Kuwunika ndi Kutsegulira Kwambiri Kumayambiriro Ndikofunika
Zomwe zikuluzikulu za thalassemia ndi thalassemia zimapangidwira zambiri osati kungoperewera kwa magazi. Mavuto omwe amapezeka ndi thalassemia amadziwika pang'ono ndi kukula kwa mtundu wanu wa thalassemia ndi chithandizo chimene mukufuna. Chifukwa thalassemia ndi matenda a magazi, ziwalo zilizonse zingakhudzidwe.
Kudziwa kuti muli pachiopsezo chachikulu cha matenda chifukwa cha thalassemia yanu yowopsya.
Dziwani kuti kukhala ndi chithandizo chamankhwala nthawi zonse ndikofunika kwambiri poyesa zovutazi ndikuyambanso kuchipatala msanga.
Kusintha kwa Chigoba
Kupanga khungu la magazi (RBC) (RBC) kumachitika makamaka m'mafupa. Pankhani ya thalassemia, kupanga RBCyi sikungathandize. Njira imodzi yomwe thupi likuyesera kukonzetsa zokolola ndikulitsa malo omwe alipo pamtambo. Chochititsa chidwi kwambiri chikupezeka m'mafupa a chigaza ndi nkhope. Anthu akhoza kupanga zomwe zimatchedwa "thalassemic facies" -mapanga ngati masaya ndi mphumi yotchuka. Kutanganidwa koyambirira kwa mankhwala osapatsirana aakulu kumathandiza kuti izi zisadzachitike.
Osteopenia (mafupa ofooka) ndi osteoporosis (mafupa oonda ndi opunduka) amatha kukhala achinyamata komanso achinyamata. Sichimveka chifukwa chake kusinthaku kumachitika mu thalassemia. Matenda a mitsempha angakhale oopsa kwambiri chifukwa amachititsa kuti fractures, makamaka ziphuphu zowonongeka. Mankhwala osokoneza thupi samawoneka kuti amalepheretsa vutoli.
Splenomegaly
Mphuno imatha kupanga maselo ofiira a m'magazi (RBC); Nthawi zambiri amataya ntchitoyi kuzungulira mwezi wachisanu wa mimba. Mu thalassemia, njira yopangira ntchito ya RBC mu fupa la mafupa ikhoza kuyambitsa ntchentche kuyambiranso kupanga. Poyesera kuchita izi, nthonje imakula kukula (splenomegaly).
Kukonzekera kwa RBC sikukwanitsa ndipo sikupangitsa kuti anemia ayambe bwino. Kutanganidwa koyambirira kwa mankhwala oika magazi kungalepheretse izi. Ngati splenomegaly imayambitsa kuchulukitsa kwa kuika magazi ndi / kapena nthawi zambiri, splenectomy (kuchotsa opaleshoni ya mphala) ingafunike.
Miyala
Thalassemia ndi magazi a magazi, omwe amatanthauza kuti maselo ofiira amagawidwa mofulumira kwambiri kuposa momwe angapangidwire. Kuwonongedwa kwa maselo ofiira a magazi kumatulutsa bilirubin, pigment, kuchokera ku maselo ofiira a magazi. Izi zowonjezera bilirubin zingayambitse chitukuko chamatumbo ambiri. Ndipotu, oposa theka la anthu okhala ndi beta thalassemia adzakhala ndi gallstones ali ndi zaka 15. Ngati nyongolotsi zimapweteka kwambiri kapena kutupa, kuchotsa ndulu (cholecystectomy) kungafunike.
Iron Overload
Anthu omwe ali ndi thalassemia ali pangozi yowonjezera kutentha kwachitsulo , yotchedwanso hemochromatosis. Chitsulo chochuluka chimachokera ku zinthu ziwiri: mobwerezabwereza magazi ofiira magazi m'magazi komanso / kapena kuchuluka kwa kuyamwa kwazitsulo kuchokera ku zakudya. Kutaya kwachitsulo kungayambitse matenda aakulu mu mtima, chiwindi, ndi zikondamoyo. Mankhwala otchedwa iron chelators angagwiritsidwe ntchito kuchotsa chitsulo kuchokera m'thupi.
Mavuto a Aplastiki
Anthu okhala ndi thalassemia (komanso ena a hemolytic anemias) amafunika kuchuluka kwa maselo ofiira a magazi ofiira.
Parvovirus B19 ndi kachilombo kamene kamayambitsa matenda ochiritsira ana omwe amatchedwa Fifth Disease. Parvovirus imayambitsa maselo amkati mu fupa la mafupa omwe amalepheretsa kupanga RBC masiku 7 mpaka 10. Izi zimachepetsedwa mu kupanga RBC kwa munthu yemwe ali ndi thalassemia kumabweretsa chitukuko cha kuchepa kwa magazi m'thupi komanso kawirikawiri kufunikira kwa kuikidwa magazi.
Matenda a Endocrine
Chitsulo chochulukitsitsa cha chitsulo ku thalassemia chingapangitse chitsulo kukhala m'ziwalo zotchedwa endocrine monga ziphuphu, chithokomiro, ndi ziwalo zogonana. Chitsulo chosakanikirana ndi matendawa chingayambitse chitukuko cha shuga. Chitsulo cha chithokomiro chingayambitse hypothyroidism (kutsika kwa timadzi timene timatulutsa chithokomiro chochepa) zomwe zingayambitse kutopa, kupweteka, kutengeka kozizira (kumverera ozizira pamene ena sali), ndi tsitsi lofiira.
Iron mu ziwalo zogonana (hypogonadism) amachititsa kuchepa kwa libido ndi kusowa mphamvu kwa amuna komanso kusowa kwa msambo kwa amayi.
Matenda a Mtima ndi Mapulogalamu
Zovuta za mtima si zachilendo kwa anthu akuluakulu a thalassemia. Kuwonjezeka kwa mtima kumachitika msinkhu wa moyo chifukwa cha kuchepa kwa magazi m'thupi. Ndi magazi ocheperapo, mtima ukufunika kuumitsa movuta kuchititsa kukulitsa. Thandizo la kutulutsidwa lingathandize kuteteza izi kuti zichitike. Kutentha kwachitsulo kwa nthawi yayitali mu minofu ya mtima ndilo vuto lalikulu. Iron mu mtima ukhoza kubweretsa mtima wodwala (arrhythmias) ndi mtima wosalimba. Kuyambitsa chithandizo cha iron chelation kumayambiriro ndikofunika kwambiri kuti zisawononge mavutowa.
Ngakhale kuti sitimvetsetsa bwino, anthu omwe ali ndi thalassemia amawoneka kuti ali pangozi yowonjezera kuthamanga kwa magazi kapena kuthamanga kwa magazi m'mapapo. Pamene kuthamanga kwa magazi kukukwera m'mapapu, zimapangitsa kuti zikhale zovuta kwambiri kuti mtima uponye magazi m'mapapo, zomwe zingabweretse mavuto a mtima. Zizindikiro zingakhale zowonongeka poyesera kuyesera ndizofunika kwambiri kuti chithandizo chikhoza kuyambitsidwa msanga.
> Zotsatira:
> Benz EJ. Kuwonetseredwa kwachipatala ndi matenda a thalassemia. Mu: UpToDate, Post TW (Ed), UpToDate, Waltham, MA.
> Makhalidwe a Malangizo Othandizira a Thalassemia-2012. http://thalassemia.com/SOC/index.aspx