Ingabe unama-platelet aphansi egazini lakho? Ake sixoxe ngalokhu (i-Thrombocytopenia)!

Unjani? Namuhla sizokhuluma ngesifo esingase sizwakale singathi sibi kakhulu, kodwa uma siqondwa kahle, singalawulwa ngezinga elikhulu. Lokho ukwehla kwama-platelet egazini, isimo esibizwa ngokuthi (i-Thrombocytopenia) ngokwezokwelapha. Kungenzeka ukuthi uke wezwa leli gama kudokotela, noma kungenzeka ukuthi ulibonile embikweni wegazi. Ungakhathazeki, sizokhuluma ngalokhu kalula, ngendlela ongayiqonda.

Okokuqala, ake sibone ukuthi ziyini lezi zinhlayiya zegazi nokuthi kungani zibaluleke kangaka kithi?

Cabanga ngale ndlela: ama-platelet ayizakhiwo ezincane ezifana nesosha ezidlula emithanjeni yethu yegazi. Uma sikhuluma iqiniso, awuhlobo lweseli elincane kakhulu, elingenambala. Njengamanye amangqamuzana egazini lethu, ama-platelet akhiqizwa ezicutshini ezithambile ngaphakathi kwamathambo ethu okuthiwa umnkantsha wamathambo.

Manje uyabuza, pho kungani sidinga la masosha amancane? Nansi into ebalulekile: Uma silimala ndawana thize bese siqala ukopha, njengalapho siya empini, lawa ma-platelet yiwona okuqala ukushesha lapho futhi ahlangane ndawonye ukuze akhe i-blood clot (`(i-clot)`) ukuze amise ukopha. Kufana nalapho ufaka usimende emgodini odongeni. Ngakho-ke, ngaphandle kwama-platelet, ngisho nenxeba elincane lingase lingakwazi ukuvimba ukopha. Uyaqonda ukuthi kubaluleke kangakanani lokho?

Ngakho-ke, iyini le nombolo ephansi yama-platelet, noma i-thrombocytopenia?

Kalula nje, i-thrombocytopenia yilapho igazi lakho linenani elingaphansi kwelejwayelekile lama-platelet. Ngokuvamile, umuntu ophilile unama-platelet aphakathi kwezigidi ezingu-1.5 nezingu-4.5 nge-microliter ngayinye yegazi. Uma leli nani lehla ngaphansi kwalokhu, silibiza ngokuthi i-thrombocytopenia.

Kodwa nansi into: ukwehla okuncane kwama-platelet akuyona into enkulu ngaso sonke isikhathi. Kuncike ekutheni kuphansi kangakanani, kungani kwehle, nokuthi kwehle ngokushesha kangakanani. Yingakho kubalulekile ukufuna iseluleko kudokotela.

Kungani sinezibalo eziphansi zama-platelet? Ziyini izimbangela?

Kungaba nezizathu ezahlukahlukene zokuthi ama-platelet egazi aphansi. Ake siwahlukanise ngezigaba ezintathu eziyinhloko.

1. Uma ukukhiqizwa kwama-platelet egazi ngomnkantsha kwehla:

Sikhulume ngaphambilini ngendlela ama-platelet enziwa ngayo emnkantsheni wethambo. Ngakho-ke, uma kunenkinga ngalo mnkantshe futhi ukukhiqizwa kwama-platelet kwehla, inani lama-platelet egazini liyancipha. Kunezizathu eziningana ezingaba khona zalokhu:

• Ezinye izifo ezibangelwa amagciwane: Isibonelo, izifo ezifana nomkhuhlane we-dengue, i-hepatitis C, kanye ne-HIV zingabangela ukungasebenzi kahle komnkantsha.
• Imithi ethile: Imithi esetshenziselwa ukwelapha umdlavuza (i-Chemotherapy), amanye ama-antibiotic, kanye nemithi yokukhipha isisu nayo ingathinta umongo wethambo.
• Ukuphuza utshwala ngokweqile: Lokhu kungalimaza nomnkantsha wamathambo.
• Ukuntuleka kwamavithamini: Uma umzimba ungenayo i-vitamin B12 eyanele (`(Vitamin B12)`) noma i-folate (`(Folate)`), ukukhiqizwa kwama-platelet egazi kungase kwehle.
• Umdlavuza wegazi: Umdlavuza wegazi ofana ne-leukemia ungabangela ukuthi umongo wethambo uyeke ukukhiqiza amaseli ajwayelekile.
• I-Aplastic Anemia: Lokhu kwenzeka lapho umongo wethambo ungakhiqizi amangqamuzana egazi ngendlela efanele.
• I-Myelodysplastic Syndromes: Lesi futhi yisimo lapho umongo wethambo ungasebenzi kahle.
• Izimo zofuzo ezingavamile: Ngezinye izikhathi, ukukhiqizwa kwama-platelet aphansi kungabangelwa yizimbangela zofuzo ezikhona lapho kuzalwa.

2. Uma ama-platelet akhiqizwayo ebhujiswa ngokushesha noma uma esetshenziswa ngokweqile emzimbeni:

Ngezinye izikhathi, noma ngabe umongo wethambo ukhiqiza ama-platelet anele, uma ebhujiswa ngokushesha emzimbeni, noma uma esetshenziswa kakhulu ngenxa yokopha kakhulu, inani lama-platelet lingancipha.

• I-ITP (Immune Thrombocytopenic Purpura): Yilapho amasosha omzimba ethu ehlasela ngephutha futhi abhubhise ama-platelet ethu egazi. Lokhu kungenzeka ezinganeni ezincane ngemva komkhuhlane wegciwane, kodwa kungenzeka nakubantu abadala.
• Lokhu kungenzeka nakwezinye izifo ezithinta amasosha omzimba, njenge-lupus kanye ne-rheumatoid arthritis.
• Imithi ethile: Eminye imithi ingabangela ukuthi amasosha omzimba abhubhise ama-platelet egazi, ngisho noma kuyimbangela yokungezwani komzimba.
• Ukutheleleka okukhulu (i-sepsis): Ezifweni ezinzima, izimo ezifana ne-DIC (Disseminated Intravascular Coagulation) zingavela, okubangela ukuncipha okusheshayo kwama-platelet egazi.
• I-TTP (Thrombotic Thrombocytopenic Purpura) (`(Thrombotic Thrombocytopenic Purpura)`) kanye ne-HUS (Hemolytic Uremic Syndrome) (`(Hemolytic Uremic Syndrome)`): Lezi yizimo ezingavamile kodwa eziyingozi. Kulesi simo, amahlule amancane egazi akhiwa ngaphakathi kwemithambo yegazi bese ama-platelet esetshenziswa.

3. Uma udende lukhula futhi ama-platelet eqoqana lapho:

I-spleen iyisitho esitholakala ohlangothini olungaphezulu kwesobunxele lwesisu sethu. Sihlunga igazi futhi sisuse amaseli egazi amadala. Uma i-spleen ikhula ngenxa yezifo ezithile (isib. isifo sesibindi - i-cirrhosis, izifo ezithile, umdlavuza wegazi), ingaqoqa ama-platelet amaningi kunokujwayelekile, okubangela ukwehla kwenani lama-platelet egazini.

Yiziphi izimpawu ezingaba khona uma ama-platelet egazi ephansi?

Izimpawu zama-platelet aphansi zingahluka kumuntu nomuntu. Kuye futhi ngokuthi ama-platelet akho aphansi kangakanani nokuthi ehla ngokushesha kangakanani. Ngezinye izikhathi abantu abane-platelet ephansi bangase bangabi nazimpawu nhlobo. Kodwa-ke, nansi ezinye zezimpawu ezivame kakhulu:

• Imivimbo: Imivimbo mikhulu, iluhlaza okwesibhakabhaka noma insomi esikhumbeni. Ngisho neqhubu elincane noma kuphi lingabangela imivimbo emikhulu.
• Amachashazi amancane abomvu esikhumbeni:Ngezinye izikhathi, amachashazi amancane abomvu noma ansomi (`(petechiae)`) avela emzimbeni wonke, njengezintuthwane ezincane, emilenzeni nasezingalweni. Lawa awanyamalali uma uwabuka.
• Kuthatha isikhathi eside ukuthi ukopha kume ngemva kokulimala.
• Izinsini eziphuma igazi, ukuphuma kwegazi ekhaleni njalo.
• Ukopha emchameni noma endle (umchamo ungaba bomvu, indle ingaba mnyama noma ibe negazi).
• Kwabesifazane, isikhathi sokuya esikhathini siba sibi kakhulu futhi sihlala izinsuku eziningi kunokujwayelekile.
• Ukuzizwa ukhathele, ukhathele.
• Ngezinye izikhathi, uma kuhlobene nenkinga yesibindi, amehlo angase abe phuzi (i-jaundice).

Okubalulekile: Uma uzwa izimpawu ezifana nobuhlungu bekhanda, uzizwa ubuthakathaka, noma ubunzima bokukhuluma, kufanele uye esibhedlela ngokushesha, ngoba lokhu kungaba uphawu lokopha ngaphakathi ebuchosheni!

Uma sinezimpawu ezinjengalezi, yini okufanele siyenze? Ingabe kufanele siye kudokotela?

Yebo, impela! Uma unesifo sokuphuma kwegazi esingavamile, amabala egazi esikhumbeni sakho, noma ukukhathala okukhulu, ungakushayi indiva bese ubona udokotela. Ungesabi, kodwa ungalibali futhi. Udokotela uzokubuza imibuzo, akuhlole, futhi akuthumelele ukuhlolwa uma kudingeka.

Udokotela ukuxilonga kanjani lokhu? Hlobo luni lokuhlolwa abalwenzayo?

Uma ubona udokotela, bazoqala bakubuze ngezimpawu zakho, imithi oyiphuzayo, nokuthi ngabe kukhona yini emndenini wakho oke waba nezinkinga ezifanayo. Ngemuva kwalokho bazokuhlola futhi bahlole ukopha, ukushintsha kombala wesikhumba, kanye nobende okhuphukile.

Ngaphezu kwalokho, kungenzeka ukwenza izivivinyo ezifana nalezi:

• Ukubalwa Kwegazi Okugcwele (i-FBC) : Lolu vivinyo oluyinhloko olunquma inani eliqondile lama-platelet egazini. Luphinde lunikeze ulwazi mayelana namaseli abomvu egazi namaseli amhlophe egazi.
• Ukuskena Kwegazi Okungaphandle : Lokhu kuhilela ukuthatha isampula yegazi bese ubheka ukuma nobukhulu bama-platelet ngaphansi kwe-microscope. Ngezinye izikhathi, babheka futhi ukuthi ama-platelet anamathele ndawonye noma ukuthi kukhona yini amaseli angajwayelekile.
• Okunye ukuhlolwa kwegazi: Kunezinye izivivinyo ezingasiza ekutholeni imbangela. Isibonelo, izivivinyo zokuhlola ukusebenza kwesibindi (izivivinyo zokusebenza kwesibindi), izivivinyo zokusebenza kwezinso, izivivinyo zokuhlola ukutheleleka ngegciwane, kanye nezivivinyo zokuhlola izimpawu zokuzivikela komzimba.
• Ukuhlolwa Komnkantsha Wamathambo Nokuhlolwa Kwe-Biopsy : Ngezinye izikhathi, uma ukuhlolwa kwegazi kuphela kungabonisi imbangela, lokhu kuhlolwa kwenziwa ukuze kubonakale ukuthi umnkantsha wamathambo ukhiqiza ama-platelet kahle yini. Lokhu kuhilela ukuthatha inani elincane lomnkantsha wamathambo endaweni encane, njengenqulu, ngaphansi kwe-anesthesia.

Yiziphi izindlela zokwelapha ama-platelet aphansi egazi?

Lena inkinga abantu abaningi abanayo. Ukwelashwa kwama-platelet aphansi kuncike ngokuphelele ekutheni yini ebangele lokhu nokuthi isimo sibi kangakanani. Asikho ikhambi elifanele bonke.

• Kulabo abanezibalo ezincane zama-platelet: Uma inani lama-platelet lingephansi kakhulu futhi kungekho zimpawu zokopha, ngezinye izikhathi akudingeki ukwelashwa, kumane kubhekwe ngokuhlolwa kwegazi njalo.
• Ukwelapha imbangela eyinhloko:
• Uma umuthi ubangele ukwehla kwenani lama-platelet egazini lakho, udokotela wakho uzokutshela ukuthi uyeke ukuthatha umuthi noma akushintshele komunye umuthi. Ucabanga ukuthi kungcono ukungayeki ukuthatha umuthi?
• Uma kungenxa yokutheleleka, leso sifo siyalashwa.
• Uma kuyisifo esibangelwa ukuzivikela komzimba, siyalashwa.
• Ukwelashwa okuqondile kwama-platelet aphansi egazi:
• Ama-Corticosteroids : Isibonelo, imithi efana ne-prednisolone. Le mithi inikezwa ukuvimba amasosha omzimba ekubhubhiseni ama-platelet egazi (ezimweni ezifana ne-ITP).
• I-Intravenous Immunoglobulin (IVIG): Lona umuthi ofana nosawoti ofakwa emthanjeni. Usetshenziselwa ukwandisa ngokushesha inani lama-platelet ezimweni ezimbi kakhulu lapho isimiso somzimba sokuzivikela sibhubhisa ama-platelet egazi.
• Eminye imithi elawula amasosha omzimba (ama-immunosuppressants): Le mithi inikezwa uma ama-steroid engasebenzi noma uma imiphumela emibi inzima kakhulu.
• Ama-agonist e-Thrombopoietin receptor (ama-TPO-RA): Le mithi ivuselela umongo wamathambo ukuthi ukhiqize ama-platelet engeziwe.
• Ukufakelwa Ama-Platelet: Uma wopha kakhulu noma uma inani lama-platelet akho liphansi kakhulu futhi liphansi ngendlela eyingozi (isib. ngaphambi kokuhlinzwa), unganikezwa ama-platelet ngaphandle. Kodwa-ke, lokhu kuyisixazululo sesikhashana nje.
• Ukususwa kwe-spleenectomy: Uma kutholakala ukuthi i-spleen inesibopho sokubhujiswa kwama-platelet, futhi ezinye izindlela zokwelapha zingasebenzi (ikakhulukazi ku-ITP yesikhathi eside), ukuhlinzwa kokususa i-spleen kungenziwa. Kodwa-ke, ukususa i-spleen kwandisa ingozi yokutheleleka.
• Ukushintshaniswa kwe-plasma (noma i-Plasmapheresis): Lokhu kwelashwa kusetshenziswa ezimweni ezikhethekile njenge-TTP.

Yini okufanele sikhathazeke ngayo lapho siphila nalesi simo?

Abantu abanama-platelet aphansi egazini kudingeka baqaphele kancane ekuphileni kwabo kwansuku zonke.

• Gwema imisebenzi engabangela ukuwa nokulimala. Isibonelo, imidlalo yokuthintana ayifaneleki.
• Qaphela kakhulu uma usebenzisa amathuluzi abukhali noma usika imifino.
• Sebenzisa ibhulashi lamazinyo elithambile uma uxubha amazinyo akho. Qaphela ukuthi ungalimazi izinsini zakho.
• Ukuthatha imithi yokunciphisa igazi njenge-aspirin, ama-NSAID (njenge-ibuprofen) ngaphandle kweseluleko sikadokotelaUngazisebenzisi lezi. Lezi zingandisa ukopha. Tshela bonke odokotela nodokotela wamazinyo ukuthi ubona ukuthi unama-platelet aphansi.
• Qaphela noma yiziphi izimpawu zokopha (amabala esikhumba, ukopha ekhaleni, izinsini eziphuma igazi). Tshela udokotela wakho uma ubona noma yiziphi izimpawu ezintsha.
• Yidla ukudla okulinganiselayo. Ngaphandle kokuthi inani lama-platelet akho liphansi ngenxa yokuntuleka kwamavithamini, ukudla kuphela ngeke kukwelaphe. Kodwa-ke, kubalulekile ukuthola ukudla okunomsoco okudingwa ngumzimba wakho.
• Nciphisa noma uyeke ngokuphelele ukuphuza utshwala .

Ingabe lokhu kungaba yinto engathi sína? Yiziphi izinkinga?

Yebo, lokhu kungaba yisimo esibi kakhulu uma inani lama-platelet lehla kakhulu noma ngokuzumayo.

Ingozi enkulu ukopha okukhulu. Lokhu kungabonakala (enxebeni, ekhaleni) noma ngaphakathi (isib., ebuchosheni, esiswini, emathunjini). Ukopha ngaphakathi kungaba yingozi empilweni.

Yingakho kubaluleke kakhulu ukuthatha ukwelashwa njengoba nje udokotela esho futhi uqaphele.

Isifinyezo namagama okugcina

Kulungile, ngakho-ke ngithemba ukuthi usunokuqonda okungcono ngalokho esikhulume ngakho namuhla (i-Thrombocytopenia) noma ama-platelet aphansi egazi. Khumbula, lokhu kusho ukuthi ama-platelet egazini aphansi kunokujwayelekile. Kungaba nezimbangela eziningi, futhi izimpawu ziyahlukahluka kumuntu ngamunye.

Into ebaluleke kakhulu ukuthi, uma unalezi zimpawu, esikhundleni sokwenza izinqumo wedwa, noma ukufuna imithi ku-inthanethi, thola udokotela omuhle, uthole imbangela eqondile, bese uthola ukwelashwa okufanele ngayo.

Ungakhathazeki, isikhathi esiningi, ngokwelashwa okufanele kanye nokuphathwa, ungalawula lesi simo futhi uphile impilo enhle. Vula futhi uthembeke kudokotela wakho ngakho konke, futhi ubuze noma yimiphi imibuzo ongase ube nayo. Lokhu kuzokusiza ukuqonde kangcono lokhu futhi kukusize ubhekane kangcono.

i- thrombocytopenia, inani lamaplatelet, amaplatelet, umnkantsha, ukopha, ukuminyana, i-ITP, izifo zegazi, isihloko sezokwelapha saseSinhala, i-petechiae