Uma ungumuntu othola ukwelashwa kwesifo sezinso, ikakhulukazi i-Chronic Kidney Disease (CKD), ingabe ngezinye izikhathi uzizwa sengathi uyaluma umzimba wonke ngendlela engabekezeleleki? Ngezinye izikhathi lokhu kuluma kuba kubi kangangokuthi awukwazi ngisho nokulala ebusuku. Eqinisweni, ngezinye izikhathi kunezimo lapho isikhumba silimala khona ngokuklwebha. Lesi yisimo esicasulayo kodwa esivamile esibonakala phakathi kweziguli zezinso. Namuhla sikhuluma ngalesi simo, esaziwa ngokwezokwelapha ngokuthi 'i-Uremic Pruritus'.
Kuyini i-Uremic Pruritus?
Kalula nje, lesi yisimo sokulunywa okukhulu okwenzeka kubantu abanesifo sezinso esingamahlalakhona (CKD) kanye nesifo sezinso sesigaba sokugcina (ESKD). Okukhethekile ngalokhu ukuthi ngokuvamile akukho ukuqubuka okusobala noma isifo sesikhumba esibangela lokhu kulunywa. Okusho ukuthi, umzimba uyaklwebheka ngaphandle kwenkinga yesikhumba ebonakalayo.
Lokhu kuluma kungakuthinta ngezindlela ezahlukene:
- Ngezinye izikhathi kungafika kudlule ngemva kwesikhashana.
- Abanye abantu bangase babe nalokhu kuluma usuku lonke.
- Lokhu kuluma kuyanda, ikakhulukazi ebusuku, futhi kungaphazamisa ubuthongo.
- Kungase kuzwakale sengathi kuyaluma emzimbeni wakho wonke ngesikhathi esisodwa, noma kungazwakala kuphela ezindaweni ezithile , njengomhlane wakho, ubuso, noma imilenze.
- Lokhu kuluma kungase kube kubi kakhulu uma isikhumba sakho somile.
- Lokhu kuluma okuqhubekayo kungaba nomthelela omkhulu empilweni yakho yengqondo kanye nekhwalithi yempilo.
Nakuba igama elithi "Uremic" lisetshenziswa ukuchaza lesi simo, akuqiniseki ngokuphelele ukuthi sibangelwa ukunqwabelana kobuthi egazini (i-Uremia). Ngakho-ke, sibizwa nangokuthi i-Chronic Kidney Disease-associated Pruritus (CKD-aP).
Ubani okungenzeka kakhulu ukuthi abone lesi simo?
Lokhu kuluma kuvame kakhulu ezigulini ezihlinzwa nge-dialyize yezinso. Okusho ukuthi, abantu abahlinzwa nge-hemodialysis noma nge-peritoneal dialysis banamathuba amaningi okubhekana nalesi simo kuneziguli zezinso ezingahlinzwanga.
Ucwaningo lubonisa ukuthi iziguli ezineminyaka engaphezu kuka-70 ubudala zinamathuba amaningi okuthola lokhu kuqubuka futhi kungaba kubi kakhulu.
Cabanga ngalokhu: Abantu abangu-70% abasebenzisa i-hemodialysis, noma abayisikhombisa kwabayishumi, babhekana nokulunywa okuthile. Lokhu kuqhathaniswa cishe nama-25% eziguli ezinesifo sezinso esingamahlalakhona ezingasebenzisi i-hemodialysis, noma cishe oyedwa kwabane.
Kukuphi lapho ulunywa khona kakhulu emzimbeni wakho?
Abantu abaningi babhekana nalokhu kuluma emzimbeni wabo wonke noma ezindaweni ezinkulu zomzimba wabo. Kodwa-ke, izindawo ezivame kakhulu iziguli ezibika ukuthi ziyaluma kakhulu umhlane, ubuso, kanye nengalo ene-dialysis shunt .
Udokotela ukuxilonga kanjani lokhu futhi yiziphi izizathu?
Uma unesifo sezinso esingamahlalakhona futhi unalolu hlobo lokulunywa, udokotela wakho uzoqala ahlole ezinye izimbangela. Uzohlola ezinye izinguquko esikhumbeni, njengokuqubuka. Bangase futhi benze ukuhlolwa kwegazi. Uma kungekho esinye isizathu esingatholakala, udokotela wakho uzohlonza lesi simo ngokuthi yi-Uremic Pruritus.
Ochwepheshe abakaqiniseki kahle ukuthi kungani lokhu kwenzeka, kodwa kunezinto ezimbalwa abacabanga ukuthi zingaba nomthelela.
| Imbangela Engaba Khona | Kalula nje... |
|---|---|
| Ukuqongelela ubuthi egazini (ubuthi be-uremic) | Uma izinso zingasebenzi kahle, ubuthi obuyingozi buqoqana egazini. Lobu buthi bungavuselela imizwa esikhumbeni futhi bubangele ukulunywa. |
| Ukungalingani kwesistimu yomzimba | Isifo sezinso singashintsha indlela amasosha omzimba wethu asebenza ngayo. Ezinye zalezi zinguquko kanye nokuvuvukala okwandisiwe emzimbeni kungabangela ukulunywa. |
| I-Neuropathy | I-neuropathy ingabangelwa ukungalingani kwamakhemikhali emzimbeni. Lokhu kwenzeka lapho imizwa ingathumeli noma ingatholi izimpawu ngendlela efanele. Lezi zimpawu ezingalungile zingachazwa ubuchopho ngokuthi 'ukuluma'. |
| Imithi oyithathayo | Eminye imithi ethathwayo yesifo sezinso ingabangela ukulunywa njengomphumela ongemuhle. |
Yiziphi izindlela zokwelapha lokhu kuluma?
Akukho ukwelashwa okukodwa okusebenzela wonke umuntu. Kodwa-ke, udokotela wakho angakusiza ukhethe ukwelashwa okufanele wena. Nazi ezinye zezindlela zokwelapha ezitholakalayo njengamanje.
| Indlela yokwelapha | Incazelo |
|---|---|
| Izinguquko ku-hemodialysis | Udokotela wakho angenza izinguquko ezithile ohlelweni lwakho lwe-dialysis ukusiza ekunciphiseni ukulunywa. |
| Ukwelashwa okulula (i-Phototherapy) | Lolu uhlobo lokwelapha olusebenzisa ukukhanya ukwelapha izimo zesikhumba. Ezinye izinhlobo zokwelapha ukukhanya ziboniswe zisebenza kahle ekunciphiseni ukulunywa. |
| Imithi yobuhlungu bemizwa | Eminye imithi esetshenziselwa ukunciphisa ubuhlungu bemizwa ingasiza nasekulawuleni ukulunywa. Isibonelo, imithi ebizwa ngokuthi iGabapentin nePregabalin. |
| Imithi ye-Kappa-opioid agonists | Le mithi isebenza ngokunciphisa izimpawu zemizwa ezibangela ukulunywa. I-Diphenhydramine kanye ne-Nalbuphine ziyizibonelo zalolu hlobo lwemithi. |
| Ukufakelwa kwezinso | Lokhu akulona ikhambi lokulunywa. Kodwa-ke, ucwaningo lubonisa ukuthi ngemva kokufakelwa izinso, ukulunywa kuyaphela ngokuphelele ezigulini ezingaba ngu-75%. |
Yini engingayenza ekhaya ngalokhu kuluma?
Khuluma nodokotela wakho ngezindlela eziphephile zokulawula ukulunywa ekhaya. Ungase uthole impumuzo kulezi zinto:
- Ukufaka umswakama esikhumbeni. Kungcono ukuwusebenzisa ngemva kokugeza isikhumba sisamanzi.
- Ukusebenzisa ama-lotion okulwa nokulunywa. Kodwa buza udokotela wakho ngaphambi kokusebenzisa noma yini.
- Abantu abaningi bathatha ama-antihistamine uma beba nokulunywa. Kodwa ochwepheshe bathi le mithi ayisebenzi kahle kulesi simo sokulunywa yi-uremic. Futhi ingabangela imiphumela emibi engafuneki.
Yiziphi izingozi uma zingelashwa?
Lokhu kuluma njalo kungathinta impilo yakho yomzimba neyengqondo.
- Ukuklwebha njalo kungalimaza isikhumba futhi kuholele ekuthelelekeni.
- Ukungalali kahle kunganciphisa izinga lempilo yakho.
- Eqinisweni, ezinye izifundo zikhombisile ukuthi izinga lokufa kweziguli zezinso ezinalokhu kuluma liphakeme kancane kuneleziguli ezingenakho ukuluma. Kucatshangwa ukuthi isizathu esikhulu salokhu kungaba izinkinga ezibangelwa ukungalali kahle.
Ngakho ungakuthathi njengento “elula nje.” Kuthinta impilo yakho iyonke.
Ingabe ikhona indlela yokuvimbela lokhu?
Ayikho indlela ethile yokuvimbela ukulunywa okuhlobene nesifo sezinso. Kodwa-ke, uma ungakwazi ukubona ezinye zezinto (izimbangela) ezenza kube kubi kakhulu, ungalawula ukulunywa ngokukugwema. Isibonelo:
- Bheka ukuthi izinto ezifana nesikhumba esomile, ukushisa okukhulu noma ukubanda, noma ukucindezeleka kuyakwandisa yini ukulunywa.
- Gwema ukugeza isikhathi eside.
- Faka i-moisturizer ngokushesha ngemva kokugeza.
- Uma isimo sezulu somile, sebenzisa i-humidifier ekamelweni.
Uma kukhona ukulunywa, tshela udokotela wakho ukuthi kubi kangakanani. Ungakushayi indiva nje. Udokotela wakho angase akwazi ukukusiza ukuthi ukulawule ngokwenza izinguquko ekwelashweni kwakho noma ngokusebenzisa ezinye izindlela.
Umlayezo Wokuya Nawe Ekhaya
- Ukuluma kuvame kakhulu kubantu abanesifo sezinso esingamahlalakhona (CKD) kanye nesifo sezinso esisesigabeni sokugcina (ESKD).
- Lokhu kuluma akubangelwa ukuqubuka okubonakalayo noma esinye isifo, ngakho ungakushayi indiva njengokuthi "kuluma nje."
- Kungakhathaliseki ukuthi ukulunywa kwakho kuncane kangakanani, qiniseka ukuthi utshela udokotela wakho ngakho futhi uchaze ukuthi kukuthinta kanjani impilo yakho.
- Kunezindlela ezahlukene zokwelapha zokulawula lokhu kuluma, ngakho akudingeki uhlupheke ngakho.
- Ngenxa yokuthi ukulunywa okuqhubekayo kungathinta ubuthongo, impilo yengqondo, kanye nokuphila konke, kubalulekile ukufuna iseluleko sezokwelapha ngokushesha okukhulu.
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