Mlembi: John Pratt
Tsiku La Chilengedwe: 14 Febuluwale 2021
Sinthani Tsiku: 14 Novembala 2024
Anonim
Matenda a Von Willebrand: ndi chiyani, momwe mungazindikire komanso momwe mankhwala amathandizira - Thanzi
Matenda a Von Willebrand: ndi chiyani, momwe mungazindikire komanso momwe mankhwala amathandizira - Thanzi

Zamkati

Matenda a Von Willebrand kapena VWD ndi matenda obadwa nawo komanso obadwa nawo omwe amadziwika chifukwa chakuchepa kapena kusapezeka kwa Von Willebrand factor (VWF), yomwe imachita mbali yofunika kwambiri pakuphatikizana. Malinga ndi kusinthaku, matenda a von Willebrand amatha kugawidwa m'mitundu itatu:

  • Lembani 1, momwe kuchepa kwa kapangidwe ka VWF kumachepa;
  • Lembani 2, momwe chinthu chopangidwa sichigwira ntchito;
  • Lembani 3, momwe muli kusowa kwathunthu kwa Von Willebrand factor.

Izi ndizofunikira kulimbikitsa kulumikizana kwa ma platelet ku endothelium, kuchepa ndikuletsa kutuluka kwa magazi, ndipo ili ndi chinthu VIII cha coagulation, chomwe chili chofunikira popewa kuwonongeka kwa platelet mu plasma ndipo ndikofunikira kuyambitsa factor X ndikupitilizabe kusefukira. kuti mupange pulatelet plug.

Matendawa ndi amtundu komanso obadwa nawo, ndiye kuti, amatha kupitilizidwa pakati pa mibadwo, komabe, amathanso kupezeka ali wamkulu munthuyo ali ndi matenda amtundu wokha kapena khansa, mwachitsanzo.


Matenda a Von Willebrand alibe mankhwala, koma kuwongolera, komwe kuyenera kuchitidwa m'moyo wonse molingana ndi malangizo a dokotala, mtundu wa matenda ndi zizindikilo zomwe zawonetsedwa.

Zizindikiro zazikulu

Zizindikiro za matenda a Von Willebrand zimadalira mtundu wa matendawa, komabe, omwe amapezeka kwambiri ndi awa:

  • Pafupipafupi ndi yaitali magazi kuchokera mphuno;
  • Kutuluka magazi pafupipafupi kuchokera m'kamwa;
  • Kuchulukitsa magazi pambuyo pocheka;
  • Magazi mu chopondapo kapena mkodzo;
  • Kuvulaza pafupipafupi m'malo osiyanasiyana amthupi;
  • Kuchuluka kwa msambo.

Kawirikawiri, zizindikirozi zimakhala zovuta kwambiri kwa odwala omwe ali ndi matenda a mtundu wa von Willebrand wa 3, chifukwa pali kuchepa kwakukulu kwa mapuloteni omwe amayang'anira kuundana.

Matendawa amapezeka bwanji

Kupezeka kwa matenda a Von Willebrand kumachitika kudzera m'mayeso a labotale momwe kuyezetsa kupezeka kwa VWF ndi plasma factor VIII, kuwonjezera pa kuyesa kwa nthawi yotaya magazi komanso kuchuluka kwa ma platelet. Sizachilendo kuti mayesowa abwerezedwenso kawiri kapena katatu kuti athe kudziwa bwino za matendawa, kupewa zotsatira zabodza.


Chifukwa ndi matenda obadwa nawo, upangiri wa majini asanabadwe kapena ali ndi pakati angalimbikitsidwe kuti awone ngati mwana angabadwe ndi matendawa.

Pokhudzana ndi mayeso a labotale, nthawi zambiri VWF ndi kusowa kwa VWF ndi factor VIII komanso aPTT yayitali imadziwika.

Momwe mankhwalawa amachitikira

Chithandizo cha matenda a Von Willebrand chimachitika molingana ndi malangizo a katswiri wa zamankhwala othandiza komanso kugwiritsa ntchito maantifibrinolytics, omwe amatha kuwongolera kutuluka kwa magazi mkamwa, mphuno, kukha magazi komanso njira zamano, nthawi zambiri amalimbikitsidwa.

Kuphatikiza apo, kugwiritsa ntchito kwa Desmopressin kapena Aminocaproic acid kuwongolera kugundana kumatha kuwonetsedwa, kuphatikiza pa Von Willebrand factor concentrate.

Mukalandira chithandizo, amalangizidwa kuti anthu omwe ali ndi matenda a Von Willebrand amapewa zochitika zowopsa, monga kuchita masewera olimbitsa thupi komanso kumwa aspirin ndi mankhwala ena osagwiritsa ntchito zotupa, monga Ibuprofen kapena Diclofenac, popanda upangiri wachipatala.


Chithandizo cha mimba

Amayi omwe ali ndi matenda a Von Willebrand amatha kukhala ndi pakati, osafunikira mankhwala, komabe, matendawa amatha kupatsira ana awo, chifukwa ndi matenda obadwa nawo.

Pakadali pano, chithandizo cha matendawa panthawi yoyembekezera chimachitika masiku awiri kapena atatu okha asanabadwe ndi desmopressin, makamaka akabereka kudzera m'chigawo chobisalira, ndipo kugwiritsa ntchito mankhwalawa kuti muchepetse magazi komanso kusunga moyo wamayi ndikofunikira. Ndikofunikanso kuti mankhwalawa agwiritsidwe ntchito mpaka masiku 15 atabereka, popeza kuchuluka kwa factor VIII ndi VWF kumatsikanso, ndikuwopsa kwa kukha magazi pambuyo pobereka.

Komabe, chisamaliro ichi sikofunikira nthawi zonse, makamaka ngati mulingo wa VIII nthawi zambiri amakhala 40 IU / dl kapena kupitilira apo. Ichi ndichifukwa chake ndikofunikira kulumikizana pafupipafupi ndi a hematologist kapena azamba kuti titsimikize kufunikira kogwiritsa ntchito mankhwala komanso ngati pali chiwopsezo chilichonse kwa mayi ndi mwana.

Kodi mankhwalawa ndi oyipa kwa mwanayo?

Kugwiritsa ntchito mankhwala okhudzana ndi matenda a Von Willebrand panthawi yoyembekezera sikuvulaza mwanayo, motero ndi njira yabwino. Komabe, ndikofunikira kuti mwanayo ayesedwe pambuyo pobadwa kuti awone ngati ali ndi matendawa, ndipo ngati ndi choncho, kuti ayambe kulandira chithandizo.

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