Kuyeza kwa magazi komwe kumadziwika kuti magazi okwanira, kapena CBC, kumawerengera ma selo anu ofiira a magazi, maselo oyera a magazi, ndi mapulateletti omwe amathandiza magazi anu kuti aphimbe. Nthendayi ikakhala yochepa, kapena ikuyembekezeka kukhala yotsika, mafupa osokoneza bongo amatha kupititsa patsogolo thupi lanu kupanga maselo a magazi.
Mankhwalawa ali ndi ngozi zowopsa kwambiri, kuphatikizapo kupindulitsa kwa magazi, ndipo sizinthu zonse za "chiwerengero chochepa" amachizidwa ndi mankhwala awa.
Pochiza khansa, kugwiritsira ntchito mankhwala osokoneza bongo kumatengedwa ngati kusamalidwa , kutanthauza kuti mankhwalawo sagwirizana ndi khansara, koma amathandiza m'njira zina.
Thupi Lanu la Mfupa, Yayandikira Kwambiri
Msupa wa mafupa ndi minofu yamoyo yomwe imakhala mkati mwa ziwalo za mafupa ena, makamaka mavupulo ndi mazira, kapena mafupa a pamphepete mwa msana. Mfupa ndi pamene magulu ambiri amtundu wa hematopoietic amakhala ndi kugwira ntchito. Ma maselo amtundu wa Hematopoietic amagawanitsa ndikupangika ku mitundu yonse ya maselo a magazi, kuphatikizapo maselo ofiira, maselo oyera, ndi mapuloletsiti.
Kuwongolera thanzi la mafupa , kupanga mankhwala kumakhala kovuta-maselo atsopano a magazi sangathe kupangidwanso kuyenda ndi akale kapena kuchenjeza maselo, kapena maselo omwe amafa ngati zotsatira za mankhwala a khansa. Mafupa a mafupa akhoza kukhala opanda thanzi pa zifukwa zosiyanasiyana. Pankhani ya khansa zina zamagazi, kapena mafupa am'thupi, mafupa ndi malo a khansara, kuphatikizapo malo omwe angathe kukhala poizoni kuchokera kuchipatala.
Kodi Kugwidwa kwa Matenda a Mfupa Ndi Chiyani?
Mfupa wathanzi umayankhidwa ndi zizindikiro za thupi zomwe zimalongosola kufunikira kolimbikitsa kupanga maselo a magazi. Asayansi aphunzira kupanga zina mwa zizindikiro izi kunja kwa thupi, ndipo ochuluka, kuti agwiritsidwe ntchito mankhwala kuti apititse patsogolo kupanga.
Nthawi zambiri amapatsidwa mlingo waukulu kuposa momwe nthawi zambiri zimapangidwira mkati mwa thupi.
"Mabanja" osiyana kapena oyimira magazi a mtundu wa maselo mumtambo akhoza kumvetsera zizindikiro zosiyanasiyana za mankhwala. Nthawi yodziwika ya chizindikiro cha mankhwala yomwe imapangitsa kuti pakhale zokolola zimakhala zofunikira kwambiri. Sikuti mankhwala onse omwe amachititsa kuti fupa la mafupa liwonjezeke, ndilo kukula.
N'chifukwa Chiyani Matenda a Khunyu Amagwiritsidwa Ntchito?
Kulimbana ndi Malipiro Ochepa
Kulimbikitsa thupi kuti likhale ndi maselo atsopano a magazi kungakhale kothandiza pamene imodzi kapena zambiri mwa selo lanu la magazi ndizochepa kapena zomwe mukuwerenga zikuyembekezeka kukhala zochepa kwambiri. Mwachitsanzo, nthawi zina mafupa amathandizidwa patsogolo, ngati njira yothandizira, pamene chiwerengero chiyenera kugwera chifukwa cha kansa yothandizira.
Odwala ena amene amalandira mankhwala a cytotoxic mankhwala amatha kukhala ndi nthawi yochepa kwambiri kwa nthawi yaitali. Maselo oyera a maselo oyera omwe amadziwika kuti neutrophils amatsatira mosamala. Maseŵera otsika a neutrophils ameneŵa, makamaka amagwirizana bwino ndi chiopsezo cha matenda. Mankhwala otsika a neutrophil ali pansipa pambali ina imatchedwa neutropenia, ndipo pamene miyendo ya neutrophils imakhala yotsika kwambiri, imadziwika kuti neutropenia.
Akatswiri alemba mabuku, kulembera malemba ambirimbiri, zokhudzana ndi momwe mafupa opatsa mafupa ayenera kuyenera kusagwiritsidwa ntchito.
Zambiri mwa zokambiranazi zimatsimikizira kuti zowopsa ndi zopindulitsa zimakhala zabwino kwa wodwalayo. Pali zinthu zambiri zochiritsira zomwe muyenera kuganizira.
Kuthandiza Wina Wina
Kulimbikitsana kwa mnofu kumagwiritsidwanso ntchito nthawi zina mwa anthu abwinobwino, pamene apereka maselo osakanikirana kwa munthu wina, mu chinachake chomwe chimatchedwa piritsi ya magazi yowonongeka maselo . Zikuoneka kuti chiwerengero chochepa cha maselo am'magazi amagazi amapezeka m'magazi, ndipo madokotala aphunzira kuwatenga kuchokera kwa anthu wathanzi; Odzipereka akhoza kupereka maselo awo opatsirana pogwiritsa ntchito mafuta a mchenga / tsinde lokha mwa kupereka magazi, nthawi zina.
Mbali imodzi mwa njirayi imapangitsa kuti fupa la mafupa likhale lothandiza kuti maselo ambiri amatha kusonkhanitsidwa mosavuta ku magazi ozungulira.
Malinga ndi Ndondomeko ya Othandizira Ndalama Zachilengedwe, kapena "Khalani Ofanana ," munthu wopereka maselo amathotholo amalandira jekeseni wa filgrastim, chiwerengero cha kukula, kwa masiku asanu asanakwane. Filgrastim imagwiritsidwa ntchito kuonjezera chiwerengero cha maselo opanga magazi m'magazi. Ndiye, pa tsiku la zopereka, magazi a wodzipereka amakoka pogwiritsa ntchito singano padzanja limodzi ndikudutsa mumakina omwe amasonkhanitsa maselo oyenera magazi. Magazi otsala amabwezedwa kwa wodzifunira kupyolera mu mkono wina.
Mitundu ya Bone Marrow Yotsitsimula Mankhwala
Zinthu zokula ndizo mankhwala omwe amaperekedwa kudzera mu jekeseni pansi pa khungu. Ena angaperekedwe mozemba, m'mimba. Gulu lanu la thanzi labwino lingapereke mankhwala mwa jekeseni, ndipo nthawi zina anthu ndi achibale amaphunzira kuwapatsanso iwo.
Zowonjezera Kukula kwa Maselo Ayera Oyera
Zifukwa za kukula kapena "zinthu zolimbikitsa" zomwe zimathandiza kuwonjezera maselo oyera a magazi ndi awa:
- Filgrastim ndi lenograstim ndiwo maganulocyte omwe amachititsa chidwi (G-CSFs)
- Pegfilgrastim ndi mawonekedwe akale a G-CSF. Zimagwira ntchito mofanana ndi filgrastim koma zimaperekedwa mochepa.
- Sargramostim ndi granolocyte macrophage-colony factor stimulating factor (GM-CSF).
Mitundu iwiri ya kukula-G-CSFs ndi GM-CSFs-ingathandize kupanga maselo oyera a magazi. Deta kuchokera ku mayesero osinthika osasinthika kuyerekezera mitundu iwiri ya zopatsa magazi zomwe pakali pano sizikusowa. Makampani ambiri azachipatala amagwiritsa ntchito G-CSF, ndipo iyi ndiyo mtundu wokhazikitsidwa kwambiri ndi umodzi womwe waphunzira kwambiri.
G-CSF angaperekedwe panthawi yoyamba ya chemotherapy kuti ateteze mavuto chifukwa cha neutropenia m'zochitika zonse za chemotherapy. G-CSFs imathandizanso kuchepetsa chiwopsezo cha malungo kwa odwala omwe ali ndi matenda a neutropenia, ndipo amachepetsa kufunika kokhala kuchipatala. Angagwiritsenso ntchito mankhwala a chemotherapy kuti apereke mankhwala apamwamba a mankhwala a chemotherapy, pa zochitika zomwe kuchepa mankhwala a chemotherapy kungayambitse kuwonetsa kwakukulu.
Nthawi zina G-CSF amaperekedwa pa mankhwala omwe amachititsa kuti mankhwalawa asamathandizidwe ngati mankhwala omwe amayamba kale amachititsa kuti thupi likhale ndi malungo, komanso kuti azifupikitsa nthawi imene munthu ali ndi neutropenia yoopsa kwambiri kuchokera ku chemo popanda kutentha thupi. G-CSFs sichivomerezedwa kuti chizoloŵezi ngati wodwala ali kale ndi malungo ndi neutropenia.
Zinthu Zowonjezera Kuonjezera Maselo Ofiira Amagazi
Zinthu zowonjezera zomwe zimathandiza kuwonjezera maselo ofiira, kapena erythrocytes, ndi awa:
- Erythropoietin ndi chinthu chomwe chimapangitsa kuti maselo ofiira magazi aziwoneka bwino.
- Darbepoetin ndi mawonekedwe a erythropoietin omwe akhala akutalika nthawi yaitali koma amatha kuperekedwa mochepa.
Kupereka erythropoietin kungathandize kupeŵa kuikidwa magazi kwa maselo ofiira a magazi. Kupatsa odwala ena erythropoietin ndi G-CSF kumapanga yankho lawo ku erythropoietin.
Mofanana ndi kukula komwe kumalimbikitsa maselo oyera a magazi, pakhala pali zoyesayesa zambiri zolemba malangizo ndi ndondomeko za momwe erythropoietin ndi darbepoetin ziyenera kugwiritsidwa ntchito. Ntchito yogwirizana pakati pa zoopsa ndi zopindulitsa ikukhudzidwa.
Kupatsa Platelets
Kawirikawiri, mankhwala omwe amatchedwa oprelvekin ndi mawonekedwe a mankhwala omwe amatchedwa interleukin-11, kapena IL-11. Oprelvekin ingagwiritsidwe ntchito popangitsa kuti apange mapepala apakhungu pambuyo pa mankhwala a khansa kapena mu zochitika zina zachipatala zomwe zimaphatikizapo mapiritsi apansi (thrombocytopenia). Mankhwalawa angathandize kuwonjezera olemba mapiritsi a odwala kwa kanthawi, komabe sizothandiza pa mitundu yonse ya odwala, kapena pa milandu yonse ya mapepala apansi.
Mankhwala ena otchedwa romiplostim amathandizanso kuwonjezera mapuloletsiti, koma amasonyeza ngati munthu ali ndi mapepala apansi omwe amachititsa mwachindunji ndi chinachake chotchedwa chronic immune thrombocytopenia, kapena chronic ITP. Romiplostim si chilengedwe chodziwika bwino, koma chimagwira ntchito poyerekeza ndi thrombopoietin, kukula, ndi chitukuko chomwe chimapangitsa mapuloletsiti.
Maphunziro Amtsogolo
Mafukufuku ambiri adayambika kuti ayese kupeza njira yabwino yolankhulira odwala omwe angapindule ndi kukula komwe kumayambitsa maselo a magazi ndi mapepala.
Palinso chidwi chodziŵitsa njira yabwino yosonkhanitsira zinthu zowonjezerana wina ndi mzake-komanso ndi othandizira ena-kuphatikizapo chemotherapy ndi mankhwala a mahomoni.
Nthawi Yomwe Muwone Dokotala Wanu
Ngati mukugwiritsa ntchito mankhwala osokoneza mafupa, dziwitsani dokotala ngati mukukumana ndi zotsatira zosafunikira. Lankhulani ndi wothandizira zaumoyo wanu mwamsanga mukakumana ndi zizindikiro zotsatirazi:
- Chiwombankhanga cha 100.4 ° F (38 ° C) kapena chapamwamba, chills-zizindikiro zotheka za matenda
- Kupuma pang'ono
- Kukukwa kwa mtima kofulumira
- Kutsekemera kumene sikungaleke pakapita mphindi zochepa
- Mphuno iliyonse yatsopano pakhungu lanu
Ngati mwauzidwa kuti muli ndi chiwerengero chochepa ndikudzifunsa kuti n'chifukwa chiyani simulandira mankhwala othandiza magazi, bweretsani mafunso awa ndi gulu lanu la thanzi. Kawirikawiri, pali zifukwa zenizeni za mankhwala otere, ndipo zosankha zimapangidwa chifukwa cha matenda anu, mbiri yachipatala, ndi ndondomeko zamankhwala.
Mawu Ochokera
Chifukwa cha ndalama zomwe zingakhale ndi zotsatira zoyipa, makomiti a akatswiri akhala akutulutsa ndi kuwongolera malangizo kwa zaka, kuthandiza athandizi othandizira azaumoyo pogwiritsa ntchito zinthu zolimbikitsa. Kugwiritsa ntchito mankhwalawa kungadalire pa zinthu monga mtundu wa malungo, msinkhu wanu, ndi mankhwala ena omwe akukonzekera.
Sikuti munthu aliyense ndi woyenera, koma pazifukwa zomveka, mankhwalawa angathandize kupewa matenda aakulu a neutropenia, malungo, ndi matenda omwe ali ndi zotsatira zoipa.
> Zotsatira:
> Yambani Pulojekiti Yothandizira Ndalama ya National Marrow. Zotsatira za Mphotho ya PBSC kapena Bone Marrow.
> Smith TJ, Bohlke K, Lyman GH, et al. Malangizo Ogwiritsira Ntchito Zowonjezera Zowonjezera WBC: American Society of Clinical Oncology Clinical Practice Guideline Update. J Clin Oncol . 2015; 33: 3199-3212.
> Kuter DJ, Rummel M, Boccia R, et al. Romiplostim kapena Standard of Care pa Odwala Amene Ali ndi Immune Thrombocytopenia. N Engl J Med. 2010; 363: 1889-1899.