Matenda a khungu

Matenda a Sickle cell ndi matenda omwe amabwera m'mabanja. Maselo ofiira ofiira omwe nthawi zambiri amapangidwa ngati diski amatenga chikwakwa kapena kachigawo. Maselo ofiira ofiira amanyamula mpweya m'thupi lonse.

Matenda a cell omwe amadwala amayamba chifukwa cha mtundu wina wa hemoglobin wotchedwa hemoglobin S. Hemoglobin ndi puloteni mkati mwa maselo ofiira amwazi omwe amanyamula mpweya.

• Hemoglobin S amasintha maselo ofiira amwazi. Maselo ofiira ofiira amafooka komanso amawoneka ngati ma crescents kapena zenga.
• Maselo achilendo amapereka mpweya wocheperako m'matumba amthupi.
• Amathiranso kulowa m'mitsempha yaying'ono ndikuphwanyika. Izi zimatha kusokoneza kuyenda kwa magazi ndikuchepetsa kwambiri kuchuluka kwa mpweya wopita kumatenda amthupi.

Matenda am'mimba amachokera kwa makolo onse. Ngati mutenga geni la chikwakwa kuchokera kwa kholo limodzi, mudzakhala ndi mawonekedwe a zenga. Anthu omwe ali ndi mawonekedwe amtundu wa zenga alibe zizindikiro za matenda amzere.

Matenda a Sickle amapezeka kwambiri mwa anthu ochokera ku Africa ndi ku Mediterranean. Amawonekeranso mwa anthu ochokera ku South ndi Central America, Caribbean, ndi Middle East.

Zizindikiro nthawi zambiri sizimachitika mpaka atakwanitsa miyezi 4.

Pafupifupi anthu onse omwe ali ndi matenda a zenga ali ndi magawo opweteka omwe amatchedwa mavuto. Izi zimatha kuyambira maola mpaka masiku. Mavuto angayambitse kupweteka kumbuyo, mwendo, mafupa, ndi chifuwa.

Anthu ena amakhala ndi gawo limodzi zaka zingapo zilizonse. Ena amakhala ndi zigawo zambiri chaka chilichonse. Vutoli limatha kukhala lokwanira mokwanira kupempha kuti agonekere kuchipatala.

Kuchepa kwa magazi kumachulukirachulukira, zizindikilo zimatha kuphatikiza:

• Kutopa
• Khungu
• Kuthamanga kwa mtima mwachangu
• Kupuma pang'ono
• Chikasu cha maso ndi khungu (jaundice)

Ana aang'ono omwe ali ndi matenda a zenga amakhala ndi zowawa m'mimba.

Zizindikiro zotsatirazi zitha kuchitika chifukwa mitsempha yaying'ono yamagazi imatsekedwa ndi maselo osadziwika:

• Kupweteka kwakanthawi komanso kwakanthawi (priapism)
• Maso kapena khungu
• Mavuto akuganiza kapena chisokonezo omwe amayamba chifukwa cha sitiroko yaying'ono
• Zilonda pamapazi apansi (mwa achinyamata ndi akulu)

Popita nthawi, ndulu imasiya kugwira ntchito. Zotsatira zake, anthu omwe ali ndi matenda a chikwakwa amatha kukhala ndi zizindikilo za matenda monga:

• Matenda a mafupa (osteomyelitis)
• Matenda a gallbladder (cholecystitis)
• Matenda a m'mapapo (chibayo)
• Matenda a mkodzo

Zizindikiro zina ndi monga:

• Kuchedwa kukula ndi kutha msinkhu
• Zowawa zolumikizidwa ndi nyamakazi
• Kulephera kwa mtima kapena chiwindi chifukwa chachitsulo chochuluka (kuchokera ku magazi)

Kuyesa komwe kumachitika kawirikawiri kuti mupeze ndikuwunika anthu omwe ali ndi matenda a zenga ndi awa:

• Bilirubin
• Kukhathamira kwa mpweya wamagazi
• Kuwerengera kwathunthu kwa magazi (CBC)
• Hemoglobin electrophoresis
• Seramu wopanga
• Seramu potaziyamu
• Kuyezetsa khungu

Cholinga cha chithandizo ndikuthana ndi kuwongolera zizindikilo, ndikuchepetsa kuchuluka kwamavuto. Anthu omwe ali ndi matenda a zenga amafunikira chithandizo chamankhwala nthawi zonse, ngakhale atakhala kuti alibe mavuto.

Anthu omwe ali ndi vutoli ayenera kumwa zowonjezera folic acid. Folic acid imathandiza kupanga maselo ofiira atsopano.

Kuchiza kwamavuto amtundu wa zenga kumaphatikizapo:

• Kuikidwa magazi (amathanso kuperekedwa pafupipafupi kuti muteteze sitiroko)
• Mankhwala opweteka
• Madzi ambiri

Mankhwala ena a matenda a chikwakwa angaphatikizepo:

• Hydroxyurea (Hydrea), yomwe imathandiza kuchepetsa kuchuluka kwa zopweteka (kuphatikizapo kupweteka pachifuwa ndi kupuma mavuto) mwa anthu ena
• Maantibayotiki, omwe amathandiza kupewa matenda a bakiteriya omwe amapezeka mwa ana omwe ali ndi matenda a zenga
• Mankhwala omwe amachepetsa chitsulo m'thupi
• Njira zatsopano zothandizira kuchepetsa pafupipafupi komanso kuopsa kwa zovuta zopweteka zavomerezedwa

Mankhwala omwe angafunike kuthana ndi zovuta zamatenda amtundu wa sickle cell ndi awa:

• Dialysis kapena impso kumuika matenda a impso
• Uphungu pazovuta zamaganizidwe
• Kuchotsa ndulu mwa anthu omwe ali ndi matenda am'mimba
• Mchiuno m'malo mwa avascular necrosis m'chiuno
• Opaleshoni ya mavuto amaso
• Chithandizo chogwiritsa ntchito mopitirira muyeso kapena kugwiritsa ntchito mankhwala osokoneza bongo
• Kusamalira mabala a zilonda za mwendo

Mafupa kapena ma cell opatsirana amatha kuchiritsa matenda amkole, koma izi sizotheka kwa anthu ambiri. Anthu omwe ali ndi matenda amtundu wa cellle nthawi zambiri samatha kupeza othandizira omwe amafanana nawo.

Anthu omwe ali ndi matenda a chikwakwa ayenera kukhala ndi katemera otsatirawa kuti achepetse kutenga kachilombo:

• Katemera wa Haemophilus influenzae (Hib)
• Katemera wa Pneumococcal conjugate (PCV)
• Katemera wa Pneumococcal polysaccharide (PPV)

Kuyanjana ndi gulu lothandizira pomwe mamembala amagawana nawo zinthu zofananako kumatha kuchepetsa nkhawa za matenda osachiritsika.

M'mbuyomu, anthu omwe ali ndi matenda a sickle cell nthawi zambiri amwalira azaka zapakati pa 20 ndi 40. Chifukwa cha chisamaliro chamakono, anthu tsopano akhoza kukhala ndi zaka 50 kapena kupitirira.

Zomwe zimayambitsa kufa zimaphatikizapo kulephera kwa ziwalo ndi matenda.

Imbani wothandizira zaumoyo wanu ngati muli ndi:

• Zizindikiro zilizonse za matenda (malungo, kupweteka kwa thupi, kupweteka mutu, kutopa)
• Mavuto azovuta
• Kupweteka komanso kukhalitsa kwakanthawi (mwa amuna)

Magazi m'thupi - chikwakwa cell; Matenda a Hemoglobin SS (Hb SS); Matenda a kuchepa kwa magazi

• Maselo ofiira ofiira, khungu la chikwakwa
• Maselo ofiira ofiira - abwinobwino
• Maselo ofiira ofiira - maselo angapo azizindikiro
• Maselo ofiira ofiira - maselo a zenga
• Maselo Ofiira - chikwakwa ndi Pappenheimer
• Zinthu zopangidwa zamagazi
• Maselo amwazi

Matenda a Howard J. Sickle cell ndi ma hemoglobinopathies ena. Mu: Goldman L, Schafer AI, olemba. Mankhwala a Goldman-Cecil. 26 wa. Philadelphia, PA: Elsevier; 2020: chap 154.

Meier ER. Njira zochiritsira matenda amzere. Chipatala cha Odwala North Am. 2018; 65 (3) 427-443. PMID 29803275 adatuluka.ncbi.nlm.nih.gov/29803275/.

National Heart Lung ndi Blood Institute. Umboni wokhudzana ndi matenda a zenga: lipoti la akatswiri, 2014. www.nhlbi.nih.gov/health-topics/evidence-based-management-sickle-cell-disease. Idasinthidwa mu Seputembara 2014. Idapezeka pa Januware 19, 2018.

Saunthararajah Y, Vichinsky EP. Matenda a Sickle cell: mawonekedwe azachipatala ndi kasamalidwe. Mu: Hoffman R, Benz EJ, Silberstein LE, et al, olemba. Hematology: Mfundo Zoyambira ndi Zochita. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier; 2018: mutu 42.

Smith-Whitley K, Kwiatkowski JL. Ma hemoglobinopathies. Mu: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, olemba. Nelson Textbook of Pediatrics. Wolemba 21. Philadelphia, PA: Elsevier; 2020: chap 489.