Kubwereza kwa Zizindikiro, Kuzindikira ndi Chithandizo cha Thrombocytopenia
Tanthauzo
Thrombocytopenia ndimatanthawuzidwe azachipatala kuti afotokoze chiwerengero chochepa cha platelet. Mipatala ndi imodzi mwa maselo athu ndipo ntchito yawo ndikutithandiza kuti tisiye magazi. Thrombocytopenia imatanthauzidwa ngati platelet kuwerengera zosakwana 150,000 maselo / mL, mosasamala za msinkhu wanu.
Zizindikiro
Chifukwa mapaleletti ndi ofunikira kwambiri pofuna kuchepetsa magazi, zizindikiro zimayenderana ndi kuwonjezeka kwa magazi.
Ngati thrombocytopenia yanu ndi yofatsa simungakhale ndi zizindikiro. Pansi wanu chiwerengero cha platelet ndi, mwinamwake muyenera kukhala ndi magazi.
Nosebleeds
Kutsekemera kuchokera ku chingamu
Magazi mumtsuko kapena pansi
Mitsempha ya magazi m'kamwa yotchedwa purpura
Kulira kosavuta
Madontho aang'ono ofiira omwe amawoneka ngati kutukwana otchedwa petechiae
Zimayambitsa
Pali zifukwa zambiri za thrombocytopenia kuphatikizapo labotale zolakwika. Zina zimayambitsa kanthawi ndipo zingathetsere mankhwala ndi zina zimafuna chithandizo chamoyo wonse.
Mavairasi: Pa matenda opatsirana pogonana mafupa anu amatha kupanga timapepala tating'ono pang'ono pang'onopang'ono; izi zimatchedwa kuthamanga kwachilombo. Ngati kachilombo kamatuluka m'thupi, mafupa amatha kuyambiranso kupanga bwino.
Mankhwala: Mankhwala ena amalepheretsa thupi kupanga mapapulaneti kapena kupanga mapuloteni omwe amawononga mapepala. Mndandanda wa mankhwala omwe amachititsa thrombocytopenia ndi yaitali ndipo umaphatikizapo maantibayotiki (vancomycin, trimethoprim / sulfamethoxazole, rifampin, ndi ena), ranitidine (Zantac), mankhwala omwe amachititsa malungo, ndi valproic acid (anti-seizure mankhwala). Mwamwayi, anthu ambiri omwe amalandira mankhwalawa sadzakhala ndi thrombocytopenia.
Matenda a Immune : Ichi ndi chikhalidwe chomwe chitetezo cha mthupi chimasokonezeka ndi kuwononga mapaleletti pamene sikuyenera.
Malignancy: Ena khansa, makamaka khansa ya m'magazi, ingawononge kuchepa kwaplatelet. Izi kawirikawiri chifukwa khansara imatenga malo m'kati mwa mafupa omwe amaletsa kupanga mapiritsi atsopano.
Chemotherapy: Makina ambiri a mankhwala amadzimadzi amagwira ntchito pomenyana mofulumira kwambiri maselo ngati maselo a kansa. Mwatsoka, maselo athu amagazi amachokera kugawikana mofulumira maselo mu fupa la mafupa ndipo akawonongeka simungathe kupanga maselo atsopano a magazi kwa kanthawi. Maselo onse atatu amagazi angakhudzidwe; izi zimatchedwa pancytopenia.
Mapulogalamu a m'magazi : Kutsekeka kwa magazi m'thupi ndi malo omwe mafupa sangathe kupanga maselo a mwazi kawirikawiri omwe angapangitse thrombocytopenia.
Thrombocytopenia Yachibadwa: Pali mikhalidwe yobadwa monga Bernard Soulier ndi MYH9 matenda okhudzana ndi matenda omwe amachititsa thrombocytopenia yachiwiri kupita ku kusintha kwa chibadwa.
Splenomegaly: Gawo la mapuloteni athu amasungidwa mumphuno, chiwalo cha chitetezo cha mthupi. Ngati nthendayo ikulitsidwa, mapiritsi ena amathyoledwa mumphuno chifukwa cha thrombocytopenia. Splenomegaly ingayambidwe ndi zochitika zambiri kuphatikizapo portal matenda oopsa kwambiri kapena cholowa spherocytosis.
Thrombotic thrombocytopenic purpura: Matendawa ambiri omwe amapezeka mwa amayi akuluakulu amachititsa kuti tizirombo timene timapanga mitsempha ya mitsempha yomwe imawononga mapiritsi ndi maselo ofiira a magazi.
Mimba: Thrombocytopenia ikhoza kuchitika kuposa 5% ya mimba yokhazikika kapena ingakhale zotsatira za pre-eclampsia.
Kudziwa
Thrombocytopenia amapezeka kuti ali ndi magazi okwanira (CBC). Izi zikhoza kutengedwa monga gawo la kafukufuku wamkati pachaka kapena chifukwa chakuti mumabwera kwa dokotala amene ali ndi zizindikiro za magazi. Kuti mudziwe chomwe chimayambitsa thrombocytopenia dokotala wanu ayenera kutumiza mabala ena. Izi zikhoza kuphatikizapo magazi omwe amapezeka m'magazi momwe maselo a magazi amayendera pansi pa microscope. Maonekedwe a mapaleti angasonyeze chifukwa chomwe chiwerengero cha platelet chochepa chimaonekera. Kuwonjezera pamenepo, mayesero omwe amayang'ana ntchito ya mapaleletti, monga platelet aggregometry, angathandize kuthandizira kudziwa chifukwa cha thrombocytopenia.
Mwina mungafunikire kutumizidwa ku katswiri wamagazi (magazi) kuti mudziwe chifukwa cha thrombocytopenia yanu.
Kuchiza
Mankhwala anu amatsimikiziridwa ndi kuopsa kwanu kwa zizindikiro za magazi ndi chifukwa cha thrombocytopenia. Odwala onse omwe ali ndi thrombocytopenia ayenera kupeĊµa aspirin kapena mankhwala osagwiritsa ntchito mankhwala opatsirana (inflammatory drugs) monga ibuprofen monga mankhwalawa amachepetsa ntchito yapamwamba ndi luso lopanga chovala.
- Palibe: Ngati thrombocytopenia ndi yofatsa kapena ngati mulibe magazi othandiza, simungafune mankhwala alionse. Ngati thrombocytopia yanu imagwiridwa kukhala yachiwiri kwa kachilombo ka HIV yanu yanuyi ingayang'ane maulendo angapo kuti muwone ngati ikubwerera.
- Kupatsirana kwa Platelet: Thrombocytopenia yochepa, yomwe imawonedwa pa mankhwala a chemotherapy, imatha kuchiritsidwa ndi magazi opatsirana. Kuikidwa magazi kumagwiritsidwanso ntchito kawirikawiri ngati muli ndi magazi othamanga ndi thrombocytopenia.
- Kupewera mankhwala: Ngati thrombocytopenia ndi zotsatira za mankhwala, wothandizira zaumoyo wanu akhoza kusiya mankhwalawo. Iyi ndi masewera olimbitsa thupi. Ngati matenda anu (monga kugwedezeka) akuyendetsedwa bwino pa mankhwala ndipo thrombocytopenia yanu ndi yofatsa, wothandizira zaumoyo angapitirizebe mankhwalawa.
- Mankhwala: Ngati thrombocytopenia yanu imachokera ku chitetezo cha mthupi (ITP), mukhoza kukhala mankhwala ndi mankhwala monga steroid, intravenous immunoglobulin (IVIg), kapena anti-D immune globulin.
- Splenectomy: Mu mitundu yambiri ya thrombocytopenia, nthenda ndiyo malo enieni a chiwonongeko cha mapaleletsiti kapena kukwapula kwa mapepala. Splenectomy, kuchotsa opaleshoni ya nthata, ikhoza kukuthandizani kuwerengera.
- Kusinthanitsa kwa plasma: Thrombotic thrombocytopenic purpura (TTP) imathandizidwa ndi kusintha kwa magazi. Mwa njira iyi plasma (gawo la madzi la magazi) imachotsedwa kudzera pa IV ndipo imalowetsedwa ndi madzi atsopano a madzi.
Mawu Ochokera
Kutsekemera kungakhale chizindikiro chowopsya. Ngati muli ndi magazi osazolowereka kapena otha msinkhu, kambiranani ndi dokotala wanu zodandaula kuti ntchito yoyenera ichitike komanso ngati mankhwala akuyambitsa ngati mukufunikira.
> Chitsime:
> George JN ndi Arnold DM. (2017). Njira kwa akulu omwe ali ndi thrombocytopenia. Ku TW Post, LLK Leung, ndi JS Tirnauer (eds.) UpToDate .