Zosankha Zothandizira Muzofunika Kwambiri Thrombocythemia

Mwachidule cha mankhwala omwe ali ofunikira kwambiri Thrombocythemia

Chofunika Kwambiri Thrombocythemia (ET) ndi imodzi mwa matenda amagazi otchedwa myeloproliferative neoplasms. Mitundu ina ya myeloproliferative neoplasms ndi yaikulu myelofibrosis ndi polycythemia vera .

Kusinthika kwa majeremusi m'thupi lofunika kwambiri kumapangitsa kuti munthu akhale ndi chiwerengero chokwanira kwambiri (thrombocytosis). Anthu ambiri alibe zizindikilo panthawi yomwe amadziwa kuti ali ndi kachilombo ka HIV.

Zovuta zimaphatikizapo mapangidwe amodzi (omwe amachititsa kudwala, kupweteka kwa mtima, kutsekemera m'mapapo, kapena mitsempha ya thrombosis), kupititsa patsogolo myelofibrosis , kapena kusinthika ku mitsempha yambiri ya myeloid (AML). Chinthu chimodzi chachilendo cha thrombocythemia chofunika kwambiri ndi chitukuko cha matenda a von Willebrand Disease , matenda a magazi.

Ambiri mwa anthu amafunika thandizo linalake kuti athetse mavuto. Komabe, nthawi yachilendo ya moyo ndi yachilendo.

Njira Zothandizira

Ngati mutapezeka kuti muli ndi thrombocythemia yofunikira funso lotsatirali ndilo, "Kodi njira zanga zothandizira?" Pali njira zingapo zomwe adokotala ayenera kukambirana nanu. Chithandizo chimene dokotala wanu amalimbikitsa chikutheka chifukwa cha zifukwa zingapo: zizindikiro zanu, msinkhu wanu, ndi ma laboratory anu. Anthu ambiri amapita zaka zingapo osakhala ndi chithandizo, zomwe nthawi zambiri zimayambika ngati mukupanga chovala.

1. Aspirin: aspirin ya tsiku ndi tsiku imagwiritsidwa ntchito pochizira anthu ndi zizindikiro zapopopotomu. Zizindikiro za Vasomotor zimaphatikizapo kupweteka mutu, chizungulire, kupweteka pachifuwa, kuwotcha manja ndi mapazi, ndi kusintha kwa masomphenya. Sizodziwika kuti aspirin imagwiritsidwe ntchito ndi mankhwala ena. Mankhwala akuluakulu a aspirin amachititsa kuti chiopsezo cha magazi chiwonjezeke ndipo sichiri chovomerezeka.

1. Hydroxyurea: Mankhwala a mankhwala am'madzi a hydroxyurea amachepetsa chiopsezo cha thrombosis pofunika kupititsa patsogolo mankhwalawa pochepetsa chiwerengero cha platelet. Hydroxyurea imayambira pa mlingo wotsika ndipo ikukula mpaka chiwerengero cha platelet chiri pafupi kwambiri (maselo 100,000 - 400,000 pa microliter). Hydroxyurea kawirikawiri imalekerera popanda zotsatira zoopsa. Zotsatirapo zimaphatikizapo kuchulukitsa (khungu) la khungu, kusintha kwa msomali (kawirikawiri mizere yakuda pansi pa msomali), kuthamanga kwa khungu, ndi zilonda za m'mimba. Hydroxyurea imachepetsanso kuchuluka kwa maselo oyera (makamaka kuwerengera kwa neutrophil) komanso hemoglobin yomwe imafuna kuyang'anitsitsa pafupi ndi malipiro athunthu (CBC).

1. Nthenda: Mankhwala osakaniza ndi mankhwala opatsirana omwe amachepetsa kuwerengeka kwa mapuloteni mwa kulepheretsa kupanga mapaleletti m'mafupa. Amagwiritsidwa ntchito pamene hydroxyurea sichigwira ntchito. Mofananamo ndi hydroxyurea, anagrelide amayamba pa mlingo wotsika ndi kuwonjezeka mpaka zotsatira zoyenera. Zotsatirapo zimaphatikizapo kupweteka mutu, kupweteka kwa mtima, kuthamanga kwa madzi, ndi kutsekula m'mimba. Zotsatirapozi zimatha kuthetsa mankhwala opitilira.
2. Alpha interferon: Alpha interferon ingagwiritsidwe ntchito poyang'anira chiwerengero cha platelet mu thrombocythemia, polycythemia vera, ndi myelofibrosis yoyamba. Ikhoza kuchepetsa kukula kwa nthata. Alpha interferon imayendetsedwa pansi pamtambo (pansi pa khungu) tsiku ndi tsiku. Alpha interferon imapezekanso mu mawonekedwe autali otchedwa pegylated interferon omwe angaperekedwe kamodzi pa sabata. Mankhwala a interferon amatha kusungirako amayi apakati kapena anthu omwe samvera mankhwala a hydroxyurea.
3. Plateletpheresis: Plateletpheresis ndi njira yomwe imachotsa mapepalawo kuti ayambe kufalitsidwa. Magazi amachotsedwa kudzera mu catheter ya intravenous (IV) ndipo amasonkhanitsidwa mumakina omwe mapaleti amagawanitsidwa ndi mbali zina za magazi (maselo oyera a magazi, maselo ofiira, ndi plasma). Magazi, kuchotsa mapiritsiwa, amabwezedwa ku thupi kupyolera mu IV kapena mankhwala a saline kapena plasma. Plateletpheresis imasungidwira anthu omwe ali ndi chiwerengero chapamwamba kwambiri cha mapepala, mapangidwe amphamvu kwambiri (mu mapapo, ubongo), kapena magazi. Zotsatira za plateletspheresis ndizochepa kuti chithandizo china chiyambe kuyambitsidwa kwa nthawi yaitali kuwerengera kwa mapepala.

Mankhwala onse omwe tatchulidwa pamwambawa sachiritsa matenda opatsirana. Amangochepetsera chiwerengero cha mapulogalamuwo kuti achepetse chiopsezo chotenga kachilombo kapena matenda a von Willebrand. Panthawiyi, palibe mankhwala othandizira odwala matenda opatsirana. Mwamwayi, ngakhale kuti alibe mankhwala ochizira, ambiri mwa anthu omwe ali ndi vuto la thrombocythemia akhoza kukhala ndi moyo wathanzi.

_Zotsatira:

_{Teferri A. Matenda ndi Matenda a Chofunika Kwambiri. Mu: UpToDate, Post TW (Ed), UpToDate, Waltham, MA. (Kufikira pa June 15, 2016)}