Kupenda kwa Zizindikiro, Kuzindikira, ndi Chithandizo
Tanthauzo
Chitetezo cha Immune thrombocytopenia (ITP), chomwe poyamba chimatchedwa idiopathic thrombocytopenic purpura, ndi chikhalidwe chimene chitetezo cha thupi lanu chimagonjetsa ndi kuwononga mapepala anu omwe amachititsa kuti tizirombo tating'ono tating'ono ( thrombocytopenia ). Mipata ya pulasitiki ndi yofunika kuti mudye magazi ndipo ngati mulibe mokwanira, mukhoza kutaya magazi.
Zizindikiro za ITP
Zizindikiro za ITP zimagwirizana ndi chiopsezo chowonjezeka cha magazi chifukwa cha kuchuluka kwa mapepala anu.
Komabe, anthu ambiri omwe ali ndi ITP alibe zizindikiro.
Nosebleeds
Kutsekemera kuchokera mu chingamu
Magazi mumtsuko kapena pansi
Kutaya magazi kwambiri kumatchedwa menorrhagia
Petechiae - madontho ang'onoang'ono ofiirawo angafanane ndi kuthamanga koma kwenikweni ndi magazi ochepa pansi pa khungu
Kuvulaza kosavuta - mikwingwirima ikhoza kukhala yaikulu ndipo imatha kukhala pansi pa khungu
Mitsempha ya magazi mkati mwa pakamwa yotchedwa purpura
Zifukwa za ITP
Kawirikawiri, chiwerengero cha mapulogalamu anu akutsikira mu ITP chifukwa thupi lanu limapanga tizilombo toyambitsa matenda lomwe limagwirizanitsa ndi mapuleti ndi kuwonetsera kuti liwonongeke. Pamene mapiritsiwa akuyenda kudzera mu nthata (chiwalo mimba yomwe imasambitsa magazi), imadziwika ndi ma antibodieswa ndikuwononga mapepala. Komanso kupanga mapaleti kungachepe. ITP imawonekera pambuyo pa zokondweretsa zina, nthawizina dokotala wanu sangathe kudziwa chomwe chochitika ichi chinali.
Mavairasi: Kwa ana, ITP nthawi zambiri imayambitsidwa ndi matenda a tizilombo. Matendawa amapezeka masabata angapo asanafike patsogolo pa chitukuko cha ITP. Pamene chitetezo cha mthupi chimapangitsa tizilombo toyambitsa matenda kumenyana ndi matendawa tizilombo toyambitsa matenda timapanga tizilombo toyambitsa matenda.
Katemera: ITP yakhala ikugwiritsidwa ntchito ndi kayendetsedwe ka katemera wa MMR (chimfine, mumps, rubella). Kawirikawiri imachitika mkati mwa milungu isanu ndi umodzi yothandizira katemera. Ndikofunika kuzindikira kuti izi ndizochitika zosayembekezereka zokhala ndi mavoti 2.6 pa katemera uliwonse wa MMM 100,000 woperekedwa. Zowopsazi ndizochepa kusiyana ndi chiopsezo chotenga ITP ngati muli ndi matenda a shuga kapena rubella. Kutaya magazi kwakukulu sikupezeka kawirikawiri ndipo anthu oposa 90% adzakhala ndi chisankho cha ITP mkati mwa miyezi isanu ndi umodzi.
Matenda osokoneza bongo: ITP imaonedwa kuti ndi matenda omwe amadzimadzimadzimodzi ndipo imayanjana ndi matenda ena omwe amadzimadzimadzi okha monga lupus ndi nyamakazi. ITP ikhoza kuyamba kufotokozera chimodzi mwa izi.
Kusanthula kwa ITP
Mofanana ndi matenda ena a magazi monga kuchepa kwa magazi ndi neutropenia , ITP imadziwika pa chiwerengero cha magazi (CBC). Palibe chidziwitso chimodzi choyesera cha ITP. Ndizozindikiritsa kuti kusokonezeka, kutanthauza kuti zifukwa zina zatulutsidwa kunja. Kawirikawiri, kuchuluka kwa mapulogalamu okha kumachepetsedwa mu ITP; maselo oyera a magazi ndi hemoglobini ndizochibadwa. Wothandizira zaumoyo wanu akhoza kukhala ndi mapuloletsiti omwe amayang'anitsidwa ndi microscope (yotchedwa magazi palimodzi) kuti atsimikizidwe kuti mapaleletiti amachepetsedwa koma amaoneka ngati abwino. Pakati pa kugwedeza, mungakhale ndi mayesero ena kuti muchotse khansara kapena zifukwa zina za chiwerengero chochepa cha platelet, koma izi sizikufunika nthawi zonse. Ngati ITP yanu ikulingalira kuti ndi yachiwiri ku matenda ena, muyenera kuyesa izi.
Kuchiza kwa ITP
Pakalipano, chithandizo cha ITP chimadalira kukhalapo kwa zizindikiro za magazi kusiyana ndi chiwerengero cha mapepala. Cholinga cha mankhwala ndicho kusiya magazi kapena kubweretsa chiwerengero cha platelet kuti chikhale "chotetezeka".
Ngakhale kuti kwenikweni si "mankhwala", anthu omwe ali ndi ITP ayenera kupewa kumwa aspirin kapena mankhwala a ibuprofen pamene mankhwalawa amachepetsa ntchito ya mapulogalamu.
Kuwonetsetsa: Ngati mulibe zizindikiro za magazi pakali pano, dokotala wanu angasankhe kukuyang'anirani popanda kupereka mankhwala.
Steroids: Steroids monga methylprednisolone kapena prednisone ndi mankhwala omwe amapezeka kwambiri kuti athetse ITP padziko lonse lapansi. Steroids imachepetsa kuwonongeka kwa mapuloletsiti mu ntchentche. Steroids ndi othandiza kwambiri koma zingatenge zoposa sabata kuti muwonjezere kuchuluka kwa mapulogalamu anu.
IVIG: Intravenous immune globulin (IVIG) ndizofala kwa LTP. Kawirikawiri amagwiritsidwa ntchito kwa odwala omwe akumwa magazi omwe amafunika kuwonjezeka mofulumira mu chiwerengero cha platelet. Amagwiritsidwa ntchito ngati intraveous (IV) kulowetsedwa kwa maola angapo.
WinRho: WinRho ndi mankhwala a IV omwe angagwiritsidwe ntchito kuonjezera chiwerengero cha mapiritsi mwa anthu omwe ali ndi magazi ena. Ndiko kulowetsedwa mofulumira kuposa IVIV.
Kuika magazi pa Platelet: Mavitamini a Platelet si othandiza nthawi zonse kwa anthu omwe ali ndi ITP koma angagwiritsidwe ntchito pazinthu zina monga ngati mukufunikira kugwira ntchito.
Ngati ITP ikupitirizabe osayankhira mankhwala oyamba inu dokotala angapereke mankhwala ena monga:
Splenectomy : Mu ITP mapapulaneti amawonongedwa mu ntchentche. Pochotsa nthata, nthawi ya moyo ya mapulateleti ikhoza kuwonjezeka. Ubwino ndi zoopsa ziyenera kuyeza musanayambe kuchotsa nthata.
Rituximab : Rituximab ndi mankhwala otchedwa antioclonal antibody. Mankhwalawa amathandiza kuwononga maselo oyera a magazi omwe amapanga ma antibodies motsutsana ndi mapulogalamu, otchedwa B-maselo. Chiyembekezo ndi chakuti pamene thupi lanu limapanga maselo atsopano a B, sichidzapangitsanso anti antiplate.
Thrombopoietin agonists: Zina mwa mankhwala atsopano ndi thrombopoietin (TPO) agonists. Mankhwala awa ndi eltrombopag (oral) kapena romiplostim (subcutaneous); amachititsa kuti mafupa anu apange mateleti ambiri.
Kusiyana kwa ana ndi akulu
Ndikofunika kuzindikira kuti mbiri ya chilengedwe ya ITP nthawi zambiri imasiyana mosiyana ndi ana. Ana oposa 80% omwe amapezeka ndi ITP adzakhala ndi kuthetsa kwathunthu. Achinyamata ndi achikulire amatha kukhala ndi matenda aakulu a ITP omwe amatha kukhala ndi matenda a moyo wonse omwe angathe kapena sakusowa chithandizo.
> Chitsime:
> CE Neunert, DL Yee. Kusokonezeka kwa Platelets. Mu: CD Rudolph, AM Rudolph, GE Lister, LR Woyamba ndi AA Gershon eds. Rudolph's Pediatrics . 22nd. New York: McGraw Hill Medical, 2011.