Uma udokotela wakho ekutshela noma othile omaziyo ukuthi unomdlavuza wegazi njenge-leukemia, bakhuluma ngendlela ngayinye yokwelapha, akunjalo? Kungenzeka ukuthi uke wezwa igama elithi 'leukapheresis'. Nakuba leli gama lingase lizwakale liyesabeka futhi liyinkimbinkimbi, aliyesabisi kangako. Namuhla, ake sixoxe ngokuthi iyini i-Leukapheresis, ukuthi yenziwa kanjani, nokuthi isebenza kanjani ngendlela elula kakhulu.
Kalula nje, kuyini i-leukapheresis?
Cabanga ngakho njengokuthi uma senza ubisi lukakhukhunathi, sicindezela ukhukhunathi bese sihlukanisa ubisi kanye ne-pulp. I-Leukapheresis iyinto efana naleyo. Lokhu kuhilela ukuthatha igazi emzimbeni wakho, ulithumele ngomshini okhethekile, ohlukanisa amangqamuzana amhlophe egazi . Bese kuthi lonke igazi, okungamaseli abomvu egazi, i-plasma, nama-platelet, libuyiselwe emzimbeni wakho.
Into ebalulekile ukuthi i-leukapheresis ayilona ikhambi lomdlavuza wegazi noma ezinye izifo zegazi. Isetshenziswa kanye nezinye izindlela zokwelapha (njenge-chemotherapy) ukusiza ukulawula izimpawu nokusekela ezinye izindlela zokwelapha.
Kungani lokhu kwelashwa kuyadingeka?
Kunezizathu eziningana ezenza odokotela batuse lokhu kwelashwa. Ake sibheke izizathu eziyinhloko.
- Uma inani lamaseli amhlophe egazini liphezulu kakhulu: Kwezinye izinhlobo ze-leukemia (isibonelo, `(Acute Myeloid Leukemia - AML)`, `(Acute Lymphocytic Leukemia - ALL)`, `(Chronic Lymphocytic Leukemia - CLL)`) amaseli amhlophe egazi angajwayelekile ayanda ngokungalawuleki. Lawa maseli angahlala emithanjeni yegazi futhi avimbele ukugeleza kwegazi. Lokhu kwandisa ingozi yokulimala kwezitho ezifana nenhliziyo nobuchopho. Ngakho-ke lokhu kwelashwa kusetshenziselwa ukususa ngokushesha lawo maseli engeziwe futhi kunikeze isiguli impumuzo.
- Qoqa amaseli okuqala: Kwezinye izinhlobo zomdlavuza (isibonelo, i-lymphoma, i-multiple myeloma), i-chemotherapy esezingeni eliphezulu ilimaza umongo wethambo. Ngakho-ke, ngaphambi kokwelashwa, amaseli okuqala aphilile aqoqwa egazini bese egcinwa, futhi ngemva kokwelashwa, abuyiselwa emzimbeni. Ngemuva kwalokho, kungenziwa amaseli amasha egazi anempilo. Lawa maseli okuqala aqoqwa ngendlela ye-leukapheresis.
- Ukunikela ngamaseli okuqala komunye umuntu: Uma ungumnikeli ofanele wokufakelwa umongo wethambo kwesinye isiguli, le ndlela isetshenziselwa nokuthola amaseli okuqala kuwe.
- Ukuthola amaseli okwelashwa okukhethekile:Izindlela ezintsha zokwelapha umdlavuza, njengokwelashwa ngamaseli e-CAR T, zihilela ukuthatha amangqamuzana omzimba esiguli, "aziqeqeshe" elabhorethri ukuze alwe nomdlavuza, bese ewabuyisela emzimbeni. Lawa maseli asuswa emzimbeni ngenqubo ebizwa ngokuthi i-leukapheresis.
Kwenzekani ngaphambi kokwelashwa?
Ngaphambi kokuqala lokhu kwelashwa, udokotela wakho uzokwenza izivivinyo eziningana.
- Ukuhlolwa kwegazi: Kuhlola inani lamaseli amhlophe egazi, kanye namazinga amaseli abomvu egazi kanye nama-platelet.
- Ukuhlolwa kwe-Electrolyte: Hlola amazinga kasawoti emzimbeni, njenge-calcium ne-potassium.
- Ukuhlolwa kokusebenza kwezinso kanye nesibindi.
- Ukuhlolwa kokujiya kwegazi.
Njengoba lokhu kwelashwa kuzothatha amahora amaningana, sicela ugqoke izingubo ezikhululekile . Kungumqondo omuhle futhi ukuletha incwadi ozoyifunda noma okuthile ongakubuka efonini yakho ngesikhathi sokwelashwa.
Kwenzekani ngesikhathi sokwelashwa?
Uzobekwa embhedeni okhululekile, futhi umhlengikazi noma udokotela uzofaka ama-cannula amabili (imigqa ye-IV) ezingalweni zakho, njenge-saline, emithanjeni yakho. Omunye uzokhipha igazi lakho kancane kancane emzimbeni wakho uye emshinini, kanti omunye uzobuyisela igazi elihlanziwe emzimbeni wakho. Ngezinye izikhathi, ithubhu elilodwa elikhulu (umugqa ophakathi) lizofakwa emthanjeni omkhulu entanyeni yakho noma ngaphansi kwengalo yakho. Lokhu kunezindlela zombili zokuthatha igazi nokulibuyisela.
Lonke lolu hlelo lungathatha amahora amabili noma amathathu .
Ngesikhathi sokwelashwa, ungase uzwe umuzwa wokucasuka ezandleni zakho, ezinyaweni nasezindebeni. Ungakhathazeki. Lokhu kungenxa yokuthi amazinga e-calcium egazini lakho aphansi kancane. Uma uzizwa ngale ndlela, tshela umhlengikazi lapho, futhi bazofaka i-calcium ethile esixazululweni se-saline abakunikeza sona. Khona-ke umuzwa uzophela.
Yini ongayilindela ngemva kokwelashwa?
Ngemva kokwelashwa kwakho, abasebenzi bezokwelapha bazokuqapha isikhashana. Bazohlola umfutho wegazi lakho kanye nokushaya kwenhliziyo. Bangase futhi bathathe elinye isampula yegazi. Kuye ngemiphumela yalezo zivivinyo, uma amazinga eseli lakho elibomvu legazi noma ama-platelet ephansi, udokotela wakho angase akuncome ukuthi umpontshelwe igazi .
Ingabe kukhona imiphumela emibi kulokhu? Ingabe kufanele ngikhathazeke?
Njenganoma yikuphi ukwelashwa kwezokwelapha, kunemiphumela emibi engaba khona. Kodwa-ke, imiphumela emibi emibi ayivamile . Into ebaluleke kakhulu ukuthi udokotela noma umhlengikazi azokubheka kulo lonke ukwelashwa. Ngakho-ke uma kunenkinga, bazongenelela ngokushesha.
Ake sibone ukuthi yimiphi imiphumela emibi engaba khona.
| Umphumela Ongemuhle | Kusho ukuthini lokhu? | Benzani odokotela? |
|---|---|---|
| I-Hypocalcemia | Amazinga e-calcium aphansi egazini. Lokhu kungabangela ukuqaqamba ezindebeni, ezandleni nasezinyaweni. | Lokhu kuvame kakhulu. Uma utshela umhlengikazi, uzofaka i-calcium kusawoti owunikezwayo. |
| I-anemia | Inani elincane lamaseli abomvu egazi lingasuswa phakathi nale nqubo, okungabangela ukwehla kwenani lamaseli abomvu egazi. | Udokotela angahlola amarekhodi akho egazi futhi, uma kudingeka, amfake igazi. |
| I-Thrombocytopenia | Ukwehla kwamazinga e-platelet, okusiza ukujiya kwegazi. Lokhu kwenza ukuphuma kwegazi kube lula kakhulu. | Ithimba lezokwelapha liqapha nalokhu. Uma kudingeka, kungenziwa ukumpontshelwa ama-platelet. |
Ngemva kokubuyela ekhaya nalapho udinga ukukhuluma nodokotela
Kungcono ukuphumula usuku olulodwa noma ngaphezulu ngemva kokwelashwa. Uma uthola lokhu kwelashwa, kungenzeka ukuthi usuvele uthola ukwelashwa komdlavuza noma isifo esihlobene negazi. Ngakho-ke, uma uhlangabezana nanoma yiziphi izimpawu ezilandelayo, yazisa udokotela wakho ngokushesha .
- Uma unomkhuhlane (ongaphezu kwama-38 Celsius noma ama-100.4 Fahrenheit), lokhu kungaba uphawu lokutheleleka.
- Uma ufaka umugqa ophakathi, indawo iba bomvu, ivuvuke, ibe buhlungu, noma kuphume uketshezi olufana nobovu .
- Izimpawu zakho ziya ziba zimbi kakhulu kunokujwayelekile.Uma uzizwa uthanda.
Ungazinaki izinto ezinjengalezi. Uma usheshe ukubika, kuba lula ukulawula noma yiziphi izinkinga.
Umlayezo Wokuya Nawe Ekhaya
- I-Leukapheresis iyindlela yokwelapha lapho igazi elithile likhishwa khona emzimbeni, amangqamuzana amhlophe egazi ahlukaniswa kusetshenziswa umshini okhethekile, bese igazi elisele libuyiselwa emzimbeni.
- Lokhu kwenzelwa kakhulu ukunciphisa ngokushesha inani lamangqamuzana amhlophe egazi aphezulu kakhulu ezifweni ezifana ne-leukemia kanye nokuqoqa amaseli okuqala ukuze kufakwe umongo wamathambo.
- Nakuba lokhu kungeyona ikhambi lesifo, kuyindlela yokwelapha ebaluleke kakhulu yokusekela ukulawula izimpawu nokwenza ezinye izindlela zokwelapha ziphumelele kakhudlwana.
- Ukuba ndikindiki ngesikhathi sokwelashwa kuvamile. Abasebenzi bezokwelapha lapho bayayelapha ngokushesha. Imiphumela emibi emibi ayivamile.
- Uma unemibuzo, ukukhathazeka, noma ukungabaza ngalokhu kwelashwa, ungesabi ukukhuluma ngokukhululekile nodokotela wakho ngakho.
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