Ngakhale kuti shingles (herpes zoster) nthawi zambiri imagwirizanitsidwa ndi kutupa khungu, nthawi zina zimatha kukhala zonyenga. Musanayambe kusonyeza zilonda zamatenda mungamve ngati mukubwera ndi chimfine. Komabe, posakhalitsa, njira yoyamba ya kukula kwa ziphuphu zidzayamba-nthawi yowonjezereka yomwe imakhala kupweteka kwambiri m'dera linalake lomwe lilipo, limodzi ndi zipsinjo, malungo, ndi zizindikiro zina. Patangotha masiku angapo pang'onopang'ono phokoso laphuphu limayambira, lomwe ndilo pamene chiwonongeko chikuwonekera. Kuthamanga kwa khunyu kumapangidwa ndi masango a tizilombo tating'onoting'ono tomwe timapitirira mofulumira kwambiri.
Ngati mumadziŵa bwino zizindikiro za shingles, mudzatha kuzindikira zomwe zikuchitika, pitirizani kuganizira mofulumira, ndikuchitapo kanthu mwamsanga. Mukangoyamba kuchitira nkhwangwa, simungayambe kulimbana ndi mavuto omwe amayamba nawo, monga chithunzithunzi cha msana (PHN, matenda a mitsempha), kupweteka mutu komanso kupweteka kwa nkhope, kapena matenda a khungu la bakiteriya.
Prodromal Stage
Kawirikawiri, zizindikiro zoyambirira kuti kachilombo ka varicella kamatenganso m'thupi ndi ofanana ndi zomwe mungayambe pachiyambi cha matenda aliwonse. Zizindikiro zina nthawi zina zimachitika nthawi zina pamene mukuvutika maganizo kapena kuthamangira pansi, ndipo ndi systemic-kutanthauza kuti zimakhudza thupi lonse. Mwina mungaganize kuti mumangotopa kwambiri kapena mumakhala ndi chimfine mukakhala ndi ziboda.
Zina mwa zizindikiro zamakono zomwe zingawoneke m'masiku ochepa oyambirira a tsatanetsatane wa ziphuphu ndi:
- Fever
- Chills
- Zimakhumudwa m'mimba
- Mutu
- Chisamaliro kuunika
Kaya ndikumva ngati chimfine pachiyambi pomwe, chizindikiro choyamba choyamba cha makhwangwala chimakhala chowawa. Kawiri kawiri, kukhumudwa kwatchulidwa kuti kukuyaka, kununkha, kumangirira, kunyoza, kukhumudwa, kupweteka, achy, kapena kuwombera. Ikhoza kukhala yopitilira kapena yophatikizapo, koma idzakhala yochepa kumbali imodzi ya thupi. Chizindikiro ichi chingakhale chonyenga, komabe.
Chifukwa chakupweteka kwa shingles kumakhala komweko, kungathe kulakwitsa chifukwa cha zinthu zina malingana ndi kumene akuyang'ana. Mwachitsanzo, kupweteka kapena kupweteka kosalekeza kumbali imodzi ya m'munsi kumbuyo kungatanthauzidwe ndi sciatica kapena vuto la impso pamene ndilo chizindikiro choyamba cha kuswa kwa mwendo. Mofananamo, kumangirira kupweteka pamilomo kungasonyeze kuti chimfine chimadwala, pomwe ululu umayang'ana maso kapena khutu kumakhala ngati kuyamba kwa migraine .
Gawo Loopsya
Khungu lopwetekedwa kwa prodromal lopweteka chifukwa cha makhwangwala nthawi zambiri limakhala lotcheru kukhudza ndi kuoneka kofiira. Pamene zizindikirozi zikuipiraipira, zingayambe kumva ngati kutentha kwa dzuwa.
Pakangotha masiku awiri mpaka asanu ndi awiri mutatha kupwetekedwa koyamba, mabala ochepa ochepa omwe amaoneka ngati mapepala adzawonekera ndipo mofulumira amachulukira mu masango, kupanga mphutsi yomwe imamva bwino kwambiri. Kuchokera kumeneko, nthawi zina mkati mwa mphindi kapena maola, ziphuphu zidzakhala mabulosi odzazidwa ndi madzi, kapena ma vesicles , omwe amadziphatikizira m'mablisters akuluakulu. Kawirikawiri, kufiira ndi kutupa kumaphatikizapo mphutsi.
Kuthamanga kwa ming'alu kumapanga masiku atatu mpaka asanu ndikupitirira pang'onopang'ono. Ngakhale kuti idzachiritsa masabata awiri kapena anai, ululu umene umakhala nawo, nthawi zina zimakhala zowawa kwambiri kuti kungodetsa khungu ndi zovala kungathe kuvulaza magetsi, kungakhale kwa milungu, miyezi, kapena zaka.
Kuthamanga kwa ming'alu kumawoneka mofanana ndi kuthamanga kwa nkhuku, ndi kusiyana kwakukulu: mitsempha ya nkhuku imabalalitsidwa pa thupi lonse. Nthawi zambiri zimakhala ndi khungu, nthawi zambiri pamaso, pamutu, kapena pachifuwa, pambali imodzi ya thupi. Malo okhudzidwa a khungu amatchedwa dermatome , dera lomwe limaperekedwa ndi ulusi wokhudzidwa wa mitsempha yapadera ya msana.
Kuphulika kungaphatikizepo ziwalo ziwiri zoyandikana, koma kawirikawiri ziwalo ziwiri zosakhala pafupi. Chokhachokha chingakhale mwa anthu amene machitidwe awo a chitetezo cha mthupi amamveka bwino, monga omwe ali ndi kachilombo ka HIV. Nthawi zambiri amakhala pachiopsezo chosabalalitsidwa (kumapezeka m'matumbo atatu kapena kuposerapo), ming'alu ya maso kapena ziwalo za mkati, ndi kubwereka kwa mimba mkati mwa miyezi isanu ndi umodzi.
Zovuta Zambiri
Kuwonjezera pa mavuto omwe angabwere ndi shingles, makamaka makamaka chifukwa cha mavuto omwe angathe.
Postherpecic Neuralgia
Khalidwe lofala kwambiri la ming'oma ndi vuto lopweteka lotchedwa postherpetic neuralgia (PHN) limene limayamba pamene mitsempha ya mitsempha yawonongeka. Amadziwika ndi ululu wopitilira kumalo kumene kutukudzika kwagwedezeka kwakhala.
Zizindikiro za PHN zingakhale zovuta kwambiri kuti zisawononge moyo wa tsiku ndi tsiku ndipo zikuphatikizapo:
- Kutentha, lakuthwa, kapena kuya, kupweteka kwa achy komwe kumakhala kwa miyezi itatu kapena patapita nthawi kuthamanga kwa mphutsi kwachiritsidwa
- Allodynia (kumvetsetsa kukhudza kukhudza): Ngakhale kutengeka kwa zovala pa khungu kungakhale kovuta.
- Kulira ndi kupweteka
- Kuvuta kutentha kutentha ndi kugwedeza
Zaka zowonjezera chiwopsezo kwa PHN. Zomwe Zimayambitsa Kuletsa Matenda ndi Kupewa Matenda (CDC) zimalengeza kuti anthu 13 peresenti ya anthu oposa 60 omwe ali ndi zibowo adzakhala ndi PHN. Zina mwazidzidzidzi zimaphatikizapo kukumana ndi ziphuphu zoopsa kwambiri. Kuthamanga pa nkhope kapena torso kumawonjezera chiopsezo cha chikhalidwecho.
Kuchiza PHN kungakhale kovuta, koma ndikofunikira, monga momwe chikhalidwe chingayambitsire mavuto ena monga kupanikizika, kutopa, vuto lakuganizira, kugona, ndi kusala kudya . Komabe, palibe njira zofanana-siyana, koma nthawi zambiri zimatenga mankhwala angapo kuti athetse ululu ndi zizindikiro zina. Zina mwa mankhwala omwe amagwiritsidwa ntchito nthawi zambiri kuti athetse PHN ndi awa:
- Zilonda za Lidocaine (kugulitsidwa pansi pa dzina lakuti Lidoderm)
- Capsaicin, chochokera ku chilengedwe cha tsabola, chili ngati kirimu kapena chigamba
- Mankhwala a antiticonvulsant monga Neurontin (gabapentin) ndi Lyrica (pregabalin)
- Matenda opatsirana pogonana, kuphatikizapo Aventyl (nortriptyline) ndi Cymbalta (duloxetine)
- Opioid monga Oxycontin (oxycodone) ndi morphine
- Steroid jekeseni
Mabakiteriya Achikopa Matenda
Zilondazi zimayambitsa zilonda zotseguka, zomwe zimapangitsa khungu kukhala loopsya ku tizilombo toyambitsa matenda zomwe zingayambitse zomwe CDC imalongosola monga "bakiteriya superinfection ya zilonda." Nkhuku zambiri zomwe zimayambitsa matendawa ndi Staphylococcus aureus ndi gulu A beta hemolytic streptococcus .
Matenda a khungu amodzi omwe nthawi zina amagwiritsidwa ntchito ndi shingles ndi impetigo , yomwe nthawi zambiri imakhudza ana. Zimayamba ndi zilonda zam'madzi zomwe zimaphulika kenako zimapanga makoswe a mtundu wa uchi. Impetigo ndi yopatsirana kwambiri koma imatha kuchiritsidwa bwino ndi maantibayotiki.
Cellulitis ndi matenda ena a khungu omwe amadziwika chifukwa cha shingles. Mosiyana ndi impetigo, yomwe imakhudza khungu lamkati, cellulitis ndi matenda a zigawo zakuya komanso ngakhale minofu pansi pa khungu, malinga ndi American Academy of Dermatology. Zimayambira ndi dera lofiira, kutupa, ndipo limakhala lofunda komanso lachikondi kukhudza. Ngati sichikuchiritsidwa, cellulitis ikhoza kufalikira mwamsanga ndipo imakhudzanso ma lymph nodes, potsiriza kumayambitsa matenda a magazi. Malingana ngati mankhwalawa athandizidwa nthawi yomweyo ndi mankhwala osokoneza bongo, cellulitis imachiritsidwa kwambiri ndipo sikungatheke kuwonongeka kwamuyaya.
Herpes Zoster Ophthalmicus (HZO)
Pakati pa khumi ndi khumi ndi zisanu (15) peresenti, ma shingles amakhudza gulu la ganglion, lomwe limatulutsa mitsempha itatu. Mwachidziwitso, kagulu kakang'ono ka trigeminal kamakhala ndi diso (nthambi ya ophthalmic); tsaya (maxillary nthambi); ndi nthambi ya mandibular (nsagwada). Mwa izi, nthambi ya ophthalmic ndiyo yomwe imakhudzidwa kwambiri ndi herpes zoster.
Malingana ndi American Academy of Ophthalmology (AAO), 25 peresenti ya milandu 300,000 mpaka 500,000 yomwe imapezeka chaka chilichonse ndi herpes zoster ophthalmicus (HZO).
HZO ikhoza kumakhudza mbali iliyonse ya diso, kuchokera ku mitsempha ya optic kupita ku conjunctiva (nembanemba yomwe imayang'ana kutsogolo kwa diso ndikuyang'ana khungu). Popanda mankhwala oletsa tizilombo toyambitsa matenda , pafupifupi theka la anthu omwe ali ndi ziphuphu pafupi ndi diso adzawonongeka maso kapena ngakhale kutaya diso, choncho n'kofunika kuona katswiri wamagetsi mwamsanga.
Zovuta Zambiri
Zina zowonjezera, ngakhale zachilendo, mavuto a umoyo omwe amayamba chifukwa cha matope ndi awa:
Mwinanso amadziwika kuti herpes zoster oticus, uku ndiko kutukusira kwa mitsempha ya nkhope kumbali imodzi mwa makutu. Zizindikirozo zimaphatikizapo kufooka kwa nkhope, kumva ululu , ndi tizilombo tating'onoting'ono (zotchedwa vesicles ) mkati mwa ngalande ya khutu. Anthu omwe ali ndi mahatchi a Ramsay nthawi zambiri amakhala ndi chizungulire kapena kusowa malire.
Maningitis
Izi ndi matenda a cerebrospinal fluid yomwe ili pafupi ndi ubongo ndi msana. Zizindikiro zimaphatikizapo kutentha thupi, kupwetekedwa mtima, kukhudzidwa ndi kuwala, ndi minofu ya achy. Chifukwa mtundu uwu wa meningitis umayambitsidwa ndi kachilombo osati bakiteriya, sungachiritsidwe ndi maantibayotiki. Izi zimayenera kuyendetsa njira yake, ngakhale kuti mankhwala opweteka angapangidwe kuti athetse mutu.
Encephalitis
Mofanana ndi meningitis, izi ndi kachilombo ka HIV kachiwiri. Zimakhudza ubongo ndipo zingayambitse zizindikiro monga mutu, kukumbukira, kutentha thupi, ndi kusintha kwa umunthu.
Msewu wa Neuropathy
Kawirikawiri kachilombo ka varicella kamakhudza khungu kokha, koma, kawirikawiri, imatha kulowa mu minofu ya minofu, kufooka kapena kutentha. Pafupifupi 75 peresenti ya anthu omwe ali ndi mphutsi za m'magalimoto adzabwezeretsanso ntchito.
Nthawi Yomwe Muwone Dokotala
Ngati mukuganiza kuti muli ndi ziphuphu, muyenera kuwona dokotala nthawi yomweyo. Kenako mukhoza kuyamba chithandizo choyenera chomwe chingakuthandizeni kuthetsa zizindikiro zanu, kufulumizitsa kuchira kwanu, ndi kuchepetsa mavuto anu. Izi ndi zofunika kwambiri ngati:
- Ali ndi zaka zoposa 60
- Khalani ndi chikhalidwe chomwe chakuchititsani kukhala ndi chitetezo chamthupi chofooka, monga HIV
- Tengani mankhwala omwe angachepetse chitetezo cha mthupi lanu (mwachitsanzo mankhwala a chemotherapy, steroids, kapena immunosuppressants pambuyo poika thupi)
- Mugawana nyumba ndi munthu amene ali ndi chitetezo cha m'thupi
- Kuthamanga kuli pamaso panu: Mabulters pafupi ndi diso lanu angayambitse kuwonongeka kwa diso kapena ngakhale kukupangitsani kuti muwononge diso limenelo.
Ngati mukakhala ndi vutoli mumakumana ndi zotsatirazi, dokotala yemwe akukudziwani nthawi yomweyo:
- Simukupeza mpumulo ku ululu ndi mankhwala.
- Kupweteka sikupita patatha masabata atatu kapena anayi.
- Chiphuphu chikufalikira kudutsa dera loyamba.
- Mukuyamba kukhala ndi zizindikiro za matenda achiwiri, monga kutentha kwakukulu, kuzizira, ndi kupweteka kwa mutu.
> Zotsatira:
> American Academy of Dermatology. Cellulitis: Mwachidule.
> American Academy of Ophthalmology. Herpes Zoster Ophthalmicus.
> Zolinga za Kuletsa ndi Kuteteza Matenda. Nkhumba (Zofupa Zoster): Kuzipatala Mwachidule. Feb 21, 2018.
> Chipatala cha Mayo. Pambuyo pa Neuralgia. Sept 16, 2015.