Kodi Pancytopenia, zizindikiro ndi zimayambitsa chachikulu

Zamkati

• Zizindikiro zazikulu
• Zimayambitsa pancytopenia
• Matendawa amapezeka bwanji
• Momwe mankhwalawa amachitikira

Pancytopenia ikufanana ndi kuchepa kwa maselo onse amwazi, ndiko kuti, ndikuchepa kwa kuchuluka kwa maselo ofiira, ma leukocyte ndi ma platelets, omwe amayambitsa zizindikilo monga pallor, kutopa, mabala, magazi, malungo ndi chizolowezi chofalikira.

Zitha kuchitika mwina chifukwa cha kuchepa kwa maselo am'mafupa, chifukwa cha kuchepa kwa vitamini, matenda amtundu, leukemia kapena leishmaniasis, komanso kuwonongeka kwa maselo amwazi m'magazi, chifukwa cha chitetezo chamthupi kapena matenda opatsa chidwi.

Kuchiza kwa pancytopenia kuyenera kuchitidwa molingana ndi malangizo a dokotala kapena hematologist malinga ndi zomwe zimayambitsa pancytopenia, zomwe zingaphatikizepo kugwiritsa ntchito corticosteroids, immunosuppressants, maantibayotiki, kuthira magazi, kapena kuchotsa ndulu, mwachitsanzo, amangowonetsedwa kutengera zosowa za wodwala aliyense.

Zizindikiro zazikulu

Zizindikiro za pancytopenia zimakhudzana ndi kuchepa kwa magazi ofiira, ma leukocyte ndi ma platelets m'magazi, omwe ndi akulu kwambiri:

Kutengera ndi momwe zimakhalira, pakhoza kukhalanso zizindikilo zochokera ku matenda omwe amayambitsa pancytopenia, monga m'mimba wokulitsidwa chifukwa chakukula kwa nthenda, ma lymph node owonjezera, kusokonekera m'mafupa kapena kusintha pakhungu, mwachitsanzo.

Zimayambitsa pancytopenia

Pancytopenia imatha kuchitika chifukwa cha zochitika ziwiri: pamene mafupa samatulutsa maselo amwazi moyenera kapena pamene mafupa amatulutsa molondola koma maselo amawonongeka m'magazi. Zomwe zimayambitsa pancytopenia ndi izi:

• Kugwiritsa ntchito mankhwala oopsa, monga maantibayotiki, chemotherapy, antidepressants, anticonvulsants ndi sedatives;
• Zotsatira za radiation kapena othandizira mankhwala, monga benzene kapena DDT, mwachitsanzo;
• Kuperewera kwa vitamini B12 kapena folic acid mu chakudya;
• Matenda achibadwa, monga kuchepa kwa magazi kwa Fanconi, kobadwa nako dyskeratosis kapena matenda a Gaucher;
• Matenda a m'mafupa, monga myelodysplastic syndrome, myelofibrosis kapena usiku paroxysmal hemoglobinuria;
• Matenda osokoneza bongo, monga lupus, Sjögren's syndrome kapena autoimmune lymphoproliferative syndrome;
• Matenda opatsirana, monga leishmaniasis, brucellosis, chifuwa chachikulu kapena HIV;
• Khansa, monga khansa ya m'magazi, myeloma yambiri, myelofibrosis kapena metastasis yamitundu ina ya khansa mpaka m'mafupa.
• Matenda omwe amachititsa chidwi cha nthata ndi maselo oteteza thupi kuwononga maselo amwazi, monga chiwindi cirrhosis, matenda a myeloproliferative ndi hemophagocytic syndromes.

Kuphatikiza apo, matenda opatsirana oyambitsidwa ndi mabakiteriya kapena ma virus, monga cytomegalovirus (CMV), amatha kupangitsa chitetezo champhamvu mthupi, chokhoza kuwononga maselo amwazi mwanjira yovuta panthawi yamatenda.

Matendawa amapezeka bwanji

Matenda a pancytopenia amapangidwa pogwiritsa ntchito kuwerengera kwathunthu kwamagazi, momwe magawo amazi ofiira ofiira, ma leukocyte ndi ma platelets ocheperako m'magazi amayang'aniridwa. Komabe, ndikofunikanso kuzindikira chomwe chidapangitsa kuti pancytopenia, yomwe iyenera kuchitidwa kudzera pakuwunika kwa dokotala kapena hematologist kudzera pakuwona mbiri yazachipatala ndikuwunika kwa wodwalayo. Kuphatikiza apo, mayesero ena akhoza kulimbikitsidwa kuti adziwe chomwe chimayambitsa pancytopenia, monga:

• Seramu chitsulo, ferritin, machulukitsidwe a transerrin ndi kuchuluka kwa reticulocyte;
• Mlingo wa vitamini B12 ndi folic acid;
• Kufufuza kwa matenda;
• Kutseka magazi;
• Mayeso amthupi, monga Coombs wachindunji;
• Myelogram, momwe mafuta amafupa amafunira kuti adziwe zambiri za mawonekedwe am'malo ano. Onani momwe myelogram imapangidwira komanso nthawi yomwe iwonetsedwa;
• Mafupa a m'mafupa, omwe amawunika momwe maselo amakhalira, kupezeka kwa kulowetsedwa ndi khansa kapena matenda ena ndi fibrosis. Pezani momwe biopsy ya mafupa imagwirira ntchito komanso kuti ndi chiyani.

Mayesero apadera amathanso kulamulidwa pa matenda omwe dotolo amakayikira, monga immunoelectrophoresis ya myeloma kapena mafupa ambiri kuti azindikire matenda, monga leishmaniasis, mwachitsanzo.

Momwe mankhwalawa amachitikira

Chithandizo cha pancytopenia chimayendetsedwa ndi a hematologist molingana ndi zomwe zimayambitsa, ndipo atha kuphatikizanso kugwiritsa ntchito mankhwala osokoneza bongo, monga Methylprednisolone kapena Prednisone, kapena ma immunosuppressants, monga Cyclosporine, pankhani yamatenda amthupi kapena yotupa. Kuphatikiza apo, ngati pancytopenia imachitika chifukwa cha khansa, chithandizo chitha kuphatikizira kupititsa m'mafupa.

Pankhani ya matenda, mankhwala amtundu uliwonse amawonetsedwa pachilombo chilichonse, monga maantibayotiki, maantivirals kapena ma pimonvalent antimonials ngati leishmaniasis, mwachitsanzo. Kuikidwa magazi sikuwonetsedwa nthawi zonse, koma kungafunike pamavuto akulu omwe amafunikira kuchira mwachangu, kutengera chifukwa.