Ingabe kukhona inkinga enkulu emzimbeni wakho? Ake sifunde nge-Waterhouse-Friderichsen Syndrome!

Wake wezwa ukuthi izindlala ezimbili ezincane emzimbeni ziyayeka ukusebenza, futhi kungaba nomthelela omkhulu empilweni yakho? Namuhla sizokhuluma ngesimo esiyingozi kangaka, futhi uma singelashwa ngokushesha, singabulala. Lokhu kubizwa ngokuthi i-Waterhouse-Friderichsen Syndrome. Nakuba igama lingase libonakale lide kancane, ake sixoxe ngokuthi liyini, kungani lenzeka, nokuthi ungasinda kanjani.

Iyini le-Waterhouse-Friderichsen Syndrome?

Kalula nje, i-Waterhouse-Friderichsen Syndrome (WFS) iyisimo esibi kakhulu. Okwenzekayo ukuthi izindlala zakho ze-adrenal , okuyizindlala ezimbili ezincane ezitholakala ngaphezu kwezinso zakho, ziphuma igazi (lokhu sikubiza ngokuthi 'i-adrenal hemorrhage') futhi eyodwa noma zombili lezi zindlala ziyeka ukusebenza. Lokhu kuvame ukubangelwa ukutheleleka okukhulu. Uma zingelashwa, lezi zindlala ze-adrenal cishe zizoyeka ngokuphelele ukukhiqiza i-hormone i-cortisol, ebalulekile emzimbeni wethu. Lokhu yilokho esikubiza ngokuthi i-adrenal crisis . Uma sikhuluma iqiniso, kuyisimo esiphuthumayo!

Kukhona elinye igama lalokhu, elithi ``i-hemorrhagic adrenalitis.'' Lokho kusho ukuthi izindlala ze-adrenal ziphuma igazi futhi zivuvukale.

Sivame kangakanani lesi simo?

Eqinisweni, i-Waterhouse-Friderickson syndrome ayivamile . Ngokuvamile, ukuhlolwa kwezidumbu kuthola ukuthi lesi simo sibangela cishe u-1% wabantu abafayo. Lokhu kusho ukuthi akusona isifo esithinta wonke umuntu, kodwa uma sivela, siyingozi kakhulu.

Ziyini izimpawu zalesi sifo?

Cabanga nje, ngokuzumayo uthole igciwane noma amagciwane bese uba nalesi simo se-WFS. Khona-ke ungaqala ngokuzumayo ukukhombisa izimpawu zokutheleleka. Uyazi ukuthi kuyini lokho?

• Ngithola umkhuhlane omkhulu.
• Umzimba uzizwa ubanda futhi uqhaqhazela (Ukugodola).
• Ikhanda lami libuhlungu kakhulu.
• Ngizohlanza, ngizohlanza.
• Imisipha emzimbeni wami iyabuhlungu, ikakhulukazi ezindaweni ezifana nomhlane wami ongezansi, isisu, kanye nemilenze.
• Amalunga ami ayabuhlungu.
• Ngezinye izikhathi kungase kube nokulahlekelwa ukwazi (i-syncope).

Uma lokhu kuphuma kwegazi kuqala ukuthinta hhayi kuphela izindlala ze-adrenal kodwa nezinye izingxenye zomzimba, kungase kuvele ezinye izimpawu. Lezi zimpawu zifaka:

• Ukujiya kwegazi okusabalele (DIC): Lokhu kuzwakala kuyinkimbinkimbi kancane, akunjalo? Kalula nje, kuyisifo lapho inqubo yokujiya kwegazi emzimbeni wonke iba yiphutha. Lapho ihlule legazi lakha endaweni eyodwa, alikwazi ukuvimba ukuphuma kwegazi kwenye indawo.
• Ukuqhuma kwesikhumba:Ngezinye izikhathi zingavela esikhumbeni njengamachashazi amancane noma amachashazi amakhulu.
• Ukushaqeka kwe-Septic: Lesi yisimo lapho umfutho wegazi wehla khona ngendlela eyingozi ngenxa yokutheleleka, okubangela ukuthi izitho zomzimba zingatholi igazi elanele. Lokhu futhi kuyingozi kakhulu.

Yiziphi izimpawu zokuphuma kwegazi emithanjeni ye-adrenal?

I-WFS ihlotshaniswa nokopha kwe-adrenal, okungase kuhambisane nezinye izimpawu:

• Isisu esibuhlungu.
• Ubuhlungu endaweni engaphezulu kwesinqe, ngaphansi kwezimbambo (izinqe).
• Ubuhlungu, umuzwa wokungakhululeki.
• Ubuvila.
• Isicanucanu nokuhlanza.
• Uhudo.

Yini ebangela lokhu?

Ezimweni eziningi, imbangela eyinhloko ye-Waterhouse-Friderickson syndrome ukutheleleka ngamagciwane namagciwane (i-sepsis) . Uma sikhuluma iqiniso, igciwane lingena emzimbeni bese lisakazeka kuwo wonke umzimba ngaphandle kokulawulwa.

Ezinye izinhlobo zamagciwane zingase zibe sengozini enkulu yalokhu. Nazi izibonelo ezimbalwa:

• `Pseudomonas aeruginosa`
• Ibhaktheriya i-Meningococcus: Lena yibhaktheriya eyingozi kakhulu engabangela i-WFS.
• `I-Streptococcus pneumoniae`
• `Umkhuhlane we-Haemophilus`
• `I-Escherichia coli (E. coli)`
• `I-Staphylococcus aureus`

Ezinye izinhlobo eziningi zamagciwane zingabangela lokhu.

Futhi, ezinye izinhlobo zamagciwane zingabangela lokhu:

• I-Cytomegalovirus (CMV)
• I-Parvovirus `(i-Parvovirus)`
• Igciwane le-Epstein-Barr
• Igciwane le-Ebola `(isifo segciwane le-Ebola)`
• Igciwane le-Varicella-zoster (yilokhu okubangela izifo ezifana ne-chickenpox kanye ne-herpes)

Ngaphezu kwalezi zifo, kunezinye izici eziyingozi zokuthuthukisa i-WFS:

• Ukusebenzisa imithi yokuvimbela ukuvuza kwegazi. Lokhu kwandisa ingozi yokopha.
• I-Thrombocytopenia: Lokhu kusho ukwehla kwenani lama-platelet (amaseli asiza ukujiya kwegazi) egazini.
• Izindlala ze-adrenal zonakele ngandlela thile.

Ubani othinteka kakhulu yilesi simo?

I-Waterhouse-Friderickson syndrome ivame kakhulu ukwenzeka ezinganeni ezincane kunakubantu abadala . Ngakho-ke, uma ingane encane iba nezimpawu ezifana nomkhuhlane kanye nobuhlungu bomzimba, kufanele uqaphele kakhulu.

Yiziphi izinkinga ezingabangelwa yilokhu?

Lena yinto ebaluleke kakhulu. Uma ingelashwa ngokushesha nangendlela efanele, i-Waterhouse-Friderickson syndrome iyabulala. Lokho kusho ukuthi ingaba yingozi empilweni. Ngakho-ke lokhu kufanele kuphathwe njengesimo esiphuthumayo.

Lesi sifo sitholakala kanjani?

Ukuze uxilonge lesi sifo, udinga usizo lukadokotela nakanjani. Udokotela uzokubuza ngezimpawu zakho, abuze ngezifo zakho zangaphambilini, bese ehlola umzimba wakho.

Kodwa ukuhlonza i-WFS kungaba nzima kancane, njengoba izimpawu zayo zifana kakhulu neze -septic shock . Ngakho-ke, ukuze aqinisekise ukuthi yi-WFS, udokotela uzoyala ukuhlolwa okuhlukahlukene.

Yiziphi izivivinyo ezisetshenziswa ukuxilonga lesi sifo?

Ukuqinisekisa ukuthi kukhona yini ukutheleleka, udokotela angenza izivivinyo ezilandelayo:

Ukuhlolwa kwezithombe

• Kungenziwa ukuskena nge-ultrasound noma i-CT (computed tomography) ukuhlola ukwakheka kwegazi ngaphakathi kwezindlala ze-adrenal. Lokhu kuskena kuthatha izithombe zangaphakathi lomzimba, ukuze bakwazi ukubona kahle izindawo zokopha.

Ukuhlolwa kwegazi

• Ukuhlolwa kwegazi kungasho ngokuqinisekile ukuthi unesifo esibangelwa amagciwane. Lokhu kuhilela ukuthatha inalithi encane emthanjeni osengalweni yakho, ukuthatha igazi elincane, bese ulibheka ngaphansi kwe-microscope. Lokhu kuzobheka izimpawu zokutheleleka.

Ukuhlolwa kwamagciwane e-Meningococcus

Uma udokotela ecabanga ukuthi imbangela yibhaktheriya ye-meningococcus, khona-ke angenza izivivinyo ezinjengalezi:

• Ukubhoboza umgogodla/umgogodla: Lokhu kuhilela ukufaka inalithi encane emhlane wakho ongezansi, phakathi kwamathambo amabili, bese uthatha inani elincane loketshezi lomgogodla. Lokhu kungase kuzwakale kusabeka, kodwa odokotela bakwenza ngokucophelela.
• I-biopsy yesikhumba: Uma unesilonda esikhumbeni sakho, kuzothathwa ingcezu encane yesikhumba esilondayo bese ihlolwa.
• Ukuhlolwa kwebala le-Gram: Kuthathwa isampula endaweni okusolwa ukuthi ikhona (njengenxeba) ukuze kubhekwe amagciwane.
• Ukuhlolwa Komchamo: Uzocelwa ukuthi uchamele esitsheni esikhethekile. Isampula yomchamo izobe isihlolwa ukuze kutholakale izimpawu zokutheleleka.

Ukuhlolwa kwe-adrenal crisis okubukhali

Lezi zivivinyo zisiza ekunqumeni ukuthi ubhekene nenkinga ye-adrenal , isimo lapho izindlala ze-adrenal zingasebenzi kahle:

• Ukuhlolwa kokukhuthazwa kwe-hormone ye-adrenocorticotropic (ACTH): Kulolu vivinyo, udokotela wakho ukunika umjovo omncane we-hormone ebizwa ngokuthi i-ACTH. Ngemuva kwemizuzu engama-30 kuya kwengama-60, bathatha isampula yegazi ukuze babone ukuthi izindlala zakho ze-adrenal zisabela kanjani ku-ACTH. Lolu vivinyo olulinganisa ukuthi izindlala zakho ze-adrenal zisebenza kahle kangakanani.
• Ukuhlolwa kweshukela egazini:Kuthathwa inani elincane legazi bese kulinganiswa inani likashukela (i-glucose) elikulo. Amazinga kashukela angehla ngesikhathi senkinga ye-adrenal.
• Ukuhlolwa kwe-Cortisol: Kuthathwa isampula yegazi lakho, umchamo, amathe, noma inhlanganisela yezinto ezimbili noma ezintathu zalezi ukuze kuhlolwe ukuthi ingakanani i-cortisol ekhiqizwa yizindlala zakho ze-adrenal.
• Ukuhlolwa kwegazi le-pH: Kuthathwa isampula yegazi bese kulinganiswa izinga layo le-acid-base (pH). Lokhu kungenziwa ngokuhlolwa kwegesi yegazi elisemithanjeni (ABG) noma iphaneli ye-electrolyte. Ngokuvamile, i-pH yegazi lethu kufanele ibe phakathi kuka-7.35 no-7.45.
• Ukuhlolwa kwegazi le-Potassium: Ukuhlolwa kwegazi ukukala inani le-potassium egazini lakho. I-Potassium iyisakhi esiza imizwa nemisipha yethu ukuthi isebenze kahle. La mazinga angashintsha ngesikhathi senkinga ye-adrenal.
• Ukuhlolwa kwegazi le-sodium: Ukuhlolwa kwegazi kulinganisa inani le-sodium egazini lakho. I-sodium nayo ibalulekile ekusebenzeni kahle kwezinzwa nemisipha yakho. La mazinga angahluka futhi.

Kuphathwa kanjani lokhu?

Uma une-WFS, ungase ube ne -sepsis . Ngakho-ke, into yokuqala odokotela abazoyenza ukukuqala ngama-antibiotic ngokushesha ngenkathi benza izivivinyo ukuze bathole ukuthi yini ngempela ebangele i-WFS. Bazophinde baqaphe amazinga akho e-electrolyte (usawoti) namanzi.

Uma izimpawu ze-sepsis sezilawulekile, odokotela bazoqala ukukunikeza imithi ebizwa ngokuthi i-glucocorticoids kanye ne-mineralocorticoids . Lawa ama-hormone e-steroid. Ama-Glucocorticoids asebenza ukunciphisa ukuvuvukala emzimbeni. Ama-Mineralocorticoids asebenza ukulawula amazinga kasawoti namanzi emzimbeni wakho. Kalula nje, afana nokukunikeza ama-hormone okufanele ukuthi akhiqizwe yizindlala zakho ze-adrenal, kodwa angakhiqizi.

Ungadinga ukumpontshelwa igazi noma inqubo ebizwa ngokuthi i-angioembolization . Lokhu kuhilela ukusebenzisa i-angiogram kanye ne-blood clot (embolization) ukuhlonza nokuvimba imithambo yegazi ehambisa igazi ezindlaleni ze-adrenal. Lokhu kwenzelwa ukuvimba ukopha.

Okubaluleke kakhulu, ngemva kwe-WFS, abantu abaningi kuzodingeka bathathe imithi eyengeziwe yama-hormone impilo yabo yonke , ngoba uma izindlala ze-adrenal zonakele, zingase zingasakwazi ukukhiqiza ama-hormone ngendlela efanele.

Ngizozizwa ngingcono ngokushesha kangakanani ngemva kokwelashwa?

Iningi labantu liqala ukuzizwa lingcono phakathi nesonto noma amabili okuqala ukwelashwa. Kodwa-ke, ngisho nangemva kokuba usululame ngokugcwele, ungase ube nezinkinga ezithile zomzimba noma zengqondo izinyanga, noma ngisho neminyaka. Isibonelo:

• Ukudla akunambitheki.
• Ngikhathele kakhulu.
• Ubunzima bokulala (ukungalali).
• Ukuthambekela kokugula kalula.
• Ukukhathazeka.
• Ukucindezeleka.

Ngakho-ke, kubalulekile ukukhumbula ukuthi kungathatha isikhathi ukululama ngokuphelele.

Yini ongayilindela uma ungenwa yilesi sifo?

Njengoba sesishilo ngaphambili, uma ingelashwa, i-WFS iyisimo esibulalayo. Akukho kungabaza ngakho.

Kodwa-ke, ngokwelashwa kwasekuqaleni, okufanele kanye nokuvuselelwa, iningi labantu abane-WFS liyalulama. Kodwa-ke, ungadinga ukunakekelwa kwezokwelapha okujulile, futhi imiphumela ye-WFS ingahlala izinyanga, ngisho neminyaka. Ngakho-ke, akuyona into okufanele ithathwe kalula.

Ingabe lesi simo singavinjelwa?

Kunezinto eziningana ongazenza ukuze unciphise ingozi yakho yokuthola i-Waterhouse-Friderickson syndrome:

• Ukugeza izandla zakho njalo nangokuphelele kungasiza ekuvimbeleni izifo. Lokhu kuyinto elula kakhulu, kodwa kungakusindisa ezifweni eziningi.
• Ukuthola umuthi wokugomela i-meningococcal bacteria kubaluleke kakhulu ezinganeni.
• Uma usola ukuthi unesifo, funa ukwelashwa ngokushesha. Ungawushayi indiva umkhuhlane noma ukukhwehlela okuncane.

Uzinakekela kanjani ngenkathi ululama?

Njengoba ululama, wena nodokotela wakho kufanele nisebenzisane ukuthuthukisa uhlelo lokuvuselela olufanele, oluphephile, nolulungele wena. Lolu hlelo lungafaka izinto ezifana nalezi:

• Phumula ngokwanele. Umzimba nengqondo kudinga ukuphumula.
• Ukulandela ukudla okunempilo okuzokusiza ukuthi ubuye uthole amandla akho kuwumqondo omuhle. Kungaba kuhle uma ungathola iseluleko kuchwepheshe wezokudla ngalokhu.
• Zibekele imigomo emincane. Isibonelo, ukuhlala embhedeni, ukuma, ukugqoka wedwa, ukugeza, ukuhamba ibanga elifushane, ukukhwela izitebhisi.
• Ukukhuluma ngemizwa yakho nomndeni wakho, abangane, noma uchwepheshe wezokwelapha kubalulekile kulezi zikhathi ezinzima.
• Vivinya umzimba uma unamandla. Qala kancane bese uvivinya umzimba ngokwemiyalelo kadokotela wakho.

Kufanele ngimbone nini udokotela? / Kufanele ngiye nini egumbini lezimo eziphuthumayo?

Uma ungazizwa kahle ngemva kokwelashwa, noma uma unenkinga yokufinyelela imigomo yakho yokuvuselela, qiniseka ukuthi ukhuluma nodokotela wakho.

I-WFS yisimo esibi kakhulu esingaba yingozi uma singelashwa. Uma unezimpawu ze-WFS, isibonelo, into engazizwa kahle noma eba yimbi kakhulu, kufanele uye ekamelweni lezimo eziphuthumayo (ETU) ngokushesha.Akukuhle ukukuhlehlisa lokhu.

Yimiphi imibuzo okufanele uyibuze udokotela wakho?

Uma uthola ukuthi une-WFS, ungase ube nemibuzo eminingi. Ungesabi, buza udokotela wakho imibuzo efana nale ukuze uqede ukungabaza kwakho:

• Wazi kanjani ukuthi ngine-Waterhouse-Friderickson syndrome?
• Uma ngingenayo i-Waterhouse-Friderickson syndrome, yisiphi esinye isimo engingaba naso?
• Iyini imbangela ye-Waterhouse-Friderickson syndrome yami?
• Ingabe kuzodingeka ngihlinzwe ukuze kulungiswe izindlala zami ze-adrenal?
• Ucabanga ukuthi ngizolulama ngokuphelele?
• Ingabe kuzodingeka ngithathe ama-hormone engeziwe?
• Kuzodingeka ngithathe ama-hormone engeziwe isikhathi esingakanani?

Ngakho-ke, yiziphi izinto ezibaluleke kakhulu okudingeka sizikhumbule kulokhu?

I-Waterhouse-Friderichsen syndrome (WFS) yisimo esibi kakhulu esidinga ukunakekelwa kwezokwelapha ngokushesha. Uma unezinye zalezi zimpawu, noma uma unesifo esingapholi, kubalulekile ukuya ekamelweni eliphuthumayo ngokushesha okukhulu.

Landela yonke imiyalelo yokwelashwa enikezwe udokotela wakho ngqo. Kungaleso sikhathi kuphela lapho ungakwazi ukulawula lesi simo se-WFS futhi ululame ngokushesha okukhulu. Khumbula, ukwelashwa kusenesikhathi kungasindisa impilo! Futhi, kubaluleke kakhulu ukuthi uzinakekele kahle ngesikhathi sokululama kwakho.

I- Waterhouse-Friderichsen syndrome, izindlala ze-adrenal, i-cortisol, i-sepsis, izifo, ukunakekelwa okuphuthumayo, ama-hormone