Purpura Thrombocytopenic e abadala: ukuxilongwa, izimbangela kanye nokwelashwa

purpura Thrombocytopenic e abadala - ukuphazamiseka engaholela ukuvela okusheshayo nemihuzuko esikhulu ukopha. Njengomthetho, ukulahlekelwa igazi kungenxa ukuwa ngobubona platelet count - amaseli anomthelela ekunqandeni yayo.

Eminye imithombo lokhu zokugula ubizwa nangokuthi thrombocytopenia mzimba. Kuthinta kokubili abadala kanye nezingane, kodwa seziguli ezisencane efana isimo ngokuvamile eba isizinda igciwane lohlobo lwe kuxazululwa ngokwa ngaphandle kwesidingo ukuphathwa ngendlela ekhethekile. Ngo abadala, lesi sifo singumbulali ezimweni eziningi isikhathi eside.

Uma une zimpawu ukopha platelet ukubala, nakuba ongaphakeme, kodwa, isimiso, egculisayo, udokotela ngeke cishe ngeke akunikeze ukwelashwa. Nokho, Ezimweni ezingavamile, inani zegazi uwela ubuncane ezibucayi, okubangela ukopha zangaphakathi ezisongela ukuphila. Ukuze yokwelapha lezi yezinkinga ezidinga ukuthi kungenelelwe lwezokwelashwa olusheshayo.

izimpawu

purpura Thrombocytopenic e abadala (ngenhla) ngaso sonke isikhathi sihambisana ukubonakaliswa kwangaphandle yesifo. Endabeni izimpawu ejwayelekile izimpawu ezilandelayo isifo:

• kumiswa okusheshayo kakhulu ukulinyazwa ezinkulu (hematoma);
• ukopha olukha phezulu esikhumbeni ukuthi libukeka isitshele ngezigigaba ezincane, izindawo abomvu-purple (petechiae) futhi itholakala ikakhulukazi imilenze;
• ngopha izinsini noma ekhaleni;
• khona igazi umchamo noma sezinyawo;
• ezinamandla ngokungavamile ukopha esesikhathini.

Lapho ukubona udokotela

purpura Thrombocytopenic e abadala kungaba ezinokubaluleka okungathi sína, futhi kulesi simo kungcono ukwenza aphoyintimenti kusengaphambili kudokotela onguchwepheshe oqeqeshiwe.

Uma waqala opha, shayela "ambulensi." Ejwayelekile salokhu ukopha isifo asikwazi kulawulwa ngezindlela ezivamile ezivela ikhithi ekhaya noma izindlela ejwayelekile wegazi ukugeleza izitobhi. Ngokwesibonelo, ngeke kukusize ingcindezi ebonakalayo phezu endaweni efanele yomzimba. Ochwepheshe batusa ukuba baphendukele usizo kodokotela ngokushesha ngangokunokwenzeka.

izizathu

Idiopathic thrombocytopenic purpura e abadala ngezinye izikhathi ithuthukisa ngoba izivikeli mzimba ukuhlaselwa emzimbeni sika ngephutha bese ebhubhisa platelet. Igama elithi "idiopathic" kusho "savela i engaziwa isizathu"; thrombocytopenia ngakho elichaza ezimweni lapho odokotela ukunquma lokho kwabangela ukusabela ukungadli izivikeli mzimba.

Izingane ukusetha zokugula isizinda ngokuvamile kulula, njengoba lesi sifo ukuba ikakhulukazi isifo esithathelwanayo (mumps noma umkhuhlane). Kusolwa ukuthi ukutheleleka kuphazamisa ukusebenza evamile izivikeli mzimba.

Khulisa platelet nokwahlukana

Uma uphethwe kokuqala iba purpura thrombocytopenic e abadala, emtholampilo (ukubonakaliswa clinical) ixhunyiwe, ngokuvamile kwemikhuba mzimba. Amasosha omzimba babiza zegazi, kwaba ukuqala kwazo njengoba amaseli ubhujiswe. Ubende yakhelwe ukubhekana nezifo ngaphandle, omzimba iyakuqaphela futhi kususa zegazi emzimbeni. Ngenxa yalokhu ukuqashelwa yokuphambuka egazini ukhiphela abambalwa kakhulu ka-platelet ngokuziqhathanisa kuyinsakavukela.

Jwayelekile platelet ibala isukela amaseli 150 kuya kwezingu-450 microliter ka afundwa igazi ngayinye. Abantu ukuthi nginesifo "purpura thrombocytopenic" (abadala) ukuhlaziywa lembula amaseli 20,000 kuphela edingekayo. Njengoba platelet ukukhuthaza igazi ekunqandeni, ukunciphisa inani lawo likhuphuka ingozi ukopha ukopha zangaphakathi. Izinga ayizinkulungwane 10 cell ngokubulala. Nge ukwehla enjalo ephawulekayo kunombolo platelet ukopha zangaphakathi uyakwazi baqale ngisho ngaphandle ukuhlukumezeka.

engcupheni

purpura Thrombocytopenic e abadala (Photo asetshenziswe ekuqaleni kwalesi sihloko, ikhombisa ukubonakaliswa kwangaphandle yesifo) itholakala ngasiphi yobudala Nokho, ososayensi baye bathola ezimbili engcupheni ukuthi sandise amathuba wokuthuthukisa izimpawu isifo. Ziyakwazi:

• ungubani ngokocansi. Ngo abesifazane, lesi sifo sitholakale umuntu ku izikhathi isilinganiso emibili kuya kwemithathu kaningi kunabantu.
• Muva nje, isifo yegciwane ezithathelwanayo. Mumps, isimungumungwane kanye izifo zokuphefumula kungaholela ukubonakala izimpawu nobuntu thrombocytopenia, kodwa ubuhlobo amagciwane atholakele kaningi izingane.

Kufanele siqaphe ukuba ingozi izinkinga. I sina iningi labo - lena nenkinga yokopha ebuchosheni, lapho kungaba yingozi.

sokukhulelwa

Nakuba purpura thrombocytopenic e abadala kutholakala ukuthi uphethwe yini ngisho abesifazane abakhulelwe, isimo sezempilo osanda kuzalwa umama zokugula enjalo ezimweni eziningi ayiphazamiseki. Nokho, ochwepheshe, kutuswa ukuba uhlole lizinga izinhlayiyana zegazi umntwana ngokushesha emva kokuzalwa.

Uma ukhulelwe, kodwa imiphumela yokuhlolwa zikhombisa ukwehla kwezinga count platelet, wena zisengozini ematfuba ukuvulwa enamandla kwangemva kokubeletha ukopha kakhulu. Ezimweni ezinjalo, kukhona wezifo zabesifazane noma esibhedlela, odokotela kufanele ukuxoxa nawe zokwelapha etholakalayo ziphephile izingane.

ukuhlola

Udokotela wakwazi ukwenza ukusazi ngokunembile isifo esikuphethe "purpura thrombocytopenic" (abadala), uphethwe yini kufanele ukwenziwa isimiso umehluko. Kufanele kube ngokushesha siqambe nezinye izimbangela ukopha futhi ukunciphisa inani zegazi - izifo isib ezingalapheki noma imiphumela engemihle yemithi ezithathwe nguwe.

Lo chwepheshe uzokubuza imibuzo ngomlando wakho wezokwelashwa, uyoveza ngihlolwa kokuqala liyoqoka umuntu noma ngaphezulu ejwayelekile sivivinyo seluhlololucwaningo. Lezi zingozi zihlanganisa ama:

• Qedela segazi. Kususelwa isampula ethathwe igazi lesiguli kunqunywa isilinganiso jikelele kwamangqamuzana egazi, kanye nenombolo oluthile platelet. Lapho thrombocytopenia ipharamitha lokugcina ngokungavamile ongaphakeme, naphezu kweqiniso lokuthi amazinga amangqamuzana amhlophe kanye abomvu izohlala kusilinganiso.
• ukuhlaziywa Clinical kwegazi. Lolu cwaningo ababevame ukucula ukuqinisekisa ezingeni platelet etholwe Imininingwane igazi ukuhlaziywa. A ndlovu nesineke ibekwe ku ingilazi slide akhethekile kuhlolwa ngesibonakhulu.
• Ukuhlaziya umnkantsha. Le ndlela ucwaningo kuphela Kunconywa for iziguli omdala unesifo yangaphambilini ye "purpura thrombocytopenic" (abadala ekuphenduleni sehlo sihambisana ngaphezulu, zingabantu kulula ukubekezelela inqubo).

Ama-platelet I akhiqizwa umnkantsha - elithambile, izicubu sithambile maphakathi amathambo ezinkulu. Kwezinye izimo, udokotela angase asuse isampula ithambo izicubu elise ngaphakathi umnkantsha biopsy indlela. Abanye ochwepheshe ancamela ukuthatha amasampula ukuze kuhlolwe inqubo ebizwa ngokuthi "isifiso," bese asuswe umnkantsha kuphela ingxenye ingxenye ewuketshezi. Ngokuvamile, izinqubo ezimbili kuyenziwa ngesikhathi esisodwa futhi zibizwa ngokuthi "umnkantsha ukuhlaziywa."

Idiopathic thrombocytopenic purpura umnkantsha ukhululekile pathologies, njengoba nokuncipha platelet omzimba kubangelwa ukubhujiswa amaseli e egazini ukungasebenzi kwekhono ubende kanye awunankinga ukukhiqizwa platelet.

ukwelashwa

Easy thrombocytopenic purpura e abadala, izimbangela zezinkumbulo ezingavikelekile thembeke esungulwe, ngokuvamile akudingi oluthile lokwelapha - ngempela njalo obonwa udokotela, futhi ngezikhathi ezithile ukuhlola ezingeni platelet. Izingane acishe never zidinga ukwelashwa nokukhungatheka siphela uqobo. Nokho, abadala, kungadinga ukwelashwa okuphumelelayo uma isimo isibe ezinzima noma nokunwetshiwe (ezingamahlalakhona) uhlamvu.

Izindlela zokwelapha izici zihlukile futhi ziyahlukahluka kusuka imithi ukukhula ukugqugquzela platelet count ngaphambi kokuba uhlinzwe ukususa ubende (splenectomy). Kungcono ukuxoxisana nodokotela wakho kusengaphambili zokwelapha kanye emihle nemibi ukusebenza. Ezinye iziguli uthole ukuthi imiphumela emibi ekuthatheni imithi ukubakhulula ngokuphazamisa ngaphezulu kanye nokuhlukumezeka kuka nemiphumela langempela lesi sifo.

imithi

Udokotela ukuxoxa nawe side effects kanye umthamo imithi kanye Izithako zokudla ukuthi uthatha okwamanje. Mhlawumbe ezinye zazo usizo kuncishiswe emazinga izinhlayiyana zegazi circulating. Le miphumela emibi babe aspirin, "ibuprofen", "ginkgo biloba" futhi "Warfarin".

Uhlu main

Lapho uphethwe kuqinisekiswa "purpura thrombocytopenic" kwabadala, ukwelashwa kungase kuhilele ukusetshenziswa ukuphuza imishanguzo ezilandelayo:

1. Imithi ukuthi nesimiso somzimba sokuzivikela. Iziguli eziningi kule yokwelapha ekuseni kukhishelwa corticosteroids temlomo ezifana "Prednisone". Ukunciphisa mzimba okwenziwa kwisistimu, lokhu izidakamizwa ikhuthaza platelet count. Uma izinga jikelele ifinyelele sezingeni elamukelekile, kuyoba ngaphansi kokuqondisa kukadokotela kancane kancane ayeke ukuthatha imithi. Inkambo yokwelashwa ithatha kusukela emasontweni amabili kuya kwayisithupha.

Inkinga iwukuthi purpura thrombocytopenic e abadala, izimpawu esahlanganisa engelutho ngemuva kokuthola "Prednisone" ubuya ekupheleni yokwelapha. Odokotela bavame inkambo entsha corticosteroids Nokho, le ndlela yokwelapha ayikwazi baqhubeka unomphela ngenxa nemiphumela emibi yalolu hlobo imithi. Lapho kungenzeka ukweqisa izidakamizwa cataract, anda amazinga kashukela egazini, anda ingozi yezifo ezithathelwanayo kwamathambo (buthakathaka amathambo).

2. Injection ukwandisa inani eliphelele kwamangqamuzana egazi. Uma corticosteroids musa asize, odokotela linqume umjovo we globulin mzimba. Lesi sidakamizwa liyasetshenziswa ezimweni lapho isiguli wembula ukopha okunzima ukuthi edinga ngokushesha kuhlinzwa. Umthelela sithatha amaviki ambalwa. Phakathi imiphumela engemihle engase - ubuhlungu bekhanda, ukuhlanza, futhi umfutho ophansi wegazi.

3. ukwakhiwa ukusheshisa ukukhiqizwa platelet. Kushaqwe izidakamizwa ezifana ne "Romiplostim" futhi "Eltrombopag" ( "PROMAKTIV"), kusiza ukuba umnkantsha emathanjeni ukhiqize platelet ngaphezulu. Ngesimo side effects kungenzeka ikhanda, isiyezi, isicanucanu nokuhlanza.

4. Okunye immunosuppressants. "Rituximab" ( "Rituxan ') kunciphisa umfutho impendulo okungavamile izivikeli mzimba eliphumela a platelet evamile ubhujiswe. Abazama side effects kuhlanganisa ukuqubuka kwesikhumba, umfutho ophansi wegazi, imfiva, kanye umphimbo obuhlungu.

Uma izidakamizwa abanamandla

Uma (futhi ngezinye izikhathi musa asize kokudla omdala ngokuvumelana nezimiso zemikhuba emihle yokuphila, ukuze umuntu agweme ukweqisa nokuthatha imithi ukuqeda inkinga) wena ethuthuka purpura thrombocytopenic, udokotela angase atuse ukuba ukuhlinzwa. Ukususwa kwezimiso ubende (splenectomy) aqede ngokushesha zokugula, njengoba udokotela ohlinzayo enquma ngumbhubhisi eyinhloko-platelet. Khumbula-ke kodwa ukuthi uzoba engozini ngenxa yezinkinga nasezinkingeni ezilandela ngemva kokuhlinzwa. Ngaphezu kwalokho, abantu ngaphandle ubende njalo e kwengozi yokuthola izifo ezithathelwanayo.

izindlela

Uma, ngoba kuthinta impilo noma ezinye izizathu, ungakwazi ukukhokhela kokuhlinzwa, onguchwepheshe angabeka ukungena kwemithi emisha - isibonelo, "azathioprine" ( "Azathioprine", "Azasan"). Nokho izidakamizwa ezinamandla kakhudlwana ehilela kakhulu imithi emizimbeni yabo. "Azathioprine", ikakhulukazi, kubangela ukwenyuka kwezinga lokushisa komzimba, ikhanda, isicanucanu, ukuhlanza, futhi ubuhlungu bemisipha.

Nge ukuhlukunyezwa okungamahlalakhona

Uxilongwe "purpura thrombocytopenic"? Kubantu abadala, okuvela kuyo lesi sifo sidinga ukushintsha indlela yabo yokuphila. Njengoba lesi sifo kuhambisana kwengozi ukopha, ukugwema ukuthintana ezemidlalo yingozi (isibhakela, karate, football) nendlela ungathatha ukunakekela umzimba siqu.