Toxic Epidermal Necrolysis: ndi chiyani, zizindikiro komanso momwe mankhwala amathandizira

Zamkati

• Zizindikiro za NET
• Zoyambitsa zazikulu
• Momwe mankhwalawa amachitikira
• Momwe matendawa amapangidwira

Systemic epidermal necrolysis, kapena NET, ndimatenda akhungu osowa omwe amadziwika ndi kupezeka kwa zilonda mthupi lonse zomwe zimatha kuyambitsa khungu. Matendawa amayamba chifukwa chogwiritsa ntchito mankhwala monga Allopurinol ndi Carbamazepine, koma amathanso kukhala chifukwa cha matenda a bakiteriya kapena ma virus, mwachitsanzo.

NET ndi yopweteka ndipo imatha kupha anthu mpaka 30% ya milandu, chifukwa chake zikayamba kuwonekera, ndikofunikira kukaonana ndi dermatologist kuti matendawa athe kutsimikiziridwa ndikuyamba kulandira mankhwala.

Mankhwalawa amachitika mu chipinda cha anthu odwala mwakayakaya ndipo amachitika makamaka poyimitsa mankhwala omwe akuyambitsa matendawa. Kuphatikiza apo, chifukwa cha kuwonekera kwa khungu ndi mucosa, njira zodzitetezera zimatengedwa kuti apewe matenda opatsirana mchipatala, omwe atha kusokoneza thanzi la wodwalayo.

Zizindikiro za NET

Chizindikiro chodziwika kwambiri cha poizoni wa epidermal necrolysis ndikuwonongeka kwa khungu kuposa 30% yamthupi yomwe imatha kutulutsa magazi ndikutulutsa madzi, kukometsa kuchepa kwa madzi m'thupi komanso matenda.

Zizindikiro zazikulu ndizofanana ndi chimfine, mwachitsanzo:

• Malaise;
• Kutentha thupi;
• Chifuwa;
• Kupweteka kwa minofu ndi molumikizana.

Zizindikirozi, zimasowa patatha masiku 2-3 ndipo zimatsatiridwa ndi:

• Ziphuphu zakhungu, zomwe zimatha kutuluka magazi ndikupweteka;
• Necrosis madera ozungulira zotupa;
• Kusenda khungu;
• Kuphulika;
• Kusintha kwa dongosolo lakumagazi chifukwa cha kupezeka kwa zotupa mu mucosa;
• Kutuluka zilonda mkamwa, pakhosi ndi anus, kawirikawiri;
• Kutupa kwa maso.

Zilonda zochokera ku poizoni wa epidermal necrolysis zimapezeka pafupifupi mthupi lonse, mosiyana ndi a Stevens-Johnson Syndrome, omwe ngakhale ali ndi ziwonetsero zofananira zamatenda, matenda ndi chithandizo, zotupazo zimakhazikika mu thunthu, nkhope ndi chifuwa. Dziwani zambiri za Stevens-Johnson Syndrome.

Zoyambitsa zazikulu

Poizoni wa epidermal necrolysis amayamba chifukwa cha mankhwala, monga Allopurinol, Sulfonamide, anticonvulsants kapena antiepileptics, monga Carbamazepine, Phenytoin ndi Phenobarbital, mwachitsanzo. Kuphatikiza apo, anthu omwe ali ndi matenda omwe amadzitchinjiriza okha, monga Systemic Lupus Erythematosus, kapena omwe ali ndi chitetezo chamthupi chofooka, monga Edzi, amakhala ndi zotupa pakhungu zomwe zimafanana ndi necrolysis.

Kuphatikiza pa kuyambitsidwa ndi mankhwala, zotupa pakhungu zimatha kuchitika chifukwa cha matenda opatsirana ndi mavairasi, bowa, protozoa kapena mabakiteriya komanso kupezeka kwa zotupa. Matendawa amathanso kutengera ukalamba komanso chibadwa.

Momwe mankhwalawa amachitikira

Chithandizo cha mankhwala oopsa a epidermal necrolysis amachitidwa m'Chipinda Chachidwi Chowotcha ndipo chimakhala ndikuchotsa mankhwala omwe akugwiritsidwa ntchito ndi wodwalayo, chifukwa nthawi zambiri NET imachitika chifukwa chotsatira mankhwala ena.

Kuphatikiza apo, m'malo mwa zakumwa ndi ma electrolyte omwe atayika chifukwa cha zotupa zambiri zakhungu zimapangidwa ndikubaya seramu mumtsinje. Kusamalira ovulala tsiku ndi tsiku kumachitidwanso ndi namwino kuti apewe khungu kapena matenda opatsirana, omwe atha kukhala owopsa kwambiri ndikusokoneza thanzi la wodwalayo.

Zilondazo zikafika pa mucosa, kudyetsa kumatha kukhala kovuta kwa munthuyo, chifukwa chake, chakudya chimaperekedwa kudzera m'mitsempha mpaka mamina atulukire.

Pofuna kuchepetsa kusapeza bwino kwa zilondazo, kuponderezedwa kwa madzi ozizira kapena kugwiritsa ntchito mafuta osalowererapo atha kugwiritsidwanso ntchito kupititsa patsogolo khungu. Kuphatikiza apo, adotolo amalimbikitsanso kugwiritsa ntchito ma anti-allergen, ma corticosteroids kapena maantibayotiki, mwachitsanzo, ngati NET imayambitsidwa ndi mabakiteriya kapena ngati wodwalayo watenga matenda chifukwa cha matendawa ndipo izi zitha kukulitsa vuto lachipatala .

Momwe matendawa amapangidwira

Matendawa amapangidwa makamaka kutengera mawonekedwe azilonda. Palibe kuyesa kwa labotale komwe kumatha kuwonetsa kuti ndi mankhwala ati omwe amachititsa matendawa ndipo mayeso oyeserera sanatchulidwe pankhaniyi, chifukwa angayambitse matendawa. Chifukwa chake, ndikofunikira kuti munthuyo amudziwitse adotolo ngati ali ndi matenda aliwonse kapena ngati akugwiritsa ntchito mankhwala aliwonse, kuti adotolo atsimikizire kuti matendawa amapezeka ndikumuzindikiritsa wothandizirayo.

Kuphatikiza apo, kuti atsimikizire kuti ali ndi matendawa, dotolo nthawi zambiri amapempha kuti amupangire khungu, kuphatikiza kuwerengera magazi kwathunthu, kuyesa magazi m'thupi, mkodzo ndi kutulutsa kwa bala, kuti awone ngati ali ndi matenda, komanso kuchuluka kwa zinthu zina zomwe zimayambitsa chitetezo cha mthupi yankho.