudabuka okuzwayo lapho ingane igula. Kodwa amandla akho angamandla amakhulu engane yakho.
- Landela imiyalelo kadokotela wakho kahle: Phuza imithi yakho njengoba uyalelwe. Ungaphuthelwa yinoma yiziphi izikhathi zokulandelela.
- Qaphela ngemigomo:Kubalulekile ukuvikela ingane yakho ezifweni ezibangelwa amagciwane njenge-chickenpox kanye ne-influenza ngenkathi uthatha i-aspirin. I-aspirin kanye namanye amagciwane angabangela isimo esingavamile kodwa esiyingozi esibizwa ngokuthi i-Reye's syndrome. Ngakho-ke khuluma nodokotela wakho ukuze uqiniseke ukuthi imigomo yengane yakho isesikhathini.
- Qaphela imijovo yegciwane eliphilayo: Imijovo yegciwane eliphilayo, njenge-measles-mumps-rubella (MMR) kanye ne-chickenpox (varicella), ayinikezwa izinyanga eziyi-11 ngemuva kokuthola ukwelashwa kwe-IVIG. Lokhu kungenxa yokuthi ukwelashwa kwe-IVIG kungavimbela umzimba ekwenzeni ama-antibodies anele kule mijovo.
- Ukunciphisa imisebenzi: Uma inhliziyo yengane yakho ithintekile, udokotela wakho angase akucebise ukuthi unciphise imidlalo enzima kanye nemisebenzi yokugijima isikhashana. Landela le miyalelo ngokucophelela.
- Duduza ingane yakho: Ngesikhathi ingane yakho isesibhedlela, mnike ithoyizi noma incwadi ayithandayo. Izwi lakho kanye nokumcindezela kwakho kuzoletha induduzo enkulu enganeni yakho phakathi nalesi sikhathi esinzima.
Umlayezo Wokuya Nawe Ekhaya
- Uma ingane yakho inomkhuhlane ohlala izinsuku ezingaphezu kwezi-5 futhi uhambisana nezimpawu ezinjengamehlo abomvu, izindebe ezidabukile, ukuqubuka, kanye nezitho ezivuvukele, ungacabangi ukuthi umkhuhlane nje ojwayelekile bese ucela iseluleko sezokwelapha ngokushesha.
- Isifo se-Kawasaki asithelelani . Ungasesabi ngokungadingekile.
- Ngokuthola lesi sifo kusenesikhathi nokuqala ukwelashwa zingakapheli izinsuku eziyi-10 zokuqala kwezimpawu, umonakalo omkhulu enhliziyweni ungavinjelwa.
- Ngisho nangemva kokwelashwa, kubalulekile ukuthi impilo yengane yesikhathi eside ilandele imiyalelo kadokotela kanye nokuhlolwa njengoba kuyalelwe.
- Nakuba lesi sifo singavamile, khumbula ukuthi ngokwelashwa, izingane eziningi ziyalulama ngokugcwele , futhi zihlala zinethemba futhi ziqinile.
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