Hemolytic anemia: chimene chiri, zizindikiro zazikulu ndi chithandizo

Zamkati

• Zizindikiro zazikulu
• Zomwe zimayambitsa
• Momwe mungatsimikizire matendawa
• Momwe mankhwalawa amachitikira

Matenda a m'magazi omwe amadziwika ndi dzina loti AHAI, ndi matenda omwe amadziwika ndi kupanga ma antibodies omwe amalimbana ndi maselo ofiira a magazi, kuwawononga ndikupanga kuchepa kwa magazi, okhala ndi zizindikilo monga kutopa, pallor, chizungulire, khungu lachikasu komanso loyipa ndi maso kukhala

Kuchepa kwa magazi kwamtunduwu kumatha kukhudza aliyense, koma kumakhala kofala kwambiri kwa achinyamata. Ngakhale zomwe zimayambitsa sizimafotokozedwera nthawi zonse, zimatha kubwera chifukwa chakuchepa kwa chitetezo chamthupi pambuyo poti munthu ali ndi kachilombo, kupezeka kwa matenda ena amthupi okha, kugwiritsa ntchito mankhwala ena, kapena khansa.

Kutulutsa magazi m'thupi mwaokha sikungachiritsidwe nthawi zonse, komabe, kuli ndi chithandizo chomwe chimachitika makamaka pogwiritsa ntchito mankhwala olamulira chitetezo cha mthupi, monga corticosteroids ndi ma immunosuppressants. Nthawi zina, kuchotsedwa kwa ndulu, yotchedwa splenectomy, kumatha kuwonetsedwa, chifukwa apa ndi pomwe mbali ina yamagazi ofiira imawonongeka.

Zizindikiro zazikulu

Zizindikiro za kuperewera kwa magazi m'thupi mwa hemolytic ndi monga:

• Zofooka;
• Kumva kukomoka;
• Zovuta;
• Kusowa kwa njala;
• Chizungulire;
• Kutopa;
• Kugona;
• Kuthetsa;
• Mutu;
• Misomali yofooka;
• Khungu louma;
• Kutaya tsitsi;
• Kupuma pang'ono;
• Khungu m'matumbo am'maso ndi mkamwa;
• Jaundice.

Zizindikirozi ndizofanana kwambiri ndi zomwe zimayambitsidwa ndi mitundu ina ya kuchepa kwa magazi, chifukwa chake ndikofunikira kuti dokotala ayitanitse mayeso omwe angathandize kudziwa chomwe chikuyambitsa, monga kuchepa kwa kuchuluka kwa maselo ofiira, kuchuluka kwa reticulocyte, maselo ofiira ofiira, kuphatikiza pamayeso amthupi.

Onani momwe mungasiyanitsire zomwe zimayambitsa kuchepa kwa magazi.

Zomwe zimayambitsa

Zomwe zimayambitsa kuchepa kwa magazi m'thupi mwake sizidziwikiratu nthawi zonse, komabe, nthawi zambiri zimatha kukhala chachiwiri pakupezeka kwa matenda ena amthupi, monga lupus ndi nyamakazi, khansa, monga ma lymphomas kapena leukemias kapena chifukwa cha momwe mankhwala amathandizira, monga Levodopa, Methyldopa, anti-inflammatories ndi maantibayotiki ena.

Zitha kukhalanso pambuyo pa matenda, monga omwe amayambitsidwa ndi ma virus mongaEpstein-Barr kapena Parvovirus B19, kapena mabakiteriya monga Mycobacterium pneumoniae kapena Treponema pallidum pamene imayambitsa syphilis apamwamba, mwachitsanzo.

Pafupifupi 20% ya milandu, kuchepa kwa magazi m'thupi kumawonjezeka chifukwa cha kuzizira, monga momwe zilili, ma antibodies amayendetsedwa ndi kutentha pang'ono, kotchedwa AHAI ndi ma antibodies ozizira. Milandu yotsalayo imatchedwa AHAI yama antibodies otentha, ndipo ndi ambiri.

Momwe mungatsimikizire matendawa

Pozindikira kuti magazi ali ndi magazi m'thupi mwawo, mayeso omwe adalamulira adokotala ndi awa:

• Kuwerengera kwa magazi, kuzindikira kuchepa kwa magazi ndikuwona kuopsa kwake;
• Mayeso amthupi, monga kuyesedwa kwachindunji kwa Coombs, komwe kumawonetsa kupezeka kwa ma antibodies opezeka pamwamba pamaselo ofiira. Mvetsetsani tanthauzo la mayeso a Coombs;
• Kuyesa komwe kumatsimikizira hemolysis, monga kuchuluka kwa ma reticulocyte m'magazi, omwe ndi maselo ofiira osakhwima omwe amapezeka m'magazi mopitilira muyeso wa hemolysis;
• Mlingo wa bilirubin wosalunjika, zomwe zimawonjezeka pakagwa hemolysis yoopsa. Dziwani chomwe ndichifukwa chake kuyesa kwa bilirubin kukuwonetsedwa.

Popeza ma anemias angapo amatha kukhala ndi zofananira komanso mayeso, ndikofunikira kuti adokotala azitha kusiyanitsa pakati pazomwe zimayambitsa kuchepa kwa magazi. Dziwani zambiri zamayeso ku: Kuyesa komwe kumatsimikizira kuchepa kwa magazi.

Momwe mankhwalawa amachitikira

Sitinganene kuti pali njira yothetsera kuperewera kwa magazi m'thupi mwaokha, chifukwa zimakhala zachilendo kwa odwala matendawa kuti aziphulika komanso kuti akhale ndi thanzi labwino.

Kuti mukhale ndi moyo nthawi yayitali munthawi yakhululukidwe, ndikofunikira kuchita chithandizo chamankhwala chomwe chikuwonetsedwa ndi hematologist, chopangidwa ndi mankhwala omwe amayang'anira chitetezo cha mthupi, monga corticosteroids, monga Prednisone, immunosuppressants, monga Cyclophosphamide kapena Cyclosporine, ma immunomodulators, monga ma immunoglobulin kapena plasmapheresis, omwe amathandizira kuchotsa ma antibodies owonjezera m'magazi, pamavuto akulu.

Kuchotsa opaleshoni ndulu, yotchedwa splenectomy, ndi njira ina, makamaka kwa odwala omwe samvera chithandizo. Popeza chiopsezo chotenga matenda chimatha kukulitsa anthu omwe amachotsa chiwalo ichi, katemera monga antipneumococcal ndi antimeningococcal amawonetsedwa. Onani zambiri zakusamalidwa ndikuchira mukachotsa ndulu.

Kuphatikiza apo, kusankha kwamankhwala kumadalira mtundu wa autoimmune hemolytic anemia, zizindikilo zomwe zimaperekedwa komanso kuopsa kwa matenda amunthu aliyense. Kutalika kwa chithandizo kumasiyanasiyana, ndipo nthawi zina mutha kuyesa kuchotsa mankhwala pakatha miyezi isanu ndi umodzi kuti muwone kuyankha, kutengera malangizo a hematologist.